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Medical Conditions 2 > Reproductive system disorders > Flashcards

Reproductive system disorders Flashcards

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USMLE® Step 1 flashcards
1
Q

Prostatitis: incidence

A
  • affects men typically under 30-50
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2
Q

Prostatitis: clinical manifestations

A
  • inflammation of the prostate gland
  • most common - chronic prostatitis/chronic Pelvic pain syndrome
  • dysuria/burning
  • sexual dysfunction
  • pelvic pain with urination
  • possible infection
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3
Q

Diagnosis of Prostatitis

A
  • urinalysis
  • lab tests - PSA - looks for a protein produced by the prostate that looks at trends/sudden spikes
  • DRE - Digital rectal exam (swollen, tender, warm)
  • can be aggravated/rectified with sexual activity
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4
Q

Benign prostatic hyperplasia

A
  • age related nonmalignant enlargement or prostate
  • 75% over 50
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5
Q

Clinical manifestations of Benign prostatic hyperplasia

A
  • depend on involvement of urethra
  • lower urinary tract symptoms similar to UTI
  • symptoms not as sever as prostatitis
  • increase daytime frequency
  • nocturia
  • increase urgency
  • slow stream
  • straining to void
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6
Q

Management of Benign prostatic hyperplasia

A
  • three main pharmacologic agents
  • medications to shrink glandular tissue
  • drugs to relax smooth muscle tissue of prostate, bladder neck, urethra
  • antimuscarinics to address overactive bladder sympdomes (ACH)
  • TURP - gold standard in surgical treatment
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7
Q

Implications to PT for Benign prostatic hyperplasia and prostatitis: questions to ask males >50

A
  • do you urinate more than 2 hours or more than once during the night
  • do you have trouble starting or continuing your urine
  • do you have weak flow of urine or interrupted urine stream
  • does it feel like your bladder is not emptying completely
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8
Q

Side effects of meds for Benign prostatic hyperplasia and prostatitis

A
  • muscle weakness
  • ED
  • loss of libido
  • gynecomastia
  • drowsiness
  • dizziness
  • tachycardia
  • orthostatic hypotension
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9
Q

Prostate cancer

A
  • adenocarcinoma = 98%
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10
Q

Prostate cancer: risk factors

A
  • race
  • age: more common in older men (they also have better outcomes)
  • genetics
  • environment
  • diet
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11
Q

Prostate cancer prevention

A
  • exercise can negative some risk factors
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12
Q

Prostate cancer symptoms

A
  • vague and often don’t present until advanced
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13
Q

Prostate cancer diagnosis

A
  • DRE
  • PSA 0-4 ng/ml and shouldn’t rise more than 0.75 per year
  • transrectal US
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14
Q

Orchitis

A
  • disorder of testes
  • inflammation of testes
  • testicular pain
  • can be bacterial
  • no traumatic injury = possible sign of this
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15
Q

Epididymitis

A
  • disorder of the testes
  • inflammation of epididymis
  • under age 40 typically
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16
Q

Testicular torsion

A
  • can cause loos of blood flow to testes
  • surgical emergency
  • abrupt onset of pain with swelling
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17
Q

Testicular cancer: Incidence and risk factors

A
  • rare
  • Risk factors: hormonal balance, familial clustering, genetics
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18
Q

Common symptoms of testicular cancer

A
  • enlargement of tests with diffuse testicular pain
  • swelling
  • hardness
  • some combination of these
  • metastatic testicular cancer can present as back, groin or pelvic pain
  • outcomes are good if caught early
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19
Q

Erectile dysfunction

A
  • impotence
  • meds can cause this
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20
Q

ED risk factors

A
  • Age
  • smoking
  • excessive cycling
  • diabetes Mellitus
  • CAD
  • HTN
  • metabolic syndrome
  • MS
  • psychiatric disorders
  • parkinsons
  • Diuretics
  • Anti-HTN
  • opiates
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21
Q

ED etiology

A
  • later in men
  • years of HTN/hypercolesterol can cause it
  • commonly due to neurogenic, vascular or hormonal
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22
Q

Menopause

A
  • Perimenopause - the change before the change
  • benefit from physical activity
  • hormone replacement can be used for pre-mature hysterectomy
  • increase risk for osteoporosis, CVD
  • estrogen levels keep HDL high, low LDLs/triglycerides
23
Q

Symptoms of menopause

A
  • weight gain
  • night sweats
  • hot flashes
  • dry skin
  • itching
  • sore joints
  • stiffness
  • back pain
  • urinary incontinence
  • dizzy
  • poor memory
  • anxiety
  • mood swings
24
Q

Pelvic inflammatory disease S&S

A
  • triad: fever elevated WBCs, and purulent cervical discharge
25
Q

Endometriosis
- What is it
- S&S

A
  • estrogen depended disorder
  • typically in younger females
  • presence of endometrial tissue outside uterus
  • abnormal bleeding pain. inflammation, pain/discomfort when estrogen peaks
  • dysmenorrhea- chief complaint
  • dysmenorrhea, dyspareunia (pain during intercourse) and infertility
26
Q

uterine fibroids

What is it and symptoms

A
  • benign
  • asymptomatic until it gets big enough to cause pain
  • fibrosis tissue
  • anemia, fatigue, weakness major symptoms
27
Q

Uterine cancer
- risk factors
- signs and symptoms

A
  • environmental, social lifestyle (smoking/heavy alcohol use)
  • abnormal bleeding esp. post-menopause
28
Q

cervical cancer

A
  • Pap smear has reduced mortality
  • early detection = best prognosis
  • symptomless
  • vaccine to prevent HPV (which can cause this)
29
Q

Ectopic pregnancy

A
  • presents as pain (they typically do not know they are pregnant)
  • tubal pregnancy
  • fallopian tube is most common
30
Q

Ovarian Cyst Disease

A
  • most are benign
  • functional cyts-rarely produce symptoms unless rupture
  • polycystic ovary syndrome
31
Q

Ovarian Cancer
- incidence
- dx:
- what decreases risk

A
  • 2nd most common urogenital cancer in women and most lethal
  • usually metastasized by dx 60-70%
  • breastfeeding decrease risk
32
Q

Pelvic congestion syndrome

A
  • incompetent and dilated pelvic cavity veins
  • varicose of veins (dilation)
33
Q

Pelvic floor muscle dysfunction

A
  • can occur in both men and women
  • spasms or weakness can cause pain/discomfort as well as problems with urination or fecal incontience
34
Q

incontinence from pelvic floor disorder

A

can be urinary or fecal

35
Q

pelvic organ prolaspe

A
  • organ falling out of place
  • gravity can push downward
  • sense of heaviness or pressure in the perineum
  • often worse after long periods of standing r upright weight-bearing postures
36
Q

Coccydynia

A
  • pain the coccyx region typically mechanical injury or sitting on the coccyx to much
37
Q

Cysocele

A
  • prolapsed bladder and urethra causing bulging or anterior bladder wall
  • pressure in anterior region
38
Q

Rectocele

A
  • prolasped rectum causes bulging of posterior region
39
Q

Uterine prolapse

A
  • uterus falls into vagina
40
Q
  • look at table 20.3: contraindications HRT
  • box 20.4: symptoms of gynecologic cancers
  • table 20.5
A
41
Q

Benign breast conditions

A
  • 20-50 years
  • diffuse cystic mastopathy and mammary dysplasia
  • box 20.10 benign breast changes
  • fluctuations in hormones can cause
42
Q

Breast cancer

A
  • most common malignancy in females in US after non-melanoma skin cancer
43
Q

Breast cancer risk factors

A
  • age >65 years
  • personal history of breast cancer
  • high endogenous estrogen or testosterone levels
  • high dose radiation to chest
  • one realtime with breast cancer
44
Q

what can mid agate risk factors for breast cancer

A
  • exercise and diet considerations
45
Q

what does hormone positive mean in relation to breast cancer

A
  • hormone causes it so you must remove where the hormone is made such as uterus
46
Q

ACS guidelines for early detection

A
  • for women aged 40-44: option to start annual breast cancer screening with mammograms
  • clinical breast exam
47
Q

High risk patients for breast cancer recommendation

A
  • recommended breast MRI
48
Q

Gonadal hormones

A
  • ovaries: estrogen and progesterone
  • testes: testosterone
49
Q
  1. Synthetic estrogens/progetins
  2. synthetic androgens
A
  1. contraception
  2. antiandrogenic drugs for prostate cancer, BPH hirsutism (excessive hair growth)
50
Q

Synthetic hormones: estrogens and progestins
- risks + uses

A
  • increase risk fo DVT
  • used for contraception: receptor agonist, partial agonist, antagonist, mixed effects; combination of estrogen and progestin alone
  • HRT: post menopausal; estrogen deficiency; reduce symptoms of menopause
51
Q

Synthetic hormones: antiestrogens

A
  • inhibit synthesis of estrogen, antagonize all estrogen receptors or at as selective estrogen receptor modulators (SERM)
  • ex tamoxifen
52
Q

synthetic hormones: Androgens

A
  • primary clinical use for replacement therapy in hypogonadism
53
Q

HRT benefits

A
  • reduced menopausal symptoms
  • reduced risk of colon cancer
  • delay of Alzheimer disease
54
Q

Risks of HRT

A
  • increase risk of endometrial cancer
  • increase risk of breast cancer
  • increase risk of thromboembolism

Medical Conditions 2 (22 decks)

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