Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Case 14 > Sexual response, contraception, menopause and ethics > Flashcards

Sexual response, contraception, menopause and ethics Flashcards

1
Q

what is gender identity and gender expression?

A

gender identity- the personal sense of ones own gender. it can correlate with ones assigned gender or differ from it
gender expression- the way a person communicates their gender based on societal factors such as gender norms and perceptions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what is gender dysphoria?

A

the unease or discomfort that a person may feel due to a mismatch in their anatomical sex and their gender identity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what is a vasectomy?

A

a small amount of the vas deferens is removed or cut and sealed by cautery. it can be a method of regulating male fertility as a form of contraception

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what is the mechanism of action of the combined oral contraceptive?

A

prevents ovulation- suppression of gonadotrophin
inhibits sperm transport- alters cervical mucus
surpasses endometrial growth- prevents implantation
interferes with normal motility/ function of the Fallopian tubes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what are the grounds upon which an abortion can take place?

A

the pregnancy has not exceeded its 24th week
the pregnancy could cause grave permanent injury to the physical or mental health of the woman
the continuance of the pregnancy involves risk to the life of the pregnant woman
there is substantial risk that if the child were born it would suffer from serious physical or mental abnormalities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

does a practitioner have a duty to carry out the abortion?

A

a practitioner does not have to take part in any procedure to which they have a conscientious objection but they must make prompt referral to another medical provider

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what are the emotional issues related to termination of pregnancy?

A

women may feel grief, regret, anxiety or distress but some may feel a sense of relief and gratitude

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what is a QALY?

A

quality adjusted life years is a generic measure of the burden of a disease, including both the quality and quality of the life lived. they can often be used when considering the impact of an intervention and cost per QALY can be used to assess the cost effectiveness of an intervention. it is calculated by multiplying the life expectancy with a quality of life score (from 0 to 1)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what are the symptoms of menopause?

A

hot flushes/night sweats, menstrual irregularities, difficulties sleeping, reduced sex drive, vaginal dryness, recurrent UTIs,, changes to memory/ mood, headaches

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

how can menopause affect someones life?

A

can impact relationships/ sex life
can impact work life- tiredness, low mood, difficulty concentration
ability to exercise or do certain activities- stiff joints hot flushes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

how does menopause affect the hormonal changes during a cycle?

A

there is the same pulsatile release of GnRH which acts of the anterior pituitary stimulate FSH release. however there are no eggs in the ovary so folliculogenesis does not occur and there is no oestrogen release of LH surge.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what are the benefits of HRT?

A
  1. symptom control- particularly vasomotor and vaginal dryness
  2. reduces risk of osteoporosis
  3. improved muscle mass
  4. menstrual cycle control- some cases
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what are the side effects of HRT?

A

fluid retention, nausea, headaches, breast tenderness, cramps
progesterone- irregular bleeding, PMS, bloating, depression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what is the mechanism of action of alkylating agents?

A

they covalently bind to alkyl groups in the nucleotide guanine causing cross linking of DNA which inhibits DNA replication and transcription causing cell cycle arrest and apoptosis
Cyclophosphamide- leukaemias, lymphoma, solid tumours
chlorambucil- lymphoma and chronic leukaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what is the mechanism of action of platinum based agents

A

bind to guanine and cause cross linking of DNA inhibiting DNA replication and transcription.
cisplatin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what is the mechanism of action of anti- metabolites?

A

interfere with the normal metabolism of nucleic acids which causes depletion of the availability of nucleic acids for DNA replication
5 fluroriracil blocks thymidylate synthase which is used in pyrimidine synthesis (T and C)
methotrexate blocks DHFR which is involved in purine synthesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what is the mechanism of action of anthracyclines?

A

1) inihibit topoisomerase II
2) indirectly inhibits helices by intercalating into DNA
3) produces reactive oxygen species which induce DNA/ cell damage and causes apoptosis
doxorubicin, epirubicin, idarubicin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what is the mechanism of action of antimicrotubules?

A 
target the mitotic spindle which is required for mitosis 
vinca alkaloids (vincristine, vinblastine)- prevent the assembly of the mitotic spindle 
taxanes (docetaxel, paclitaxel) - prevent mitotic spindle from contracting
19
Q

what is tamoxifen and what is its mechanism of action?

A

tamoxifen is a hormone antagonist- selective estrogen receptor modulator.
it is a a competitive inhibitor of estradiol binding to oestrogen receptor (ER). ER is a major driver of cancer growth and survival in ER positive breast cancers so inhibiting this receptor will reduce cell proliferation

20
Q

what is imatinib and what is its mechanism of action?

A

imatinib is a protein kinase inhibitor.
it inhibits the oncogenic protein kinase BCR-ABL which is a uniques factor in the pathogenesis of chronic myeloid leukaemia. it inhibits ATP binding of BCR-ABL oncoprotein preventing phosphorylation and activation of signalling pathways

21
Q

how does BCR-ABL contribute to the pathogenesis of chronic myeloid leukaemia?

A

ABL and BCR are normal genes on chromosome 9 and 22 which code for protein kinases whose activities are tightly regulated. a translocation can occur which causes fusion of the BCR and ABL genes. this new gene encodes for a protein with deregulated tyrosine kinase activity which causes pathogenicity.

22
Q

what are PD-1 immune checkpoint inhibitors and what is their mechanism of action?

A

they are a type of immunotherapy which activates the bodies immune system against cancer cells. cancer cells over express PD-L1 on their surface which binds to the PD-1 receptor on T cells and deactivates them so the cancer can evade immune attack. PD-1 immune checkpoint inhibitors block this checkpoint and let the body continue its attack. PD-1 receptor antagonists prevent the tumour cell binding to PD-1 so the T cell remains active.
pembrolizumab, nivolumab

23
Q

what are the major pharmakokinetics and side effects of anti- cancer drugs?

A

the half life of a drug determines the dosing regime- tend to dose high (close to toxicity), and as often as possible to prevent the cancer regrowing
side effects- hair/skin (allopoecia, rashes), mucosal linings (nausea, ulcers, constipation, diarrhoea), gonadal function (infertility), bone marrow- reduced erythrocytes, leukocytes, platelets (anaemia, infection, bleeding)

24
Q

what are the stages of the sexual response?

A

excitement, plateau, orgasm, resolution

25
Q

what are the 3 types of female sexual dysfunction?

A

sexual interest disorders, female orgasmic disorders, sexual pain disorders

26
Q

what are causes of female sexual dysfunction?

A

psychological- anxiety, depression, past trauma
vascular- atherosclerosis can impact the ability for the clitoris to become engorged
neurological- disorders of CNS, PNS
endocrine- oestrogen insufficiency, thyroid disease, diabetes
pregnancy and postpartum period
chronic pain
medications

27
Q

what is dyspareunia?

A

the sensation of pain during sexual intercourse. can be superficial (infection, vaginismus), or deep pain (inflammation of vagina or cervix, fibroids, PID). can be psychological

28
Q

what are the management options for female sexual dysfunction?

A

non-pharmacological- lifestyle changes, CBT, pelvic floor exercises, vaginal dilators (vaginismus)
pharmacological- vaginal lubricant, oestrogen preparations (post menopausal)

29
Q

what type of nerve fibre is responsible for erection?

A

parasympathetic

30
Q

what type of nerve fibre is responsible for ejaculation?

A

sympathetic

31
Q

what is the mechanism of erection?

A

parasympathetic nerve fibres release acetylcholine which acts on muscarinic receptors causing activation of nitric oxide synthase. this produces NO which activates guanylate cyclase in smooth muscle cells which converts GTP to cGMP. cGMP causes calcium levels in smooth muscle cells to fall causing relaxation. this relaxation allows cavernosal spaces to expand and fill with blood. the pressure of the blood compresses veins trapping blood inside the copora and the erectile tissue becomes engorged

32
Q

what are some causes of erectile dysfunction?

A

psychological
vascular- atherosclerosis of penile arteries, hypertension- damage to endothelial cells, cant make NO, hyperglycaemia- hyaline deposits in arterioles
neurological- MS, stroke, nerve damage
endocrine- low testosterone

33
Q

what are the management options for erectile dysfunction?

A 
treat associated disease
lifestyle changes, CBT 
vacuum erection device
PDE-5 enzyme inhibitors- leads to higher levels of cGMP 
prostaglandin E1 injections 
penile implants
34
Q

what is the causative agent of chlamydia?

A

chlamydia trachomatis

35
Q

what are the symptoms of chlamydia?

A

pain while peeing, discharge, women- pain in tummy, bleeding after sex/between periods, men- swollen, painful testicles

36
Q

what is the treatment for chlamydia?

A

doxycycline: 100mg twice daily for 7 days

37
Q

what is the causative agent of gonorrhoea?

A

neisseria gonnorrhoeae

38
Q

what are the symptoms of gonorrhoea?

A

men- urethritis (mucopurulent discharge), dysuria
women- endocervical infection ( abnormal discharge), PID
neonates- swelling and discharge from eyes

39
Q

what is the treatment for gonorrhoea?

A

ceftriaxone- 500mg intramuscular single dose plus azithromycin 1g oral single dose

40
Q

what is the causative agent of syphilis?

A

treponema pallidum

41
Q

what are the symptoms of syphilis?

A

primary syphilis- primary lesion (chancre) at site of inoculation 3 weeks after exposure, disappears without treatment
secondary syphilis- red, maculopapular rash on any region of body 6 weeks after primary lesion, condylomata lata - wart like lesions in anogenital region
tertiary syphilis- dementia, gummata- inflammatory nodules/plaques, locally destructive, found on skin, bone

42
Q

what is the treatment for syphilis?

A

Intramuscular benzathine benzylpenicilin

43
Q

what is the causative agent of anogenital warts and where can they occur?

A

HPV
they commonly occur in the genial, perianal and anal regions. can also occur in urethral meatus, vagina, cervix, and anal canal

Case 14 (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions