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Sexuality And Sexual Health Flashcards

1
Q

Female sex steroid hormones

A

Estrogens

Progestins

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2
Q

Pituitary gonadotropin hormones

A

Follicle stimulating hormone

Luteinizing hormone

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3
Q

Female sex steroid hormones and pituitary gonadotropin hormones promote

A

Development of primary and secondary sex characteristics

Start of menses and regulation of the menstrual cycle

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4
Q

Three major endogenous estrogens

A

Estradiol
Estrone
Estriol

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5
Q

Estrogens are responsible for

A

Development and maintenance of the female reproductive system
Development of female secondary sex characteristics
Shaping of body contours and development of the skeleton

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6
Q

Pharmacotherapy for estrogens (10)

A 
Conjugated estrogens (Premarin)
Esterified estrogens (Estragyn)
Estradiol transdermal (Climara, Divigel)
Estradiol vaginal ring (Estring)
Estradiol valerate
Estrone (Folliculum)
Estropipate (Ogen)
Ethinyl estradiol (Alesse)
Estradiol, vaginal dose forms (Vagifem, Estring)
Estrone (Vaginal cream)
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7
Q

Pharmacotherapy for Progestins

A 
Levonorgestrel (Mon-Ovral)
Medroxyprogesterone (Provera, Depo-Provera)
Megestrol (Megace)
Norethindrone (norlutate)
Progesterone (Prometrium) 
Steroidal 
Nonsteroidal
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8
Q

Estrogen deficiency disorders that can be fixed with pharmacological estrogen

A

Atrophic vaginitis
Hypogonadism
Uterine bleeding
Vasomotor spasm of menopause “hot flashes”
Osteoporosis
Breast or prostrate cancer
Ovarian failure or castration (removal of ovaries)
Cross-gender hormone treatment for trans people
Severe acne

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9
Q

Contraindications of estrogen pharmacotherapy

A 
Drug allergy 
Estrogen dependent cancer 
Undiagnosed abnormal vaginal bleeding 
Pregnancy 
Active thromboembolic disorder/history
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10
Q

Interactions of pharmacotherapy estrogens

A 
Oral anticoagulants (estrogens decrease their activity)
Rifampin (estrogens decrease it effect)
St. John’s wort 
Tricyclic antidepressants 
Smoking
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11
Q

Adverse effects of estrogen pharmacotherapy

A 
Thrombolytic events 
Nausea 
Hypertension 
Thrombophlebitis 
Edema
Vomiting, diarrhea, constipation, abdominal pain
Photosensitivity, chloasma
Amenorrhea, breakthrough uterine bleeding 
Tender breasts, fluid retention 
Carbohydrate tolerance, headache
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12
Q

Progestins are used to treat

A

Functional uterine bleeding caused by hormonal imbalance, fibroids, uterine cancer
Primary and secondary amenorrhea
Adjunctive and palliative treatment of some cancer and endometriosis
Prevent contraception
Prevent potential miscarriage
Alleviate premenstrual syndrome symptoms
Liver dysfunction
Thrombophlebitis and thromboembolic disorders
Nausea/vomiting
Amenorrhea
Edema

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13
Q

Medroxyprogesterone

A

Provera, Depo-Provera
Inhibits secretion of pituitary gonadotropins
Prevents follicular maturation and ovulation
Stimulates growth of mammary tissues
Antineoplastic actions against endometrial cancer

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14
Q

Medroxyprogesterone used to treat

A

Uterine bleeding
Secondary amenorrhea
Endometrial cancer
Contraception

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15
Q

Nursing conditions for estrogens and Progestins doses

A

Give smallest does possible
Intramuscular injections into large muscles sites, rotate sites
Oral doses with meals to reduce GI problems
Educate on self admin and what to do if missed dose

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16
Q

Polycystic ovary syndrome

A

Few or anovulatory menstrual cycles
Elevated levels of androgens
Polycystic ovaries
Genetic predisposition and obesity

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17
Q

Endometriosis

A

Functioning endometrial tissue or implantation outside of the uterus

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18
Q

Possible causes of endometriosis

A 
Coelomic metaplasia 
Retrograde menstruation
Embryonic cell rest 
Latrogenic mechanical transplantation 
Lymphatic and vascular dissemination 
Genetic predisposition
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19
Q

Three forms of oral contraceptives

A

Monophasic, biphasic, triphasic

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20
Q

Forms of contraception

A

Oral, injection, transdermal patch, vaginal ring

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21
Q

Contraceptives mechanism of action

A

Prevent ovulation by inhibiting the release of gonadotropins and increasing uterine mucous viscosity

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22
Q

Cervical cancer is almost always associated with

A

HPV infection

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23
Q

HPV causes

A

High grade dysplasia and cancer

Cervical intraepithelial neoplasia and cervical carcinoma in situ

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24
Q

Risk factors for cervical cancer

A 
Multiple sexual partners 
Young age at first sexual intercourse 
High parity 
Immunosuppression 
Oral contraceptives 
Use of nicotine
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25
Vaginal cancer
Rare | Usually squamous cell carcinoma
26
Vulvar cancer
Usually squamous cell carcinoma | Associated with HPV, increasing age, previous cancer, autoimmune conditions, immunosuppression
27
Endometrial cancer
Most common uterine cancer and gynaecological malignancy
28
Primary risk factor for endometrial cancer
Unopposed estrogen exposure | Leads to endometrial hyperplasia
29
Endometrial cancer is associated wigh
Type 2 diabetes
30
Endometrial cancer usually occurs in — women
Post menopausal
31
Three types of ovarian cells
Germ cells Endocrine and interstitial hormone producing cells Epithelial cells Benign and malignant tumours come from each of the three types of cells
32
Benign breast disease
Non cancerous changes in the breast
33
Common symptoms of benign breast disease
Pain, palpable mass, nipple discharge
34
Broad classifications of benign breast disease
Nonproliferative breast lesions Proliferative breast disease without atypia Atypical (atypia) hyperplasia
35
Non proliferative breast lesions
Simple breast cysts Papillary apocrine change Mild hyperplasia of the usual type
36
Simple breast cyst
Fluid filled sacs Often rupture and release secretory material into tissues Results in chronic inflammation and scarring
37
Papillary apocrine change
Increase in ductal epithelial cells that has apocrine changes or an eosinophilic cytoplasm
38
Mild hyperplasia of the usual type
Increase in the number of epithelial cells within a duct that is more than two but less than four cells in depth
39
Proliferative breast lesions without atypia
Proliferation of ductal epithelium or stroma without cellular signs of abnormality
40
PBLW/OA | usual ductal hyperplasia
Additional or proliferating epithelial cells that fill and distend the ducts and lobules
41
PBLW/A | Intraductal papillomas
Solitary papillomas Diffuse papillomas Can harbour areas of atypia requiring surgical excision
42
PBLW/A | Sclerosing adenosis
Lobular lesion with increased fibrous tissue and scattered glandular cells
43
PBLW/A | Radial scar
Irregular, radial proliferation of duct like small tubules entrapped in a dense central fibrosis
44
PBLW/A | Simple fibroademonas
Benign solid tumours that contain glandular and fibrous lesions
45
Proliferative breast lesions with atypia Atypical hyperplasia
Increase in the number of cells or proliferation and the cells have some variance in structure
46
Proliferative breast lesions with atypia | Atypical ductal hyperplasia
Abnormal proliferating cells in breast ducts
47
Proliferative breast lesions with atypia | Atypical lobar hyperplasia
Proliferation of cells in the lumen of lobular units
48
Proliferative breast lesions with atypia is associated with
Increased risk of breast cancer | The younger the woman the higher the risk of developing breast cancer
49
Breast cancer risk is related to
Timing, duration, pattern of exposure
50
Terminal duct lobular units
Predominant source of breast cancer Lobular involution Postlactational involution
51
Lobular involution associated with
Reduced risk of breast cancer
52
Postlactational involution
Mammary gland regresses and remodels to it prepregnant State
53
Six factors that affect the risk of breast cancer
Protective effect of an early (20’s) first pregnancy Protective effect of removal of the ovaries and pituitary gland Increased risk associated with early menarche, late menopause, and nulliparity Relationship between types of fate, free estrogen levels, oxidative changes in estrogen metabolism Hormone dependent development and differentiation of mammary gland structures Efficacy of anti hormone therapies for treatment and prevention of breast cancer
54
Insulin and insulin like growth factors
IGF’s regulate cellular functions involving cell proliferation, migratory, differentiation and apoptosis Insulin therapy and sulfonylurea were found to be mildly associated with breast cancer risk
55
Prolactin and growth hormone
GH induces the production of IGF’s in the liver | IGF signalling is important for breast development and is implicated in breast cancer
56
Oral contraceptives
Combined estrogen and progesterone oral contraceptives increase the risk for breast, cervix amd live cancers
57
Mammographic breast density
Radiological appearance of the breast, reflecting variations in breast composition
58
Radiation
Ionizing radiation is a know mutagen and carcinogen for breast cancer
59
BRCA 1 gene
Breast cancer 1 gene Located on chromosome 17 Tumour-suppressor gene Carriers are at higher risk for breast and ovarian cancer
60
BRCA2
Breast cancer 2 gene Located on chromosome 13 More likely in men who develop breast cancer
61
Pathogenesis of breast cancer | Ductal/lobular epithelium
Proliferation of epithelial cells that is confined to the ducts and lobules
62
Pathogenesis of breast cancer | Infiltrating ductal type
Invasive Tumour stays small but metastasize early 70-80% of breast cancers
63
Pathogenesis of breast cancer | Heterogeneous
Diverse molecular, biological, phenotypical, and pathological changes
64
Ductal carcinoma in situ
Limited to breast ducts and lobules without invasion of the basement membrane Does not progress from low grade to higher grades
65
Lobular carcinoma in situ
Originates from the terminal duct lobular unit | Cells grow non cohesively due to loss of the tumour suppressive adhesion protein E-cadherin
66
Manifestations of breast cancer
``` Painless lump Palpable nodes in axilla Dimpling of skin Edema Bone pain ```
67
Treatment of breast cancer is based on
The stage of the cancer
68
Breast cancer treatment
``` Surgery Radiation Chemo Hormone therapy Biological therapy ```
69
What reduces the risk of penile cancer
Circumcision at birth
70
Penile cancer is most commonly caused by what kind of cells
Squamous cell carcinoma
71
Penile cancer may be the site of
Metastatic spread of solid tumours from the bladder, prostate, rectum or kidney
72
Penile cancer is primarily managed with
Surgery
73
Cancer of the testis usually caused by
``` Germ cell tumours: Seminomas Embryonal carcinomas Tertomas Choriosarcomas ```
74
Cancer of the testis is treated with
Surgery Chemotherapy Radiation
75
Epididymitis
Inflammation of the epididymitis
76
Epididymitis is usually caused by
Sexually transmitted micro-organisms: Neisseria gonorrhoea Chlamydia trachomatis
77
How do sexually transmitted micro organisms reach the epididymitis
By ascending the vasa deferentia from an already infected urethra or bladder
78
Main syotoms of epididymitis
Scrotal or inguinal pain

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