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Chapter 7 Pathology > The Reproductive System > Flashcards

The Reproductive System Flashcards

1
Q

What are congenital anomalies of the female reproductive organs usually in the form of?

A

Duplications

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2
Q

What are the normal positions of the uterus?

A

Slight anteflexion, which means the fundus is anterior to the cervix and also anteverted in that the fundus is away from the rectum

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3
Q

What is retroversion of the uterus?

A

When the fundus is tipped backward so that there is no longer a 90 degrees angle between the vagina, cervix, and uterine body. The fundus is now posterior to cervix

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4
Q

What is retroflexion of the uterus?

A

When there is a backward flexion and the uterine body is not pointing toward the rectum

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5
Q

What is acute anteflexion of the uterus?

A

When the fundus of the uterus is flexed forward more than it should be

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6
Q

What is the uterus made from?

A

Paired ducts called Mullerian ducts

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7
Q

Where do the Mullerian ducts fuse from?

A

The lower ends

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8
Q

What do the lower ends of the Mullerian ducts form when the fuse together?

A

The uterus

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9
Q

What do the top ends of the Mullerian ducts form when they fuse together?

A

Each become a fallopian tube

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10
Q

Many malformations of the mullerian ducts can be detected by what radiographic studies?

A

Hysterosalpingography

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11
Q

What is uterine aplasia?

A

When the Mullerian ducts do not form in utero which results in no uterus

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12
Q

What is unicornuate uterus?

A

When only one ducts forms, there can be no fusion. One duct remains as one half of an elongated uterus and only one fallopian tube. Normal vagina present and successful pregnancy can occur.

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13
Q

What condition is usually associated with a missing kidney on the same side as the missing half of the uterus?

A

Unicornuate uterus

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14
Q

What is didelphic uterus?

A

A rare condition that occurs when there is nonfusion of the two Mullerian ducts

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15
Q

What is the result of didelphic uterus?

A

Complete duplication including two cervixes and two uterine bodies but the normal number of fallopian tubes. In most cases the vagina is septate, causing a double vagina

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16
Q

What is a bicornuate bicollic uterus?

A

It occurs when the ducts fuse to the level of the cervix, creating one vagina, two cervixes, and two uterine bodies

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17
Q

What is a bicornuate uterus?

A

When the ducts fuse to the level of the body so that there are two fundi

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18
Q

What is a arcuate uterus?

A

If the nonfusion of the Mullerian ducts begins at the level of the fundus

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19
Q

What is the most common anomaly?

A

A arcuate uterus

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20
Q

What is a septate uterus?

A

A septum extends through the normal uterine body to reach the cervix, dividing the uterus into two complete compartments

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21
Q

What is a subseptate uterus?

A

It has a partial septum dividing the body only. The septum does not extend to the cervix

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22
Q

What occurs more often in women with a subseptate uterus?

A

Twins occur three times more often than women with a normal uterus

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23
Q

What complications are associated with a subseptate uterus?

A

Abortion, premature delivery, hemorrhages, retained placenta, and breech presentation

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24
Q

What is endometriosis?

A

Defined as the growth of endometrial tissue outside the uterus

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25
Q

Where does endometriosis occur?

A

Usually in the ovary, fallopian tube, broad ligament, pouch of Douglas, or retrovaginal septum

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26
Q

Who does endometriosis occur more often in?

A

Women who have never been pregnant and are over the age of 30

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27
Q

What is the term used for women who have never been pregnant?

A

Nulligravida

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28
Q

What happens when the endometrium sloughs off during the monthly cycle?

A

Some of the blood and mucus refluxes into the pelvis and attaches to the aforementioned ectopic areas

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29
Q

What is the term used for women who have never given birth?

A

nullipara

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30
Q

Even though the endometrial tissue lies outside the usterus, what does it still respond to?

A

Hormonal changes and undergoes a proliferative and secretory phase along with sloughing a subsequent bleeding

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31
Q

What happens to the old blood?

A

It turns brown

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32
Q

What are chocolate cysts?

A

The pockets of endometrial tissue

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33
Q

What are the symptoms of endometriosis?

A

severe pain with the period and a dull aching pain during the remainder of the month

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34
Q

What is the term used when a woman experiences pain with the period?

A

dysmenorrhea

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35
Q

What is adenomyosis?

A

The ingrowth of endometrium into the uterine musculature

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36
Q

What condition may coexist with endometriosis?

A

Adenomyosis

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37
Q

What is pelvic inflammatory disease?

A

an inflammation of the female upper genital tract including the fallopian tubes

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38
Q

What is the most serious complications of sexually transmitted disease?

A

Pelvic inflammatory disease

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39
Q

How may an infection occur with PID?

A

By routes such as an intrauterine contraceptive device and nonsterile abortions or deliveries

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40
Q

What are the different types of PID?

A

Acute and Chronic

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41
Q

What does acute PID cause?

A

Slight uterine enlargement

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42
Q

What happens in the early stages of acute PID?

A

The pelvic sidewall structures can still be identified

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43
Q

If the infundibulum is not closed by scar tissue with acute PID, what happens?

A

An infection may spread to the ovaries and adjacent structures because the fallopian tubes open into the pelvic cavity

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44
Q

What happens as acute PID progresses?

A

The adnexa become thicker and begins to merge with the sidewall

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45
Q

What are the complications associated with acute PID?

A

Ectopic pregnancy, infertility, and/or chronic abdominal pain

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46
Q

What happens if acute PID is left untreated?

A

A pyosalpinx will develop

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47
Q

What is a pyosalpinx?

A

Pus in the tube

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48
Q

What does pyosalpinx eventually lead to?

A

A tubal ovarian abscess (TOA)

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49
Q

What happens if a TOA or pyosalpinx ruptures?

A

Peritonitis may ensue which can be localized in the RUQ under the liver

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50
Q

What is usually seen with PID?

A

Free fluid in the cul-de-sac

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51
Q

What happens in chronic PID?

A

All the signs of acute PID are gone and the uterus has sharp borders

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52
Q

What does the adnexa demonstrate with chronic PID?

A

It may demonstrate nonspecific thickening because of continued scarring

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53
Q

What is chronic PID a common cause of?

A

Ectopic pregnancy

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54
Q

What are leiomyomas of the uterus?

A

they are the overgrowth of the normal muscular wall of the uterus

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55
Q

What is another term used for leiomyomas?

A

Fibroids

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56
Q

At what age are leiomyomas most common after?

A

The age of 35 years

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57
Q

What do leiomyomas thrive on?

A

Estrogen

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58
Q

Because leiomyomas thrive on estrogen, what occurs in postmenopausal women?

A

Postmenopausal women do not grow new tumors and if a neoplasm exists before menopause, it will atrophy as the estrogen levels drop after menopause

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59
Q

What are the most common benign tumor of the uterus?

A

Leiomyomas

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60
Q

What are the three different types of leiomyomas?

A

Submucosal, intramural, and subserous

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61
Q

What are submucosal leiomyomas?

A

They are the least common and grow off the endometrium into the uterine cavity

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62
Q

What are intramural leiomyomas?

A

They are the most common type and grow within the myometrium

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63
Q

What are subserous leiomyomas?

A

They are mostly pedunculated and grow off the perimetrium into the pelvic cavity

64
Q

What often happens with myomas?

A

They will calcify with time

65
Q

What can myomas be present with?

A

Pregnancy and can cause an abortion or an abruption placenta

66
Q

What can myomas cause with pregnancy?

A

They can prevent a normal vaginal delivery if they are located near the cervix

67
Q

What are teratomas?

A

benign “cysts” of the ovary that contain skin, hair, teeth, and fatty elements that derive from ectodermal tissue

68
Q

What is another name for teratomas?

A

Dermoids

69
Q

What do one-half of teratoms contain?

A

Calcifications usually in the form of teeth, but may include the wall of the cyst

70
Q

What are single cystic lesions?

A

Lesions of the ovaries that are rarely significant and are usually a follicular cyst or a corpus luteum cyst

71
Q

What might be an indication of endometriosis?

A

Multiple cystic areas

72
Q

What are polycystic ovaries?

A

Enlarged ovaries consisting of many small cysts

73
Q

What manifestation is associated with polycystic ovaries?

A

Stein-leventhal syndrome, which is characterized by facial hair, excess weight, amenorrhea, and infertility

74
Q

What is fibrocystic disease of the breast?

A

A common benign condition occurring in about 20% of women who are premenopausal

75
Q

What term is used that encompasses a variety of changes that occur?

A

Fibrocystic disease

76
Q

What are the most obvious changes associated with fibrocystic disease?

A

fibrous and cystic dilation of the ducts (it is usually bilateral with cysts of various sizes distributed throughout the breasts)

77
Q

What will the breast contain with fibrocystic disease?

A

an increased amount of fibrous tissue

78
Q

What is a important change to note with fibrocystic disease?

A

hyperplasia of the ducts (thought to be a precursor to cancer)

79
Q

If hyperplasia is present with fibrosis and cystic dilation, what term is used?

A

Proliferative fibrocystic disease

80
Q

What is a fibroadenoma?

A

The most common benign breast tumor

81
Q

How does a fibroadenoma generally appear?

A

As a smooth, well-circumscribed mass with no invasion of surrounding tissue

82
Q

TRUE OR FALSE
With fibroadenoma, the masses may be moved around within the breast as they have no attachments to the overlying skin or underlying tissue

A

True

83
Q

What is adenocarcinoma?

A

It is the most common invasive gynecologic malignancy of the endometrium

84
Q

What are the different classifications of adenocarcinoma?

A

Type 1 and Type 2

85
Q

Who does Type 1 adenocarcinoma occur most often in?

A

Pre- and perimenopausal women

86
Q

Who does Type 2 adenocarcinoma occur most often in?

A

In older, postmenopausal women who have never born a viable baby

87
Q

What has been associated with increased frequency of endometrial carcinoma?

A

Prolonged estrogen stimulation and therefore women on hormone replacement therapy are at an increased risk

88
Q

What are the clinical symptoms associated with adenocarcinoma?

A

bleeding, hypermenorrhea, or postmenopausal bleeding

89
Q

Where may adenocarcinoma project into?

A

Into the uterine cavity or it may infiltrate the wall of the uterus

90
Q

What will an IVU show with adenocarcinoma?

A

It will show the bladder wall depressed by an enlarged uterus

91
Q

What is cystadenocarcinoma?

A

Ovarian cancer

92
Q

Where does cervical cancer arise from?

A

Epithelial tissue around the neck of the uterus

93
Q

What is cervical cancer caused by?

A

It is caused by certain types of human papillomavirus (HPV)

94
Q

What happens when a female has been infected by certain types of HPV and the virus does not go away on its own?

A

Abnormal cells can develop in the lining of the cervix

95
Q

What does an IVU demonstrate with cervical cancer?

A

Hydronephrosis in one-third of the patients

96
Q

What is the most common cause of death in patients with carcinoma of the cervix?

A

Impaired renal function caused by ureteral obstruction

97
Q

What is breast cancer?

A

The most common malignancy among women

98
Q

What factors increase the risk of women getting breast cancer?

A

The age at which a woman has her first full-term pregnancy, women who delay childbirth (higher risk), early menarche (those who begin a the age of 12 or younger are at higher risk)

99
Q

How are all breast cancers seen mammographically?

A

As a tumor mass, clustered calcifications, or both

100
Q

What are some secondary changes of breast carcinoma?

A

skin thickening around the areola and nipple retraction

101
Q

What is the typical malignant tumor mass with breast cancer?

A

Poorly defined, has irregular margins, and demonstrates numerous fine linear strands or spicules radiating out from the mass

102
Q

What are clustered calcifications in breast cancer?

A

They are typically numerous, very small, and localized to one segment of the breast, They demonstrate a wide variety of shapes including fine linear, curvilinear and branching forms

103
Q

Where do the testes normally descend from?

A

The intra-abdominal area through the inguinal canal into the scrotum near the end of the gestational period

104
Q

What is cryptorchidism?

A

Condition of undescended testes

105
Q

What is the most common birth defect of male genitalia?

A

Cryptorchidism

106
Q

What modality is used as a screening mechanism to determine the location of an undescended testical in the inguinal canal, pelvis, or abdomen?

A

Ultrasonography

107
Q

What are undescended testes associated with?

A

reduced fertility, testicular torsion, and a higher rate of malignancy

108
Q

What is orchiopexy?

A

When the undescended testicle must be brought down and surgically fixed in the scrotum

109
Q

What is orchiectomy?

A

When the testicle is removed

110
Q

When is orchiectomy performed?

A

On patients who are diagnosed after the onset of puberty

111
Q

What is prostatic hyperplasia?

A

An enlargement of the prostate gland

112
Q

What is prostatic hyperplasia related to?

A

decreased hormone secretions

113
Q

What happens as the prostate gland enlarges?

A

It pushes on the bladder, which results in an inability to completely empty the bladder

114
Q

When the enlarged prostate gland pushes on the bladder, which results in an inability to completely empty the bladder, what happens?

A

It leads to obstruction, bilateral ureteral dilation, and hydronephrosis

115
Q

What does an IVU demonstrate with prostatic hyperplasia?

A

it demonstrates the elevation and smooth impression on the floor of the bladder by the prostate. The elevation of the bladder also causes the elevation of the insertion of the ureters on the trigone

116
Q

What is the characteristic associated with prostatic hyperplasia?

A

J-shape, or fish-hook appearance of the distal ureters

117
Q

What does a transurethral resection of the prostate do?

A

It relieves symptoms of obstruction associated with prostatic hyperplasia

118
Q

What are prostatic calculi?

A

Small, multiple calcifications found in the prostate gland

119
Q

What are visible on radiographs with prostatic calculi?

A

The calculi, if dense enough

120
Q

What is testicular torsion?

A

Occurs when the testicle twists over on its pedicle

121
Q

What symptoms are associated with testicular torsion?

A

A sudden onset of severe scrotal pain and swelling

122
Q

What will diagnose testicular torsion?

A

Doppler ultrasound through the absence of the sound of blood flow

123
Q

What is epididymitis?

A

Inflammation of the epididymis and also leads to swelling of the scrotum accompanied by pain and erythema

124
Q

What may be associated with epididymitis?

A

Orchitis

125
Q

What is orchitis?

A

inflammation of the testes

126
Q

What is the difference between epididymitis and testicular torsion?

A

Arterial perfusion is decreased or absent in testicular torsion, whereas in epididymitis the blood flow is increased

127
Q

What is gynecomastia?

A

Enlargement of the male breast

128
Q

What is the result of estrogen stimulation in gynecomastia?

A

Proliferation of ducts and connective tissue

129
Q

What stimuli can cause males to secrete more estrogen than normal causing gynecomastia?

A

Cirrhosis, certain neoplasms, TCH, difitalis, and Klinefelter syndrome

130
Q

What is usually the cause of bilateral gynecomastia?

A

Aging, with decreased androgen production

131
Q

What can cause masses in the testes?

A

Trauma or inflammation

132
Q

What age is often affected most by benign neoplasms of the testes?

A

Males between the ages of 25 and 40

133
Q

What are the benign masses of the testes?

A

Hydrocele and spermatocele

134
Q

What is hydrocele?

A

A collection of fluid in the testis or along the spermatic cord

135
Q

What is spermatocele?

A

A cystic dilation of the epididymis

136
Q

Are benign or malignant tumors more common in the testes?

A

Malignant

137
Q

What are the two major types of malignant testicle cancer?

A

Seminomas and teratomas

138
Q

What are malignant seminomas?

A

They arise from the seminiferous tubules and are extremely radiosensitive and prognosis is excellent

139
Q

What are malignant teratomas?

A

They have poor prognosis and arise from a primitive germ cell and consist of a variety of structures

140
Q

How are seminomas and teratomas spread?

A

Spread by lymphatics and the blood to the area of the renal hilum

141
Q

What is the second most common malignancy in men?

A

Adenocarcinoma of the prostate gland

142
Q

What does an IVU demonstrate with adenocarcinoma of the prostate gland?

A

An elevated bladder with an irregular impression of the bladder floor because of the irregular, lobulated borders of the tumor

143
Q

Why is CT a good modality to use when imaging seminomas and teratomas of the testes?

A

It is the best because it will also detect metastasis to the lung, liver, or bone

144
Q

What modality is used to detect carcinoma of the prostate gland?

A

Ultrasonography with the use of a transrectal probe

145
Q

Why is it important to determine carcinoma of the prostate early?

A

Because it spreads to the rectum directly

146
Q

What is hysterosalpingography?

A

A procedure that may be diagnostic as well as therapuetic

147
Q

What are the diagnostic indications for hysterosalpingography?

A

Abnormal bleeding or spotting between menstrual periods, patency of tubes, anomalies, habitual spontaneous abortions, amenorrhea, dysmenorrhea and a lost intrauterine contraceptive device

148
Q

What are the therapeutic indications for hysterosalpingography?

A

Restoring patency to the tubes, stretching adhesions, dilation of the tubes, or straightening of the tubes

149
Q

What are some contraindications of hysterosalpingography?

A

pregnancy, pelvic inflammatory disease, vaginal or cervical infection, or menses

150
Q

What two types of contrast media are used for hysterosalpingography?

A

Water soluble and oily

151
Q

What forms does the water soluble medium come in?

A

Salpix or sinografin

152
Q

What is the advantage to water-soluble contrast?

A

It is absorbed quickly and leaves no residue

153
Q

What is the disadvantage to water-soluble contrast?

A

the great deal of pain they produce

154
Q

What is the advantage to oily contrast?

A

It is very opaque and causes little or no pain

155
Q

What is the disadvantage to oily contrast?

A

The oil persists in the body

Chapter 7 Pathology (1 decks)

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