Week 12-reproductive System

Question 1

List benign neoplasms females

Answer 1

Benign
• Lichen sclerosis – affects vulva and labia
• Ovarian (80% benign, women 20-45 years of age, i.e. teratoma)
• Benign exophytic lesions (genital warts) STI’s
• Vulvar/endometrial polyps (may cause abnormal bleeding and infertility)
• Leiomyoma (fibroid)
• Cysts & Polyps

Question 2

List malignant neoplasms female

Answer 2

Malignant
• Cervical carcinoma (4th mc cancer in women worldwide. >50% mortality. HPV)
• Endometrial carcinoma (7% of invasive cancers in women)
• Vulvar / squamous cell/cervical carcinoma (F >60 years)
• Papillary Hidradenoma (nodule in labial folds)
• Extramammary Paget’s Disease (vulva)
• Leiomyosarcom

Question 3

What is endometriosis

Answer 3

Presence of ectopic endometrial tissue at a site outside the uterus

Can cause infertility, pelvic pain, dysmenorrhea (irregular periods) fatigue, depression, abdominal pain, abnormal bleeding
Mc 3rd 4th decades of life
10% of women
3 classifications,
Superficial, ovarian and deep

features are
infertility
fatigue
depression
asymptomatic
abnormal pain and bleeding
LBP
chronic pelvic pain
Dysmenorrhoea

Question 4

What is poly cystic ovarian syndrome (PCOS)

Answer 4

(PCOS)
• Characterised by:
 Hyperandrogenism
 Menstrual abnormalities
 Polycystic ovaries
 Chronic anovulation
 Decreased fertility
• Affects 6-10% of women of reproductive age worldwide
• Associated with DM, obesity ad premature atherosclerosis
• Possible metabolic aetiology

Question 5

What is gonorrhoea

Answer 5

Gonorrhoea
 Bacterial
 Endocervical canal and/or urethra
 Can cause pelvic inflammatory disease
 Mucopurulent discharge common
 Increased urge to urinate
 Swelling or redness at the tip of the penis
 A persistent sore throat
 Swelling or pain in the testi

Question 6

What is syphilis

Answer 6

Bacterial
 Small painless sores and ulcers
 Blotchy red rash affecting the palms of the palms of the hands or soles of
the feet.
 Small skin growths on the
vulva or anus
 Constitutional signs of
infect

Question 7

testosterone location and function

Answer 7

location: interstitial cells
function: Stimulates spermatogenesis
* Promotes & regulates the
development of secondary
sexual characteristics
* Associated with sex drive
levels

Question 8

follicle-stimulating hormone (FSH) location and function

Answer 8

location: Pituitary gland
function: Stimulates the production of
sperm cells in the
seminiferous tubules

Question 9

lutenising hormone (LH) location and function

Answer 9

pituitary gland
Promotes the production of
testosterone by the interstitial
cells

Question 10

Gonadotrophin-
releasing hormone
(GnRH) location and function

Answer 10

hypothalamus

Stimulates secretion of FSH
& LH

Question 11

list hormones from anterior pituitary

Answer 11

Adrenocorticotrophic hormone (ACTH)

Thyroid-stimulating hormone (TSH)

Luteinising hormone (LH)

Follicle-stimulating hormone (FSH)

Prolactin (PRL)

Growth hormone (GH)

Melanocyte-stimulating hormone (MSH)

Question 12

what hormones are released from posterior pituitary

Answer 12

oxytocin and antidiuretic hormone (ADH, or vasopressin).

Question 13

pre-hypogonadism signs

Answer 13

small testes
small penis
small prostate
barely any facial, axillary and pubes
high pitched voice
lack of libido
infertility
gynecomastia
low bone mineral density
low muscle mass, high body fat %

Question 14

post-hypogonadism signs

Answer 14

=low testosterone

changes in mood
decreased well being
diminished cognitive function

small testes
type 2 diabetes
fatigue
osteoperosis
thinning of facial, axillary and pubic hair
gynecomastia
loss of libido
low bone mineral density
hot flashes
infertility
low muscle mass, high %body fat
erectile disfunction
male pattern baldness

Question 15

what is gynecomastia

Answer 15

an increase in the amount of breast gland tissue in boys or men

imbalances ce of hormones oestrogen and testosterone

Question 16

list sexually transmitted infections

Answer 16

gonorrhoea
mumps
granulomatous
syphillis

Question 17

list disorders of the scrotum

Answer 17

Torsion:
 Twisting of the spermatic cord typically cuts off the venous drainage of the testis.
 Can lead to infarction
 Occurs in 2 settings; Neonatal
Adult - sudden onset of testicular px in adolescent boys
Needs manual untwisting within 6 hours – medical emergency

Cryptorchidism
 Failure of the testis to descend (Crypto = hidden, orchis = testis).
 Up to 30% of premature newborn’s
 If untreated will cause:
- Infertility
- Testicular cancer

Question 18

list 3 pathological processes of the prostate

Answer 18

inflmmation
benign prostatic hypertrophy (BPH) MC
tumours

Question 19

what is benign prostatic hypertrophy

Answer 19

MC benign prostate disease in men >50
30% caucasian men

s&s
urinary obstruction
bladder hypertropgy
urine retention
nocturia

difficulty initiating stopping the flow of urine

dribbling
dyuria
infections

Question 20

what is Adenocarcinoma

Answer 20

MC form of cancer in men
 A disease of aging
 70% of males from 70-80 years
 Causes; genetic and environmental interplay
 S&S:
 Early stage is largely asymptomatic and picked
up on - PSA testing
 Advanced stage – urinary obstruction

Question 21

Why has testosterone decreased over recent years?

Answer 21

rising prevalence of obesity as well as the sharp decline in cigarette smoking might help explain their findings, given that testosterone levels are lower among overweight people and smoking increases testosterone levels.

Question 22

How much is testosterone decreasing each year?

Answer 22

Beginning around age 40, men’s testosterone levels start to gradually drop by about 1 to 2% each year

Question 23

What can you advise patients to do to increase
testosterone levels?

Answer 23

A combination of aerobic (increase in heart rate) and resistance (weightlifting) training has been found to increase the production of testosterone

Question 24

list risk factors for endometrioss

Answer 24

first degree relative with endometriosis
late menopause
low BMI
prolonged mnstruation
shorter menstrual cycle
white race
shorter lactation intervals

Question 25

female hypogonadism

Answer 25

Impaired gonad function
* Primary or secondary
* Leads to oestrogen deficiency and menstrual cycle abnormalities

Clinical Features of Oestrogen Deficiency:
 Delayed puberty
 Amenorrhoea
 Dry, dull skin
 Decreased vaginal moisture
 Increased fine lines and wrinkles
 Small, atrophic breast
 Thinning and loss of pubic hair
 Osteoporosis
Endocrine Disorders

Question 26

list placental and gestational disorders

Answer 26

miscarriage)
Defined as pregnancy loss before 20 weeks of gestation
- Foetal chromosomal anomalies
- Maternal endocrine factors
- Physical defects of the uterus
- HT/Coagulopathies
- Infections

Ectopic pregnancy
- Implantation of the foetus in a site other the the normal intrauterine location ( 90% cases is the
extrauterine fallopian tube)
- PID/appendectomy are predisposing factors