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Pathophysiology > Week 13: Reproductive System > Flashcards

Week 13: Reproductive System Flashcards

1
Q

Epididymis—maturation of _________

A

sperm

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2
Q

Vas deferens—transport of sperm to __________

A

urethra

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3
Q

Seminal vesicles—secretion to nourish __________

A

sperm

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4
Q

Prostate gland—secretions to _________________

A

balance pH

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5
Q

Penis— _____________ of semen

A

ejaculation

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6
Q

Cowper glands (bulbourethral)—secretes alkaline __________

A

mucus

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7
Q

Male hormones
-Follicle-stimulating hormone (FSH)—initiates ____________
- Luteinizing hormone (LH)—stimulates ____________production
- Testosterone—maturation of ________, sex characteristics, protein metabolism, muscle development

A

-Follicle-stimulating hormone (FSH)—initiates spermatogenesis
- Luteinizing hormone (LH)—stimulates testosterone production
- Testosterone—maturation of sperm, sex characteristics, protein metabolism, muscle
development

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8
Q

Congenital Abnormalities of the Penis

-Epispadias—urethral opening on _________________surface of the penis
- Hypospadias—urethral opening on _________ surface (underside) of the penis

  • Either condition may result in incontinence/infection.
    -Treatment—____________ reconstruction
A

-Epispadias—urethral opening on ventral or upper surface of the penis
- Hypospadias—urethral opening on dorsal surface (underside) of the penis

  • Either condition may result in incontinence/infection.
    -Treatment—surgical reconstruction
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9
Q

-Cryptorchidism—testis fails to descend into _________ properly

  • Ectopic testis—testis positioned outside of ___________
    — Can cause degeneration of seminiferous tubules and spermatogenesis is impaired
    — Risk of testicular cancer increased significantly if treatment not done by age 5 years
A

-Cryptorchidism—testis fails to descend into scrotum properly

  • Ectopic testis—testis positioned outside of scrotum
    — Can cause degeneration of seminiferous tubules and spermatogenesis is impaired
    — Risk of testicular cancer increased significantly if treatment not done by age 5 years
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10
Q

Hydrocele—occurs when excessive _______ collects in space between layers of the tunica
vaginalis of the scrotum

  • May occur as congenital defect in newborn
    -May be acquired as result of injury, infection, tumor
  • May compromise blood supply or lymph drainage in testes
A

Hydrocele—occurs when excessive fluid collects in space between layers of the tunica
vaginalis of the scrotum

  • May occur as congenital defect in newborn
    -May be acquired as result of injury, infection, tumor
  • May compromise blood supply or lymph drainage in testes
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11
Q

Spermatocele— _____ containing _____ and sperm that develops between the testis and
the epididymis

  • May be related to developmental abnormality
  • Surgical removal
A

Spermatocele—cyst containing fluid and sperm that develops between the testis and
the epididymis

  • May be related to developmental abnormality
  • Surgical removal
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12
Q

Varicocele—a ______________ in the spermatic cord
-Lack of valves allows backflow in veins; leads to increased pressure and dilation
-Causes impaired blood flow to testes and decreased spermatogenesis
- Requires surgery

A

Varicocele—a dilated vein in the spermatic cord
-Lack of valves allows backflow in veins; leads to increased pressure and dilation
-Causes impaired blood flow to testes and decreased spermatogenesis
- Requires surgery

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13
Q

Torsion of the testes—testes _______ on spermatic cord, compressing arteries and veins
- Ischemia develops, scrotum swells
- Testis may be infarcted if torsion is not reduced
- Can occur spontaneously or following trauma
- Treated manually and surgically

A

Torsion of the testes—testes rotate on spermatic cord, compressing arteries and veins
- Ischemia develops, scrotum swells
- Testis may be infarcted if torsion is not reduced
- Can occur spontaneously or following trauma
- Treated manually and surgically

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14
Q

Prostatitis—infection or inflammation of the ___________

Four recognized categories
1. Acute ________
2. Chronic __________
3. Nonbacterial
4. Asymptomatic _____________

A

Prostatitis—infection or inflammation of the prostate gland

Four recognized categories
1. Acute bacterial
2. Chronic bacterial
3. Nonbacterial
4. Asymptomatic inflammatory

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15
Q

Prostatitis

  • Acute bacterial—gland is tender and ________ , urine and secretions contain bacteria
  • Nonbacterial—urine and secretions contain large numbers of ___________
  • Chronic bacterial—gland only slightly _________ , dysuria, frequency, urgency
A
  • Acute bacterial—gland is tender and swollen, urine and secretions contain bacteria
  • Nonbacterial—urine and secretions contain large numbers of leukocytes
  • Chronic bacterial—gland only slightly enlarged, dysuria, frequency, urgency
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16
Q

Prostatitis (Cont.)

  • Acute bacterial infection is caused primarily by ____________ and sometimes by Pseudomonas, Proteus, or Streptococcus faecalis.
  • Chronic bacterial infection is related to repeated infection by ______
  • These are opportunistic bacteria from the normal flora of the gut.
A
  • Acute bacterial infection is caused primarily by Escherichia coli and sometimes by Pseudomonas, Proteus, or Streptococcus faecalis.
  • Chronic bacterial infection is related to repeated infection by E. coli.
  • These are opportunistic bacteria from the normal flora of the gut.
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17
Q

Prostatitis occurs in

  • Young men with _____
  • Older men with prostatic hypertrophy
  • In association with _____
  • With instrumentation such as catheterization
  • Through bacteremia
A
  • Young men with UTIs
  • Older men with prostatic hypertrophy
  • In association with STDs
  • With instrumentation such as catheterization
  • Through bacteremia
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18
Q

Prostatitis -Signs and symptoms

-dysuria, urinary frequency, and ________
- Decreased urinary ______
- Acute form includes fever and chills
- Lower ______ pain; Muscle aches
- Leukocytosis
-Abdominal discomfort
- Systemic signs include fever, malaise, anorexia

A

-dysuria, urinary frequency, and urgency
- Decreased urinary stream
- Acute form includes fever and chills
- Lower back pain; Muscle aches
- Leukocytosis
-Abdominal discomfort
- Systemic signs include fever, malaise, anorexia

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19
Q

Prostatitis treatment for acute or chronic bacterial infection
- ____________ drugs such as ciprofloxacin

Treatment for nonbacterial infection
- ________________ drugs and prophylactic antibacterial agents

A

Prostatitis treatment for acute or chronic bacterial infection
- Antibacterial drugs such as ciprofloxacin

Treatment for nonbacterial infection
- Anti-inflammatory drugs and prophylactic antibacterial agents

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20
Q

Balanitis
- ________ infection of the glans penis
- Sexually transmitted
- Caused by Candida albicans
- Vesicles develop into patches
- Severe burning and itching
- Treatment—topical _________ medication

A
  • Fungal infection of the glans penis
  • Sexually transmitted
  • Caused by Candida albicans
  • Vesicles develop into patches
  • Severe burning and itching
  • Treatment—topical antifungal medication
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21
Q

Tumors: Benign Prostatic Hypertrophy
- Occurs in up to ____ of men > 65 years
- Hyperplasia of prostatic tissue
- Compression of urethra and urinary obstruction
- Related to estrogen–testosterone ___________
- Does not predispose to prostatic carcinoma

A
  • Occurs in up to 50% of men > 65 years
  • Hyperplasia of prostatic tissue
  • Compression of urethra and urinary obstruction
  • Related to estrogen–testosterone imbalance
  • Does not predispose to prostatic carcinoma
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22
Q

Tumors: Benign Prostatic Hypertrophy (Cont.)
- Enlarged ______ palpated on digital rectal examination
- Leads to frequent __________
- Continued obstruction causes distended bladder, dilated ureters, hydronephrosis, and
renal failure if untreated.

A
  • Enlarged gland palpated on digital rectal examination
  • Leads to frequent infections
  • Continued obstruction causes distended bladder, dilated ureters, hydronephrosis, and
    renal failure if untreated.
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23
Q

Tumors: Benign Prostatic Hypertrophy - Signs and symptoms
- Obstructed urinary ______
- Hesitancy in starting flow
- Dribbling
- Decreased flow _________
- Increased frequency and urgency
- Nocturia
- Dysuria occurs if infection is present.

A
  • Obstructed urinary flow
  • Hesitancy in starting flow
  • Dribbling
  • Decreased flow strength
  • Increased frequency and urgency
  • Nocturia
  • Dysuria occurs if infection is present.
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24
Q

Tumors: Benign Prostatic Hypertrophy (Cont.)

Treatment
- Drugs such as dutasteride (Avodart) to slow ___________
- Smooth muscle ______ such as tamsulosin (Flomax)
- Combo of finasteride (Proscar) and doxazosin (Cardura) reduces progression of hypertrophy
- Surgery

A

Treatment
- Drugs such as dutasteride (Avodart) to slow enlargement
- Smooth muscle relaxers such as tamsulosin (Flomax)
- Combo of finasteride (Proscar) and doxazosin (Cardura) reduces progression of hypertrophy
- Surgery

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25
Q

Tumors: Cancer of the Prostate
- Most common cancer in men > ____ years
- Third leading cause of cancer death in men
- One in ____ men affected
- Most are adenocarcinomas arising near surface of gland
- The more undifferentiated the tumor, the more aggressive
- Many tumors are androgen-dependent.

A
  • Most common cancer in men > 50 years
  • Third leading cause of cancer death in men
  • One in six men affected
  • Most are adenocarcinomas arising near surface of gland
  • The more undifferentiated the tumor, the more aggressive
  • Many tumors are androgen-dependent.
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26
Q

Tumors: Cancer of the Prostate (Cont.)
- Both invasive and metastatic
- Some forms are highly aggressive but others are not.
- 5% to 10% caused by ___________ mutations
-Other causes—high androgen levels, increased insulin-like growth factor, history of recurrent prostatitis

A
  • Both invasive and metastatic
  • Some forms are highly aggressive but others are not.
  • 5% to 10% caused by inherited mutations
    -Other causes—high androgen levels, increased insulin-like growth factor, history of recurrent prostatitis
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27
Q

Tumors: Cancer of the Prostate - Signs and symptoms
- Hard _______ felt on periphery of gland
- Hesitancy in urination
- Decreased urine stream
- Frequent __________
- Recurrent UTI

A
  • Hard nodule felt on periphery of gland
  • Hesitancy in urination
  • Decreased urine stream
  • Frequent urination
  • Recurrent UTI
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28
Q

Tumors: Cancer of the Prostate (Cont.)

Diagnosis
- Serum markers
* Prostate-specific antigen (PSA)
* Prostatic acid phosphatase
- Ultrasonography
- Biopsy
- Bone scans to detect metastases

Treatment
- ________ (radical prostatectomy)
- ___________ : external or implanted pellets
- If androgen-sensitive, then orchiectomy is effective, as well as antitestosterone drugs.
- New chemotherapies are in clinical trials.

A

Diagnosis
- Serum markers
* Prostate-specific antigen (PSA)
* Prostatic acid phosphatase
- Ultrasonography
- Biopsy
- Bone scans to detect metastases

Treatment
- Surgery (radical prostatectomy)
- Radiation: external or implanted pellets
- If androgen-sensitive, then orchiectomy is effective, as well as antitestosterone drugs.
- New chemotherapies are in clinical trials.

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29
Q

Cancer of the Testes
- Most testicular tumors are ___________.
- 1 in 300 affected; Most _________ solid tumor cancer in young men
- Number of cases increasing
- Testicular self-examination is essential for early detection.

A
  • Most testicular tumors are malignant.
  • 1 in 300 affected; Most common solid tumor cancer in young men
  • Number of cases increasing
  • Testicular self-examination is essential for early detection.
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30
Q

Cancer of the Testes (Cont.)
- May originate from one type of cell or mixed ______ from various sources
-Teratoma—tumor consisting of mixture of different _____ cells
- Some malignant tumors secrete hCG or AFP, which serve as useful markers for diagnosis.

A
  • May originate from one type of cell or mixed cells from various sources
    -Teratoma—tumor consisting of mixture of different germ cells
  • Some malignant tumors secrete hCG or AFP, which serve as useful markers for diagnosis.
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31
Q

Cancer of the Testes (Cont.)
- Typical _______ pattern
- Appear in common iliac and para-aortic lymph nodes
-Then to the mediastinal and supraclavicular lymph nodes
- Then through the ______ to the lungs, liver, bone, and brain

A
  • Typical spreading pattern
  • Appear in common iliac and para-aortic lymph nodes
    -Then to the mediastinal and supraclavicular lymph nodes
  • Then through the blood to the lungs, liver, bone, and brain
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32
Q

Cancer of the Testes - Signs and symptoms
- Tumors are ____, painless, usually unilateral
- Testes may be _________ or feel heavy.
- Dull _______ scrotum and pelvis
- Hydrocele or epididymitis may develop.
- Gynecomastia occurs if the tumor is hormonesecreting.

A
  • Tumors are hard, painless, usually unilateral
  • Testes may be enlarged or feel heavy.
  • Dull aching scrotum and pelvis
  • Hydrocele or epididymitis may develop.
  • Gynecomastia occurs if the tumor is hormonesecreting.
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33
Q

Cancer of the Testes - Diagnostic tests
- _______ is not usually done.
- ______ markers (hCG and AFP)
- Ultrasound
- Computed tomography
- Lymphangiography

A
  • Biopsy is not usually done.
  • Tumor markers (hCG and AFP)
  • Ultrasound
  • Computed tomography
  • Lymphangiography
34
Q

Cancer of the Testis - Treatment

-Combination of:
* _______ (orchiectomy)
* ________therapy
* Chemotherapy
- NOTE: the client may wish to donate sperm prior to treatment to ensure future fertility.

A
  • Surgery (orchiectomy)
  • Radiation therapy
  • Chemotherapy
  • NOTE: the client may wish to donate sperm prior to treatment to ensure future fertility.
35
Q

Vulva
- Mons pubis—_______ tissue and hair covering the symphysis pubis

  • Labia majora and minora—outer and inner __________ of skin extending back and down from the
    mons pubis
A
  • Mons pubis—adipose tissue and hair covering the symphysis pubis
  • Labia majora and minora—outer and inner thin folds of skin extending back and down from the
    mons pubis
36
Q

Clitoris— _________ tissue anterior to urethra

A

erectile

37
Q

Vagina—__________, distensible ________ extending upward from the vulva to the cervix

A

Vagina—muscular, distensible canal extending upward from the vulva to the cervix

38
Q

Uterus—muscular organ within which fertilized ______ may implant and develop

A

ovum

39
Q

Cervix—opening into uterus and neck of the uterus

External os
* ________ from vagina filled with thick mucus
* Prevents vaginal flora from ascending into the uterus

Internal os

A

External os
* Opening from vagina filled with thick mucus
* Prevents vaginal flora from ascending into the uterus

Internal os

40
Q

Fallopian tubes (oviducts)—tubes from ovaries to _______

A

uterus

41
Q

Ovaries—produce _____ and estrogen and progesterone hormones

A

ova

42
Q

Breasts
- Glands produce colostrum and _____ for newborn
- ________ tissue

A
  • Glands produce colostrum and milk for newborn
  • Adipose tissue
43
Q

Hormones and the menstrual cycle

-Cycle may be from 21 to 45 days
- Cycle consists of:
* ___________ (days 1 to 5)
* Endometrial proliferation and production of estrogen (days vary)
* Maturation of ovarian ________
* Release of _____ , causing ovulation

A

-Cycle may be from 21 to 45 days
- Cycle consists of:
* Menstruation (days 1 to 5)
* Endometrial proliferation and production of estrogen (days vary)
* Maturation of ovarian follicle
* Release of LH, causing ovulation

44
Q

The Menstrual Cycle
- Follicle becomes the corpus luteum, produces __________
- Vascularization of ___________ in preparation for implantation (12 to 14 days prior to onset
of next menstruation)

If implantation does not occur:
- Corpus luteum atrophies
- Uterine muscle contracts → ischemia
- Endometrium degenerates

A
  • Follicle becomes the corpus luteum, produces progesterone
  • Vascularization of endometrium in preparation for implantation (12 to 14 days prior to onset
    of next menstruation)

If implantation does not occur:
- Corpus luteum atrophies
- Uterine muscle contracts → ischemia
- Endometrium degenerates

45
Q

Structural Abnormalities

Normal position of uterus
- Slightly anteverted and anteflexed
- Cervix downward and posterior

Retroflexion of uterus
- Uterus tipped posteriorly
- May be excessively ______ or bent
- Marked retroversion may cause back ______ dysmenorrhea, dyspareunia
- In some cases, ___________ may occur.

A

Normal position of uterus
- Slightly anteverted and anteflexed
- Cervix downward and posterior

Retroflexion of uterus
- Uterus tipped posteriorly
- May be excessively curved or bent
- Marked retroversion may cause back pain dysmenorrhea, dyspareunia
- In some cases, infertility may occur.

46
Q

Structural Abnormalities (Cont.)

Uterine displacement or prolapse
- First-degree prolapse if cervix drops into the ___________
- Second-degree prolapse if cervix lies at opening to the vagina
* Body of uterus is in the vagina
- Third-degree prolapse if uterus and cervix protrude through the vaginal orifice
* Early stages of prolapse may be asymptomatic.
* Advanced stages cause discomfort, infection, and decreased _________.

A

Uterine displacement or prolapse
- First-degree prolapse if cervix drops into the vagina
- Second-degree prolapse if cervix lies at opening to the vagina
* Body of uterus is in the vagina
- Third-degree prolapse if uterus and cervix protrude through the vaginal orifice
* Early stages of prolapse may be asymptomatic.
* Advanced stages cause discomfort, infection, and decreased mobility.

47
Q

Structural Abnormalities (Cont.)

Rectocele
- Protrusion of the rectum into the posterior _________
- May cause constipation and pain

Cystocele
- Protrusion of ________ into the anterior vagina
- May cause UTIs

If severe, conditions are treated surgically to increase the support of the pelvic ligaments.

A

Rectocele
- Protrusion of the rectum into the posterior vagina
- May cause constipation and pain

Cystocele
- Protrusion of bladder into the anterior vagina
- May cause UTIs

If severe, conditions are treated surgically to increase the support of the pelvic ligaments.

48
Q

Menstrual abnormalities

Amenorrhea (__________ of menstruation)
* May be primary or secondary
- Primary form may be genetic.
- Secondary form usually hormonal imbalance

Dysmenorrhea
* _______ menstruation caused by excessive release of ___________ bc of endometrial ischemia
* Usually begins a few days prior to menses and lasts a few days after onset
* NSAIDs offer relief.

A

Amenorrhea (absence of menstruation)
* May be primary or secondary
- Primary form may be genetic.
- Secondary form usually hormonal imbalance

Dysmenorrhea
* Painful menstruation caused by excessive release of prostaglandins bc of endometrial ischemia
* Usually begins a few days prior to menses and lasts a
few days after onset
* NSAIDs offer relief.

49
Q

Menstrual abnormalities - Premenstrual syndrome

  • Begins approximately ________ before onset of menses
  • Pathophysiology not completely known; may be several forms
  • Breast tenderness, weight gain, abdominal distension or bloating, irritability, emotional liability, sleep disturbances, depression, headache, fatigue
  • Treatment is individualized and may include exercise, limiting salt intake, use of oral
    contraceptives, diuretics, or antidepressant drugs
A
  • Begins approximately 1 week before onset of menses
  • Pathophysiology not completely known; may be several forms
  • Breast tenderness, weight gain, abdominal distension or bloating, irritability, emotional liability, sleep disturbances, depression, headache, fatigue
  • Treatment is individualized and may include exercise, limiting salt intake, use of oral
    contraceptives, diuretics, or antidepressant drugs
50
Q

Abnormal Menstrual Bleeding- usual cause is lack of ovulation, but a hormonal imbalance in the pituitary-ovarian axis may be a factor.

  • Menorrhagia
  • Increased amount and duration of ____
  • Metrorrhagia
  • Bleeding between _______
  • Polymenorrhea
  • ______ cycles of less than 3 weeks
  • Oligomenorrhea
  • _____ cycles of more than 6 weeks
A
  • Menorrhagia
  • Increased amount and duration of flow
  • Metrorrhagia
  • Bleeding between cycles
  • Polymenorrhea
  • Short cycles of less than 3 weeks
  • Oligomenorrhea
  • Long cycles of more than 6 weeks
51
Q

Menstrual Disorders - Endometriosis

  • Endometrial tissue occurs outside the ________.
  • Ectopic endometrium responds to cyclical hormone changes.
  • Bleeding leads to inflammation and ______.
  • Fibrous tissue may cause adhesions and obstructions of the involved structures.
  • Cause has not been established but thought to be congenital in some cases

Treatment
* _________ suppression
* Surgical removal of ectopic tissue

A
  • Endometrial tissue occurs outside the uterus.
  • Ectopic endometrium responds to cyclical hormone changes.
  • Bleeding leads to inflammation and pain.
  • Fibrous tissue may cause adhesions and obstructions of the involved structures.
  • Cause has not been established but thought to be congenital in some cases

Treatment
* Hormonal suppression
* Surgical removal of ectopic tissue

52
Q

Infections: Candidiasis

-Form of vaginitis that is not _________ transmitted
- Caused by the fungus Candida albicans

  • Opportunistic infection by normal flora of vagina
    — _______ therapy
    —Pregnancy
    — Diabetes
    — Reduced host resistance
A

-Form of vaginitis that is not sexually transmitted
- Caused by the fungus Candida albicans

  • Opportunistic infection by normal flora of vagina
    — Antibiotic therapy
    —Pregnancy
    — Diabetes
    — Reduced host resistance
53
Q

Candidiasis causes red and swollen, intensely pruritic mucous membranes and a thick, white, curdlike discharge.

-May extend to vulvar tissues
- __________ treatment

A

Candidiasis causes red and swollen, intensely pruritic mucous membranes and a thick, white, curdlike discharge.

-May extend to vulvar tissues
- Antifungal treatment

54
Q

Infections: Pelvic Inflammatory Disease
- Infection of uterus, fallopian tubes, and/or ovaries
- May be acute or chronic
- Infection usually originates as an ascending infection from _______ reproductive tract.
- May occur because of bacteremia
- Most infections arise from ________ transmitted diseases, nonsterile abortions, or childbirth.

A
  • Infection of uterus, fallopian tubes, and/or ovaries
  • May be acute or chronic
  • Infection usually originates as an ascending infection from lower reproductive tract.
  • May occur because of bacteremia
  • Most infections arise from sexually transmitted diseases, nonsterile abortions, or childbirth.
55
Q

Pelvic Inflammatory Disease (Cont.)
- Scarring of tubes increases risk of infertility and ectopic pregnancy.
- Potential acute complications
- Peritonitis
- Pelvic abscesses
- Septic shock

  • _________ is usually first sign
  • Increased temperature
  • Guarding
  • Nausea and vomiting
  • Leukocytosis
  • _______ discharge may be present.
  • Treatment usually requires aggressive ____________ therapy in hospital.
A
  • Scarring of tubes increases risk of infertility and ectopic pregnancy.
  • Potential acute complications
  • Peritonitis
  • Pelvic abscesses
  • Septic shock
  • Pelvic pain is usually first sign
  • Increased temperature
  • Guarding
  • Nausea and vomiting
  • Leukocytosis
  • Purulent discharge may be present.
  • Treatment usually requires aggressive antibiotic therapy in hospital.
56
Q

Benign Tumors

Leiomyoma (fibroids)
- Benign tumor of the myometrium
- Common during the reproductive years
- Classified by location
- Usually multiple, well-defined, encapsulated masses
* Abnormal bleeding may occur.
* May interfere with __________
- Often asymptomatic until large growth
- Hormonal therapy or surgery

A

Leiomyoma (fibroids)
- Benign tumor of the myometrium
- Common during the reproductive years
- Classified by location
- Usually multiple, well-defined, encapsulated masses
* Abnormal bleeding may occur.
* May interfere with implantation
- Often asymptomatic until large growth
- Hormonal therapy or surgery

57
Q

Benign Tumors (Cont.)

Ovarian cysts
- Variety of types occur
- Physiological type lasts about 8 to 12 weeks and disappear without complications
- Usually multiple, small, fluid-filled sacs
- If __________ occurs, more serious inflammation occurs.
* Requires surgical intervention
- Ultrasound or laparoscopy for identification

A
  • Variety of types occur
  • Physiological type lasts about 8 to 12 weeks and disappear without complications
  • Usually multiple, small, fluid-filled sacs
  • If bleeding occurs, more serious inflammation occurs.
  • Requires surgical intervention
  • Ultrasound or laparoscopy for identification
58
Q

Benign Tumors (Cont.)

Polycystic ovarian disease
- Fibrous capsule thickens around follicles of ______
-May be hereditary
- Absence of ovulation and infertility
- Hormonal imbalance
- Amenorrhea
-Hirsutism
- Treatment may be surgical wedge resection or pharmacology.

A

Polycystic ovarian disease
- Fibrous capsule thickens around follicles of ovary
-May be hereditary
- Absence of ovulation and infertility
- Hormonal imbalance
- Amenorrhea
-Hirsutism
- Treatment may be surgical wedge resection or pharmacology.

59
Q

Benign Tumors (Cont.)

Fibrocystic breast disease
- Includes a broad range of _______ changes and increased density of breast tissue
- Cyclic occurrence of nodules or ________ in breast tissue
-Increased risk of breast cancer if atypical cells are present.
- Increased density makes breast self-examination difficult
- Increased cystic masses with caffeine intake

A

Fibrocystic breast disease
- Includes a broad range of breast changes and increased density of breast tissue
- Cyclic occurrence of nodules or masses in breast tissue
-Increased risk of breast cancer if atypical cells are present.
- Increased density makes breast self-examination difficult
- Increased cystic masses with caffeine intake

60
Q

Malignant Tumors

Carcinoma of the breast
- Incidence increases after age ___ years
* Most cases in women between ages _________ years
- Most tumors are unilateral
- Earlier onset associated with more aggressive growth
- Different types * Most arise from ductal epithelial cells
- Metastasis occurs via lymph nodes early in the course of the disease.
- Presence of estrogen or progesterone receptors on tumor cells influences treatment

A
  • Incidence increases after age 20 years
  • Most cases in women between ages 50 and 69 years
  • Most tumors are unilateral
  • Earlier onset associated with more aggressive growth
  • Different types * Most arise from ductal epithelial cells
  • Metastasis occurs via lymph nodes early in the course of the disease.
  • Presence of estrogen or progesterone receptors on tumor cells influences treatment
61
Q

Carcinoma of the Breast - Predisposing factors
- First-degree ________ with the disease
- Strong ______ predisposition (BRCA1 and BRCA2)
- Longer and higher exposure to estrogen
- Nulliparous or late first pregnancy
- Lack of exercise
- Smoking
-High _____ diet
- Radiation therapy to the chest
- Cancer of the uterus, ovaries, or pancreas

A
  • First-degree relative with the disease
  • Strong genetic predisposition (BRCA1 and BRCA2)
  • Longer and higher exposure to estrogen
  • Nulliparous or late first pregnancy
  • Lack of exercise
  • Smoking
    -High-fat diet
  • Radiation therapy to the chest
  • Cancer of the uterus, ovaries, or pancreas
62
Q

Carcinoma of the Breast - Signs and symptoms
- Change on __________
- Initial sign—single, small, hard, painless _______
- Later—distortion of breast tissue, dimpled skin, _______ from nipple
- Ultrasound or needle biopsy confirms diagnosis.

A
  • Change on mammogram
  • Initial sign—single, small, hard, painless nodule
  • Later—distortion of breast tissue, dimpled skin, discharge from nipple
  • Ultrasound or needle biopsy confirms diagnosis.
63
Q

Course of breast cancer
- Metastasis occurs by the time the tumor is ______ cm in diameter.
- Axillary lymph node involvement
- Secondary tumors in:
* Bone
* Lung
* Brain
* Liver

A
  • Metastasis occurs by the time the tumor is 1 to 2 cm in diameter.
  • Axillary lymph node involvement
  • Secondary tumors in:
  • Bone
  • Lung
  • Brain
  • Liver
64
Q

Carcinoma of the Breast - Treatment
- Surgery may be a lumpectomy or removal of the ______.
- ___________ may be removed, depending on the stage of the disease.
- Tissue biopsy will determine the presence of specific growth factors to design drug treatment
and chemotherapy.
- Radiation therapy may be done before or after surgery.

A
  • Surgery may be a lumpectomy or removal of the breast.
  • Lymph nodes may be removed, depending on the stage of the disease.
  • Tissue biopsy will determine the presence of specific growth factors to design drug treatment
    and chemotherapy.
  • Radiation therapy may be done before or after surgery.
65
Q

Carcinoma of the Cervix
- Most cases of cervical cancer are caused by ___________ infection, a sexually transmitted virus.
- Vaccines now exist against the causative strains of HPV.
-Routine ___________ of cervical cells are important in identifying early, treatable stages of the disease:
- By age 20 years or in the year that sexual intercourse begins
- At intervals, as advised by health care worker

A
  • Most cases of cervical cancer are caused by human papillomavirus (HPV) infection, a sexually transmitted virus.
  • Vaccines now exist against the causative strains of HPV.
    -Routine Pap smears of cervical cells are important in identifying early, treatable stages of the disease:
  • By age 20 years or in the year that sexual intercourse begins
  • At intervals, as advised by health care worker
66
Q

Carcinoma of the Cervix - Risk factors
- Age < 40 years
- Strongly linked to _____ viral infection (STD)
- Multiple partners
- Sexual intercourse beginning _____________ years
- Smoking
- History of prior STDs

A
  • Age < 40 years
  • Strongly linked to HPV viral infection (STD)
  • Multiple partners
  • Sexual intercourse beginning in early teenage years
  • Smoking
  • History of prior STDs
67
Q

Carcinoma of the Uterus
-Most common in _____________ women
- Early indicator is painless vaginal __________ or spotting

Risk factors
- Age > 50 years
- High-dose _________ hormone treatment without progesterone
- Obesity
- Diabetes

A

Carcinoma of the Uterus
-Most common in postmenopausal women
- Early indicator is painless vaginal bleeding or spotting

Risk factors
- Age > 50 years
- High-dose estrogen hormone treatment without progesterone
- Obesity
- Diabetes

68
Q

Carcinoma of the Uterus (Cont.)
- ___________ does not detect this cancer
- Usually arises from glandular epithelium
- Relatively slow-growing but is invasive
- Staging of cancer based on degree of localization
- Treatment—surgery and radiation are commonly used.

A
  • Pap smear does not detect this cancer
  • Usually arises from glandular epithelium
  • Relatively slow-growing but is invasive
  • Staging of cancer based on degree of localization
  • Treatment—surgery and radiation are commonly used.
69
Q

Ovarian cancer
- No reliable screening available
* Large ______ detected by pelvic examination
* Transvaginal ultrasound
- Considered a ______ tumor
* Few diagnosed in the early stage
* Research is ongoing to identify markers for serum diagnosis.
- Different types—vary in aggressiveness

A
  • No reliable screening available
  • Large mass detected by pelvic examination
  • Transvaginal ultrasound
  • Considered a silent tumor
  • Few diagnosed in the early stage
  • Research is ongoing to identify markers for serum diagnosis.
  • Different types—vary in aggressiveness
70
Q

Ovarian Cancer (Cont.)

Risk factors
- Obesity
-BRCA1 _____
- ______ menarche
- Nulliparous or late first pregnancy
- Use of fertility drugs

-Oral contraceptives containing progesterone are somewhat protective.
- Surgery and chemotherapy are usual treatments.

A

Risk factors
- Obesity
-BRCA1 gene
- Early menarche
- Nulliparous or late first pregnancy
- Use of fertility drugs

-Oral contraceptives containing progesterone are somewhat protective.
- Surgery and chemotherapy are usual treatments.

71
Q

Infertility
- Cause may be a female condition, male condition, or a combination of both
- Associated with __________ imbalances
-Age of ___________
- Structural abnormalities
-Infections
- Chemotherapy
- Workplace toxins
- Other environmental factors
- Idiopathic

A
  • Cause may be a female condition, male condition, or a combination of both
  • Associated with hormonal imbalances
    -Age of parents
  • Structural abnormalities
    -Infections
  • Chemotherapy
  • Workplace toxins
  • Other environmental factors
  • Idiopathic
72
Q

(STDs): Bacterial

Chlamydial infections
- Considered one of the most _____________
- Caused by Chlamydia trachomatis

Males—urethritis and epididymitis
* Symptoms include dysuria, itching, white discharge from penis (urethritis symptoms)
* Painful, swollen scrotum, usually unilateral, fever (epididymitis); inguinal lymph nodes swollen

Females
* Often __________ until PID or infertility develops
* Newborns may be infected during birth.

A

Chlamydial infections
- Considered one of the most common STDs
- Caused by Chlamydia trachomatis

Males—urethritis and epididymitis
* Symptoms include dysuria, itching, white discharge from penis (urethritis symptoms)
* Painful, swollen scrotum, usually unilateral, fever (epididymitis); inguinal lymph nodes swollen

Females
* Often asymptomatic until PID or infertility develops
* Newborns may be infected during birth.

73
Q

(STDs): Bacterial (Cont.)

Gonorrhea
- Caused by Neisseria gonorrheae
* Many strains have become resistant to penicillin and tetracycline.

Males
* Most common site is _______, which is inflamed
* Some males are asymptomatic.

Females
* Frequently ___________
* PID and infertility are serious complications.

  • May infect the eyes of the newborn, causing irreversible damage and blindness
  • May spread systemically to cause septic arthritis
A

Gonorrhea
- Caused by Neisseria gonorrheae
* Many strains have become resistant to penicillin and tetracycline.

Males
* Most common site is urethra, which is inflamed
* Some males are asymptomatic.

Females
* Frequently asymptomatic
* PID and infertility are serious complications.

  • May infect the eyes of the newborn, causing irreversible damage and blindness
  • May spread systemically to cause septic arthritis
74
Q

STDs: Syphilis is Caused by Treponema pallidum, a spirochete

Primary stage
-Presence of chancre at site of infection
* Genital region
* Anus
* Oral cavity
-Painless, firm, ulcerated _______
- Occurs about 3 weeks after exposure
- Lesion heals spontaneously but client is still contagious

A

-Presence of chancre at site of infection
* Genital region
* Anus
* Oral cavity
-Painless, firm, ulcerated nodule
- Occurs about 3 weeks after exposure
- Lesion heals spontaneously but client is still contagious

75
Q

STDs: Syphilis (Cont.)

Secondary stage
-If untreated, a _______ illness occurs, with a widespread symmetrical rash—self-limited but client remains contagious

Latent stage
- May persist for ______
-Transmission may occur.
- Tertiary syphilis—irreversible changes
- Gummas in organs and major blood vessels
- Dementia, blindness, motor disabilities

A

Secondary stage
-If untreated, a flulike illness occurs, with a widespread symmetrical rash—self-limited but client remains contagious

Latent stage
- May persist for years
-Transmission may occur.
- Tertiary syphilis—irreversible changes
- Gummas in organs and major blood vessels
- Dementia, blindness, motor disabilities

76
Q

STDs: Syphilis (Cont.)
- Organism can be transmitted to fetus in _______
- Baby born with tertiary syphilis changes that are not reversible
- Treatment is usually ____________ drugs.
- Increase in antibiotic resistant strains causing an increase in prevalence

A
  • Organism can be transmitted to fetus in utero
  • Baby born with tertiary syphilis changes that are not reversible
  • Treatment is usually antimicrobial drugs.
  • Increase in antibiotic resistant strains causing an increase in prevalence
77
Q

STDs: Viral Infections

Genital herpes—herpes simplex
- Caused by HSV-2 or HSV-1
* HSV-1 possible with oral sex
- Lesions similar to HSV-1
- Recurrent outbreaks of blister-like ________ on the genitalia
* Preceded by tingling or ________ sensation
* _________ are extremely painful.
- After acute stage, virus migrates back to dorsal root ganglion
- Infectivity greater when symptoms are present

A

Genital herpes—herpes simplex
- Caused by HSV-2 or HSV-1
* HSV-1 possible with oral sex
- Lesions similar to HSV-1
- Recurrent outbreaks of blister-like vesicles on the genitalia
* Preceded by tingling or itching sensation
* Lesions are extremely painful.
- After acute stage, virus migrates back to dorsal root ganglion
- Infectivity greater when symptoms are present

78
Q

STDs: Genital Herpes (Cont.)

___________ is common and may be associated with:
- Stress
- Illness
- Menstruation
- Antiviral drugs are used for treatment and prevention of transmission.
- Infection is considered lifelong.

A

Reactivation is common and may be associated with:
- Stress
- Illness
- Menstruation
- Antiviral drugs are used for treatment and prevention of transmission.
- Infection is considered lifelong.

79
Q

STDs: Viral Infections (Cont.)

Condylomata acuminata—genital warts
- Caused by _____
- Incubation period may be up to 6 months
- Disease may be asymptomatic
- Warts vary in appearance.
- Warts can appear wherever contact with _______ has occurred.
- Warts can be removed by different methods.
- May predispose to cervical or vulvar cancer

A
  • Caused by HPV
  • Incubation period may be up to 6 months
  • Disease may be asymptomatic
  • Warts vary in appearance.
  • Warts can appear wherever contact with virus has occurred.
  • Warts can be removed by different methods.
  • May predispose to cervical or vulvar cancer
80
Q

STDs: Viral Infections (Cont.)

Trichomoniasis
-Caused by Trichomonas vaginalis, a protozoan _________
-Localized infection

Men
* Usually asymptomatic

Women
* May be subclinical
* Flares up when _______ balance in vagina shifts
* Causes intense itching

-Systemic treatment necessary for both partners

A

Trichomoniasis
-Caused by Trichomonas vaginalis, a protozoan parasite
-Localized infection

Men
* Usually asymptomatic

Women
* May be subclinical
* Flares up when microbial balance in vagina shifts
* Causes intense itching

-Systemic treatment necessary for both partners

Pathophysiology (23 decks)

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