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week 3, lec 3 BAD Flashcards

1
Q

typical manifestation of reproductive problems

A

menstruation, pelvic pain, infertility

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2
Q

main causes of reproductive problems

A

abnormal hypothalamic or pituitary function

ovarian dysfunction

disorder of uterus or menstrual outflow

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3
Q

hypothalamic changes causing amenorrhea

which hormone?

A

GnRH pulses altered

which alters progesterone and estrogen cycles then can cause intermittent bleeds

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4
Q

hypothalamic changes causing amenorrhea

what causes?

A

stress (i.e. food, psychology, over exercise)

hyper/hypothyroid (impacts negative feedback loops of GnRH, LH, FSH, estrogen/progesterone)

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5
Q

hypothalamic amenorrhea

A

from stress

(physiologic, eg. overtraining/underrecovery, undernutrition; psychologic);

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6
Q

pituitary changes causing amenorrhea

what hormones?

A

FSH and LH

rarely an adenoma

reduce menses

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7
Q

pituitary changes causing amenorrhea

what causes?

A

prolactinemia (pituitary adenoma- prolactin suppresses FSH/LH similar to lactation)

post-partum necrosis of pituitary gland (Sheehan syndrome)

head trauma

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8
Q

ovarian changes that cause amenorrhea

A

PCOS (androgens and insulin)

premature ovarian failure

ovarian dysgenesis

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9
Q

ovarian insufficiency is AKA

and at what age

A

early menopause

lack of viable follicles prior to 40yoa

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10
Q

what does ovarian insufficiency do to menses and fertility

A

reduced or cessation of menses

lose fertility

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11
Q

causes of ovarian insufficiencies

A

autoimmune, diabetes, hypothalamic, exogenous (i.e. radiation)

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12
Q

levels of hormones in ovarian insufficiency

A

high LH and FSH
low estrogen

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13
Q

ovarian dysgenesis

A

female a birth (phenotypic female)

genotypes causes deletions in X chromosome

can impact pubertal development and cause primary amenorrhea or early ovarian insufficiency

Y chromosome = high risk of gonadal neoplasia

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14
Q

consequences of amenorrhea

A

lack of menses

fertility

osteropororis

CVD function

thinning of estrogen dependent epithelia

inadequate progesterone increases risk of endometrail cancer

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15
Q

dygenesis

A

abnormal or absent development of uterus and vagina from genetic polymorphisms

effects estrogens, androgens, reproductive tissue development

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16
Q

Imperforate hymen or transverse vaginal septum cause

A

amenorrhea

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17
Q

Sherman syndrome (causes amenorrhea)

A

Endometrial adhesions and scarring following vigorous curettage (procedure) or uterine tuberculosis

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18
Q

causes of abnormal uterine bleeding

A

polyp
adenomyosis
lelomyoma
malignancy
iatrogenic (i.e. IUD)
endormtrial
ovulatory
coagulopathy

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19
Q

3 types of benign uterine masses “PAL”

A

endometrial polyps

adenomyosis

leiomyoma (fibroids)

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20
Q

endometrial polyps

A

outgrowths of endometrial tissue into lumen of uterus (or in fallopian tubes)

intermenstural bleeding

possible dysplasia

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21
Q

adenomyosis

A

endometrial glands in myometrium

downward growth of endometrium

heavy and painful bleeds

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22
Q

endometrial polyps vs adenomyosis growth differences

A

polyps- outward growth

adeno- downward growth

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23
Q

leiomyoma is aka

and pathophysio

A

AKA fibroids

tumors of muscle mass in myometrium

heavy bleeds, pelvic pressure

24
Q

endometrial hyperplasia

what happens?

due to?

common in?

A

increase gland: stroma ratio

due to excessive/unopossed estrogen stimulation (without progesterone) {i.e. chronic anovulation from no corpus luteum, androgen in periphery from obesity, estrogen therapy}

common in peri/post menopause

predisposed to malignancy esp if dysplastic cells

25
endometrial carincoma is most common in
uterine tract then progress to endometrial hyperplasia metastases common
26
primary dysmenorrhea definition
painful mesnsturation/ cramps without structural abnormalities
27
why excessive contractions in primary dysmenorrhea
endometrial necrosis stimulates prostaglandins --> myometrial contractions --> muscle hypoxia and irritate pain fibers
28
prostaglandins în primary dysmenorrhea cause pain but also
excess bleeding
29
other common things that go with pain in primary dysmenorrhea
stress and anxiety
30
PMS includes what
non-structural dysmenorrhea plus a range of other potentially endocrine-mediated systemic symptoms estrogen and progesterone cycling on mood, lymphatic function, mammary tissue, digestive function, metabolism, libido
31
endometriosis is
Presence of endometrial tissue outside of the uterine lining (“ectopic”) can be anywhere; myometrium, ovaries (common), pelvic cavity...
32
endometriosis is due to
* * * a) retrograde menstruation through Fallopian tubes into pelvic cavity, and/or b) metaplasia of celomic mesenchyme into endometrial tissue, and/or c) vascular or lymphatic dissemination of endometrial “seeds
33
the tissue in endometriosis still responds to
estrogen and progesterone cycling
34
endometriosis sx and pathophysiology
menses has more pain inflammation and cytokines and angiogenesis cause new blood vessels and pain nerves in endometrial lesions scarring obstruct reproductive pathways and bowerls fertility, endocrine disruption pain, anxiety, stress in CNS
35
pelvic inflammatory disease
acute infection of upper genital tract i.e. mucopurulent secretions (from gonorrhoea), tubo-ovarian abscesses and peritonitis and fever etc
36
sx in PID
not cyclic scarring, adhesions, obstruction of reproductive tract leading to chronic sx and infertility
37
ovarian masses
mostly non-neoplastic i.e. cysts (rupture and cause pain) can be neoplastic and malignant (usually not painful until advanced, can rupture, bleeding, torsion and then cause pain)
38
prolapse
Extrusion of the uterus, anterior vaginal wall with/without bladder, posterior vaginal wall with/without rectum, vaginal apex, or the perineum through the pelvic floor or vaginal introitus
39
what causes prolapse
dysfunction of pelvic floor (esp levator ani)
40
who's prolapse most common in and sx
parous (given birth) or older no pain, but heavy/uncomfortable and incontinence
41
stages of prolapse is based on
degrees in relation to the plane of the hymen: 1: cervix in the lower third of the vagina 2: cervix protrudes through the introitus 3: “procidentia;” entire uterus protrudes past the hymen with eversion of the vagina
42
procidentia
stage 3 of prolapse when entire uterus protrudes past the hymen with eversion of the vagina
43
cervicitis is due to
changing vaginal microbiome, with or without frank infection
44
what can influence the vaginal microbiome to change in cervictiis
cycling homrmone levels can change vaginal pH and flora
45
what cell is present in cervical atypia and dysplasia
squamous cell
46
how to detect CERVICAL ATYPIA AND DYSPLASIA
Pap smear; cytologic exam
47
sx of CERVICAL ATYPIA AND DYSPLASIA
abrnomal bleeding possible
48
cause of CERVICAL ATYPIA AND DYSPLASIA
high risk HPV infection (16 and 18) but also other factors increase risk (smoking, immunosuppression, large # sex partners)
49
how HPV infection causes CERVICAL ATYPIA AND DYSPLASIA
HPV hijacks cervical epithelial cells to make viral particles inactivates tumor suppressor genes lead to local invasion and metastasis
50
vaginitis and vulvitis is from
inflamed epithelium: changes in microbiome (pH, hormones, exogenous like trauma or pathogen) (not necessarily pathological) effect vaginal discharge
51
sx of vaginitis and vulvitis
abnormal sx: pain, pruritic, burn, erythema inflam and ROS
52
infectious vs non-infectious vaginitis
infectious: bacterial vaginosis, vulvovaginal candidiasis, trichomoniasis non-infectious: atrophic vaginitis, allergic vaginitis, foreign body, chemical irritation, desquamative vaginitis, lichen planus
53
atrophy of vagina
thin vaginal epithelium --> irritation, infection and bleeding pre-pubescent or post-menopausal
54
vulvo/vaginal malignancy what type of cell
squamous cell carcinoma cervical atypia --> dysplasia vulvar/vaginal intraepithelial neoplasia
55
types of contraception
surgical sterilization hormonal: i.e. IUD, cervical ring, pill, implant, patch barrier: diaphragm, condoms spermicide: lube, sponge fertility awareness (temp) emergency contraception
56
hromonal contraception affect hormones
progesterone influence to thin endometrium, thicken cervical mucus and negatively impact FSH/LH secretion
57
fertility awareness is
Body temperature = cervical position and mucus + LH levels + knowledge of cycle

BMS250 (52 decks)

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