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Pathophys II - Final! > Witwer - Female GU > Flashcards

Witwer - Female GU Flashcards

1
Q

fxn of the menstrual cycle (2)

A

production of oocytes

preparation of uterus for pregnancy

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2
Q

common sx of pre-menstruation (6)

A

acne

tender breasts

bloating

malaise

irritability

mood changes

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3
Q

what is PMS

A

sx of pre menstruation interfere w. normal activities

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4
Q

usual age for menopause

A

45-55 yo

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5
Q

3 components of menstrual cycle

A

hypothalamus/pituitary cycle

ovarian cycle

uterine cycle

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6
Q

hormones involved in the hypothalamus/pituitary cycle

A

GnRH

FSH

LH

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7
Q

3 phases of ovarian cycle

A

follicular

ovulation

luteal

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8
Q

in the follicular phase, granulosa cells proliferate in response to __

and produce __

A

FSH

estradiol

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9
Q

in the follicular phase, __

stimulates theca cells to produce __,

which promotes __ in granulosa cells

A

LH

andorgens

estradiol

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10
Q

in the follicular phase, __

and __ stimulate GnRH,

which stimulates __

and __

A

estradiol and progestins

FSH and LH

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11
Q

in the luteal phase, __ stimulates follicular cell transformation into

__

A

LH

corpus luteum

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12
Q

in the follicular phase, the corpus luteum produces __

and __

A

progesterone and estradiol

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13
Q

progesterone, estradiol, and inhibin are produced by __

and suppress __ (2)

A

granulosa cells

LH and FSH

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14
Q

without fertilization, the __ regresses and the ovarian cycle begins again

A

corpus luteum

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15
Q

3 phases of the uterine cycle

A

menstruation

proliferative

secretory

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16
Q

the __ is critical in initiation and maintenance of all the cycles of menstruation

A

hypothalamus-pituitary-ovarian axis

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17
Q

what is the primary signal in the hypothalamus-pituitary-ovary axis

A

GnRH from hypothalamus

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18
Q

GnRH stimulates the release of __ (2)

from the __

A

FSH and LH

anterior pituitary

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19
Q

what do FSH and LH stimulate (2)

A

gamete (ovum) maturation

hormone production

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20
Q

in embryology, the egg divides into (2)

A

morula

blastocyst

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21
Q

fertilization occurs __ hours after ovulation

and implantation occurs ~ __ days after fertilization

A

12-24 hr

7+ days

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22
Q

day 0 of fertilization/implantation

A

ovulation –> ovary releases oocyte

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23
Q

12-24 hr of fertilization/implantation

A

fertilization → zygote (fertilized egg)

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24
Q

day 2 of fertilization/implantation

A

first cleavage

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25
Q

day 4 of fertilization/implantation

A

morula

8 cell stage

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26
Q

day 5 of implantation

A

blastocyst → inner cell mass

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27
Q

day 8-9 of fertilization/implantation

A

implantation of blastocyst

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28
Q

2 normal variations in positioning/configuration of the uterus

A

version

flexion

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29
Q

tilting of uterus

A

version

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30
Q

bending of body of uterus

A

flexion

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31
Q

position of uterus in regards to normal

A

cession

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32
Q

4 supporting structures of the uterus

A

pelvic diaphragm

urogenital diaphragm/perineal membrane

perineal body

true supporting ligaments

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33
Q

pelvic diaphragm is composed of (3)

A

levator ani

coccygeus

fascia

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34
Q

what are the 3 true supporting ligamentous structures of the uterus

A

transverse (cardinal)

anterior pubocervical

uterosacral

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35
Q

ligament from either side of the cervix to the pelvic walls

A

transverse (cardinal)

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36
Q

ligament from the posterior cervix to the front of the sacrum

A

uterosacral

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37
Q

ligament from the uterus to the pubic symphysis

A

anterior pubocervical

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38
Q

the uterosacral ligament is composed of (3)

A

rectouterine folds

fibrous tissue

muscular fibers

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39
Q

ligaments of the ovary that are not true support structures

A

broad

round

suspensory

peritoneal folds

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40
Q

supporting structure of the bladder

A

pubocervical fascia

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41
Q

mechanism of cystocele

A

weakness of pubocervical fascia → posterior portion of bladder drops down → cystocele

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42
Q

cystocele w. prolapse is usually associated w.

A

childbirth

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43
Q

sx of cystocele

A

stress incontinence

bulge in anterior vaginal wall that is worse w. cough

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44
Q

supporting structures of the uterus and/or vagina weaken

A

uterine prolapse

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45
Q

rectal support structures weaken

A

rectal prolapse

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46
Q

what are the 2 rectal supporting structures

A

sacrum

levator ani

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47
Q

mc oragnisms responsible for STIs

A

neisseria gonorrhea

chlamydia trachomatis

48
Q

ovarian tumors mc arise from __ cells (2)

A

epithelial

germ

49
Q

mc benign ovarian tumors (3)

A

cystadenomas

serous

mucinous

50
Q

malignant ovarian tumor

A

cystadenocarcinoma

51
Q

less common type of ovarian tumor

A

ovarian germ cell tumor

52
Q

the majority of ovarian germ cell tumors are __

and occur in __

A

benign

young females

53
Q

what do ovarian germ cell tumors contain

A

hair

skin

teeth

54
Q

ovarian tumors in pt’s < 45 yo are usually _,

and the mc type is __

A

benign

serous cystadenomas

55
Q

very large tumors that sometimes appear on the news

A

mucinous

56
Q

what are papillary elements of tumors

A

growths on cyst wall

57
Q

on imaging, benign ovarian tumors usually appear (3)

A

thin walls

homogenous fluid

no masses

58
Q

only definitive determination of benign vs malignant ovarian tumor

A

bx

59
Q

what do you think when you see bilateral ovarian tumor

A

malignant

60
Q

rf for malignant ovarian tumors

A

age

nulliparity

BRCA 1 and 2

lynch syndrome

hx of breast ca

postmenopausal estrogen therapy

obesity

61
Q

what do you think when you see, hereditary non-polyposis colorectal ca

A

lynch syndrome

62
Q

ovarian tumors mc metastasize to (2)

A

omentum

perineum

63
Q

60% of ovarian tumors present w. advanced dz; what are 5 signs of advanced ovarian tumor metastasis

A

sister mary joseph sign

malignant ascites

palpable ovarian mass

malignant pleural effusion

tumor marker: CA125

64
Q

menorrhagia definition

A

heavy or prolonged flow

65
Q

spotting/heavy bleeding btw menstrual flow

A

metorrhagia

66
Q

uterus and cervix d.o include (4)

A

menstruation d.o

pregnancy d.o

tumors

infxn

67
Q

d.o of the ovary or adnexa include (3)

A

tumors

endometriosis

PID

68
Q

hormonal d.o include (3)

A

pituitary

ovarian

endogenous

69
Q

the PAP test evaluates

A

appearance of cervical cells

70
Q

on PAP, malignant cells appear (2)

A

enlarged

misshaped nuclei

71
Q

least common gynecologic ca

A

cervical carcinoma

72
Q

majority of cervical carcinomas are

A

squamous cell

73
Q

rf for cervical carcinoma (6)

A

hpv 16 and 18

early onset of sex

multiple partners

smoking

OCP

immunodeficiency

74
Q

mc sx of cervical carcinoma

A

abnormal vaginal bleeding

75
Q

other sx of cervical carcinoma (2)

A

malodorous d.c

ureter blockage from tumor →

post renal failure

76
Q

mc diagnosed gynecologic tumor

A

leiomyoma

77
Q

leiomyoma is same same

A

uterine fibroids

78
Q

leiomyoma is a __

__ muscle tumor

A

benign

smooth

79
Q

2 rf for leiomyoma

A

AA

>30 yo

80
Q

why are fibroids larger in pregnancy

A

they are estrogen dependent

81
Q

sx of fibroids

A

menorrhagia

obstructive delivery

constipation

frequency/urgency/incontinence

+/- infertility

82
Q

dx for fibroids

A

US

MRI

83
Q

tx for fibroids

A

myotomy

hysterectomy

84
Q

what do you think when you see: endometrial glandular tissue w.in the myometrium → enlarged uterus

A

uterine adenomyosis

85
Q

3 sx of uterine adenomyosis

A

pelvic pain

menorrhagia

dysmenorrhea

86
Q

dx for adenomyosis

A

myometrial bx

87
Q

tx for adenomyosis

A

hysterectomy

88
Q

t/f: adenomyosis and endometriosis are caused by the same estrogen sensitive endometrial glandular tissue

A

T!

89
Q

mc malignant gynecologic tumor

A

endometrial carcinoma

90
Q

what do you think when you see post menopausal bleeding

A

endometrial ca

91
Q

rf for endometrial ca

A

prolonged estrogen stimulation

OCPs

92
Q

3 types of endometrial ca

A

adenocarcinoma

adeno-squamous

papillary

93
Q

mc type of endometrial carcinoma

A

adenocarcinoma

94
Q

where does endometrial ca mc spread

A

superiorly into intestines

95
Q

dx for endometrial ca

A

endometrial bx

96
Q

what do you think when you see: functioning uterine glands and stroma outside of the uterus → cyclic bleeding of glandular and stromal elements

A

endometriosis

97
Q

what do you think when you see a 25-59 yo pt w. dysmenorrhea

A

endometriosis

98
Q

mc pathogenesis of endometriosis

A

reverse menses thru tubes

99
Q

common sites of endometriosis

A

ovaries

rectal pouch

fallopian tubes

intestines

100
Q

mc location for endometriosis

A

ovaries

101
Q

sx of endometriosis

A

dysmenorrhea → mc

abnormal bleeding

painful bm during menses

dyspareunia

enlarged ovaries

102
Q

endometriosis increases risk for (3)

A

intestinal obstruction

ectopic pregnancy

infertility

103
Q

dx for endometriosis (2)

A

laparoscopy

tumor marker CA125

104
Q

outer portion of blastocyst that develops into the placenta

A

trophoblastic cells

105
Q

trophoblastic tumors arise from

A

placental tissue

106
Q

hyatidiform mole is same-same

A

molar pregnancy

107
Q

in a molar pregnancy, the fertilized egg does not have __

and does not develop into __

A

maternal DNA

fetal tissue

108
Q

molar pregnancies grow from (2)

A

chorion

placenta

109
Q

4 sx of molar pregnancy

A

vaginal bleeding at 6-16 weeks

severe hyperemesis

enlarged uterus

markedly increased beta HCG

110
Q

tx for molar pregnancy (2)

A

D&C

follow bHCG

111
Q

malignant trophoblastic tumor

A

choriocarcinoma

112
Q

choriocarcinoma mc arise from

A

molar pregnancy (trophoblastic cells)

113
Q

choriocarcinoma can also arise from (2)

A

spontaneous abortion

full term pregnancy

114
Q

sx of choriocarcinoma

A

hemorrhagic lesions → vaginal bleeding

SOB/hemoptysis

CP

multiple lung metastases

elevated bHCG

115
Q

choriocarcinoma mc metastasizes to (3)

A

lungs

vagina

brain

116
Q

tx for choriocarcinoma

A

chemo → great response → low mortality

Pathophys II - Final! (4 decks)

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