Ch.23 – Flashcards

c.Breast development or thelarche is the first sign of puberty. Premature closure of the epiphysis is due to precocious puberty. Absence of menarche by age 15 or 16 is a clinical diagnosis of delayed puberty.

a. Dysmenorrhea is painful menstruation; primary dysmenorrhea is due to release of prostaglandins in ovulatory cycles. Hirsutism is abnormal hairiness. Primary amenorrhea is failure of menarche by the age of 14. Secondary amenorrhea is the absence of menarche for the equivalent of three cycles.

c. Metrorrhagia is irregular flow. Menopause is cessation of menstrual flow or menses. Excessive menstrual flow is menorrhagia. Heavy, irregular flow is menometrorrhagia.

b. Polycystic ovary syndrome is based on two of the following conditions: androgen excess, oligo-ovulation or anovulation, or clinical signs of hyperandrogenism and polycystic ovaries. Signs usually start at puberty and include loss of normal menstrual function. This may be either amenorrhea or dysfunctional uterine bleeding. Hirsutism is common. Obesity is also likely.

c.Bartholin glands are the ducts that lead from the vaginal opening. They may be inflamed by normal floral of the genital area or by sexually transmitted pathogens.

a. Cystocele is the descent of a portion of the posterior bladder wall. Urethrocele is a sagging urethra. A pessary is a removable mechanical device that holds the uterus in position. Uterine prolapse is descent of the cervix or entire uterus into the vaginal canal.

b. Dermoid cysts contain elements from all three germ layers. They are common ovarian neoplasms. Ovarian torsion is rare but is a gynecologic emergency. These women have severe abdominal pain. A corpus luteum cyst occurs because of a hormonal imbalance including low LH and progesterone levels. Follicular cysts can be caused by a transient condition in which the dominant follicle fails to rupture or one or more of the nondominant follicles fails to regress.

c.They develop from smooth muscle and increase from age of 30 through 50 and decrease at menopause. They are more common in black and Asian women.

c.Smoking, Chlamydia infection, HIV infection, immunosuppression, and poor nutrition are factors in cervical cancer development.

c.The scars in urethral stricture are more likely to result from trauma or untreated or severe urethral infections, most often from long-term use of indwelling urinary catheters.

d.Balanitis is inflammation of the glans penis. Priapism is a prolonged erection. Phimosis is a condition in which the foreskin cannot be retracted. Paraphimosis is when the foreskin is retracted and cannot be reduced.

a.Varicocele is dilation of the veins of the spermatic cord. A hydrocele is a collection of fluid within the tunica vaginalis. Spermatocele is a painless diverticulum of the epididymis. Cryptorchidism is a condition of testicular maldescent.

b is a condition in which the testis twists on its cord. There is decreased blood flow. It is common in neonates and boys near puberty. There is no relief with elevation of the scrotum. It is a surgical emergency, and surgery must be done within 6 hours if it cannot be untwisted with manual manipulation.

a. Orchitis is inflammation of the testes often caused after an infection with mumps. Prostatitis is an inflammation of the prostate. Epididymitis is an infection of the epididymis. Testicular torsion is rotation of a testis, which twists blood vessels in the spermatic cord.

d. BPH is a common condition. It may be a problem if there is compression of the urethra. Eighty percent of men will have it before age 80. The prostate increases in size throughout life and is the smallest at birth.

d. The median age is 61 for breast cancer. It has been on the rise since 1950. It is the most common cause of cancer in American women. Early childbirth lowers the risk of having breast cancer.

c. Florid hyperplasia is considered a proliferative breast lesion. Cysts and calcifications that are found in cysts are included in the symptoms of nonproliferative fibrocystic changes.

a. Peyronie disease is a fibrotic condition that causes lateral curvature of the penis during erection. It develops slowly and usually affects middle-aged men. Phimosis and paraphimosis are problems with the foreskin. Orchitis is inflammation of the testes.

c. Pain is the main symptom of epididymitis. There may be pyuria or bacteriuria and urinary symptoms. In young men the cause may be a sexually transmitted organism.

A. The most frequent sites for distant metastasis include lymph nodes, bones, lungs, liver, and adrenals.

c. The three normal processes include erection, emission, and ejaculation.

a. Nonpuerperal hyperprolactinemia or excessive amounts of prolactin in the blood NOT related to pregnancy is the most common cause. This may be caused by any factor that stimulates or overstimulates the pituitary gland.

a. Removal of the ovaries and pituitary gland offers a protective effect. This is not often done, but it has been researched. There are protective effects of early pregnancy. There is increased risk with early menarche and late menopause.

D. The genes linked to breast cancer include TP53, Bcl-2, HER-2Neu, and c-myc.

C. A woman who is nulliparous or has no children is at risk for ovarian cancer.

C. It has an incidence of 32% to 40% and is most common in adolescents or men older than 40. It usually starts as a 2-cm mass in the subareolar area.

C. Prior or concurrent cervical cancer and diethylstilbestrol exposure are linked to vaginal cancer, which is rare.

Secondary sex characteristics have not appeared in girls by age 13 Or menarche has not happened within 5 years of thelarche or by 16 Secondary sex characteristics have not appeared in boys by age 14 enlargement of testes, thin scrotal skin 95% of cases are physiologic aka constitutional (hormonal- or hypothalamic-pituitary-gonadal axis delay) Just slow to mature 5% are caused by some type of disruption of the hypothalamic-pituitary-gonadal axis To treat or not to treat?

Sexual maturation before age 6 in black girls and age 7 in white girls Sexual maturation before age 9 in boys Forms Isosexual precocious puberty- same sex Heterosexual precocious puberty- opposite sex Incomplete precocious puberty HORMONE RESPONSIBLE IS LEPTIN

Painful menstruation associated with prostaglandin release in ovulatory cycles Related to duration and amount of menstrual flow

+Painful menstruation related to pelvic pathology. Something is really wrong here. +Can occur at any time in the menstrual cycle

Failure of menarche and the absence of menstruation by age 14 years without the development of secondary sex characteristics or by age 16 years regardless of the presence of secondary sex characteristics

Absence of menstruation for a time equivalent to three or more cycles or 6 months in women who have previously menstruated

Anatomic defect in the outflow tract Vagina, uterus

Ovarian disorders

Disorder of the anterior pituitary

Disorder of the hypothalamus

Pregnancy Dramatic weight loss Malnutrition or excessive exercise Hypothyroidism Polycystic ovary syndrome Common during early adolescence, perimenopause, pregnancy, and lactation +Clinical manifestations Infertility, vasomotor flushes, vaginal atrophy, acne, osteopenia, hirsutism

Most common cause of cycle irregularities

Lots of Prolactin in the Blood. Milk comes after baby.

+Menstrual irregularity -Anovulatory cycles -Other: tumors, polyps, cysts +Dysfunctional uterine bleeding -Heavy or irregular bleeding without disease -Perimenopause -Hormone imbalances

+Oligo-ovulation or anovulation +Elevated levels of androgens or clinical signs of hyperandrogenism and polycystic ovaries +Leading cause of infertility in United States +Multifactorial -Hyperinsulinism- prevents follicular decline +Dysfunction of follicle development

+Cyclic physical, psychologic, or behavioral changes that impair interpersonal relationships or interfere with usual activities +Occurs in the luteal (postovulatory) phase +Abnormal nervous, immunologic, vascular, and GI tissue response to the normal menstrual cycle (>200 symptoms) +Treatments? ssri's inhibitors its new

+Acute inflammation caused by infection -Can travel through the lymphatic system +May involve any organ of reproductive tract -Salpingitis- fallopian tubes -Oophoritis-ovaries +Sexually transmitted diseases migrate from the vagina to the upper genital tract -Thanks infected sperm +Polymicrobial infection -Microbes ascend from infected cervix to -endometrial tissue; infect uterus and adnexae

+Infection of the vagina +Sexually transmitted pathogens and Candida albicans (Yeast) +Acidic nature of vagina provides some protection -Maintained by cervical secretions, normal flora

+Inflammation or infection of the cervix +Mucopurulent cervicitis (MPC) Pus coming from the cervix

+Inflammation of the female external genitalia +Causes -Contact with soaps, detergents, lotions, hygienic sprays, shaving, menstrual pads, perfumed toilet paper, or nonabsorbing or tight-fitting clothing -Vaginal infections that spread to the labia

+Inflammation of one or both ducts that lead from the vaginal opening to Bartholin glands +Caused by microorganisms that infect the lower female reproductive tract +nflammation narrows the distal portion of the ducts +Leads to obstruction and stasis of glandular secretions

+The bladder, urethra, and rectum are supported by the endopelvic fascia and perineal muscles +The muscular and fascia tissue loses tone and strength with aging

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Bladder and Rectum coming thru the vagina

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+Unilateral +Produced when a follicle or number of follicles are stimulated but no dominant follicle develops and reaches maturity +Follicular cysts +Corpus luteum cysts +Dermoid cysts -Can contain hair, skin, muscle, bone

Commonly called uterine fibroids Benign tumors of smooth muscle cells in the myometrium Cause abnormal uterine bleeding, pain, and symptoms related to pressure on nearby structures

+Islands of endometrial glands surrounded by benign endometrial stroma within the myometrium

+Functioning endometrial tissue implants outside the uterus Can range from the vagina to the lungs +Responds to hormone fluctuations of the menstrual cycle +Causes infertility, pain, dysmenorrhea, dyschezia, and dyspareunia +Possible causes -Retrograde menstruation, spread through vascular or lymphatic systems, stimulation of multipotential epithelial cells on reproductive organs, or depressed Tc cells tolerate ectopic tissue

Hurts when you poop

Hurts when you have sexual intercourse

+Cervical dysplasia +Cervical carcinoma in situ -Top cells have cancer but underlying tissue is ok -Generally a precursor of invasive carcinoma of the cervix +Invasive carcinoma of the cervix +Almost exclusively caused by cervical human papillomavirus (HPV) infection +With early detection and treatment, prognosis is excellent Woman under the age of 26 is most likely to get cervical cancer because there cervix hasn't reached maturity.

+Frequently diagnosed after metastases have occurred +Risk factors: -Women over 40, early menarche, late menopause, nulliparity, and use fertility drugs, p53 tumor suppressor gene abnormalities, and BRCA1 gene alterations +Decreased Risk/Factors -Multiple pregnancies, prolonged lactation, and use of oral contraceptives

+Disorders of desire (inhibited sexual desire, decreased libido) +Vaginismus (involuntary spasm) closed for business +Anorgasmia (orgasmic dysfunction) +Rapid orgasm - Comes fast and done +Dyspareunia (painful intercourse)

+Inability to conceive after 1 year of unprotected intercourse with same partner +Fertility can be impaired by factors in the man, woman, or both +Fertility tests -Structural -Hormonal

Inflammation of the urethra usually but not always caused by a STD Nonsexual origins can be due to urologic procedures, insertion of foreign objects, anatomic abnormalities, or trauma

Fibrotic narrowing of urethra caused by scarring Commonly due to trauma or untreated or severe urethral infections

Inability to retract foreskin from the glans of the penis (distal to proximal)

Inability to replace or cover the glans with the foreskin (proximal to distal)

Bent nail" syndrome Slow development of fibrous plaques (thickening) in the erectile tissue of the corpus cavernosa, causing lateral curvature of penis during erection Occurs in middle-aged men and causes painful erections and intercourse

Condition of prolonged penile erection

+Inflammation of the glans penis +Usually associated with foreskin inflammation (posthitis) Accumulation under the foreskin (smegma) causes irritation of the glans

+Carcinoma of the penis is rare +Mostly squamous cell carcinomas +HPV, smoking +Often diagnosed in men older than age 55

Failure of one or more of the testes to descend from the abdominal cavity into the scrotum

Testis that has strayed from the normal pathway of descent

+Rotation of the testis +The rotation causes the twisting of the blood vessels in the spermatic cord +Painful and swollen testis +Condition may be spontaneous or follow physical exertion or trauma

Acute inflammation of the testis Complication of a systemic disease or related to epididymitis Most commonly related to mumps

Among the most curable of cancers Common in men between ages 15 and 35 Causes painless testicular enlargement 90% is germ cell tumors

+Inflammation of the epididymis +Common in sexually active young men +The pathogenic microorganism reaches the epididymis by ascending the vas deferens from an already infected bladder or urethra

+Enlargement of the prostate gland +Symptoms associated with urethral compression +Relationship to aging +Evaluation -Digital rectal exams -Prostate-specific antigen (PSA) monitoring

+Inflammation of the prostate +Normal protective barriers Urethral length, micturition, and ejaculation +Similar symptoms to BPH -Urinary retention, nocturia, dysuria +Acute bacterial -Fever, chills, lower back pain +Chronic bacterial +Nonbacterial +Prostatodynia -Chronic pelvic pain syndrome

95% of prostate neoplasms are adenocarcinomas and demonstrate peripheral zone growth Prostatic cancer is asymptomatic until its advanced stages Symptoms are similar to BPH

Persistent and sometimes excessive secretion of milky fluid from the breasts of a woman who is not pregnant or nursing Galactorrhea can also occur in men Nonpuerperal hyperprolactinemia Women with galactorrhea also experience menstrual abnormalities Causes hypothyroidism, anterior pituitary disorders, various medications

Fibrocystic changes Sensitive to the menstrual cycle

Epithelial hyperplasia Florid hyperplasia Sclerosing adenosis Complex sclerosing lesion Papillomas

Most common cancer in American women Leading cause of death from ages 40 to 44 Second most common killer after lung cancer First sign- painless lump Ductal carcinoma in situ Controversy on whether lesions progress to infiltrative malignancy Aspirin can actually reduce risk

Overdevelopment of the breast tissue in a man Results from hormone alterations Idiopathic and system disorders, drugs, or neoplasms

Most commonly seen after age 60 Tumors resemble carcinomas of the breast in women Crusting and nipple discharge are common clinical manifestations