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Pathophysiology 212 > Disorders of the Female Reproductive System > Flashcards

Disorders of the Female Reproductive System Flashcards

1
Q

Disorders of the Uterine Cervix: Cervical Cancer (Risk Factors)

A

Risk Factors

  • Linked to Human Papilloma Virus (HPV) infection
  • Smoking
  • Dietary/nutritional
  • Early age of first sexual intercourse/contact
  • Family history
  • Immunodeficiency
  • Multiparity
  • Oral contraceptives
  • h/o chlamydial or herpes virus infection
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2
Q

Cervical Cancer : Pathogenesis & Manifestations

A

Pathogenesis

  • Cell dysplasia can be pre-cancerous (Pap smear)
  • Long latent period but rapid once starting
  • Squamous cell carcinoma most common

Manifestations

  • Abnormal vaginal bleeding, spotting, discharge (increased after intercourse)
  • Pain (pelvic, back, leg)
  • Hematuria, fistulas
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3
Q

Treatment of Cervical Cancer

A
  • Removal of lesion
  • Surgical removal of organs
  • Radiation
  • Chemo-radiation
  • Chemotherapy
  • Brachytherapy (inplant medication right into the cervix)
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4
Q

Pelvic Inflammatory Disease

A
  • Involves upper reproductive tract
  • Uterus to fallopian tubes to ovaries
  • Caused by polymycrobial sexually transmitted organisms
  • And more rarely, endogenous organisms
Risk Factors
- 16-24 years old
- Multiparity
- Multiple sexual partners
- h/o PID, IUD use 
risk for PID is enhanced during menstruation
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5
Q

Pelvic Inflammatory Disease Manifestations

A
  • Lower abdominal pain (just after menstruation)
  • Cervical pain on manipulation
  • Purulent discharge
  • Bleeding (especially if on oral contraceptives)
  • Fever
  • Elevated WBC, ESR, CRP
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6
Q

Endometriosis

A
  • Cells from the lining of the uterus flourish elsewhere
  • Ectopic
  • Cause is unknown, but 10-15% of premenopausal women have this
    > Common sites for growth:
    1. Ovary
    2. Rectum
    3. Uterus
    4. bladder
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7
Q

Endometriosis Risk Factors and Manifestations

A

> Risk Factors

  • Early/altered menarche
  • Postponed childbearing
  • Familial
  • Dysmenorrhea (painful menstruation)

> Manifestations
- Pain: pelvic, back, micturition, & defecation d/t bleeding during menstruation
- infertility
ovarian cysts

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8
Q

Endometriosis treatment

A
  • Symptomatic (pain)
  • Endometrial suppression
  • Surgical removal
  • Tissue
  • Hysterectomy
  • Hysterectomy & BSO
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9
Q

Endometrial Cancer & Risk factors and manifestations

A
  • Most common Ca of female reproductive tract (adenocarcinoma type)
> Risk Factors
- Post-menopause 
- Estrogen excess
- Nulparity 
- Endometrial hyperplasia (cell changes in the endometrium) 
> Manifestations
- Post menopausal painless bleeding
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10
Q

Disorders of Uterine Support

A
  1. Cystocele
    Herniation of bladder into vagina (difficulty empyting bladder, frequency)
  2. Rectocele
    Herniation of rectum into vagina (discomfort, difficulty defecating)
  3. Uterine prolapse
    Bulging of uterus into vagina (discomfort, irritation of exposed membranes of cervix/vagina)
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11
Q

Ovarian Cysts Manifestations & Types

A
  • Common, but often benign
    > Manifestations
  • discomfort, aching
  • Occasionally can rupture or become infected
    > Types:
    1. Follicle doesn’t burst and release ovum
    2. Luteal cyst (from corpus luteum not dissolving)
    3. Dermoid cyst
  • Benign “teratoma”
  • Skin, hair, bone, nails, teeth, eyes, thyroid tissue
    4. Chocolate cyst (caused by endometriosis)
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12
Q

Polycystic Ovary Syndrome Risks & Pathophysiology

A 
- Affects 5-10% of reproductive aged women
Risks:
- Hormonal changes 
- Chronic anovulation causing amenorrhea
- Obesity

Pathophysiology

  • Follicles develop but don’t ovulate
  • LH levels remain, stimulating androgen production, which stimulates cycle to continue
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13
Q

Polycystic Ovary Syndrome Manifestations

A
  • Menstrual irregularity
  • Hyperandrogenism (male pattern baldness in women)
  • Infertility
  • Hyperinsulinemia/insulin resistance
  • Hypertension
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14
Q

Polycystic Ovary Syndrome Treatment

A
  • Symptom relief
  • Weight loss
  • Oral contraceptives (to control hormonal levels)
  • Spironolactone (inhibits androgen production by adrenal gland)
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15
Q

Ovarian Tumors

A

Benign Tumors (80% are!)

  • Epithelial cell
  • Endometriomas or “chocolate cysts”
  • Fibromas
  • Teratomas/dermoid cyst (serous/sebaceous/hair/teeth)

Functioning tumors: secrete hormones

  • Estrogens: alter menstrual cycle
  • Androgens: cause masculine characteristics
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16
Q

Ovarian Cancer & Risk Factors

A
  • 2nd to endometrial cancer
    Risk Factors
  • Nullparity
  • Older women (usually)
  • Family history of breast or ovarian cancer
  • High mortality rate as vague symptoms are not recognized early
  • Up to 75% have metastasized when diagnosed
17
Q

Ovarian Cancer Manifestations & Treatment

A 
Manifestations
- Often asymptomatic
- Increased abdominal size (ascites)
- Dyspepsia
- Bloating, early satiety 
Treatment
- Total hysterectomy & BSO
- Possible omentum removal
- Chemotherapy
18
Q

Menorrhea

A 
A = absence 
Hypo = scanty
Oligo = infrequent
Poly = frequent
Dys = painful
19
Q

…rrhagia

A

Metro = bleeding between periods

Meno = excessive bleeding

Menometro = heavy bleeding between and during periods

20
Q

Breast Cancer

A
  • Most common female cancer (1 in 9)
  • Normally, BRCA1 or BRCA2 genes suppress tumor growth by repairing DNA that has mutated
  • Mutation of these genes leads to cancer growth
  • Breast cells supplied with extra estrogen or growth factor receptors prone to cancer
21
Q

Breast Cancer Risk Factors

A

Risk Factors (many diagnosed have none!)

  • Increased age
  • Family history/genetic mutation
  • h/o benign breast disease
  • Hormonal changes that influence breast maturation (early menarche, late menopause)
22
Q

Breast Ca Modifibale Risk Factors

A 
Modifiable Risk Factors
- Obesity
- Physical inactivity 
- Postmenopausal hormone therapy
Alcohol use:
2 drinks/day increases risk by 8.5%
5-10% of those diagnosed can be linked to alcohol use)
23
Q

Breast CA detection

A
  • Solitary, painless fixed lesion with poorly defined borders is most common
  • Upper outer quadrant most common
    1. Mamography
    2. Self-examination
    3. MRI
    4. Biopsy
24
Q

Breast Cancer Classification & Tx

A

Classification
- Size/nodal involvement/metastasis

Treatment

  • Surgery (radical, modified)
  • Chemotherapy
  • Radiation therapy
  • Hormonal manipulation
25
Q

Breast Ca Surgery

A
  1. Lumpectomy (wide local excision)
  2. Partial or segmental mastectomy or quadrantectomy
  3. Total mastectomy
  4. Modified radical mastectomy (leave some of the muscle behind)
  5. Radical mastectomy (take all the tissue out)

Pathophysiology 212 (18 decks)

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