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Pathophysiology and Pharmacology 2 > Female Reproductive Health > Flashcards

Female Reproductive Health Flashcards

1
Q

Benign Breast Disease etiology/patho

A 
common in teens & 20s
fibrocystic disease
fibroadenoma
intraductal papilloma 
abscess
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2
Q

proliferative

A

increased cell production = increased risk of cancer

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3
Q

benign breast disease s/s

A

pain
palpable mass
nipple discharge

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4
Q

benign breast disease DX

A

palpation
ultrasound
mammogram
biopsy

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5
Q

benign breast disease TX

A

often not needed
self-breast exam
education

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6
Q

mastitis

A

erythema/inflammation of breast

most common in breast feeding

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7
Q

mastitis trigger

A 
nipple irritation 
tissue trauma
chafing from ineffective infant latch
nipple fissures
yeast infections
fatigue
stress
poor nutrition
plugged milk ducts
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8
Q

mastitis s/s

A 
usually 4-6 wks post birth
local tenderness
swelling
warmth
erythema
pain while breastfeeding
systemic: flue-like symptoms, loss of appetite
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9
Q

mastitis TX

A 
lactation consult (improve BF technique)
analgesics
antipyretics
cold compresses
rest 
healthy diet
lancing (culture if needed)
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10
Q

galactorrhea

A

discharge of milk (or milk-like substance) from breast in absence of pregnancy (or more than 6 mon postpartum in those that did not BF)

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11
Q

galactorrhea causes

A

medications (oral contraceptives, psych meds, codeine, morphine)
pituitary tumors (most common)
thyroid disorders (increased TRH in hypothryoidism)
chronic renal failure (increased prolactin from impaired kidney fx)
neurogenica cause, injury etc

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12
Q

galactorrhea s/s

A 
systemic: headache
weight changes
appetite changes
history of thyroid or endocrine disorders
visual changes
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13
Q

galactorrhea DX

A

prolactin >5x normal

increased T4/TSH

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14
Q

galactorrhea TX

A

dopamin agonist

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15
Q

breast cancer RF

A 
age
gender
family hx of 1st degree relative <50 y/o
BRCA1 or 2 mutation 
menarche <12 
menopause <55
proliferative benign breast disease
high-fat diet
HRT
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16
Q

breast cancer classification

A

estrogen receptors
progesterone receptors
human epidural growth factor receptor 2
BRCA1/2

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17
Q

breast cancer s/s

A 
may be asym
dimpling
inverted nipple
thickening of skin
blood-tinged discharge
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18
Q

benign ovarian cysts types

A

follicular: form when ovum fails to be released during follicular phase
corpus luteal: form in absence of pregnancy, corpus luteum does not dissolve
lutein: form from excessive hCG from multiple gestations or ovarian hyperstiumulation

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19
Q

benign ovarian cyst s/s

A 
pelvic/ab pain
painful intercourse
abnormal menses
ab pressure
polyuria
urgency
ab distension
fullness w/out eating
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20
Q

benign ovarian cysts DX and TX

A

ultrasound/lab

oral contraceptives or laparoscopic removal/drainage for larger cysts

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21
Q

polycystic ovary syndrome PCOS

A

abnormal function of hypothalamic-pituitary-ovarian axis or elevated hormones/androgens causes excessive cysts

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22
Q

PCOS s/s

A 
menstrual dysfunction
anovulation (infertility)
hyperandrogenism (hirsutism &amp; acne)
irregular menses
obesity
metabolic syndrome
diabetes
insulin resistance
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23
Q

PCOS DX and TX

A

endocrine testing
oral contraceptives (hyperandrogenism)
clomiphene (infertility)
meformin (insulin resistance)

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24
Q

ectopic pregnancy

A

any gestation that occurs outside endometrial lining (usually in fallopian tube)

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25
Q

ectopic pregnancy RF

A 
damage to fallopian tubes
previous ectopic preg
smoking
infertility meds
mulitple sex partners
advanced maternal age
history of STD
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26
Q

ectopic pregnancy s/s

A 
triad: ab pain, amenorrhea, vaginal bleeding
dizziness
weakness
fever
vomiting
syncope
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27
Q

ectopic pregnancy DX and TX

A

serum hCG and ultrasound
methotrexate (based on gestational age)
surgery (to prevent rupture)

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28
Q

ovarian cancer

A

unknown cause
most common cause of GYN cancer death
linked to genetics (BRCA) high-fat diet and talc powerders

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29
Q

ovarian cancer s/s

A 
silent
ab bloating
pelvic/ab pain 
frequency
painful intercourse
back pain
constipation 
weight loss
fullness w/out eating
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30
Q

ovarian cancer DX

A

no good screening test exists

CA125 & surgical staging of disease

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31
Q

ovarian TX

A

aggressive debulking surgery
chemo
poor prognosis due to typically advanced disease

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32
Q

abnormal uterine bleeding prepuberty

A

precocious puberty (hypothalamic, pituitary or ovarian in origin)

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33
Q

adolescene ab uterine bleeding

A

anovulatory cycle

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34
Q

ab uterine bleeding reproductive age

A

comp of pregnancy

or porliferations

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35
Q

ab uterine bleeding perimenopause

A

anovulatory cycle
irregular shedding
proliferations

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36
Q

postmenopausal ab uterine bleeding

A

proliferations

endometrial atrophy

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37
Q

dysfuncitonal uterine bleeding

A

hemorrhaging that occurs on noncyclic basis or in abnormal amounts
frequently reported by women (common reason for a hysterectomy)
variety of causes (often an imbalance between estrogen and progesterone)

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38
Q

estrogen causes

A

proliferation of endometrium

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39
Q

progesterone

A

limits and stabilizes endometrial growth

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40
Q

dysfunctional uterine bleeding TX

A

drugs for uterine bleeding
conjugated estrogens w/ medroxyprogesterone
NSAIDS sometimes adjunct therapy

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41
Q

dysfuncitonal uterine bleeding s/s (6 cat)

A 
menorrhagia
intermenstrual bleeding
metrorrhagia
menometrorrhagia
polymenorrhagia
dysmenorrhea
42
Q

dysfunctional uterine bleeding DX adn TX

A

CBC, hCG, testosterone, TSH, ultrasound
NSAIDs, hormone therapy
severe: ablation/hysterectomy

43
Q

amenorrhea

A

abscence of spontaneous menstruation in women of reproductive age
absence by age 15 (primary)
cessation of regular menstruation for at least 3 months not preg/lactation/hormone meds/menopause (secondary)

44
Q

amenorrhea s/s

A

no periods

45
Q

amenorrhea DX and TX

A

pregnancy test, progesterone, LH, FSH
depends on causative factors
psychological treatment (if cause is ex: anorexia, bulimia)

46
Q

dysmenorrhea

A

primary (painful menstrual cycle in absence of pelvic disease)
secondary: result of underlying idsease (PID, endometriosis)
pain increased to prostaglandin levels

47
Q

dysmenorrhea s/s

A

primary: occurs w/in 6 mo of menarche
secondary: usually in 20/30s
high intensity cramping w/ menses
heavy, irregular flow
painful intercourse
vaginal discharge
poor response to analgesics

48
Q

dysmenorrhea DX and TX

A

suspect PID: lab to rule out infection/preg

NSAIDS, oral contraceptives, lifestyle management

49
Q

premenstrual syndrome

A

unknown causes

deficiency/ imbalance of hormones, MG, CA, serotonin etc

50
Q

PMS s/s

A

emotional: mood swings, irritability, withdrawal, poor concentration, insomnia, depression, changes in sexual desire
physical: increased thirst, cravings, breast tenderness, bloating, weight gain, HA, fatigue, swelling of hands/feet, skin/GI problems, ab pain

51
Q

premenstrual syndrome TX

A

diet: add complex CHO/calcium rich foods, avoid sugar, caffeine/alcohol
SSRIs may improve mood
NSAIDs for pain

52
Q

endometrial polyps

A

exact cause unknown
hyperplastic growth of endometrial glands & stoma
may be d/t imbalance of estrogen & progesterone

53
Q

endometrial polyps s/s

A 
abnormal heavy bleeding
ab pain
post-menopausal bleeding
infertility
miscarriage
54
Q

endometrial polyps DX and TX

A

ultrasound, hysteroscopy, biopsy
typically no TX
if symptomatic (bleeding) = surgical removal

55
Q

adenomyosis

A

exact etiology unknown
invasion of glandular endometrial tissue into myometrium
r/t invasive procedures (c-section)

56
Q

adenomyosis s/s

A 
menorrhagia
pelvic pain 
intercourse pain
dysmenorrhea
30-50s
obese
mulitple children
early menses
hx of uterine surgery
57
Q

adenomyosis DX & TX

A

MRI
oral contraceptives
mirena IUD
(goal is to control diameter)

58
Q

leiomyomas (fibroids)

A

exact etiology unknown
estrogen/progesterone promote growth
most common in reproductive years (regress in menopause tho can cause bleeding)

59
Q

leiomyomas (fibroids) s/s

A

pelvic “fullness”
bloating
intercourse discomfort
infertility

60
Q

leiomyomas (fibroids) Dx & TX

A

exam/ultrasound

only TX if symptomatic: surgery

61
Q

endometriosis

A

unkonwn cause
endometrial cells move from uterus and implant outside of uterous
increased incidence w/ 1st degree relative

62
Q

endometriosis s/s

A

pelvic pain before/during menstruation
painful intercourse
infertility
bleeding between menses

63
Q

endometriosis DX and TX

A 
NSAIDs
leuprolid acetate (suppresses ovarian function)
surgical removal (reduces overgrowth of tissue)
64
Q

endometrial cancer

A

most common GYN cancer
starts as endometrial hyperplasia
type 1: estrogen
type 2: non-hormonal (genetics/leiomyomas)
RF: obesity, DM, high-fat diet, increased exogenous estrogen, early menarche, hx anovulation, infertility, nulliparity
if stage 1: excellent survival rate

65
Q

endometrial cancer s/s

A

vaginal bleeding (post-menopausal bleeding)
pelvic pain
pelvic fullness
unintentional weight loss

66
Q

endometrial cancer DX & TX

A

biopsy

surgical removal, chemo,radiation

67
Q

pelvic organ prolapse

A

pelvic floor muscles become weak (age) or injured (childbirth) = organs drop
RF: decreased estrogen, menopause, pelvic tumors, obesity, COPD, chronic constipation, marfans

68
Q

pelvic organ prolapse s/s

A 
sensation of fullness
vaginal spotting
painful intercourse
palpable bulge
frequency
urgency
incontinence
cystocele
rectocele
enterocele
uterine prolapse
69
Q

pelvic organ prolapse DX & TX

A

post-void residual
pessaries (support): vagina/uterus/bladder/rectum
exercises (kegel): PT
surgery

70
Q

exocervix

A

stratified squamous epithelium

71
Q

endocervix

A

columnar epithelium

72
Q

transformation zone

A

transforms columnar epithelium to squamous epithelium (more likely to become cancerous)

73
Q

cervicitis

A

inflammatory conditions associated w/ purulent drainage
infections vs noninfectious
related to STDS

74
Q

cervical cancer

A

3rd most common cancer in woemn
HPV cause
RF: age of first intercourse, multiple sex partners, hx of STD

75
Q

cervical cancer s/s

A

abnormal vaginal bleeding
malodorous discharge
dysuria
lower ab pain

76
Q

cervical cancer DX & TX

A

papsmear, colposcopy, biopsy

surgery radiation chemo

77
Q

vaginitis

A

inflammation of vagina due to change in normal flora

decreased estrogen after menopause

78
Q

vaginitis s/s and DX

A

itching, discharge, malodorous discharge, pain

exam, microscopic ID

79
Q

vaginitis TX

A

ABX
personal hygiene education
perfume/dye free soaps
if atrophic: moisturizing products

80
Q

vulvovestibulitis

A

pain in vestibule (surrounds vaginal opening)

81
Q

vulvovestibulitis s/s & DX

A

pain
redness
burning in vestibule
DX: severe pain w/ pelvic exam

82
Q

vulvovestibulitis TX

A

topical A & D ointment
witch hazel
lidocaine gel
surgery (last resort)

83
Q

bartholinitis

A

inflammation of bartholin gland (lubrication & mucus secretion)
buildup of fluid causes cyst & discomfort

84
Q

batholinitis s/s and DX

A

unilateral mass w/ or w/out pain

physical exam

85
Q

bartholinitis TX

A

excision & drainage
ABX
analgesics
recurrent/extreme: excision of gland

86
Q

vaginal cancer

A

very rare
most often >60 w/ HX of HPV
if squamous: slow spread
adenocarcinoma: likely to mets

87
Q

vaginal cancer s/s

A 
abnormal bleeding
dysuria
painful intercourse
vaginal lump
pain/swelling in legs
88
Q

vaginal cancer DX & TX

A

pap smear, colposcopy, biopsy

surgery radiation chemo

89
Q

vulvar cancer

A

vulvar intraepithelial neoplasia (VIN) r/t HPV
chronic irritation
history of lichen sclerosis
not common <70

90
Q

vulvar cancer s/s

A

lump or sore causing itching (repeated injury)

91
Q

vulvar cancer DX & TX

A

biopsy, imaging

surgery, chemo, radiation

92
Q

causes of infertility

A 
cervix (stenosis or pH imbalance)
uterus (congenital or acquired defects)
ovaries (failure to ovulate most common)
fallopian tubes (abnormalities or drainage)
peritoneum (defects, infection, adhesion, masses)
93
Q

infertility DX

A

failure to conceive after 1 year of unprotected intercourse

94
Q

infertility TX

A

reproductive endocrinology interventions

medications

95
Q

clomiphene

A

selective estrogen receptor modulator
ovulation stimulator
stims relase of LH = increased ovarian follicles acts @ hypothalamus
SE: ovarian enlargement, vasomotor flushes, distention, breath discomfort, multiple births
contra: primary ovarian failure, leiomyomas, ab uterine bleeding, thrombophlebitis, liver disease, intracranial lesions
interx: ospemifene (toxic)
X

96
Q

vaginismus

A 
unknown cuases
vaginal tightness causing discomfort
burning pain
penetrationi problems
inability to have intercourse
pain with intercourse
97
Q

vaginismus TX

A

pelvic floor exercises

psychotherapy if needed

98
Q

Orgasmic dysfunction

A

never orgasm, difficulty reaching orgasm, decreased intensity orgasm
primary: never achieved (genetic or trauma)
secondary: hypoactive sexual desire disorder
TX: psychotherapy

99
Q

dyspareunia

A

painful intercourse, no specific cause

TX: sex education/position changes, lube, psychotherapy (if needed)

100
Q

menopause (climacteric)

A

natural process of aging, permanent cessation of menses
progressive decrease in estrogen secretion by ovaries
s/s: hot flashes, night sweats, irregular menses, bone mass loss

101
Q

consequences of estrogen loss early, mid, post

A

E: mood disturbances, depression, irritability, insomnia, hot flashes, irregular menses, HA
M: vaginal atrophy, increased infections, painful intercourse, skin atrophy, stress urinary incontinence, sexual disinterest
P: atherosclerosis, CV disease, osteoporosis, alzheimer’s like dementia, colon cancer

102
Q

hormone replacement therapy

A

TX unpleasant symptoms of menopause
prevents long-term consequences of estrogen loss
estrogren-progestin combo risks: MI, stroke, breast cancer, dementia, venous thromboembolism BUT less risk of hip fracture/colorectal cancer
estrogen alone: increased risk of stroke/thromboembolism alone

Pathophysiology and Pharmacology 2 (27 decks)

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