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Drug Action II > Block 5: Female Reproductive Phys. > Flashcards

Block 5: Female Reproductive Phys. Flashcards

1
Q

What is the overall function of the female reproductive system?

A
  1. Production of offspring
  2. Production of eggs and hormones
  3. Site for fertilization and delevoping a fetus
  4. Produce milk
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1
Q
A
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2
Q

What is the primary sex organ in females?

A

Ovaries: producing gametes

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3
Q

What are the components of internal genitalia?

A
  1. Ovaries
  2. Duct system (Fallopian tubes, uterus, and vagina
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4
Q

What are the components of external genitalia?

A
  1. Mons pubis
  2. Labia majora
  3. Labia minora
  4. Clitoris
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5
Q

Disorders in the reprosystem may alter what?

A
  1. Menstration
  2. Pelvic pain
  3. Infertility
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6
Q

What are the 5 hormones in females?

A
  1. Estrogen
  2. Progesterone
  3. Gonadotropin-releasing hormone (GnRH)
  4. Follicle-stimulating hormone (FSH)
  5. Luteinizing hormone (LH)
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7
Q

What is the difference between FSH and LH?

A

FSH: Development of oocytes and spermatozoa
LH: Stimulates ovulation and testosterone production

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8
Q

What are the types of breast disorders?

A
  1. Benign Breast Disease (BBD)
  2. Galactorrhea
  3. Mastitis
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9
Q

What is BBD?

A

Benign Breast Disease: All noncancerous ailments of breast tissue

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10
Q

What are the tissues affected by BBD?

A
  1. Stroma
  2. Epithelium
  3. Fat
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11
Q

What are cooper ligaments?

A

Connective tissue that helps shape the breast, dimpling may occur due to growth beneath

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12
Q

What are the types of BBD? Differences?

A

Based on cellular changes of breast tissue:
1. Proliferative: Increase in cell production increasing the risk of developing cancer
2. Nonproliferative: No increase in cellular production with no risk for cancer

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13
Q

What are sx of BBD?

A
  1. Pain in breast: Linked to menstrual cycle or noncyclic pain in postmenopause
  2. Palpable mass: solid or fluid filled
  3. Nipple discharge
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14
Q

What is galactorrhea?

A

Discharge of milk or any milk-like substance from the breast in the absence of pregnancy or beyond a 6-month postpartum period in a woman who did not breastfeed

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15
Q

Characterisitcs of the flow of milk during galactorrhea?

A
  1. Continuous or intermittent
  2. In trace amounts or abundant
  3. Expressible or free flowing
  4. Unilateral or bilateral
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16
Q

What are the causes of galactorrhea?

A

Medications: OC, psychiatric, pain, HTN, herbal supplements
1. Changes in hormones
2. Stimulation of lactotrophs

Tumors: Prolactinoma in pituitary
1. Producing prolactin
2. Blocking dopamine channels

Thyroid Disorders: Hypothyroidism
1. Increasing thyrotropin-releasing hormone (TRH)

Chronic renal failure: Decreases in kidney clearance of prolactin

Neurogenic causes: Breast stimulation during sexual activity

Neonatal galactorrhea: Elevated levels of estrogen in the intrapartum period leading to breast engorgement and lactation in neonates

Injuries: That may cause hyperprolactemia

Idiopathic: Results when breast tissue is particularly sensitive to prolactin in the blood

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17
Q

What are the sx of galactorrhea?

A
  1. Poor growth
  2. Gigantism
  3. Hirsutism
  4. Acne
  5. Amenorrhea
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17
Q

What is mastitis?

A

Localized erythematous and painful inflammation of the breast most often found during breastfeeding

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18
Q

What are the triggers of mastitis?

A
  1. Nipple irritation
  2. Breast tissue trauma
  3. Chafing
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19
Q

What are the sx of mastitis?

A
  1. Local tenderness
  2. Warmth
  3. Swelling
  4. Erythema
  5. Burning
  6. 4-6 weeks after childbirth
  7. Flu like sx
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20
Q

What is the menstrual cycle?

A

Monthly cycle of changes in the ovaries and uterus that produces an ovum

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21
Q

What is menstruation?

A

Endpoint of the menstrual cycle if the egg is not fertilized

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22
Q

What is the function of “the pill?”

A
  1. Stopping ovulation by suppressing FSH and LH
  2. Thinning the uterine lining preventing implantation
  3. Thickening cervical mucus inhibiting sperm from reaching the uterus
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23
Q

What are the types of birth control?

A
  1. LA reversible contraception
  2. SA hormonal
  3. Combined hormonal
  4. Barrier
  5. Emergency contraceptives (Plan B, morning after pill)
  6. Sterilization: Tubul ligation, vasectomy
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24
Q

What are the types of LA reversible contraception?

A

Intrauterine:
1. Hormonal IUD: Releases a progestin hormone (levonorgestrel) into uterus
2. Copper IUD: Prevents sperm from reaching and fertilizing the egg, and it may prevent the egg from attaching in the womb

Implants

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25
Q

What are the types of SA hormonal methods?

A
  1. Progestin injectables
  2. Progestin only pills (mini pill)
26
Q

What are the combined hormonal methods?

A
  1. Combined oral contraceptives (the pill)
  2. Contraceptive patch
  3. Vaginal ring
27
Q

What are the disorders of menstruation?

A
  1. Dysmenorrhea
  2. Amenorrhea
  3. Dysfunctional Uterine Bleeding (DUB)
  4. Premenstrual Syndrome (PMS)
28
Q

What is dysmenorrhea?

A

Release of prostaglandins (PGs) from the endometrial cells of the uterus causing:
1. Uterine contraction of the myometrium
2. Obstruction of blood flow
3. Vasoconstriction

29
Q

What are the types of dysmenorrhea?

A

Primary: Symptoms begin about 6 months after menarche (more painful)
Secondary: Affects patients in their second and third decades of life (tolerable pain)

30
Q

What is amenorrhea?

A

Absence of spontaneous menstruation in a woman of reproductive age

31
Q

What are the types of amenorrhea?

A

Primary amenorrhea: Absence of menarche by age 15
Secondary amenorrhea: Occurs when a patient has had regulatory menstrual cycles and then stops menstruating for at least 3 months in the absence of pregnancy, lactation, cycle suppression, or menopause.

32
Q

Describe the physiology of menstrastion?

A

Physiology of hormones in the menstrual cycle:
1. GRH -> LH and FSH
2. FSH: prepares follicle for ovulation.
3. LH: causes ovulation.
4. Corpus luteum: forms to allow for implantation of fertilized egg.
5. If implantation does not occur within 14 days, the corpus luteum is shed and menstruation begins.

33
Q

What are the causes of primary amenorrhea?

A
  1. PCOS
  2. Eating disorders
  3. Chronic illness
  4. Pregnancy
  5. Ovarian failure
  6. Hypothalamic amenorrhea
34
Q

What are the sx of amenorrhea?

A
  1. Abesence of menstration
  2. Pubertal development (Requires activation of hypothalamic-pituitary-gonadal (HPG) axis)
  3. Vaginal obstruction
35
Q

What is DUB?

A

Dysfunctional Uterine Bleeding: Any abnormal bleeding from the uterus not associated with a physical lesion such as a tumor, inflammation, or pregnancy

36
Q

What is the cause of DUB?

A

Aberrations or irregularity of the menstrual cycle affecting those who just started cycle or perimenopausal

37
Q

What occurs during the luteal phase?

A
  1. Progesterone levels increase
  2. Estrogen, LH, and FSH levels decrease.
  3. If ovum is not implanted, the lining of the uterus is shed.
38
Q

What are the sx of DUB?

A

Bleeding at different times throughout the month:
1. Menorrhagia: Abnormally heavy bleeding.
2. Intermenstrual bleeding: Bleeding that occurs during normal cycles.
3. Metrorrhagia: Irregular and frequent bouts of bleeding that are noncycle related.
4. Menometrorrhagia: Excessive bleeding over a prolonged period of time at irregular intervals.
5. Polymenorrhea: Bleeding that occurs at intervals of 21 days or less.
6. Dysmenorhea: Painful menstruation.
7. Iron deficiency
8. Hormonal imbalance

39
Q

What is menorrhagia?

A

Abnormally heavy bleeding

40
Q

What is intermenstrual bleeding?

A

Bleeding that occurs during normal cycles

41
Q

What is metrorrhagia?

A

Irregular and frequent bouts of bleeding that are noncycle related

42
Q

What is Menometrorrhagia?

A

Excessive bleeding over a prolonged period of time at irregular intervals

43
Q

What is Polymenorrhea?

A

Bleeding that occurs at intervals of 21 days or less

44
Q

What is dysmenorhea?

A

Painful menstration

45
Q

What is PMS?

A

A complex of symptoms affecting women of childbearing age that can cause a variety of physical and psychologic symptoms

46
Q

What are the causes of PMS?

A
  1. Seratonin def
  2. Magnesium and calcium def
  3. Estrogen and progesterone may shift more rapidly.
  4. Lower levels of endorphins may increase discomfort
  5. Low levels of GABA and hypoprolactinemia
47
Q

What are the sx of PMS?

A
  1. Emotional sx
  2. Physical sx
48
Q

How do you diagnose PMS?

A
  1. Must be present for 5 days before the menstrual period begins.
  2. Should persist for at least 3 consecutive menstrual cycles.
  3. Must clearly interfere with normal activities of life.
  4. Must end within 4 days after the menstrual cycle begins.
49
Q

What is the adnexal space?

A

Area between lateral pelvic wall and utterine horns

50
Q

What components of the repro are more vulnerable to disease?

A

Ovaries and fallopian tubes

51
Q

What is adnexa?

A
  1. Ovaries
  2. Fallopian tubes
  3. Broad ligaments
  4. Remnant of embryonic Mullerian duct
52
Q

What are PCOS?

A

Disorder in which metabolism of estrogen and androgen is abnormal, causing many small cysts to grow on the ovaries

53
Q

What are the cuases of PCOS?

A

Abnormal function of the hypothalamic-pituitary-ovarian axis

54
Q

What are the sx of PCOS?

A
  1. Menstrual dysfunction
  2. Anovulation
  3. Signs of hyperandrogenism: Hirsutism: Unwanted male-pattern hair growth on a woman’s face, chest, and back
55
Q

What is endometriotis?

A

The presence and growth of functioning endometrial tissue in places other than the uterus

56
Q

What are the causes of endometriosis?

A
  1. Endometrial cells moving from uterus and implanting in ectopic sites
  2. Transport could be through menstrual tissue
57
Q

What are the common sites of ectopic growth?

A
  1. Fallopian tubes
  2. Vagina
  3. Cervix
  4. Uterosacral ligaments
58
Q

What are the sx of endometriosis?

A
  1. Pelvic pain
  2. Inability to get pregnant
  3. Bleeding between periods
  4. Dysmenorrhea
59
Q

What is infertility?

A

Inability to conceive after having regular unprotected sexual intercourse

60
Q

What is the infertility assessment?

A
  1. After 1 year of regular unprotected intercourse in women under age 35.
  2. After 6 months of unprotected intercourse in women age 35 and older.
  3. May be initiated sooner in women with irregular menstrual cycles or in those who have risk factors for infertility
61
Q

What is the cause of invertility?

A

Multifactorial:
Cervix: Cervical stenosis or abnormalities
Uterus: Congenital or acquired defects
Ovaries: failure to ovulate
Fallopian tubes: Abnormalities and damage to fallopian tubes
Peritoneum: Anatomic defects, infection, adhesions

62
Q

What are the sx of infertility?

A
  1. Changes in the menstrual cycle and ovulation
  2. Hormonal problems
  3. Sx: abnormal or irregular periods
63
Q

What is GBS?

A

Group B Streptococcus (GBS): Bacteria found normally in the intestine, vagina, and rectum of all healthy pregnant women

64
Q

What are the types of pregnancy complications?

A
  1. Group B Streptococcus (GBS)
  2. Bacterial Vaginosis (BV)
65
Q

What is an effective treatment for pregnancy and postpartum for the prevention of relapse in bipolar disorder?

A

Lithium

Drug Action II (28 decks)

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