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Pathophysiology > Class 6 chapter 40 > Flashcards

Class 6 chapter 40 Flashcards

1
Q

Cervical Cancer risk factors

A 
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

A

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

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3
Q

Cervical Cancer manifestations

A

Abnormal vaginal bleeding, spotting, discharge (intercreased after intercourse)
Pain (pelvic, back, leg)
Hematuria, fistulas

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4
Q

Cervical Cancer treatment

A 
Removal of lesion
Surgical removal of organs
Radiation
Chemo-radiation
Chemotherapy
Brachytherapy
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5
Q

Pelvic Inflammatory Disease

A

Involves upper reproductive tract (Uterus to fallopian tubes to ovaries)
Caused by polymycrobial sexually transmitted organisms (more rarely, endogenous organisms)

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6
Q

Pelvic Inflammatory Disease risk factors

A 
16-24 years old
Multiparity
Multiple sexual partners
H/o PID, IUD use (predisposes to endometritis)
Enhanced during menstruation
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7
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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8
Q

Endometriosis

A

Cells from the lining of the uterus flourish elsewhere
Ectopic
10-15% of premenopausal women have this
Common sites – ovary, rectum, uterus, bladder
Cyst development interferes with blood flow

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9
Q

Endometriosis risk factors

A

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

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10
Q

Endometriosis manifestations

A

Pain (pelvic, back, micturition and defecation)
D/t bleeding during menstruation
Infertility
Ovarian cysts

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11
Q

Endometriosis treatment

A 
Symptomatic (pain)
Endometrial suppression
Surgical removal
- Tissue
- Hysterectomy
- Hysterectomy and BSO
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12
Q

Endometrial Cancer

A

Most common Ca of female reproductive tract (adenocarcinoma type)

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13
Q

Endometrial Cancer risk factors

A

Post-menopause (seldom seen under 40)
Estrogen excess
Nulparity (no pregnancies)
Endometrial hyperplasia

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14
Q

Endometrial Cancer manifestations

A

Post-menopausal painless bleeding

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15
Q

Disorders of Uterine Support

A 
1. Cystocele
Herniation of bladder into vagina
Difficulty emptying 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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16
Q

Ovarian Cysts

A

Common, but often benign

17
Q

Ovarian Cysts manifestations

A

Discomfort, aching

Occasionally can rupture or become infected

18
Q

Ovarian Cysts types

A
  1. Follicle doesn’t burst and release ovum
  2. Luteal cyst (from corpus luteum not dissolving)
  3. Dermoid cyst
    - Benign “termatoma”
    - Skin, hair, bone, nails, teeth, eyes, thyroid tissues etc
  4. Chocolate cyst
    - Caused by endometriosis
19
Q

Polycystic Ovary Syndrome risk factors

A

Hormonal changes
Chronic anovulation causing amenorrhea
Obesity

20
Q

Polycystic Ovary Syndrome pathophysiology

A

Follicles develop but don’t ovulate

LH levels remain, stimulating androgen production, which stimulates cycle to continue

21
Q

Polycystic Ovary Syndrome pathophysiology

A

Follicles develop but don’t ovulate

LH levels remain, stimulating androgen production, which stimulates cycle to continue

22
Q

Polycystic Ovary Syndrome manifestations

A 
Menstrual irregularity
Hyperandrogenism (male hormone)
Infertility
Hyperinsulinemia/insulin resistance
Hypertension
23
Q

Polycystic Ovary Syndrome treatment

A

Symptom relief
Weight loss
Oral contraceptives
Spironolactone (inhibits androgen production by adrenal gland)

24
Q

Ovarian Tumors

A
  1. Benign tumours (80% of all)

2. Functioning tumours (secrete hormones)

25
Q

Benign tumours

A 
More common in younger women
Epithelial cell
Endometriomas or “chocolate cysts”
Fibromas
Teratomas/dermoid cyst
- Serous/sebaceous/hair/teeth
26
Q

Functioning tumors

A

Estrogens: alter menstrual cycle
Androgens: cause masculine characteristics

27
Q

Ovarian Cancer

A

2nd to endometrial cancer

28
Q

Ovarian Cancer risk factors

A

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

29
Q

Ovarian Cancer manifestations

A

Often asymptomatic
Increased abdominal size (ascites)
Dyspepsia (indigestion)
Bloating, early satiety

30
Q

Ovarian Cancer treatment

A

Total hysterectomy and BSO
- Possible omentum removal
Chemotherapy

31
Q

Menorrhea

A

A = Absence
Hypo = Scanty
Oligo = Infrequent
Poly = Frequent (less than 21 days apart)
Dys = painful
- Primary (prostaglandin excess)
- Secondary (from another disease condition causing this)

32
Q

…rrhagia

A 
Metro = bleeding between periods
Meno = Excessive bleeding 
Menometro = Heavy bleeding between and during periods
33
Q

Breast Cancer

A

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

34
Q

Breast Cancer risk factors

A 
Many diagnosed have none
Increased age
Family history/genetic mutation
h/o benign breast disease
Hormonal changes that influence breast maturation (early menarche, late pregnancy or menopause)
35
Q

Breast Cancer modifiable risk factors

A

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)

36
Q

Breast Cancer detection

A

Solitary, painless lesion with poorly defined borders
Upper outer quadrant most common
1. Mamography
2. Self-examination
3. MRI
4. Biopsy
Look for lump, pulled in nipple, dimpling, dripping, redness/rash, skin changes

37
Q

Breast Cancer classification

A

Size/nodal involvement/metastasis

38
Q

Breast Cancer treatment

A

Surgery (radical, modified)
Chemotherapy
Radiation therapy
Hormonal manipulation

39
Q

Breast Cancer surgery

A
  1. Lumpectomy (wide local excision)
  2. Partial or segmental mastectomy or quadrantectomy
  3. Total mastectomy
  4. Modified radical mastectomy (leave some muscle, take as many lymph nodes out as they need to)
  5. Radical mastectomy (take breast, muscle below, lymph nodes)

Pathophysiology (13 decks)

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