Exam 4- Reproductive Syndrome Flashcards
Primary dysmenorrhea
Attributed to excessive endometrial prostaglandin production. Elevated levels of prostaglandins cause uterine hypercontractility, decreased blood flow to the uterus, and increased nerve hypersensitivity, thus resulting in pain.
Secondary dysmenorrhea
Secondary dysmenorrhea results from disorders such as endometriosis (the most common cause), endometritis (infection), pelvic inflammatory disease, obstructive uterine or vaginal anomalies, uterine fibroids, polyps, tumors, ovarian cysts, pelvic congestion syndrome, or nonhormonal intrauterine devices (IUDs).
PCOS
No single factor fully accounts for the abnormalities of PCOS. A hyperandrogenic state is a cardinal feature in the pathogenesis of PCOS. However, glucose intolerance/insulin resistance (IR) and hyperinsulinemia often run parallel and markedly aggravate the hyperandrogenic state, thus contributing to the severity of signs and symptoms of PCOS.
Obesity adds to and worsens IR. Excessive androgens affect follicular growth, and insulin affects follicular decline by suppressing apoptosis and enabling follicles, which would normally disintegrate, to survive.
Normal process of follicles
Follicles respond to hormonal signals from the pituitary gland
Follicles enlarge - secrete estradiol
Dominant follicle develops, it secretes higher levels of estradiol
Stimulates the LH surge that comes from the pituitary
LH causes follicle to rupture, releasing the ova
If dominant follicle develops before ovulation, the corpus luteum becomes vascularized and secretes progesterone.
Progesterone arrests development of other follicles in both ovaries in that cycle.
Benign ovarian cysts
Benign cysts of the ovary are produced when a follicle or a number of follicles are stimulated but no dominant follicle develops and completes the maturity process.
HPV
Previous efforts at early screening resulted in many young women receiving treatments on their cervix. These treatments destroyed or removed cervical cells and in many cases altered the structural integrity of the cervix, resulting in an increase in preterm births in women treated without substantially decreasing the later rates of cervical cancer. It is unknown why some women are able to clear HPV infection and others cannot. Smoking has been shown to increase the risks of persistent infection and later development of cervical cancer. Infection with “high-risk” (oncogenic) types of HPV is a necessary precursor to development of the precancerous dysplasia of the cervix that leads to invasive cancer.
STIs
Many infected individuals do not seek treatment because symptoms are absent, minor, or transient or because health services are inaccessible, unaffordable, or culturally insensitive. Urogenital infections caused by Chlamydia closely parallel those caused by gonorrhea.
Cystocele
Cystocele is descent of a portion of the posterior bladder wall and trigone into the vaginal canal and usually is caused by the trauma of childbirth.
Rectocele
Rectocele is the bulging of the rectum and posterior vaginal wall into the vaginal canal. During childbirth women may sustain damage that can lead to a rectocele. Lifelong chronic constipation and straining may produce or aggravate a rectocele.
Spermatoceles
Spermatoceles (epididymal cysts) are benign cystic collections of fluid of the epididymis located between the head of the epididymis and the testis.
Prostatitis
Prostatitis syndromes: (1) acute bacterial prostatitis (ABP), (2) chronic bacterial prostatitis (CBP), (3) chronic pelvic pain syndrome (CPPS), and (4) asymptomatic inflammatory prostatitis.
Acute bacterial prostatitis is an ascending infection of the urinary tract.
Clinical manifestations: Sudden onset of malaise, low back and perineal pain, high fever (up to 40° C [104° F]) and chills is common, as are dysuria, inability to empty the bladder, nocturia, and painful ejaculation.
