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Flashcards in Genitourinary System Deck (121):
1

Differentiation of male and female gonads occurs at:

-6 weeks after fertilization

2

Testes

-production of gametes and sex hormones

3

Epididymis

-conducts sperm from efferent tubules to vas dererens

4

Scrotum

-protects testes, epididymides, spermatic cord

5

Penis

-delivery of sperm to female vagina and elimination of urine

6

Sex Hormones (Male)

-Androgens
(testosterone is primary sex hormone)

7

Pathologies of Male Reproductive System

-prostatitis
-benign prostatic hyperplasia
-prostate cancer
-orchitis
-epididymitis
-testicular torsion
-testicular cancer
-impotence

8

Prostatitis

-inflam/infection of prostate
-acute/chronic
-bacterial/nonbacterial
-preceded by UTI
-more pain than BPH

9

Diagnosis of Prostatitis

-urinalysis
-specimen analysis
-DRE

10

Treatment of Prostatitis

-meds
-TURP (Trans urethral prostatectomy)

11

Acute Prostatitis

-very painful

12

Chronic Prostatitis

-wax/wane over time
-some meds

13

Most Common Type of Prostatitis

-nonbacterial

14

S/Sx of Prostatitis

-table 19-1 (p966)

15

BPH

-benign prostatic hyperplasia
-most common in older men (>50)
-non-malignant enlargement of prostate gland

16

S/Sx BPH

-related to effect on lumen of urethra
-urine retention
-trouble getting flow started
-progress:
--to UTI
--hydroureter
--hydronephrosis
--renal failure
--death

17

Diagnosis of BPH

-history
-palpation
-urodynamic tests

18

Treatment of BPH

-based on level of obstruction
-monitoring
-TURP vs TUIP
-meds
-thermotherapy (microwave/laser to destroy prostate tissue)

19

TUIP

-Transurethra incision of prostate

20

TURP

-transurethral prostatectomy

21

Common Questions for BPH

-do you urinate often (esp at night)?
-trouble starting or continuing urine?
-weak flow of urine or interrupted urine stream?
-feel like bladder not emptying completely?

If yes (and unexplainedLBP, pelvis, hip, upper thigh pain), refer

22

Prostate cancer tends to start:

-at outer edge of prostate
-gets bad before detecting b/c it starts away from urethra (silent for a while)

23

Most common cancer of US males

-prostate cancer

-second most common cause of male death from cancer

24

S/Sx Prostate Cancer

-variable
-lymph nodes in groin
-abdominal swelling
-may show up as urinary S/Sx or constitutional S/Sx
-asymptomatic until well-progressed

25

Prostate Cancer Metastasizes to:

-bone (usually)
-lungs
-liver

26

Prostate Cancer Dx

-DRE
-PSA Serum assay after age 50
-radiologic studies
-biopsy

27

Primary Prevention of Prostate Cancer

-increasing lycopene
-vitamine E
-selenium
-decrease fat in diet

28

RT-PCR

-reverse transcription-polymerase chain

-new test for Prostate Cancer

29

Prostate Cancer Treatment

-observation
-prostatectomy
-radition
-hormonal therapy (orchiectomy)
-pelvic floor rehab after prostate resection

30

BPH Risk Factors

->50 yo
-west (USA)>east
-Black>white
-tobacco>alcohol

31

Prostate Cancer Risk Factors

->50 yo
-USA & Scandinavia
-Black
-Alcohol
-Family History
-high-fat diet
-Environmental Cadmium

32

Epididymitis

-inflammatory condition of epididymis

33

Orchitis

-inflammatory condition of testes

34

Risk Factors for Orchitis & Epididymitis

-sexually active men with multiple partners
-primary infections arising elsewhere in body (esp GU)

35

S/Sx of Orchitis

-low abdominal pain

36

S/Sx Epidiydimitis

-low abdominal
-groin
-hip adductors

37

Treatment of Orchitis & Epididymitis

-NSAIDS
-antibiotics
-bed rest
-scrotal support

38

Orchitis & Epididymitis

-can be associated with pneumonia

39

Testicular Torsion

-abnormal twisting of spermatic cord as testes rotates
-medical emergency (surgery needed to preserve testes within 3 hours)

40

Testicular Torsion often concurrent with:

-congenital abnormalities
-males 8-18 years or neonates

41

S/Sx Testicular Torsion

-abrupt pain
-scrotal swelling
-N/V
-tachycardia

42

Testicular Cancer

-most common cause of cancer in young men
-second most common in 35-39 yo

43

Caues of Testicular Cancer

-unknown
-family history (genetic)

44

S/Sx Testicular Cancer

-painless enlargement of testicle
-lumbar pain
-metastasis to lungs

45

Testicular Cancer Metastases

-lungs
--cough, dyspnea, bloody sputum

46

Early Detection of Testicular Cancer

-testicular self-exam

47

Diagnosis of Testicular Cancer

-palpation
-serumm assays
-US
-radiologic studies

48

Treatment of Testicular Cancer

-removal of mass (radiation, chemo, surgery)
-relapse not common

49

Impotence/ED

-increases with age
-consider Kegel Exercises
-can be warning of ischemic heart disease

50

Vagina

-epithelial cells responsive to hormonal changes
-protection from infection
-permits stretch during coitus/child birth
-self-cleanses

51

Cervix

-neck of uterus
-projects into vagina

52

Uterus

-muscular organ
-anchors nad protects fertilized ovum

53

Fallopian Tubes

-conduct ova from spaces around the ovaries to uterus

54

Ovaries

-produce ova and female sex hormones

55

Sex Hormones (Female)

-estrogens, progesterone, androgens

56

Cancer Screening of Female Reproductive System

-abnormal bleeding
-pelvic pain
-gastrointesintal disturbances
-urinary disturbances
-abnormal swelling
-changes in vulva/vagina
-LBP

57

S/Sx of Endometriosis

-pain
-inflam
-infertility
-rectal bleeding
-fatigue

58

S/Sx Ovarian Cancer

-silent
-vague symptoms (abdominal bloating, discomfort, fatigue, malaise, flatulence, gastritis)
-less common Sx: abn vaginal bleeding, leg pain, low back pain, pelvic pain,

59

Risk Factor of Ovarian Cancer

-Family History

60

Diagnosis of Endometriosis

-laparoscopy
-laparotomy
-US
-MRI (more sensitive)

61

Treatment of Endometriosis

-preservation of fertility
-pain relief
-ovulation inhibition

62

Diagnosis of Ovarian Cancer

-US
-Cervical smear

63

Treatment of Ovarian Cancer

-Surgery (local/regional)
-chemotherapy (adjuvant)
-under investigation (monoclonal antigodies, gene therapy, vaccines)

64

Ovarian Cystic Disease

-most are benign
-most common form of ovarian tumor
-4 Types (S/Sx dep on size/location of cyst)
-

65

S/Sx Ovarian Cystic Disease

-abdominal pressure, pain
-bloating
-painful urination
-bowel movements
-intercourse
-chronic pelvic pain
-episodic pain in abdomen, groin, buttocks, LBP

66

PCOS

-polycystic ovary syndrome

67

PCOS Manifestations

-obesity
-prominent facial/body hair
-severe acne
-thinning hair
-infertility
-dysmenorrhea
-impaired glucose tolerance
-obstructive sleep apnea
-fibrocystic breasts

68

Diagnosis of Ovarian Cystic Disease

-pelvic exam
-ultrasound
-laparoscopy
-lab tests

69

Treatment of Ovarian Cystic Disease

-based on age and Sx

-drainage of cyst
-surgical excision
-hormonal therapy
-DM management techniques

70

Uterine Fibroids

-painful growths of uterus
-primary reason TAH (total abdominal hysterectomy)

71

S/Sx Uterine Fibroids

-pain
-increased bleeding
-urinary frequency
-asymptomatic

72

Treatment of Uterine Fibroids

-meds
-surgery
-fibroid embolization ablation
-diet

73

Most Common Cancer of Reproductive Organs

Uterine Cancer

74

Risk Factors of Uterine Cancer

-age
-HTN
-DM
-Social/lifestyle (exercise is good)

75

S/Sx Uterine Cancer

-abnormal bleeding
-LE swelling

76

Treatment of Uterine Cancer

-BSO (bilateral sypingo-oophorectomy)
-TAH
-Hormonal Therapy
-radiation/chemo

77

Diagnosis of Uterine Cancer

-endometrial sampling
-US

78

Cervical cancer

-pap smear drastically reduced mortality rate
-primary cause: HPV

79

S/Sx Cervical cancer

-abnormal bleeding
-bowel/bladder dysfunction

(Late disease Sx)

80

Cervical cancer Diagnosis

-pap smear
-sentinal lymph node assessment
-CT scan

81

Cervical CancerTreatment

-Excision (local/regional)
-radiation
-chemo

82

Ectopic Pregnancy

-gynecological emergency
-

83

Risk Factors of Ectopic Pregnancy

-fallopian tubes

84

S/Sx Ectopic Pregnancy

-lower abdominal quadrant/pelvic pain
-possible Kehr's sign
-irregular bleeding

85

Diagnosis of Ectopic Pregnancy

-physical exam
-US
-lab tests
-laparoscopy

86

treatment of Ectopic Pregnancy

-laparoscopy
-laparotomy
-possible chemo (to get rid of damaged/abnormal tissue)

87

Kehr's Sign

-Left shoulder pain with splenic irritation
-usually with peritonitis

88

Rupture of Right Ovary refers to

-right shoulder (irritates liver)

89

Effects of Pregnancy

-relaxin
-center of gravity shift
-pressure on vascular structures
-increased cardiac demand/output
-increased need for folic acid

90

Primary Dysmenorrhea Pathophys

-excessive endometrial prostaglandin production

91

S/Sx Primary Dysmenorrhea

-pelvic pain with onset of menses, backage, anorexia, vomiting, diarrhea, syncope, headache

92

Eval/treatment of Primary Dysmenorrhea

-medical Hx
-pelvic exam
-hormonal contraceptives may relieve pn
-TENS to relieve pn

93

PMS Pathophys

-abnormal tissue response to normal change of menstrual cycle triggered by fluctuating estrogen and progesterone levels
-asssociated with genetic predisposition

94

S/Sx PMS

-over 200 physical, emotional, behavioral Sx

95

Pelvic Inflammatory Disease Pathophys

-pelvic infection caused by microbes ascending through cervix to infect uterus

96

S/Sx PID

-range from sudden and severe abdominal pain to no Sx at all, pain onset may be slow and steady or exacerbated by walking, jumping, or intercourse

97

PID

pelvic inflammatory disease

98

PID Eval

-diagnosis based on pt Hx
-Sx
-evidence of infective agents

99

PID Treatment

-bed rest
-avoid intercourse
-antibiotic therapy
-surgery required if pelvic adhesion

100

Breast cancer: more masses in____

-axillary tail than any other part of breast

101

female breast

-function is to provide nourishment for newborn

102

breast nobes

-15-20 per breast

103

nipple

deliver breast milk

104

breast nodules

-20-40 lobules per lobe

105

breast acini

-lined with epithelial cells capable of contracting to secrete milk

106

Sub-areolar structures

-fatty/fibrous tissue
-few duct-like structures in sub-areolar area

107

Fibrocystic Disease & Fibroadenoma

-benign changes/tumors in breast

108

S/Sx of Fibrocystic Disease & Fibroadenoma

-Cysts
-fibrous tissue
-bilateral pain/tenderness
-(especially as menstruation approaches)

109

Risk Factors for Fibrocystic Disease & Fibroadenoma

-age
-menstrual Hx
-pregnancy Hx
-prior breast biposies

110

Diagnosis of Fibrocystic Disease & Fibroadenoma

-physical exam
-mammography
-biopsy
-US

111

Treatment of Fibrocystic Disease & Fibroadenoma

-palliative
-reduce caffeine/xanthines
-low-fat diet
-analgesics
-adequate undergarment support
-synthetic androgen for severe pain
-surgical excision

112

Breast Cancer: Females

-most common female cancer in US
-Same risk factors as Fibrocystic Disease & Fibroadenoma
-6 types of cancer

113

Breast Cancer Etiology
(female)

-has some genetic basse but largely unknown
-estrogen seems to be key factor in promoting disease

114

S/Sx Breast Cancer

-painless lump
-dimpling/retraction of breast
-nipple discharge
-local rash/ulceration
-palpable lymph nodes in axila
-bone pain (metastases in vertebrae)

115

Breast Cancer Diagnosis

-clinical exam
-mammography
-percutaneous needle aspiration
-biopsy
-US
-ductal lavage
-hormone receptor assays

116

Treatment Breast Cancer

-based on stage
-surgery
-radiation
-hormone therapy
-biologic therapy
-biologic therapy
-bone marrow transplantation in cases of metastases

117

Prevention of Breast Cancer

-BSE (breast self-exam) monthly
-periodic dr. performed breast exams
-mammogram every 1-2 years after 40 yo

118

Male Breast Cancer S/Sx

-nipple discharge
-skin retraction
-ulceration of skin over tumor
-axillary node involvement
-pattern of metastases same as females

119

Gynecomastia Pathophys

-overdevelopment of breast tissue in males
-32-40% of male population
-can be made of: fat, glandular or combination

120

Glandular characteristics

-small button or small fingers spreading into chest fat

121

Eval/Treat Gynecomastia

-diagnosis on phyical exam
-monitor for malignancy
-reconstructive surgery