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NPLEX I (2022) > Repro > Flashcards

Repro Flashcards

1
Q

Male reproductive system embryo

A

mesoderm

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2
Q

Female reproductive system embryo

A

mesoderm, week 7 and 8

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3
Q

What structures develop from surface ectoderm?

A

epidermis, adenohypophysos, lens of eye, epithelial linings of oral cavity, sensory organs of ear, olfactory epithelium, anal canal below the pectinate line, parotid, sweat, mammary gland

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4
Q

Breast embryo

A

first week of development from cytotrophoblast

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5
Q

What structures develop from surface ectoderm?

A

epidermis, adenohypophysos, lens of eye, epithelial linings of oral cavity, sensory organs of ear, olfactory epithelium, anal canal below the pectinate line, parotid, sweat, mammary gland

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6
Q

What structures develop from neural tube (ectoderm)?

A

brain, neurohypophysis, CNS neurons, oligodendrocytes, astrocytes, ependymal cells, pineal gland, retina, spinal cord

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7
Q

What structures develop from neural crest cells (ectoderm)?

A

ELMO PASSES
Enterochromaffin cells, leptomeninges (arachnoid, pia), melanocytes, odontoblasts, PNS ganglia (dorsal root, cranial, and autonomic), adrenal medulla, Schwann cells, Spiral membrane (aorticopulmonary septum), Endocardial cushions, Skull bone

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8
Q

What structures develop from mesoderm?

A

muscle, bone, connective tissue, peritoneum, pericardium, pleura, spleen, cardiovascular structures, lymphatics, blood, wall of gut tube, proximal vagina, kidneys, adrenal cortex, dermis, testes, ovaries, microglia, dura mater, tracheal cartilage

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9
Q

What structure develop from endoderm?

A

gut tube epithelium, most of urethra and distal vagina, lungs, liver, gallbladder, pancreas, eustachian tube, thymus, parathyroid, thyroid follicular and parafollicular cells

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10
Q

Male reproductive system gross anatomy

A

Internal: ductus deferens, seminal vesicle, ejaculatory duct, prostate

External: testes, glans penis,

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11
Q

Female reproductive system gross anatomy

A

External: labia, clitoris, vaginal opening

Internal: ovaries, uterine tubes, uterus, broad ligament, and vagina

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12
Q

Mammary gland structure

A

lobes (12-20) -> lobules -> alveoli -> mammary secretory epithelial cells

Lactiferous ducts: connect all lobes, open into areola to drain milk

Stroma: adipose + fibrous connective tissue (turns into suspensory ligaments of Cooper attach mammary glands to dermis) situated necks to lobes

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13
Q

Breast Structure microanatomy

A

lobes (12-20) -> lobules -> alveoli -> mammary secretory epithelial cells

Lactiferous ducts: connect all lobes, open into areola to drain milk

Stroma: adipose + fibrous connective tissue (turns into suspensory ligaments of Cooper attach mammary glands to dermis) situated necks to lobes

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14
Q

Areola structure

A

4th intercostal space lateral to midclavicular line
sebaceous glands
get bigger in pregnancy
secrete oily substances

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15
Q

Nipple

A

conical in center or areola
no fat, hair, or sweat glands
lactiferous ducts open right into it
made up of circularly arranged smooth muscle fibers

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16
Q

Breast blood supply and innervation

A

A: medial mammary branches, lateral thoracic, thoraocarmial, posterior intercostal

V: axillary and internal thoracic

N: anterior and lateral cutaneous branches of 4-6th intercostal

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17
Q

Ovaries

A

lateral pelvic wall attached by mesovarium and suspensory ligament
produce oocytes, estrogen, and progesterone

Blood: ovarian and ascending branch of uterine

N: ovarian plexus and uterovaginal plexus

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18
Q

Fallopian tube structure, blood, nerve

A

infundibulum -> ampulla -> isthmus

Blood: ovarian and ascending branch of uterine

N: ovarian plexus and uterovaginal plexus

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19
Q

Uterus

A

body, cervix, external os, internal os, uterine cavity, cervical canal
bw bladder and rectum

B: Uterine arteries

N: Inferior hypogastric plexus

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20
Q

Gametogenesis

A
  1. condensation of chromatin strand into visible pairs of chromosomes, cells are duplicated
  2. maternal and paternal copy of the same chromosome finds each other inside the nucleus
  3. attach to each other near the telomere region, cluster to one side of nucleus, genetic material is exchanged
  4. recombination of the four chromatids
  5. dissolution of the synaptonemal complexes
  6. remain dormant until puberty
  7. spindle microtubules attach to homologous pairs of chromosomes and align them along the equator of the spindles
  8. separated towards opposite poles
  9. Cytoplasmic division in females occurs asymmetrically and produces a small polar body and a much larger primary oocyte. In males, the cell division is incomplete and spermatocytes retain a cytoplasmic bridge.
  10. sister chromatids are aligned with the centromeres, they are separated along the spindle fibers to the opposite poles of the cell, four genetically unique haploid cells are produced
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21
Q

Implantation

A

oocyte is fertilized by sperm, cells divide and turn into blastocyst -> travels down fallopian tube and floats around uterus -> implants

low ratio of estrogen to progesterone allow for this

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22
Q

Embryogenesis

A

blastocyst get implanted day 5 -> divide into trophoblast and blastocyst -> trophoblast secrete hCG on day 8 which tells corpus luteum to continue to make estrogen and progesterone-> corpus leutm degrades at 13 weeks and syncytiotrophoblast make progesterone, estriol, human placental lactogen -> 2 weeks blastocyst start to organize into two-layered disc of embryonic cells (epiblast and hypoblast outer layer), amniotic cavity opens between it and trophoblast, hypoblast form yolk sac -> 3 weeks cells divide into 3 layers and become multipotent via gastrulation and forming an privative streak -> create endoderm, mesoderm, ectoderm

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23
Q

testes

A

Lobules, septa, mediastinum of testis, seminiferous tubules (convoluted/straight), rete testis, efferent ductules.

tunica albuginea → lobes → seminiferous tubules and Leydig cells → germinal epithelium → Sertoli cells
Tunica vaginalis

N: Testicular plexus

B: Testicular artery

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24
Q

prostate

A

true internal connective tissue capsule -> a false external capsule-> peripheral and anterior zone -> central zone -> transitional zone

B: internal pudendal artery, inferior vesical artery, middle rectal arteries.

N: pelvic splanchnic nerves

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25
Q

glans penis

A

Root (bulb of penis, crura, ischiocavernosus muscles, bulbospongiosus muscle)
Body (distal parts of corpora cavernosa and corpus spongiosum)
Glans (neck and corona of glans)

Tunica albuginea, deep fascia of penis (Buck’s fascia) and superficial fascia/subcutaneous tissue of penis (Colles’ fascia)

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26
Q

glans penis

A

Root (bulb of penis, crura, ischiocavernosus muscles, bulbospongiosus muscle)
Body (distal parts of corpora cavernosa and corpus spongiosum)
Glans (neck and corona of glans)

Tunica albuginea, deep fascia of penis (Buck’s fascia) and superficial fascia/subcutaneous tissue of penis (Colles’ fascia)

B: internal pudendal artery
N: cavernosal nerves

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27
Q

epididymis

A

Formed by efferent ductules from testis → join together in head and body → become single duct in tail → continues as ductus deferens

B: testicular arteries
N: testicular plexus

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28
Q

Ectocervix microanatomy

A

stratified squamous epithelium, non-keratinized

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29
Q

Transformation zone microanatomy

A

squamocolumnar junction

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30
Q

Endocervix microanatomy

A

simple columnar epithelium

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31
Q

Uterus cell layer type

A

simple columnar epithelium w/ long tubular glands in proliferative phase and coiled glands in secretory phase

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32
Q

Fallopian tube microanatomy

A

simple columnar epithelium, ciliated

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33
Q

Ovary outer surface microanatomy

A

simple cuboidal epithelium, germinal epithelium covering surface of ovary

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34
Q

What is the pathway of sperm during ejaculation?

A 
SEVEn UP
seminiferous tubules
epididymis
vas deferens 
ejaculatory ducts

urethra
penis

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35
Q

Ovary microanatomy

A

thin capsule of simple cuboidal epithelium
tunica albuginea dense layer of connective tissue

cortex: oocytes (round cell, large nucleus surrounded by zona pellucida (glycoprotein) and follicular cells) and ovarian follicles (single layer of cuboidal granulosa cells, theca cells), highly cellular connective tissue
medulla: losse fibroelastic connective tisse, blood vessels, lymphatic vessels

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36
Q

Leydig cells

A

interstitium, endocrine cells, seminiferous tubules

F: secrete testosterone in presence of LH, testosterone production unaffected by temp

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37
Q

Menstrual cycle

A

first 10 days theca cells bind LH and granulosa cells bind FSH → androstenedione and aromatase → aromatase converts androstenedione to 17beta-estradiol → day 10-14 granulosa cells develop LH receptors → follicles grow and ↑estrogen → negative feedback on anterior pituitary → some follicles will stop growing and die off → follicle w/ most FSH receptors becomes dominant → secretes estrogen → pituitary is more responsive to GnRH → ↑ estrogen leads to ↑↑↑FSH ↑↑↑LH → release of oocyte → endometrial lining is shed last for 5 days → ↑ estrogen during day 11-15 thickens endometrium, growth of endometrial glands, spiral arteries grow, and change cervical mucus to allow for sperm → corpus luteum is formed from dominant follicle → theca cell secrete androstenedione →granulosa cells convert it to estrogen, secrete P450scc due to ↓LH and inhibin → ↑ progesterone & inhibin → ↓LH ↓FSH ↓estrogen → endometrium receptive to implantation, spiral ateries longer, uterine gland more mucus → day 15 corpus luteum turn into corpus albicans → ↓estrogen & progesterone → spiral arteries collapse and functional layer sloughs off → mensuration

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38
Q

Spermiogenesis

A

seminiferous tubules
synthesis of BMP8B
spermatogonia (large round nuclei, round) →primary spermatocytes (large nuclei, big cytoplasm, clumps of chromatin) → secondary spermatocytes (divide quickly) → two haploid/early spermatids (small size, round nuclei)→ late spermatids z9small pointed nuclei) → spermatozoa

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39
Q

Oogenesis

A

outer layer of ovary
oogonium → mitosis → primary oocyte → at puberty LH/FSH cause development of a number of follicles → primary oocyte finishing first meiotic division → secondary oocyte → at ovulation it is released to uterus

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40
Q

Ovulation

A

14 days before the next mensural cycle

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41
Q

Physiological changes in cardio in pregnancy

A

↓SVR and ↑ blood volume → ↑SV→ ↑CO→↑ placental prefusion

hemodilution → ↓oncotic pressure → peripheral edema

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42
Q

Estrogen composition

A

ovaries, adrenal cortex, placenta, and fat cells

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43
Q

Physiological changes in GI in pregnancy

A

↓GI motility, ↓ LES tone, gallbladder stasis, constipation, GERD, gallstones

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44
Q

Estrogen regulation

A

FSH/LH, GnRH

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45
Q

Physiological changes in Respiratory system in pregnancy

A

respiratory center stimulation → chronic hyperventilation → mild respiratory alkalosis

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46
Q

Estrogen composition

A

ovaries, adrenal cortex, placenta, and fat cells

cholesterol reaches theca cells → cholesterol desmolase turns it into pregnenolone → 17-hydroxypregenolone → dehydroepiandrosterone → 3beta-hydroxysteroid dehydrogenase converts it into androstenedione → goes to theca cells → aromatase converts to 17beta-estradiol

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47
Q

Physiological changes in Renal in pregnancy

A

vasodilation → ↑renal plasma flow → ↑GFR→ ↓BUN and ↓creatinine
mild glucosuria, proteinuria, hydronephrosis, hydroureter, pyelonephritis

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48
Q

Progesterone composition/formation

A

cholesterol reaches theca cells → cholesterol desmolase turns it into pregnenolone → 3beta-hydroxysteroid dehydrogenase converts to progesterone

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49
Q

Estrogen transport

A

sex-hormone binding globulin

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50
Q

Progesterone composition

A

cholesterol reaches theca cells → cholesterol desmolase turns it into pregnenolone → 3beta-hydroxysteroid dehydrogenase converts to progesterone

cholesterol in granulosa cells → pregnenolone via P450scc → progesterone via 3beta-hydroxysteroid dehydrogenase

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51
Q

Progesterone transport

A

transcortin, albumin

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52
Q

Estrogen composition/synthesis

A

ovaries, adrenal cortex, placenta, and fat cells

cholesterol reaches theca cells → cholesterol desmolase turns it into pregnenolone → 17-hydroxypregenolone → dehydroepiandrosterone → 3beta-hydroxysteroid dehydrogenase converts it into androstenedione → goes to theca cells → aromatase converts to 17beta-estradiol

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53
Q

Estrogen function/effect

A

make ovarian follicles develop and secrete hormones, thicken endometrium and sprout progesterone receptors,
maturation of fallopian tubes, uterus, cervix, vagina, breast, widening of hips, fat on buttocks, hips & thighs, makes blood vessel walls flexible, sustain bone density, lower LDL, ↑osteoblasts, ↑ clotting factors, ↑steroid-binging protein, ↑ acidification and provides food source for lactobacilli

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54
Q

Estrogen regulation

A

FSH/LH, GnRH

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55
Q

Progesterone function/effect

A

maturation of fallopian tubes, uterus, cervix, vagina; skin elasticity, bone strength

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56
Q

Progesterone composition/synthesis

A

cholesterol reaches theca cells → cholesterol desmolase turns it into pregnenolone → 3beta-hydroxysteroid dehydrogenase converts to progesterone

cholesterol in granulosa cells → pregnenolone via P450scc → progesterone via 3beta-hydroxysteroid dehydrogenase

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57
Q

Progesterone transport

A

transcortin, albumin

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58
Q

Progesterone function/effect

A

maturation of fallopian tubes, uterus, cervix, vagina; skin elasticity, ↑lobular development ↓ milk production ↓endometrial growth, ↑endometrial secretion, mucosal secretion become thicken, ↑ total cholesterol, ↑LDL, ↑ Na excretion, ↑ internal temp, ↑ bone growth and strength

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59
Q

Progesterone regulation

A

FSH/LH, GnRH

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60
Q

Testosterone composition/synthesis

A

Leydig cells and some in adrenal cortex
cholesterol → dehydroepiandrosterone (DHEA) →androstenedione → testosterone via 17beta-hydroxysteroid dehydrogenase → dihydrotestosterone via 5 alpha-reductase has effects on cell

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61
Q

Testosterone function/effect

A

enlargement of penis & testes, increased libido, male pattern of hair growth, changes to larynx and vocal folds, growth spurt, closer of plate in puberty, broad shoulders, muscular arms and legs, erythropoiesis

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62
Q

Testosterone transport

A

Sex-hormone binding globulin, albumin

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63
Q

Testosterone regulation

A

GnRH, LH/FSH

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64
Q

Estrogen degradation

A

liver
estradiol → estrone → hydrocylation via CYP1A1 enzymes → 2-OHE2
CYP1B1→ 4-OHE2
CYP3A4→ 16a-OHE2

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65
Q

Progesterone degradation

A

liver

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66
Q

Testosterone degradation

A

metabolized to inactive metabolites in the liver, kidney, gut, muscle, and adipose tissue.

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67
Q

Amenorrhea def

A

absence of mentation in those w/ a uterus
primary: >15 hasn’t had menarche and has secondary sexual characteristic or >13 w/ no menarche or secondary sexual characteristics

secondary: stop having regular cycles for 3 month or 6 mon in those w/ irregular periods

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68
Q

Amenorrhea cause

A

turner syndrome, Mullerian agenesis, imperforate hymen, pregnancy, mesopause, breastfeeding, functional hypothalamic amenorrhea, hyperprolactinemia, PCOS, premature ovarian failure, Cushing syndrome, Hypo or Hyperthyroid

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69
Q

Amenorrhea RF

A

FH, eating disorder, over-exercising, genetics, obesity

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70
Q

Amenorrhea comp

A

hip and wrist fractures, cardiovascular disease,

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71
Q

Amenorrhea clinical

A

loss of period

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72
Q

Anovulation comp

A 
Endometrial hyperplasia
Insulin resistance or type 2 diabetes mellitus
Cardiovascular disease
Venous thromboembolism 
Electrolyte derangements 
Arrhythmias
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73
Q

Anovulation clinical

A

irregular periods, lack of periods, lighter or heavier mensural bleeding, infertility

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74
Q

Dysfunctional Uterine Bleeding def

A

uterine bleeding has changed w/ time and absent ovulation

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75
Q

Dysfunctional Uterine Bleeding cause

A

menopause, imbalance in the sex hormone

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76
Q

Dysfunctional Uterine Bleeding path

A

estrogen continually secreted→ never turns into follicle →progesterone isn’t produced → uterine lining keep growing annd gets sloughed off at irregular intervals →

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77
Q

Dysfunctional Uterine Bleeding comp

A

endometrial hyperplasia and cancer

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78
Q

Dysfunctional Uterine Bleeding clinical

A

painless uterine bleeding, Menstrual bleeding lasting more than 7 days, Menstrual bleeding lasting less than 2 days, Heavy menstrual bleeding, Bleeding or spotting between periods

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79
Q

Menopause/

Perimenopause def

A

entire year has passed since last menstrual period

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80
Q

Dysfunctional Uterine Bleeding path

A

estrogen continually secreted→ never turns into follicle →progesterone isn’t produced → uterine lining keep growing annd gets sloughed off at irregular intervals →

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81
Q

Menopause/

Perimenopause RF

A

female, old age,

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82
Q

Menopause/

Perimenopause comp

A

fracture, cardiovascular disease,

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83
Q

Menopause/

Perimenopause clinical

A

hot flashes, night sweats, trouble sleeping, vaginal dryness, dyspareunia, osteoporosis, high LDL

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84
Q

Ovarian Insufficiency/

Failure def

A

ovaries stop functioning normally before 40

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85
Q

Ovarian Insufficiency/

Failure cause

A

chromosomal abnormalities (Turner syndrome), BRCA1, fragile X syndrome, chemo/radiation, autoimmune

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86
Q

Ovarian Insufficiency/

Failure path

A

few or no follicles → started out w/ few or degraded quickly → can’t respond to LH/FSH
OR
dysfunctional follicles → can’t generate gonadotropins, don’t respond to LH/FSH, or can’t make hormone → can’t respond to LH/FSH

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87
Q

Ovarian Insufficiency/

Failure RF

A

FH, 35-40, folx w/ uterus, genetics

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88
Q

Ovarian Insufficiency/

Failure comp

A

cardiovascular disease, fractures

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89
Q

Ovarian Insufficiency/

Failure clinical

A

missed/infrequent periods, infertility/difficulty, hot flashes, night sweats, vaginal dryness, dyspareunia, osteoporosis, spontaneous pregnancy due to intermittent ovarian function

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90
Q

Balanitis def

A

Inflammation of the glans penis

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91
Q

Ovarian Insufficiency/

Failure path

A

few or no follicles → started out w/ few or degraded quickly → can’t respond to LH/FSH
OR
dysfunctional follicles → can’t generate gonadotropins, don’t respond to LH/FSH, or can’t make hormone → can’t respond to LH/FSH

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92
Q

Balanitis comp

A

May cause Infection (STIs, fungal.candida, viral), trauma, irritants

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93
Q

Balanitis cause

A

inadequate personal hygiene, Candida albicans, Group B and group A beta-hemolytic streptococci, Neisseria gonorrhea, Chlamydia species, chemicals, tetracycline, sulfonamide

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94
Q

Balanitis path

A

oor hygiene, a tight foreskin, and a buildup of smegma serve as a nidus for bacterial and fungal overgrowth which can lead to irritation and inflammation

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95
Q

Balanitis RF

A

Uncircumcised males, obesity, diabetes, nursing home, condom catheters, CHF, nephrosis, reactive arthritis, STI

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96
Q

Balanitis comp

A

May cause Infection (STIs, fungal.candida, viral), trauma, irritants

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97
Q

Balanitis clinical

A

Inflammation, soreness, itchiness, or irritation of the glans, A thick cheesy white discharge under the foreskin (smegma), smell, Tight foreskin cannot retract, Painful urination, Swollen glands near the penis, Sores

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98
Q

Cervicitis def

A

swelling or inflamed tissue of the end of the uterus (cervix)

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99
Q

Cervicitis cause

A

Neisseria gonorrhea, Chlamydia trachomatis, mechanical, and chemical irritants

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100
Q

Cervicitis RF

A

sexually active, don’t use condom

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101
Q

Cervicitis comp

A

pelvic inflammatory disease, abscess formation, chronic pain and infection, ectopic pregnancy, and infertility

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102
Q

Cervicitis clinical

A

purulent or mucopurulent vaginal discharge and intermenstrual or post-coital bleeding, dyspareunia

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103
Q

Cervicitis path

A

infectious or noninfectious agent sets up shop in the uterus → immune system recognize antigen → causes inflammation and destruction of the area

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104
Q

Endometriosis def

A

when endometrial cells grow outside of the uterus

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105
Q

Endometriosis path

A

endometrial cells travel to ovaries, fallopian tubes, uterine ligament via blood caring endometrial cells goes into fallopian tubes →implants or exist via opening in fallopian tube → immune system don’t responds to endometrial implants

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106
Q

Endometriosis RF

A

FH, never been pregnant, early menarche, late menopause

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107
Q

Endometriosis comp

A

adhesions, rupture, ovarian carcinomas

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108
Q

Endometriosis cause

A

retrograde mensuration theory, dysfunction w/ immune system, metaplastic theory, benign metastases theory, extrauterine stem cell theory

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109
Q

Endometriosis path

A

endometrial cells travel to ovaries, fallopian tubes, uterine ligament via blood caring endometrial cells goes into fallopian tubes →implants or exist via opening in fallopian tube→ immune system don’t responds to endometrial implants

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110
Q

Endometritis cause

A

Peptostreptococcus, Peptococcus, Bacteroides, Prevotella, Clostridium, groups A and B Streptococci, Enterococcus, Staphylococcus, Klebsiella pneumoniae, Proteus species, and Escherichia coli

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111
Q

Endometritis cause

A

Peptostreptococcus, groups B Streptococci, Ureaplasma urealyticum, Chlamydia trachomatis, Neisseria gonorrhoeae, tuberculosis

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112
Q

Endometritis RF

A

pregnancy, cesarean section, placental or fetal tissue not removed, hysteroscopy, IUD,

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113
Q

Endometritis comp

A

endomyometritis, peritonitis, salpingitis, oophoritis, Asherman’s syndrome (fibrous band, don’t respond to hormone, infertility, recurring pregnancy loss)

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114
Q

Endometritis cause

A

Peptostreptococcus, groups B Streptococci, Ureaplasma urealyticum, Chlamydia trachomatis, Neisseria gonorrhoeae, tuberculosis

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115
Q

Endometritis path

A

infectious cause get into the endometrium causing inflammation when they reach upper genital tract

childbirth mucus plug breaks allowing bacteria to enter

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116
Q

Endometritis RF

A

pregnancy, cesarean section, placental or fetal tissue not removed, hysteroscopy, IUD,

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117
Q

Orchitis cause

A

viral mumps infection, coxsackie B virus, E. coli

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118
Q

Orchitis path

A

mumps virus spreads to the testis → replicates and causes inflammation

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119
Q

Orchitis RF

A

Sexually active

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120
Q

Orchitis comp

A

atrophy, infertility, reactive hydrocele

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121
Q

Orchitis path

A

mumps virus spreads to the testis → replicates and causes inflammation

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122
Q

Pelvic Inflammatory Disease def

A

infection of upper female reproductive system

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123
Q

Pelvic Inflammatory Disease cause

A

Neisseria gonorrhoeae, Chlamydia trachomatis,

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124
Q

Pelvic Inflammatory Disease path

A

decreased mucus or inability to overcome bacteria w/ mucus, retrograde menstruation, sexual intercourse cause bacteria to get into upper tract → neutrophils, plasma cells, and lymphocytes → damage tubal epithelium → fill with pus → scar tissue is repaired and area w/ damage stick together forming pouches

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125
Q

Pelvic Inflammatory Disease comp

A

infertility, tubo-ovarian abscess, hydrosalpinx, ectopic pregnancy, chronic pelvic pain, Fitz-Hugh Curtis syndrome (inflammation expends into peritoneum and Glisson’s capsule→ adhesions liver to peritoneum)

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126
Q

Pelvic Inflammatory Disease cause

A

Neisseria gonorrhoeae, Chlamydia trachomatis, 30% polymicrobial, vagina or cervix

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127
Q

Pelvic Inflammatory Disease RF

A

sexually active, multiple partners, don’t use condoms

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128
Q

Pelvic Inflammatory Disease clinical

A

no symptoms or pelvic pain, tenderness around the ovaries & fallopian tubes, fever, abnormal vaginal discharge

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129
Q

Pelvic Inflammatory Disease comp

A

infertility, tubo-ovarian abscess, hydrosalpinx, ectopic pregnancy, chronic pelvic pain, Fitz-Hugh Curtis syndrome (inflammation expends into peritoneum and Glisson’s capsule→ adhesions liver to peritoneum, RUQ tenderness)

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130
Q

Pelvic Inflammatory Disease clinical

A

no symptoms or pelvic pain, tenderness around the ovaries & fallopian tubes, fever, abnormal vaginal discharge, cervical motion tenderness

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131
Q

Salpingitis def

A

Inflammation of the fallopian tubes caused by bacterial infection

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132
Q

Salpingitis cause

A

Peptostreptococcus, groups B Streptococci, Ureaplasma urealyticum, Chlamydia trachomatis, Neisseria gonorrhoeae,

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133
Q

Salpingitis path

A

bacteria in the fallopian tube cause immune system to create damage and inflammation

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134
Q

Salpingitis RF

A

sexually active, multiple partners, no condoms, pregnancy, cesarean section, placental or fetal tissue not removed, hysteroscopy, IUD,

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135
Q

Salpingitis comp

A

tubal scarring, adhesions, blockages, ectopic pregnancy’s, infertility

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136
Q

Salpingitis clinical

A

acute: unusual vaginal discharge, abdominal, pelvic, or low back pain, pain during menstruation, ovulation, or sex
chronic: mild or no symptoms

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137
Q

Vaginitis (candidal) def

A

inflammation or infection of the vagina

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138
Q

Vaginitis (candidal) cause

A

Candida albicans

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139
Q

Vaginitis (candidal) path

A

reduction or change of normal vaginal flora → candida can grow

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140
Q

Vaginitis (candidal) RF

A

DM, recent antibiotic use, immunosuppression, high estrogen levels

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141
Q

Vaginitis (candidal) comp

A

septic shock

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142
Q

Vaginitis (candidal) clinical

A 
intense itching
thick white odorless vaginal discharge 
vulvar burning 
dyspareunia
dysuria
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143
Q

Bacterial vaginosis (BV) comp

A

salpingitis and/or endometritis, postsurgical infections, and adverse outcomes in pregnancy, mixed infection

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144
Q

Bacterial vaginosis (BV) clinical

A

discharge thin/homogenous/off white/foul smell,

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145
Q

Bacterial vaginosis (BV) path

A

number of lactobacilli decrease→ ↑pH→ bacterial vaginosis can can proliferate

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146
Q

Cryptorchidism def

A

incomplete/partial descent of testis into scrotal sac

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147
Q

Cryptorchidism path

A

mispositioned testis found in inguinal can

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148
Q

Cryptorchidism RF

A

prematurity, low birth weight, twining, 1st trimester maternal exposure to estrogen, FH, genetic syndromes, disorders of sexual development

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149
Q

Cryptorchidism comp

A

testicular atrophy, infertility, dysfunction, trauma, testicular torsion, germ-cell tumors,

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150
Q

Cryptorchidism clinical

A

asymptomatic, testes absent from scrotal sac

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151
Q

Epispadias def

A

dorsal urethral opening

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152
Q

Epispadias cause

A

hormones, genetics

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153
Q

Epispadias path

A

genital tubercle grows in posterior direction instead of cranial direction

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154
Q

Epispadias RF

A

FH, hormonal disturbances, low androgens, maternal age >35, maternal exposure to environmental toxins

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155
Q

Epispadias comp

A

urinary tract obstruction, UTI, infertility, psychosocial problems

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156
Q

Epispadias clinical

A

difficulty urinating/incontinence

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157
Q

Hypospadias def

A

ventral urethral opening

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158
Q

Hypospadias cause

A

hormones, genetics

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159
Q

Hypospadias path

A

urethral folds along penile urethra do not close properly -> abnormal opening along penile shafts ventral surface

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160
Q

Hypospadias RF

A

FH, hormonal disturbances, low androgens, maternal age >35, maternal exposure to environmental toxins

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161
Q

Hypospadias com

A

urinary tract obstruction, UTI, infertility, psychosocial problems

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162
Q

Hypospadias clinical

A

difficulty urinating/incontinence

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163
Q

Fragile X syndrome cause

A

X-linked Dominant, FMR1

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164
Q

Fragile X syndrome def

A

genetic condition due to changes to FMR1

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165
Q

Fragile X syndrome cause

A

X-linked Dominant, FMR1

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166
Q

Fragile X syndrome path

A

increased number of CGG repeats caused by slipped mispairing, promoter is locked into off

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167
Q

Fragile X syndrome RF

A

FH, genetics,

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168
Q

Fragile X syndrome clinical

A

intellectual disability, delayed speech, delayed motor development, autism, ADHD, seizures, long/narrow face, prominent jaw & forehead, large ears that stick out, males large testes

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169
Q

Imperforate Hymen def

A

the hymen remains intact during development

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170
Q

Imperforate Hymen path

A

hymen central epithelial cells fail to degenerate during fetal development→ during puberty menstrual blood accumulates

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171
Q

Imperforate Hymen comp

A

retrograde menstruation and endometriosis, and/or fertility complications

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172
Q

Imperforate Hymen clinical

A

bulging/bluish hymenal membrane, recurrent menstrual cramps and abdominal or pelvic pain

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173
Q

Klinefelter syndrome def

A

chromosomal male inherits one or more X chromosomes

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174
Q

Klinefelter syndrome cause

A

extra X chromosome

175
Q

Klinefelter syndrome path

A

sperm or egg contains extra x chromosome → meiosis I or meiosis II they don’t sperate→ 2 X in one gamete → ↓Sertoli and Leydig cell function→ ↓testosterone and inhibin→ ↓sperm production, testes maturation, secondary sex characteristics

176
Q

Klinefelter syndrome RF

A

FH,

177
Q

Klinefelter syndrome path

A

sperm or egg contains extra x chromosome → meiosis I or meiosis II they don’t sperate→ 2 X in one gamete → ↓Sertoli and Leydig cell function→ ↓testosterone and inhibin→ ↓sperm production, testes maturation, secondary sex characteristics

178
Q

Klinefelter syndrome clinical

A

hypogonadism, sterile, tall, long legs, short torso, broad hips, gynecomastia, less muscle mass, less facial & body hair, weaker bones, fatigue

179
Q

Paraphimosis def

A

foreskin becomes trapped behind the corona and forms tight band of constricting tissue

180
Q

Paraphimosis path

A

foreskin becomes trapped behind the corona and forms tight band of constricting tissue

181
Q

Paraphimosis RF

A

uncircumcised males

182
Q

Paraphimosis comp

A

pain, infection, and inflammation of the glans penis

183
Q

Paraphimosis clinical

A

erythema, pain, and swelling of foreskin and glans

184
Q

Phimosis def

A

inability to retract the skin (foreskin or prepuce) covering the head (glans) of the penis

185
Q

Phimosis cause

A

Physiologic phimosis: born with tight foreskin at birth and loosens over time
scarring, infection or inflammation, balanitis xerotica obliterans

186
Q

Phimosis path

A

prepuce fits tightly → oily secretion accumulate in preputial sac → build up and irritate skin

187
Q

Phimosis RF

A 
Being uncircumcised.
Diabetes.
Frequent diaper rash as an infant.
Poor hygiene.
Young age.
188
Q

Phimosis path

A

prepuce fits tightly → oily secretion accumulate in preputial sac → build up and irritate skin

189
Q

Phimosis clinical

A

erythema, itching, discharge, or pain with sexual intercourse.

190
Q

Pseudohermaphroditism def

A

person whose gonads are consistent with the chromosomal sex but who has external genitalia of the opposite sex

191
Q

Pseudohermaphroditism cause

A

Congenital adrenal hyperplasia, testosterone during pregnancy, mother ovarian tumors, Aromatase deficiency, gonadal dysgenesis, 5-alpha-reductase deficiency, androgen insensitivity syndrome,

192
Q

Pseudohermaphroditism path

A

problems w/ testes, problems w/ hormone formation, problem using hormones,

193
Q

Pseudohermaphroditism RF

A

exposure to hormones in utero, genetics, FH

194
Q

Pseudohermaphroditism clinical

A

infertility, opposite genitalia

195
Q

Septate Vagina and Uterus def

A

vagina and uterus are divided to create two of each

196
Q

Septate Vagina and Uterus cause

A

genetics

197
Q

Septate Vagina and Uterus path

A

problem in embryonic development

198
Q

Septate Vagina and Uterus RF

A

premature birth, cesarean birth, fetal growth restriction, pre-labor rupture of membranes, placental abruption

199
Q

Septate Vagina and Uterus comp

A

infection, obstruction

200
Q

Septate Vagina and Uterus clinical

A

pain, abnormal vaginal bleeding

201
Q

Turner syndrome def

A

chromosomal disorder affecting females where one X chromosome is completely or partially absence

202
Q

Turner syndrome cause

A

45 X

203
Q

Turner syndrome path

A

nondisjunction in sperm cells following meiosis I or II → egg combines w/ it
mosaicism → nondisjunction during mitosis → leading to mix of 45X and 46XX
→ ↓estrogen

204
Q

Turner syndrome RF

A

genetic, random

205
Q

Turner syndrome path

A

nondisjunction in sperm cells following meiosis I or II → egg combines w/ it
mosaicism → nondisjunction during mitosis → leading to mix of 45X and 46XX
→ ↓estrogen

206
Q

Turner syndrome clinical

A

↑ loss of eggs, ovaries fail to form, preductal coarctation of aorta, bicuspid aortic valve, horseshoe kidney, lymphedema, neck webbing, cyanosis, and skeletal abnormalities, ↑ risk of DM II and hypothyroidism, low-set ears, broad chest, arms turn outward, widely spaced nipples, short stature, infertile, and amenorrhea

207
Q

Erectile dysfunction def

A

inability to develop and maintain a full erection

208
Q

Erectile dysfunction cause

A

stress, performance anxiety, depression, inadequate blood supply, HTN, atherosclerosis, DM, surgery, stoke, trauma, hypogonadism, meds (diuretics, antidepressants, methadone)

209
Q

Erectile dysfunction path

A

low testosterone → low NO

210
Q

Erectile dysfunction RF

A

mental health conditions, obesity, high fat diet, smoking, alcohol

211
Q

Erectile dysfunction comp

A

psychosocial impacts

212
Q

Erectile dysfunction clinical

A

not being able to maintain an erection

213
Q

Hematocele def

A

hemorrhage into the tunica vaginalis space

214
Q

Hematocele cause

A

traumatic or surgical injury or testis tumor

215
Q

Hematocele RF

A

varicocele, Hydrocele

216
Q

Hematocele comp

A

rupture

217
Q

Hematocele clinical

A

a firm and painless scrotal mass

218
Q

Hydrocele def

A

Accumulation of serous fluids between visceral and parietal layer of tunica vaginalis of testis

219
Q

Hydrocele cause

A

Congenital:
Acquired: Orchitis, Wuchereia Bancrofti , trauma (hernia, torsion), tumor

220
Q

Hydrocele path

A

processus vaginalis doesn’t close

221
Q

Hydrocele RF

A

premature babies, injury, STI

222
Q

Hydrocele comp

A

May cause atrophy of testes due to compression, hematocele, calcification

223
Q

Hydrocele clinical

A

Usually painless, may feel heaviness
May cause swelling of scrotum
soft, fluctuant, non-tender fullness in scrotum

224
Q

Spermatocele def

A

cystic mass arising from a dilation of the epididymis, Rete testis, or efferent ductules

225
Q

Spermatocele cause

A

trauma, infection, autoimmune

226
Q

Spermatocele clinical

A

asymptomatic or pain

227
Q

Varicocele def

A

abnormal enlargement of the pampiniform venous plexus in the scrotum

228
Q

Varicocele cause

A

idiopathic, renal cell carcinoma

229
Q

Varicocele path

A

impaired venous drainage → ↑venous pressure → vein dilation in left side → ↑flow of resistance from left testicular vein drainage into left renal vein

230
Q

Varicocele comp

A

infertility, ↓sperm concnration, ↓sperm motility, other side can get affected

231
Q

Varicocele path

A

impaired venous drainage → ↑venous pressure → vein dilation in left side → ↑flow of resistance from left testicular vein drainage into left renal vein

232
Q

Diffuse Cystic Mastopathy (Fibrocystic Breast Disease) RF

A

20-40YO

233
Q

Diffuse Cystic Mastopathy (Fibrocystic Breast Disease) clinical

A

Painful, changes with cycle

234
Q

Diffuse Cystic Mastopathy (Fibrocystic Breast Disease) def

A

changes to breast tissue

235
Q

Diffuse Cystic Mastopathy (Fibrocystic Breast Disease) path

A

acini, stomal fibrosis, calcifications
cells in terminal ductal/lobular epithelium, atypical cells
simple cysts, papillary apocrine changes or metaplasia, stromal fibrosis

236
Q

Diffuse Cystic Mastopathy (Fibrocystic Breast Disease) comp

A

invasive carcinoma

237
Q

Diffuse Cystic Mastopathy (Fibrocystic Breast Disease) comp

A

sclerosing adenosis inc risk of breast cancer

238
Q

Diffuse Cystic Mastopathy (Fibrocystic Breast Disease) clinical

A

bilateral breast pain, tenderness changes with cycle, multiple smooth well-defined mobile lumps usually upper outer quadrant

239
Q

Galactocele path/cause

A

ecretory breast epithelium, prolactin stimulus, and ductal obstruction
Distal obstruction of the terminal duct lobular unit causes proximal focal ductal dilatation

240
Q

Galactocele RF

A

Difficulty in breastfeeding, If breastfeeding is contraindicated and breastmilk is not emptied, oral-contraceptive pill

241
Q

Galactocele comp

A

crystals

242
Q

Galactocele sx

A

lump in her breast
solitary, non-tender, firm, discrete, and freely movable, may or may not be associated with a milky discharge from the nipple

243
Q

Mammary Duct Ectasia def

A

benign (non-cancerous) breast condition that occurs when a milk duct in the breast widens and its walls thicken

244
Q

Mammary Duct Ectasia path

A

inflammation & fibrosis cause blockage in subareloar ducts affected duct becomes dilated and tortuous, either due to breast involution or other factors, and accumulates granular debris with numerous lipid-laden macrophages.

245
Q

Mammary Duct Ectasia RF

A

aging, nipple inversion, obesity, smoking

246
Q

Mammary Duct Ectasia comp

A

obstruction, mastitis

247
Q

Mammary Duct Ectasia sx

A

asymptomatic or nipple discharge ranging from thick to thin, serous, dirty white, yellow, or green and may fluctuate unilateral or palpable mass

248
Q

Mastitis def

A

inflammation of breast tissue

249
Q

Mastitis cause

A

Staphylococcus aureus, Streptococcus spp, milk stasis, vitamin A deficency

250
Q

Mastitis path

A

bacteria from mouth of infant gains entry via cracks or fissure in the nipple -> inflammation and damage

251
Q

Mastitis RF

A

cracked/damaged nipples, poor hygiene, ineffective breastfeeding technique, impaired immunity, diabetes, smoking

252
Q

Mastitis comp

A

abscess formation

253
Q

Mastitis sx

A 
localized, firmness, redness, swelling, heat 
palpable lump 
breast pain 
tender/enlarged  axillary nodes 
fever, malaise, myalgias
254
Q

Traumatic Fat Necrosis def

A

inflammation of adipose tissue in breast leading to loss of oxygen supply

255
Q

Traumatic Fat Necrosis cause

A

breast trauma, fine needle aspiration or biopsy, anticoagulation treatment, radiation, and breast infection

256
Q

Traumatic Fat Necrosis path

A

area of fatty tissue gets damages → lipase releases fatty acids → form complex w/ calcium → saponification → more occurs → calcification →fibrosis via reactive inflammatory components

257
Q

Traumatic Fat Necrosis RF

A

smoking, obesity, and older age, radiation, chemotherapy, and mastectomy

258
Q

Traumatic Fat Necrosis comp

A

infection, need for multiple operations, and breast deformity, pain

259
Q

Traumatic Fat Necrosis sx

A

feels like a firm, round lump or lumps, painless, fixed mass w/ possible skin or nipple retraction

260
Q

Fibroadenoma def

A

benign tumors that arise from periductal stromal tissue

261
Q

Fibroadenoma path

A

overgrowth of cellular & myxoid stroma surrounds & compresses epithelium-lined glandular & cystic spaces w/ age stroma become hyalinized, glandular epithelium atrophies

262
Q

Fibroadenoma RF

A

premenopausal women

263
Q

Fibroadenoma sx

A

asymptomatic
small, well-defined, spherical, painless, solitary, mobile breast mass
older women: mammographic density w/ possible calcification
can increase in size during luteal phase and lactation

264
Q

Lobular Carcinoma def

A

a type of breast cancer that begins in the milk-producing glands (lobules) of the breast

265
Q

Lobular Carcinoma cause

A

BRCA1 and BRCA2, genetic mutations occur in the DNA of breast duct cells

266
Q

Lobular Carcinoma path

A

DNA damage and genetic mutations that can be influenced by exposure to estrogen

267
Q

Lobular Carcinoma RF

A

advanced age, FH, ovarian cancer, estrogen exposure (mulliparity, late 1st pregnancy, early menarche, late menopause), alcohol, absence of breastfeeding, obesity, whites

268
Q

Lobular Carcinoma comp

A

metastasis

269
Q

Lobular Carcinoma sx

A

unilateral, firm, fibrous, rock-hard, palpable, sharp margins
advanced: skin dimpling, nipple retraction

270
Q

Ductal Carcinoma def

A

invasive breast cancer arising terminal ductal lobular unit, most common type in males

271
Q

Ductal Carcinoma cause

A

genetic mutations occur in the DNA of breast duct cells

272
Q

Ductal Carcinoma path

A

DNA damage and genetic mutations that can be influenced by exposure to estrogen

273
Q

Ductal Carcinoma RF

A

advanced age, FH, ovarian cancer, estrogen exposure (multiparty, late 1st pregnancy, early menarche, late menopause), alcohol, absence of breastfeeding, obesity, whites

274
Q

Ductal Carcinoma comp

A

metastases to lymph nodes,

275
Q

Ductal Carcinoma sx

A

bilateral w/ multiple lesions non-palpable

276
Q

Paget disease of the breast def

A

ductal carcinoma extends into lactiferous ducts or nipple & areola

277
Q

Paget disease of the breast sx

A

eczematous skin lesion or persistent dermatitis

278
Q

Paget disease of the breast RF

A

female, 20-30, FH breast cancer,

279
Q

Paget disease of the breast comp

A

breast cancer,

280
Q

Paget disease of the breast sx

A

bloody/serous nipple discharge
breast feels full
eczematous skin lesion or persistent dermatitis

281
Q

Benign Prostatic Hyperplasia def

A

increase in number of cells in the prostate gland

282
Q

Benign Prostatic Hyperplasia cause

A

normal part of aging

283
Q

Benign Prostatic Hyperplasia path

A

↑5 alpha-reductase w/ age → ↑dihydrotestosterone→ prostate cells live longer and multiple

284
Q

Benign Prostatic Hyperplasia RF

A

males, older, >50

285
Q

Benign Prostatic Hyperplasia comp

A

obstruction, bladder hypertrophy, bacterial infection, bladder stones, kidney damage, bladder damage

286
Q

Benign Prostatic Hyperplasia sx

A 
Urgency
Frequency
Nocturia 
Involuntary urination
Urge incontinence 
Urinary hesitancy
Weak stream
Straining 
Leaking after end of urination
Dysuria possible 
Hesitancy, weak stream, sensation of incomplete emptying, double voiding (within 2hrs), straining, post-void dribbling
DRE: Smooth (non-nodular), firm (rubbery), painless enlargement
287
Q

Acute Bacterial Prostatitis def

A

inflammation of the prostate due to bacteria

288
Q

Acute Bacterial Prostatitis cause

A

E. Coli, Klebsiella, proteus

289
Q

Acute Bacterial Prostatitis path

A

infection causes prostate to enlarge and get damaged due to immune response

290
Q

Acute Bacterial Prostatitis RF

A

Young men, BPH, epididymitis, orchitis, urethritis, sexually active, STI, immunocompromised, prostate manipulation, urethral stricture, phimosis

291
Q

Acute Bacterial Prostatitis comp

A

Prostatic abscesses

292
Q

Acute Bacterial Prostatitis sx

A

Sudden onset of fever, severe dysuria, myalgia, malaise
Irritative voiding sx or BOO (oliguria or anuria)
Hematuria, bacteriuria, pyuria
Acutely tender prostate on DRE

293
Q

Chronic Bacterial Prostatitis def

A

Inflammation of the prostate gland that is caused by a bacterial infection and that continues or gets worse over a long period of time

294
Q

Chronic Bacterial Prostatitis cause

A

Escherichia coli

295
Q

Chronic Bacterial Prostatitis path

A

bacteria enters prostate causing infection

296
Q

Chronic Bacterial Prostatitis RF

A

Intraprostatic ductal reflux and prostatic calculi
Other infections (eg, acute epididymitis, urinary tract infections)
Phimosis
Unprotected penetrative anal intercourse
Manipulation of the lower urinary tract
Secretory dysfunction of prostate gland

297
Q

Chronic Bacterial Prostatitis comp

A

erectile dysfunction, prostate cancer

298
Q

Chronic Bacterial Prostatitis sx

A

Fever, chills, pain, urgency, dysuria,

299
Q

Ovarian Cysts def

A

fluid-filled growth that develops in/on ovary

300
Q

Ovarian Cysts cause

A

functional: no LH surge, dysfunction in hypothalamic-pituitary-ovarian axis, corpus luteum doesn’t dissolve, overstimulation of hCG

neoplastic:

301
Q

Ovarian Cysts RF

A

early menarche, obesity, infertility, fertility treatments, PCOS, hypothyroidism, hyperandrogenism, tamoxifen use, smoking

302
Q

Ovarian Cysts comp

A

rupture, hemorrhage, ovarian torsion

303
Q

Ovarian Cysts sx

A

asymptomatic, pelvic pain/lower abdominal pressure sensation, dyspareunia,

304
Q

Paraovarian Cysts def

A

fluid-filled sac found in the fallopian tubes near your ovaries.

305
Q

Paraovarian Cysts path

A

remnants of paramesonephric (müllerian) or mesonephric (Wolffian) ducts that are present during urogenital embryologic development

306
Q

Paraovarian Cysts comp

A

rupture, torsion, hemorrhage

307
Q

Paraovarian Cysts sx

A

asymptomatic

dull unilateral pelvic pain

308
Q

Polycystic Ovary

Syndrome (PCOS) def

A

a condition in which the ovaries produce an abnormal amount of androgens

309
Q

Polycystic Ovary

Syndrome (PCOS) cause

A

dysfunction in hypothalamic-pituitary-ovarian axis, insulin resistance,

310
Q

Polycystic Ovary

Syndrome (PCOS) path

A

insulin resistance → insulin causes theca cells to grow more LH receptors→ GnRH speeds up →anterior pituitary makes ↑LH → theca cells make ↑androstenedione → flows into blood → turned into estrone in adipose cells→ no LH surge to trigger dominant follicle to break free

311
Q

Polycystic Ovary

Syndrome (PCOS) RF

A

Oligoovulatory infertility, obesity, insulin resistance, DM, premature adrenarche, FH, anti-seizure meds,

312
Q

Polycystic Ovary

Syndrome (PCOS) comp

A

infertility, DM, metabolic syndrome, heart disease, and high blood pressure

313
Q

Polycystic Ovary

Syndrome (PCOS) sx

A

amenorrhea, acne, hirsutism, male-patterned baldness, oligomenorrhea, overweight, acanthosis nigricans

314
Q

Tubo-Ovarian Cysts cause

A

pelvic inflammatory disease, Escherichia coli, Bacteroides fragilis, other Bacteroides species, Peptostreptococcus, Peptococcus, and aerobic streptococci

315
Q

Tubo-Ovarian Cysts path

A

Bacteria from the lower genital tract ascend to create an inflammatory mass involving the fallopian tube, ovary, and potentially other adjacent pelvic organs

316
Q

Tubo-Ovarian Cysts RF

A

multiple partners, sexually active, not using condoms, IUD insertion,

317
Q

Tubo-Ovarian Cysts comp

A

rupture, sepsis,

318
Q

Tubo-Ovarian Cysts sx

A

abdominal pain, pelvic mass on examination, fever, and leukocytosis, vaginal discharge, nausea, and abnormal vaginal bleeding

319
Q

Choriocarcinoma def

A

Malignant, fast-growing tumor from trophoblastic cells

320
Q

Choriocarcinoma def

A

Malignant, fast-growing tumor from trophoblastic cells from the placenta

321
Q

Choriocarcinoma cause

A

miscarriage
ectopic pregnancy
abortion

322
Q

Choriocarcinoma path

A

Overexpression of p53 and MDM2

cytotrophoblastic cells function as stem cells and undergo malignant transformation (Placenta)

323
Q

Choriocarcinoma Rf

A

maternal age extreme younger than 20 and older than 35, pervious, abortion or ectopic, molar pregnancy

324
Q

Choriocarcinoma comp

A

profuse bleeding, hematogenous metastasis to lungs, brain, liver

325
Q

Choriocarcinoma sx

A

abnormal uterine bleeding, unexplained amenorrhea, insomnia, anxiety, tachycardia, palpitations, theca lutein cyst, lower abdominal pain, high hCG

mets: coughing, dyspnea, hemoptysis, headache, dizziness, nausea, slurred speech, visual disturbances, neuropathy, hemiparesis

326
Q

Hydatidiform Mole def

A

rare complication of pregnancy characterized by the abnormal growth of trophoblasts, the cells that normally develop into the placenta

327
Q

Hydatidiform Mole cause

A

an abnormally fertilized egg

328
Q

Hydatidiform Mole path

A

error in normal fertilization
empty egg fuses w/ normal sperm
normal egg fuses w/ two sperm

329
Q

Hydatidiform Mole RF

A

maternal age extreme younger than 20 and older than 35, previous molar pregnancy

330
Q

Hydatidiform Mole comp

A

infection, shock, preeclampsia, sepsis

331
Q

Hydatidiform Mole sx

A

complete: ↑hCG, missed periods, positive pregnancy test, vaginal bleeding, insomnia, anxiety, tachycardia, palpitations, N/V, dehydration, pain or pressure on affect side w/ theca lutein cyst, uterus larger than expected age
incomplete: uterus is not larger than expected, missed periods, vaginal bleeding

332
Q

Invasive Mole def

A

penetration of molar tissue (complete or partial mole) into myometrium or uterine vasculature, Edematous villus and proliferative trophoblasts invade myometrium

333
Q

Invasive Mole cause

A

evacuation of a molar pregnancy

334
Q

Invasive Mole RF

A

complete mole pregnancy, prior molar pregnancy, advanced maternal age (>40 years), and Asian and American Indian ancestry

335
Q

Preeclampsia def

A

develops after a molar pregnancy and is characterized by the presence of edematous chorionic villi with trophoblastic proliferation invading the myometrium

336
Q

Invasive Mole sx

A

abnormal uterine bleeding, unexplained amenorrhea, insomnia, anxiety, tachycardia, palpitations, theca lutein cyst, lower abdominal pain, high hCG

337
Q

Preeclampsia def

A

new onset of hypertension (>140/>90) after 20 weeks gestation-6 weeks after delivery

338
Q

Preeclampsia path

A

abnormal placenta→ spiral arteries become fibrous →narrow → less blood → placenta releases pro-inflammatory proteins → cause endothelial cells that line blood vessels to become dysfunctional → vasoconstriction and retain Na → local vasospasm → decreased blood flow to organs

339
Q

Preeclampsia Rf

A

first pregnancy, multiple gestations, mother >35, HTN, diabetes, obesity, FH

340
Q

Preeclampsia comp

A

stroke, placental abruption, emboli, eclampsia

341
Q

Preeclampsia sx

A

oliguria, proteinuria, blurred vision, flashings lights, scotoma, elevation in liver enzymes, RUQ pain, edema, cough, SOB, headaches, confusion, seizures
HELP (hemolysis, elevated liver enzymes, low platelets)

342
Q

Bartholin Cysts def

A

a small fluid-filled sac just inside the opening of the Bartholin glands on vulva

343
Q

Bartholin Cysts path/cause

A

Sometimes the openings of these glands become obstructed, causing fluid to back up into the gland

344
Q

Bartholin Cysts RF

A

sexually active, 20-30, infection, injury or surgery, STI

345
Q

Bartholin Cysts comp

A

infection, abscess

346
Q

Bartholin Cysts sx

A

asymptomatic, soft, painless lump, pain if large

347
Q

Cystocele vagina def

A

a condition in which supportive tissues around the bladder and vaginal wall weaken and stretch, allowing the bladder and vaginal wall to fall into the vaginal canal

348
Q

Cystocele vagina cause

A

vaginal childbirth, contipation, obesity, heavy lifting, chronic cough, hysterectomy, pelvic prolapse repair, genetics, Ehlers-Danlos

349
Q

Cystocele vagina path

A

muscles and tissues supporting the vagina weaken and stretch, allowing the bladder to move out of place

350
Q

Cystocele vagina RF

A

older, giving birth vaginally, having a history of pelvic, surgery, overweight, FH

351
Q

Cystocele vagina comp

A

urinary retention, kidney damage

352
Q

Cystocele vagina sx

A

asymptomatic, a vaginal bulge, pressure in the vagina or pelvis, urinary incontinence, hesitancy, slow stream, frequency, urgency

353
Q

Reectocele def

A

Posterior vaginal prolapse, causing the rectum to bulge into the vagina

354
Q

Reectocele cause

A

vaginal childbirth and chronic increases in intra-abdominal pressure, Ehlers-Danlos

355
Q

Reectocele path

A

occurs when healthy rectovaginal septal tissue loses integrity, and the rectum herniates through into the vaginal lumen

356
Q

Reectocele RF

A

age, vaginal birth, constipation

357
Q

Reectocele comp

A

Pressure or discomfort in the pelvic area.
Constipation.
Leakage of bowel movements (incontinence)
Sexual dysfunction.

358
Q

Reectocele sx

A

Pressure in the pelvic area
Constipation
Leakage of bowel movements (incontinence)
Sexual dysfunction

359
Q

Urethrocele def

A

urethra moves from its normal position and presses against the front wall of the vagina

360
Q

Urethrocele cause

A

pregnancy and childbirth, being overweight, or with frequent constipation

361
Q

Urethrocele path

A

muscles and tissues that hold the urethra in place get weak or damaged

362
Q

Urethrocele RF

A

age, pregnancy, obesity,

363
Q

Urethrocele comp

A

urinary retention, kidney damage, recurrent UTI

364
Q

Urethrocele sx

A

Abdominal pain
Back pain that may be only on one side
Severe side (flank) pain and spasms that may reach to the groin, genitals, and thigh
Blood in the urine
Burning pain while urinating (dysuria)
Fever
Difficulty starting urine flow or slowing of urine flow

365
Q

Cervical Intraepithelial Neoplasia (CIN) def

A 
dysplasia of basal layer of transformational zone
CIN 1 (1/3)→ CIN II (2/3)→ CIN III (3/3)→ CIS→ invasive
366
Q

Cervical Intraepithelial Neoplasia (CIN) cause

A

HPV 16, 18, 31, 33 sexually transmitted

367
Q

Cervical Intraepithelial Neoplasia (CIN) path

A

virus inserts into the immature squamous cells → integrates its DNA → makes E6 & E7→ inhibits p53 and pRB → uncontrolled replication

368
Q

Cervical Intraepithelial Neoplasia (CIN) RF

A

multiple sexual partners, not using condoms, early age at 1st intercourse, smoking, immunosuppression, low SES

369
Q

Cervical Intraepithelial Neoplasia (CIN) comp

A

squamous cell carcinoma or adenocarcinoma, vaginal cancer, bladder (hydronephrosis/renal failure), rectum, liver, lungs

370
Q

Cervical Intraepithelial Neoplasia (CIN) sx

A

koilocytes

postcoital bleeding, vaginal discomfort, foul-smelling vaginal discharge

371
Q

Endometrial Hyperplasia def

A

increased growth of endometrium

372
Q

Endometrial Hyperplasia cause

A

exposed to high levels of estrogen for long time, obesity, ganulosa cell tumor, PCOS, estrogen replacement therapy, tamixofen, mutation of PTEN

373
Q

Endometrial Hyperplasia path

A

↑estrogen and low progesterone→ leads to ↑gland to low stroma ratio→

374
Q

Endometrial Hyperplasia RF

A

early menarche, late menopause, never given birth,

375
Q

Endometrial Hyperplasia comp

A

endometrial cancer (need nuclear atypia)

376
Q

Endometrial Hyperplasia sx

A

menorrhagia, metrorrhagia, amenorrhea,

377
Q

Fibroids (Leiomyoma) def

A

benign smooth muscle tumors of uterus, most common

378
Q

Fibroids (Leiomyoma) cause

A

MED12 gene, estrogen and progesterone, hereditary leiomyomatosis and renal cell carcinoma syndrome

379
Q

Fibroids (Leiomyoma) path

A

MED12 gene → regulates how transcription factors bind to RNA polymerase
fibroids ↑ receptors for estrogen and progesterone→ ↑fibroid growth

380
Q

Fibroids (Leiomyoma) RF

A

African descent, premenopausal, never having a pregnancy, ↑ menstrual cycles, diethylstilbestrol

381
Q

Fibroids (Leiomyoma) comp

A

infertility, miscarriage, fetal malpresentation, preterm labor, postpartum hemorrhage

382
Q

Fibroids (Leiomyoma) sx and types

A

Types: intramural (most common), subserosal, submucosal, pedunculated, cervical

round, firm, grayish-white,
Asymptomatic or 
Compressive sxs
Bleeding
abdominal pain 
Urinary frequency
383
Q

Invasive Carcinoma of the Cervix def

A

Cancer that has spread from the surface of the cervix to tissue deeper in the cervix or to other parts of the body

384
Q

Invasive Carcinoma of the Cervix cause

A

HPV 16, 18, 31, 33 from Cervical Intraepithelial Neoplasia sexually transmitted

385
Q

Invasive Carcinoma of the Cervix path

A

virus inserts into the immature squamous cells → integrates its DNA → makes E6 & E7→ inhibits p53 and pRB → uncontrolled replication

386
Q

Invasive Carcinoma of the Cervix RF

A

early onset of sexual activity, multiple sexual partners, not using condoms, PHM STI, immunosuppression, OCPs, low SES, smoking, genetics,

387
Q

Invasive Carcinoma of the Cervix comp

A

vaginal cancer, bladder (hydronephrosis/renal failure), rectum, liver, lungs

388
Q

Invasive Carcinoma of the Cervix sx

A

postcoital bleeding, vaginal discomfort, foul-smelling vaginal discharge

389
Q

Leiomyosarcomas def

A

malignant tumor of smooth muscle from myometrium

390
Q

Leiomyosarcomas path

A

mutations to oncogenes or tumor suppressors

391
Q

Leiomyosarcomas RF

A

postmenopausal

392
Q

Leiomyosarcomas comp

A

metastasis

393
Q

Leiomyosarcomas sx

A

abdominal uterine bleeding, abdominal or pelvic pain or pressure
single lesion w/ necrosis and hemorrhage

394
Q

Erection

A

physical stimulation or thoughts→ parasympathetic nerve fiber release Ach→ bind to muscarinic receptors on endothelial cells → activates nitric oxide synthase→ converts arginine to citrulline and NO → NO enters smooth muscle cells → activates guanylate cyclase → GTP to cGMP→ fall in intracellular Ca smooth muscle relax → cavernosal spaces expand and compress veins

395
Q

Chancroid def

A

gram negative coccobacillus, non-motile, facultative anaerobic, oxidase +, catalase -, chocolate agar +

396
Q

Chancroid cause

A

Haemophilus ducreyi

397
Q

Chancroid path

A

enter cell through skin or mucosal breaks → attaches to cell via Flp1, Flp2, Flp3 → make its secrete IL-6 and IL-8 → CD4 T, neutrophils, macrophage → produce ROS → Haemophilus produces copper-zinc superoxide dismutase → produces HdCTD and cytotoxic hemolysin → cell death and lysis of foreskin epithelial cells, macrophage, T cell, and B cell → disorganization of epidermis →erythematous papules

398
Q

Chancroid RF

A

multiple sex partners, unprotected sex,

399
Q

Chancroid comp

A

HIV

400
Q

Chancroid sx

A

erythematous papules→ pustules → soft canker gray/yellow purulent exudate, bleeds easily

men: corona, prepuce, glans
female: labia, vaginal introitus, perianal areas, dysuria, dyspareunia, abnormal vaginal discharge, rectal bleeding, painful defecation, unilateral lymphadenopathy

401
Q

Herpes Simplex Virus (HSV) 1 def

A

enveloped, double strained DNA

402
Q

Herpes Simplex Virus (HSV) 1 cause

A

Herpes Simplex Virus (HSV) 1 due to stress, skin damage, viral illness

403
Q

Herpes Simplex Virus (HSV) 1 path

A

dives into mucosa→ binds to epithelial receptors→ virus enters cells →transcribed and translated →new viral proteins→ travel up axon of sensory neurons (latent) in trigeminal or sacral

404
Q

Herpes Simplex Virus (HSV) 1 RF

A

young age, sharing thing w/ infected person,

405
Q

Herpes Simplex Virus (HSV) 1 comp

A

encephalitis (brain infection) or keratitis (eye infection)

406
Q

Herpes Simplex Virus (HSV) 1 sx

A

no symptoms,
lesions on gums, palate, tongue, lip, and facial area, fever and enlarged lymph nodes, pharyngitis (children)
cluster of small, painful, fluid-filled blisters that ooze and ulcerate

Reactivation: asx, vermillion border lesions on one side, smaller

407
Q

HSV 2 path

A

dives into mucosa→ binds to epithelial receptors→ virus enters cells →transcribed and translated →new viral proteins→ travel up axon of sensory neurons (latent) in sacral or trigeminal

408
Q

HSV 2 cause

A

HSV 2 due to stress, skin damage, viral illness

409
Q

HSV 2 path

A

dives into mucosa→ binds to epithelial receptors→ virus enters cells →transcribed and translated →new viral proteins→ travel up axon of sensory neurons (latent) in sacral or trigeminal

410
Q

HSV 2 RF

A

sexually active, not using condome, STI, HIV,

411
Q

Human Papillomavirus (HPV) def

A

non-enveloped DNA virus

412
Q

Syphilis cause

A

Treponema pallidum

413
Q

Syphilis sx

A

Primary: Painless chancre
Secondary: Fever, lymphadenopathy, skin rashes, condylomata lata
Tertiary: Gummas, tabes dorsalis, general paresis, aortitis

414
Q

Human Papillomavirus (HPV) cause

A

Human Papillomavirus 6, 11, 16, 18

415
Q

Human Papillomavirus (HPV) path

A

virus inserts into the immature squamous cells → integrates its DNA → makes E6 & E7→ inhibits p53 and pRB → uncontrolled replication

416
Q

Human Papillomavirus (HPV) RF

A

multiple sex partners, immunocompromised, smoking, radiation

417
Q

Human Papillomavirus (HPV) comp

A

cervix, vagina, vulva, penis, anus cancer

418
Q

Human Papillomavirus (HPV) sx

A

numerous warts, skin-collored, range in size, cauliflower look, painless, itching, burning, local pain or bleeding

419
Q

Syphilis def

A

gram-negative, spirochete, obligate parasite, endoflagella,

420
Q

Syphilis cause

A

Treponema pallidum
enter through body fluids via cuts or sexual contact or contaminated needles or direct contact w/ skin lesion or congenital

421
Q

Syphilis path

A

1-3 week destroy skin where they enter body → 6-12 weeks enter blood → lymph node→ tissues → latent phase in capillaries of organs & tissues → tertiary type IV hypersentivity

422
Q

Syphilis RF

A

sexual activity, no condom, IV drugs,

423
Q

Syphilis comp

A

coagulative necrosis, damage to heart (endarteritis, aortic aneurysms), brain (loss of vibration and proprioception’s, paralysis, memory loss, paresis), liver, joint, testes, Argyll Robertson pupil, stillborn

424
Q

Syphilis sx

A

Primary: Painless chancre

Secondary (most infectious): Fever, lymphadenopathy, non-itchy maculopapular rash, pustular or papulosquamous condylomata lata (genital smooth small flat growth, grey)

Tertiary: Gummas (non-cancerous growth), tabes dorsalis (demyelination of dorsal column), general paresis, aortitis, fever, edema,

425
Q

Toxic Shock Syndrome (TSS) def

A

gram +, facultative anaerobes, non-motile, no spores, catalase +, cocci, coagulase +

426
Q

Toxic Shock Syndrome (TSS) path

A

mediated by toxic shock syndrome toxin-1 → growth of S. aureus in vagina/surgical sites → multiple organ dysfunction

427
Q

Toxic Shock Syndrome (TSS) RF

A

immunosuppression, IV drugs, recent invasive procedure, foreign material in body, dialysis

428
Q

Toxic Shock Syndrome (TSS) comp

A

sepsis, bacteremia, invasive infection

429
Q

Toxic Shock Syndrome (TSS) sx

A

fever, hypotension, rash, coagulopathy, tissue necrosis

430
Q

Trichomoniasis def

A

flagellated protozoan parasite

431
Q

Trichomoniasis path

A

sexually transmitted→ infects squamous epithelium of lower genital tract → replicates by longitudinal binary fission → inflammatory response

432
Q

Trichomoniasis RF

A

sexual activity, multiple sex partners, female

433
Q

Trichomoniasis comp

A

HIV, premature birth, urethritis, cystitis

434
Q

Trichomoniasis sx

A

asymptomatic, watery, foul-smelling vaginal discharge, burning, Vaginitis, strawberry cervix, motile in wet prep, pruritus, urethral discharge

NPLEX I (2022) (20 decks)

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