Reproduction Exam 3

Question 1

__________ – normal physiologic process that occurs without incidence the majority of the time

Answer 1

Conception

Question 2

Risk Factors

Adolescent population – reproductive high risk population

____________ – defective genes, inherited disorders

Psychosocial – smoking, excessive caffeine intake, alcohol,

Sociodemographic – low income, inadequate prenatal care

_________________ – industrial pollution, tobacco, radiation

Answer 2

Biophysical

Environmental

Question 3

__________ Puberty - Occurs when the secondary sex characteristics develop later

Causes:
- Hypergonadotropic Hypogonadism (↑FSH ↑ LH)
Turner Syndrome; Klinefelter Syndrome

• Hypogonadotropic Hypogonadism (↓LH, ↓FSH)
  Reversible – Physiologic delay; weight loss/anorexia; strenuous exercise
  Irreversible – ↓ Gonadotropin-releasing hormone; hypopituitarism
• Eugonadism
  Congenital Anomalies; Androgen insensitivity syndrome

Answer 3

Delayed

Question 4

____________ Puberty – sexual maturation occurring before 6 in African American girls; 7 in Caucasian girls and 9 in boys

_______ Precocious Puberty - Premature development of appropriate characteristics for the child’s gender

_______ Precocious Puberty - Partial development of appropriate secondary sex characteristics

_____ Precocious Puberty - Development of some secondary sex characteristics of the opposite gender

Answer 4

Precocious

Complete

Partial

Mixed

Question 5

Primary - painful menstrual cycle in absence of pelvic disease

Secondary - result of underlying disease, such as endometriosis or PID

Pain from primary caused by increased prostaglandin levels

Answer 5

Dysmenorrhea

Question 6

Absence of spontaneous menstruation in women of reproductive age

Primary - absence of menarche by age 15

Secondary - cessation of regular menstruation for at least 3 months in absence of pregnancy, lactation, hormone medication, or menopause

Contributing factors: PCOS, high stress, excessive exercise, malnutrition, obesity, OCPs, antipsychotic medications

Answer 6

Amenorrhea

Question 7

Any abnormal bleeding from the uterus not associated with tumor, inflammation, or pregnancy

Hormonal insufficiency caused by an increase in endogenous or exogenous estrogen production

Most common in women who have just started their menstrual cycle and those who are perimenopausal or menopausal

Left untreated, may lead to hyperplasia and malignancy

Answer 7

Dysfunctional Uterine Bleeding

Question 8

____menorrhea: Cycles shorter than 3 weeks

_____menorrhea: Cycles longer than 6-7 weeks

____orrhagia: Intermenstrual bleeding or bleeding of light character irregularly between cycles

_____menorrhea: Excessive flow

___orrhea/___orrhagia: increased amount and duration of flow

_______rorrhagia: Prolonged flow associated with irregular and intermittent spotting between bleeding episodes

Answer 8

Polymenorrhea

Oligomenorrhea

Metrorrhagia

Hypermenorrhea

Menorrhe/Menorrhagia

Menometrorrhagia

Question 9

Definitive cause unknown; possible serotonin deficiency

Deficiencies of magnesium or calcium may be cause

Other theories include alterations in endorphins and rapid hormonal shifts

Answer 9

Premenstrual Syndrome (PMS)

Question 10

acute inflammatory process caused by infection – many caused by sexually transmitted microorganisms

Inflammatory process leads to necrosis with repeated infections

Answer 10

Pelvic Inflammatory Disease (PID)

Question 11

Hyperplastic growth of the endometrial glands and stroma

Exact etiology unknown

Thought to be result of imbalance of estrogen and progesterone

Answer 11

Endometrial Polyps

Question 12

Invasion of glandular endometrial tissue into the uterine myometrium

Exact etiology unknown

Thought that invasive procedures such as C-section and D&C allow endometrial tissue to invade the uterine myometrium

Answer 12

Adenomyosis

Question 13

Exact etiology unknown

Estrogen and progesterone promote growth of these fibroids

Most common in reproductive years and regress in menopause

Answer 13

Leiomyomas

Question 14

Benign Growths and Proliferative Conditions

__________ cysts - caused by variations of normal physiologic events

_________ cysts – transient condition in which the dominant follicle fails to rupture

______ Luteum cyst – instracystic hemorrhage in the vascularization stage

_______ Cysts – ovarian teratomas that contain elements of all three germ layers

Answer 14

Functional

Follicular

Corpus Luteum

Dermoid

Question 15

Presence of functional endometrial tissue or implants outside the uterus

Answer 15

Endometriosis

Question 16

Vaginal tightness that causes discomfort, burning, pain, penetration problems, or complete inability to have intercourse

Exact etiology unknown

Usually linked to female anxiety or fear of intercourse

Pain with intercourse

Answer 16

Vaginismus

Question 17

Pain with intercourse

No single etiology, but may be caused by various reproductive conditions

Pain with or after intercourse

Answer 17

Dyspareunia

Question 18

Never reaching orgasm, difficulty reaching orgasm, or substantially decreased intensity of orgasm

Primary - Never achieved orgasm; usually genetic or trauma-related

Secondary - Usually related to hypoactive sexual desire disorder

Answer 18

Orgasmic Dysfunction

Question 19

Any gestation that occurs outside of the endometrial lining, most frequently in the fallopian tube

Risk factors: damage to fallopian tubes, previous ectopic pregnancy, smoking, infertility medications, multiple sex partners, advanced maternal age, history of STI

Triad of symptoms: abdominal pain, amenorrhea, and vaginal bleeding

Answer 19

Ectopic Pregnancy

Question 20

Results from an abnormal function of the hypothalamic-pituitary-ovarian axis

Elevated hormones or androgens cause symptoms

Appear within 2 years of puberty, often includes dysfunctional uterine bleeding or amenorrhea, hirsutism, acne and infertility

Menstrual dysfunction
Anovulation
Hyperandrogenism (hirsutism and acne)

Answer 20

Polycystic Ovary Syndrome (PCOS)

Question 21

Defined as the inability to conceive after 1 year of unprotected sex

Causes – infections or inflammation, endocrine or hormonal disorders, immunologic problems in which men produce antibodies to their own sperm, environmental and lifestyle factors

Female – malfunctions of the fallopian tubes, ovaries, reproductive hormones and thyroid disorders

Answer 21

Infertility

Question 22

Pain in the breasts
Palpable mass
Nipple discharge

Answer 22

Benign Breast Disease

Question 23

Discharge of milk or milk-like substance from the breast

Systemic findings may include: headache, changes in weight/appetite, history of thyroid or endocrine disorder, visual changes

Answer 23

Galactorrhea

Question 24

Most often appear within 4-6 weeks after childbirth

Local tenderness, swelling, warmth, erythema, and consistent or intermittent pain in one breast while breastfeeding

Flu-like symptoms, fever, chills, body aches, headache, loss of appetite

Answer 24

Mastitis

Question 25

May be asymptomatic in early disease Changes in size or shape of breast, skin changes (dimpling, inverted nipple, thickening of skin, red and scaly rash) Blood-tinged nipple discharge, red and scaly nipples, ulceration of breast tissue Mass felt in breast or axillary tissue that is hard, fixed, and nonmobile

Answer 25

Breast Cancer

Question 26

Both are congenital abnormalities of the penis found in newborns Hypospadias: Meatus develops on the ventral (underneath) part of the penis Epispadias: Rare defect where the meatus develops on the dorsal (upper) part of the penis

Answer 26

Hypospadias and Epispadias

Question 27

Disorders of the foreskin of the penis _______: Condition where the foreskin cannot be retracted over the glans penis _______: Irretractable foreskin of the penis ____________: Occurs in uncircumcised or partially circumcised males when the retracted foreskin is trapped behind the coronal sulcus ____________: Swollen and painful glans penis in a client who is circumcised or partially circumcised

Answer 27

Phimosis and Paraphimosis

Question 28

Prolonged erection that continues for hours Painful condition of blood not being able to leave the penis Uncommon in the general population but more common in males with sickle cell disease Other causes: blood disorders, prescription medications (antidepressants and blood thinners), erectile dysfunction medications, spider and scorpion bites, spinal cord injury, gout, penile cancer

Answer 28

Priapism

Question 29

Caused by fibrous plaque that affects the tunica albuginea, causing the penis to curve or bend Etiology is unknown, but may involve prior injury to the penis or an autoimmune disease Bend in the penis causes painful erections

Answer 29

Peyronie Disease

Question 30

Most common male sexual disorder Inability to maintain or sustain an erection sufficient to permit satisfactory intercourse Occurs in men of all ages and may be chronic, intermittent, or episodic A disruption of the normal neurovascular event requiring functional autonomic and somatic nerves, smooth and striated muscles in the penile shaft and pelvic floor, and adequate arterial blood flow

Answer 30

Erectile Dysfunction

Question 31

____________: Inflammation of the epididymis; may be acute or chronic; infectious process but difficult to identify the infectious agent ____________: Pain and swelling over several days ________: Inflammation of one or both of the testes; may be caused by a viral or bacterial infection; viral cases usually from STIs and bacterial usually occurs in sexually active men with BPH ________: Sudden symptoms and include swelling in one or both testicles, pain, tenderness, fever, nausea, and vomiting

Answer 31

Epididymitis Orchitis

Question 32

Spermatic cord twists within the testicle, cutting off blood supply to the ipsilateral testis Medical emergency Intravaginal: The tunica vaginalis is genetically set too high, allowing the spermatic cord to rotate Extravaginal: The tunica vaginalis is not yet firmly secured, the tunica vaginalis and spermatic cord twist as a unit; most often occurs in newborns

Answer 32

Testicular Torsion

Question 33

Male Disorders - Urethra Urethritis – inflammatory process often caused by a sexually transmitted microorganism Symptoms – itching, burning, frequency and urgency Urethral Stricture – narrowing of the urethra caused by scarring – likely due to trauma Symptoms – diminished force and caliber of urine stream

Answer 33

Study

Question 34

Male Disorders - Penis _________ – inflammation of the glans penis __________ – abnormal dilation of the testicular vein and the pampiniform plexus within the scrotum _________ – collection of fluid between the layers of tunica vaginalis (most common cause of scrotal swelling)

Answer 34

Balanitis Varicocele Hydrocele

Question 35

Impairment of any or all of the processes of: erection, emission and ejaculation Causes – - Chronic diseases and their treatment - Low energy levels, stress or depression - Chemical –alcohol and other CNS depressants, anti-hypertensives, anti-histamines and hormonal preparations.

Answer 35

Sexual Dysfunction

Question 36

Healthy Pregnancy Pregnancy spans 9 months or 10 lunar months 40 weeks or 280 days 3 Trimesters (1 – 13; 14 – 26; 27 – 40) Pregnancy is considered term if it advances to the completion of __ weeks Blood volume increases by 30 – 45% The need for Na increases Decrease is systemic vascular resistance = reduced blood pressure ___ increases 20 – 30% ___ increases in the second trimester and peaks in the third trimester

Answer 36

37 RBC WBC

Question 37

_______ Labor - Regular contractions that is accompanied by cervical dilation and effacement _______ Birth – any birth that occurs between 20 0/7 and 36 6/7

Answer 37

Preterm

Question 38

Infection is the only definitive association factor of PTL/PTB Other Causes: periodontal disease; bleeding at the site of implantation; stress; uterine overdistention; allergic reaction; decrease in progesterone Risk Factors: poverty; lack of education; lack of access to prenatal care; genetics Clinical monitoring: cervical length; fetal fibronectin test Although preterm birth is often not preventable, early recognition is still essential

Answer 38

Preterm Labor/Delivery

Question 39

Pregnancy that ends as a result of natural causes before 20 weeks gestation Approximately 10 – 15% of all clinically recognized pregnancies end in miscarriage Types: 1) threatened; 2) inevitable; 3) incomplete; 4) complete; 5) missed _____ loss (<12 weeks gestation) 25% are due to chromosomal abnormalities Endocrine imbalance Immunologic factors ``` ____ loss (12 – 20 weeks) Risk factors – race, ethnicity, pregnancy history; obesity; alcohol use; caffeine ``` CM: presence of uterine bleeding; uterine contractions or abdominal pain If occurs prior to the 6th week a woman may report a heavy period Treatment: Delivery; Medication Management; D & C

Answer 39

Spontaneous Abortion Early Late

Question 40

? Causes – direct trauma (childbirth), pelvic floor surgery, damage to pelvic innervation Symptoms – urinary frequency; incontinence, constipation; urgency; vaginal, bladder, rectal pain; lower back pain ``` Treatment – Isometric exercises (Kegel) Estrogen Surgery Weight Loss Avoidance of constipation ``` ____ocele – descent of the bladder an anterior vaginal canal _____rocele – sagging of the urethra ____ocele – bulging of the rectum and posterior vaginal wall into the vaginal canal _____ocele – herniation of the rectouterine pouch into the rectovaginal septum

Answer 40

Pelvic Organ Prolapse Cystocele Urethrocele Rectocele Enterocele