Reproductive system disorders Flashcards
1
Q
Prostatitis: incidence
A
- affects men typically under 30-50
2
Q
Prostatitis: clinical manifestations
A
- inflammation of the prostate gland
- most common - chronic prostatitis/chronic Pelvic pain syndrome
- dysuria/burning
- sexual dysfunction
- pelvic pain with urination
- possible infection
3
Q
Diagnosis of Prostatitis
A
- urinalysis
- lab tests - PSA - looks for a protein produced by the prostate that looks at trends/sudden spikes
- DRE - Digital rectal exam (swollen, tender, warm)
- can be aggravated/rectified with sexual activity
4
Q
Benign prostatic hyperplasia
A
- age related nonmalignant enlargement or prostate
- 75% over 50
5
Q
Clinical manifestations of Benign prostatic hyperplasia
A
- depend on involvement of urethra
- lower urinary tract symptoms similar to UTI
- symptoms not as sever as prostatitis
- increase daytime frequency
- nocturia
- increase urgency
- slow stream
- straining to void
6
Q
Management of Benign prostatic hyperplasia
A
- three main pharmacologic agents
- medications to shrink glandular tissue
- drugs to relax smooth muscle tissue of prostate, bladder neck, urethra
- antimuscarinics to address overactive bladder sympdomes (ACH)
- TURP - gold standard in surgical treatment
7
Q
Implications to PT for Benign prostatic hyperplasia and prostatitis: questions to ask males >50
A
- do you urinate more than 2 hours or more than once during the night
- do you have trouble starting or continuing your urine
- do you have weak flow of urine or interrupted urine stream
- does it feel like your bladder is not emptying completely
8
Q
Side effects of meds for Benign prostatic hyperplasia and prostatitis
A
- muscle weakness
- ED
- loss of libido
- gynecomastia
- drowsiness
- dizziness
- tachycardia
- orthostatic hypotension
9
Q
Prostate cancer
A
- adenocarcinoma = 98%
10
Q
Prostate cancer: risk factors
A
- race
- age: more common in older men (they also have better outcomes)
- genetics
- environment
- diet
11
Q
Prostate cancer prevention
A
- exercise can negative some risk factors
12
Q
Prostate cancer symptoms
A
- vague and often don’t present until advanced
13
Q
Prostate cancer diagnosis
A
- DRE
- PSA 0-4 ng/ml and shouldn’t rise more than 0.75 per year
- transrectal US
14
Q
Orchitis
A
- disorder of testes
- inflammation of testes
- testicular pain
- can be bacterial
- no traumatic injury = possible sign of this
15
Q
Epididymitis
A
- disorder of the testes
- inflammation of epididymis
- under age 40 typically
16
Q
Testicular torsion
A
- can cause loos of blood flow to testes
- surgical emergency
- abrupt onset of pain with swelling
17
Q
Testicular cancer: Incidence and risk factors
A
- rare
- Risk factors: hormonal balance, familial clustering, genetics
18
Q
Common symptoms of testicular cancer
A
- enlargement of tests with diffuse testicular pain
- swelling
- hardness
- some combination of these
- metastatic testicular cancer can present as back, groin or pelvic pain
- outcomes are good if caught early
19
Q
Erectile dysfunction
A
- impotence
- meds can cause this
20
Q
ED risk factors
A
- Age
- smoking
- excessive cycling
- diabetes Mellitus
- CAD
- HTN
- metabolic syndrome
- MS
- psychiatric disorders
- parkinsons
- Diuretics
- Anti-HTN
- opiates
21
Q
ED etiology
A
- later in men
- years of HTN/hypercolesterol can cause it
- commonly due to neurogenic, vascular or hormonal
22
Q
Menopause
A
- Perimenopause - the change before the change
- benefit from physical activity
- hormone replacement can be used for pre-mature hysterectomy
- increase risk for osteoporosis, CVD
- estrogen levels keep HDL high, low LDLs/triglycerides
23
Q
Symptoms of menopause
A
- weight gain
- night sweats
- hot flashes
- dry skin
- itching
- sore joints
- stiffness
- back pain
- urinary incontinence
- dizzy
- poor memory
- anxiety
- mood swings
24
Q
Pelvic inflammatory disease S&S
A
- triad: fever elevated WBCs, and purulent cervical discharge
25
Endometriosis
- What is it
- S&S
- estrogen depended disorder
- typically in younger females
- presence of endometrial tissue outside uterus
- abnormal bleeding pain. inflammation, pain/discomfort when estrogen peaks
- dysmenorrhea- chief complaint
- dysmenorrhea, dyspareunia (pain during intercourse) and infertility
26
uterine fibroids
| What is it and symptoms
- benign
- asymptomatic until it gets big enough to cause pain
- fibrosis tissue
- anemia, fatigue, weakness major symptoms
27
Uterine cancer
- risk factors
- signs and symptoms
- environmental, social lifestyle (smoking/heavy alcohol use)
- abnormal bleeding esp. post-menopause
28
cervical cancer
- Pap smear has reduced mortality
- early detection = best prognosis
- symptomless
- vaccine to prevent HPV (which can cause this)
29
Ectopic pregnancy
- presents as pain (they typically do not know they are pregnant)
- tubal pregnancy
- fallopian tube is most common
30
Ovarian Cyst Disease
- most are benign
- functional cyts-rarely produce symptoms unless rupture
- polycystic ovary syndrome
31
Ovarian Cancer
- incidence
- dx:
- what decreases risk
- 2nd most common urogenital cancer in women and most lethal
- usually metastasized by dx 60-70%
- breastfeeding decrease risk
32
Pelvic congestion syndrome
- incompetent and dilated pelvic cavity veins
- varicose of veins (dilation)
33
Pelvic floor muscle dysfunction
- can occur in both men and women
- spasms or weakness can cause pain/discomfort as well as problems with urination or fecal incontience
34
incontinence from pelvic floor disorder
can be urinary or fecal
35
pelvic organ prolaspe
- organ falling out of place
- gravity can push downward
- sense of heaviness or pressure in the perineum
- often worse after long periods of standing r upright weight-bearing postures
36
Coccydynia
- pain the coccyx region typically mechanical injury or sitting on the coccyx to much
37
Cysocele
- prolapsed bladder and urethra causing bulging or anterior bladder wall
- pressure in anterior region
38
Rectocele
- prolasped rectum causes bulging of posterior region
39
Uterine prolapse
- uterus falls into vagina
40
- look at table 20.3: contraindications HRT
- box 20.4: symptoms of gynecologic cancers
- table 20.5
41
Benign breast conditions
- 20-50 years
- diffuse cystic mastopathy and mammary dysplasia
- box 20.10 benign breast changes
- fluctuations in hormones can cause
42
Breast cancer
- most common malignancy in females in US after non-melanoma skin cancer
43
Breast cancer risk factors
- age >65 years
- personal history of breast cancer
- high endogenous estrogen or testosterone levels
- high dose radiation to chest
- one realtime with breast cancer
44
what can mid agate risk factors for breast cancer
- exercise and diet considerations
45
what does hormone positive mean in relation to breast cancer
- hormone causes it so you must remove where the hormone is made such as uterus
46
ACS guidelines for early detection
- for women aged 40-44: option to start annual breast cancer screening with mammograms
- clinical breast exam
47
High risk patients for breast cancer recommendation
- recommended breast MRI
48
Gonadal hormones
- ovaries: estrogen and progesterone
- testes: testosterone
49
1. Synthetic estrogens/progetins
2. synthetic androgens
1. contraception
2. antiandrogenic drugs for prostate cancer, BPH hirsutism (excessive hair growth)
50
Synthetic hormones: estrogens and progestins
- risks + uses
- increase risk fo DVT
- used for contraception: receptor agonist, partial agonist, antagonist, mixed effects; combination of estrogen and progestin alone
- HRT: post menopausal; estrogen deficiency; reduce symptoms of menopause
51
Synthetic hormones: antiestrogens
- inhibit synthesis of estrogen, antagonize all estrogen receptors or at as selective estrogen receptor modulators (SERM)
- ex tamoxifen
52
synthetic hormones: Androgens
- primary clinical use for replacement therapy in hypogonadism
53
HRT benefits
- reduced menopausal symptoms
- reduced risk of colon cancer
- delay of Alzheimer disease
54
Risks of HRT
- increase risk of endometrial cancer
- increase risk of breast cancer
- increase risk of thromboembolism
