Reproductive Systems Flashcards
(162 cards)
1
Q
What bacteria causes Chlamydia? **
A
Chlamydia trachomatis
2
Q
What bacteria causes Gonorrhea? **
A
Neisseria gonorrhoea
3
Q
Complications of Gonorrhea?
A
Pelvic Inflammatory Disease
Sterility
4
Q
Tongue symptoms of oral Gonorrhea?
A
-Tongue is swollen, red, dry
5
Q
Tell me about the incidence of Syphilis and age range for the genders.
A
- Incidence increasing in homosexual males and decreasing in women
- Women 20-24 yrs
- Men 35-39 yrs
6
Q
Bacteria that causes Syphilis? **
A
Treponema pallidum, a spirochete **
7
Q
What is the oral manifestation of primary syphilis infection? What does it look like? **
A
Chancre **
-looks like an ulcer (deep seated non-healing ulcer appearance)
8
Q
What is the most common area of primary syphilis oral manifestation? What are the next common?
A
The lip is the most common extra-genital site followed by the tongue and tonsillar area
9
Q
How long after infection does primary syphilis lesion appear?
A
2-6 weeks after infection
- papule
- erodes
10
Q
How long after primary infection does secondary syphilis develop?
A
1-4 weeks after
11
Q
What manifestation of secondary syphilis is noted on the skin and mucous membranes?
A
-Maculopapular rash on skin and mucous membranes
12
Q
How long after secondary syphilis does tertiary stage appear?
A
3 or more years later.
13
Q
Where can lesions of tertiary syphilis develop?
A
-Lesions of skin, bones, viscera, CNS, CVS
Goes beyond the oral cavity and beyond the skin
14
Q
How does congenital syphilis develop?
A
-Develops from infected mother to the infant
15
Q
What is the most frequently reported STD?
A
Chlamydia
16
Q
How is chlamydia contracted and what are the symptoms? Is the damage reversible?
A
- Usually a silent infection
- Contracted from oral, penile, vaginal contact or during birth
- White mucopurulent discharge, frequent urination, mild burning
- Irreversible damage
17
Q
Are chlamydia symptoms more prominent in males or females?
A
Males
18
Q
What are the oral manifestations of chlamydia?
A
NO oral manifestations
19
Q
Of the bacterial infections talked about, which can co-exist?
A
Gonorrhoea may co-exist with chlamydia infection
20
Q
How is gonorrhoea contracted?
A
Via oro-genital contact or self inoculation
21
Q
Gonorrhoea symptoms (not specific to oral).
A
-Discharge, painful orchitis, sore throat, pain on urinating (males) may be symptomless for females
22
Q
What population is gonorrhoea found more commonly in?
A
Homosexual males
23
Q
Which gender may be symptomless for gonorrhoea?
A
Females
24
Q
Where is syphilis common?
A
-primarily a genital infection but common on tongue and other oral sites
25
How can syphilis be transmitted?
May be transmitted via blood
26
What kind of disease is syphilis?
And acute and chronic relapsing disease.
27
What are the stages of syphilis (no details, just the stages)
Stages: Primary, Secondary, Tertiary
28
What is the name of the grouping of congenital syphilis manifestations called? **
-Hutchinson's Triad **
29
What are the 3 points of Hutchinson's Triad?
1. Eighth nerve deafness
2. Interstitial Keratitis (see white area when look in eyes)
3. malformed teeth (Hutchinson's incisors and mulberry molars are examples)
30
What other manifestations are there for congenital syphilis besides the triad?
Facial malformations
| -Significant head and neck manifestations
31
Oral mucosa symptoms of oral gonorrhoea?
-Oral mucosa is itching and burning sensation
32
What happens to lesions in oral gonorrhoea?
-Lesions become eroded
33
What bacterial infection has a symptom of foul breath?
Oral gonorrhoea
34
What bacterial infection may have a pseudomembrane present?
Oral gonorrhoea
35
What other type of infection may oral gonorrhoea resemble?
-May resemble lichen planus or herpetic stomatitis
36
What bacterial infection has the possibility of a temperature/fever developing?
Oral gonorrhoea
37
How long does it take for primary syphilis oral manifestations to heal?
-heals in 2-4 weeks even if untreated
38
During what stages of syphilis is a person infectious?
Primary- highly infectious
Secondary- highly infectious
Nothing noted for tertiary
39
What are the oral manifestations of secondary syphilis called? **
Oral lesions = mucous patches **
40
What do the oral lesions of secondary syphilis look like?
Multiple, grayish-white plaques
| -sometimes resemble lukoplakia
41
Are the oral lesions of secondary syphilis painful?
No, painless
42
How long do the oral lesions of secondary syphilis persist?
Last for a few week up to a year. They have periods of latency.
43
What kind of process is syphilis and therefore what type of lesions develop in tertiary syphilis?
- Syphilis is a granulomatous necrotizing process
| - Granulomatous lesions develop
44
What is the oral manifestation of tertiary syphilis called and how does it develop?
Orally- formation of necrotic area = gumma **
45
Where can the oral manifestations of tertiary syphilis be found (where orally and where else is the body is common)?
On the palate, but can also be found on the heart
46
What can gumma cause in the oral cavity?
Gumma may cause palatal perforation
47
What stage of syphilis has chancre as the oral manifestation?
Primary
48
What stage of syphilis has oral lesions called mucous patches?
Secondary
49
What stage of syphilis has the formation of gumma?
Tertiary
50
How many strains of the Herpes simplex virus?
Two: Type 1 and Type 2
51
What are the symptoms of type 1 herpes and where does it mainly infect?
Cold sores, mainly infects mouth region
52
What are the symptoms of type 2 herpes?
Genital lesions
53
What are the general characteristics of herpes?
Redness, swelling, itching, blisters
- Blisters crust over in about 3 weeks
- Future attacks last about 5 days
- Most women with herpes choose to have a C section
54
Does herpes goes away?
No, recurrence over life
55
Treatment for herpes?
Anti-viral drugs (Acyclovir)
56
How many types of HPV?
Lots! Over 100 types
57
How does HPV infect?
Via genital contact
- About 30 strains are sexually transmitted
- Infect penis, vulva, vagina, cervix or rectum
58
Are most HPV infections symptomatic or asymptomatic?
Asymtomatic
59
What type of cells do all HPV strains infect?
Squamous cells
60
What strains of HPV are high risk and may lead to cancers? **
Type 16 and type 18 **
61
What do low risk HPV strains cause?
Genital warts
62
What type of lesions indicate the HPV strain was caused by and STD? Describe these lesions.
Papillary type lesions: multiple in number and large ins size
63
What strains of HPV cause condyloma acuminatum?
HPV 6 and 11
64
What HPV related infection is also called venereal wart (genital wart)?
Condyloma acuminatum
65
Is condyloma acuminatum infectious? Will it turn to cancer?
Yes it is infectious. There is no malignant potential so will not turn to cancer.
66
What shape and what kind of projection is condyloma acuminatum?
Cauliflower shape. Sessile (fixed in one place, immobile) to papillary projection.
67
Is condyloma acuminatum related to an STD and if so why?
Yes, papillary type lesions (multiple in number and large in size) = caused by STD
68
What histological feature is diagnostic of HPV?
Koilocytes
69
What are koilocytes? What features make them distinct?
HPV altered cells. Hyperchromatic nuclei, clear perinuclear halo.
70
What is the common causative organism of fungal vaginitis?
Candida albicans
71
What fungal infection is common with 75% of women affected?
Fungal vaginitis
72
Symptoms of fungal vaginitis?
Abnormal vaginal "cottage-cheese" like discharge
| Itching
73
Can fungal vaginitis be transmitted, if so how?
Yes, can be transmitted during sexual contact
74
What are some causes of fungal vaginitis?
- Pregnancy
- Diabetes mellitus
- Use of broad spectrum antibiotics
- Use of corticosteroid medications
75
What is genital candidiasis called when it happens in the mouth?
Pseudomembranous candidiasis
76
What type of biopsy is done to confirm a candida infection?
Cytologic smear biopsy
77
What is the infective agent of Trichomoniasis?
Trichomonas Vaginalis
78
Does trichomoniasis affect only women?
No, it affects both men and women
79
What is the most common curable infection in sexually active women?
Trichomoniasis
80
What are the oral manifestations of trichomoniasis?
None, no oral manifestations
81
What disease has an increased susceptibility to HIV and other STDs?
Trichomoniasis
82
What is the treatment for trichomoniasis?
Metronidazole/Tinidazole
83
Symptoms of trichomoniasis?
Abnormal vaginal discharge with an unpleasant fishy odour. If discharge is present it is usually frothy.
84
Inflammation of glans penis?
Balanitis
85
Inflammation of urethra?
Urethritis
86
Abnormally tight foreskin?
Phimosis
87
Balanitis
Inflammation of glans penis
88
Urethritis
Inflammation of urethra
89
Phimosis
Abnormally tight foreskin
90
Hypospadias
-Ventral surface
A birth defect of the urethra in the male where the urinary opening is not at the correct location on the head of the penis.
91
Epispedias
-Dorsal surface
A rare type of malformation of the penis in which the urethra ends in an opening on the upper aspect (the dorsum) of the penis
92
What are the neoplasms of the penis to know and are they cancerous?
Bowen's Disease- carcinoma in situ
| Squamous cell carcinoma
93
What is cryptorchidism?
Undescended testis
94
What is orchitis?
Inflammation of testes
95
What would presentation of mumps in the genitals indicate?
Inflammation of testes- orchitis
96
What condition of the testes is an emergency and is extremely painful?
Torsion of Testes
97
95% of testicular tumours are what kind of cell?
Germ cell tumors
98
What are the age peaks for testicular tumours?
Less than 5, 20-50 and greater than 80
99
Risk factors for testicular tumours?
Cryptorchidism (undescended testes)
Chromosomal abnormalities
Testicular dysgenesis
100
What is seminoma?
The most common germ cell testicular tumour. Malignant but 95% 5-yr survival rate, low aggression.
101
What is non-seminoma?
Germ cell testicular tumour. TERATOMA - benign tumour that has tissue types of different origin.
102
Is non-seminoma benign or malignant?
Benign in children, malignant in adults.
103
What is inflammation of the prostate called?
Prostatitis
104
What form of prostatitis can be related to tuberculosis?
Chronic prostatitis
105
What is the incidence of benign prostatic hyperplasia?
VERY very very common. Risk increases with age.
106
Symptoms of benign prostatic hyperplasia?
Prostate gland increases in size but there are no abnormal features present, no increased risk of cancer.
Frequent urination and having problems starting and stopping may occur, often no symptoms though.
107
What is the marker for benign prostatic hyperplasia and prostate cancer?
PSA: prostate specific antigen
| Levels increase with age
108
What is the most common cause of benign prostatic hyperplasia and how is it believed to develop?
Ageing.
Growth receptors on prostate cells are for testosterone. Estrogen levels increase with age in men. Increase in estrogen levels causes increase in receptors.
109
What zone does benign prostatic hyperplasia occur in the prostate?
Transitional zone
110
What is the incidence of prostate cancer?
Very common. Increase with age. #3 cause of cancer death in men.
111
What is the specific name for prostate cancer?
Prostate is a gland so = prostate adenocarcinoma
112
What zone does prostate cancer occur in the prostate?
Peripheral zone, making it easy to detect on a digital rectal exam.
113
How does prostate cancer spread?
Spreads locally. Invades capsule, seminal vesicles, bladder.
| Spreads via lymphatics more than blood.
114
What kind of bone metastasis is prostate cancer?
Can be osteolytic or osteoblastic making the radiographs a mixture of radiolucency and radio-opacity
115
Blood tests used to screen for prostate cancer look for what?
PSA: prostate specific antigen
-rises normally with age and BPH but it is much higher in cancer
PAP: prostatic acid phosphatase
-correlates with bone metastases
116
What scale is used to grade prostate cancer? **
Gleason scale **
117
What surgery is done for benign prostatic hyperplasia? Is this also for prostate cancer?
TURP: trans-urethral resection of prostate
Hard to detect prostate cancer because prostate cancer is in the peripheral zone and TURP is looking in the transitional zone where BPH usually is located.
118
What is leukoplakia?
Means "white patch on mucosa"
This is just a clinical term, a description, NOT a diagnosis.
Note: Does NOT wipe off like candidia dose
Can mean anything from hyperkeratosis to malignant.
119
What stage is each of the three vulvar intraepithelial neoplasias?
VIN I = mild dysplasia
VIN II = moderate dysplasia
VIN III = severe dysplasia or carcinoma in situ
VIN is a spectrum of precancerous changes
- maturation
- cell changes
- koilocytes if HPV related
120
Clinical features of vulvar intraepithelial neoplasia?
- pruritus (itchiness)
- white, brown, red or speckled lesions
- sharp margins, often elevated
121
What is vulvar intraepithelial neoplasia often associated with?
HPV and cervix dysplasia
122
What are the 3 vulvar and vagina malignancies?
Squamous cell carcinoma- affects vulva
Embryonal rhabdomyosarcoma- skeletal muscle malignancy
Extramammary Paget Disease- spread of malignant cells within the epithelium
123
What does extramammary paget disease appear as?
Inflammatory dermatosis
124
Where in the cervix are 99% of cervical cancers found and why?
Zone of cell proliferation termed to Transformational Zone (where internal and external epithelium meet)
Squamocolumnar junction (ectocervix is squamous and endocervix is mucous columnar), this junction migrates out at puberty making it vulnerable during this time.
125
What stage is each of the cervical intraepithelial neoplasias?
CIN I= mild dysplasia
CIN II= moderate dysplasia
CIN III= severe dysplasia to carcinoma in situ
126
What are the risk factors and co-factors for cervical intraepithelial neoplasia?
HPV risk factors with things like early sexuality, multiple partners and risky partner.
Co-factor of cigarette smoking
127
What type of biopsy is a PAP smear and why is is useful?
PAP smear is cytological smear biopsy (like what is down for candidiasis), it is a diagnostic modality for cervical cancer. Since the progression of CIN I-III is slow this screening is very powerful.
128
What are the 3 patterns of squamous cell carcinoma (cervical cancer)?
Fungating (or exophytic), ulcerating, infitrative cancers
129
How does squamous cell carcinoma (cervical cancer) spread?
Direct spread to peritoneum, urinary bladder, ureters, rectum, vagina.
Local/distant lymph nodes involvement.
Distant metastasis to the liver, lungs, bone marrow.
130
What is endometriosis?
Presence of endometrial tissue outside the uterus. Common cause of abnormal bleeding in older women.
131
What is the aetiology of endometriosis?
Unopposed estrogen
132
What is the #1 neoplasm in females?
Leiomyoma located in the uterus (most common location for leiomyoma)
Leiomyoma = bening smooth muscle
133
What are the 2 types of endometrial hyperplasia and their chances of cancer?
Simple endometrial hyperplasia: no dysplasia, cancer is rare
| Atypical endometrial hyperplasia: Some dysplasia, 25% cancer
134
What is the #1 malignancy of female genitals?
Endometrial Adenocarcinoma
135
What are the risk factors for endometrial adenocarcinoma?
- Atypical endometrial hyperplasia
- Unopposed estrogen
- Breast cancer
136
What occurs in endometrial adenocarcinoma?
Shaggy mass fills the uterus. Malignant glands replace endometrium.
137
What is the most common type of ovarian cyst?
Follicular cyst
138
How does a follicular cyst develop?
Develops when the Graafian follicle doesn't ovulate
139
What are 2 things polycystic ovary disease can cause?
Infertility (common cause) and endometrial hyperplasia, CA
140
What is another name for polycystic ovary disease ** and why can it be called a syndrome?
Stein Leventhal Syndrome **
| -When there are multiple signs and symptoms something can be called a syndrome
141
What are the signs and symptoms of Stein Leventhal Syndrome?
- Irregular menses
- Body hair
- +/- small breasts, obesity
142
What are risks of ovarian cancer?
- Nulliparity (never having given birth)
- Family history
- Mutations in BRCA1 & 2 increases susceptibility (patient with history of breast cancer carries and increased risk of developing ovarian cancer)
143
What can germ cell ovarian tumours appear as?
Benign teratomas
- Skin appendages
- Thyroid tissue
- even teeth
144
What is the marker used for female genital tumours? **
CA-125 **
145
Breakdown of what a lump in the breast actually ends up being? **
```
40% Fibrocystic changes
30% No disease
13% Miscellaneous benign
10% Cancer
7% Fibroadenoma
```
146
Most common breast "disease"?
Fibrocystic disease
147
Is proliferative or non-proliferative worse to hear?
Proliferative is worse to hear, it means there are some signs of dysplasia and the patient needs to be monitored.
148
What is non-proliferative fibrocystic disease? What is proliferative fibrocystic disease? (In relation to breasts)
Cysts of fibrosis WITHOUT epithelial cell hyperplasia, just simple fibrocystic change.
Proliferative is with duct or ductal epithelial hyperplasia
149
What is a very well-defined, circumscribed lesion that is a benign breast neoplasms common in women 20-35?
Fibroadenoma
150
What is papilloma?
Benign neoplasm of the breast
| Tumor of major duct
151
What is Phyllodes tumor?
Benign neoplasm of the breast
152
What is the most common malignancy of the breast?
Carcinoma- Breast carcinoma
153
What are the genes for breast cancer? Are they autosomal dominant or recessive?
BRCA1 and BRCA2. Autosomal-dominant
154
What are some clinical features of breast carcinoma?
- retraction or dimpling of skin or nipple
| - localized lymphedema, skin thickened around exaggerated hair follicles (orange peel look)
155
What are the 5 risk factors for breast carcinoma?
1. Genetics
2. Previous breast cancer or atypic
3. Environment
4. Hormonal status (note that birth control does NOT increase the risk for breast cancer but it does for ovarian)
5. Age (risk increases with age)
156
What is the most common location for breast carcinoma (50%)?
Upper outer quadrant
157
Breast carcinoma or "no special type" or "not otherwise specified", poorly defined mass, and gritty calcifications of mammogram?
Infiltrating ductal carcinoma
158
What are signs and symptoms of Paget Disease of the Breast?
Obvious skin features, looks like eczema.
159
How does breast cancer spread?
Lymphatic (mainly by this rather than blood)
- axillary nodes
- internal mammary nodes
Blood
- to liver, adrenals, ovaries, bone, CNS, lungs
- can spread to jaws
160
Is is good or bad to have estrogen receptors in breast cancer?
Good! The prognosis is better because there is medication to target these receptors (Tamoxifen).
161
What are some things that relate to breast cancer prognosis? **
Size
Lymph node involvement, number involved by metastases
Distant metastases
Grade
Histologic type
Presence or absence of estrogen/progesterone receptors (presence is good, allows target!)
Proliferative rate of the cancer
Aneuploidy (if cancer cells have abnormal amount of chromosomes will have bad prognosis)
Overexpression of HER2/NEU (bad prognosis)
162
Unilteral crusting exudate over the nipple and aerolar skin would indicate what?
Paget Disease of the Breast
