Unit 6: Repro Paths Flashcards

(99 cards)

1
Q

Vaginitis

A

Inflammation of the vagina

Common

Candiasis
Trichomonos
Gardnerella bacteria

Itching, bleeding, discharge, dysuria

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2
Q

Vulvitis

A

Infection of the vulva

Often HPV (genital warts)

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3
Q

Cervicitis

A

Inflammation of the cervix

Often gonorrhea, chlamydia, HPV, or HSV2

Discharge, pain, dysuria, menstrual abnormalities

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4
Q

Pelvic Inflammatory Disease

A

Infection of the uterus and/or fallopian tubes
Usually ascends from lower reproductive organs (cervix, vagina

Gonorrhea, chlamydia, vaginal flora, etc

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5
Q

PID: Sx

A
fever
dysmenorrhea
dyspareunia
abdominal pain 
irregular bleeding
(or asymptomatic)
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6
Q

PID: complications

A

Peritonitis and sepsis (which can lead to endocarditis, arthritis, and meningitis)
Ectopic pregnancy
Infertility
Chronic pelvic pain

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7
Q

Cervical Dysplasia

A

Abnormal changes in the cells on the surface of the surface

May be cause by HPV
Usually asymptomatic

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8
Q

Cervical Eversion

A

A condition in which a portion of the endocervical epithelium protrudes through the external os into the vagina.

Metaplasia: becomes stratified squamous epithleium

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9
Q

Cervical Eversion: Sx

A

May have the same appearance as early cervical cancer, even though it is not an abnormality

May be associated with non-purulent discharge, and/or post-coital bleeding

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10
Q

Cervical Polyps

A

Common, benign growths of the cervix or endocervix

2-5% of women.
Usually results from chronic inflammation

Dx with speculum. Small.
May bleed between menses, or post-coital

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11
Q

Endometrial Hyperplasia

A

Growth of endometrium due to excess estrogen (relative to progesterone levels)

Causes abnormal and heavy menstrual bleeding

Can be treated with oral contraceptives

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12
Q

Cervical Carcinoma: Risk Factors

A

HPV
Smoking
Oral contraceptives
Immunosupppression

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13
Q

Cervical Carcinoma: Sx

A

No early symptoms

Later: bleeding, spotting, discharge, pain

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14
Q

Endometriosis

A

Endometrial cells found outside uterus
Ovary, pelvic peritoneum most commonly

Very common

Growths can’t be shed during menses, so are encapsulated
Also manufacture high levels estrogen

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15
Q

Endometriosis: Sx

A

Infertility
Dysmenorrhea
Dyspareunia

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16
Q

Endometriosis: Complications

A

Adhesions
Obstruction of uterine tubes/ectopic pregnancies
Anemia
Uterine hyperplasia

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17
Q

Myometrial tumours

A

Leimyoma (benign, common)

Leiomyosarcoma (malignant, rare)

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18
Q

Endometrial tumours

A

Adenocarcinoma (malignant, common)

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19
Q

Leiomyomas

A

Benign fibroid tumor in or around the uterus

Can range from microscopic to several pounds
20% of women
Stimulated by estrogen

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20
Q

Leiomyomas: Sx

A

Often asymptomatic, but if big enough can put pressure on nerves, bladder, bowels, or interfere with pregnancy.

Can cause heavy, painful periods, anemia, infertility

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21
Q

Most common invasive cancer of female genital tract

A
Endometrial adenocarcinoma (7%)
Most commonly in 55-65 (peri/postmenopausal) age group
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22
Q

Stage IV cervical cancer usually extends (fatally) to:

A

Urinary bladder, uterus.

Death by local obstruction, not distant metastases

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23
Q

Uterine Sarcoma

A

5% of uterine cancers

Nonglandular

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24
Q

Stromal Sarcoma

A

(Uterine) sarcoma affecting connective tissue

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25
Leiomyosarcoma
Rare, malignant tumour of the uterine muscle cells
26
Malignant mixed mesodermal tumours
Uterine | Combine features of adenocarcinomas and sarcomas
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Uterine Sarcomas: Sx
leukorrhea, pain, pelvic mass, pain with sex, change in bladder/bowel habits, unintended weight loss
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Four mechanisms of uterine sarcoma metastasis
Direct contact Peritoneal fluid Lymphatics Circulatory system
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Endometrial hyperplasia
Increased proliferation of the endometrial glands (relative to the stroma) Important cause of abnormal bleeding Simple or complex May be premalignant
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Endometrial hyperplasia results from
Prolonged exposure to estrogen
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Endometrial hyperplasia: S
menorrhagia metrorrhagia (abnormal bleeding) Menometrorragia (prolonged/excessive bleeding)
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Salpingitis
Inflammation of the fallopian tubes
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Follicular ovarian cyst
Most common type Follicle doesn't rupture completely, blister forms at site. Usually resolves on its own
34
Corpus luteum ovarian cysts
Follicle doesn't heal normally after ovulation Creates pregnancy-like symptoms until resolution (2-3 months) May cause bleeding into peritoneum
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Polycystic Ovarian Syndrome
AKA Stein-Leventhal syndrome Formation of multiple cysts on the ovaries Affects 3-6% of reproductive aged women
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PCOS: Related conditions
``` Metabolic syndrome Obesity Hirsuitism Anovulation Endometriomas Cystadenomas Dermoid cysts ```
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PCOS: Sx
Often asymptomatic unless cyst ruptures Dyspareunia Back pain that radiates to legs May compress other organs Early signs may mimic advanced ovarian cancer Sx
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Breakdown of ovarian neoplasms
Surface epithelium 70% (90% of malignancies) Germ cells 20% Sex cord stromal cells 10%
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Ovarian neoplasms: surface epithelium
Most common ovarian neoplasm (70%) | Develop near sites of ovulatory rupture, so oral contraceptives reduce risk
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Ovarian neoplasms: germ cells
``` 20% of ovarian neoplasms Affect young ( ```
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Ovarian neoplasm
Second most common gynecologic cancer | Most deadly reproductive cancer
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Subtypes of surface epithelial ovarian tumours
Serous (25% malignant). May be associated with BRCA1 & 2 Mucinous (15% malignant) Endometroid (100% malignant)
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Most common germ cell tumour
Teratoma (benign) | 95% of germ cell tumours
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Ovarian neoplasms: Sx
Abdominal pain and distenstion Urinary tract symptoms Vaginal bleeding
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A uterus that has not been hormonally primed with estrogen and progesterone ...
Cannot allow an embryo to implant
46
Morning sickness
Increased estrogen levels May cause dehydration, weight loss, alkalosis, hypokalemia Can start in 6th week of pregnancy
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Hyperemesis gravidarum
Really effing bad morning sickness | 1% of pregnancies
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Ectopic pregnancy
Embryo implants in fallopian tubes, not uterus
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Ectopic pregnancy: Risk factors/pathogenesis
Anything that may affect the transportation of the egg, fallopian motility, or that otherwise distorts anatomy, PID Abortion STI IUD
50
Miscarriage
Pregnancy loss before viability Half of embryos miscarried in the first 13 weeks have chromosomal abnormalities
51
Four categories of hypertension in pregnancy
1. chronic hypertension 2. preeclampsia (hypertension + proteinuria + systemic edema) 3. eclampsia (preeclampsia + convulsions) 4. gestational hypertension (HBP after 20 weeks, returns to normal, no signs of preeclampsia)
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Hypertension in Pregnancy: Complications
HELLP Hemolysis Elevated Liver enzymes Low Platelets
53
Toxemia
Another name for preeclampsia
54
Placenta previa
Implantation of the placenta over of near the cervix 1/200 deliveries Requires c-section
55
Gestational Trophoblastic Disease
Placental abnormality leading to either hydatidiform mole or choriocarcinoma
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Hydatidiform Mole
Trophoblastic condition Results from doubling up of paternal chromosome, loss of maternal Sx of pregnancy, but no viable/identifiable fetus May lead to malignancy
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Choriocarcinoma
Trophoblastic condition Malignancy of placental cells (50% from complete molar pregnancy) Good prognosis if it hasn't spread to brain.
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Gestational Diabetes
Glucose intolerance developed during pregnancy, often third trimester
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Breast Lumps: Pie Chart
``` 40% fibrocystic changes 30% no disease 13% miscellaneous benign 10% cancer 7% fibroadenoma ```
60
Fibroadenoma
``` 7% of breast lumps Benign Well-encapsulated, hormone-sensitive, freely movable Firm on palpation Easily removed ```
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Breast Cancer
2nd most frequently diagnosed cancer in women 1:8 lifetime risk Most Dx in women 50 and older
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Types of breast cancer
``` Ductal carcinoma (70-80%) Lobular carcinoma (5-10%) Also: Inflammatory breast cancer Paget disease of the breast Medullary breast cancer ```
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Breast Cancers: Risk factors
``` Age (50+) Estrogen exposure (early menarche, late menopause, few/no pregnancies) 1+ drink/day History of chest radiation BRCA 1/2 (5-10% Dx) ```
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Breast Cancer: Metastases
Usually primary/in situ, then spread to: ``` Lymphatics Bones Liver Lung Brain ```
65
Genital herpes
Caused by HSV-2 Asymptomatic periods with recurring episodes of small, painful, fluid-filled ulcers. Flare ups can be stimulated by stress or depressed immunity.
66
Genital Warts
AKA verrucae Common benign viral infections of the genitals Caused by HPV Treated with laser, cryotherapy or surgery
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Syphilis
Easily treated with antibiotics If untreated can affect any system
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Syphyllis: Primary Stage
Chancre | Inguinal lymphadenopathy
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Syphyllis: Secondary stage
2 months to 2 years after infection. Systemic spread Macular rash, hepatitis, inflammation of other organs
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Syphyllis: Tertiary
Can occur 10-20 years after infection CNS, cardiovascular lesions Other systematic lesions
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Gummatous Syphyllis
Tertiary Rubbery granulomatous lesions form in liver, bones, testes, etc. May break down, ulcerate, fibrose
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Cardiovascular Syphyllis
Tertiary Chronic inflammatory destruction of Vado vasorum -->Aneurysm formation in ascending aorta --> aortic valve insufficiency
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Neurosyphyllis
Disruption of dorsal roots --> impaired sensation, proprioception. (Tabes dorsalis) Cortical damage --> "general paresis of the insane"
74
General paresis of the insane
AKA paralytic dementia, is a severe neuropsychiatric disorder, classified as an organic mental disorder and caused by the chronic meningoencephalitis that leads to cerebral atrophy in late-stage syphilis
75
Tabes dorsalis
Tabes dorsalis, also known as syphilitic myelopathy, is a slow degeneration (specifically, demyelination) of the nerves primarily in the dorsal columns (posterior columns) of the spinal cord (the portion closest to the back of the body). These nerves normally help maintain a person's sense of position (proprioception), vibration, and discriminative touch.
76
Chlamydia
Bacterial (Chlamydia trachomatis) Urethral pain without discharge Men: mostly asymptomatic
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Most common cause of bacterial urethritis in men
Chlamydia
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Candiasis
Yeast infection Itching, discharge
79
Bacterial vaginosis
Bacterial infection of vagina Caused by imbalance of bacterial flora Abnormal discharge, unpleasant odour Often confused with candiasis
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Vulvodynia
Chronic pain syndrome Cause often unidentified
81
Orchitis
Inflammation of testes Can be isolated, or comorbid with epididymitis Often follows chlamydia or mumps infection, or complication of medical procedure
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Orchitis: Sx
Swollen and painful testis | Fever, malaise
83
Epididymitis
Inflammation of the epididymis
84
Epididymitis is usually a complication of
urethritis or prostatitis medical procedures TB (or in younger men, STIs)
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Epididymitis: complications
testicular infarction, pyocele, loss of fertility,
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Testicular torsion
abnormal twisting of the spermatic cord, which cuts off blood supply to the testis Usually results from abnormal development of the spermatic cord or the membrane covering the testis Most often in young men (puberty - 25) Pain, swelling, nausea Medical emergency
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Hypogonadism
Diminished functional activity of the gonads Deficiency of sex hormones --> defective primary and/or secondary sexual development
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Two types of testicular cancer
``` Germ cell (95%) -- seminomas and nonseminomas Non-germ cell (5%) -- stromal (usually benign) or sex cord ``` (Rarely secondary)
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Seminoma
Malignant germ cell tumour of the testicle. Easily treatable.
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Nonseminoma
Germ cell tumour of the testicle. | Include teratomas, embryonal carcinomas (most common), endodermal sinus tumors (yolk sac tumors), and choriocarcinomas
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Testicular cancer
Most common solid organ tumour in young men Affects Westerners, caucasians more
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Teratoma
Differentiated, benign nonseminoma. Can contain teratocarcinoma cells
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Teratocarcinoma
Malignant nonseminomatous germ cell tumour
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Which tumour type can result in a positive pregnancy test for men?
Choriocarcinomas and yolk sac tumours Produce hCG Usually found in teratocarcinomas
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Benign Prostatic Hyperplasia
Enlarged prostate gland 50% of men over 50; 70% over 70 etc 90% don't need treatment
96
BPH: Sx
Difficult urination Weak flow, incomplete emptying, leaking UTI Acute urinary retention
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Prostate Cancer
Most common cancer of internal organs in males Second most common cause of cancer related deaths Hormone sensitive; diet involved
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Prostate tumours tend to metastasize to
Local lymph nodes, vertebrae, other bones
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Prostate Cancer: Sx
``` Enlarged, hard prostate Obstruction of urethra Pain with urination, ejaculation Blood in urine Can't maintain erection LBP which refers to legs ``` Looks like BPH