Pathophys 4 Disorders Of Female Reproductive Sys

Front 1

what is the pathology of Vulvitis?
How does it manifest?
How is it treated?

Back 1

Inflammation accompanied by pruritus of the vulva
causes irritation and discharge
treat: remove causative agent, local bath & wash

Front 2

what is the pathology of Folliculitis?
how does it manifest?

Back 2

infection of hair follicles caused by bacteria, or tight clothing around genitals
->erruption of red papule/pustule surrounding the hair shaft

Front 3

bartholin's cyst/abcess are the result of________________

Back 3

No Pain
result of occlusion of duct syst within bartholins gland
a cyst infected w bacteria/pus causes abcess

Front 4

carcinoma of the vulva is most commonly seen in women

a) 15-30
b) 25-50
c) less than 40
d) greater than 60

Back 4

Greater than 60- due to hormonal imbalance
(small portion 20-30- STD)

Front 5

what is the pathology of carcinoma of the vulva?
what causes it

Back 5

dysplasia of the epithelial tissue

caused by hormonal imbalance in elderly

STD in adults (HPV)

Front 6

how does carcinoma of the vulva manifest?

Back 6

thickening of skin-small raised lump/ulceration that fails to heal

accompanied by pruritus and local discomfort

swelling of inquinal lymph nodes

Front 7

what is the pathology of vaginits?
how does it manifest?

Back 7

inflammation of vagina
vaginal discharge-itchy/malodorous/burns
red/swollen vaginal tissues
dysuria
pain w sex

Front 8

what are the causes of vaginitis?

Back 8

premenarch- poor hygeine, pinworm/intestinal parasite, foreign bodies

sex active- bacteria, parasite, yeast, candida
post-menopause- atrophic due to lack of estrogen

Front 9

cancer of the vagina occurs mostly in which group?

Back 9

elderly
due to prolonged irritation

Front 10

to get an accurate pap smear where must the sample come from

Back 10

transformation zone of the cervix

Front 11

what is the pathology of cervicitis and what are the causes?

Back 11

inflammation of the cervix
direct- via bacteria, yeast, parasite, virus
secondary- to vaginal/uteran infxn

Front 12

all of the following often manifest with pain except:

a) Cervical Polyps
b) Vaginitis
c) Bartholin's Cyst
d) Endometriosis
e) A/C
f) B/C

Back 12

Cervical Polyps & Bartholins cyst

Front 13

what are some manifestations of Cervicitis

Back 13

red/edematous , painful cervix
purulent discharge
itching
malodorous leukorrhea

Front 14

cervical polyps are most common during

1) puberty
2) reproductive years
3) menopause

Back 14

reproductive years

Front 15

Which pathology is often asymptomatic?

a) Cervicitis
b) Cervical Polyps
c) Endometriosis
d)Endometritis

Back 15

Cervical polyps- unless they protrude through cervical os and cause postcoital bleeding

Front 16

List some risk factors for Cervical Cancer

Back 16

intercourse at early age
multiple partners
promiscuous male partner
smoking
STDs

Front 17

what is the pathology of cervical cancer

Back 17

atypical squamous cell->local cancer (latent period of 7-10 years) -> invasive cancer

dysplastic period may regress spontaneously or progress to next step

Front 18

this pathology primarily manifests as abnormal uterine bleeding

Back 18

cervical cancer

(endometrial cancer- painless or xs/long mense flow)

Front 19

list the common ways in which cervical cancer is often detected

Back 19

pap smear 80-90%
colposcopy w iodine staining and biopsy
cervicography
conization-tx for early cancer

Front 20

what are some risk factors for endometritis?

Back 20

post partum
post abortal
post instrumentation
IUD

Front 21

list some causes for endometritis

Back 21

gonorrhea
chlamydia
TB
E Coli
Klebsiella

Front 22

list some manifestations of Endometritis

Back 22

fever, pain/malaise
abnormal uterine bleeding
foul leukorrhea

Front 23

what is the general pathology of Endometriosis

Back 23

functional endometrial tissue found in ectopic sites outside the uterus- tissues respond to hormonal stimulation the same as normal endometrial tissue
->bleeding into surrounding structrs
->pain & adhesion

Front 24

who is at risk for endometriosis?

Back 24

early menarche
reg periods w short cycles/long duration >7days
first degree relative

Front 25

Endometriosis in the ovaries causes what kind of pathology

Back 25

Endometrioma= ovarian cyst filled w old blood "chocolate cyst"

Front 26

pathology of endometriosis in the pelvis

Back 26

small hemorrhagic lesions usually located near "Douglas Culdesac"

Front 27

what is the suggested triad related to manifestations of endometriosis

Back 27

dysmenorrhea
dyspareunia
infertility

Front 28

T/F
endometrial cancer is most common in young adults

Back 28

F
Elderly (55-65 peaks)

Front 29

list some risk factors for endometrial cancer

Back 29

prolonged use of Progesteron or unopposed Estrogen
obesity
anovulatory cycles
perimenopause
diabetes

Front 30

what is the pathology of endometrial cancer and how can it be treated?

Back 30

hyperplasia of endometrium causing cancer
treated with cyclic progesterone

Front 31

what are the manifestations of endometrial cancer

Back 31

abnormal painless bleeding
xs/prolonged menses
late stage- pelvic cramping, postcoital bleeding, enlarged lymph nodes

Front 32

what is the definition of PMS?

Back 32

physical and psychologic symptoms 3-14 days before menses, and relieved by onset of menses

Front 33

PMS is most common in women

a) teenage
b) twenties
c) thirties
d) all of the above

Back 33

thirties

Front 34

what is the pathology of endometrial cancer and how is it typically treated?

Back 34

hyperplasia of endometrial tissue

cyclic progesterone for tx

Front 35

D&C is often used to diagnose _____

Back 35

endometrial cancer

Front 36

what is the pathology of Leiomyoma?

Back 36

benign hypertrophy/tumor of smooth muscle of the uterus that increases in size when estrogen is present (ovulation) and spontaneously regresses after menopause

Front 37

T/F

Leiomyoma will spontaneously regress after menopause?

Back 37

True

Front 38

_____ is the most common form of leiomyona?

Back 38

intramural

Front 39

T/F

Subserosal Leiomyoma causes abnormal bleeding, pain, cramping, and necrosis

Back 39

False

Submucosal

Front 40

Which group of women is most often affected by leiomyoma?

Back 40

>35 yrs, Black Women

Front 41

What is the pathology of Pelvic Inflammatory Disease?

What is the mechanism behind the disease?

Back 41

inflammation of the upper reproductive tract

ascending infection through the cervical os

Front 42

T/F

PID descends through the reproductive tract

Back 42

F

ascending infection through the cervical os

Front 43

List some of the causative agents of PID

Back 43

Chlamidia
Bacteriods
Ecoli
Mycoplasma Hominis

Front 44

List some manifestations of PID

Back 44

fever
lo ab pain post menses
purulent discharge
adnexal tenderness
extreme pain of cervix
increase ESR in blood
WBC > 10,000/microL

Front 45

your px complains of ab pain that is worse right after her menses. She has a fever and her blood tests show hi count of ESR & WBCs in the blood

what is the diagnosis/

Back 45

PID

Front 46

What is the pathology of an Ectopic Pregnancy

what is the mechanism?

Back 46

fertilized ovum implants outside the uterine cavity

stricture of the fallopian tube or delayed ovum transport

Front 47

what are some predisposing factors for Ectopic Preg?

Back 47

PID
Abortion, Morning after pill
Tubal Ligation or reversal
Intrauterine exposure to DES
Fertility Drugs to induce Preg

Front 48

shoulder pain may be a manifestation of ____

Back 48

Ectopic Preg

Front 49

List some manifestations of ectopic preg?

Back 49

lo ab pain- diffuse or localized
spotting
referred shoulder pain
excrutiating ab pain followed by syncope

Front 50

how is an ectopic pregnancy diagnosed?

Back 50

all preg women have pelvic ultrasound by 5th week
definitive diagnosis = laparoscopy

Front 51

T/F
Ovarian cysts are typically benign

Back 51

true

Front 52

Polycystic ovary disease
a) is due to xs LH and increased androgen
b) is filled with blood
c) can affect fertility
d) a & c
e) b & c

Back 52

ovarian cyst due to xs LH/androgen
can affect fertlity

Front 53

cystic teratoma arises from _____

Back 53

form of ovarian cyst- primordial follicle that develops abnormally

Front 54

which type of ovarian cyst is filled with blood

Back 54

endometrioma- "chocolate cysts"

Front 55

____ arises from a follicle that does not ovulate and is filled w fluid

Back 55

follicular ovarian cyst

Front 56

which disease is not common in elderly?
a) Ovarian cancer
b)Fibroadenoma
c) Endometrial Cancer
d) all of the above are common in elderly

Back 56

Fibroadenoma

Front 57

T/F
risk of ovarian cancer declines w age

Back 57

F- risk increases w age - peak btween 65-84

Front 58

what is the risk factor for ovarian cancer?

Back 58

increased length of uninterrupted of ovarian cycle w/o preg, birth control, lactation

Front 59

what are the possible pathologies of ovarian cancer

Back 59

epithelial tumor
germ cell tumor
gonadal stromal tumor

Front 60

which disorder is relatively asymptomatic

Back 60

ovarian cancer

Front 61

This disorder lies on chromosome 17
a)Endometrial Cancer
b)Ovarian Cancer
c)Breast Cancer
d)A/C
e)B/C
f)All

Back 61

Ovarian Cancer
Breast Cancer (chrom 17&13

Front 62

T/F

Fibrocystic CHange is mostly singular and unilateral

Back 62

F

Fibroadenoma is mostly singular/unilateral

Front 63

your px exhibits multiple granular breast masses that are dull and ache especially during the luteal phase
what is the diagnosis?

Back 63

Fibrocystic change

Front 64

what is the pathology of non-proliferative fibrocystic change

Back 64

cystic dilation of terminal ducts and increase in fibrous stroma

Front 65

what is the pathology of proliferative fibrocystic change?

Back 65

ductal epithelial hyperplasia increasing risk of cancer

Front 66

T/F

proliferative fibrocystic change is hypertrophy of ductile epithelia

Back 66

F

Hyperplasia

Front 67

Which pathology is uncommon before age of 35

a) Fibroadenoma
b) Fibrocystic Change
c) Breast Cancer
d) PID

Back 67

Breast Cancer

Front 68

List some manifestations of Breast Cancer

Back 68

nipple retraction
irregular mass
thickening in breast contour/Peau d'orange
unusual nipple discharge

Front 69

what is the pathology of breast cancer

Back 69

adenocarcinoma

Front 70

List some risk factors for breast cancer

Back 70

genetic (chrom 17/13)
early menarche, late menopause
nulliparous women
first preg post 35yrs
hi saturated fat diet
fibrocystic change
previous breast cancer (10fold)

Front 71

when is the best time to perform self breast exam

Back 71

right after menses
same day e month for menopausal
shower
bedtime

Front 72

when should a women receive a baseline mammography?
how often should they return

Back 72

baseline at 35 yrs
every 2 yrs from 40-50yrs
yearly after 50 yrs

Front 73

fine needle aspiration and excisional biopsy are diagnostic methods for ______

Back 73

breast cancer

Front 74

define infertility

Back 74

inability to conceive a child after 1 year of unprotected sex

Front 75

define sterility

Back 75

inability to father or become pregnant

Front 76

explain the difference between primary and secondary infertility

Back 76

primary: no prior conception
secondary: 1 or more previous pregnancies

Front 77

list some causes for male infertility

Back 77

varicocele
ejaculatory dysfunction
infection
obstruction
congenital anomolies

Front 78

T/F azoospermia is if a man produces < 2mil sperm/ml

Back 78

F
< 1mil sperm/ml

Front 79

list the manifestations of male infertility

Back 79

azoospermia
oligospermia
asthenospermia

Front 80

define oligospermia
define asthenospermia

Back 80

<20 mil sperm/ml

< 50% sperm able to move

Front 81

describe healthy ejaculate

Back 81

>20 mil sperm/ml
2-5 ml of ejaculate
>50% mobility
> 65% normal morphology

Front 82

List some female factors that could cause infertility

Back 82

anovulatory cycle
luteal phase defect/not enough progesterone
cervical mucus problem
uterine abnormalities
tubal factor/obsrxn, PID