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238 Cards in this Set
- Front
- Back
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What are the characteristics of Leiomyoma?
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Benign tumor of smooth muscles of the uterus increasing in size under the stimulation of estrogen, and regressing spontaneously after menopause.
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At what age is Leiomyoma most common? Gender?
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Females 35 y/o or older.
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What are the three classifications of Leiomyoma?
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Submucosal, intramural, subserosal.
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Which classification of Leiomyoma is most common?
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Intramural
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Which classification of Leiomyoma causes more abnormal bleeding, necrosis, and infection?
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Subserosal
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What are the manifestations of Leiomyoma?
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Abnormal uterine bleeding or prolonged, excessive menstrual flow.
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What is the definition of pelvic inflammatory disease (PID)?
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Inflammation of the upper reproductive tract.
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What are the risk factors of PID?
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- age 16-24 unmarried with multiple sex partners
- history of STD -history of IUD |
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What are the six manifestations of PID?
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fever, lower abdominal pain which may start after menses, purulent discharge, adnexal tenderness, exquisitely painful cervix, blood test: ESR increases, WBC> 10,000/ mcl
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What is the definition of ectopic pregnancy?
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A fertilized ovum implants outside of uterine cavity
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What is the incidence of ectopic pregnancies?
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4.5 - 16.8/ 1,000 pregnancies
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What are the seven predisposing factors of ectopic pregnancies?
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PID, therapeutic abortion, tubal ligation or reversal, previous ectopic pregnancy, intrauterine exposure to DES, use of fertility drug to induce ovulation, and morning after pills
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What is the mechanism of ectopic pregnancies?
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Stricture of fallopian tube or localized to one side
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What are the five manifestations of ectopic pregnancies?
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Mostlyoccurs in the fallopian tube, lower abdominal discomfort, spotting, referred shoulder pain, and excruciating pain followed by syncope
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How do you diagnose ectopic pregnancies?
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Pelvic ultrasound 5th week, definitive laparoscopy, culdocentesis
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Most ovarian cysts are _____
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benign
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What are the five classifications of ovarian cysts?
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Follicular cyst, luteal cyst, polycystic ovary disease, endometrioma, cystic teratoma
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What is the incidence of ovarian cancer? (Age)
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Increases with age (65-84 y/o)
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What is the pathology of ovarian cancer?
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epithelial tumor, germ cell tumor, gonadal stromal tumor
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What are the manifestations of ovarian cancer?
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no sx or so vague that women seldom seeks care until disease is far advanced, abdominal distress, discomfort, flatulence, bloating
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How do you diagnose ovarian cancer?
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Blood test- CA 125 lacks sensitivity
TVS Gene of chromsome 17 is affected |
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What is the definition of a cystocele?
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Herniation of the bladder into the vagina
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What is the mechanism of cystocele?
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Weakness of muscles to support the bladder
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What is the mode of herniation of a cystocele?
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Through the anterior vaginal wall
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What are the 4 manifestations of cystocele?
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Bearing- down sensation, difficulty of urination ( frequency and urgency also), recurrent cystitis, stress incontinence
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What is the definition of uterine prolapse?
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Bulging of the uterus into the vagina
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What is the cause of uterine prolapse?
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Weakness of cardinal alignment
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What is the 1st degree of uterine prolapse?
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Cervix doesn't reach the introitus
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What is the 2nd degree of uterine prolapse?
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Cervix passes through the introitus
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Xi-Cleft of ST
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Liangqiu ST 34
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What is the definition of mastitis?
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Inflammation of the breast
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What are the risk factors of mastitis?
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lactating women, trauma, skin infection
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What are the manifestations of mastitis?
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Abscess, tenderness, warmth
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What is fibroadenoma?
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Benign, well demarcated, mostly single and unilateral
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When does fibroademoma enlarge?
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During pregnancy
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When does fibroadenoma cease to grow?
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After menopause
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What age does fibrocystic change occur?
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Women of all ages
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What is the cause of fibrocystic change?
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Unknown
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What are the two classifications of fibrocystic change?
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Non-proliferative and proliferative
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Describe non-proliferative fibrocystic change
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Cystic dilation of terminal ducts and increase in fibrous stroma
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Describe proliferative fibrocystic change
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Ductal epithelial hyperplasia and increased risk of cancer
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What are the manifestations of fibrocystic change?
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Grandular breast masses. Dull, aching pain, heaviness in luteal phase
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Breast cancer is uncommon before what age?
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35
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What are the five risk factors of breast cancer?
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Genetic, hormonal status (early menarche, late menopause, first pregnancy after 35), diet (high in saturated fat), fibrocystic change, and previous breast cancer
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What is the pathology of breast cancer?
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adenocarcinoma
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What are the four risk factors of breast cancer?
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Irregular mass, thickening of breast contour, unusual discharge, nipple retraction
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How do you diagnose breast cancer?
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BSE, phsyical exam every 3 years, mammograpght, excisional biopsy
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Define infertility
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Unable to conceive a child after 1 year of unprotected sex
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Define primary infertility
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there has been no prior conception
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Define secondary infertility
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there has been one or more pregnancies
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Define sterility
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Inability to father or to become pragnant
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What are the five causes of male infertility?
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Varicocele (quality of sperm cells), ejactulatory dysfunction, infection, obstruction, congenital anomalies
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What are the manifestations of male infertility?
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Azoospermia, oligospermia, asthenospermia
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Define azoospermia
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No sperm
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Define oligiospermia
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Small amount of sperm
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Define asthenospermia
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Sperm isn't moving
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What are the five female factors of infertility?
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Anolulatory cycle, luteal phase effect, cervical mucus problem, uterine abnormalities, and tubal factor, (10-15% unknown cause)
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How to you manage female infertility?
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IVF, GIFT, ZIFT, TET
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What is condylomata acuminata?
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Genital Warts
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What are the types of genital warts?
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Condylomata acuminate (cauliflower shapes), keratotic warts (thick and horny layer), popular warts (smooth surface), flat warts (macular)
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What is the pathology of condylomata acuminata?
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Innoculation of HPV into the stratified squamous epithelium leading to infection that replicates squamous epithelium (get bigger)
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What is the incubation period of condylomata acuminata?
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6 weeks to 8 months
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What is the subclinical manifestation of condylomata acuminata?
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No visible warts (more common)
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What is a manifestation od condylomata acuminata?
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Warts
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How do you diagnose condylomata acuminata?
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Slide examination and abnormal pap smear. Also vulvar pruritus
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How do you treat and prevent condyloma acuminata?
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Burn, surgical removal, vaccine
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What is the main causative agent of genital herpes?
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HSV2
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What is the pathology of genital herpes?
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vescicular lesion of dermis infecting local nerves; hiding in dorsal root of sacral regions
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What ia the incubation period of genital herpes?
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2-10 days
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What is the prodomal sign of genital herpes?
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local itching, burning, tingling, flu like symptoms
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Describe the acute phase of genital herpes
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Rupturing of vesicles on 5th day resulting in painful ulcers, swollen lymph nodes
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How do you diagnose genital herpes?
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S/X, ID of virus taken from lesion, serologic test (ID antibodies)
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How do you prevent and treat genital herpes?
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No cure.... good hygiene
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What is the causative agent of chanchroid?
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Haemophilus ducreyi
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What is the pathology of chanchroid?
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Acute ulcerative lesions with pustular discharge of the genitalia and lymph nodes
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What are the manifestations of chancroid?
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Macules--> pustules --> rupturing pustules --> painful ulcers
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How do you diagnose chancroid?
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Specific lesions, culture and PCR
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How do you treat chancroid?
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Antibiotic
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Lymphogranuloma venereum is caused by what?
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Chlamydia trachomatis
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What is the pathology of acute Lymphogranuloma venereum?
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Swollen and tender inguinal lymph nodes
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What is the pathology for chronic Lymphogranuloma venereum?
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Cervicitis and elephantitis
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How do you diagnose and treat Lymphogranuloma venereum?
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Clinical signs and serology test. Antibiotic treatment
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What is the causative agent of candidiasis (yeast infection)?
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candida albicans
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What are the risk factors for candidiasis (yeast infection)?
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BCP, indiscrimate use of antibiotic, underwear material and style, obesity, diabetes, systemic steroid use, and immunocompromised condition
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What is the pathology of candidiasis (yeast infection)?
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Local irritation and inflammation
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What are the manifestations of candidiasis (yeast infection)?
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Vulvar pruritis, dysuria, cheesy vaginal discharge
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How do you diagnose candidiasis (yeast infection)?
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clinical signs, wet mount slide with KOH, and culture
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What is the treatment for candidiasis (yeast infection)?
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Antifungal, sodium bicarbonate bath
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What is the causative agent for trichmonas?
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Trichomonas vaginalis
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What is the pathology of trichmonas?
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Organism feeds on the mucosa and white cells (local infection)
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What are the manifestations of trichmonas?
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Asymptomatic in male, copious and nasty discharge, local pruritis, strawberry spot of vagina or cervix, and increase vaginal pH
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How do you diagnose and treat trichmonas?
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Clinical signs and positive wet mount slide. Treatment is metronidazole
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What is the most prevalent vaginitis?
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Bacterial vaginosis
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What is the pathology of bacterial vaginosis?
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presence of anaerobic bacteria, sexual activity (gardnerella vaginosis), minimal inflammation
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What are the manifestations of bacterial vaginosis?
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Thin and gray and fishy discharge, no local irritation
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What is the diagnosis of bacterial vaginosis?
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fishy vaginal discharge (KOH), vaginal pH increases, presence of "clue cell"
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What is the treament of bacterial vaginosis?
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metronidazole
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What is the most prevalent STD in the US?
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chlamydial infection
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The coexistence of chlamydia and ____ is common
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gonorrhea
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What is the pathology of chlamydia?
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PID, pneumonia, trachoma,
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What are the manifestations of chlamydia?
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dysuria, mucopurulent cervical discharge, 75% of women and 50% of men are asymptomatic, untreated in women can lead to PID --> infertility
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How do you diagnose chlamydia?
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clinical signs, routine screening, flourescent antibody test, NAAT
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How do you treat chlamydia?
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Antibiotic
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At what age is gonorrhea most prevalent?
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15-44
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Gonorrhea most of the time is following a single or multiple exposure?
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Single
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What is the pathology of gonorrhea?
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Infection of mucus secreting epithelia, start from urethra and accessory glands, systemic infection
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Are men more likely to be symptomatic than women? (gonorrhea)
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Yes
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How do you diagnose gonorrhea?
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Hx of sexual exposure and symptoms, + Gram stain of vaginal discharge, culture if asymptomatic, detection of gonococcal enzyme, and testing for other STDs
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How do you treat gonorrhea?
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Antibiotic
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How is syphyllis transmitted?
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Sex
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Describe stage 1 of syphyllis
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Highly contagious, painless chancre of genitalia, swollen inguinal lymph nodes, healing within 2-12 weeks with or without tx
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Describe stage 2 of syphyllis
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6 weeks to 6 months after stage 1, rash of palms and soles, genital condyloma, alopecia... fever.. loss of appetite, lesions resolve in 2-6 weeks
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Describe stage 3 of syphyllis
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gummas, cardiovascular lesions, cns lesions
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how do you diagnose syphyllis?
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dark field exam (1 and 2 stages), non-specific test (VDRL, RPR), specific test (FTA-Abs, MHA-TP)
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How do you treat syphyllis?
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Antibiotic penicillin
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The testes develop by which months of gestation?
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7-9 months
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What does the dartos muscle do?
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Separates the two testes and responds to temperature change
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The tunica albuginea does what to the testes?
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Gives shape
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The spermatic cord includes what structures?
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Testicular artery, pampiniform plexus, nerve, ductus deferens, cremaster muscle
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What does the pampiniform plex do?
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Regulates temperature in testes
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The two seminal vesciles secrete a fluid containing what three properties?
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Fructose, prostaglandin, protein
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Prostate secretes what three properties ?
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Calcium, acid phosphate, and clotting enzyme
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What are the erectile tissues of the penis?
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lateral copora cavernose and ventral corpus spongiosum
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Whe hypothalamus excretes which hormone?
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GnRH
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GnRH controls which gland?
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Pituitary
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LH produces which hormone (male)?
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Testosterone
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FSH is responsible for what action in males?
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Initation of spermatogenesis
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Spermatogenesis occurs in the ____ tubules and initiated by ____ cells
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seminiferous.... sertoli
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Sperm cells can survive how many days within the female genital tract?
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1-2
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Which nerves are responsible for emission and ejaculation?
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Sympathetic
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Where are the parasympathetic nerves located?
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Sacral spinal cord
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What is hyposadias?
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Termination of the ventral surface of the penis
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What is episadias?
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Opening of urethra on the dorsal surface of the penis
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What is phimosis?
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Tightening of the penile foreskin that prevents retraction over the glans
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What is paraphimosis?
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Ischemia of the glans
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What is a priapsim?
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Involuntary erection that may last over 24 hours
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When does the incidence of priapism peak?
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5-10 y/o and 20-50 y/o
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What are the two mechanisms of priapism?
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Stasis of blood (Low flow) in the corpus cavernosum
And high flow |
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What is the primary and secondary classifcations of priapism?
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Primary- Trauma, infection
Secondary- Hemetologic disorders |
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When is the onset of peyronie's disease?
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Middle-aged and elderly
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What is peyronies disease?
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Progressive fibrosis of the tunica albuginea of the corpus.... painful and difficult intercourse
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What is balantis?
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acute of chronic inflammation of the glans penis
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What balanoposthitis?
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Inflammation of glans and prepuce
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What are the causes of blanitis and balanosthitis?
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Mainly overgrowth of bacteria
Trauma and infection |
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What are the cause and manifestation of penile cancer?
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Poor hygeine. Lumps and swollen lymph nodes
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What is cryptochidism?
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Failure of one or two testes
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What is the incidence of cryptochidism?
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Directly related to birth weight
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What is the manifestation of cryptochidism?
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Non-palpable testes
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What complications can arise from cryptochidism?
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cancer and infertility
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How do you diagnose cryptochidism?
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Ultrasound
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How do you treat cryptochidism?
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hormonal therapy
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What is hyrdocele?
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Excess of fluid in the visceral and parietel layers of the tunica vaginalis
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What is the incidence of hyrdocele?
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Greater than 40
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What are the causes of hyrdocele?
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Congenital.. local injury
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What are the manifestations of hydrocele?
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Papable cysts and ultasound
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What is the incidence of varicocele? age
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15-35
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Why can varicocele lead to infertiliy?
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Retrograde blood flow can affect sperm prodction
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What are the manifestations of varicocele?
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Heavy feeling in scrotum, feels liek a bag of worms, straining valsalvar maneuver
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What are the manifestations of epididymitis?
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Pain, fever, dysuria, increase in WBC
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What are the causes of scrotal cancer?
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Poor hygeine, HPV
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What is the age of scrotal cancer?
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60 or older
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What is the manifestation of scrotal cancer?
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Wartlike growth that eventually ulcaerates
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What is the incidence of tesicular cancer?
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15-35
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What is the manifestation of testicular cancer?
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Enlargment of testicle with some aching
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How do you diagnose tesicular cancer?
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Self exam, biopsy, ultrasound
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What are the manifestation of acute prostatis?
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High fever, frequent and urgent urination, dysuria, dull pain in scrotum
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How do you treat acute prostatis?
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antibiotic
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Chronic prostatis symptoms are mild or severe? they are easy or hard to treat?
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Mild... hard
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What age is benign prostatic hyperplasia most common?
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60-69
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What is a possible cause for benign prostatic hyperplasia?
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increased estrogen
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What is the main manifestation of benign prostatic hyperplasia? Seconary?
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Compression of urethra.Recurrent UTI, hypertrophy of UB, kidney infection
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How do you diagnose benign prostatic hyperplasia?
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blood tests, ultrasound, perform DRE
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How do you treat benign prostatic hyperplasia?
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Watch and wait... antiandrogen.. surgery
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What are the causes of prostate cancer?
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high testosterone, high fat diet, genetic
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How do you diagnose prostate cancer?
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DRE, PSA, ultrasound, biopsy
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How do you treat prostate cancer?
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Surgery and radiotherapy
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Describe the vesitbule
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Area between labia minora.. includes urethral and vaginal opening of bartholins glands
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The vagina is fermented by which bacilli?
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Doderlins
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What is the approximate pH of the vagina?
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3.8-4.2
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The uterus and cervix are held by which ligaments?
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uteralsacral and cardinal
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The ovaries are fully developed at which month of fetal life?
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3rd
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FSH in women stimulates what?
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Ovaries and estrogen
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LH in women stimulates what?
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ovulation and progesterone
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Estrogen is produced by which glands?
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Ovary and adrenal
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What are the functions of estrogen?
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Develops secondary sexual characteristics, promote reproduction process, decrease bone resorption, increases HDL and reduces LDL
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Progestrone is secreted by what?
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corpus luteum
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What are the functions of progesterone?
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Glandular development of breast and endometrium.. relaxes smooth muscle
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FSH does what to the ovaries?
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Enlarges
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Progesterone makes the body temp high or low?
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High
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The proliferative phase is stimulated by ____ and secretory phase is stimulated by _____
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Estrogen.. progesterone
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___% of dysfunctional menstrul cycles are anovulatory in nature
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90
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What are two manifestations of dysfunctional menstrual cycle?
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heavy bleeding at irregular interval, prolonged flow, no cramps
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Describe physiologic amenorrhea
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Teenage, prior or right after menarche, pregnancy, menopause
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Desrcibe pathologic amenorrhea
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absence of both menstruation and secondary sexual characteristics at 14 y/o, absence of menstruation at 16y/o regardless if there are secondary sexual characterisitcs, any age when menses ceased in a woman who had normal menstruation before
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What are acquired causes of amenorrhea?
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nutrition deficiency, emotional stress, too much exercise, intrauterine adhesion
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Describe primary dysmenorrhea
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Painful menstruation in absence of pelvic lesions, associated with ovulatory cycle, pain is spasmotic
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What is secondary dysmenorrhea?
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Painful menses in presence of organic disease
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What causes secondary dysmenorrhea?
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PID, endometriosis, tumor of eterus
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What age is PMS most prevalent?
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Mid 30s
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What are some manifestations of PMS?
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Psychological, GI, weight gain, neuromuscular
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What is the definition of menopause?
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Cessation of menstrual cycle of a year
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What are the manifestations of menopause?
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Depression, decreased estrogen and increased FSH, degradation of seconary sexual characteristics
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What lactiferous duct is located where?
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Nipple
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During pregnancy which hormone is responsible for the vascularity and heaviness of breasts?
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Estrogen
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During pregnancy which hormone buds and grows alveolar structures (lactation state)
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Progesterone
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Which hormone is responsible for milk ejection?
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oxytocin
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What are the causes of vulvitis?
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candida albicans, STD, menopause
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What age is carcinoma of the vulva most prevalent?
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greater than 60 y/o
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What is the causes of carcinoma of the vulva in the elderly? adults?
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elderly- hormonal imbalance
adults- STD |
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What is the pathology of carcinoma of the vulva?
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dysplasia of the epithelium tissue
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What are manifestations of carcinoma of the vulva?
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Late stage is swelling of ingunal lymph nodes.. persistent pruritis
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What are the causes of vaginitis ofa premenarchal girl? sexually active population? postmenopausal?
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premarche- poor hygeine
Sexually active- bacteria, yeast postmeno- atrophic vaginitis (estrogen deficiency) |
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What are the manifestations of vaginitis?
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Yucky vaginal discharge, redness and sweeling of vaginal tissues, pain during urination
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What is the incidence of cancer of the vagina?
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Rare.. mostly in elderly
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What are the causes of cancer of the vagina?
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Prolonged local irritation
metastasis |
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What are the manifestations of cancer of the vagina?
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abnormal bleeding, vaginal discharge, pelvic pain, dysuria
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What are the causes of cervicitis?
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Direct infection by yeast, bacteria or parasite. Secondary to viginal infection
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What are the manifestations of cervicitis?
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Red and edmatous cervix. Purulent itching and malodorous leukorrhea
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How do you manage cervicitis?
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ID the causative agent and then antibiotherapy accordingly
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What is the age range of cervical polyps?
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most during reproductive years
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What are the manifstations of cervical polyps?
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mostly asymptomatic
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What are the risk factors of cervical cancer?
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early age of intercourse, multiple sex partners, smoking
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What is the pathology of cervical cancer?
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Begins with squamos cels, then dysplastic period, carcinoma in situ has a long latent period (7-10) before transformng into the invasive period
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What is the manifestation cervical cancer?
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abnormal uterine bleeding
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What is the most definitive diagnosis of cervical cancer? what are the others?
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pap smear most definitive. Coloonoscopy and cervicography
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What are the risk factors of endometritis?
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post partum, post laboral, IUD
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What are the manifestations of endometritis?
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fever, abnormal uterine bleeding
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What is the definition of endometriosis?
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Endometrial tissue is found outside the uterus
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What is the incidence of endometriosis?
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Mostly western countries.. high in women with infertiliy or young women with chronic pelvic pain
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What are the risk factors in endometriosis?
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early menarche, regulary periods with shorter or longer cycles
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What is the pathology of endometriosis?
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Lesions and blood found in ovaries and pelvis
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What are the manifestations of endometriosis?
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dysmenorrhea, dyspaeunia, infertility
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How do you manage endometriosis?
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antiinflammatory, hormonotherapy, laparoscopy
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What age does endometrial cancer peak at?
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55-65 y/o
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What are risk factors to endometrial cancer?
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Obesity, anovulatory cycles, perimenopause, diabetes
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Orplonged use of progesterone (or unapposed estrogen therapy) causes hyperplasia of the ____
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endometrium
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What are the manifestations of endometrial cancer?
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Abnormal painless bleeding or prolonged nestrual flow.. late stage is cramping pelvic pain and enlarged lymph nodes
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How do you diagnose endometrial cancer?
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endometrial biopsy or ultrasound
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