1
Q
what thing related to the penis can be affected by vascular conditions?
A
penile erection
2
Q
what category of disorder is hypospadiasis?
A
congenital disorder of the penis
3
Q
what category of disorder is epispadias?
A
congenital disorder of the penis
4
Q
where is the urethra of hypospadiasis?
A
ventral (underside)
5
Q
what may be accompanied by hypospadiasis?
A
undescended testes and inguinal hernia
6
Q
where is the urethra in epispadias?
A
dorsal (Upper)
7
Q
what could be accompanied by epispadias?
A
extrophy of the bladder
8
Q
what is the tightening of the prepuce or penile foreskin that prevents its retraction over the glans?
A
phimosis
9
Q
what is foreskin so tight and constricted that it cannot cover the glans?
A
paraphimosis
10
Q
what is inflammation, either chronic or acute, of the glans penis?
A
balanitis
11
Q
what is inflammation of the prepuce (foreskin)?
A
posthitis
12
Q
what is the inflammation of both the penis and the prepuce (foreskin)?
A
balanoposthitis
13
Q
what is a localized and progressive fibrosis of unknown origin that affects the tunica albuginea?
A
peyronie disease
14
Q
What are the manifestations of Peyronie’s? (SATA)
A- painful erection
B- bent erection
C- presence of hard mass at site of fibrosis
D- erectile dysfunction
E- prolonged erection is painful
F- changes in tissue consistency
G- ischemia in the penile tissue
H- painful after erection
A
A- painful erection
B- bent erection
C- presence of hard mass at site of fibrosis
E- prolonged erection is painful
F- changes in tissue consistency
H- painful after erection
15
Q
what is the inabiity to achieve and maintain an erection sufficient to permit satisfactory sexual intercourse?
A
erectile dysfunction
16
Q
what does increased bp do to erection?
A
it affects blood flow
17
Q
is HTN a risk factor for ED (Erectile Dysfunction?
A
YES
18
Q
is alcohol a risk factor for ED?
A
NO
19
Q
is hyperlipidemia a risk factor for ED?
A
YES
20
Q
is cigarette smoking a risk factor for ED?
A
YES
21
Q
is DM a risk factor for ED?
A
YES
22
Q
is pelvic radiation a risk factor for ED?
A
YES
23
Q
is afterial insufficiency a risk factor for ED?
A
YES
24
Q
Is hypotension a risk factor for ED?
A
NO
25
What are the organic causes of ED? (SATA)
A. Neurogenic
B. Hormonal
C. Vascular
D. Performance Anxiety
E. Drug induced
F. Depression
G. Penile related etiologies
A. Neurogenic
B. Hormanal
C. Vascular (not sufficient BF)
E. Drug induced
G. penile related etiologies
26
What are psychogenic causes of ED? (SATA)
A. Performance anxiety
B. Neurogenic
C. A strained relationship
D. vascular
E. depression
F. overt psychotic disorders
performance anxiety
a strained relationship
depression
overt psychotic disorder
27
what is the involuntary, prolonged (over 4 hrs) abnormal and painful erection that continues beyond / unrelated to sexual stimulation?
priapism
28
The result of conditions such as trauma, infection, and neoplasm (Cancer) is what for priapism?
A. Primary
B. Secondary
A. Primary
29
Hematologic conditions such as leukemia, sickle cell disease, and thrombocytopenia are what causes priapism?
A. Primary
B. Secondary
B. secondary
30
Renal failure is what for priapism?
A. Primary
B. Secondary
B. Secondary
31
Neurologic conditions such as stroke, spinal cord injury, and other central nervous system lesions are what to priapism?
A. Primary
B. Secondary
B. Secondary
32
Is low flow ischemic or non ischemic?
ischemic
33
What kind of flow is it when there is stasis of bloodflow in the corpora cavernosa without resultant failure of detumescence (shrinking of swollen/ erect organ)?
low flow
34
what is detumescence?
Reduction of swelling, subsiding erection
35
what kind of flow involves persistant arterial flow into the corpora cavernosa for priapism?
high flow (non ischemic)
36
These signs indicate what:
invasive carcinoma of the penis begins as a small lump/ulcer
penile cancer
37
what can be present during penile cancer if you have this:
painful swlling, purulent drainage, or difficulty urinating
phimosis
38
what may be present with penile cancer for this in the inguinal region?
palpable lymph nodes
39
what are these set of risk factors indicate?
- increased age
- neonatal circumcision status
- poor hygiene
- smoking
penile cancer
40
what do these risk factors indicate risk of for the male?
- HPV infection
- ultraviolet radiation exposure
- immunodeficency state
- smoking
Penile cancer
41
how do you diagnose erectile dysfunction? (SATA)
A. careful history
B. Physical exam
C. Labratory tests
D. EKG
A. careful history
B. physical exam
C. labratory tests
42
what can these treat?
- psychosexual counseling
- androgen replacement therapy
- oral and intracavernous drug tx (meds PO or directly
Erectile dysfunction
43
what can these treat?
- vacuum constriction devices (Adds for pressure to put blood flow)
- Surgical tx: implant penis shaft
ED (erectile dysfunction)
44
what is the shunting of blood into the corpus cavernosum?
Erection
45
What is erection controlled by?
ANS
Neurotransmitters and endothelial relaxing factors
46
what kind of disorder is cryptorchidism?
Testes
47
What disorder category is balanoposthitis?
penis
48
what kind of disorder is phimosis?
penis
49
what is the main problem of cryptorchidism?
undescended testes
50
this occurs when 1 or both testicles fail to move down into the scrotal sac
cryptorchidism
51
these consequences indicate what disorder?
infertility
malignancy
testicular torsion (increase 10x risk)
possible psychological effects of empty scrotum
cryptorchidism
52
is this true or ectopic cryporchid?
Abdominal
TRUE
53
what type of cryptorchid is inguinal?
TRUE
54
what kind of cryptorchid is suprascrotal?
TRUE
55
what kind of cryptorchid is prepenial?
ectopic
56
what kind of cryptochid is superficial?
Ectopic
57
what kind of cryptorchid is prescrotal?
ectopic
58
what kind of cryptorchid is femoral?
ectopic
59
what kind of cryptorchid is perineal?
ectopic
60
what is fluid filled in shaft (Scrotum) that may go away on its own?
hydrocele
61
what is blood filled in shaft (scrotum)?
hematocele
62
who is hydrocele common in?
newborns
63
what is epididymis cyst containing sperm?
spermatocele
64
what is poor valve function, dilated scrotal veins of the spermatic cord and inadequate valves?
varicocele
65
what can lead to increase of scrotal temperature and cause infertility
varicocele
66
what is the twisting of spermatic cord and with severe pain and swelling? it also blocks blood flow
testicular torsion
67
what is a torturous (twist and turn) mass on the surface of the scrotum?
testicular torsion
68
what requires immediate surgery to save the testicle?
testicular torsion
69
ED is most common in people with ...?
DM
70
which condition is more likely to cause testicular torison?
cryptorchidism
71
what is the inflammation of epididymis?
Epididymitis
72
what are these causes of?
STD r/t urethritis
UTI and prostatitis
Bacterial pathogens
epididymititis
73
What are main causes of epididymitis?
BACTERIAL PATHOGEN
UTI
STI
74
what are the two types of epididymitis?
STI associated with urethritis
Primary non-sexually transmitted infection with UTI and prostatitis
75
What is this list of diagnosis able to detect?
Lab findings reveal increased WBD count
Urinalysis and urine culture
Gram stain examination or culture of midstream urine specimen/ urethral specimen
doppler ultrasound may be useful, revealing increased bloodflow to the affected testes
ESR (erythrocyte sedimentation rate) - faster rate means more inflammation
Epididymitis
76
What condition can males get after mumps or other infection like scarlet fever?
Orchitis
77
what does orchitis effect?
testicular blood barrier
78
what virus cause orchitis?
MUMPS
79
inflammation of the testes AFTER male patient develops an infection is what
ORCHITIS
80
primary infection fo the GU tract (UTI) can cause what? and the infection can be spread to testes through the bloodstream or the lymphatics
ORCHITIS
81
neoplasms due to exposure to tar, soot, and oils is what kind of cancer?
scrotal cancer
82
chronic inflammation
poor hygiene
HPV
(chimney sweeps)
can be a cause for what?
scrotal cancer
83
Risk factors: cryptorchidism, genetic factors, and disorders of testicular development --> what is this a risk of?
Testicular cancer
84
What is the first signs of testicular cancer?
slight enlargement of the testicle with some discomfort
85
how can you dx early for testicular cancer?
monthly self exam
86
how to do diagnosis testicular cancer? (SATA)
A. Palpation of the testes surrounding structures
B. Bloodwork
C. trans-illumination of the scrotum
D. ECG
E. abdominal palpations
F. US (ultrasound), CT (like x ray), and MRI to check metastatic spread
A, C, E, F
87
What is a treatment for testicular cancer?
orchiectomy (removal of the testicle)
88
what stage is tumor confined to testes, epididymis, or spermatic cord only? (testicular cancer: TNM classification)
STAGE I
89
At what stage does the tumor spread to the retroperitoneal lymph nodes below the diaphragm? (testicular cancer: TNM classification)
STAGE II
90
what stage is metastases outside of retroperitoneal nodes or above the diaphragm?(testicular cancer: TNM classification)
STAGE III
91
what does mumps look like?
swollen neck/ cheeks
92
what are the types of prostatitis?
Acute bacterial
Chronic bacterial
Chronic prostatisis/ chronic pelvic pain syndrome
93
What two types of chronic prostatitis / chronic pelvic pain syndrome is there?
inflammatory prostatitis
non inflammatory prostatitis
94
what are s/sx of prostatitis?
(SATA)
A. sedation
B. need to urinate frequently
C. anuria
D. headache
E. N/V
F. Involuntary urination at night
G. Fever
B, D, F, G
95
these risk factors can cause what condition?
hypothermia
lifestyle
alcohol
obesity
hormones
injuries
stress
prostatitis
96
what is prostatitis?
inflammation of the prostate gland (makes seminal fluid)
97
What is BPH?
non malignant enlargment of the prostate gland
98
what age related change is associated with BPH
change in hormone levels
99
what is digital rectal exam (DRE) a method for diagnosing?
BPH
100
What is the desired level for PSA (prostate specific antigen)?
less than 4 but mroe age based
101
what is characterized by the formation of large, discrete lesions in the periurethral region of the prostate rather than the peripheral zones in the prostate cancer
BPH
102
What does an elevated PSA level indicate?
Prostate cancer
103
what does a sudden sharp rise in PSA suggest?
prostate cancer
104
what are two additional diagnostic tests for BPH?
WBC and BUN/Creatinine levels
105
what is a common tx for BPH
finasteride
106
what surgical procedure is used to treat BPH?
transurethral resection of the prostate (TURP)
107
what is the Gleason score used for?
grading prostate cancer
108
what are these dx and tx used for?
- biopsy
- Gleason score
- tumor markers
- watchful waiting
- surgery
prostate cancer
109
what are these dx and tx used for the male condition?
- radiation therapy
- high intesity focused ultrasound
- chemotherapy
- cyrosurgery
- hormonal therapy
-combination
prostate cancer
110
does high PSA level mean cancer?
not all the time, may be benign or may be prostate cancer
111
what is CT scans of the chest, abdomen, and pelvis?
method of staging tumors
112
what method is ultrasonography for detection of bulky inferior nodal metastases used for?
method of staging tumors
113
what is lymphangiography used to stage?
tumors
114
what is radiographic methods to detect metastatic spread used for?
staging tumor
115
what diagnostic tool is used for prostate cancer?
Transrectal MRI
116
what is a surgical option for prostate cancer?
robotic prostatectomy
117
fill in the blank
primary stage tumors are ________ and discovered on histologic examiniation of prostatic tissue specimens (T1)
asymptomatic
118
Fill in the blank
Tumors are _________ on digital examination but are confined to the _______________. (T2)
palpable
prostate gland
119
Fill in the blank
Tumors have _________ __________ the ___________ (T3)
Extended beyond
Prostate
120
Fill in the blank
Tumors have pushed beyond the __________ to involve _________ _________ (T4)
prostate
adjacent structures
121
what controls erection? parasympathetic or sympathetic?
parasympathetic
122
what controls ejaculation / the penis relaxation? parasympathetic or sympathetic?
sympathetic
123
what does an erection involve?
shunting of blood into corpus cavernosum
124
what are two causes of ED?
Psychogenic
organic
125
which one is fast onset r/t stress and anxiety for ED?
Psychogenic causes
126
which one is slow gradula onset r/t gradual deterioration of fxn for ED?
Organic causes
127
what treats ED?
phosphodiesterase type V inhibitors mimic nitric oxide (Ex: sidenafil (viagara) or meds that end in fil )
128
what is the fluid filled sac that results from the occulution of the duct system in bartholin gland?
the cyst becomes infected the contents become purulent and an abscess can result if untreated
bartholin cyst
129
what do these treatment methods treat?
administration of appropriate antibiotics (if its big)
local application of moist heat (if its small)
incision and drainage (if its big)
Bartholin cyst
130
what is the inflammation and pruritus (itching) of the vulva that is not considered a specific disease, typically accompanies other local and systemic disorders.
vulvitis
131
what is a condition with females that is common with diabetes, chronic kidney disease, blood dyscrasias, and malnutrition?
vulvitis
132
what is blood dyscrasias
anything abnormal in the blood work
133
what is the syndrom eof unexpalined vulvar pain?
vulvodynia
134
what does rash/ hyperpigmentation of the vulva, changes in pH and flora diagnose?
vulvitis
135
how can you treat vulvitis?
hygiene
loose clothes
corticosteroid creams
136
What condition is associated with dysmenorrhea, interstitial cystitis (bladder infection), IBS, and anxiety/mood disorders?
localized vulvodynia
137
What condition is associated with no specific etiology (brain or spinal cord circuits sensitized) with stinging, burning, tender, cutting pain upon penetration
localized vulvodynia
138
What is associated with severe, constant, widespread pain or burning that interferes with ADLs, and no abnormalities are identified on exam? It can be triggered by infections, irritations, steroid creams, an increase in Ca oxalate, and a decrease in immunoglobulin A or CRP (remembering phantom pain)
Generalized vulvodynia
139
what accounts for about 3% of all genital malignancies occuring in females 60 yrs of age or older?
vulva cancer
140
These less common types of cancer are what in the vulva?
adenocarcinoma
Carcinoma of the Bartholin gland
basal cell carcinoma
malignant melanoma
Adenocarcinoma is in the form of extramammary paget disease (intraepithelial or invasive)
141
inflammation of the vagina
vaginitis
142
males with poor hygiene, immunosupression, or diabetes are more prone to what penile condition?
balanitis
143
how to treat vaginitis
antibiotic tx underlying issue
144
how to diagnose vaginitis? (3 ways)
1. patient history
2. visual inspection of internal/ external genitalia
3. wet prep and pH
145
what is an infection that involves the hair follicles of the mons or labia majora
folliculitis
146
these manifestations are what?
small red papules or pustules surrounding the hair shaft
folliculitis
147
what causes folliculitis? (list 2)
1. density of bacteria in the area
2. occlusive nature of clothing covering the genitalia
148
what describes a fluid filled sac that results from the occlusion of the duct system?
bartholin cyst
149
for premenchal, what are 3 reasons a person gets vaginitis?
1. poor hygiene,
2. intestinal parasites
3. the presence of foreign bodies
150
for child bearing years, what are 2 reasons for vaginitis?
C. albicans - yeast infection
Trichomonas vaginalis - STI
151
What are the causes of vaginitis during menopause? (1 cause)
atrophic vaginitis
152
pregnancy outside of the uterus (most of the time in fallopian tubes) are what?
ectopic pregnancy
153
what are risk factors of ectopic pregnancy? (3 risks)
1. previous ectopic pregnancy
2. tubule ligations (other tubule surgeries)
3. tubule abnormalities
154
What are some tubular abnormalities? (4 types)
lesions
narrowed
convoluted
diverticula
155
what do these s/sx indicate?
pelvic pain
lower abd discomfort diffused or localized to one side that progresses to severe pain caused by rupture
spotting
syncope (temporary loss of consciousness)
referred shoulder pain
amenorrhea (absence of periods)
Ectopic pregnancy
156
absence of menstruation
amenorrhea
157
scanty menstruation
hypomenorrhea
158
infrequent menstruation
oligomenorrhea
159
frequent menstruation
polymenorrhea
160
excessive menstration
menorrhagia
161
bleeding in between periods
metrorrhagia
162
heavy bleeding during and between menstrual periods
menometrorrhagia
163
what are these signs of:
mass or lump
puckering of the skin
nipple retraction
unusual discharge from the nipple
breast cancer
164
what is the pH level for vagina
3.8-4.5pH
165
what do these symptoms indicate:
abnormal bleeding
abnormal vaginal discharge
palpable mass
pain during intercourse
vaginal carcinoma
166
what do these cause:
local extension of cervical cancer
Exposure to sexually transmitted HPV
Rarely from local irritations such as others with prolonged used of a pessary
Vaginal cancers
167
what can be a precursor to vaginal cancer
HPV
168
is UTI a precursor to vaginal cancer?
NO
169
is local irritation a precursor to vaginal cancer
YES (ex: pessary)
170
What is the visible portion that is covered with stratified squamous epithelium which also lines the vagina called?
Exocervix
171
What is lined with columnar epithelium?
Endocervical canal
172
what kind of cells are in the cervix?
Squamous epithelium (also lines vagina) -visible portion exocervical
Columnar epithelium - endocervical canal
Presence of endometrial cells in cervical cytologic sample during luteal phase or post menopause is associated with endometrial disease
173
What is AGCUS
atypical glandular cells of undetermined significance
term used in pap smear results.
basically means they are unclear if they are serious or not
174
Where does Adenocarcinoma originate?
cancer that originates in glandular cells
175
Nabothian cysts
cysts found on the cervix. Usually harmless
176
what is a physical examination in breast cancer screening?
manually checking the breast for lumps, changes in the shape, or other abnormalities
177
what is ultrasonography in breast cancer screening?
using sound waves to create images of the breast tissue, helping to identify masses or abnormalities
178
what is percutaneous needle aspiration?
procedure that uses a thin needle to remove fluid or tissue from a suspicious area in the breast for testing
179
What is stereotactic needle biopsy?
minimally invasive procedure that uses imaging guidance to accuratley locate and sample breast tissue
180
What is an excisional biopsy?
surgical procedure that involves removing a lump or a portion of breast tissue for examination to determine if it is cancerous.
181
what is the function of cervix?
muscular structure thats a passageway for the baby
keeps bacteria and foreign material out of the uterus
during pregnancy forms a waxy mucus plug
182
waht does the cervix produce
rich protective mucus that change during teh menstral cycle
183
what is a pap smear
test for cervical cancer
looks for SIL (squamous intraepithelial lesions)
184
what is a visual examination of the vagina and cervix under magnification?
colposcopy
185
what is punching small tissue samples out like scraping it out?
biopsy sample vagina for diagnisis of cervical cancer
186
what are soft, velvety lesions, usually pedunculated (growth attached to tissue by a stalk) and often found protruding through the cervical
Polyps
187
Higher incidences during the reproductive years for ____.
Polyps
188
What usually develop as a result of inflammatory hyperplasia of the endocervial mucosa
polyps
189
Typically asymptomatic; may have associated with poscoital (after intercourse) bleeding is ______.
Higher incidence during reproductive years
Usually develop as a result of inflammatory hyperplasia of the endocervical mucosa
Cervical polyps
190
most of these are benign but should be removed and examined.
polyps
191
What do these cause:
direct infection of the cervix
secondary to a vaginal or uterine infection
caused by a variety of infective agents
acute cervicitis
192
What takes high resolution photos of the cervis
cervical cancer screening
cervicography
193
what is LEEP
Loop electrosurgical excision procedure for removing abnormal cervical cells
194
how to diagnose cervical cancer (5 ways)
pap smear (SIL)
colposcopy
biopsy sample
cervicography
LEEP
195
what is the bulging of the uterus into the vagina?
uterine prolapse
196
what do these cause:
post child birth
pelvic tumors
spina bifida (spinal cord doesnt close completely)
diabetic neuropathy
uterine prolapse
197
what are these manifestations of?
reddened and edematous
copious mucopurulent drainage and leukorrhea
acute cervicitis
198
what can untreated cervicitis lead to? (list 6)
pelvic cellulitis (bacterial infection of soft tissues in pelvis)
low back pain
dyspareunia (painful intercourse)
cervical stenosis (narrowing of cervical canal)
Dysmenorrhea (painful menstural cramps)
ascending infection (happens in PID) (starts low in reproductive tracts and moves upward into uterus)
199
What is CIN (cervical intraepithelial neoplasia) grading system
determines dysplasia/carcinoma
200
what is PID
inflammation of the upper repro tract, uterus (Endometritis, fallopian tubes, ovaries)
201
What is PID? What kind of infection?
polymicrobial infection
202
What are risk factors associated with PID? (list 4)
1. 16-24 yrs old
2. Nulliparity (never pregnant)
3. History of multiple sex partners
4. previous history of PID
203
what level of CIN is inital 1/3 of epithelia layer involved
well differentiated lesion
CIN I (mild dysplasia)
204
what level of CIN is initial 2/3 of epithelial layer
less well-differntialed lesion
CIN II (moderate dysplasia)
205
what CIN is full thickness involvemnet and undeifferntiaed lesion?
CIN III (Severe dysplasia or carcinoma in situ --> cancer in its earliest stage/ hasn't spread)
206
What is PCOS
polycystic ovarioan syndrome
207
what does PCOS cause (polycystic ovary syndrome)? (SATA)
A. hematuria
B. oligomenorrhea
C. high blood pressure
D. High test levels
E. small cysts on the peripheral of the ovary
F. Anovulation = infertility
G. Hyperandrogenism
H. Hypoandrogenison
B, D, E, F, G
208
what is infection caused by multiple types of microorganism that is a gynocological condition
polymicrobial infection
209
what is excess levels of male hormones in females
hyperandrogenism
210
what is infertility due to lack of ovulation
anovulation
211
how can you do early tx of cervical cancer?
Removal of lesions by one of various techniques
212
what are different ways to remove lesions for early tx of cervical cancer?
biopsy or local cautery
electrocautery
cyrosurgery
carbon dioxide laser therapy used to treat moderate to severe dysplasia limited to the exocervix
Therapeutic conization if the lesion extends into the endocervical canal
213
There a link between cervical cancer and ____ infection
HPV
214
what is inflammation of the endometrium
cervical barrier is compromised
endometritis
215
what are the cervical cancer HPV types?
16, 18, 31, 33, and 45
215
What are cervical cancer risks? (SATA)
A. Early age at intercourse
B. multiple sexual partners
C. promiscuous male partner
D. smoking
E. alcohol
F. history of STIs
G. HTN
A, B, C, D, F
216
What are the two strains of HPV that are responsible for 70% of cervical cancer?
16 and 18
217
what are the two most common benign strains of HPV which account for up to 90% of genital warts/.
6 and 11
218
What prevents infection with the HPV subtypes 16, 18, 6 and 11
gardasil
219
what is the functional endometrial tissue is found in ectopic sites
endometriosis
220
most common cancer found in the female pelvis
endometrial cancer
221
what is endometrial glands and stroma are found within the myometrium
adenomyosis
222
what causes acute endometritis?
Abortion or delivery
223
where is endometritis?
uterine lining (endometrium)
224
where is endometriosis?
ovaries, fallopian tubes, bladder, intestines, and other pelvic organs
225
Where is adenomyosis?
uterine muscular wall (endometrial tissue growing within the uterine muscular wall -- myometrium )
226
How can you diagnose endometritis?
curettage (scoop tissue from wall of body cavity of uterine lining)
227
what is a condition in which functional endometrial tissue is found in ectopic sits outside the uterus?
endometriosis
228
what do these symptoms indicate?
pelvic pain is the MOST COMMON presenting symptom
back pain
dyspareunia (pain during intercourse)
pain on defecation and micturition (urinating)
endometriosis
229
How to treat endometriosis? (list 3 ways)
1. pain relief
2. endometrial suppression (pregnancy can help)
3. surgery
230
what is a definitive tx of endometriosis?
total hysterectomy (removal of entire uterus) and
bilateral salpingo (fallopian tube) -oophor (ovary) ectomy
(removal of both fallopian tubes and both ovaries)
231
what is the main type of endometrial cancer?
Adeno (gland) carcinoma
cancer that starts in the gland forming cells in the uterine lining
232
what are some examples of locations that adenocarcinomas can occur
1. breast
2. colon and rectum
3. lungs
4. prostate
5. stomach
6. cervix (rare type)
7. vulva
8. uterus
Any gland forming or mucus secreting epithelium can develop this cancer
233
what are main reasons for endometrial cancer? (2 categories)
1. prolonged estrogen stimulation and endometrial hyperplasia
A thick overgrown endometrium has a higher chance of turning into endometrial cancer (adenocarcinoma)
2. hyperestrinism (excess estrogen) and endometrial hyperplasia
Too much estrogen --> overstimulation of endometrium --> endometrial hyperplasia (overgrowth of uterine lining)
234
What does hyperestrinism and endometrial hyperplasia mean?
Hyperestrinism --> hormone sensitive tumor because estrogen drives their growth
Hyperestrinism --> low grade tumors (adenocarcinomas) slowly and abnormal growth, less aggressive
Hyperestrinism --> favorable prognosis because it has one of the highest cure rates
Hyperestrinism --> painless abnormal uterine bleeding (KEY FACTOR: thickened unstable endometrium sheds without cramping)
235
What are the 3 types of leiomyomas
1. submucosal
2. subserosal
3. intramural
236
which type of leiomyoma is displace endometrial tissue and are more likely to cause bleeding, necrosis, and infection than either of the other types
submucosal
237
what type of leiomyomas is located beneath the perimetrium of the uterus
subserosal
238
what type of leiomyomas is embedded in the myometrium
intramural
239
what are these signs and symptoms of ?
pelvic pain
back pain
dyspareunia (painful intercourse)
pain on defication and micturition
endometriosis
240
what is leiomyomas?
(GIANT OUTPOUCHING TUMORS)
also known as fibroids
leio = smooth
myo = muscle
oma = tumor
benign tumor of the smooth muscle commonly found in myometrium (smooth muscle of the uterus)
241
how to diagnose adenomyosis?
MRI most accurate
ultrasound
242
how to treat adenomyosis
PO contraceptives
NSAIDs
Severe = hysterectomy
243
What cancer is hormone sensitive, low grade, and have a favorable prognosis with painless bleeding.
Most common cancer found in the female pelvis
Endometrial Cancer
244
how to diagnose endometrial cancer
endometrial biopsy
245
Endometrial cancer treatement for each stage.
Stage I - hysterectomy (+/- post op radiation)
Stage II-III - Hysterectomy + lymphnode excision +/- radiation
Stage IV - systemic chemotherapy
246
what is the most common type of tumor for uterus?
leiomyomas
247
how to diagnose leiomyomas?
discovered during routine pelvic examination
248
how to treat leiomyomas?
myomectomy (remove the tumors)
249
what is the building up of pus within the bartholin glands (within the labial folds)
Bartholinian cyst
250
where do you see a bartholin cyst?
on the outside
251
what is on the external genetailia; inflammation and puritis of the vulva
vulvitis
252
what is the symptoms of rash/ hyperpigmentation of the vulva, changes in pH and flora
vulvitis
253
what causes vulvitis?
- diabetes
- CKD
- blood dyscrasias (abnormal condition of the blood - ex: anemia, leukemia, thombocytopenia, etc)
- malnutrition
254
how to treat vaginitis
antibiotics to treat underlying issue
255
what is the inflammation of the upper reproductive tract that involves the uterus, fallopian tubes, and the ovaries
pelvic inflammatory disease
256
what is the inflammation of the uterus called
endometritis
257
what is the inflammation of the fallopian tubes called
salpingitis
258
what is the inflammation of the ovaries called
oophoritis
259
what is a condition that is a polymicrobial infection where the cause varies by geographic loaction and population?
PID (pelvic inflammatory disease)
260
what are the 4 predisposing factors of PID? (pelvic inflammatory disease)
1. an age of 16-24
2. Nulliparity (pregnant)
3. History of multiple sexual partners
4. Previous history of PID
261
what dx test for endometritis?
curettage (take something to scrape tissue)
262
what dx test for endometriosis
laparoscopy (looking inside abdomen with a camera)
263
how to dx test for adenomyosis
ultrasound (through tissue organ itself, look for growth)
264
what are factors of predisposing development of ectopic pregnancy? (4 ways)
1. previous tubual surgery
2. tubal ligation (tying fallopian tubes) or tubal reversal
3. previous ectopic pregnancy
4. tubal abnormality
265
what are tubal abnormalities?
lesion
narrowed
convuluted
diverticula (small pouch like bulges)
266
what is the MOST COMMON form of ovarian tumor?
cysts
267
disorders of the ovaries frequently cause what kind of problems?
menstrual and fertility
268
what is ovarian cysts and tumors related to?
hypothalamic
pituitary
adrenal dysfunction
269
polycystic ovary syndrome (PCOS) symptoms (list 5)
1. oligomenorrhea (irregular/ infrequent periods)
2. hyperadrogenism (too much male type hormones in a female body)
3. increased testosterone levels (block normal ovulation)
4. numerous small cysts at ovary periphery (unreleased follicles)
5. anovulation can lead to infertility (not ovulating)
270
what kind of cancer is diagnosed at an advanced stage because many symptoms are nonspecific and is therefore difficutl to distinguish from other problems presenting ot a primary care provider?
Ovarian cancer
271
what are some symptoms of ovarian cancer?
persistent bloating
felling full quickly
loss of appetite
urinary urgency
fatigue
unexplained weight loss
pelvic or stomach pains
272
what are four types of ovarian tumors?
1. serous and mucinous CYSTADENOMAS (fluid filled)
2. Endometriomas (chocolate cyst)
3. Ovarian FIBROMAS (connective tissue with collagen)
4. Cystic teratomas (DERMOID): contain sebaceous material, hair, or teeth
273
what is the fluid filled benign type of ovarian tumor?
serous and mucinous cystadenomas
274
what are chocolate cysts of ovarian tumors?
endometriomas (caused by endometriosis inside the ovary, old blood)
275
what is the connective tissue with collagen and that is benign solid ovarian tumors?
ovarian fibromas
276
which tumor contains sebaceus material, hair, or teeth or benign germ cell tumors?
cystic teratomas (dermoid)
277
how can you treat ovarian tumors
surgical excision
278
what is ovarian tumor risk associated with?
ovulatory age
279
Which ovarian tumor cyst is fluid-filled? Serous and mucinous, benign
cystadenomas
280
which ovarian cyst is solid with connective tissue and collagen?
ovarian fibromas
281
which cyst sheds like chocolate?
endometriomas
282
what are the four tyeps of ligaments?
1. uterosaceral
2. Round
3. broad
4. cardinal
283
what is a strong, slinglike structure that supprots the uterus, vagina, urinary bladder, and rectum?
muscular floor
284
what is a herniation of the bladder into the vagina (aging and postmenopausal changes to pelvic floor)
CYSTOCELE
285
what is the herniation of the rectum into the vagina? (Aging related)
RECTOCELE
286
what is it called when weakness in the area between the uterosacral ligaments just posterior to the cervix form a hernial sac into which the small bowel **protrudes** when the woman is standing?
ENTEROCELE (intestines)
287
what is enterocele word breakdown
intestine pushing into the vaginal wall
Entero = intestine
Cele = hernia or protrusion
288
what is the bulging of the uterus into the vagina?
uterine prolapse
289
how is uterine prolapse ranked?
by degree of protrusion
290
what are the causes of uterine prolapse? (4 reasons)
1. post childbirth (multiparous) = weakens pelvic floor muscles
2. pelvic tumors = weight and pressure pulls uterus into vagina
3. spina bifida (reducing the ability to seal) = nerve damage; cannot support uterus
4. diabetic neuropathy that interrupts the innervation of the muscle = muscles weaken and uterus descends
291
what kind of mestruation cycle is <21 days?
polymenorrhea (frequent periods)
292
what is intermenstrual bleed?
bleeding between periods (metororrhagia)
293
what is dysmenorrhea?
pain during menstruation
294
what is physical abnormality or pathology of menstration pain? (primary or secondary?)
primary
295
What is due to the specific organ condition for the pain in menstrual cycle? (primary or secondary)
Ex: endometriosis, fibroids, adenomyosis, pelvic adhesion, IUDs and PID
secondary
296
what are some secondary causes of pain during periods?
endometriosis (growth of endometrial tissue -uterine lining) outside the uterus)
fibroids
adenomyosis
pelvic adhesion
IUDS
PID
297
what is stereotactic needle biopsy?
Using imaging guidance to accuratly locate and sample breast tissue
298
what hormone deprivation is this:
retrogression of a previously built up endometrium and bleeding
bleeding often is irrecular in amount and duration
estrogen
299
what hormone deprivation is this:
abnormal menstrual bleeding
absence allows estrogen to induce thicker endometrial layer with greater blood supply
progesterone
300
what can happen with IUD that is dangerous and you need MRI for?
perforate. IUD prevents implantation
301
what is mild-moderate physical and psychological symptoms within 14 days of menses
PMS (premenstrual syndrome)
302
what is MOST SEVERE form of premenstrual distress and assocated with mood disorders?
PMDD (premenstrual dysphoric disorder)
303
what are contributing factors to PMS and PMDD?
depression
hormonal variation
fluctuations of serotonin
304
what is secretion of breast milk in non lactating breast?
galacorrhea
305
what is inflammation of the breast called?
mastitis
306
waht is grayish green nipple discharge?
Ductal disorders
307
what is firm, rubbery, sharply defined round mass? (benign solid tumor)
fibroadenoma
308
what is nodular granular breast masses? (cyst + fibrosis)
fibrocystic
309
what is the most common female cancer?
breast cancer
310
how is breast cancer detected?
palpation
mammography
311
how can you diagnose breast cancer? (SATA)
A. physical examination
B. Mammography
C. Ultrasonography
D. LEEP
E. Percutaneous needle aspiration
F. Excisional biopsy
G. Pap smear
H. stereotactic needle biopsy
A, B, C, E, F, H
312
Where is a nabothian cyst located?
cervix
313
what is a mobetron?
intraoperative electron radiation (IORT)
one time radiation treatment focused
GIANT MACHINE
314
what does TIA stand for?
Transient Ischemic Attack
315
TIA and strokes can be caused by what
disruption of cerebral circulation
316
What is a syndrome of acute focal neurologic deficit from a vascular disorder that injures brain tissue?
stroke
317
what is the difference between a TIA and a stroke?
similar to heart attack:
stroke has tissue death
TIA does not
318
watch out for stroke BEFAST
Balance
Eyes
Face
Arms
Speech
Time
319
what are the types of stroke?
ichemic
hemorrhagic
320
What is caused by an interruption of blood flow in a cerebral vessel, and are the most common type of strokes?
Ischemic stroke
321
What is caused by bleeding into brain tissue, usually from a blood vessel rupture caused by hypertension, aneurysms, or arteriovenous malformations?
hemorrhagic strokes
322
which is more fatal? TIA or stroke?
Stroke
323
what is this result of?
focal hematoma, edema, compression of the brain vein draining artery contents, or spasm of the adjacent blood vessels
Herorrhagic stroke results
324
what are the most common predisposing factors of a stroke?
Advancing age hypertension
325
what kind of stroke is caused by cerebrovascular obstruction by thrombosis or emboli
TIA as well
Ischemic strokes
326
what do TIA and stroke both result in?
disruption of the cerebral circulation
327
what is the second leading cause of kidney failure
glomerulonephritis
328
what is the inflammation of the glomeruli of the kidney
glomerulonephritis
329
what does the disease that provoke proliferative inflammatory response of endothelial mesangial or epithelial cells of the glomeruli cause?
glomerulonephritis
330
what does the inflammatory process of the glomerulonephritis do? (3 main things)
1. damage the capillary wall (lead to sclerosis)
2. permits RBS to escape the urine
3. produces hemodynamic changes that decrease the GFR (retention of waste products)
331
What are the characteristics of the immune mechanism of glomerulonephritis?
Immune mechanism
- glomerular antibodies
- circulating antigen-antibody complexes
332
what are the characteristics of glomerulonephritis?
Hematuria with red cell cast
Diminished GFR
Azotemia (lab finding waste: presence of nitrogenous wastes in the blood)
Oliguria (limited urine)
Hypertension (high BP)
333
what are urinary changes in glomerulonephritis?
proteinuria* (protein)
hematuria (blood)
pyuria (pus)
oliguria (little)
Edema*
hypertension
Azotemia (waste)
*more pronounced in nephrotic syndrome*
334
what are manifestations of NEPHROTIC syndrome?
massive proteinuria
hypoalbuminemia (losing protein from bloodstream)
Edema
Hyperlipidemia/ hyperlipiduria (fat in blood and urine)
335
What is the difference of nephrotic vs nephritic syndrome?
Nephrotic: leaky filter
- massive proteinuria
- HYPOalbuminemia (in blood)
- Edema
- Hyperlipidemia/hyperlipiduria
*high concentration of water to lower concentration of water*
Nephritic: Clogged filter
- Hematuria
- Oliguria
- Azotemia
- Hypertension
336
Glomerulonephritis will result from what?
Basement membrane thickening
Sclerosis (scarring of tissue)
Fibrosis (capillary wall damage)
Hypercellularity (excessive number of cells)
337
which (hodgkin/non hodgkin) disease is lymphoma arises in a single node or chain of nodes?
Hodgkin
338
which (h/nh) has reed sternberg cells?
Hodgkin
339
which (h/nh) ie mediastinal masses and B cell origin?
Hodgkin
340
Which (h/nh) is lymphoma originates at extranodal sites and spreads to anatomically continuous nodes?
Non hodgkin
341
Which (h/nh) takes a while to identify?
non hodgkins
342
Which one is retroperitoneum, mesentary, pelvis (multiple places and no pattern)
Non hodgkin
343
Which on is B, T, or NK cell origin?
Non hodgkin
344
which anemia is common worldwide and affects people of all ages?
Iron deficiency anemia
345
what is part of the intrinsic pathway?
PTT
Heparin
18-28 sec
346
what is part of the extrinsic pathway (tissue factor)
PT, INR
Coumadin/ Warfarin
12-14 sec
INR = 1.1 or less (2-3 therapeutic)
347
Which hemolytic anemia is inherited?
Heriditary spherocytosis
Sickle cell anemia
Thalassemia
G6PD enzyme deficiency
348
Which hemolytic anemia is acquired?
Antibody-mediated lysis
349
What is the damage to red cell membrane anemia?
Thalassemia
350
What is denature of Hemoglobin molecule anemia
G6PD enzyme deficiency
351
what anemia is the loss of membrane surface?
Hereditary spherocytosis
352
What anemia leads to severe hemolytic anemia and occlusion --> tissue hypoxia --> pain and edema?
Sickle cell anemia
353
What are acute s/sx of sickle cell anemia?
chest syndrome (ischemia in lungs)
stroke
renal ischemia
354
Which anemia is an autosomal recessive disease?
Sickle cell anemia (10% African heritage)
355
What is the tx for sickle cell anemia?
NO CURE
Alleviate s/sx:
IV fluids
PO fluids
Electrolytes
O2 for hypoxia and control sickling
bed rest
analgesics for pain
blood transfusion
356
What is caused by impaired DNA synthesis that results in enlarged red cells
Vitamin B12 (cobalamin) deficiency anemia
- pernicious anemia (prevent B12 absorption)
Folate deficiency anemia
Megaloblastic anemia
357
what are some ways you can have megaloblastic anemia?
stomach surgery
cancer
weight loss
decrease absorption
decrease vitamin B12
358
what is the disorder of pluripotential bone marrow stem cells for anemia
aplastic anemia
359
what occurs as a complication of chronic infections, inflammation, and cancer
- inflammatory cytokines that interfere with EPO production or response
chronic disease anemias (disease battle for long time)
360
Do all anemias look the same?
YES
361
what are 2 types of kidney failure?
1. AKI (acute kidney failrure)
abrupt onset
often reversible if recognized early and treated
2. CKD (chronic kidney disease)
develops slowly over years
irreparable damage to kidneys
362
what are common causes of CKD?
1. uncontrolled HTN
2. diabetes
3. Glomerulonephritis
4. other kidney disease
363
what are the stagest of CKD?
1. diminisehd renal reserve
2. renal insufficiency
3. kidney failure
4. end stage kidney disease
364
accumulation of nitrogenous waste is a manifestation of what kidney disorder?
CKD (waste removal)
365
alterations in water, electrolyte and acid base balance is a manifestation of what kidney disorder?
CKD (waste removal
366
Skeletal disorder is what manifestion in kidneys?
CKD (hormone production)
367
Hematologic disorders is what manifestion of kidney disorder?
CKD (Hormone production)
368
HTN and alterations in cardiovascular function is a manifestation of what kidney?
CKD (sodium and water removal)
369
Anemia, coagulopathies, heart disease, and pericarditis are manifestations of a kidney disorder?
CKD (hormone production)
370
What kidney condition has hematuria, diminished GFR, Azotemia, Oliguria, HTN, with glomerular antibodies, circulating antigen-antibody complexes?
Glomerulonephritis
ABSN
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