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Alterations of the Reproductive Systems
Terms in this set (88)
Which of the following is the first sign of puberty in girls?
B. Pubic hair
D. Premature closure of epiphysis
c.Breast development or thelarche is the first sign of puberty. Premature closure of the epiphysis is due to precocious puberty. Absence of menarche by age 15 or 16 is a clinical diagnosis of delayed puberty.
Which of the following terms is appropriate for painful menstruation associated with the release of prostaglandins in ovulatory cycles?
A. Primary dysmenorrhea
B. Primary amenorrhea
D. Secondary amenorrhea
a. Dysmenorrhea is painful menstruation; primary dysmenorrhea is due to release of prostaglandins in ovulatory cycles. Hirsutism is abnormal hairiness. Primary amenorrhea is failure of menarche by the age of 14. Secondary amenorrhea is the absence of menarche for the equivalent of three cycles.
Which of the following terms is appropriate for irregular menstrual flow?
c. Metrorrhagia is irregular flow. Menopause is cessation of menstrual flow or menses. Excessive menstrual flow is menorrhagia. Heavy, irregular flow is menometrorrhagia.
A woman presents with hirsutism, amenorrhea, and infertility. She is also very obese. Which of the following is the most likely cause of her symptoms?
A. Premenstrual syndrome
B. Polycystic ovary syndrome
C. Pelvic inflammatory disease
D. Primary amenorrhea
b. Polycystic ovary syndrome is based on two of the following conditions: androgen excess, oligo-ovulation or anovulation, or clinical signs of hyperandrogenism and polycystic ovaries. Signs usually start at puberty and include loss of normal menstrual function. This may be either amenorrhea or dysfunctional uterine bleeding. Hirsutism is common. Obesity is also likely.
A woman presents with an inflammation of one of the ducts that lead from the vaginal opening. Which of the following is the appropriate term for this condition?
D. Pelvic inflammatory disease
c.Bartholin glands are the ducts that lead from the vaginal opening. They may be inflamed by normal floral of the genital area or by sexually transmitted pathogens.
A woman has a prolapse of a portion of her bladder. Which of the following is an appropriate term for this condition?
B. Uterine prolapse
Which of the following types of cysts contains skin, hair, and sebaceous and sweat glands?
A. Corpus luteum cyst
B. Dermoid cysts
C. Ovarian torsion
D. Follicular cyst
a. Cystocele is the descent of a portion of the posterior bladder wall. Urethrocele is a sagging urethra. A pessary is a removable mechanical device that holds the uterus in position. Uterine prolapse is descent of the cervix or entire uterus into the vaginal canal.
Which of the following types of cysts contains skin, hair, and sebaceous and sweat glands?
A. Corpus luteum cyst
B. Dermoid cysts
C. Ovarian torsion
D. Follicular cyst
b. Dermoid cysts contain elements from all three germ layers. They are common ovarian neoplasms. Ovarian torsion is rare but is a gynecologic emergency. These women have severe abdominal pain. A corpus luteum cyst occurs because of a hormonal imbalance including low LH and progesterone levels. Follicular cysts can be caused by a transient condition in which the dominant follicle fails to rupture or one or more of the nondominant follicles fails to regress.
Which of the following is a TRUE statement regarding uterine fibroids (leiomyomas)?
A. More common in white women
B. Most prevalent in young age
C. Decreases with menopause
D. Develops from cartilage
c.They develop from smooth muscle and increase from age of 30 through 50 and decrease at menopause. They are more common in black and Asian women.
Which of the following is NOT a cofactor for the development of cervical cancer?
B. Chlamydia infection
C. Breast cancer
D. HIV infection
c.Smoking, Chlamydia infection, HIV infection, immunosuppression, and poor nutrition are factors in cervical cancer development.
Which of the following is the most common cause of urethral stricture in a man?
C. Indwelling catheter
D. Congenital defect
c.The scars in urethral stricture are more likely to result from trauma or untreated or severe urethral infections, most often from long-term use of indwelling urinary catheters.
A man presents with inflammation of the glans penis. Which of the following is the correct medical term for this condition?
d.Balanitis is inflammation of the glans penis. Priapism is a prolonged erection. Phimosis is a condition in which the foreskin cannot be retracted. Paraphimosis is when the foreskin is retracted and cannot be reduced.
A man is diagnosed with a scrotal disorder. There is abnormal dilation of the veins in the spermatic cord. It feels like a "bag of worms." Which of the following is the name for this condition?
a.Varicocele is dilation of the veins of the spermatic cord. A hydrocele is a collection of fluid within the tunica vaginalis. Spermatocele is a painless diverticulum of the epididymis. Cryptorchidism is a condition of testicular maldescent.
Which of the following is a TRUE statement regarding torsion of the testis?
A. Relief is obtained with elevation of the scrotum.
B. A high-riding testis may be noted.
C. It is a benign condition.
D. It is most common in middle-aged men.
b is a condition in which the testis twists on its cord. There is decreased blood flow. It is common in neonates and boys near puberty. There is no relief with elevation of the scrotum. It is a surgical emergency, and surgery must be done within 6 hours if it cannot be untwisted with manual manipulation.
A 24-year-old man has pain in his testes. He has just recovered from the mumps. Which of the following is the most likely cause of his testicular pain?
D. Testicular torsion
a. Orchitis is inflammation of the testes often caused after an infection with mumps. Prostatitis is an inflammation of the prostate. Epididymitis is an infection of the epididymis. Testicular torsion is rotation of a testis, which twists blood vessels in the spermatic cord.
Which of the following is a TRUE statement regarding benign prostatic hyperplasia?
A. Ten percent of men will have it by age 80 years.
B. It is an uncommon condition.
C. The prostate is largest at birth and continues to shrink.
D. It may be problematic if urethral compression occurs.
d. BPH is a common condition. It may be a problem if there is compression of the urethra. Eighty percent of men will have it before age 80. The prostate increases in size throughout life and is the smallest at birth.
Which of the following is TRUE regarding breast cancer?
A. The older the woman at her first childbirth, the lower is her risk.
B. It is the second most common cause of cancer in women.
C. The incidence has declined since 1955.
D. The median age for breast cancer is 64.
d. The median age is 61 for breast cancer. It has been on the rise since 1950. It is the most common cause of cancer in American women. Early childbirth lowers the risk of having breast cancer.
Which of the following is a NOT a nonproliferative change in breast tissue?
A. Fibrocystic changes
C. Florid hyperplasia
D. Calcifications in cysts
c. Florid hyperplasia is considered a proliferative breast lesion. Cysts and calcifications that are found in cysts are included in the symptoms of nonproliferative fibrocystic changes.
A man complains of an abnormal curvature of his penis. He states it has been getting worse since puberty and that intercourse is painful. Which of the following is the most likely cause?
A. Peyronie disease
a. Peyronie disease is a fibrotic condition that causes lateral curvature of the penis during erection. It develops slowly and usually affects middle-aged men. Phimosis and paraphimosis are problems with the foreskin. Orchitis is inflammation of the testes.
A man complains of unilateral pain in his scrotum. He has a red and swollen area on his scrotum. He is sexually active, with many partners. Which of the following is the most likely cause of his pain?
D. Benign prostatic hypertrophy
c. Pain is the main symptom of epididymitis. There may be pyuria or bacteriuria and urinary symptoms. In young men the cause may be a sexually transmitted organism.
Which of the following is NOT a frequent site for distant metastasis for prostate cancer?
B. Lymph nodes
A. The most frequent sites for distant metastasis include lymph nodes, bones, lungs, liver, and adrenals.
Which of the following is NOT one of the three normal processes of sexual response?
c. The three normal processes include erection, emission, and ejaculation.
Which of the following is the most common cause of galactorrhea?
D. Pituitary tumor
a. Nonpuerperal hyperprolactinemia or excessive amounts of prolactin in the blood NOT related to pregnancy is the most common cause. This may be caused by any factor that stimulates or overstimulates the pituitary gland.
Which of the following is TRUE regarding hormonal factors and breast cancer?
A. Protective effects of ovary removal
B. Protective effects of late pregnancy
C. Protective effects of early menarche
D. Protective effects of late menopause
a. Removal of the ovaries and pituitary gland offers a protective effect. This is not often done, but it has been researched. There are protective effects of early pregnancy. There is increased risk with early menarche and late menopause.
Which of the following genes has NOT been linked with breast cancer?
D. The genes linked to breast cancer include TP53, Bcl-2, HER-2Neu, and c-myc.
Which of the following is NOT a risk factor for ovarian cancer?
A. Early menarche
B. Late menopause
D. Fertility drugs
C. A woman who is nulliparous or has no children is at risk for ovarian cancer.
Which of the following is TRUE regarding gynecomastia in men?
A. It may begin as a palpable mass anywhere on the chest.
B. It affects less than 3% of the male population.
C. Incidence is greatest among adolescents and older men.
D. It generally indicates cancer.
C. It has an incidence of 32% to 40% and is most common in adolescents or men older than 40. It usually starts as a 2-cm mass in the subareolar area.
Which of the following is considered a risk for vaginal cancer?
A. Prior or concurrent cervical cancer
C. Concurrent breast cancer
D. Birth control pills
C. Prior or concurrent cervical cancer and diethylstilbestrol exposure are linked to vaginal cancer, which is rare.
Secondary sex characteristics have not appeared in girls by age 13
Or menarche has not happened within 5 years of thelarche or by 16
Secondary sex characteristics have not appeared in boys by age 14
enlargement of testes, thin scrotal skin
95% of cases are physiologic aka constitutional (hormonal- or hypothalamic-pituitary-gonadal axis delay)
Just slow to mature
5% are caused by some type of disruption of the hypothalamic-pituitary-gonadal axis
To treat or not to treat?
Precocious puberty (rare)
Sexual maturation before age 6 in black girls and age 7 in white girls
Sexual maturation before age 9 in boys
Isosexual precocious puberty- same sex
Heterosexual precocious puberty- opposite sex
Incomplete precocious puberty
HORMONE RESPONSIBLE IS LEPTIN
Primary dysmenorrhea 50%-90% of young women
Painful menstruation associated with prostaglandin release in ovulatory cycles
Related to duration and amount of menstrual flow
+Painful menstruation related to pelvic pathology. Something is really wrong here.
+Can occur at any time in the menstrual cycle
Failure of menarche and the absence of menstruation by age 14 years without the development of secondary sex characteristics or by age 16 years regardless of the presence of secondary sex characteristics
Absence of menstruation for a time equivalent to three or more cycles or 6 months in women who have previously menstruated
Classified by compartments
Anatomic defect in the outflow tract
Disorder of the anterior pituitary
Disorder of the hypothalamus
Dramatic weight loss
Malnutrition or excessive exercise
Polycystic ovary syndrome
Common during early adolescence, perimenopause, pregnancy, and lactation
Infertility, vasomotor flushes, vaginal atrophy, acne, osteopenia, hirsutism
Most common cause of cycle irregularities
Lots of Prolactin in the Blood. Milk comes after baby.
Abnormal uterine bleeding
-Other: tumors, polyps, cysts
+Dysfunctional uterine bleeding
-Heavy or irregular bleeding without disease
Polycystic ovary syndrome
+Oligo-ovulation or anovulation
+Elevated levels of androgens or clinical signs of hyperandrogenism and polycystic ovaries
+Leading cause of infertility in United States
-Hyperinsulinism- prevents follicular decline
+Dysfunction of follicle development
Premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD
+Cyclic physical, psychologic, or behavioral changes that impair interpersonal relationships or interfere with usual activities
+Occurs in the luteal (postovulatory) phase
+Abnormal nervous, immunologic, vascular, and GI tissue response to the normal menstrual cycle (>200 symptoms)
+Treatments? ssri's inhibitors its new
Pelvic inflammatory disease (PID)
+Acute inflammation caused by infection
-Can travel through the lymphatic system
+May involve any organ of reproductive tract
-Salpingitis- fallopian tubes
+Sexually transmitted diseases migrate from the vagina to the upper genital tract
-Thanks infected sperm
-Microbes ascend from infected cervix to -endometrial tissue; infect uterus and adnexae
+Infection of the vagina
+Sexually transmitted pathogens and Candida albicans (Yeast)
+Acidic nature of vagina provides some protection
-Maintained by cervical secretions, normal flora
+Inflammation or infection of the cervix
+Mucopurulent cervicitis (MPC)
Pus coming from the cervix
+Inflammation of the female external genitalia
-Contact with soaps, detergents, lotions, hygienic sprays, shaving, menstrual pads, perfumed toilet paper, or nonabsorbing or tight-fitting clothing
-Vaginal infections that spread to the labia
+Inflammation of one or both ducts that lead from the vaginal opening to Bartholin glands
+Caused by microorganisms that infect the lower female reproductive tract
+nflammation narrows the distal portion of the ducts
+Leads to obstruction and stasis of glandular secretions
Pelvic Organ Prolapse
+The bladder, urethra, and rectum are supported by the endopelvic fascia and perineal muscles
+The muscular and fascia tissue loses tone and strength with aging
Cystocele and rectocele
Bladder and Rectum coming thru the vagina
Benign ovarian cysts (common)
+Produced when a follicle or number of follicles are stimulated but no dominant follicle develops and reaches maturity
+Corpus luteum cysts
-Can contain hair, skin, muscle, bone
Commonly called uterine fibroids
Benign tumors of smooth muscle cells in the myometrium
Cause abnormal uterine bleeding, pain, and symptoms related to pressure on nearby structures
+Islands of endometrial glands surrounded by benign endometrial stroma within the myometrium
+Functioning endometrial tissue implants outside the uterus
Can range from the vagina to the lungs
+Responds to hormone fluctuations of the menstrual cycle
+Causes infertility, pain, dysmenorrhea, dyschezia, and dyspareunia
-Retrograde menstruation, spread through vascular or lymphatic systems, stimulation of multipotential epithelial cells on reproductive organs, or depressed Tc cells tolerate ectopic tissue
Hurts when you poop
Hurts when you have sexual intercourse
+Cervical carcinoma in situ
-Top cells have cancer but underlying tissue is ok
-Generally a precursor of invasive carcinoma of the cervix
+Invasive carcinoma of the cervix
+Almost exclusively caused by cervical human papillomavirus (HPV) infection
+With early detection and treatment, prognosis is excellent
Woman under the age of 26 is most likely to get cervical cancer because there cervix hasn't reached maturity.
+Frequently diagnosed after metastases have occurred
-Women over 40, early menarche, late menopause, nulliparity, and use fertility drugs, p53 tumor suppressor gene abnormalities, and BRCA1 gene alterations
-Multiple pregnancies, prolonged lactation, and use of oral contraceptives
Sexual Dysfunction in a female
+Disorders of desire (inhibited sexual desire, decreased libido)
+Vaginismus (involuntary spasm) closed for business
+Anorgasmia (orgasmic dysfunction)
+Rapid orgasm - Comes fast and done
+Dyspareunia (painful intercourse)
+Inability to conceive after 1 year of unprotected intercourse with same partner
+Fertility can be impaired by factors in the man, woman, or both
Inflammation of the urethra usually but not always caused by a STD
Nonsexual origins can be due to urologic procedures, insertion of foreign objects, anatomic abnormalities, or trauma
Fibrotic narrowing of urethra caused by scarring
Commonly due to trauma or untreated or severe urethral infections
Inability to retract foreskin from the glans of the penis (distal to proximal)
Inability to replace or cover the glans with the foreskin (proximal to distal)
Bent nail" syndrome
Slow development of fibrous plaques (thickening) in the erectile tissue of the corpus cavernosa, causing lateral curvature of penis during erection
Occurs in middle-aged men and causes painful erections and intercourse
Condition of prolonged penile erection
+Inflammation of the glans penis
+Usually associated with foreskin inflammation (posthitis)
Accumulation under the foreskin (smegma) causes irritation of the glans
+Carcinoma of the penis is rare
+Mostly squamous cell carcinomas
+Often diagnosed in men older than age 55
Failure of one or more of the testes to descend from the abdominal cavity into the scrotum
Testis that has strayed from the normal pathway of descent
Torsion of the testis
+Rotation of the testis
+The rotation causes the twisting of the blood vessels in the spermatic cord
+Painful and swollen testis
+Condition may be spontaneous or follow physical exertion or trauma
Acute inflammation of the testis
Complication of a systemic disease or related to epididymitis
Most commonly related to mumps
Cancer of the testis
Among the most curable of cancers
Common in men between ages 15 and 35
Causes painless testicular enlargement
90% is germ cell tumors
+Inflammation of the epididymis
+Common in sexually active young men
+The pathogenic microorganism reaches the epididymis by ascending the vas deferens from an already infected bladder or urethra
Benign prostatic hyperplasia
+Enlargement of the prostate gland
+Symptoms associated with urethral compression
+Relationship to aging
-Digital rectal exams
-Prostate-specific antigen (PSA) monitoring
+Inflammation of the prostate
+Normal protective barriers
Urethral length, micturition, and ejaculation
+Similar symptoms to BPH
-Urinary retention, nocturia, dysuria
-Fever, chills, lower back pain
-Chronic pelvic pain syndrome
Cancer of the prostate
95% of prostate neoplasms are adenocarcinomas and demonstrate peripheral zone growth
Prostatic cancer is asymptomatic until its advanced stages
Symptoms are similar to BPH
Persistent and sometimes excessive secretion of milky fluid from the breasts of a woman who is not pregnant or nursing
Galactorrhea can also occur in men
Women with galactorrhea also experience menstrual abnormalities
Causes hypothyroidism, anterior pituitary disorders, various medications
Nonproliferative breast lesions
Sensitive to the menstrual cycle
Proliferative breast lesions without atypia
Complex sclerosing lesion
Most common cancer in American women
Leading cause of death from ages 40 to 44
Second most common killer after lung cancer
First sign- painless lump
Ductal carcinoma in situ
Controversy on whether lesions progress to infiltrative malignancy
Aspirin can actually reduce risk
Overdevelopment of the breast tissue in a man
Results from hormone alterations
Idiopathic and system disorders, drugs, or neoplasms
Male breast cancer
Most commonly seen after age 60
Tumors resemble carcinomas of the breast in women
Crusting and nipple discharge are common clinical manifestations
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