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Ch. 16 Reproductive System Diseases and Disorders

Terms in this set (83)

anuria
absence of urine formation
cervicitis
inflammation of the cervix
chancre
firm, red, ulcerated sore; primary indication of syphilis; occurs at the point of entry of the infection
conization
surgical removal of a cone of tissue, such as excision of cervical tissue for microscopic examination
cyroblation
a procedure to remove tissue through the use of extreme cold
dilation and curettage
the uterine cervical canal is expanded (dilated) to allow scraping (curettage) of the surface lining of the uterus
effacement
dilation of the cervix
epididymis
a small, oblong organ resting on and beside the posterior surface of a testis, consisting of a convoluted tube 13 to 20 ft long, enveloped in the tunica vaginalis, ending in the ductus deferens
hysterosalpingography
use of x-rays to visualize the uterus and fallopian tubes
leiomyoma
timor of smooth-muscle tissue
lochia
postpartum discharge of blood, mucus, and tissue from the uterus
meiosis
process of two successive cell divisions, producing cells, egg, or sperm that contain half the number of chromosomes in somatic cells; when fertilization occurs, the nuclei of the sperm and ovum fuse and produce a zygote with the full chromosome complement
menarche
initial menstrual cycle, marking the onset of fertility
metrorrhea
abnormal uterine discharge
nystagmus
rhythmic, involuntary movement of the eyeball
oogenesis
the creation of the mature human ovum
orchidectomy
surgical removal of the testis
panhysterosalpingo-oophorectomy
surgical removal of the entire uterus, including the cervix, ovaries, and fallopian tubes
parturition
act of giving birth
primigravida
woman during her first pregnancy
prostaglandin
class of chemically related fatty acids present in many body tissues and having the ability to stimulate smooth-muscle contractions, lower blood pressure, and regulate or influence many other body functions
purulent
containing pus
rhonchus
rale or rattling in the throat, especially when it resembles snoring
spermatogenesis
process of creating a mature human sperm cell
tertoma
tumor composed of a number of different tissue types, none of which is normally found in the area of occurrence; usually occur in the testes or ovaries
variocele
dilation of the complex network of veins that comprise part of the spermatic cord to form a palpable swelling within the scrotum
infertility:
diagnosed as the failure to become pregnant after 1 year of regular, unprotected intercourse, even after one or more pregnancies; female fertility normally peaks at age 24 and diminishes after 30; female is most fertile within 24 hours of ovulation; male fertility peaks usually at age 25 and declines after age 40; greatest fertility for a male occurs when he has sexual intercourse four times a week; cause of infertility include hormonal problems, nutritional deficiencies, infections, tumors, and anomalies of the reproductive organs; males: persistent infertility may be caused by sperm deficiencies, congenital abnormalities, endocrine imbalances, surgical intervention, and infections and chronic inflammation of the testes, epididymis, or vas deferns; in both advancing age; other causes alcohol or illegal drug abuse, obesity and radiation exposure; inability to conceive after 1 year of regular, unprotected intercourse
dx/ treatment/ prevention of infertility:
female: analysis of cervical mucus within 1 hour after coitus to check for motile sperm; hysterosalpingography; endoscopy; CBC; male: complete ejaculate following sexual abstinence for 4 days; complete physical exam; include CBC, sperm count, reproductive hormone levels; cystoscopy; vasography; seminal vesiculography/ female-salpingostomy; lysis of adhesions; removal of ovarian abnormalities; correction of endocrine imbalance; alleviation of cervicitis; hormone therapy; microsurgical excision of tubal obstructions; males-surgical correction of any abnormality; correction of testicular hypofunction secondary to hypothyroidism; surgical correction of hydrocele or varicocele; hormone therapy/ avoiding causative factors
gonorrhea:
contagious bacterial infection of the epithelial surfaces of the genitourinary tract in males and females; one of 700 americans is infected; US highest reported cases; caused by bacterium neisseria gonorrhoeae; transmitted during sexual intercourse with an infected partner or through other forms of intimate sexual contact; can grow in the mouth, throat, eyes, and anus; infants born to infected mother can contract through vaginal delivery; varying ordering to site and duration of infection; females: asymptomatic or produce symptoms so slight that they are ignored; males: acute urethritis, pus or purulent urethral discharge, pain, and urinary frequency
dx/ treatment/ prevention of gonorrhea:
bacterial cultures; testing urine/ antibiotics/ use of condoms, avoidance of multiple partners, and the tracing of the sexual contacts of an infected individual
genital herpes:
highly contagious viral infection of the male and female genitalia; tends to recur spontaneously; two stages; active stage and latent stage; 45 million individuals ages 12 and older; caused by herpes simplex virus (HSV); two strains of virus-HSV-1, HSV-2; transmitted through direct contact with infected bodily secretions; skin lesions on their genitals, mouth, and/or anus; multiple, shallow, ulcerations, pustules, or erythematous vesicles; fever, headache, malaise, muscle pain, anorexia, and dysuria
dx/ treatment/ prevention of genital herpes:
physical exam; scraping and biopsy; blood tests/ acyclovir; topical medications/ no proven method besides avoiding sexual intercourse and using condoms
genital human papillomavirus (HPV) infection:
most common of the STDs; over 40 types; approx 20 million americans currently infected; do not realize they are infected; typically spread from person to person during intimate sexual contact; genital warts prolonged incubation period 1 to 6 months and grow rapidly in the presence of heavy perspiration, poor hygiene, or pregnancy; most individuals do not develop symptoms
genital warts:
one type of HPV; circumscribed, elevated skin lesions, usually seen on the external genitalia or near the anus
dx/ treatment/ prevention of genital warts:
no test, usually goes away on its own; cervical changes can lead to cervical cancer/ no cure/ girls and women HPV vaccine
trichomoniasis:
protozoal infestation of the vagina, urethra, or prostate; common STD with about 7.4 million new cases a year; cause is trichomonas vaginalis, a motile protozoan; usually transmitted via sexual intercourse or vulva to vulva contact; 10-20% of females are asymptomatic; acute vaginitis: a strong-smelling, greenish yellow, frothy vaginal discharge, possibly accompanied by itching, swelling, dyspareunia, and dysuria; males disease is asymptomatic; urethritis; dysuria and urinary frequency
dx/ treatment/ prevention of trichomoniasis:
facilitated by wet-mount microscopic exam of vaginal or seminal discharge; urinalysis/ oral metronidazole; avoid alcohol during and for 24-48 hours/ avoid over-the-counter douches and vaginal sprays
chlamydial infections:
sexually transmitted infection that is now highly prevalent and is among the most potentially damaging of all STDs in US; 1.2 million cases, twice that number undetected; caused by bacterium chlamydia trachomatis; transmission through oral, vaginal, or anal sexual contact; asymptomatic; called the "silent" STD
dx/ treatment/ prevention of chlamydial infections:
confirmed by cytologic and serologic studies/ antibiotic such a azithromycin taken for 1 day or doxycycline take for 7 days; all partners should be treated/ use condoms during sexual activity
common symptoms of sexually transmitted diseases (STDs):
dysuria, hematuria, urinary frequency or incontinence, purulent discharge, or burning and itching on urination; pelvic or genital pain; any skin ulcerations, especially in the genital area; fever and malasie; dyspareunia
benign prostatic hyperplasia (BPH):
an enlarged prostate; growth occurs in one of two ways: 1st- cells multiply and squeeze urethra, 2nd- cells grow into the urethra and the bladder outlet area; 2nd type usually requires surgery; common in males older than 50; etiology not well understood, but seems to be due to metabolic and hormonal changes associated with aging; urinary obstruction; difficulty in initiating urination or in completely emptying the bladder in the first stage; nocturia, dribbling, urinary frequency, hematuria, weak urine stream, and incontinence
dx/ treatment/ prevention of BPH:
symptomatology and a digital rectal exam; blood tests/ alpha blocker medications; thermotherapy; surgical procedures/ no specific prevention, just older males should get their prostates checked regularly
prostatitis:
inflammation of the prostate gland; acute or chronic; more common in young and middle-aged men; bacterial or nonbacterial; enter either the urethra or bloodstream; low back pain, pain in pelvic region, perineal fullness or pain, fever, dysuria, and urinary frequency and urgency; rectal exam; urine cultures; cystoscopy; antibiotic and/ or antimicrobial therapy; alpha blockers; sitz baths; regular ejaculation; early UTIs is the best prevention
epididymitis:
inflammation of the epididymis due to infection; typically unilateral; most common infection of male reproductive system especially 19-35 years; result of prostatitis, a UTI, tuberculosis, or STDs; enlarged, hard, and tender, causing pain; clients may "waddle" as they walk trying to protect scrotal area; blood in semen, discharge from penis, enlarged lymph nodes in groin area
dx/ treatment/ prevention of epididymitis:
swab sample from urethral discharge; ultrasound; urinalysis and urine cultures/ antibiotic or antimicrobial therapy/ early treatment for UTI is best prevention
prostatic cancer:
malignant neoplasm of the prostate tissue; third leading cause of cancer death in males; metastasize, often spreading to the bones, of the spine or pelvis before it is detected; rare before age 50; four factors suspected: family or racial predisposition, exposure to environmental or chemical elements, coexisting STDs, endogenous hormonal influence; asymptomatic; urinary obstruction, dysuria, difficulty voiding, urinary frequency, lower back pain, or urinary retention, hematuria, bone pain or tenderness, unintentional weight loss, and lethargy
dx/ treatment/ prevention of prostatic cancer:
digital rectal exam; biopsy; CT or ultrasonography; PSA blood test/ depends on stage and grade; surgery; various hormonal therapies; medications; radiation therapy; cryoablation; chemotherapy/ no known prevention
testicular cancer:
malignant neoplasm of a testis; various forms; primarily affects young to middle-aged males; rare in males older than 40; cause essentially unknown; smooth, firm, painless mass of varying size in the testicles; breast enlargement and nipple tenderness
dx/ treatment/ prevention of testicular cancer:
regular self-exam; ultrasound and CT or MRI; blood tests/ any combination of surgery, radiation, and chemotherapy/ no known prevention just early detection
common symptoms of male reproductive diseases and disorders:
any urinary complaints such as frequency, urgency, incontinence, dysuria, or nocturia; pain in any of the reproductive organs or any unusual discharge; swelling or enlargement of any of the reproductive organs; any sexual disorder or concern
premenstrual syndrome (PMS):
distinct cluster of physical and psychological symptoms that regularly recur 3 to 14 days before the onset of menstruation and relieved by the onset of menses; 30-40% of women experience mild to severe; appears frequently in women 30s-40s; cause is not clearly understood; thought to be multifactorial; irritability; anxiety or depression; sleeplessness; fatigue; acne; appetite changes or food cravings; headache or backache; syncope; lowered resistance to infections; nervousness; arthralgia; abdominal bloating and weight gain; heart palpitations; swollen and tender breasts; easily bruised skin
dx/ treatment/ prevention of PMS:
depends on timing of symptoms; blood tests; history and physical/ no one effective treatment; helpful to take multivitamin every day; reduce salt intake for 2 weeks prior to menses; avoidance of stimulants/ no known prevention
amenorrhea:
absence of menarche, the initial menstrual cycle, beyond age 16 or the absence of menstruation for 6 months in a female who has previously had regular, periodic menses and is not menopausal; thorough physical and pelvic exam; analysis of blood and urine samples; ultrasound, CT scan, laparoscopy with an endometrial biopsy; hormone therapy; surgery; prevention include adequate diet and a balanced physical exercise program
dysmenorrhea:
pain associated with menstruation; one of the most frequent gynecologic disorders, affecting more than half of menstruating women; more commonly seen among women who had early onset of menses, have long or heavy menstrual periods, and who smoke; specific cause is difficult to pinpoint; aching, spasmodic, colicky, cramping pains in the lower abdominal area; headache, nausea, diarrhea, fatigue, irritability, dizziness, and syncope; detailed medical history and pelvic exam; analgesics and nonsteroidal anti-inflammatory drugs; correction of any hormonal imbalances may be helpful in prevention
ovarian cysts and tumors:
etiology unknown, however genetics are thought to play a part; some asymptomatic; large may produce pelvic pain, low back pain, and dyspareunia; fever and vomiting and causes faintness or dizziness medical emergency
dx/ treatment/ prevention of ovarian cysts and tumors:
ultrasonography most commonly used; CT scans; blood tests/ may disappear spontaneously; may require drug-induced ovulation therapy or surgical resection; laparoscopy or laparotomy/ no known prevention
endometriosis:
appearance and growth of endometrial tissue in areas outside the endometrium, the lining of the uterine cavity; affects 5.5 million females in US during active reproductive years; cause remains unknown, although various theories have been proposed; dysmenorrhea occurs with pain in the lower back and vagina; profuse menses, infertility, dyspareunia, dysuria, and even painful defecation
dx/ treatment/ prevention of endometriosis:
physical exam; visualizing ectopic deposits; laparoscopy/ goals include relieving the pain and discomfort, shrinking or slowing endometrial growths, preserving fertility, and preventing recurrence; pain medications; hormone therapy; panhysterosalpingo-oophorectomy/ no prevention
pelvic inflammatory disease (PID):
an acute or a subacute, or recurrent or chronic, infection of the uterus, fallopian tubes, or ovaries; may me inflammation of the uterus, cervix, fallopian tubes, and ovaries; more than 1 million women in US; more than 100,000 infertile as a result; causes include (1) infections from, most commonly, N. gonorrhoeae or C. trachomatis (2) infections following parturition, the act of giving birth (3) iatrogenic causes; most common in young nulliparous females who have never produced a viable offspring; also occur after childbirth, abortion, or miscarriage; often no symptoms while serious damage is being done; sudden pelvic pain, a purulent and foul-smelling vaginal discharge, fever, sexual dysfunction, abnormal uterine bleeding and rebound pain; cervical dysplasia; alteration in size, shape, and organization of mature cells; laceration
dx/ treatment/ prevention of PID:
difficult to diagnose; taking a smear of uterine secretions for culture; ultrasonography/ antibiotics best treatment; supplemental therapy; surgery/ no known prevention
menopause:
cessation of menses and ovarian function, with a resultant decrease in estrogen and progesterone levels; occurs naturally in women between 45-55; menstrual irregularities, a decrease in the amount of menstrual flow, and finally cessation of menses; occur over a period of months or years; hot flashes, night sweats, syncope, tachycardia, and loss of elasticity in the skin; reduction in size an firmness of breast tissue; depression, poor memory, and loss of interest in sexual activity
dx/ treatment/ prevention of menopause:
careful history; blood serum levels screened/ some need no treatment; other require hormone replacement therapy (HRT), counseling, or both/ menopause cannot be prevented
ovarian cancer:
sixth most common cancer among females and fifth leading cause of cancer deaths in US; called the silent killer because it usually was not found until it had spread to other organs; exact cause unknown, but contributing factors include infertility, familial tendency, HRT with estrogen only, obesity, and use of male hormone androgen to treat endometriosis; urinary urgency, pelvic pain, abdominal pressure or fullness and bloating, persistent indigestion or nausea, unexplained bowel habits, loss of appetite, increased abdominal girth, dyspareunia, lack of energy, low back pain, and changes in menstruation
dx/ treatment/ prevention of ovarian cancer:
clinical evaluation, complete history and physical exam; transvaginal sonography, abdominal ultrasound, CT scan/ depends on the grading and staging of tumor; surgery; chemotherapy/ yearly pelvic exam; factors that reduce the risk are taking oral contraceptives, pregnancy followed by breastfeeding, and tuba ligation or hysterectomy
fibrocystic breasts:
breasts with palpable lumps or cysts that fluctuate in size with menstrual cycle; more frequent in women 30-55; rarely after menopause; fairly common; more than half of women experience this at some point in their lives; cause not well understood, but linked to hormonal changes associated with ovarian activity; tendency to run in families; widespread lumpiness or localized mass; pain, tenderness, and feeling of fullness; fluctuating size of breast lumps, nonbloody nipple discharge, and changes in both breasts
dx/ treatment/ prevention of fibrocystic breasts:
monthly breast self-exam; mammogram; ultrasound; biopsy/ no treatment is usually warranted/ reducing caffeine and fat in the diet are helpful measures
carcinoma of the breast (breast cancer):
encompasses a variety of malignant neoplasms of the breast; most common site of cancer in females; caused by genetic abnormalities; higher in women with biopsy-confirmed atypical hyperplasia, a long menstrual history, and obesity after menopause; abnormality shown on mammogram; breast changes- lump, thickening, dimpling, swelling, skin irritation, distortion, retraction or scaliness of the nipple, nipple discharge, pain and tenderness; edema, redness, nodularity or ulceration of the skin and enlargement or shrinkage of the breast
dx/ treatment/ prevention of breast cancer:
early detection; mammography; ultrasonography; CT scan; MRI; biopsy/ depends on stage and clients preferences; curative treatment; radiation; targeted cancer therapy; no known prevention
common symptoms of female reproductive system diseases and disorders:
premenstrual and postmenstrual complaints; lower abdominal or pelvic pain; consistent bloating or fullness; any abnormal vaginal discharge or itching; fever; dyspareunia or any sexual dysfunction; breast changes
spontaneous abortion (miscarriage):
expulsion of the conceptus before the 20th week of pregnancy; 20-30% of pregnancies may end this way; higher in first pregnancies; most occur in the first 7 weeks; higher in women over age 35 and those who previous have had one; pink or brown discharge may precede the onset of cramping and increased vaginal bleeding; cervix will dilate, and uterine contents will be expelled; if entire contents are expelled, bleeding and cramping stop; if contents remain, so does cramping and bleeding
dx/ treatment/ prevention of miscarriage:
evidence of expelled uterine contents; pelvic exam; lab studies/ if remnants remain in uterus (D&C) or medications/ usually cannot be prevented; less likely to occur if early, comprehensive prenatal care is received
ectopic pregnancy:
occurs when the fertilized ovum implants and grows somewhere other than in the uterine cavity; most common site is within one of the fallopian tubes; no way to save, cannot turn normal; often due to scarring or inflammation of the fallopian tubes as a result of infection or due to congenital malformations of the tubes; abdominal pain and tenderness, slight vaginal bleeding; rupture of a fallopian tube due to the development
dx/ treatment/ prevention of ectopic pregnancy:
pelvic exam; careful history; serum pregnancy test and ultrasound exam; laparoscopy and exploratory laparotomy/ laparotomy/ prompt treatment of any genitourinary infection
pregnancy-induced hypertension (PIH):
a hypertensive disorder that may develop during the third trimester; more likely to occur in women in their first pregnancy ages 12-18 or in women older than 35 who have multiple pregnancies; cause is not known, predisposing factors include preexisting vascular and renal disease; hypertension, generalized edema, proteinuria, and sudden weight gain; headache, vertigo, malaise, irritability, epigastric pain, nausea; tonic-clonic convulsions, coma, crackling or rhonchi, rhythmic, nystagmus, and oliguria or anuria
dx/ treatment/ prevention of PIH:
clinical picture of convulsions/ goal of treatment is to deliver a healthy baby; antihypertensives/ adequate nutrition, good prenatal care, and control of high blood pressure during pregnancy
placenta previa:
placenta is implanted abnormally low in the uterus so that it covers all or part of the internal cervical os, or opening; obstetric complication that occurs in the 2nd or 3rd trimester; cause is unknown, predisposing factors include multiparity, scars in uterine lining, and previous uterine surgery; painless, bright-red bleeding
dx/ treatment/ prevention of placenta previa:
ultrasonography/ bleeding not severe-bed rest; severe bleeding- hospitalization to control bleeding; c-section/ no known prevention
abruptio placentae:
premature separation of a normally implanted placenta from the uterine wall at about the 20th week gestation; most common in multigravidas; cause unknown; wide range of symptoms- mild to moderate bleeding; continuous pain; sudden, severe abdominal pain with boardlike rigidity, tenderness of the uterus, hemorrhage, and onset of shock
dx/ treatment/ prevention of abruptio placentae:
ultrasonography, pelvic exam, history/ goals of treatment are to control bleeding, deliver healthy infant and prevent complications; hospitalization is required, and c-section performed/ no known prevention
premature labor:
early onset of rhythmic uterine contractions after fetal viability but before fetal maturity
premature rupture of membranes (PROM):
early rupture of the amniotic sac; close to 90% of term clients and 50% of preterm clients go into labor within 24 hours after rupture; most common diagnosis with preterm delivery; caused by cervical incompetence. preeclampsia, multiple pregnancy, abruptio placentae, anatomic malformations, infections, or fetal death; blood-tinged flow from vagina, with uterine contractions and cervical dilation or effacement
dx/ treatment/ prevention of premature labor/ PROM:
prenatal history and vaginal and physical exam; ultrasonography; electronic fetal monitoring/ 36 weeks or more- deliver baby; prior to 36 weeks delivery is delayed/ best prevention good prenatal care
common symptoms of diseases and disorders of pregnancy and delivery:
abdominal pain, tenderness, cramping; unusual discharge, pink, red, or brown in color. or clotted; hypertension, rapid weight gain, edema, and malaise
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