Unit 17 Reproduction - Patho UCF

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When does puberty begin for females?
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Terms in this set (135)
When does puberty begin for females?
between 8-9 years of age
When does puberty begin for males?
about 11 years old
How does puberty begin and end in females?
Begins with thelarche (breast buds) and ends with the first ovulatory menstrual period
How does puberty begin and end in males?
Begins with voice changes and ends with mature sperm
Gonadal Maturation is referred to as
Gonadarche
The maturation of the female reproductive organs is referred to as
Thelarche
Increased production of androgens is referred to as
Adrenarche
How does Vaginal Mucosa protect itself from infection
because of its acidic pH
After ovulation, the follicle develops into what?
Corpus Luteum
When does the corpus luteum enlarge and begin to secrete hormones that maintain and support pregnancy
If fertilization occurs
When does the corpus luteum secrete hormones for 14 days before degenerating, triggering the maturation of another follicleIf fertilization does not occurEstrogens (Estradiol / E2), progesterone and Androgens are the sex hormones of:FemalesIn the development of the reproductive system, testosterone would trigger the development of aMaleIn the development of the reproductive system, what are the hormones that would trigger the development of a female?Estrogen, Follicle-Stimulating Hormone (FSH), Luteinizing Hormone (LH)The age when menstruation begins is known asMenarcheAge when menstruation stops is known asMenopauseWhat are the roughly ten years prior to when menstruation stops referred to as?Peri-MenopauseWhat are the phases of the Menstrual Cycle?M - Menstruation (menses) F - Follicular/Proliferative L - Luteal/Secretory I - Ischemic/Menstrual Then it starts againThe process of follicular maturation, ovulation, corpus luteum development, and corpus luteum degeneration is known asOvarian CycleWhich hormone inhibits follicle-stimulating hormone (FSH) synthesis and secretion?InibinWhich hormone stimulates (activates) follicle-stimulating hormone (FSH) synthesis and secretion?ActivinVasomotor flushes are also known asHot FlashesMenopause causes what changes in a female- Breast tissue - Urogenital - Skeletal (less estrogen) - Cardiac ChangesBecause menopause causes decreased ovarian function which leads to what changes in these hormones? - Estrogen - Progesterone - Luteinizing Hormone - Follicle-Stimulating Hormone- Decreased Estrogen and Progesterone - Increased LH and FSH (normal negative feedback)How does a male exhibit aging of the male reproductive system?Decreased erectile dysfunction, and ejaculatory function, their testes atrophy, decrease in weight, and softenHow does the aging of the male reproductive system affect these hormones? - Testosterone - Gonadotropins - Libido- Decreased levels of testosterone - Decreased libido - Gonadotropins increaseA 45-year-old female is experiencing menopause. Which of the following would be expected to accompany this condition? A. Increased dysmenorrhea B. Increased estrogen C. Increased progesterone D. Increased FSH and LHD. Increased FSH and LHThe development of secondary sex characteristics is referred to asPubertyThe age of onset of puberty is multifactorial but is typically within the ages of8-13Delayed puberty is normal in about...95% of casesDelayed puberty is normal in about 95% of cases, the other 5% caused by what?by disruption of hypothalamic-pituitary-gonadal axis or systemic diseaseWhat is precocious puberty?Sexual maturation before 6 or 7 in females Sexual maturation before 9 in malesWhat can cause precocious puberty?Obesity, increased protein consumption, lethal CNS tumorsDifficult or painful monthly flow (menses or menstruation). The chief symptom of this condition is pelvic pain associated with the onset of mensesDysmenorrhea (dys- difficult or painful, men-menses or menstruation, orrhea-flow)Painful menstruation associated with prostaglandin release in ovulatory cycles - Excessive prostaglandin F2α - Increased myometrial contractions - Constricted endometrial blood vessels - Increased nerve hypersensitivityPrimary dysmenorrhea pay attention to the specificity that it happens in ovulatory cyclesThis condition is related to pelvic pathology (infection...) - May occur any time in the menstrual cycleSecondary dysmenorrheathis type of dysmenorrhea only happens during ovulatory cyclesPrimary dysmenorrheathis type of dysmenorrhea may occur at any time in the menstrual cycleSecondary dysmenorrheaWhen there is a failure of menarche (1st period) and absence of menstruation by age 13 without development of secondary sex characteristics or by age 15 regardless of presence of secondary sex characteristicsPrimary AmenorrheaWhat is primary amenorrhea caused byCompartment disorders - Anatomic defects - Involve the ovary, genetic disorders, and androgen insensitivity syndrome - Involve anterior pituitary gland and result in failure of hormonal signaling to ovaries - CNS disorders, primarily hypothalamic defectsHow is primary amenorrhea treated?by correcting the underlying disorderThis condition is the absence of menses after previous menstrual periods - Common in early adolescence, pregnancy, lactation, and during perimenopauseSecondary amenorrheaWhat is secondary amenorrhea caused byAssociated with thyroid disorders, hyperprolactinemia, excessive stress or weight loss, and polycystic ovary syndromeWhat should be ruled out prior to diagnosing secondary amenorrheaPregnancyMenstrual irregularity and dysfunctional uterine bleeding are types ofAbnormal Uterine BleedingHeavy or irregular bleeding in the absence of organic disease is called...Dysfunctional uterine bleedingThis condition is associated with lack of ovulation, can lead to iron deficiency anemia and other associated symptoms, usually perimenopausalAbnormal or Dysfunctional uterine bleedingPolycystic ovary syndrome (PCOS) is associated withgenetic predisposition and obesityIf a patient presents with at least two of the following, what is their diagnosis: - Few or anovulatory menstrual cycles - Elevated levels of androgens - Low levels of sex hormone binding globulin(AKA testosterone-estrogen binding globulin (TeBG)) - Polycystic ovariesPolycystic ovary syndrome (PCOS)How do you treat PCOSTreated with oral contraceptives and off-label use of MetforminThis is an acute inflammatory process caused by infection of an organ of the genital tract.Pelvic Inflammatory Disease (PID)In the most severest form of Pelvic Inflammatory Disease (PID) what is involvedEntire pelvic cavityMultiple sexual partners, previous PID, douches, IUD for birth control can causePelvic Inflammatory Disease (PID) isIf a sexually transmitted diseases migrates from the vagina to the upper genital tract it can causePelvic Inflammatory Disease (PID)In this condition, inflammation causes changes in the columnar epithelium that lines the upper reproductive tract (fallopian tubes), causing localized edema and possible necrosisSalpingitis (salping-fallopian tube, itis-inflammation)What are some causes of salpingitis?- Gonorrhea gonococci attach to fallopian tube - Chlamydia enters the tubal cells and replicates, causing the cell membrane to burst as the chlamydia reproduces. Causes permanent scarringinfertility and tubal obstruction, ectopic pregnancy, pelvic pain, and intestinal obstruction can be caused bySalpingitissymptoms of salpingitisManifestations vary from no pain to sudden severe abdominal pain with fever Symptoms often vague—mild to severe painWhat is the difference between PID (pelvic Inflammatory Disease) and Salpingitis?PID involves the entire reproductive tract, while Salpingitis involves only the upper reproductive tract.What gives support to the bladder, urethra, and rectumare supported by the endopelvic fascia and perineal musclesHow does aging affect muscular and fascial tissueThe muscular and fascial tissue loses tone and strength with agingWhen endopelvic fascia and perineal muscles fails to maintain organs in proper positionPelvic Organ ProlapsePelvic Organ Prolapse is associated withaging, obesity, and hysterectomyWhat are the types of pelvic organ prolapse-cystocele -urethrocele -rectocele -enteroceleThe descent or herniation of a portion of the posterior bladder wall and trigone into the vaginal canal (Associated with childbirth)Cystocele (cyst-bladder, sac)Bulging of the rectum and posterior vaginal wall into the vaginal canal - Genetic and familial predispositionRectoceleWhich kind of pelvic organ prolapse is genetic and is related to familial predispositionrectoceleHerniation of the rectouterine pouch into the rectovaginal septum (Congenital or acquired)EnteroceleDescent of the cervix or entire uterus into the vaginal canal or completely through the vaginaUterine Prolapse or urethroceleWhen someone is diagnosed with Urethrocele and it doesn't need to be treated until it causes discomfort, how would you grade this?Grade 1 urethroceleWhen someone is diagnosed with Urethrocele and it causes them feelings of fullness, heaviness, and collapse through the vagina, how would you grade this?Grade 3 or 4 UrethroceleWhat is a pessary and what is it used for?This is how you can treat pelvic organ prolapses, it is a removable mechanical device that holds the uterus in position,How do u treat prolapse of pelvic organsPessary, kegel, estrogen therapy, and surgery as a last resortThese are commonly known as myomas or uterine fibroids, it is a benign tumor of the smooth muscle cells in the myometrium. These cause abnormal uterine bleeding, pain, and symptoms that related when pressure is applied to nearby structures. - classified as subserous, submucous, or intramuralLeiomyomasLeiomyomas are sensitive to which hormones?Estrogen and progesteroneIslands of endometrial glands surrounded by benign endometrial stroma within the myometrium. - this is characterized by abnormal bleeding, dysmenorrhea, uterine enlargement and tenderness, or can be asymptomaticAdenomyosis (adeno-gland)Patient A presents with abnormal bleeding, dysmenorrhea, uterine enlargement, and tenderness. An MRI showed islands of endometrial stroma surrounded glands within the myometrium. What is the diagnosis?AdenomyosisWhen tissue that typically grows inside the lining of the uterus, is growing outside the uterus and responds to hormone fluctuations of the menstrual cycleEndometriosisWhat is a hallmark symptom of endometriosis?Dyschezia (pain on defecation)Coelomic metaplasia, Retrograde menstruation, Embryonic cell rest, Iatrogenic mechanical transplantation, Lymphatic and vascular dissemination, and Genetic predisposition are the possible causes of which condition?Endometriosis______________ is highly associated with infertilityendometriosisHow you treat endometriosis?treatment is to prevent progression, alleviate pain, and restore fertilityThis type of cancer is almost always associated with Type 16 HPV infection. - HPV causes cervical intraepithelial neoplasia and cervical carcinoma in situCervical CancerWhat gives the HPV the ability to act as a carcinogen?It depends on the viral proteins E6 and E7 that interfere with activity of tumor suppressor proteinsWhat are the risk factors included with HPV?multiple sex partners, losing virginity at young age, high parity, immunosuppression, oral contraceptives, and the use of nicotineHow do you test for cervical cancer?Pap Smear and HPV testingHow do you treat cervical cancer?Treatment based on neoplastic change, size and location of lesion, extent of metastasisIncreased levels of this hormone are associated with the ejection of breast milk during lactation, causing the smooth muscles around the glands to contract. It contracts the uterus. It increases in response to stress, and promotes social attachment, has a antidiuretic effect also is release during an orgasm in men and women.OxytocinPersistent and sometimes excessive secretion of milky fluid from the breasts of a woman who is not pregnant or nursing, and can also occur in menGalactorrheaExcessive amounts of prolactin in the blood not related to pregnancy or childbirthNonpuerperal HyperprolactinemiaNonpuerperal Hyperprolactinemia is associated withCertain drugs, hypothyroidism, and pituitary tumorsOxytocin is secreted byposterior pituitary glandProlactin is secreted by theanterior lobe of pituitaryWomen with galactorrhea may also experiencemenstrual abnormalitiesWhat is the leading cause of death in women ages 40-44Breast CancerWhat is a Estrogen-receptor-positive (ER+) cancerEstrogen-receptor-positive (ER+) cancer has receptors for estrogen and uses the estrogen to grow, differentiate, and avoid apoptosisWhat is a progesterone-receptor-positive (ER+) cancerhas progesterone receptors, which allow them to growHaving your first pregnancy in the 20s, and removing your ovaries and pituitary gland are waysto protect against breast cancerEarly menarche, late menopause (older than 52), nulliparity (no babies) Obesity, hormone-dependent development of mammary glands structures and the effectiveness of anti-hormone treatments are waysto increase risk of developing breast cancerHow does obesity affect your risk of developing breast cancerrelationship between fat, free estrogen levels, and oxidative changes in estrogen metabolismMost breast cancers are hormone dependent (at least at first) T or FTrueHow does hormone replacement therapy affect your risk of developing breast cancer- estrogen plus progesterone therapy (MHT) - estrogen-only therapy (ET) - Estrogen-progestogen menopausal therapy and - estrogen-progestrogen contraceptives all increase your risk of developing breast cancerHow does insulin and IGF's affect your risk of developing breast cancer- IGFs regulate cellular functions involving cell proliferation, migratory, differentiation, and apoptosis - Insulin therapy and sulfonylurea were found to be mildly associated with increased breast cancer riskHow does prolactin and growth hormone affect your risk of developing breast cancer?GH induces the production of IGFs in the liver; IGF signaling is important for breast development and is implicated in breast carcinogenesisHow do oral contraceptives affect your risk of developing breast cancer?Combined estrogen-progestogen oral contraceptives (OCs) increase the risk for breast, cervix, and liver cancersHow does someone's mammographic breast density affect their risk of developing breast cancer?Dense breasts-Radiologic appearance of the breast, reflecting variations in breast composition is strong and consistent risk factor for breast cancerHow do environmental factors affect your risk of developing breast cancer?Environmental causes of breast cancer possibly affect the breast the most during critical phases of development Mitotic activity and cell division are greater than they are later in lifeHow does physical activity affect your risk of developing breast cancer?May reduce overall risk and reduce the invasiveness of breast cancerHow does a sedentary lifestyle affect your risk of developing breast cancer?may increased risk for insulin resistance (type 2), Inflammation, and decreased immune functionRisk of breast cancer increases with who is affectedRisk of breast cancer increases with number of first-degree relatives affectedWhat breast cancer gene is more likely in men?BRCA2 (breast cancer 2 gene) is located on chromosome 13 - is more likely in men who develop breast cancerWhat breast cancer gene puts carriers at the highest risk for breast and ovarian cancer?BRCA1 (breast cancer 1 gene) - Located on chromosome 17 - Tumor-suppressor gene - Carriers are at higher risk for breast and ovarian cancerWhat cancer gene is located on chromosome 13?BRCA2What cancer gene is located on chromosome 17?BRCA1What is the first sign of breast cancer?Typically a painless lumpWhat is the likely prognosis when "orange peel" skin is seen on the surface of the breastWhat is causing the dimpling associated with "orange peel"?a phenomenon in which hair follicles become buried in edema, resulting from blockage of lymphatic drainage with or without associated stromal infiltration.This BC is limited to breast ducts and lobules without invasion of the basement membrane, and most lesions will not evolve to invasive cancerDuctal carcinoma in situ (DCIS)Patient D presents with a painless lump, palpable lymph nodes in axilla, dimpling of skin (orange peel), edema, and bone pain. What is the diagnosis?Breast cancerThis is a fibrotic narrowing of the urethra caused by scarring and is a commonly a result of trauma or untreated or severe urethral infections. If it is severe enough and is prolonged long enough it can result in hydronephrosis and renal failureUrethral StricturesThis is the inability to retract foreskin from the glans of the penis (distal to proximal) that is frequently caused by poor hygiene or chronic infections. This may require circumcision (gross)PhimosisThis is the inability to replace or cover the glans with the foreskin (proximal to distal) and is a surgical emergency to prevent necrosisParaphimosisThis is referred to as "bent nail syndrome" and occurs in middle aged men and causes painful erections and intercourses. This is the slow development of fibrous plaques (thickening) in the erectile tissue of the corpus cavernosa, causing lateral curvature of the penis during erectionPeyronie DiseaseThis is an inflammation of the glans penis usually associated with prepuce inflammation (posthitis) - accumulation under the foreskin (smegma) can irritate the glans or lead to infectionBalanitisThis is an abnormal dilation of the testicular vein and the pampiniform plexus within the scrotum "bag of worms" - commonly in infertile men - most develop in adolescenceVaricoceleThis is scrotal swelling caused by collection of fluid between the layers of the tunica vaginalis that may be congenital or caused by infection, trauma, or torsion. Diagnosed with transilluminationHydrocele1. Urethral inflammation due to STI (sexually transmitted illness) 2. Fibrosis (scarring) that causes narrowing of urethra. 3. Foreskin won't retract back 4. Cannot move foreskin forward to cover the glanspenis 5. Fibrous plaques cause bent nail appearance of penis 6. Prolonged erection 7. Inflammation of glans penis 8. Collection of fluid in scrotum 9. Abnormal dilation of testicular veins Possible AnswerMatch these to the correct definition: Urethral Stricture, Phimosis, Peyronie disease, Urethritis, Priapism, Paraphimosis, Varicocele, Balanitis, HydroceleThis is benign cystic collections of fluid of the epididymis, usually painless. identified by discrete, firm, freely mobile masses distinct from the testisSpermatoceleThis is the failure of one or more testes to descend completely where they may remain in the abdomen, inguinal canal, or puboscrotal junction. It can be treated with hormonal therapy or surgery.CryptorchidismWhat should the nurse include in the teaching of a teenage boy who has a history of cryptorchidism? A. Eat more iron-rich foods in the diet B. Get at least 30 minutes of cardiovascular exercise each day C. Take the prescribed course of antibiotics until complete D. Perform regular testicular self-examsD. Perform regular testicular self-examsThis is when the testis has strayed from the normal pathway of descentEctopic testisWhen the testis rotates on its vascular pedicle, interrupts its blood supply. This results in painful and swollen testis and may be spontaneous or follow physical exertion or trauma. It is a surgical emergency.Testicular TorsionThis is a benign enlargement of the prostate gland with symptoms associated with urethral compression and has relation to aging.Benign Prostatic Hyperplasia (BPH)How is benign prostatic hyperplasia evaluated and treated?Evaluation: - Digital rectal exams - Prostate-specific antigen monitoring Treatment is aimed to shrink prostate: - a1-adrenergic blockers - Antiandrogen agentsThis the acute onset of an ascending infection of the urinary tract that stimulates an inflammatory response in which the prostate becomes enlarged, tender, firm, or boggy. We treat this with antibioticsProstatitis