Medical Pathophysiology: Altered Reproductive Function
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Questions and Answers

During which phase of the sexual response are cardiovascular and respiratory functions returning to their baseline levels?

  • Orgasm
  • Resolution (correct)
  • Excitement
  • Plateau
  • What physiological change is characteristic of the excitement phase of the human sexual response?

  • Vasocongestion of the genitals (correct)
  • Ejaculation in males
  • Refractory period in males
  • Increased peristaltic waves in the uterus
  • What is the approximate heart rate (beats/min) during the orgasm phase?

  • 120
  • 220
  • 80
  • 180 (correct)
  • In the male sexual response, what process describes the movement of sperm into the urethra?

    <p>Emission (B)</p> Signup and view all the answers

    What is a key difference in the resolution phase between males and females?

    <p>Males experience a refractory period, while females do not. (A)</p> Signup and view all the answers

    What percentage of infertility cases are due to male factors?

    <p>30-40% (D)</p> Signup and view all the answers

    Which factor directly diminishes sperm's capacity to navigate the female reproductive system?

    <p>Sperm density of 10 million/mL (C)</p> Signup and view all the answers

    What condition represents dilated veins that can interfere with spermatogenesis in males?

    <p>Varicocele (D)</p> Signup and view all the answers

    What role does cervical mucus play in female fertility?

    <p>Assists sperm transport and maintains sperm viability (A)</p> Signup and view all the answers

    What is the primary concern regarding fallopian tubes in the context of female fertility?

    <p>Their patency and motility for ovum transfer (D)</p> Signup and view all the answers

    An individual who has previously conceived but is now unable to conceive after one year of unprotected intercourse would be classified as experiencing what type of infertility?

    <p>Secondary infertility (D)</p> Signup and view all the answers

    What is the significance of endometrial development in female fertility?

    <p>It supports implantation and nourishment of a fertilized ovum (C)</p> Signup and view all the answers

    What is a potential impact of leiomyomas (fibrous tumors) on female reproductive function?

    <p>Distortion of the endometrial cavity (B)</p> Signup and view all the answers

    What is the clinical definition of infertility?

    <p>Inability to conceive (C)</p> Signup and view all the answers

    Antibodies to male sperm contribute to altered reproductive function through which mechanism?

    <p>Destroying sperm quickly (A)</p> Signup and view all the answers

    Which semen analysis result would be considered normal?

    <p>Sperm morphology with 6% normally shaped (C)</p> Signup and view all the answers

    Which of the following is an example of a uterine dysfunction that can lead to female altered reproductive function?

    <p>Uterine fibroids (B)</p> Signup and view all the answers

    Which of the following is the most important cause of reproductive disorders?

    <p>Sexually Transmitted Infections (STIs) (B)</p> Signup and view all the answers

    Which of the following STIs is caused by a parasite/protozoa?

    <p>Trichomoniasis (C)</p> Signup and view all the answers

    Which of the following provides the best protection against STIs?

    <p>Barrier contraception (C)</p> Signup and view all the answers

    What differentiates primary dysmenorrhoea from secondary dysmenorrhoea?

    <p>Primary dysmenorrhoea is associated with prostaglandin release in ovulatory cycles; secondary is related to pelvic pathology. (A)</p> Signup and view all the answers

    A 15-year-old female has not experienced menarche. This would be considered:

    <p>Primary amenorrhoea (D)</p> Signup and view all the answers

    Which of the following is an example of a parasitic STI?

    <p>Trichomoniasis (B)</p> Signup and view all the answers

    What characterizes secondary amenorrhoea?

    <p>The absence of menstruation for a duration equivalent to three or more cycles in women who previously had menses. (B)</p> Signup and view all the answers

    Which diagnostic procedure involves injecting a radiopaque material into the uterus and fallopian tubes, followed by the use of a fluoroscope and radiograph?

    <p>Hysterosalpingogram (C)</p> Signup and view all the answers

    What is the primary mechanism by which hormonal contraceptives with a constant blood level of ovarian hormones prevent pregnancy?

    <p>Cessation of ovulation (C)</p> Signup and view all the answers

    In the context of infertility, what does laparoscopy primarily allow for?

    <p>Direct visualization of peritoneal and abdominal structures outside the uterus and fallopian tubes (D)</p> Signup and view all the answers

    Progestin-only contraceptives primarily prevent pregnancy by what mechanism?

    <p>Thickening cervical mucus to block sperm entry (A)</p> Signup and view all the answers

    What is the primary goal of postcoital contraception that uses high hormone concentrations?

    <p>To prevent a fertilized egg from implanting, or fertilization altogether (A)</p> Signup and view all the answers

    When evaluating altered reproductive function, what information can be gathered by observing cervical mucus changes?

    <p>Occurrence and timing of ovulation (C)</p> Signup and view all the answers

    Which of the following is NOT a listed factor to consider while treating altered reproductive function?

    <p>Genetic predispositions (A)</p> Signup and view all the answers

    Which of the following contraceptive methods involves altering behaviors?

    <p>Behavioral (A)</p> Signup and view all the answers

    What is the typical characteristic of functional cysts?

    <p>They occur due to variations of physiological events. (B)</p> Signup and view all the answers

    Which condition is characterized by the abnormal presence of endometrial tissue outside the uterus?

    <p>Endometriosis (B)</p> Signup and view all the answers

    What symptoms are commonly associated with leiomyomas?

    <p>Menstrual irregularities and excessive bleeding (C)</p> Signup and view all the answers

    Which type of cyst develops after ovulation from granulosa cells?

    <p>Corpus luteum cysts (A)</p> Signup and view all the answers

    What is a potential complication of endometriosis?

    <p>Infertility and chronic pain (A)</p> Signup and view all the answers

    Flashcards

    Vasocongestion

    Swelling of genitals due to increased blood flow.

    Myotonia

    Muscle tension during sexual response.

    Orgasm Duration

    Short, intense reaction lasting 3-15 seconds.

    Male Ejaculation

    Involves emission of sperm into urethra and expulsion from it.

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    Female Orgasmic Platform

    Rhythmic contractions in female during orgasm.

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    Refractory Period

    Time after orgasm when male cannot achieve another erection.

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    Primary Infertility

    Inability to conceive after a year without prior pregnancies.

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    Varicocele

    Dilated veins reducing blood flow affecting sperm production.

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    Hormonal imbalance

    Disruption of hormones affecting ovulation and oocyte development.

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    Motility impairment

    Obstruction or adhesion interfering with sperm and egg transport.

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    Infertility

    Inability to conceive after 12 months of trying.

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    Semen analysis

    A test evaluating male fertility metrics such as volume and motility.

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    Amenorrhea

    Absence of menstruation due to hormonal changes.

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    Cervical mucus

    Fluid produced by the cervix that aids sperm transport.

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    Female reproduction contributions

    Complex processes including ovum release and suitable uterine conditions.

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    Sexual response phases

    Four stages: excitement, plateau, orgasm, and resolution.

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    Functional ovarian cysts

    Cysts formed from physiological events, usually harmless.

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    Follicular cysts

    Dominant follicle fails to rupture, leading to a cyst.

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    Endometrial polyps

    Benign masses of endometrial tissue causing bleeding.

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    Leiomyomas

    Commonly known as uterine fibroids, benign smooth muscle tumors.

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    Endometriosis

    Presence of endometrial tissue outside the uterus causing pain.

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    Dysmenorrhoea

    Painful menstruation linked to prostaglandin release or pelvic pathology.

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    Primary Amenorrhoea

    Absence of menstruation by age 14 or 16 in the absence of secondary sex characteristics.

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    Secondary Amenorrhoea

    Absence of menstruation for three or more cycles after previously having periods.

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    Primary Dysmenorrhoea

    Painful menstruation linked to prostaglandin release in ovulatory cycles.

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    Secondary Dysmenorrhoea

    Painful menstruation associated with pelvic pathology, can arise anytime.

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    Premenstrual Syndrome (PMS)

    Cyclical pain and mood swings before menstruation affecting 5-10% of women.

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    Sexually Transmitted Infections (STIs)

    Major cause of reproductive disorders, preventable by barrier contraception.

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    Determination of ovulation

    Monitoring physiological signs like mucus, temperature, and LH surge to confirm ovulation.

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    Hysterosalpingogram

    An imaging test using a radiopaque material to check for obstructions in the uterus and fallopian tubes.

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    Laparoscopy

    A minimally invasive surgery to visualize abdominal and pelvic organs using a small scope.

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    Sperm analysis

    A test that assesses male fertility factors such as sperm count, motility, and morphology.

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    Supportive counseling

    Guidance and education provided to individuals experiencing reproductive issues.

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    Hormonal contraception

    Methods that maintain constant hormone levels to prevent ovulation and change uterine conditions.

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    Postcoital contraception

    Emergency hormonal methods used after intercourse to prevent fertilization or implantation.

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    Progestin-only contraceptives

    Birth control methods focusing on progestin to thicken cervical mucus and reduce ovulation.

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    Study Notes

    Applied Pathophysiology: A Conceptual Approach to the Mechanisms of Disease

    • This lecture material is adapted from a 2022 textbook.
    • It focuses on the mechanisms of disease, specifically altered reproductive function.
    • The author is Dr. Romeo Batacan Jr.
    • The lecture series is titled MPAT12001 Medical Pathophysiology.

    Altered Reproductive Function

    • Hormonal Imbalance:
      • Absence or infrequent ovulation
      • Impaired oocyte development
    • Motility Impairment:
      • Issues with sperm or egg movement through reproductive tracts
    • Pathway Obstruction:
      • Adhesion or blockage in the pathway from cervix to ovary
      • Problems with sperm and egg joining
      • Inhospitable cervical mucus that blocks sperm
      • Infections leading to adhesions
      • Leiomyomas (fibrous tumors in uterus) distorting the endometrial cavity
    • Immune Problems:
      • Antibodies to sperm destroying them rapidly

    General Manifestations of Altered Reproductive Function

    • Infertility: inability to conceive
    • Pain: indicative of infection, inflammation, or structural problems
    • Amenorrhea: hormonal alterations affecting menstruation

    Male Contribution to Pregnancy

    • Men need sufficient sperm quantity and motility
    • Semen analysis assesses:
      • Volume (2-5 mL)
      • Sperm density (15-39 million/mL)
      • Motility (>32% good/progressive)
      • Viability (>58% alive)
      • Morphology (>4% normally shaped)
      • Viscosity (full liquefaction within 20 minutes)

    Female Contribution to Pregnancy

    • Female contribution is complex and requires:
      • Production of mature ovum
      • Cervical mucus for sperm transport/viability
      • Patent fallopian tubes for ovum transfer
      • Endometrium suitable for implantation and fetal growth.
      • Vagina without obstructions or malformations

    Sexual Response Physiology

    • Four Phases:
      • Excitement: Vasocongestion, myotonia, increased heart rate, gland secretions
      • Plateau: Variables sustained or slightly increase, with vasocongestion and myotonia possible increase
      • Orgasm/Climax: Short, intense reaction (3-15 sec), heart rate increase( ~180 bpm), male ejaculation (emission of sperm into urethra & expulsion), female orgasmic platform contractions, cervix plunges rhythmically into vagina
      • Resolution: cardiovascular and respiratory functions return to normal. Male-refractory period; Female-multiple orgasms possible.

    Infertility

    • Inability to conceive after a year of unprotected intercourse
    • Causes are almost equally divided between:
      • Male factors (30-40%)
      • Female factors (30-40%)
      • Combined factors (30-40%)
    • ~10% to 25% of infertile couples have an unknown cause.
    • Common causes include: Infections, inflammation, endocrine disorders, autoantibodies to sperm, environmental and lifestyle factors.

    Male Altered Reproductive Function

    • Causes: Varicocele (10-15% of males), hormonal issues (hyper/hypogonadism) infection/immune probs (antisperm antibodies), obstruction and congenital anomalies, ejaculatory dysfunction

    • Treatment: depends on the cause; surgery, medication, artificial insemination (with donor sperm)

    Female Altered Reproductive Function

    • Causes of female infertility can be located in the following areas:Hypothalamus-pituitary, Ovaries, Fallopian tubes, Uterus, and Vagina. Numerous factors can contribute to each anatomical locations difficulties in the reproductive process.

    Sexually Transmitted Infections (STIs)

    • Single most important cause of reproductive disorders in many situations
    • Reporting not mandatory for all types, but in Australia there are approximately 70,000 reported cases per year
    • Transmission preventable with barrier contraception (latex condoms, female femidoms)
    • Treatment effectiveness differs in ease or difficulty.

    Hormonal and Menstrual Alterations

    • Dysmenorrhea: Primary -ovulatory cycle related painful menstruation, Secondary- related to pelvic pathology
    • Amenorrhea: Primary-absence of menstruation by age 14 (or 16), Secondary- Absence of menstruation for 3+ cycles or 6 months in menstruating women.
    • Premenstrual Syndrome (PMS): Distressing symptoms in the luteal phase of women's menstrual cycles. Symptoms range from physical discomfort, emotional distress, and behavioral changes.

    Detecting Altered Reproductive Function

    • History and physical examination
    • Sperm analysis
    • Ovulation determination (cervical mucus/basal body temp/LH surge)
    • Lab hormone levels, antibody detection
    • Reproductive structures patency (hysterosalpingogram)
    • Laparoscopy
    • Genetic testing

    Treating Altered Reproductive Function

    • Dependent on the underlying cause.
    • Supportive counseling and education
    • Treatment options vary depending on the cause of problem, including infection, hormone imbalance, motility problems, and immune system problems.

    Assisted Reproductive Technology (ART)

    • Surgical removal of oocytes.
    • Fertilization of oocytes
    • Return of fertilized oocytes to the woman's body (in vitro fertilization)
    • In vitro fertilization (IVF) is an expensive and sometimes painful procedure dealing with oocytes, hormones, and embryos.

    Contraception

    • Behavioral (rhythm method, abstinence) and barrier methods (condoms, diaphragms) along with hormonal methods to prevent pregnancy. Methods of hormonal contraception include:
    • Using constant blood levels of ovarian hormones or
    • Tricking the hypothalamic-pituitary axis
    • Using high hormone concentrations or
    • Interfering with normal hormone signals
    • Preventing fertilization or
    • Using progestin only methods like thickening cervical mucus, decreasing ovulation frequency, creating inhospitable endometrium etc.

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    Description

    Explore the mechanisms of disease related to altered reproductive function in this quiz based on Dr. Romeo Batacan Jr.'s lecture series. You'll learn about hormonal imbalances, motility impairments, pathway obstructions, and immune problems affecting reproductive health. Test your understanding of these key concepts in medical pathophysiology.

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