Pathology of Female Reproductive System
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Questions and Answers

What is the primary cause of natural decline of reproductive hormones leading to menopause?

  • Hysterectomy
  • Primary ovarian insufficiency
  • Natural decline of reproductive hormones with age (correct)
  • Chemotherapy and radiation therapy

    • What is the main reason Hormone Replacement Therapy is no longer encouraged?

  • Risk of heart disease
  • Risk of breast cancer
  • Risk of osteoporosis
  • All of the above (correct)

    • What is the primary goal of non-hormonal therapy in treating menopause symptoms?

  • To reduce hot flashes
  • To alleviate vaginal dryness
  • To promote bone density
  • To improve overall quality of life (correct)

    • What is the most common cause of Pelvic Inflammatory Disease (PID)?

    <p>Gonorrhea and chlamydial infections</p> Signup and view all the answers

    What is a common complication of Pelvic Inflammatory Disease (PID)?

    <p>All of the above</p> Signup and view all the answers

    What is the main characteristic of Endometriosis?

    <p>Presence of normal endometrial tissue outside the uterine cavity</p> Signup and view all the answers

    What is the main theory of how endometrial tissue implants outside the uterus?

    <p>Through menstrual backflow and implantation</p> Signup and view all the answers

    What is the main goal of treatment for Pelvic Inflammatory Disease (PID)?

    <p>To eradicate the infection</p> Signup and view all the answers

    What is the primary symptom of abdominal pressure?

    <p>Pain in the hips, lower back, and inner thighs</p> Signup and view all the answers

    What is the definition of oligomenorrhea?

    <p>Light or infrequent menstrual periods (&gt; 35 days interval, 4 – 9 times per year)</p> Signup and view all the answers

    What is the primary complication of vaginal bleeding?

    <p>Anemia</p> Signup and view all the answers

    What is the purpose of a resectoscope in endometrial ablation?

    <p>To remove polyps and fibroids</p> Signup and view all the answers

    What is the definition of menopause?

    <p>Absence of menstrual periods for 12 months</p> Signup and view all the answers

    What is the treatment for toxic shock syndrome (TSS)?

    <p>Avoidance of superabsorbent tampons and pads</p> Signup and view all the answers

    What is a common symptom of dysmenorrhea in endometriosis?

    <p>Pelvic pain</p> Signup and view all the answers

    What is the purpose of balloon thermotherapy?

    <p>To treat vaginal bleeding</p> Signup and view all the answers

    What is the purpose of NSAIDS/Prostaglandin blockers?

    <p>To treat abdominal pressure</p> Signup and view all the answers

    What is the diagnosis tool used to detect uterine fibroids?

    <p>Hysteroscopy</p> Signup and view all the answers

    What is the treatment of choice for a 26-year-old woman with uterine fibroids who wishes to have children?

    <p>Myomectomy</p> Signup and view all the answers

    What is the clinical manifestation of endometriosis?

    <p>All of the above</p> Signup and view all the answers

    What is the treatment for endometriosis in women who no longer desire to bear children?

    <p>Hysterectomy</p> Signup and view all the answers

    What is the characteristic of leiomyomas?

    <p>Benign smooth muscle tumors</p> Signup and view all the answers

    What is the common symptom of leiomyomas?

    <p>Abnormal uterine bleeding</p> Signup and view all the answers

    What is the treatment for leiomyomas?

    <p>All of the above</p> Signup and view all the answers

    What is the greatest risk factor for ovarian cancer?

    <p>Family history</p> Signup and view all the answers

    What is the primary method of diagnosis for endometrial cancer?

    <p>Endometrial biopsy</p> Signup and view all the answers

    What is the first choice of treatment for endometrial cancer?

    <p>Hysterectomy</p> Signup and view all the answers

    What is the most common type of ovarian cancer?

    <p>Epithelial carcinoma</p> Signup and view all the answers

    What is the primary method of internal radiation treatment for cervical cancer?

    <p>Brachytherapy</p> Signup and view all the answers

    What is a common manifestation of vaginal cancer?

    <p>Bleeding not related to menses</p> Signup and view all the answers

    What is a risk factor for vulvar cancer?

    <p>DES exposure</p> Signup and view all the answers

    What is a common treatment option for all gynecological cancers?

    <p>Surgery, chemotherapy, and radiation</p> Signup and view all the answers

    What is the primary function of hormonal therapy in the treatment of PCOS?

    <p>To shrink the tumor and maintain sterility</p> Signup and view all the answers

    What is the direct effect of insulin on ovarian stroma in PCOS?

    <p>It stimulates androgen secretion</p> Signup and view all the answers

    What is the primary role of hyperinsulinemia in PCOS?

    <p>It plays a key role in androgen excess and anovulation</p> Signup and view all the answers

    What is the primary symptom of anovulation in PCOS?

    <p>Infrequent or absent menstrual periods</p> Signup and view all the answers

    What is the primary method of diagnosis for PCOS?

    <p>Ultrasound and laparoscopy</p> Signup and view all the answers

    What is the primary cause of cervical cancer?

    <p>Human papilloma virus (HPV)</p> Signup and view all the answers

    What is the primary method of staging cervical cancer?

    <p>Cervical intraepithelial neoplasia (CIN) grading</p> Signup and view all the answers

    What is the primary risk factor for cervical cancer?

    <p>Multiple sex partners</p> Signup and view all the answers

    Study Notes

    Abdominal Pain and Bleeding

    • Pressure in the abdomen, pain in the hips, lower back, and inner thighs, and upset stomach with vomiting and loose stools can be symptoms of abdominal vaginal bleeding
    • Treatment options include drug therapy with NSAIDS, prostaglandin blockers, oral contraceptives, relaxation techniques, heat therapy, exercise, acupuncture, and transcutaneous nerve stimulation

    Abnormal Uterine Bleeding

    • Oligomenorrhea: light or infrequent menstrual periods (> 35 days interval, 4-9 times per year)
    • Amenorrhea: absence of menses
    • Menorrhagia: prolonged menstrual bleeding
    • Metrorrhagia: bleeding from the uterus between menstrual periods
    • Complications of vaginal bleeding include anemia, toxic shock syndrome, and infertility

    Complications of Vaginal Bleeding

    • Anemia: assess for excessive fatigue, monitor vital signs, and provide safety measures for the weak patient
    • Toxic Shock Syndrome (TSS): assess for high fever, vomiting, diarrhea, weakness, myalgia, and sunburn-like rash; avoid using superabsorbent tampons and pads, and change them frequently

    Treatment of Vaginal Bleeding

    • Drug therapy with oral contraceptives and balloon thermotherapy
    • Surgical therapy with myomectomy and endometrial ablation

    Menopause

    • Absence of menstrual periods for 12 months, with a decline in reproductive hormones
    • Stages: premenopause, perimenopause, menopause, and postmenopause
    • Causes include natural decline of reproductive hormones, hysterectomy, bilateral oophorectomy, chemotherapy, radiation therapy, and primary ovarian insufficiency
    • Treatment options include drug therapy with hormone replacement therapy, antidepressants, and selective estrogen receptor modulators, as well as non-hormonal therapy with a cool environment, loose fitting clothing, moisturizing soaps and lotions, a healthy diet with vitamin D, and exercise

    Pelvic Inflammatory Disease (PID)

    • Infection of the uterus, fallopian tubes, ovaries, and peritoneal cavity
    • Causes: gonorrhea and chlamydial infections
    • Manifestations: abdominal pain, fever, and vaginal discharge
    • Complications: septal shock, infertility, and ectopic pregnancy
    • Treatment: drug therapy, force fluids, heat to abdomen or Sitz bath, and patient teaching for prevention of re-infection

    Endometriosis

    • Presence of normal endometrial tissue outside the uterine cavity
    • Characterized by endometrial glands and stroma in a location outside the endomyometrium
    • Clinical manifestations: dysmenorrhea, pelvic pain, dyspareunia, dysuria, and infertility
    • Diagnosis: pelvic exam, ultrasound, and laparoscopy
    • Treatment options include ibuprofen, oral contraceptives, medroxyprogesterone, danazol, gonadotropin-releasing hormone agonists, and surgical therapy with laparoscopic laser surgery and hysterectomy

    Benign Reproductive System Tumors

    • Leiomyomas: benign smooth muscle tumors in the uterus, diagnosed with hysteroscopy
    • Polycystic ovary syndrome (PCOS): bilateral enlarged ovaries with multiple outer follicular cysts, absence of corpora lutea, and hyperplastic ovarian stroma with thickening capsule

    Cancers of the Female Reproductive System

    • Cervical cancer: early changes in cervical epithelial tissue consist of dysplasia, with etiology linked to STDs, multiple sex partners, and environmental factors
    • Staging: cervical intraepithelial neoplasia (CIN) graded from I to III
    • Treatment options: surgical therapy with hysterectomy, chemotherapy, and radiation with brachytherapy
    • Endometrial cancer: major risk factor is prolonged exposure to estrogen, with other risk factors including age, infertility, diabetes, family history, and lifestyle
    • Diagnosis: endometrial biopsy
    • Treatment options: surgical therapy with hysterectomy, chemotherapy, and radiation with brachytherapy
    • Ovarian cancer: greatest risk factor is family history, with other risk factors including age, high-fat diet, greater number of ovulatory cycles, hormone replacement therapy, and use of infertility drugs
    • Clinical manifestations: increase in abdominal girth, bowel and bladder dysfunctions, persistent pelvic or abdominal pain, and menstrual irregularities
    • Diagnosis: CA-125, ultrasound, and yearly pelvic examination
    • Vaginal cancer: risk factors include age, cancer of the cervix or endometrium, and young women with DES exposure
    • Clinical manifestations: bleeding not related to menses, dyspareunia, dysuria, and vaginal discharge
    • Vulvar cancer: risk factors include age, chronic irritation, and history of HPV or Herpes 2
    • Clinical manifestations: pruritus, burning, enlarged inguinal lymph nodes, asymmetry, lesions or mass, and change in color
    • Treatment options for all cancers: surgery, chemotherapy, and radiation

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