Patho Repro Slides Only PDF

# Patho Repro Notes ## Anatomy & Physiology ### Female Structures **External** - Vulva - Labia majora and minora - Clitoris - Vestibule and vestibular glands - Hymen - Vaginal orifice **Internal** - Ovaries - Fallopian tubes - Uterus - Cervix - Vagina ### Female Hormones - Estrogen - Progest...

# Patho Repro Notes ## Anatomy & Physiology ### Female Structures **External** - Vulva - Labia majora and minora - Clitoris - Vestibule and vestibular glands - Hymen - Vaginal orifice **Internal** - Ovaries - Fallopian tubes - Uterus - Cervix - Vagina ### Female Hormones - Estrogen - Progesterone ## Male Structures **External** - Scrotum - Penis **Internal** - Testes - Epididymis - Vas deferens - Urethra - Seminal vesicles - Bulbourethral and prostate glands ## Common Signs and Symptoms ### Female - Abdominal and pelvic pain - Fever and malaise - Abnormal vaginal discharge - Burning and/or itching of genitals - Pain during sexual intercourse - Any change in breast tissue - Abnormal discharge from nipple ### Male - Urinary disorders: frequency, dysuria, nocturia, incontinence - Pain in pelvis, groin, or reproductive organs - Lesions on external genitals - Swelling of reproductive organs - Abnormal penile drainage - Burning, itching of the genitals ## Diagnostic Tests ### Female - Bimanual examination - Hysterosalpingogram - Pap smear of cervix - Cervical biopsy - Cone biopsy - Dilatation and curettage - Laparoscopy - Mammography - Blood tests ### Male - Digital rectal examination - Cystoscopy - Biopsy - Laboratory tests: including various prostate-specific antigen (PSA) tests ## Female Reproductive System Diseases ### Premenstrual Syndrome (PMS) - Symptoms: - Headache - Nausea - Back and joint pain - Edema and bloating - Weight gain - Breast tenderness - Sleep disturbances - Irritability - Mood Swings - Depression - Treatment: - Individualized - Dietary changes: avoid caffeine, chocolate, nicotine, salt, sugar, and alcohol ### Menstrual Abnormalities - Amenorrhea - Dysmenorrhea - Menorrhagia - Metrorrhagia ## Menopause - Natural halting of menstruation - NOT a disease, is normal physical change related to aging. - Usually takes place between age 40 and 50. - Can be surgically induced at any age by removal of both ovaries. - Symptoms: - Hot flashes, night sweats, and vaginal dryness - For some women: psychological symptoms of depression, sleep disorders, and decreased libido - Diagnosis: - Blood tests for presence of FSH - Treatment: - MHT (menopausal hormone therapy) on an individual basis in consultation with a physician ## Vaginitis - Inflammation of the vagina - Causes: - Bacteria - Yeast - Symptoms: - Vaginal burning, itching, swelling of the vagina and external genitalia - A white cottage cheese-appearing discharge with Candida - Diagnosis: - Testing vaginal fluid pH - Culture; antigen detection - Treatment: - Identify and treat cause - Abstain from sexual intercourse until condition has healed - Common types of vaginitis include: - Candida: fungus or yeast - Trichomonas: parasite - Atrophic: postmenopausal ## Endometriosis - Abnormal growth of endometrial tissue outside of uterus - Common implantation sites: - Ovaries - Fallopian tubes - Abdominal wall - Intestines - Implanted endometrial tissue continues to act under the influence of hormones producing chocolate cysts, scar tissue, and adhesions. - Symptoms: - Dysmenorrhea - Low back, vaginal, and pelvic cramping - Heavy menses - Dyspareunia - Primary complication is infertility - Treatment: - Hormones - Remission with pregnancy, nursing, and menopause - Panhysterectomy ## Pelvic Inflammatory Disease (PID) - Inflammation of some or all pelvic reproductive organs - May include cervicitis, endometritis, salpingitis, and oophoritis - Causes: - Most commonly STDs - Symptoms: - Fever - Chills - Pelvic pain - Leukorrhea - Treatment: - Antibiotics - Analgesics - Rest - Prevention: - Practicing safe sex with proper use of condoms ## Ovarian Cyst - Commonly benign fluid-filled sac(s) on or near ovary - Two types: - Physiologic - Neoplastic - Symptoms: - Low back pain - Pelvic pain - Dyspareunia - Nausea and vomiting - Treatment: - Depends on type and size - May resolve by itself or require laparoscopy ## Fibroid Tumor - Also known as leiomyomas - Benign tumors of smooth uterine muscle - Most common tumor of female reproductive system - Symptoms: - Abnormal uterine bleeding - Excessive menstrual bleeding and pain - Treatment: - Depends on woman's age and desire for children: - Surgical removal - Hysterectomy ## Toxic Shock Syndrome - A severe, life-threatening illness - Found almost exclusively in menstruating females using tampons. - Cause: - Organism called Staphylococcus aureus - Symptoms: - Sudden onset of high fever - Vomiting - Diarrhea - Decreasing blood pressure - Treatment: - IV fluids - Antibiotics ## Uterine Prolapse - Uterus protrudes into vagina - Symptoms: - Heaviness in pelvis - Urinary stress - Dysuria - Low back pain - Treatment: - Hysterectomy ## Cystocele - Herniation of urinary bladder through anterior vaginal wall - Symptoms: - Pelvic pressure - Urinary urgency, frequency, and incontinence - Treatment: - Depends on degree of herniation - Kegel Exercise - Surgery ## Rectocele - Herniation of rectum through posterior vaginal wall - Symptoms: - Discomfort - Constipation - Fecal incontinence - Treatment: - Surgical repair ## Cervical Cancer - Most common cause: Human papillomavirus (HPV) - Symptoms: - Abnormal cervical bleeding - Treatment: - Surgical removal of tumor - Risk factors: - Beginning sex at an early age - Multiple sex partners - Smoking - Sex with males who smoke - Sex with males who have a spouse diagnosed with cervical cancer - Obesity - Excessive alcohol consumption - Prevention: - Reduce risk factors AND - Have yearly pap smear tests - follow up on results - Get HPV vaccine ## Uterine Cancer - Develops in endometrium and spreads to uterine wall - Symptoms: - Abnormal bleeding in postmenopausal females - Treatment: - Surgical removal of uterus and ovaries - Radiation therapy - Chemotherapy ## Ovarian Cancer - Quite common and often fatal - Symptoms: - Pressure on bladder - Abdominal or pelvic pain - General feeling of ill health - Treatment: - Complete hysterectomy - Radiation - Chemotherapy ## Diseases of the Breast ### Fibrocystic Disease - Most common breast disorder of premenopausal females between age 30 and 55. - Cause: Cysts linked to estrogen levels - Treatment: - To decrease breast pain: - Reduce caffeine and salt - Use mild diuretics - Use mild analgesics week before menstruation ## Mastitis - Inflammation of breast tissue - Symptoms: - Redness, heat, swelling - Pain - Bloody nipple discharge - Treatment: - Antibiotics - Application of heat - Analgesics - Firm, supporting bra to decrease discomfort ## Breast Cancer - Adenocarcinoma of breast ducts - Most common breast neoplasm - Risk factors: - Age 40 and over - Family member affected with breast cancer - Early onset of menses - Late menopause - Nullipara - First child after age 30 - Obesity - Chronic breast disease - Brassiere wear time - Symptoms: - Nontender lump - Occurs most often in upper outer quadrant of breast - Often with dimpling - Treatment: - Lumpectomy - Mastectomy - Chemotherapy - Radiation ## Disorders of Pregnancy ### Ectopic Pregnancy - Fertilized ovum attaches to tissue outside uterus - Usually in fallopian tubes - Symptoms: - Acute pelvic pain - Vaginal bleeding - Positive pregnancy test - Treatment: - Prompt surgery to terminate pregnancy - Every effort taken to preserve ovary and tube if future pregnancy desired ### Spontaneous Abortion - Natural termination of pregnancy before fetus is viable - Also known as miscarriage - Symptoms: - Vaginal bleeding - Cramping and pelvic pain - Treatment: - Bed rest - Once spontaneous abortion begins, it is difficult to stop - D&C ### Morning Sickness - Associated with first trimester of pregnancy - Symptoms: - Nausea and vomiting - Treatment: - Not necessary unless excessive vomiting - Light meals several times per day - Dry food before drinking - Avoidance of fatty foods - Rest after meals ### Hyperemesis Gravidarum - Excessive vomiting during pregnancy - Symptoms: - Excessive vomiting - Leading to dehydration, weight loss, and possible electrolyte imbalance - Treatment: - IV fluids - Withholding all foods and oral fluids - Usually subsides by second pregnancy ### Toxemia - Usually appears during third trimester - Symptoms: - Hypertension - Sudden weight gain - Proteinuria - Edema in face, hands, and feet - Treatment: - Frequent monitoring of blood pressure, weight, and urine protein ### Abruptio Placentae - Separation of placenta from uterus - Symptoms: Determined by degree of separation: - Partial separation may be asymptomatic - Complete separation may cause severe abdominal pain and vaginal bleeding - Hemorrhage, shock, and decrease in fetal heart tones - Treatment: - Prompt delivery either vaginally or by cesarean section (C-section) - Blood replacement may also be necessary ### Placenta Previa - Abnormal positioning of placenta in lower uterus often near or covering cervical os - Symptoms: - Painless, bright red vaginal bleeding during third trimester - Treatment: - Vaginal delivery if asymptomatic or bleeding not severe - Emergency C-section if maternal bleeding or fetal anoxia ## Male Reproductive System Diseases ### Prostatitis - Inflammation of prostate gland - Symptoms: - Dysuria - Pyuria - Fever - Low back pain - Treatment: - Antibiotics - Warm sitz baths - Increased fluid intake - Analgesics ### Benign Prostatic Hyperplasia (BPH) - Enlargement of prostate gland due to normal cells overgrowing and enlarging - Common in males over age 50 - Symptoms: - Nocturia - Inability to start urination - Weak urinary stream - Inability to empty bladder - Treatment: - Prostatic massage - Sitz bath - Catheterizations - Regular sexual intercourse - Surgery ### Prostatic Carcinoma - Neoplasm of prostate gland affecting males over age 50 - Second most common cause of cancer-related deaths in males - Symptoms: - Similar to BPH - Treatment: - Depends on age, physical condition of individual, and degree of metastasis ### Epididymitis - Inflammation of epididymis - Symptoms: - Swollen, hard, and painful epididymis - Severe scrotal pain and swelling - Treatment: - Rest - Analgesics - Use of scrotal support - Avoidance of alcohol, spicy foods, and sexual stimulation ### Orchitis - Inflammation of one or both testes due to viral or bacterial infection - Symptoms: - Swelling, pain, and tenderness of one or both testes - Fever - Malaise - Treatment: - Depends on cause - Antibiotic if bacterial - Bed rest, analgesic, antipyretic, scrotal support ### Testicular Tumor - Commonly affects young males between age 20 and 35 - Most common type of cancer in this age group - Symptoms: - Painless mass felt in testicle - Treatment: - Orchiectomy - Chemotherapy - Radiation ### Cryptorchidism - Undescended testicle - Common Cause: premature birth - Treatment: - Surgery ## Sexually Transmitted Diseases (STDs) - Formerly called venereal diseases - A group of many diseases that are spread by intimate or sexual contact - Treatment commonly consists of identifying sex partners and treating the infected individuals concurrently - Prevention of STDs is best achieved by avoiding intimate contact with infected individuals ### Acquired Immunodeficiency Syndrome (AIDS) - Blood-borne viral infection - Discussed in detail in Chapter 5 ### Hepatitis - Viral infection of the liver - Hepatitis B and C can be spread by sexual intercourse - Discussed in detail in Chapter 12 ### Genital Herpes - Viral infection f the mucous membranes - Cause: Herpes simplex virus - Symptoms: - Blisters - Extreme pain - Severe itching - Painful urination - Symptomatic treatment: - Antiviral medications - Sitz baths - Ice therapy - Analgesics - No cure ### Gonorrhea - One of the most common STDs in the United States - Causes inflammation in mucous membranes of genital and urinary system - Cause: Neisseria gonorrhoeae bacterium - Symptoms: - Purulent discharge from penis and vagina - Dysuria - Urinary frequency in males and females - Cervicitis in females - Genital itching and burning pain - Treatment: - Antibiotics: - Penicillin - Tetracycline - Ceftriaxone ### Syphilis - Chronic, life-threatening STD - Cause: Treponema pallidum bacterium - Symptoms: Three stages: - **Primary:** Painless chancre appears - **Secondary:** Chancre heals, rash appears - **Tertiary:** Period of rest lasting 6 weeks to 1 year, bacteria invade organs throughout body leading to gumma (curable with antibiotics during this stage but effects of lesions irreversible) - Treatment: - Penicillin - Tetracycline ### Chlamydia - Very common, one of the most damaging STDs - Also known as silent STD - Cause: Bacterial - Symptoms: - Drainage from penis and vagina - Burning and itching of genital area or with urination - Abdominal pain and dyspareunia in the infected - Treatment: - Antibiotics ### Trichomoniasis - Common STD affecting approximately 10% of all sexually active individuals - Cause: Protozoan - Trichomonas vaginalis - Symptoms include: (often asymptomatic) - Male: - Urethritis - Epididymitis - Prostatitis - Female: - Itching and burning of genital area - Green, frothy vaginal discharge - Treatment: - Antiparasitic medications ### Genital Warts - One of the most common STDs - Warts that affect the warm, moist tissue of the genital area - Cause: HPV (virus) - Symptoms: Tenderness, discomfort related to size, location, and number of warts - Treatment: Chemical or surgical removal - Cervical cancer more common in females with genital warts ## Sexual Dysfunction ### Dyspareunia - Pain or discomfort with sexual intercourse - May affect males and females - Cause: physical or psychological conditions - Treatment: - Dependent on cause ### Female Arousal-Orgasmic Dysfunction - Also known as frigidity - Lack of sexual desire or responsiveness - Cause: Often due to neurologic and psychological conditions - Symptom: Inability to reach orgasm - Treatment: - Education on healthy sex attitudes and sexual stimulation techniques ### Impotence/Erectile Dysfunction (ED) - Now most commonly known as ED - Symptoms: - Inability of male to achieve or maintain erection sufficient to complete sexual intercourse - Does not affect fertility - Cause: - Vascular insufficiency and psychological factors - Treatment varies: - Change in medications - Psychological counseling - Surgery - Internal and external devices - Medications - Prevention: - May not be preventable - Activities related to healthy lifestyle may aid in prevention ### Premature Ejaculation - Expulsion of seminal fluid during foreplay, prior to complete erection, or immediately after beginning sexual intercourse - Most common sexual problem in males - Especially young males - Cause: Usually psychological rather than physical - Treatment: - Based on cause - Can include sex therapy and education ## Infertility - Inability of couple to achieve pregnancy - **Female causes:** - Presence of STD - Hormonal disorders - Abnormality of reproductive organs: endometriosis, scarring or blockage of fallopian tubes, vaginal antibodies that kill sperm - **Male causes:** - Presence of STD or other infection in tract - Structural abnormalities - Hormonal disorders - Treatment: - Surgery - Medications to correct hormone imbalance - Fertility drugs - Inseminations ## Trauma ### Rape - Sexual intercourse (vaginal or anal) without consent or against will of individual - May be any age and against either sex - High incidence - Date rape drugs - Difficult recovery ## Rare Diseases ### Vaginal Cancer - Rare form of cancer that occurs in daughters of mothers who used diethylstilbestrol (DES) hormone - Treatment: - Surgery - Chemotherapy - Radiation ### Puerperal Sepsis - Infection of endometrium following childbirth - Treatment: - Antibiotics - Prevention: - Asepsis during and after childbirth ### Hydatidiform Mole - Grape-like cysts in uterus that mimic pregnancy - Treatment: - D&C - At higher risk to develop choriocarcinoma: - Requiring frequent follow-up examinations ## Effects of Aging on Females - Thinning and graying of pubic hair - Decreased elasticity and atrophy - Shrinking of internal organs - Decreased vaginal lubrication - Greater stimulation and lubricants required for sexual pleasure - Breast atrophy ## Effects of Aging on Males - Decreases in testosterone and sperm - Decrease in size of testes - Decreased elasticity of penis and scrotum - Thinning and graying of pubic hair - Greater stimulation required for erection - Diminished ejaculation amount - Enlarged prostate, which can cause problems with urination