Module 10: Reproductive

What do high levels of Prostaglandin F do to cause primary dysmenorrhea? (3)

-Uterine hyper-contractility -Decreased uterine blood flow -increased nerve sensitivity

What are 3 risk factors for developing Chlamydia?

1. Age <26 years 2. New sexual partner 3. Drug use

What 3 organisms are responsible for BV?

1. Gardnerella Vaginalis 2. Mobiluncus 3. Mycoplasma hominis

What are 3 risk factors for the development of pelvic organ prolapse? (6 listed)

1. Menopause 2. Aging 3. Low estrogen 4. Chronically increased intraabdominal pressure (pregnancy, coughing, lung disease, constipation, obesity, prolonged sitting/standing) 5. Pelvic floor trauma (vaginal birth, hysterectomy) 6. Genetic factors (connective tissue disorders, spina bifida)

What are 3 clinical manifestations of Bartholinitis? (6 listed)

1. Most asymptomatic and require no treatment in women <40 years 2. 1-8 cm cyst located in posterior-lateral portion of the vulva 3. fever 4. Malaise 5. cyst may be reddened/painful 6. pus may be visible at opening of duct

What are 2 risk factors for developing HPV?

1. Multiple sex partners 2. early onset of sexual activity 3. alcohol use, smoking, HIV infection are strongly correlated with persistent HPV infection

What are 3 risk factors for the development of leiomyomoas? (7 listed)

1. Nulliparity 2. Obesity 3. PCOS 4. Black 5. Asian 6. Post-menopausal hormone use 7. HTN

Name 3 clinical manifestations/complications of PCOS. (10 listed)

1. Obesity 2. Oligomenorrhea (infrequent menstrual periods) 3. Amenorrhea 4. Hyperandrogenism 5. Infertility 6. Insulin resistance 7. Hirsutism 8. Acanthosis nigricans 9. Acne 10. Sleep Apnea

What are 3 clinical manifestations of endometriosis? (9 listed)

1. Pain 2. Infertility 3. Progressive dysmenorrhea 4. Dysuria 5. Pain on defecation 6. Constipation 7. Abnormal vaginal bleeding 8. Dyspareunia 9. Asymptomatic pelvic mass with movable nodules and a fixed retroverted uterus (if implants are within the pelvis)

What can cause Bartholinitis? (3)

1. Streptococci 2. Staphyloccocci 3. STD's

What are 3 clinical manifestations of leiomymoas? (7 listed)

1. abnormal bleeding 2. pelvic pain 3. pelvic pressure 4. urinary symptoms (d/t pressure on bladder) - frequency - urgency - dysuria - bladder distention (d/t pressure on ureter) 5. constipation (d/t rectosigmoid pressure) 6. Abdominal/uterine heaviness 7. infertility/sub-fertility

What are 3 features of NORMAL vaginal discharge? (6 listed)

1. clear 2. milky/cloudy 3. slippery/clumpy texture 4. Non-irritating 5. Mild smell 6. May yellow after drying

Name 3 risk factors for the development of breast cancer in a woman <45 years old.

1. close relative who was diagnosed with breast cancer at <45 years old 2. >1 MALE relative diagnosed with breast cancer 3. Alterations in BRCA1 and BRCA2 genes 4. Ashkenazi Jewish heritage 5. Treatment with radiation to breast or chest during childhood or early adulthood

What are 3 risk factors for the development of ovarian cancer? (5 listed)

1. early menarche 2. late menopause 3. nulliparity (above are conditions associated with increased ovulation over the lifetime) 4. history of endometriosis 5. Genetics (BRCA1, BRCA2)

What are the two common causes of benign ovarian enlargement in ovulating women?

1. follicular cysts 2. corpus luteum cysts

What are 3 symptoms of syphilis in a newborn?

1. growth abnormalities 2. rashes 3. hepatosplenomegaly 4. jaundice 5. CNS involvement - blindness, deafness 6. Late manifestation: notched incisors

Name 3 potential causes of primary amenorrhea. (5 listed)

1. hypothalamic disorders (hypothalamic-pituitary-ovarian access is dysfunctional) 2. Autoimmune disease (hyperprolactinemia) 3. Medications 4. Congenital absence of vagina, uterus 5. Disorders of anterior pituitary gland (e.g. tumors) - prevents the ovary from receiving the necessary signals and ovulation/menstruation do not occur 6. Genetic abnormalities (such as androgen insensitivity or Turner's Syndrome)

PCOS is defined as having at least 2 of the following...

1. irregular ovulation 2. elevated levels of androgens (testosterone) 3. appearance of polycystic ovaries on US

What are 2 conditions that would cause hypothalamic-pituitary-ovarian access dysfunction, resulting in primary amenorrhea? (4 listed)

1. malnutrition (anorexia nervosa) 2. stress 3. infection (meningitis, syphilis) 4. TBI

What are 3 risk factors for the development of cervical cancer? (5 listed)

1. multiple sex partners 2. smoking 3. many children 4. long history of oral contraceptive use 5. immunocompromised

Name 3 pelvic disorders that can cause secondary amenorrhea. (9 listed)

1. ovarian cysts 2. adenomyosis 3. endometriosis 4. endometritis (infection) 5. PID 6. Uterine fibroids 7. Polyps 8. Tumors 9. ParaGard IUD (non-hormonal)

What are the 4 most common sites of endometriosis?

1. ovaries 2. uterine ligaments 3. rectovaginal septum 4. pelvic peritoneum

What are 3 factors that can protect a woman against developing ovarian cancer? (3 listed)

1. pregnancies 2. prolonged lactation 3. use of hormonal contraceptives that limit ovulation (birth control, tubal ligation, hysterectomy)

What does cryptochordism put you at risk for? (2)

1. testicular cancer (risk is 35-50x times greater) 2. infertility

In what 2 situations does the fishy odor associated with BV increase?

1. when exposed to semen 2. during menstruation

Testicular cancer is the most common form of cancer in young men between what ages?

15-35

The diagnosis of secondary amenorrhea is made when there is an absence of regular menstrual periods for ______ months.

3 months

what is the lifetime risk percentage of developing uterine cancer?

3%

More than 2/3 of breast cancers in women are diagnosed at over ______ years.

55 years

90% of men older than ________ will experience BPH

70 years

A fibroadenoma is: a. a well-defined mobile breast mass, smooth and hard like a marble on physical examination. b. a "squishy" breast mass. c. a painful irregular breast mass. d. a painless irregular breast mass.

A

Pelvic inflammatory disease is often characterized by: a. Gradual onset of dull and steady low bilateral abdominal pain. b. Sudden onset of dull and steady low bilateral abdominal pain. c. Sudden unilateral sharp and stabbing abdominal pain. d. Gradual onset of dull pain that is located in the left lower quadrant Correct answer A

A

What is the most common microorganism that causes acute bacterial prostatitis? a. Escherichia coli b. Haemophilus influenza c. Treponema pallidum

A

There are 3 distinct syndromes associated with HSV infection; which occurs when individuals have no antibodies to HSV 1 and HSV 2? A. First episode primary HSV infection B. First episode non-primary HSV infection C. Recurrent infections

A. First episode primary HSV infection

PID is: A. multimicrobial B. primarily caused by Staphylococcus aureus C. associated with a hyperandrogenic state D. affects only the cervix

A. Multimicrobial there are multiple organisms that cause it, so generally it is because of chlamydia or gonorrhea, but 66% of women will also have BV

The APRN suspects prostate cancer because the patient is over 65 years old and has: A. symptoms of urinary obstruction that are progressive and are not relieved by treatment B. penile discharge C. painful erections D. fibrous plaques found on dorsum of penile shaft

A. symptoms of urinary obstruction that are progressive and not relieved by treatment

Chlamydial cervicitis is suspected. What will the APRN typically find on examination of the cervix? A. yellow mucopurulent discharge B. blisters and erythema C. thin grey malodorous discharge D. unexplained bleeding

A. yellow mucopurulent discharge

The presence of endometrial tissue within the uterine myometrium is called what?

Adenomyosis

what is the number one risk factor for BPH?

Age

Early menarche, late menopause, and nulliparity are risk factors for: a. Cervical cancer b. Ovarian cancer c. Vaginal cancer

B

What type of ovarian cyst causes more symptoms, especially if it ruptures? A. follicular cyst B. corpus luteum cyst C. dermoid cyst

B. Corpus luteum cyst (less common than follicular cysts)

The APRN palpates a 1.5 cm firm, non-tender, mobile mass in the upper outer quadrant of a 34-year-old woman's breast. There is no family history of breast cancer. The APRN suspects this mass is a: A. Breast Cyst B. Fibroadenoma C. Cancerous lesion D. Usual ductal hyperplasia

B. Fibroadenoma It is a fibroadenoma because it is MOBILE, cysts are not usually FIRM (usually squishy), Fibroadenomas are also NON-TENDER and SMOOTH

There are 3 distinct syndromes associated with HSV infection; which occurs when individuals have pre-existing antibodies? A. First episode primary HSV infection B. First episode non-primary HSV infection C. Recurrent infections

B. first episode non-primary HSV infection

An individual has secondary stage syphilis. what will the APRN typically find? A. Hard chancre and firm enlarged lymph nodes B. low-grade fever, malaise, and sore throat C. Gummas, cardiovascular lesions, and neurosyphilis D. Nothing except antibodies present on lab results

B. low-grade fever, malaise, and sore throat Chancre - primary (1) Gummas - tertiary (3) Nothing - latent

The following are symptoms of what disorder? § Urge to urinate often § Delay in starting urination § Decreased force of urinary stream § As the obstruction progresses, the bladder cannot empty all the urine and the increasing volume then can lead to long-term urine retention § The volume of urine retained may be great enough to produce an uncontrolled overflow incontinence with any increase in intraabdominal pressure

BPH

The following are clinical manifestations for what disease? § Elevated vaginal pH (5-5.5) § Vaginal discharge · Strong fishy odor o Especially after intercourse and during menses o Odor is intensified with alkaline secretions (semen, menstrual discharge) · Thin · Gray · Homogeneous · Adheres to vaginal walls and can drain from vagina · Frothy

BV

what condition is a sexually associated condition, but not considered an STI?

BV

____________ __________ is present in up to 66% of women with PID.

Bacterial Vaginosis

Whey are young women at greater risk of acquiring an STI when compared with older women?

Because of the position of the susceptible cells on the surface of their cervix

Newborns born to mothers infected with gonorrhea who have prolonged rupture of membranes must be treated to prevent what?

Blindness

Aside from skin cancer, what is the most common cancer in American women?

Breast cancer

A 45 year old female is being evaluated by the APRN for abnormal uterine bleeding, pain, and pelvic pressure. The APRN suspects the diagnosis will be: a. Endometriosis b. Adenomyosis c. Leiomyomas d. Uterine polyps

C

Most abnormal uterine bleeding is a result of: a. leiomyomas b. Adenomyosis c. anovulation d. endometriosis

C

Ovarian Cancer: A. has a hereditary (genetic) cause B. is the rarest of the female genital cancers C. has often metastasized prior to diagnosis D. Is easily detected with pap smears

C

BPH: A. Is caused by cellular hypertrophy B. Produces compression of the spermatic cord C. Produces obstructive and annoying symptoms D. Is associated with stress incontinence

C. Produces obstructive and annoying symptoms A - hyperplasia is a better term, and is caused by enlargement of the gland

Dysmenorrhea is most likely the result of the release of the following? A. Progesterone B. Prolactin C. Prostaglandin D. Estrogen

C. Prostaglandin

There have been recent ads on TV promoting a medication that treats a penile condition in which there are fibrous plaques found on the dorsum of the penile shaft. This condition is: a. Paraphimosis b. Phimosis c. Peyronie disease d. Priapism

C. peyronie disease

Use of antibiotics contributes to the development of what type of vaginitis?

Candida Albicans (yeast)

What diagnosis? men - clear mucus penile discharge - mild burning with urination - unilaterally painful scrotum women -90% asymptomatic -yellow mucopurulent discharge from cervical os -hypertrophic edematous and friable area of cervical ectopy -intermenstrual or post-coital spotting -erythematous, raw, friable cervix

Chlamydia

What disease pathogenesis involves an elementary body?

Chlamydia

What is the leading cause of preventable infertility and ectopic pregnancy?

Chlamydia

What is the most common bacterial STI reported in the U.S.?

Chlamydia

What maternal infection can cause an eye infection and pneumonia during childbirth?

Chlamydia

What bacteria causes Chlamydia?

Chlamydia trachomatis

A 43 year old female is experiencing abnormal periods. In order to for the midwife to make a diagnosis, the abnormal periods must be present the majority of the past______months. a. 2 b. 3 c. 4 d. 6

D. 6 months

What type of ovarian cyst are ovarian teratomas that contain elements of all 3 germ layers and may contain mature tissues, including skin, hair, sebaceous and sweat glands, muscle fibers, teeth, and bone?

Dermoid cyst

What type of ovarian cyst is usually asymptomatic, found incidentally on pelvic exam, and has malignant potential?

Dermoid cyst

What is the most common microorganism that causes acute bacterial prostatitis?

E. Coli

Men who practice unprotected anal intercourse may acquire sexually transmitted epididymitis because of what 3 pathogens?

E. coli haemophilis influenzae, tuberculosis cryptococcus

The presence of functioning endometrial tissue outside the lining of the womb is called what?

Endometriosis

what is the diagnosis? 1. severe acute pain 2. scrotal/inguinal pain 3. flank pain 4. pyuria 5. bacteriuria 6. scrotum on involved side is red and erythematous

Epididymitis

What duration is considered NORMAL uterine bleeding?

Every 28 days, with variations up to 7 days

T/F: The endometrial tissue in adenomyosis responds to cyclic hormonal changes.

FALSE The endometrial tissue in adenomyosis does NOT respond to cyclic changes (unlike endometriosis)

T/F: The majority of ovarian cancers are associated with a known pattern of inheritance.

FALSE The majority of ovarian cancers are SPORADIC and not associated with a known pattern of inheritance

T/F: The uterus is enlarged and tender with leiomyomas.

FALSE. Uterus is enlarged and irregular, but NON-TENDER and nodularity is appreciated upon pelvic exam

T/F: The urinary symptoms related to prostate cancer are the same as those for BPH.

False. § Unlike urinary symptoms of BPH, the symptoms of an obstruction caused by prostatic cancer and are progressive and do not relent

What is the diagnosis? · Sudden onset of painful urination or purulent penile discharge (or both) within 1 week of infection · Some men will only have a little discharge or sometimes just urethral itching · If left untreated, can cause penile abscesses, fistula and strictures

Gonorrhea

What are the 3 bacterial STI's discussed in our module?

Gonorrhea Chlamydia Syphilis

What is the diagnosis and what gender? · Dysuria · Increased vaginal discharge · Abnormal menses · Dyspareunia · Lower abdominal/pelvic pain · Fever · Friable cervix · Mucopurulent discharge from cervical os · Discharge from the Skene or Bartholin glands may be asymptomatic until infection has spread

Gonorrhea Women

what are the 2 main pathogens for Pelvic Inflammatory Disease?

Gonorrhea and Chlamydia

What do these uterine prolapse grades mean? Grade 0 Grade 1 Grade 2 Grade 3

Grade 0: normal Grade 1: halfway to the hymenal ring Grade 2: reaches the hymen Grade 3: passes the hymen

What grade of uterine prolapse rarely requires correction?

Grade 1 (minimal)

If the uterus descends into the vaginal space and reaches to the hymen, what grade is this?

Grade 2

what grade of uterine prolapse? uterus is so low that the cervix protrudes from the vagina.

Grade 3 (Severe)

what is the first sign of ascending infection in PID?

Gradual onset of dull, steady, aching bilateral lower abdominal pain

What is the most common symptomatic viral STI in the U.S.?

HPV

What virus is most commonly implicated in causing cervical cancer?

HPV strains 16 and 18 (cause 70% of cervical cancers)

JY is a 46-year-old woman who has detected a thickening in the upper outer quadrant of her LT breast. She is examined by her APRN who finds a single non-mobile, painless lump. JY is referred to a surgeon and a biopsy of the lump reveals lobular carcinoma in situ. She has a 15-year-old daughter and she is concerned about her daughter's risk for breast cancer. What would you tell her about that?

Her daughter has an increased risk because JY is young and pre-menopausal. She should be referred for Genetic testing for BRCA1 and BRCA2.

A collection of fluid within the tunica vaginalis is known as what?

Hydrocele

What is the most common benign tumor of the uterus?

Leiomyoma (fibroid)

Primary amenorrhea is a failure of ____________ by age ______ with no secondary sex characteristics or age _______ regardless of development of sex characteristics.

Menarche 13 - no secondary sex characteristics 15 - regardless of development of sex characteristics

What bacteria causes Gonorrhea?

Neisseria gonorrhoeae

When are leiomyomas most common?

Not seen before menarche Incidence increases in women ages 30-50 years incidence decreases with menopause (because leiomyomas occur at times of estrogen exposure)

What kind of female reproductive cancer is often termed the 'silent killer'?

Ovarian Cancer it is commonly diagnosed after metastasis has occurred

What type of incontinence would you see with BPH?

Overflow incontinence

AUB is classified by the CAUSE of the uterine bleeding, using what system?

PALM-COEIN System

What disorder is the most common cause of anovulation and ovulatory dysfunction in women?

PCOS

What is the leading cause of infertility in the U.S.?

PCOS

what female disorder is associated with metabolic dysfunction, including dyslipidemia, insulin resistance, and obesity?

PCOS

What is the main symptoms of epididymitis?

Pain (acute/severe)

Which is a medical emergency: A. Paraphimosis B. Phimosis

Paraphimosis - because it will cut off blood supply and cause necrosis

what is a fibrotic condition of the tunica albuginea of the penis that results in varying degrees of curvature and sexual dysfunction?

Peyronie Disease

AUB is classified by the CAUSE of the uterine bleeding, using the PALM-COEIN System. What does PALM-COEIN stand for?

Polyp Adenomyosis Leiomyoma Malignancy Hyperplasia Coagulopathy Ovulatory dysfunction Iatrogenic Not yet classified

Painful, persistent erection that lasts >4 hours without sexual stimulation is known as what?

Priapism

In what stage of syphilis does a chancre develop?

Primary syphilis

What hormone increases milk production and suppresses ovulation?

Prolactin

Women with painful periods produce 10x more what?

Prostaglandin F

What is the most commonly diagnosed non-skin cancer in men in the U.S.?

Prostate CA

An adult male has severe rectal pressure and pain, fever x2 days, worsening pain that radiates to the back, inability to sit, urinary frequency, urgency and dysuria. What is your diagnostic hypothesis? What is the usual causative agent?

Prostatitis E. Coli

Testicular cancer tumors are most often on what testicle?

RT

what is the greatest risk factor for contracting an STI?

Risky Behaviors (those with unprotected intercourse or genital/oral contact with multiple partners are at the greatest risk)

what is the usual cause of epididymitis?

STI's (Neisseria Gonnorrhea or Chlamydia Trichomonas)

What type of dysmenorrhea results from pelvic disorders (ovarian cysts, adenomyosis, endometriosis, etc.)?

Secondary dysmenorrhea

Pathologic studies have found endometriosis on all organs of the body except for where?

Spleen

T/F: In premenopausal and postmenopausal women, any bleeding is considered abnormal

TRUE

T/F: Persistent corpus luteum is a normal finding in the 1st trimester of pregnancy.

TRUE § Corpus luteum produces progesterone to support the pregnancy until the placenta is established

Janice is concerned because the NP said there were fibrocystic changes in the breasts. What does this mean?

The breast tissue responds to hormonal changes of the menstrual cycle and is usually benign.

Why is it common for malignant tumors of the female reproductive system to grow large before causing pain, leading to late diagnosis?

The female pelvis and abdomen are poorly innervated because it's designed to accommodate a growing fetus

What area of the cervix is very vulnerable to the oncogenic effects of HPV and, therefore, where carcinoma in situ is most likely to develop?

Transformation zone (where the squamous epithelium cells and columnar epithelial cells meet)

What bacteria causes syphilis?

Treponema pallidum

The following are clinical manifestations for what STI? § Range from none to severe § Vaginal discharge and internal pruritis most common manifestations § Vaginal discharge · Copious · Frothy · Malodorous · Yellow green to gray-green § Internal pruritis § Dyspareunia § Dysuria § Vaginal walls appear erythematous, sore with small punctate red marks (strawberry marks) on vaginal walls and cervix § Women report an increase in symptoms after menses § Most men are asymptomatic but have scant intermittent d/c, slight pruritis and mild dysuria

Trichomoniasis (Trich)

T/F: As long as the blood supply is sufficient, the ectopic endometrium proliferates, breaks down, and bleeds with the normal menstrual cycle

True

T/F: Most ovarian cancers are sporadic and have no known pattern of inheritance.

True

Is testicular torsion a surgical emergency?

Yes - torsion twists the arteries and veins and spermatic cord, thereby reducing/stopping circulation to the testes

What is Prostaglandin F (associated with primary dysmenorrhea)?

a potent myometrial stimulant and vasoconstrictor

What is the main symptom of endometrial cancer?

abnormal uterine bleeding, especially if post menopausal

Define amenorrhea

absence or suppression of menstruation

The following are symptoms of what disorder? § Sudden onset of malaise § Low back and perineal pain § High fever (up to 104 F) § Chills § Dysuria § Symptoms of lower urinary tract obstruction · Slow/small/narrowed urinary stream, which may be a medical emergency · Edema can compress the urethra, causing urinary obstruction § Symptoms of UTI or pyelonephritis

acute bacterial prostatitis

Abnormal uterine bleeding is most commonly caused by what?

anovulation

With a cystocele, you will see a bulge in the ________ wall of the vagina.

anterior (top)

Why can obesity cause abnormal uterine bleeding?

because adipose tissue secretes estrogen

Why would someone who isn't having a Herpes outbreak still be able to transmit the virus to a partner?

because the virus can shed even if they are asymptomatic

Enlargement of the prostate gland is known as what?

benign prostatic hyperplasia

what is the first manifestation of prostate cancer?

bladder outlet obstruction symptoms (slow urinary stream, hesitancy, incomplete emptying, nocturia, dysuria, frequency)

Define ectropion.

cells from the inside of the cervical canal (granular cells) are present on the outside of the vaginal portion of the cervix

After ovulation, the _________ ____________ secretes ________________, which limits growth and changes the vasculature of the endometrium, thus limiting the bleeding that occurs during endometrial shedding.

corpus luteum progesterone

What type of cyst is normally formed by the granulosa cells left behind after ovulation?

corpus luteum cyst

Testicular maldescent is AKA as what?

cryptorchidism

testicular cancer is most often associated with what?

cryptorchordism

the descent of the portion of the posterior bladder wall into the vaginal canal is called what?

cystocele

If a patient has adenomyosis, what will their uterus be like on clinical exam?

diffusely enlarged (2-3x expected size) globular most tender before/after menstruation

the congenital adhesions that cause phimosis in infancy are separated naturally by what?

during the first 3 years of life, they separate naturally with penile erections

When is secondary amenorrhea common? (3 life periods listed)

early adolescence peri-menopausal period pregnancy/lactation

What are some risk factors for developing breast cancer?

early menarche late menopause nulliparity The longer the exposure to estrogen, the higher the risk.

What is the most common cause of secondary dysmenorrhea?

endometriosis

As an ovarian follicle grows, it produces _____________, which causes proliferation of the ____________________.

estrogen endometrium

T/F: Genital herpes is a reportable disease

false

What breast changes will a client notice right before they are due for the period, characterized by an increased breast tenderness/lumpiness?

fibrocystic changes

what kind of cyst forms when the dominant follicle fails to rupture or one or more of the nondominant follicles fail to regress?

follicular cyst

Follicular cysts and corpus luteum cysts are called _______________ cysts because they are caused by variations of normal physiologic events.

functional

Condylomata acuminata is AKA what and associated with what virus?

genital warts HPV

what is the cardinal characteristic of PCOS?

hyperandrogenic state

How does a hypothalamic disorder cause primary amenorrhea?

hypothalamic-pituitary-ovarian (HPO) access is dysfunctional and the hypothalamus is unable to synthesize the gonadotropin-releasing hormone (GNRH). The pituitary then fails to secrete LH and FSH - and the ovary does not receive the hormonal signals required to stimulate estrogen production, therefore ovulation and menstruation do not occur

What is the most likely theory regarding the etiology of endometriosis?

impaired cellular and humoral immunity

What is the most plausible theory of endometriosis?

impaired cellular and humoral immunity

Phimosis is normal in _______ and caused by congenital _________.

infancy adhesions

in what stage of syphilis is the patient asymptomatic?

latent

What duration is considered ABNORMAL uterine bleeding?

menstrual cycle <21 days or >35 days, lasting longer then 7 days

When is a fetus most at risk when the mother has a primary herpes outbreak?

near birth/delivery if they have an active lesion during birth, they will generally have a cesarean

does adenomyosis respond to estrogen/hormones?

no

What increases the risk of developing cervical cancer? (5 listed)

numerous sexual partners smoking HPV exposure chronic stress poor nutrition

What criteria must be met before diagnosing abnormal uterine bleeding?

o Vaginal bleeding that is abnormal in duration, volume, frequency, or regularity and has been present for the majority of the previous 6 months

inflammation of the ovaries is called?

oophoritis

What type of cancer causes more deaths than any other female reproductive cancer?

ovarian cancer

The uterine endometrium has an overactive response to ___________ and an underactive response to ________.

overactive response to ESTROGEN underactive response to PROGESTERONE This impairs the endometrial receptivity to blastocyst implantation and decreases the chance of a successful pregnancy.

What is the pH of the vagina with a BV infection?

pH is increased (alkaline) 5-5.5

Define dyspareunia

painful intercourse

What is the first sign of breast cancer?

painless lump

What is usually the first sign of testicular cancer?

painless testicular enlargement

what is it called when the foreskin is retracted band cannot be moved forward (reduced) to cover the glans?

paraphimosis

Who is most commonly affected by abnormal uterine bleeding?

peri-menopausal women

what is it called when the foreskin cannot be retracted back over the glans?

phimosis

Phimosis is most commonly caused by what?

poor hygiene

with a rectocele, you will see a bulge in the ______ wall of the vagina.

posterior (bottom)

What condition must be ruled out before diagnosing secondary amenorrhea?

pregnancy

what is the most common cause of secondary amenorrhea?

pregnancy

Name the 4 stages of syphilis.

primary, secondary, latent, tertiary

Abnormal uterine bleeding can be attributed to the lack of corpus luteum that produces what hormone?

progesterone

There is ________________ resistance of endometrial cells.

progesterone

Women who fail to ovulate experience irregularities in their menstrual cycle, which is related to the lack of _________.

progesterone

What is often associated with the initial development of idiopathic priapism?

prolonged sexual stimulation

what is the primary risk factor for the development of endometrial cancer?

prolonged unopposed estrogen Exposure to unopposed estrogen includes: estrogen-only hormone replacement therapy, Tamoxifen use, early menarche, late menopause, nulliparity, PCOS

Primary dysmenorrhea is associated with the release of what?

prostaglandins in ovulatory cycles

If a woman states that she needs to splint her posterior vaginal wall to accomplish defecation, what do you suspect she has?

rectocele

the bulging of the rectum and posterior vaginal wall into the vaginal canal is called what?

rectocele

inflammation of the fallopian tubes is called?

salpingitis

In what stage of syphilis does a condylomata lata form?

secondary

Secondary amenorrhea is the absence of menses for ___ months or irregular menses for ___ months in women who have ____________ _______________.

secondary amenorrhea is the absence of menses for 3 MONTHS or irregular menses of 6 MONTHS in women who have PREVIOUSLY MENSTRUATED.

In what stage of syphilis would you see systemic symptoms?

secondary syphilis

Epididymitis occurs more often in whom?

sexually active young males <35 years old

What is the most common benign breast lesion?

simple breast cyst

What is it? - solid lumps of masses composed of stromal and glandular tissue -well defined mobile solid mass on US -smooth/hard like a marble -common in ages 15-35 years - hormonal role (increase in size during pregnancy and during estrogen therapy and regress after menopause)

simple fibroadenoma

In what stage of syphilis do gummas develop?

tertiary syphilis

Rotation of the testis which twists blood vessels and the spermatic cord is known as what?

testicular torsion

where on the breast do the majority of breast carcinomas occur?

the upper outer quadrant (this is where most of the glandular tissue of the breast is located)

Why are women with polycystic ovary syndrome (PCOS) at risk for uterine cancer?

they tend to have more anovulatory cycles and produce less progesterone. Unopposed estrogen may lead to uterine cancer.

What increases the risk of developing endometrial cancer? (5 listed)

unopposed estrogen early menarche late menopause family history obesity

leiomyomas are also known as what?

uterine fibroids

decent of the cervix/entire uterus into the vaginal canal is called what?

uterine prolapse

What causes a cystocele?

weakening of the anterior vaginal wall

Do leiomyomas enlarge with exposure to estrogen?

yes

Does gonorrhea cross the placenta to the fetus in an infected mother?

yes

What are 2 normal cell types of the cervix?

§ Squamous epithelium cells § Columnar epithelial cells

The NP notes that the patient's cervix has descended half way past the hymen. This is a: a. Grade 1 prolapse b. Grade 2 prolapse c. Grade 3 prolapse d. Grade 4 prolapse

C - grade 3 prolapse

A 60 year-old female presents to the APRN's office because of vaginal bleeding. Until proven otherwise, what is the APRN's diagnosis? a. Vaginal infection b. Cervical cancer c. endometrial cancer d. endometrial polyps

C.

Breast lesions that are not clinically definitive because they encompass a heterogeneous are classified as: a. Breast cancer b. Breast cyst c. Fibrocystic changes d. Mastitis

C.

RR "Googled" symptoms of trichomoniasis before seeing the APRN and is sure they must be infected. The APRN would expect to see the following upon a vaginal exam: a. Thin, watery discharge b. Thick white discharge c. yellow-green frothy discharge d. no discharge, only odor

C.

Primary amenorrhea etiology is classified into several Compartment Disorders. Amenorrhea that involves the ovary and are often linked to genetic disorders such as Turner Syndrome and androgen insensitivity syndrome (AIS) is a: a. Compartment IV Disorder b. Compartment III Disorder c. Compartment II Disorder d. Compartment 1 Disorder

C. Compartment II

Dermoid cysts A. Are a function of ovulation B. Contain a yellowish fluid C. Contain all 3 embryo layers D. Contain clear fluid

C. Contain all 3 embryo layers

John is experiencing painful blisters on his penis. He also feels ill (like the flu). He has a fever and tender and enlarged lymph nodes in his groin. The APRN suspects he has: A. Syphilis B. Gonorrhea C. Herpes D. Condyloma acuminate

C. Herpes This is correct because: PAINFUL BLISTERS What makes this not syphilis? main symptom of syphilis is usually one chancer (one little sore) that is found

A 43-year old male presents with painless scrotal swelling one week after a motorcycle accident. He denies injury at the time of the accident. On exam, the APRN finds a painless swelling around the testicles and explains to the patient that this is: A. torsion of the testes B. A spermatocele C. A hydrocele D. Cryptorchidism

C. Hydrocele Not: -Torsion, because it's painful (medical emergency) -spermatocele is fluid around the epididymus