Patho Final

Hypospadia

Congenital abnormality of the penis where meatus develops on the ventral(underneath part of the penis; urologic dysfunction, abnormal position of the urethral meatus on the penis

Epispadia

Congenital abnormality of the penis where meatus develops on the dorsal(upper) part of the penis: urologic dysfunction, abnormal position of the urethral meatus on the penis

Diagnosed with physical exam and treated with surgery

How are hypospadia and epispadia diagnosed and treated?

Newborns

What age group are hypospadia and epispadia found within?

Hydrocele

A fluid-filled sac around the testicle; painless but large and inconvenient, usually disappears without treatment in the first year

Swelling of the scrotum

What is hydrocele first noticed as?

Newborns

What age group is a hydrocele most commonly seen in?

Inflammation or injury

What are hydrocele in adults usually due to?

Chronic kidney disease

Loss of kidney function over time; results from a failure of the body to remove waste products

Renal failure

Chronic kidney disease leads to what?

Waste build up slowly

Kidneys filter waste and excess fluid from the blood. As they fail, what happens?

Low levels of GFR, presence of albumin in urine, and high levels of creatinine in blood due to filtration issues

What should you look for when diagnosing chronic kidney disease?

It means the nephrons in the kidney have been damaged?

What does it mean when protein in present in urine for CKD?

Acute kidney function

Rapid decrease in kidney function, kidneys cannot filter waste from the blood

RAAS is activated

Your bowman's capsule allows blood to come in the capsule and urine is made. What happens when the capsule is not getting enough blood

Makes sure that more blood is getting to the nephron

What does the RAAS do?

You can't make a new one

Once the nephron dies..

AKI to CKD to ESRD

The loss of nephrons makes you go from

Transplant

ESRD requires a

Polycystic ovarian syndrome

Results from abnormal function of the hypothalamic-pituitary-ovarian axis; enlarged ovaries with small cysts on the outer edges

Elevated hormone levels or androgens

What is PCOS caused by?

Testosterone type hormones

People with PCOS are producing more of what kind of hormones?

Abnormalities of the menstrual cycle, anovulation, facial hair, acne, and obesity

What are the most common symptoms of people with PCOS?

Diagnosed with physical examination and treated with OCPs and clomiphene which causes LH surges

What is PCOS diagnosed and treated with?

Menopause

A decline in a woman's reproductive hormones

45 to 55

Menopause occurs in females around what age?

breast cancer, amenorrhea, leiomyomas, vaginitis, and pelvic organ prolapse

Menopause can be a cause of

Estrogen and sex drive

Menopause will cause a decrease in

Benign prostatic hyperplasia

Non-malignant enlargement of the prostate gland; prostate enlarges and compresses the urethra causing urinary problems; related to obstruction

Incomplete emptying of the bladder, increase in estrogen, and increased sensitivity to DHT

BPH can cause

Higher estrogen than testosterone

What leads to BPH?

Troubles with urination, weak urine flow, hematuria, and bladder fullness

What are some symptoms of BPH?

digital rectal exam

How is BPH diagnosed?

Elevated PSA levels

What will a DRE reveal in someone who has BPH?

Their estrogen levels go up and their testosterone levels go down

BPH happens with men as they get older because..

Prostate cancer

The second most common cancer in men, causes urination issues and erectile dysfunction; usually unnoticed until pain occurs; not obstructive; most susceptible is the peripheral zone; usually curable and responds well with treatment

In the periphery of the gland

With prostate cancer, tumors develop where?

Lymph node, lungs, then other organs

Prostate cancer will often spread to

Gleason scoring system

How is prostate cancer diagnosed?

Well differentiated

What is grade 1 of prostate cancer?

Poorly differentiated with poor prognosis

What is grade 5 of prostate cancer?

Surgery and radiation

How do you treat prostate cancer?

Yes

Can you still have sexual relations even after the removal of the prostate?

prostatitis

Inflammation of the prostates, symptoms include inflammation, infection, ejaculatory problems, and urine issues, could casue risk for UTI or kidney stones

Because your prostate is inflamed

Why would you not be peeing much if you have prostatitis?

Acute bacterial prostatitis

Least commons, caused by gram negative bacteria

Chronic bacterial prostatitis

Often with recurrent UTI's

chronic pelvic pain syndrome

Most common type of prostatitis, inflammatory or noninflammatory

Diagnosed with a DRE or urine culture and treated with antibiotics

How is prostatitis diagnosed and treated?

Prolactinoma

A tumor of the pituitary gland, too much prolactin being produced, most common cause of galactorrhea

estrogen and testosterone

Prolactinoma causes lower levels of

Prolactin

CKD causes elevated levels of what?

Galactorrhea

Milk form the breast being discharged; discharge of milk or milk-like substance from the breast in absence of pregnancy or more than 6 months postpartum in women who did not breastfeed

During pregnancy, 6 months after pregnancy, and in a newborn

When is galactorrhea normal in women?

A tumor in the hypothalamus

What is galactorrhea cause by usually?

Pituitary tumors, thyroid disorders, and chronic renal failure

What are the three main causes of galactorrhea?

Prolactin and T3 T4 levels

What will be elevated in galactorrhea?

Breast cancer

Most common cancer in women in the United States; classification is based on the presence or absence of estrogen receptors, progesterone receptors, and human epidural growth receptor 2

1st degree relative under 50, BRCA 1 or 2 mutation, menarche, and menopause

What are the main risk factors for breast cancer?

In normal cells with damaged DNA that do not die

Where does the cancer occur with breast cancer?

4

How many stages of breast cancer are there?

Menarche

Known as the females first menstrual period

12

What age does menarche usually occur?

Breast cancer and endometrial cancer

Menarche is a risk factor for

amenorrhea

Absence of menarche by 15 can mean

Dysmenorrhea

Occurs usually within 6 months of menarche

Dysmenorrhea

Painful menstrual cycle, painful cramping, can have painful intercourse or vaginal discharge

Primary dysmenorrhea

Not getting your period by age 15, painful menstrual cycle in absence of pelvic disease, usually occurs within 6 months of menarche, a lot of cramping with low back pain, no labs needed for diagnosis

Increased prostaglandin levels

What is primary dysmenorrhea usually cause by?

Secondary dysmenorrhea

Had your period and it left for at least 3 months, result of underlying disease such as endometriosis or PID, irregular flow and painful intercourse, labs needed for diagnosis

20s or 30s

What age group does secondary dysmenorrhea usually affect?

NSAIDs or OCPs

How are both types of dysmenorrhea treated?

PMS

Pains that come along with getting your period, comes with both emotional and physical symptoms due to fluctuations in hormone levels, unknown cause

Serotonin, magnesium, and calcium deficiencies or increased prostaglandin levels

What are the possible causes of PMS?

No

Do you need to experience all of the symptoms to have PMS?

SSRI's and NSAIDs

What treatments are used for PMS?

To go easy on caffeine, sugar, and alcohol intake

What would a doctor recommend to someone with PMS?

Cervical cancer

The third most common reproductive cancer in women worldwide, tumor in the cervix, abnormal vaginal bleeding, discharge and abdominal pain

Sexual contact from a young age or with multiple partners or history of STIs

What is cervical cancer due to?

HPV

What is the main cause of cervical cancer?

Diagnosed with Pap smear and treated with chemo and radiation

How is cervical cancer diagnosed and treated?

Gardasil vaccine

What vaccine should you get to prevent yourself form contracting HPV?

HPV

Most prevalent of all STIs, virus usually goes undetected because people are asymptomatic, infects the basal layer of epithelium

HPV-16,18,31,33,45, causes anogenital cancers

What are the high risk types for HPV?

HPV-6 and 11, only causes genital warts

What are the low risk types for HPV?

No, once you get HPV you have it for the rest of your life

Can HPV be cured?

Cervical cancer

What can HPV develop into?

Diagnosed with Pap smear and treated with creams

How is HPV diagnosed and treated?

10 to 12

At what age should you get the HPV vaccine in order to prevent it?

Menstrual cycle

Monthly cycle of changes in the ovaries and uterus that produces an ovum making pregnancy possible, the endpoint of this cycle if the egg is not fertilized

Menstruation

Blood and mucosal lining that has built up in the uterus is discharged through the vagina when egg isn't fertilized

28 days

How many days is a normal menstrual cycle?

Day 14

What day is the egg released?

Estrogen

What hormone peaks before you get your period around day 13?

Progesterone

What hormone peaks after ovulation?

24 to 32 hours

Once an egg is released, how long does it have to survive?

1 to 7 days

A period usually lasts around how many days?

LH

What hormone rises just before ovulation and falls right after ovulation?

A female is born with all of the eggs she will ever have

When does a girl receive her eggs?

1-14

When is the follicular phase?