chapter 8 conditions

carcinoma of the cervix

malignant cells within the cervix (cervical cancer)

-infection with human papillomavirus (HPV) is the most important cause of and risk factor for cervical cancer

-surgical treatment requires radical (complete) hysterectomy

-radiation therapy and chemotherapy are used to treat disease that has spread beyond the uterus, into the pelvis, and to distant organs

risk factors for cervical cancer

HPV, cigarette smoking, having multiple sexual partners, and having a weakened immune system (example: patients with AIDS)

Human papillomavirus (HPV)

one of the most common sexually transmitted infections in the world

-some types of HPV cause genital warts, and others cause cancer, especially HPV types 16 and 18

-most HPV infections do not progress to cervical cancer, but the risk of developing cancer increases as Pap tests become abnormal and biopsies reveal dysplasia, or more seriously, carcinoma in situ (CIS)

genital warts

benign growths on the vulva, cervix, vagina, or anus

dysplasia

abnormal cell growth

carcinoma in situ (CIS)

a localized form of cancer

-conization may be needed to treat CIS and prevent development of invasive cancer

conization

local resection

radical (complete) hysterectomy

surgical treatment for cervical cancer in which the entire uterus with ligaments, supportive tissues, and the top one-third of the vagina are removed

cervical intraepithelial neoplasia (CIN)

preinvasive neoplastic lesions diagnosed by a pap test

-graded as CIN I to CIN III

Pap test

microscopic examination of cells scraped from cervical epithelium

HPV vaccine

given in a series of three shots over 6 months to protect females and males against HPV infections

-girls can get this vaccine to prevent cervical cancer, vulvar and vaginal cancer, and genital warts

-boys get the vaccine to prevent anal cancer and genital warts

cervicitis

inflammation of the cervix

-condition that can become chronic because the lining of the cervix is not renewed each month as is the uterine lining during menstruation

-bacteria such as Chlamydia trachomatis and Neisseria gonorrhoeae commonly cause cervicitis

acute cervicitis

is marked by cervical erosions or ulcerations that appear as raw, red patches on the cervical mucosa

-may present with leukorrhea

leukorrhea

clear, white, or yellow-pus filled vaginal discharge

-a sign of cervical erosion

cryocauterization

destroying tissue by freezing of the eroded area and treatment with antibiotics

-used after the presence of malignancy has been excluded by Pap test or biopsy

carcinoma of the endometrium (endometrial cancer)

malignant tumor of the uterine lining (Adenocarcinoma)

-most common sign of endometrial cancer is postmenopausal bleeding

-occurs more often in women exposed to high levels of estrogen, either from exogenous estrogen pills or estrogen-producing tumors, or with obesity (estrogen is produced by fat tissue), and in nulliparous women

-to diagnose: physicians perform endometrial biopsy, hysteroscopy, and dilation or dilatation, and curettage

-when the cancer is confined to the uterus, surgery, either hysterectomy and bilateral salpingo-oophorectomy, is curative

-radiation oncologists administer radiation therapy as additional treatment

dilation or dilatation

widening of the cervical canal

curettage

scraping the inner lining of the uterus

endometriosis

endometrial tissue located outside the uterus

-endometrial tissue may be found in the ovaries, fallopian tubes, supporting ligaments, or small intestine, causing inflammation and scar tissue

-when the endometrium sheds and bleeds in its monthly cycle, it may cause dysmenorrhea and pelvic pain

-infertility and dyspareunia may also occur

-most cases are the result of growth of bits of menstrual endometrium that have passed backward through the lumen, opening, of the fallopian tube and into the peritoneal cavity

-when the disease affects the ovaries, large blood-filled cysts (chocolate cysts or endometriomas) develop

-treatment: ranges from symptomatic relief of pain and hormonal drugs that suppress the menstrual cycle to surgical removal of ectopic endometrial tissue and hysterectomy

endometriomas ("chocolate cysts")

large blood-filled cysts that typically develop when endometriosis affects the ovaries

fibroids

benign tumors in the uterus

-also called leiomyomata or leiomyomas

-composed of fibrous tissue and muscle

-if they grow too large and cause symptoms like metrorrhagia, pelvic pain, or menorrhagia, then a hysterectomy or myomectomy is indicated

-fibroid ablation (destruction) without surgery may be accomplished by uterine artery embolization (UAE)

lei/o

smooth

my/o

muscle

-oma

tumor

uterine artery embolization (UAE)

procedure that can accomplish fibroid ablation (destruction) without surgery

-done by which tiny pellets (Acting as emboli) are injected into a uterine artery, blocking the blood supply to the fibroids, causing them to shrink

subserosal mass

mass that lies under the serosal (outermost) layer of the uterus

submucosal leiomyoma

fibroid that grows under the mucosal (innermost) layer

intramural masses

fibroids that arise within the muscular uterine wall

ovarian carcinoma (Cancer)

malignant tumor of the ovary (adenocarcinoma)

-each year about 22,000 women in the US are diagnosed with ovarian cancer

-2 types of ovarian cancer are most common: serous (clear fluid) and mucinous (thick, pasty fluid) cystic adenocarcinomals

-tumor is usually discovered in an advanced stage as an abdominal mass and may produce few symptoms in its early stages

-in most patients, the disease metastasizes beyond the ovary before diagnosis and often causes ascites

-treatment: consists of total abdominal hysterectomy, bilateral salpingo-oophorectomy, and removal of the omentum, which often contains deposits of tumor, followed by chemotherapy

-a protein marker, CA 125, can be measured in the bloodstream to assess effectiveness of treatment

serous

clear fluid

mucinous

thick, pasty fluid

ascites

accumulation of fluid in the abdominal cavity

BRCA1 and BRCA2

inherited mutations (Changes) in genes that greatly increase the risk of developing ovarian and breast cancer

-short for breast cancer 1 and breast cancer 2

-women with a strong family history of ovarian cancer (with multiple members of the family affected) may seek genetic counseling to determine if they should be tested for these inherited defects

prophylactic oophorectomy

removal of the ovaries that significantly reduces the odds of developing ovarian cancer if a woman is at high risk

prophylactic

preventative

ovarian cysts

collections of fluid within sacs (cysts) in the ovary

-some cysts are benign and lined by typical cells of the ovary

-these cells originate in unruptured ovarian follicles (follicular cysts) or in the follicles that have ruptured and have immediately been sealed (luteal cysts)

-other cysts are malignant and lined with atypical or tumor cells (cystadenocarcinomas)

-physicians decide to remove these cysts to distinguish between benign and malignant tumors

dermoid cysts

cysts that contain a variety of cell types, including skin, hair, teeth, and cartilage, and arise from immature egg cells in the ovary

-because of the strange assortment of tissue types in the tumor, it is often called a benign cystic teratoma or a mature teratoma

-surgical removal of the cyst cures the condition

-cysts are bilateral 15% of the time

terat/o

monster

pelvic inflammatory disease (PID)

inflammation and infection of organs in the pelvic region; salpingitis, oophoritis, endometritis, endocervicitis

-sexually transmitted infections (STIs) are the leading causes of PID

-repetitive episodes of these infections can lead to formation of adhesions and scarring within the fallopian tubes

-after PID, women have an increased risk of ectopic pregnancy and infertility

-signs and symptoms: fever, vaginal discharge, abdominal pain in the left and right lower quadrants (LLQ and RLQ), and tenderness to palpation of ther cervix

-antibiotics treat PID

palpation

examination by tough

Sexually Transmitted Infections (STIs)

examples of bacterial and viral STIs in women are:

-gonorrhea (gonococcal bacteria)

-chlamydial infection (chlamydial bacteria)

-symphilis (spirochete bacteria)

-genital herpes (herpes simplex virus- HSV)

-HPV infection and genital warts (human papillomavirus)

carcinoma of the breast (breast cancer)

malignant tumor of the breast (Arising from milk glands and ducts)

-most common type of breast cancer is invasive ductal carcinoma

-other histopathologic types are lobular and medullar carcinoma of the breast

-breast cancer spreads first to the lymph nodes in the axilla adjacent to the affected breast and then to the skin and chest wall