Ch.11 Structural Disorders and Neoplasms of the Reproductive System Study Reproductive System Lecture notes (completed)

Practice flashcards covering structural disorders, benign neoplasms, malignant tumors, and surgical interventions of the female reproductive system based on lecture notes.

What is the most common variation of normal uterine placement?

Uterine displacement, which is most commonly posterior or retroversion, though it can also be anteflexion.

How is uterine prolapse (pelvic relaxation) characterized?

The uterus and cervix protrude through the vagina, with severity ranging from mild to complete.

What are the primary risk factors for alterations in pelvic support?

Weakness of support structures secondary to trauma, strain, stress, the aging process, or birth-related injury.

What common complaints are associated with uterine prolapse?

Pelvic pressure, low back pain, and fatigue.

What are the conservative management (Mx) options for uterine prolapse?

Kegel's exercises, a fitted pessary, and the knee-chest position.

What is a cystocele?

A protrusion of the bladder into the vagina resulting from injury to the supporting structures in the vesicovaginal septum.

What is a rectocele?

The herniation of the anterior rectal wall through a relaxed or ruptured vaginal fascia and rectovaginal septum.

What are the common clinical presentations for cystocele and rectocele?

Complaints of a bearing down sensation, recurrent UTIs, and constipation.

What surgical procedure is used for managing rectocele?

Colporrhaphy.

What occurs in a follicular ovarian cyst?

A mature graafian follicle fails to rupture, or an immature follicle fails to resorb fluid after ovulation; this is common in young women.

When does a corpus luteum cyst typically occur?

After ovulation, when an increased amount of progesterone leads to increased fluid in the corpus.

What symptoms are associated with a corpus luteum cyst?

Pain or tenderness and potentially delayed menstrual cycles.

What can cause the development of theca-lutein cysts?

Prolonged overstimulation of the ovaries by hCG, use of ovulation induction drugs, or abnormal tissue growth from a fertilized egg.

What does a dermoid cyst (germ cell tumor) contain?

Hair, teeth, and bones.

How is Polycystic Ovarian Syndrome (PCOS) defined endocrinologically?

A balance of high estrogen, testosterone, and LH levels, along with decreased secretion of FSH.

Which axis problems are related to the development of PCOS?

Hypothalamic-pituitary axis problems.

How can the trait for PCOS be transmitted genetically?

As an X-linked dominant or autosomal dominant trait.

What are the primary clinical manifestations of PCOS?

Hirsutism, irregular menses, and infertility.

What are the long-term health risks for a patient with PCOS?

Diabetes Mellitus (DM) and Cardiovascular Disease (CVD).

What are the common management strategies for PCOS?

Treatment of symptoms, oral contraceptives (OC), weight loss, and Metformin.

What are uterine polyps?

Benign tumors arising from uterine or cervical mucosa derived from hormones or inflammation.

What are leiomyomas?

Benign tumors derived from the muscle tissue of the uterus, also known as fibroids, fibromas, or myomas.

List the different areas where leiomyomas can develop within the uterine wall.

Pedunculated, subserous, intramural, cervical, and submucosal.

What are common manifestations of uterine leiomyomas?

Abnormal bleeding, backache, constipation, and a distended abdomen.

Which medical management involves blocking blood flow to fibroids?

Uterine artery embolization.

Which surgical procedure removes a benign tumor like a leiomyoma while preserving the uterus?

Myomectomy.

At what age is endometrial cancer most common?

Around age $60$ (postmenopausal women).

What are the risk factors for endometrial cancer?

Obesity, DM, HTN, infertility, late menopause onset, hormone imbalance, and use of Tamoxifen.

How does endometrial cancer typically spread?

It starts in the fundus, spreads to the myometrium and cervix, and then moves to other reproductive organs.

What are the clinical presentations of endometrial cancer?

Abnormal uterine bleeding, postmenopausal bleeding, and back or pelvic pain.

How is endometrial cancer diagnosed?

Through a Pap test and endometrial biopsy.

What is the primary surgical management for endometrial cancer?

Radical hysterectomy.

At what age does ovarian cancer typically present?

In the $50+$ age group.

Which inherited genetic mutations are risk factors for ovarian cancer?

BRCA1 and BRCA2.

What are the protective factors against ovarian cancer?

Birth control use for $> 5$ years, having given birth, and surgical tubal ligation.

What are the clinical presentations of ovarian cancer?

Abdominal distention or fullness and urinary frequency.

What is the most preventable female reproductive cancer?

Cervical cancer.

What is Cervical Intraepithelial Neoplasia (CIN)?

Dysplasia noted in the epithelial cells of the cervix.

Where are preinvasive cervical lesions usually located?

At the squamocolumnar junction, also known as the transformation zone.

What characterizes CIN 1?

Abnormal cells in the lower $\frac{1}{3}$ of the epithelium, which are self-limiting and regress to normal.

What characterizes CIN 2?

Involvement of the lower $\frac{1}{2}$ or $\frac{2}{3}$ of the epithelium.

What characterizes CIN 3?

Involvement of the full thickness of the epithelium, progressing to carcinoma in situ (CIS).

What is the primary risk factor for cervical cancer, associated with $90\%$ of cases?

Human Papillomavirus (HPV).

What are the risk factors for cervical cancer besides HPV?

First coitus at age $< 20$ years, multiple partners, and high parity.

What is the classic clinical presentation of cervical cancer?

Post-coital bleeding.

What diagnostic procedures are used following abnormal Pap results to evaluate the cervix?

Colposcopy, conization (cone biopsy), and loop electrosurgical excision procedure (LEEP).

What are the common symptoms of vulval cancer in the $50+$ age group?

Vulval itching, a lump on the labia majora, or a lump in the groin.

What is the difference between a total hysterectomy and a radical hysterectomy?

A total hysterectomy is the surgical removal of the entire uterus; a radical hysterectomy includes the uterus and nearby tissue.

What is a total hysterectomy with salpingo-oophorectomy?

Removal of the uterus, cervix, fallopian tubes, and ovaries.

Define salpingostomy.

The surgical opening of a fallopian tube.

What is an oophorectomy?

The surgical removal of one or both ovaries.

What is the purpose of Dilatation and Curettage (D&C)?

To widen the cervical canal with a dilator and scrape the uterine walls with a curette.

What is cryosurgery used for in cervical cancer treatment?

The freezing of abnormal cells.

What is laser ablation?

The use of heat to remove diseased tissue.

What is the incidence of cancer during pregnancy?

Approximately $1:1000$ pregnancies.

What does the LEEP procedure involve?

The use of a wire loop electrode to excise and cauterize tissue.