BIO 271 -- Study Questions for Chapter 19 Reproductive System Disorders

Define:
 Cryptorchidism – testis fail to properly descend into scrotum; Complication: degeneration of
seminiferous tubules and impaired spermatogenesis. 90% complete their descent by 1 year of age,
otherwise surgery recommended.

 Hydrocele – excessive fluid collects in space between visceral and parietal layers of the tunica
vaginalis; Causes: congenital or acquired from injury, infection, tumor. Onset usually middle age.

 Varicocele – dilated vein in spermatic cord (more common on left) causing pain & sensation of
heaviness. “Bag of worms”

 Testicular Torsion – testes rotate on spermatic cord causing compression of arteries and veins
resulting in ischemia. Can occur spontaneously or after trauma, most commonly seen in
adolescents* and neonates. S/S: severe unilateral pain, swelling, discoloration, testis is higher on
affected side, n/v, fever. Needs manual or surgical reduction.

Which of the above disorders is a medical emergency?

- Testicular torsion !!

Which of the disorders above has a significantly increased risk of testicular cancer if left untreated?
- Cryptorchidism !!

Male Genital Tract Infections:

Infectious prostatitis = continuous mucosa between male urinary tract & prostate allow for migration of
bacteria. Often ascending infection from urinary tract; opportunistic bacteria from the normal flora of gut
Noninfectious = trauma to prostate (bike riding)
Acute Prostatitis Chronic Prostatitis Balanitis
Location of Prostate Prostate Inflammation of the
infection glans penis
Most common Escherichia coli (E. Coli) Repeated infection by Fungal; Candida
infecting organism E Coli albicans
Signs/Symptoms Urine & secretions contain Bacteria “hide” in Severe burning and
bacteria. Usually see prostate. itching.
accompanying infection of **Prostate is slightly
urinary tract. enlarged, irregular and More common in
**Prostate is tender, firm due to fibrosis. uncircumcised males;
enlarged, soft and boggy. Both manifested by smegma accumulation.
Both manifested by dysuria, dysuria, urinary Caused by STDs &
urinary frequency, urgency. frequency, & urgency. contact allergy –
Acute = fever and chills. condoms.

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Benign Prostatic Hypertrophy (BPH): enlargement of prostate gland due to hyperplasia of prostate
gland
 How common is BPH?
- Occurs in up to 50% of men over age 65

 Does BPH affect younger or older men? – OLDER; over age 65

 How is BPH typically diagnosed?

- Enlarged gland palpated on digital rectal exam

 What symptoms and complications are seen?

- S/S:
o Compression of urethra occurs; leads to symptoms of urinary obstruction:
o Hesitancy, Dribbling, and decreased urine stream
o Incomplete emptying of bladders: frequency, nocturia, frequent UTI – dysuria
- Complications:
o Cystitis
o Hydronephrosis and renal damage

 Does BPH predispose to prostate cancer? – NO!!

Prostate Cancer:
Where does this disorder rank in terms of cancer deaths in men?
- Second leading cause of cancer death in men!

Signs & Symptoms of Prostate Cancer:

- Hard nodule felt on periphery of gland
- Because of peripheral location – do not see early signs of urinary obstruction
o Hesitancy in urination, decreased urine stream, frequent urination – nocturia, & recurrent UTI

What finding on a rectal exam would raise concern for possible prostate cancer?
- Areas of firmness, bogginess, asymmetry, feelings of tender

Female Reproductive Tract:

Structural Issues:
What does the term “retroverted” uterus mean?
- Uterus tipped posteriorly and bent backwards

Is the uterus normally “slightly anteverted” or “slightly retroverted”?

- Normally: Slightly anteverted and anteflexed.

Describe each of the three degrees of uterine prolapse?

- First degree: cervix drops into the vagina
- Second degree: cervix lies at vaginal opening; body of uterus is in the vagina
- Third degree: uterus and cervix protrude through the vaginal orifice

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Define Rectocele AND Cystocoele
- Rectocele: protrusion of the rectum into the posterior vagina; may cause constipation & pain
- Cystocoele: protrusion of bladder into the anterior vagina; may cause UTIs

Symptom Terminology:
Define each of the following terms:
 Amenorrhea – “absence of menstruation.” Primary – lack of menarche (Turner’s Syndrome).
Secondary – cessation of menstruation in an individual who had menarche.
 Menarche – first menstruation
 Dysmenorrhea – painful menstruation. Primary – no physical abnormality. Secondary – due to
pelvic pathology (endometriosis)
 Menorrhagia – increased amount and duration of flow
 Metrorrhagia – bleeding between cycles
 Oligomenorrhea – long cycles of more than 6 weeks

Premenstrual Syndrome: (PMS)

Describe the symptoms and treatment options for PMS.
- Begins approx.. a week before onset of menses.
- S/S: breast tenderness, weight gain, abdominal distention or bloating, irritability, emotional
liability, sleep disturbances, depression, headache, fatigue
- Treatment is individualized and may include exercise, limiting salt intake, use of OCP, diuretics, or
antidepressant drugs

Explain the pathophysiology and typical symptoms of endometriosis.

- Endometriosis: endometrial tissue occurs outside the uterus
- Ectopic endometrium responds to cyclic hormone changes; bleeding leads to inflammation & pain.
- Fibrous scar tissue forms. Endometrial tissue in ovary causes formation of cyst  “chocolate cyst”
- S/S: dysmenorrhea is a major symptom. May have dyspareunia

What are the typical signs and symptoms seen in Polycystic Ovary Syndrome?
- Polycystic Ovary Disease (Stein Leventhal Syndrome): endocrine disorder; abnormal hormone levels
result in arrest of maturation of follicles. S/S: absence of ovulation and infertility, amenorrhea, hirsutism,
obesity – type 2 DM

Pelvic Inflammatory
Disease (PID)
Two most common pathogens
that cause the disorder
Describe the pathophysiology
of this disorder
Gonorrhea, chlamydia
Ascending infection from uterus into fallopian tubes. Inflammation and
edema of wall of uterus.
Tubes fill with purulent exudate  restricts drainage into uterus and
exudate flows out of fimbriae of fallopian tube into peritoneum

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Signs and Symptoms? Lower abdominal pain and pelvic pain = 1st sign!!
Fever, N/V, leukocytosis
Dysuria, purulent discharge from cervix may be present
Cervical motion tenderness & possibly signs of peritonitis
What complications can Peritonitis, pelvic abscesses, septic shock (most common cause of death
occur? in PID), and scarring may lead to infertility and increased risk of ectopic
pregnancy
What does the term Inflammation of fallopian tubes
“salpingitis” refer to?

Sexually Transmitted Diseases:

Disorder Infectious virus, bacterium Clinical manifestations (S/S) AND possible

pathogen or protozoan? complications
Chlamydia – Chlamydia Bacterial Males: urethritis (dysuria, itching, white
considered to be trachomatis discharge from penis) and epididymitis
one of the most (painful, swollen scrotum, usually unilateral,
common STDs and fever, & inguinal lymph nodes swollen)
leading cause of Females: often asymptomatic until PID or
PID! infertility develops. May see urethritis,
bartolinitis, cervicitis.
Gonorrhea Neisseria Bacterial Males: most common site is inflammation of the
gonorrheae urethra. Urethritis & epididymis. Some are
asymptomatic.
Females: frequently asymptomatic. PID and
infertility are serious complications! More
likely to become bacteremic (septic arthritis)
Genital Herpes Herpes Viral Recurrent outbreaks of blister-like vesicles on
(HSV) simplex the genitalia.
- Preceded by tingling or itching sensation
- Lesions are extremely painful & heal: 3-4 wks
- Blisters rupture leaving ulcer which
eventually crusts over.
Human Condylomata Viral Disease may be asymptomatic.
Papilloma Virus acuminata Warts vary in appearance and can appear
(HPV – genital wherever contact with virus has occurred.
warts)
Trichomoniasis Trichomonas Protozoan Localized infection. Men: usually asymptomatic
vaginalis parasite Women: may be subclinical; flare up when
microbial balance in vagina shifts; **causes
intense itching and foul smelling yellow/green
vaginal discharge.

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Sexually Transmitted Diseases:
Syphilis:
 Pathogen that causes syphilis? Treponema Pallidum
 Is this pathogen a bacterium, virus or protozoan organism? Bacterial
 List the names of the four stages of syphilitic infection:
1. Primary stage – presence of chancre at site of infection. Occurs 3 wks after exposure. Lesion
heals spontaneously but clients still contagious. Lesions could be missed in female if on cervix.
2. Secondary Stage
3. Latent stage – may persist for years and transmission may occur.
4. Tertiary stage – irreversible changes

 Describe the chancre seen in primary infection

o Painless, firm, ulcerated nodule! (contagious)

 What symptoms & signs are seen in the secondary stage?

o If untreated, a flulike illness occurs (sore throat, low grade fever, malaise, anorexia).
o A widespread symmetrical rash including palms and soles (contagious).
o Mucous patches on tongue – white, necrotic material that’s highly infectious
o Condyloma lata – painless, wart like lesions in perineal/genital area that’s highly infection

 How long can the next stage i.e. the “latent stage” last? (measured in weeks, months or years?)
o May persist for years and transmission may occur

 What are the clinical manifestations of tertiary syphilis?

o Gummas develop in organs and major blood vessel causing necrotic and fibrous lesions with a
central necrotic area surrounded by inflammation
o CVS, nervous system, liver, skin, and growths in tissue due to body’s reaction to bacteria.
o Neurosyphilis (dementia, blindness, motor disabilities)
o Aneurysms (aortic aneurysms)

 What special concern applies to syphilis infection during pregnancy?

o Organism can be transmitted to fetus in utero

 What drug (listed in your lecture notes) is commonly used to treat syphilis
o Penicillin (antimicrobial drugs)

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