NU 545 Pathophysiology Unit 3 Exam
Questions And Accurate Answers
1.Know all STI: pathophysiology, etiology, clinical manifestations, diagnostic tests,
treatment, and complications. - ANSWER Use EB's chart
· How is each transmitted during pregnancy to the fetus?
· Know the different stages of syphilis.
· what organism causes each STI and is it viral, bacterial etc.?
· Do you treat both partners and why?
· What age group has the greatest risk of STIs and why? Young women
· What causes cervical cancer? HPV exposure
2. Know the different types of uterine tumors - ANSWER · Leiomyomas (uterine fibroids):
benign smooth muscle tumor in the myometrium; the majority remain small and
asymptomatic
o Located in the fundus of the uterus in multiples or in singles throughout
o Subserous, submucous, or intramural
o Presentations: AUB (due to increased uterine surface area), pain, distorted uterine
cavity that may compress an adjacent structure
o Evaluation: enlarged and irregular uterus; confirm diagnosis with MRI
Treatment: GnRH antagonists, IUD, oral contraceptive, hysterectomy or myomectomy
(removal of fibroid)
3. What is PCOS and what does it cause? Clinical manifestations? Treatment? Causes?
Pathophysiology? - ANSWER · At least two of the following: irregular ovulation, elevated
levels of androgen (testosterone), polycystic ovaries on ultrasound
· Patho: hyperandrogenic state is a cardinal feature, glucose intolerance increases the
severity
,• Symptoms: obesity, menstrual disturbance, hyperandrogenism, DM, HTN • Etiology:
associated with metabolic dysfunction, dyslipidemia, insulin resistance, and obesity •
Treatment: goal is the reversal of androgen excess and induction of cyclic
menstruation; oral contraceptives first line to establish regular period, weight loss,
progesterone therapy if pregnancy is not desired
4. What is the difference between primary and secondary amenorrhea, what is
compartment II? - ANSWER · Primary amenorrhea: failure of menarche and the absence
of menstruation by age 13 · Secondary amenorrhea: absence of regular menses for 3
months or irregular menses for 6 months in women who have previously menstruated;
exclude pregnancy before further evaluation
• Compartment II: disorders involving the ovary and associated with genetic anomalies;
gonadal dysgenesis (turner syndrome) or androgen insensitivity syndrome (AIS)
5. What are the signs of puberty in girls and boys? What delays puberty? - ANSWER ·
Reproductive maturation involves the hypothalamic pituitary-gonadal (HPG) axis, the
CNS, the endocrine system; adrenarche is the increased production of adrenal
androgens Axillary and pubic hair growth and body odor
· Girls: 8-9 years of age, with thelarche (breast development); puberty is complete with
the first menstrual period may be 1-2 years after menarche or first period)
without estradiol no development of breasts, maturation of the reproductive organs, fat
deposits in the hips
estrogen and increased growth factors leads to rapid skeletal growth in girls and boys
· Boys: age 11 years, events related to increased weight and BMI; complete with the first
ejaculation of mature sperm o Testosterone stimulates the growth of the testes,
scrotum, and penis · Delayed puberty: Low circulating estrogen leads to insufficient
bone density; low levels of gonadotropins: skull imaging required to exclude pituitary or
other CNS tumor o Girls :FHH, disruption in HPG axis; estrogen therapy
o Boys: deficient FSH/LH, disruption of HPG axis; treat with testosterone
6. What is the pathophysiologic mechanism for the signs and symptoms of menopause? -
ANSWER · Cessation of ovulation and menses due to ovarian failure, marks the end of
reproduction; premature menopause (before 40 years old); defined by the point that
marks 12 consecutive months of amenorrhea
· "climacteric": gradual changes of ovarian function that start before menopause due to
a loss of ovarian follicles resulting in reduced ovarian production of estradiol, increased
, FSH/LH, and decreased inhibin
· Changes:
o Ovarian: utero- number of follicles steadily decrease, starts in the late 30s
o Uterine: primarily endometrium affected, proliferative growth; longer exposure to
estrogen causes greater thickness of endometrium which causes heavy/unpredictable
bleeding
o Breast: shrink and lose tone as fat deposits increase
o Genital tract : vagina shrinks and loses elasticity, hydrogen ion concentration (pH) of
vagina increase and causes vaginitis, urethral tone diminishes causing
frequency/urgency /UTIs /incontinence due to estrogen deficiency
o Systematic: vasomotor flushes are due to the rise in temp. and dilation of blood
vessels and due to increased level of noradrenaline
o Cardiac: due to a loss of estrogen, BP and LDL increase that leads to weight gain
7. What is in breast milk? - ANSWER · Most suitable nutrition for the newborn.
· Colostrum is rich in immunologic components (IgA, lactoferrin, leukocytes, growth
factor)
o Secretory IgA and antimicrobial factors (lysosomes and lactoferrin) protect the infant
against infection
8. What is the BRCA1 gene? - ANSWER · A tumor suppressor gene located on
chromosome 17; any mutation in the gene may inhibit its suppressor function leading to
uncontrolled cell proliferation; the most important breast cancer genes are BRCA1 and
BRCA2.
· This alteration results in an increased risk for breast cancer.
Testes - ANSWER organs of reproduction; produces gametes (sperm), sex hormones
(androgens and testosterone)
§ Suspended outside of the body because sperm production requires 1-2 C lower than
body temp § Seminiferous tubules are 80% of the testicular volume and are the site of
sperm production; Leydig cells occur in clusters and produce testosterone
§ Sperm mature in the epididymis; its function is to conduct sperm from the efferent
tubules to the vas deferens which transports sperm toward the urethra; sperm are
Questions And Accurate Answers
1.Know all STI: pathophysiology, etiology, clinical manifestations, diagnostic tests,
treatment, and complications. - ANSWER Use EB's chart
· How is each transmitted during pregnancy to the fetus?
· Know the different stages of syphilis.
· what organism causes each STI and is it viral, bacterial etc.?
· Do you treat both partners and why?
· What age group has the greatest risk of STIs and why? Young women
· What causes cervical cancer? HPV exposure
2. Know the different types of uterine tumors - ANSWER · Leiomyomas (uterine fibroids):
benign smooth muscle tumor in the myometrium; the majority remain small and
asymptomatic
o Located in the fundus of the uterus in multiples or in singles throughout
o Subserous, submucous, or intramural
o Presentations: AUB (due to increased uterine surface area), pain, distorted uterine
cavity that may compress an adjacent structure
o Evaluation: enlarged and irregular uterus; confirm diagnosis with MRI
Treatment: GnRH antagonists, IUD, oral contraceptive, hysterectomy or myomectomy
(removal of fibroid)
3. What is PCOS and what does it cause? Clinical manifestations? Treatment? Causes?
Pathophysiology? - ANSWER · At least two of the following: irregular ovulation, elevated
levels of androgen (testosterone), polycystic ovaries on ultrasound
· Patho: hyperandrogenic state is a cardinal feature, glucose intolerance increases the
severity
,• Symptoms: obesity, menstrual disturbance, hyperandrogenism, DM, HTN • Etiology:
associated with metabolic dysfunction, dyslipidemia, insulin resistance, and obesity •
Treatment: goal is the reversal of androgen excess and induction of cyclic
menstruation; oral contraceptives first line to establish regular period, weight loss,
progesterone therapy if pregnancy is not desired
4. What is the difference between primary and secondary amenorrhea, what is
compartment II? - ANSWER · Primary amenorrhea: failure of menarche and the absence
of menstruation by age 13 · Secondary amenorrhea: absence of regular menses for 3
months or irregular menses for 6 months in women who have previously menstruated;
exclude pregnancy before further evaluation
• Compartment II: disorders involving the ovary and associated with genetic anomalies;
gonadal dysgenesis (turner syndrome) or androgen insensitivity syndrome (AIS)
5. What are the signs of puberty in girls and boys? What delays puberty? - ANSWER ·
Reproductive maturation involves the hypothalamic pituitary-gonadal (HPG) axis, the
CNS, the endocrine system; adrenarche is the increased production of adrenal
androgens Axillary and pubic hair growth and body odor
· Girls: 8-9 years of age, with thelarche (breast development); puberty is complete with
the first menstrual period may be 1-2 years after menarche or first period)
without estradiol no development of breasts, maturation of the reproductive organs, fat
deposits in the hips
estrogen and increased growth factors leads to rapid skeletal growth in girls and boys
· Boys: age 11 years, events related to increased weight and BMI; complete with the first
ejaculation of mature sperm o Testosterone stimulates the growth of the testes,
scrotum, and penis · Delayed puberty: Low circulating estrogen leads to insufficient
bone density; low levels of gonadotropins: skull imaging required to exclude pituitary or
other CNS tumor o Girls :FHH, disruption in HPG axis; estrogen therapy
o Boys: deficient FSH/LH, disruption of HPG axis; treat with testosterone
6. What is the pathophysiologic mechanism for the signs and symptoms of menopause? -
ANSWER · Cessation of ovulation and menses due to ovarian failure, marks the end of
reproduction; premature menopause (before 40 years old); defined by the point that
marks 12 consecutive months of amenorrhea
· "climacteric": gradual changes of ovarian function that start before menopause due to
a loss of ovarian follicles resulting in reduced ovarian production of estradiol, increased
, FSH/LH, and decreased inhibin
· Changes:
o Ovarian: utero- number of follicles steadily decrease, starts in the late 30s
o Uterine: primarily endometrium affected, proliferative growth; longer exposure to
estrogen causes greater thickness of endometrium which causes heavy/unpredictable
bleeding
o Breast: shrink and lose tone as fat deposits increase
o Genital tract : vagina shrinks and loses elasticity, hydrogen ion concentration (pH) of
vagina increase and causes vaginitis, urethral tone diminishes causing
frequency/urgency /UTIs /incontinence due to estrogen deficiency
o Systematic: vasomotor flushes are due to the rise in temp. and dilation of blood
vessels and due to increased level of noradrenaline
o Cardiac: due to a loss of estrogen, BP and LDL increase that leads to weight gain
7. What is in breast milk? - ANSWER · Most suitable nutrition for the newborn.
· Colostrum is rich in immunologic components (IgA, lactoferrin, leukocytes, growth
factor)
o Secretory IgA and antimicrobial factors (lysosomes and lactoferrin) protect the infant
against infection
8. What is the BRCA1 gene? - ANSWER · A tumor suppressor gene located on
chromosome 17; any mutation in the gene may inhibit its suppressor function leading to
uncontrolled cell proliferation; the most important breast cancer genes are BRCA1 and
BRCA2.
· This alteration results in an increased risk for breast cancer.
Testes - ANSWER organs of reproduction; produces gametes (sperm), sex hormones
(androgens and testosterone)
§ Suspended outside of the body because sperm production requires 1-2 C lower than
body temp § Seminiferous tubules are 80% of the testicular volume and are the site of
sperm production; Leydig cells occur in clusters and produce testosterone
§ Sperm mature in the epididymis; its function is to conduct sperm from the efferent
tubules to the vas deferens which transports sperm toward the urethra; sperm are
