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DMS 400 OB/GYN > Class 11: EP, Infertility, Contraceptives > Flashcards

Class 11: EP, Infertility, Contraceptives Flashcards

1
Q

what is the only form of contraception where ultrasound is useful?

A

IUD

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2
Q

IUDs prevent implantation in the uterus. T/F?

A

true

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3
Q

2 types of IUD?

A
  1. copper T/paragard T380A
  2. progestasert
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4
Q

how does the paragard IUD work?

A

releases copper and kills sperm

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5
Q

how does the progestasert IUD work?

A

releases progesterone, thickens cervical mucous so sperm can’t reach the egg; high progesterone levels can also block ovulation

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6
Q

risks for IUD?

A

PID
EP
pregnancy with IUD
uterine perforation

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7
Q

U/S appearance of IUD?

A

echogenic & central in UT
shadowing with entrance & exit echoes

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8
Q

which phase of the menstrual cycle may an IUD not be seen in?

A

secretory phase

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9
Q

what is infertility?

A

failure to conceive after 1 year of trying

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10
Q

factors for male infertility (3)

A
  • decreased sperm count or motility
  • urethral strictures or STD
  • varicoceles
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11
Q

what is a varicocele?

A

dilated scrotum veins

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12
Q

factors for female infertility? (6)

A
  • older maternal age
  • infection
  • surgery
  • disease
  • congenital anomalies
  • hormonal imbalance
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13
Q

another name for ovulation induction therapy

A

assisted reproductive therapy (ART)

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14
Q

purpose of ovulation induction therapy

A

stimulate the early growth of follicles for harvest

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15
Q

drugs used for ovulation induction therapy

A

clomid & perganol

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16
Q

what drug may be used to induce ovulation for ovulation induction therapy?

A

HCG

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17
Q

what are 3 parameters to predict follicular development?

A
  1. increased basal body temperature
  2. watery cervical mucous
  3. high estrogen levels
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18
Q

4 side effects of ovulation induction therapy?

A
  1. multiple pregnancies
  2. ovarian hyperstimulation syndrome (OHS)
  3. ectopic pregnancy
  4. heterotropic pregnancy
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19
Q

what is a heterotropic pregnancy

A

2 pregnancies with 1 IUP & 1 EP

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20
Q

what is OHS?

A

when multiple follicles are induced, it may lead to theca lutein cysts (bilateral), enlarged ovaries, and edema of stroma

21
Q

3 methods of ART?

A
  1. in-vitro fertilization with embryonic transfer
  2. gamete intrafallopian transfer
  3. zygote intrafallopian transfer
22
Q

what is the process for IVT-ET

A

ova & sperm are extracted and fertilized in a test tube, wait for cell division, when morulas become embryos, they’re implanted in the uterine cavity

23
Q

2 methods of retrieval for IVT-ET

A
  1. laparoscopy
  2. US guided retrieval
24
Q

what is GIFT?

A

gamete intrafallopian transfer
sperm & ova are placed in fallopian tube to fertilize

25
Q

indications to use GIFT?

A
  • endometriosis
  • cervical stenosis
  • oligospermia
  • immunologic infertility
  • unexplained infertility for > 2 years
26
Q

what is ZIFT?

A

zygote intrafallopian transfer
extract sperm & ova to fertilize in laparscopy dish & wait for zygote
then transfer zygote into fallopian tube

27
Q

what defines an ectopic pregnancy?

A

the implantation of ovum outside the endometrial cavity

28
Q

what is the leading cause of maternal death in 1st trimester?

A

ectopic pregnancies

29
Q

most common location for an ectopic pregnancy?

A

ampulla of fallopian tube

30
Q

which part of the fallopian tube is the most dangerous for an EP to occur?

A

interstitial part

31
Q

5 other locations for an ectopic pregnancy besides FT?

A
  1. ovaries
  2. abdomen
  3. interligamentous
  4. cervix
  5. rudimentary uterine horn
32
Q

8 causes of ectopic pregnancy?

A
  1. any mechanical obstruction in FT
  2. hx of EP
  3. PID w salpingitis
  4. tubal ligation
  5. FT abnormality
  6. UT & adnexal masses/adhesions
  7. IUD
  8. transmigration
33
Q

2 types of transmigration?

A
  1. internal
  2. external
34
Q

what is internal transmigration?

A

fertilized ovum migrates across the uterus to implant into opposite FT

35
Q

what is external migration?

A

fertilization occurs in cul de sac, then fimbrae from opposite FT picks up fertilized ovum & implants in opposite FT

36
Q

what proves transmigration occured?

A

seeing corpus luteum cyst on contralateral ovary

37
Q

are HCG levels higher or lower in an ectopic pregnancy compared to a normal pregnancy?

A

lower than a normal pregnancy

38
Q

3 other procedures besides U/S that can detect ectopic pregnancy?

A
  1. D&C
  2. culdocentesis
  3. laparoscopy
39
Q

what is the gold standard in detecting EP?

A

laparoscopy

40
Q

during D&C, getting chorionic villi indicates ___ pregnancy

A

intrauterine pregnancy

41
Q

during D&C, getting only decidual tissue indicates ___ pregnancy

A

ectopic

42
Q

which cul de sac is culdocentesis performed?

A

posterior cul de sac

43
Q

what does culdocentesis help diagnose?

A

a ruptured ectopic pregnancy

44
Q

what drug can help treat an ectopic pregnancy?

A

methotrexate

45
Q

methotrexate can be used up to ___ weeks from LMP

A

6 weeks from LMP

46
Q

treatment options for tubal pregnancy? (2)

A
  1. total salpingectomy
  2. salpingostomy
47
Q

2 treatment options for interstitial pregnancy?

A
  1. hysterectomy
  2. wedge resection of uterus
48
Q

treatment option for abdominal pregnancy?

A

always surgical

DMS 400 OB/GYN (21 decks)

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