Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Block I: Reproduction & Sexuality > Clinical: Menstruation and ART > Flashcards

Clinical: Menstruation and ART Flashcards

(93 cards)

Start Studying
1
Q

Define the follicular phase

A

Begins with the onset of menses and ends on the day of the luteinizing hormone (LH) surge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Hormone levels in late luteal phase

A

Withdrawal of estrogen and progesterone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Phase in which the ovary is least hormonally active

A

Early follicular phase (low serum estradiol and progesterone)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

GnRH and FSH levels during the early follicular phase

A

Release from negative feedback effects of estrogen and progesterone = increased GnRH pulse frequency –> 30% increase in serum [FSH]

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Number of primordial follicles stimulated by FSH release from pituitary during the follicular phase

A

5 - 15

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

When is a single dominant follicle selected?

A

By late follicular phase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Describe the 2-cell process by which the developing dominant follicle produces estrogen

A
  • Theca interna cells produce androstenedione in response to LH stimulation
  • Granulosa cells conert androstenedione –> estradiol when stimulated by FSH
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Effects of estrogen on the uterine lining during the follicular phase

A

Thicken/proliferate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

GnRH and LH levels during the follicular phase

A

GnRH pulse frequency increases –> rise in LH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Effect of raised LH levels during the follicular phase

A

Stimulation of androgen synthesis –> androgens converted to estrogens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Peak of serum estradiol concentrations

A

Approx 1 day before ovulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Midcycle LH levels (~day 14)

A

LH spike in response to estrogen surge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Why does ovulation occur?

A

Increase in LH level causes the follicle to rupture and release mature ovum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Describe the effect of rising estradiol levels at the end of the follicular phase on LH concentration

A

10-fold increase (positive feedback switch from negative feedback; poorly-understood phenomenon)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

When does the oocyte in the dominant follicle complete the 1st meiotic division

A

In response to the LH surge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

When is the oocyte released from follicle at ovarian surface?

A

~36 hours after LH surge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Even before the oocyte is released, what do the granulosa

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

When does the luteal phase begin?

A

After ovulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What does the remnants of the follicle become after ovulation

A

Corpus luteum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Time it takes for the ovum to travel down the tube to the uterus

A

3 -4 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

When must fertilization occur and what is the consequence of it not occuring?

A

Must occur within 24 hours of ovulation or ovum degenerates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What forms the corpus luteum cyst and when

A

Granulosa and theca interna cells lining the wall of the follicle after ovulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Function of corpus luteum

A

Synthesize estrogen and large amounts of progesterone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Effect of progesterone on endometrium

A

Stimulate endometrium to become more glandular/secretory in preparation for implantation of fertilized ovum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Substance synthesized by trophoblast if fertilization occurs
Human chorionic gonadotropin (hcg)
26
Function of HCG
Maintain the corpus luteum so it may continue producing estrogen and progesterone to support the endometrium
27
When is the placenta developed and what function does it take over?
8-10 weeks gestation Takes over production of estrogen and progesterone
28
8 events occuring in the luteal phase if fertilization does not occur
* Corpus luteum is not maintained by HCG * Corpus luteum degenerates after ~14 days * Estrogen and progesterone levels fall * Increased prostaglandins and leucocytes in endometrium * Constriction of spiral arteries * Desquamation and ischemia of endometrium * Arteriolar relaxation, bleeding and tissue breakdown * FSH levels slowly rise again in absence of negative feedback
29
2 types of dysfunctional uterine bleeding (DUB)
Anovulatory Ovulatory
30
4 types of organic disease linked to abnorma uterine bleeding
* Systemic * Reproductive disease * Pregnancy-related * Iatrogenic
31
6 common terminologies for abnormal uterine bleeding
* Menorrhagia * Metrorrhagia * Menometorrhagia * Hypermenorrhea * Polymenorrhea * Oligomenorrhea
32
Bleeding cycle of menorrhagia
Regular cycles, prolonged duration, excessive flow
33
Bleeding pattern of metrorrhagia
Irregular cycles
34
Bleeding pattern of menometorrhagia
Irregular, prolonged, excessive
35
Bleeding pattern of hypermenorrhea
Regular, normal duration, excessive flow
36
Bleeding pattern of polymenorrhea
Frequent cycles
37
Bleeding pattern of oligomenorrhea
Infrequent cycles
38
When can anovulatory bleeding occur?
First year after menarche Perimenopause
39
6 conditions where anovulatory bleeding can occur
* Polycystic Ovary Syndrome (15% all women) * Adult-onset Congenital Adrenal Hyperplasia * Androgen producing tumors * Hypothalamic dysfunction * Hyperprolactinemia * Pituitary disease
40
Typical bleeding pattern of anovulatory bleeding
Irregular, heavy, and-or prolonged
41
4 identifiable causes of abnormal ovulatory bleeding
* Fibroids * Adenomyosis * Polyps * Infection
42
5 risk factors for fibroids
* Nulliparity * Obesity * Fam Hx * HTN * African-American
43
Bleeding pattern associated with fibroids
Heavier periods
44
Define adenomyosis
Endometrial glands within the myometrium
45
Symptoms and bleeding patterns of adenomyosis
* Usually asymptomatic (symptoms usually occur after age 35- 45) * Potential heavy or prolonged bleeding * Often dysmenorrhea (painful periods) up to one week before menstruation
46
3 bleeding patterns of endometrial polyps
* Intermenstrual bleeding * Irregular bleeding * Menorrhagia
47
2 bleeding patterns of cervical polyps
* Intermenstrual spotting * Postcoital spotting
48
3 infectious causes of abnormal uterine bleeding
* Pelvic Inflammatory Disease (PID) * Chronic endometritis * Endocervicitis
49
3 usual symptoms of PID
* Fever * Discomfort * Adnexal tenderness NOTE: Can present atypically
50
2 bleeding patterns associated with PID
Menorrhagia or metrorrhagia
51
When does PID most commonly occur?
During menstruation and with bacterial vaginosis
52
3 reasons why oral contraceptice pills may cause contraceptive bleeding
* Lower dose contraceptives * Skipped pills * Altered absorption/metabolism (i.e. upset GI)
53
3 causes of contraceptive bleeding
* Oral Contraceptive Pills * Intra-uterine device (IUD) * Depo Provera
54
5 prescriptions medications that may cause abnormal uterine bleeding
* Anticoagulants * SSRI's * Antipsychotics * Corticosteroids * Tamoxifen
55
4 OTC medications that may cause abnormal uterine bleeding
* Soy supplements * Gingkgo * Ginseng * St. John's Wort
56
Why might ginseng cause abnormal uterine bleeding?
Estrogenic properties
57
Why might St. John's Wort cause abnormal uterine bleeding
Interaction with oral contraceptive --\> breakthrough bleeding
58
2 endocrine abnormalities that may cause abnormal uterine bleeding
* Hyperthyroidism * Hypothyroidism
59
4 bleeding patterns associated with hyperthyroidism
* Amenorrhea * Oligomenorrhea (most common) * Hypermenorrhea * Polymenorrhea
60
4 bleeding patterns associated with hypothyroidism
* Amenorrhea * Oligomenorrhea * Polymenorrhea * Menorrhagia NOTE: Occurs more frequently with severe hypothyroidism
61
Two most common bleeding disorders that may cause abnormal uterine bleeding
* Von Willebrand's disease * Thrombocytopenia
62
First step of homeostasis during menstruation
Formation of a platelet plug
63
When may abnormal uterine bleeding due to a bleeding disorder may be particularly severe and why
At menarche due to the dominant estrogen stimulation causing increased vascularity
64
5 lab studies for abnormal uterine bleeding
* CBC * Urine or serum pregnancy test * TSH * PT, PTT, and bleeding time * PCOS/adult-onset CAH investigations
65
5 substance levels tested for PCOS/Adult-onset CAH
* LH * FSH * Testosterone * Androstenedione * Basal 17-hydroxyprogesterone (17-HP)
66
3 things to evaluate in ultrasound to investigate abnormal uterine bleeding
* Ovaries for PCOS * Fibroids * Endometrial stripe
67
Define PMS
**Recurrent** psychological or physical symptoms during the **luteal phase** of menstrual cycle, resolves by the end of menstruation, and **interferes **with some aspect of function
68
Define Premenstrual Dysphoric DIsorder (PMDD)
More severe form of PMS meeting **DSM-IV criteria**
69
4 general UCSD criteria for diagnosing PMS
* \>1 somatic and affective symptom 5 days prior to menses x 3 cycles * Resolve within 4 days onset of menses and symptom free until day 12 of cycle * Not due to meds, drugs, or EtOH use * Causes dysfunction
70
6 somatic symptoms that can be used to diagnose PMS
* Depression * Anger * Irritability * Confusion * Social withdrawal * Fatigue
71
4 affective symptoms that can be used to diagnose PMS
* Breast tenderness * Bloating * Headache * Swelling
72
5 DSM-IV criteria to diagnose PMDD
* \>5 symptoms of PMS 1 week prior to and resolve during menses * \>1 psychological symptom x 1 year during most cycles * Interferes with social, occupation, sexual or school functioning * symptoms discretely related to menstrual cycle and not a worsening of a psychiatric or medication condition * **Documented** symptoms meeting criteria for at least 3 cycles
73
4 psychological symptoms that can be used to diagnose PMDD
* Depressed mood * Increased sensitivity * Anxiety * Irritability
74
7 differential diagnoses for PMS
Menstrual exacerbation of * Psychiatric disorder * Medical condition: * Dysmenorrhea * Hyper- or hypo- thyroidism * Peri-menopause * Migraine * Chronic fatigue syndrome * Irritable bowel syndrome
75
4 prescriptions for mild to moderate PMS with at least some evidence
* Vit B6 during luteal phase * Calcium * Evening primrose oil * Magnesium
76
7 Rx of mild to moderate PMS with unknown benefits
* Exercise * Relaxation * Chiropractic manipulation * CBT * Light therapy * Eliminating caffeine * Reducing sugar and salt
77
Beneficial treatment for moderate to severe PMs
Spirolactone 500-200 mg OD during luteal phase
78
Contraindication for spirolactone as treatment for PMS
Pregnancy
79
6 treatments for moderate to severe PMS that are **likely beneficial**
* Alprazolam 0.25-1 mg TID in luteal phase * Buspirone 5 - 10 mg TID * GnRH analogues * Metolazone * NSAIDs in luteal phase * OCP
80
3 PMS symptoms improved by spirolactone
* Breast tenderness * Weight gain * Mood
81
Risk of using alprazolam as PMS treatment
Dependence
82
Benefit of buspirone
Global symptoms improvement
83
When is GnRH analogue considered as treatment for PMS
Patients not responding to other therapies (short term Rx only)
84
5 disadvantages of using GnRH analogues as treatment for PMS
* 11% bone loss with continuous treatment (should not exceed 6 months without add-back hormone therapy) * Hot flashes * Nausea * Night sweats * Headaches
85
Advantage of using GnRH analogue as treatment for PMS
Given in luteal phase = improved breast tenderness
86
3 benefits of Metolazone as treatment for PMS
Improved * Weight gain * Mood * Swelling
87
3 improved PMs symptoms by OCP
* Acne * Appetite * Food cravings
88
4 treatments for PMS that have a trade-off between benefit and harm
* Clompramine * Danazol 200 mg OD * SSRI's * Progesterone
89
Benefits/harm of clompramine as PMS treatment
* Benefit = improve psychological symptoms only * Harm = significant drowsiness, nausea, vertigo, headache
90
Benefits/harm of danazol 200 mg as treatment for PMS
Effective but masculinization
91
Benefits/harm of SSRI's as treatment for PMS
Effective but may increase risk of suicide (warnings about use in children and adolescents)
92
5 potential adverse effects of progesterone as treatment for PMS
* Bleeding * Dysmenorrhea * Abdo pain * Nausea * Headache
93
4 lab tests for PMS
* CBC * -lytes * TSH * +/- menopause workup

Block I: Reproduction & Sexuality (23 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions