Dvt Flashcards
(152 cards)
1
Q
Best day to do fsh
A
Day 3
Normal value less thsn 10 iu
Most common test for ovarian reserve
2
Q
Best test for ovarian reserve
A
AMH(antimullerian hormone) 1 ng
3
Q
Primary amenorrhea and raised fsh
A
Gonadal dysgenesis
4
Q
Primary amenorrhea and low fsh
A
Kall mann syndrome
5
Q
Normal level of fsh in
A
Pcos
Asherman symd
Mullerian agenesis
6
Q
Amin role of fsh
A
Seection and growth of dominant follocle
It peaks before ovulation by progestrone
7
Q
Estrogen
A
Under the influence of fsh ovary produce estrogen
C18 component
Endometrium proliferation
estrogen peak required for LH surge -200 pg X 48 hr
8
Q
Decreased estrogem causes
A
Hot flishes vaginal atrophy
9
Q
Estrogen levels in pcos
A
E1 increased
E2 normal
E2 :E1 ratio reversed
10
Q
LH surge occurs
A
36 hrs before ovulation
Lh peak 12 hrs before ovulation
11
Q
Which hormone maintain corpoluteum
A
Lh
12
Q
Lh in pcos
A
Persiaitemly increasing
13
Q
Persiatance of corpus liteum without pregnancy
A
Halbans disease
14
Q
Androgen produced by
A
Theca cells under lh surge
Leutinized granulosa cells produce progesterone
15
Q
Progesterone
A
C 21 compound
Causes secretory changes in endometrium
Cx mucus thick scantvagina intermediate cella
Increased basal body temp
16
Q
Best test of ovulation
A
Serum progesterone done at day 21
17
Q
Progesterone challenge test negative menas
A
Estrogen deficiency/endometrium/ hpo axis damage
18
Q
Pct positive means
A
Anovulation
19
Q
Peak level of progesterone seen at
A
8 days post ovulation
20
Q
Day of ovulat
A
Length of menstrual cycle -14
21
Q
Treatment of choice for hyperplasia without atypia
A
Estrogen
22
Q
Androgens
A
C19 compounds
Produced by theca cells
23
Q
Androgens not produced by ovary
A
DHT and DHEAS
24
Q
Androgens priduced in max amount
A
Androstenidione
25
Pubic and axilliary hair produced by
Androgens or testosterones
26
In pcos androgens are
Mildly reduced(<200ng)
27
GnrH
Decapeptide
| Realesed as pulsatile manner at puberty(night by decreased GABA increase in kiss petin)
28
Ansent gnrh in
Kallman ,anosmia
29
Low frequency pilses of gnrh causes
Fsh release
30
High frequency pilse sof gnrh causes
LH release
31
In case of aub isg shows a growth in uterinecavity what will you do next
Hysteroacooy(best)
32
Any women with more than 45 years with c/o aub ir how willk you proceed
Irrepective of usg finding do endometrial biopsy or endometrial aspiration cytology (EAC)-karmans cannula
33
If patient had post coital bleeding and u see visible growth or abnormal cervix
Punch biopsy
34
Abnormal paps
Colpobiopsy
35
Treatment of choice for preinvasive lesions
LEEP
36
If atypical galdular cells on pap smear
Colpobiopsy+endeocerbical curettage+endometrial sampling
37
Fibroid uterus
```
Enlarged uterus
Heavy bleeding
More than equal to 35 yrs
Non tender uterus(tender if degeneration or
Irregular uterus
IOC- USG
Treatment
Asymptomatic fibroid no treatment
Fibroud perimenopausal no treatment
Asymptomatic fibroid desire pregnancy-no treatment (except submicosal -hysteroacopic myomevtomy
Intramural blocking b/l cornu myomectomy
```
38
Investigationof choice for submicosal fibroid
Hysteroacopy
39
Polyp
```
Increased size of uterus
Irregular bleding
Peri and post menopausal
Non tender
Usg- feeder vessel sign
```
Ioc-hysteroscopy
Treatment of choice - polypectomy
40
Adenomyosis
```
Enlarged uterus
Heavy bleeding(dysmenorrhea
40-45
Tender
Globular
Ioc- mri
Diagnosis- HPE
```
41
Usg findings in adenomyosis
Venetian blind
Saalt pepper
Poorly defined junctional zone
Treatment of choice-hysterectomy
42
Treatment of symptomatic traetment
Pressure symptoms-given gnrh analogs and antagonist
If menorrhagia- intramural-ocp
Submicosal- hysteroacopic myomectomy
43
Endometrial hyperplasia without atypia toc
Progesterone (mirena)
44
Hyperplasia with atypia
Next step-
D and c with hysteroacopy
If asked toc- hysterectomy
45
Most common cause of post menopausal bleeding
Atrophic endometritis
| Endo ca 10%
46
Mullerian agenesis
Ansent uterus
Breast >=thanner 2normalnpubic and axillary hair
Absent vagina46 XX
47
Androgen insensitivity syndrome
```
Abseent uterus
No pibic and axillary hair
Braest mor than 2 thanner
Blind ending vagina
46XY
Gonadectomy after piberty
```
48
Most common cause of male pseudohermaphrodite
Androgen insensitivity syndrome
49
Most comkon cause of female paeudohermaphrodite
CAH- congenital adrenal hyperplasia
50
Gonadal dusgenesis
```
Uterus small
Abdent breasovary not visible
Fsh increased
Short statute- turner45 x0
Normal stature -pure gonadal dysgeneses
Pure can be xx xy
Xy_swyers- gonadectomy as soon as diagnosis made
```
51
Kallman
```
46xX
Anosmia
Ovaried normal
Uterus present
Fsh low
```
52
Imperforate hymen
Bulging memrane on l/ e
Normal uterua and normal ovaries
46 xx
Breast development presnet
53
Features of imperforate hymen
```
Hematocolpos
Hematometra
Cyclic pain
Acute urinary retension
Mx- cruciate incision
```
54
Imperforate hymen vs vaginal septum
Trnasverse septum there is no bulge
Cough impulse negative in vaginal septum
Cough impulse preseng in imperforate hymen
55
Investigation of choice for mullerian anomalies
3 D usg
56
Gold std for mullerian anomalies
Mri
If not
Then laproscopy and hysteroscopy
57
Dippong fundis and wide angle in
Bicotnuate uterus
| Partialfusion 2 uterine horns 1 cervix
58
Bi cornuate mx
Strass man metroplasty
59
Complete failure of fusion in which uterine anomaly
Didlephius(2 uterine horns and 2 cervix)
Hoghest riak of vaginal septum
Highest risk of U/l renal agenesis(on the side of septum)
60
Ectopic pregnancy,evtopic ovary and u/l dysmenorrhea are characteriatic of which uterine anomalu
Unicornuate
High risk of urinary tract anomalies
Endometriosis
Uterine rupture
61
All mullerian anomalies have
1) Obstruction-cyclic pain,endometriosis,infection aub hemato colos and hematometra
2) urinary tract abnormalities-renal agenesis,horse shoe kidney,ipailateral
3) preg complicatins-abortion,iugr/nal presentation/pph,abnormal or prolonged labour
62
Most common cause of infertility
```
Ovarian
Pcos-(who grp 2 anovulation)
Doc ocps(for hirsuitism also 2 nd line spironolactone)
```
63
Doc for ovulation induction
Letrozole
| More live birth rate and monofoliiculqr development
64
Differential diagnosis for pcos
Adult onset CAH-17 ohp test
65
Second line traetment for ovulation induction
Gonadotropins>lap ovarian drilling
66
Investyof choice for tubal patency
HSG (day 5-day 11)
67
Best test for tubal patency
Laparoscopic chromopertubation
68
Hag ahows b/l block next step
Laproscopic chromopertubation
69
Hag shows b/l cornual block then
Hysteroscopic pic cannulation
70
Bl/ hydrosalpynx toc
IVF
| Next step -salpinchectomy or tubal clipping
71
Gentinal tb most commonly involved in which organ
Fallopian tube
Spread hematogenous
Most common presentation pain and infertility
Normal pv findings
72
Diagnosis of genital tb
Endomitral biopsy/PCR of menstrual blood
73
Choclate cyst and adhesions seen in which type of endometriosis
Moderate to severe
Treatment of choice-IVF
Donot remove choclate cyat beforeivf
74
Most common cause of male factor infertility
Primary hypogonadosm
| Testicular/spermatogenesis/non obstructive)
75
Hormonal status in primary hypogonadosm
Incraesed fsh
Increased lh
Decreased testosterone
76
Obstructive azoospermia
All hormones are normal
| Eg cystic fibrosis
77
Moat important hormone differentiating non obstructive and obstructive azoospermia is
Fsh
78
Investigation of choice for vaginal discharge
Salime microscopy
79
Greyiah white,Foul amelling d/c with ph more than 4.5,no pruritis
clue cells/whiff test
Bacterial vaginosis
80
Criteria for bacterial vaginosis
Amsel criteria 3
81
Doc for bacterial vaginosis
Metronidazole/clindqmycin
82
Important test in bac vaginosis
Gramstain
| Nugent score score of 7-10
83
Which infection a/w preterm labour
Bacterial vaginosis
84
```
Greenish yellow foul smelling frothy discharge
With pruritis,dysuria and dysparunia
Ph> 4.5
O/e
Strawberry cervix
```
Trichomoniasis
| Doc metronidazole
85
Patient presented with pruritis and thickk curdy white scandy diacharge,ph less than 4.5
Non foul smelling
Not std
Candidiasis
Doc- fluconozole
Kit 2 green clr- secnidazole 2 gm stat+ t fluconozole 150 mg stat
86
Mechanism of action of emergency contraceptive
Inhibit fertilization
87
Most commonly used ec
LNG tab 1.5 mg (72 hrs)
88
Most effective ec
Cut (5days)
89
Moat effective hormonal ec
Ulipristal 30 mg
90
Pcos usg findings
12 or more follicles2-9 mm each
| Volume of ovary >=10 cc
91
Multiple large follicles
Ovarian hyper stimulation symdrome
| Highest risk for gonadotropin (hcg)
92
Best therapy for pcos
Recombinant fsh but costly
| So hmg therapy
93
Late onset ohss causes
Pregnancy hcg
94
Hyperpigmented velvety necjk in
HAIR AN syndrome— severe pcos (it is the indication for metformin therapy)
Hyperandrogenesim,insulin resistance,acanthosia nicricans
95
Laparoscopic ovarian drilling
Surgical ovulation induction
4 holes 40 w current
High risk for ovarian failure
96
Asherman syndrome most comkon cause
D and c
| Tb schistosomiasis
97
Ipc for asherman sydn
Hysteroscopy
| Rx- adhesiolysis+ peadiatric foleys and estrogen supplements
98
Banana shaped uterus
Unicornuate uterus
99
Golf club tube appearance in hsg
Tb
| Others tobacco pouch pebble stone lead pipe
100
Leaf kike protozoa with flagella highly motile
Trichomonas
101
Complicated candidiasis treatment
Boric acid
| Causative organisms candida glabrata c.tropicalis
102
Triple line endometruim is at
Midcycle due to estrogen
103
Tubal ligation in which serosa opened up ligate and cut tubes and bury the stump by tubal serosa
Uchida method
Zero failure
If medial end buried under myometrium(irwing )
If make loop ligate loop and cut loop -pomoroy
104
Tubal ligation in which fimbriae is cut off
Kroner method
105
Ligate the two end and cut in between
Parkland merhod
106
Place pf tubal ligation
Medial 1/3 and lateral 2/3
107
Madlena method
Made loop crush the loop and ligate the loop
| Failure rate 7%
108
Gollocle like arrangemnet of cells in
Granulosa cell tumor
Call exner bodies
Marker-inhibin b
109
Granuloma cell tumour associated with
Tumou in uterus becos mc estrogenic tumour
110
Tumour in children with elevated alpha feta protein and schiller duval body(pink cells inside)
Yolk sac tumour
111
Tumour marker for young girls with adnexal mass
LDH-dysgerminoma
Afp- yolk sac tumour
Inhibin b
Hcg choriocarcinoma embryonal ca
112
Signet ring cell appearance
Krukenberg tumour
Most common primary site pylorus of stomach(lymphatic route)
Poor prognonsis kidney ahaped large tumour
113
Investigation for figo 0-5
Saline infused sonography
114
Contraindication of hsg
Active tb
115
Ioc of endometriosis
Laparoscopy
116
Blue berry spots deep ,red flame lesion
| Powder burn lesion seen in
Endometriosis/emdometrioma
117
Hole in peritoneum called
Allen master syndrome due to adhesion
118
Diagnosis of haemoperitoneum(ruptured ectopic)
Culdocentesis
119
Couvelaire uterus seen in
Abruptio placenta
| Concealed abruptio
120
Painless profise bleeding
Placenta previa
Mx c section
Expectant manegement-macafee johnososn regimen deadline 37 week
121
Lamba sign in
Dichorionic dizygotic
122
Most common monozygotic
Mcda
123
Nuchal transulency assaociated with which test
Dual test
124
Post coital bleeding
| Lesion on cervix what to do next
Direct punch biopsy
125
Doyens retractor
Retract anterior abdominal wall in c section
126
Episiotomy scissor
One narrow blade for vagina
| One broad blade for perineum
127
Episiotomy is sutured back by
Chromic cat gut 1-0
| Rapid vicoryl no 1
128
MVA SYRINGE(manual vacum aspiration )
2 valves
600-660 mmhg pressure
Used for mtp upto 12 wks or abortions of first trimester
129
Cuacos speculum
Self reataining speculum
130
Ayers spatula and cyto brush
```
For papsmear(wood)
Cytobrush-for endocerviacal cytology for dysplasia scrrening
```
131
Intra decidual space/ sac sign
Earliest sign of implantion in usg
132
Double decidual space sign
Second sign of implantation
133
Double bleb sign
Amniotic sac and yolk sac
134
Ring of fire appearanec is seen in
Ectopic pregnancy
| Also in corpus luteum
135
Spalding sign
Intrauterine fetal death
| Sign of maceration
136
Velamentous placenta
Cord avulsion
Fetal distress
Fetal blood loss
137
APT test used to
Diffenretiate maternal blood from fetal blood
138
Apt test positive in
Vasa previa
139
Q shaped placenta
Small chorionic plate
Raised membranes all around
Unutilised desidua basalis
Circum vallate placenta
| Fetus with iugr oligo preterm
140
Leopoeld grip
1 fundal grip
2 lateral /umbilical
3-pawlik grip one hamd used for to identify presentation
4-deep pelvic grip facing legs
141
Compression suture in pph
B lynch suture during c section
142
Pph suture in normal delivery
Haymans suture
143
Hegar dialatore
Rapid cervical dialatores
Used for mtp,cervical incompetence
If hegar 8 dialator inserted -hegars teat
144
Purse string suture at portio vaginalis
Mc donalds cerclage
145
Pregancy in assymetrical uterus
Angular pregnanacy
| Piskacek sign
146
Perineal tear
1 degree- perinela skin
2-muscles also
3-anal sphincter
4-anal mucosa
147
Pinard maneuver
For extended legs
148
Maneuver for extended arm
Lovset
149
Pragve maneovout
After coming head is delibered
150
Mc roberts maneuvemsv /mauriceau smellie veit
Malar flexion shoulder traction
151
I maneuver for shoulder dystocia
Mc roberts maneuver
152
Gaskin maneuver
Knee hand postion
