Exam #2 -G&D part 1

Question 1

Puberty

Answer 1

transition between childhood and sexual maturity

-hormones develop into cyclic pattern- 1 year before menarche (~13 years)

Question 2

Menarche

Answer 2

first menstruation

-initially irregular, unpredictable, painless, and anovulatory

Question 3

Menstruation

Answer 3

periodic uterine bleeding

• 14 days after ovulation; avg. cycle ~28 days
• avg. blood loss 20-80 ml

Question 4

Progesterone

Answer 4

• the maturing hormone (either matures uterus or relaxes)
• produced by corpus
• maintains the pregnancy

Question 5

Menstrual cycle hormones

Answer 5

FELOP

• F- follicle stimulating hormone (FSH)
• E- Estrogen
• L- Leutinizing hormone (LH surge)
• O-Ovulation
• P- Progesterone

Question 6

Infertility

Answer 6

No conception after 1 year of unprotected sex

unless female >35 years = 6 mo.

Question 7

Sterility

Answer 7

Absolute factor completely prevents reproduction

Question 8

Subfertility

Answer 8

When both partners have reduced fertility

Question 9

Primary infertility

Answer 9

Couple has never had a child

Question 10

Secondary infertility

Answer 10

Couple has previously conceived

Question 11

Optimal age to become pregnant

Answer 11

20-25 years

Question 12

Male and female factors preventing pregnancy

Answer 12

• weight: shouldn’t be under or over
• age: mostly women >35 years
• Smoking and alcohol: decrease or stop consumption in both. Slows male sperm
• Stress
• Chemical exposure: pesticides, work exposure, BPA

Question 13

Most important determinant of fertility

Answer 13

Age

Question 14

Anovulation

Answer 14

(inconsistent ovulation)

-hormonal imbalance impairs ovulation (from hypothalamus)

Question 15

Tubal structure

Answer 15

• delicate tubal tissue is damaged or scarring (interfere with ova getting uterus)
• ectopic or tubal pregnancy risk

Question 16

Pelvic inflammatory disease

Answer 16

• most common cause of tubal damage
• salpingitis- fallopian tube inflammation
• endometriosis - uterine tissue outside the uterus -alters transport thru tube

Question 17

Uterine fibroids

Answer 17

• growths on uterine wall
• after implantation
• risk spontaneous abortion

Question 18

Cervical mucus

Answer 18

• receptive cervical mucus: thin consistency, clear, watery, profuse, alkaline, acellular, elastic (stretchy)
• estrogen: hormone that causes mucus to become receptive
• cervical surgeries- can result in removal of mucus producing glands (dry cervix)
• hormonal imbalance-inadequate estrogen
• cervical infection-changes mucus pH - if pH becomes acidic it kills the sperm

Question 19

Treatments for unreceptive mucus

Answer 19

• estrogen therapy (6 mo.)

- robitussin (thins mucus)

Question 20

Spermatogenesis

Answer 20

process of forming mature sperm

Question 21

Spermatogenesis abnormalities

Answer 21

• decreased LH, FSH, and testosterone production
• Gonadotoxins- substances that effect sperm motility, quantity, and formation and shape (alcohol, chemotherapeutics, heroin, medications)
• Illness and infections
• Repro system infections (orchitis: inflam. of testicles bc sperm made there) (Prostatitis: prostate produces fluid to protect sperm) (STI)
• heat exposure
• pelvic radiation
• Structural: (vasectomy, hernia, varicocele)
• ED and retrograde ejaculation

Question 22

Immunologic infertility

Answer 22

• Female or male immune systems can produce sperm antibodies
• male system triggered by surgery/trauma of reproduction organs. or female vaginal flora cause antibodies
• female system stimulated by male semen

Question 23

Semen analysis

Answer 23

• collect semen after 2-3 days of abstinence

- semen obtained on site or brought in w/in hour

Question 24

BBT (basal body temperature)

Answer 24

• determines if normal ovulation is occurring
• measure temperature each day to detect rise
• same time each morning before you get out of bed
• day prior to ovulation see elevation in temp.

Question 25

LH surge detection test

Answer 25

- OTC test - urine test detects LH surge (optimal time to have sex) - peak of LH during ovulation

Question 26

Cervical mucus evaluation

Answer 26

-determine quality of receptive mucus

Question 27

Ferning capacity

Answer 27

- ferning in mucus is an indirect indication of estrogen - look at mucus under a microscope. - ferning pattern if receptive - lined channels: for sperm to travel - new saliva test for ferning

Question 28

Hyersterosalpingography

Answer 28

- radiopaque dye into uterus evaluates patency of tubes - done after menses - therapeutic - moderate discomfort and cramping (ibuprofen prior to suppress inflammation) - reference of pelvic inflammatory disease (admin. antibiotics prophylactically)

Question 29

Hysteroscopy

Answer 29

Scope placed in the uterus to visualize structures and for polyps/fibroids

Question 30

Diagnostic laparascopy

Answer 30

- pelvic organ visualization - post-op pain: shoulder chest (bc CO2 instilled) - evaluated for endometriosis, PID, adhesions, tumors, cysts

Question 31

Endometrial biopsy

Answer 31

- biopsy of uterus at the end of the menstrual cycle | - evaluates endometrium to see if normal changes are occurring

Question 32

Mittleschmerz

Answer 32

pain associated with ovulation

Question 33

Teaching

Answer 33

- timing and signs of ovulation (bbt, cervical mucus, mittleshmerz) - no douching or artificial lubricants (decrease fertility of 50%) - remain in bed 1 hour after sex

Question 34

Sperm antibodies

Answer 34

- give corticosteroids to suppress antibody production | - condom prevents male and female flora from mixing. take off just when ovulating

Question 35

Clomid

Answer 35

- administers for 5 days taken orally - cycle days 3-7 - stimulates hypothalamus to secrete GnRH (^FSH and LH)