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Flashcards in GYN&BREAST Deck (112)
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1

Amenorrhea and + progestin challenge

Anovulatory. Workup for PCOS

2

Order of events of normal female puberty

Adrenarche
Gonadarche
Thelarche
Pubarche
Growth spurt
Menarche

3

Pubic hair dev at tanner stage 1

Prepubertal so no hair growth.

4

What tanner stage is breast budding seen?

Tanner Stage II

5

What tanner stage is slight growth of fine labial hair seen?

Stage II

6

What do the breasts look like in stage 4 (tanner)

Further breast enlargement: areola and papilla form secondary growth ABOVE level of breast.

7

Precocious puberty: Increased LH and FH with additional release following administration of GnRH suggest what etiology

Pituitary gland activation

8

Precocious puberty: low LH and FSH with no response to GnRH suggests what etiology?

Excess sex steroid production

9

Increased estrogen in the presence of low LH and FSH suggests ?

Exogenous hormone production (neoplasm)

10

Describe follicular phase

FSH stimulates GROWTH of OVARIAN FOLLICLE (granolas cells) which in turn secretes estradiol.
ESTRADIOL induces ENDOMETRIAL PROLIFERATION and further increases FSH and LH secretion from positive feedback of pituitary

11

Describe luteal phase

Residual follicle (i.e., CORPUS LUTEUM) secretes estradiol and progesterone to MAINTAIN ENDOMETRIUM and induce devo of secretory ducts.
High estradiol levels inhibit FSH and LH.
IF egg is NOT fertilized, corpus lute degrades, progesterone and estradiol levels decrease, and the ENDOMETRIAL LINING DEGRADES.

12

Diagnosis of menopause requires how long of amenorrhea?

One year

13

Which hormone induces LH surge?

Estrogen

14

What hormone is responsible for increasing the basal body temperature?

Progesterone

15

What is Asherman syndrome

Scarring of the uterus that follows infection or postpartum infection

16

Primary amenorrhea: no secondary sexual characteristics, high FSH, LH. Dx?

Gonadal agenesis
Gonadal dysgenesis
Ovarian failure

17

Next step in primary amenorrhea with no secondary sexual characteristics and LOW FSH, LH

Prolactin level. If normal, its a GnRH deficiency or other hypothalamic-pituitary dysfunction

18

If estrogen-progesterone challenge is negative, dx?

Asherman syndrome

19

If estrogen-progesterone challenge test is positive, next step?

Check FSH, LH.
If high: ovarian failure
If low: HPA axis disfunction

20

Tx for PMS and PMDD

Exercise
Vitamin B6
NSAIDS
OCPs
Progestins
SSRIs with or without alprazolam

21

"Powder burn" lesions and cysts on laparoscopy

Endometriosis

22

Define abnormal uterine bleeding

Menses with 35 day intervals
Lasting >7 days
or
blood loss > 80 mL

23

most common cause of androgen excess in women

PCOS

24

What causes ovarian cysts in PCOS?

A result of androgen hyper secretion; do NOT cause the disease!!!

25

Labs in PCOS

Increased LH
LH:FSH ratio >3
Increased DHEA
Increased androstenedione
Positive progestin challenge

26

What kind of cancer are patients with PCOS at higher risk for?

Endometrial cancer, secondary to chronically high estrogen levels.

27

2 infections that cause vaginal pH >4.5

Gardnerella and trichomonas

28

What are gumbos?

Granulomatous lesions of skin, bone, and liver seen in tertiary syphilis

29

Labs FOLLOWING syphilis tx

RPR and VDRL will become negative
FTA-ABS will remain positive FO LIFE

30

Bubo formation seen in what STDS

Chancroid and lymphogranuloma venereum! Significant inguinal swelling