Miscellaneous Flashcards
(251 cards)
1
Q
theca lutein cyst:
What is it?
What is the treatment?
A
- cyst that forms as a result of hyperstimulation by HCG (molar pregnancy)
- WILL RESOLVE ON OWN WITH REMOVAL OF HCG STIMULATION
2
Q
Immature Cystic Teratoma:
What is it?
What does it look like/present?
What determines the metastatic potential?
A
- malignant neoplasm with derivatives of all three germ layers, esp neural tissue (won’t have properly formed features though ex: won’t have hair because immature)
- looks similar to mature teratoma
- the amount of immature neural tissue
3
Q
Define perimenopause
A
- transition period before menopause (4 years prior until menopause)
- decreased inhibin, increased FSH
- more variable periods, skip 2+ periods
4
Q
pediculosis pedis
what is it?
presentation?
treatment?
A
- ectoparasite, skin contact, sex(most contagious std)
- itching, redness, perineal, pubic, perianal distribution, presence of nits
- permethrin
5
Q
What would be an indication that a resolved hydatidiform mole has persisted and can become malignant?
A
- if HCG levels do not decrease or plateau off after curretage of pregnancy
6
Q
scabies
what is it
presentation
treatment?
A
- ectoparasite, burrows into skin
- pruritis, redness, vesicles, nodules papules
- permethrin
7
Q
What is the discriminatory zone?
What are common values for the discriminatory zone for transvaginal ultrasound vs abdominal ultrasound
A
- threshold bHCG level by which gestational sac can be visualized on ultrasound
- transvaginal- 1500- 2000
- abdominal- 5000- 6000
8
Q
What would necessitate immediate scrotal exploratory surgery?
A
Testicular Fracture
High suspicion of Torsion
Penetrating scrotal trauma
9
Q
For 5a reductase deficiency:
- what is the karyotype?
- what are the external genitalia?
- mullerian ducts present?
- wolffian ducts present?
- body features?
A
- 46 XY
- external genitalia female/ambiguous (little to no DHT, so no male differentiation)
- mullerian ducts absent
- wolffian ducts present
- decreased body hair/no palpable prostate
10
Q
What are the 3 types of vaginal prolapse?
A
anterior wall (cystocele), posterior wall (rectocele), apical prolapse
11
Q
What is Lichen simplex chronicus? What does it present as? What causes it?
A
- benign dermatologic condition
- thickened, leathery vulvar region
- “itch that causes a rash” (itching continually will cause rashing)
- itching can be caused by lichen sclerosis, candidiasis, heat, sweating, irritation, topical agents
12
Q
What is septic abortion?
How does it present?
A
- serious infection after spontaneous or induced abortion
- fever, hemorrhage, shock, pain, incomplete removal of fetal contents
13
Q
If a patient already uses a medication that is a cytochrome p450 inducer, which contraceptives should you not use in these patients? what contraceptive can you use?
A
- DON’T USE HORMONAL CONTRACEPTIVES (metabolized by same cp450s, won’t work)
- copper IUD effective
14
Q
What is the bell clapper deformity? What does it put you at risk for?
A
- tunica vaginalis inserts abnormally high
- puts you at risk for testicular torsion
15
Q
The ____ space allows for substantial nutrients necessary for rapid growth of the fetus
A
intervillous space
(spills from uterine spiral arteries), between villi
16
Q
Ovarian mucinous cystadenoma:
What is it?
pathology?
presentation?
A
- benign neoplasm, unilateral
- mucin filled, glandular cells, septated/multilocular, CAN BE V LARGE
- pelvic pain, pressure, distended abdomen (USE CT)
- less malignant potential than serous
17
Q
placenta previa:
what is it?
how does it present
how can it be found?
is this a concern?
what puts you at risk for it?
A
- placenta implants on internal cervical os (complete, marginal, low- lying
- PAINLESS bleeding
- ultrasound (transvaginal)
- no, most spontaneously resolve (previous c section increases risk)
- uterine surgery, previous previa, multiparous, smoking
18
Q
treatment for PID
A
- outpatient: ceftriaxone and doxycycline
- inpatient: parental cifoxitin and doxycycline (+/- metronidazole if bacterial vaginosis present)
19
Q
What is the most effective contraception? What is the least effective?
A
most effective- implant
least effective- oral contraception (not reliably taken)
20
Q
uterine adenosarcoma
what is it
what is its two parts?
A
- low grade tumor
- benign epithelial and malignant sarcoma
rarely high grade
21
Q
What is main metabolic substrate for the placenta?
Which layer of the placenta is responsible for making HCG, estrogen, progesterone, and hPL (aka everything)?
A
- glucose
- syncytiotrophoblast
22
Q
mixed causes of hypogonadism in men
A
- Severe illness/malnutrition
- Alcohol excess
- Glucocorticoid excess (Rx or Cushing’s)
- HIV/AIDS
- COPD
- End stage renal disease
- Medications
- Hemochromatosis (primary?)
23
Q
The LH surge happens approximately ____ hours before ovulation and reaches its peak _____ hours before ovulation
A
- 30-36 hours
- 10-12 hours
24
Q
What is Depo-Provera?
A
- injectable progestin (think “DEPOsit PROgesterone into your skin)
- inhibits ovulation, thickens mucus, thins endometrium
- can decrease bone density, but will go back to normal as soon as you stop using it
25
90% of ovarian malignancies are _____ in origin
- epithelial
26
What is ovarian torsion?
How does ovarian torsion present?
Why do ovarian teratomas tend to cause torsion
- twisting of the ovary
- sudden onset of pain
- mass without vascular supply/ischemic (twist cuts off vascular supply from IP ligament)
- cause torsion because it's heavier due to germ cell derivatives (ex: teeth), so it's more likely to twist
27
What are the treatment methods to treat overactive bladder?
- physical therapy/timed voids
- anticholinergic agents (CI: narrow angle glaucoma, SE: dry eye dry mouth constipation, impaired cognitive function)
- B3 agonist (CI: uncontrolled htn, SE: htn, UTI, headache)
- botox injection (prevent acetylcholine release)
- neuromodulation (inject nerve root)
28
Pregnancy tests measure what?
- HCG (made by trophoblasts)
29
What causes height spurt, voice changes, penile growth and facial hair in men?
testosterone
30
Which gland (skene's or bartholin's) is located close to the urethra?
skene's
31
What happens to the CNS that triggers the onset of puberty?
- decrease in GABAergic inhibition of CNS
32
Genetic pathognomatic finding for testicular cancer
isochrome of the short arm of chromosome 12
33
describe estrogen levels from birth to puberty
- low from birth until puberty when it surges
34
What type of abortion has a closed cervix but fetal demise (no bleeding)
missed abortion
35
For puberty:
In men, FSH causes ____ maturation
In women, FSH causes _____ development
- seminiferous tubule maturation (NOT TESTOSTERONE)
| - ovarian follicle development
36
post-menopause
- Stage 1: first 5 years after menopause (hot flashes, etc)
| - Stage 2: 5 years- death
37
necrotizing fasciitis of the vulva
what is it?
what causes it?
how does it present?
treatment?
- simple infection of submucosa that goes along fascial planes --> thrombosis of microvasculature --> necrosis of submucosa
- clostridium, e coli, strep, staph, klebsiella
- acute, severe vulvar pain and fever, anemia, leukorrhea, cellulitis, crepitus
- surgical debridement and antibiotics af
38
Inhibin B is released by _____ cells (before/after) ovulation, and Inhibin A is released (before/after) ovulation
- released by granulosa cells
- Inhibin B released Before ovulation
- Inhibin A released After ovulation
39
seminoma
pathology?
- homogenous, circumscribed, tan mass
- clear cytoplasm with nuclei center (sunny side up egg)
- no hemorrhage or necrosis
40
What is the role of Leptin in puberty? How do Leptin levels affect obese females vs anorexic females and their onset of puberty?
- threshold level of leptin necessary for onset of puberty
- leptin made in adipocytes, more fat= more leptin
- obese women have earlier onset of puberty
- anorexic women have later onset of puberty
41
what is protraction in regards to labor?
- decreased rate of cervical dilation during active labor
<1.2 cm/hr primipara
<1.5 cm/hr multipara
42
Invasive mole:
How far does it invade the uterus?
Does it metastasize to other organs? If so, where?
How does it present histologically?
- invades myometrium
- does NOT metastasize
- histologically IDENTICAL to complete mole --> hydropic villi
43
What are the 3 types of fetal heart rate deccelerations? What are they associated with?
- Early: associated with head compression, esp during contractions/labor (v quick descent with peak at peak of contraction)
- Variable: V shaped decceleration, associated with cord compression, prolapse, lack of amniotic fluid (squishing of cord)
- Late: peak of decceleration is AFTER contraction, can't overcome stress, EMERGENCY FOR HYPOXIA
- VEAL CHOP
- Variable, Early, Acceleration, Late
- Cord compression, head compression, OK, placental concern
44
Which two ovarian cancers have endometriosis as a precursor?
endometroid and clear cell
45
Besides ovarian epithelial cancer, which cancer can present with vaginal bleeding?
fallopian tube cancer
46
embryonal carcinoma
pathology?
- hemorrhagic and necrosis
| - alternating tan and brown
47
What ultrasound findings would be indicative of CMV?
- echogenic bowel
- intrahepatic calcifications
- periventricular calcifications
- microcephaly
- ventriculomegaly
48
complete hydatidiform male:
What is the genetic makeup?
What is in the uterus when pregnant?
malignant potential?
what is the histology?
- - diploidy (2 sperm empty egg or 1 sperm duplicates --> fetal dna completely paternal)
- diffuse trophoblastic proliferaiton, NO fetal/embryonic structures
- enlarged uterus, theca lutein cysts from high HCG
- higher chance of post molar malignant process
- histology: all hydropic villi with trophoblastic proliferation
49
Cocaine use during pregnancy is associated with what?
- hypertension and placental abruption
50
What is the most common form of contraception used in the US?
sterilization
51
What is the main ultrasound measurement during first trimester?
What is the main ultrasound measurements during second/third trimester?
- crown rump length
| - biparietal diameter, head circumference, femur length, abdominal circumference
52
theca interna cells have abundant ____ receptors that stimulate the the production of ______ from cholesterol?
- LH receptors
| - testosterone and androstenedione
53
When can Plan B used vs. Ella vs. Copper IUD for emergency contraception
- Plan B: 72 hours to delay ovulation (prior to LH surge) via progesterone
- Ella: 120 hours to delay ovulation (up until LH peak) via progesterone modulator
- Copper IUD: most effective until 5 days from unprotected sex (until implantation) via inhospitable environment
54
Which type of cesarian section is associated less with uterine rupture? why?
- lower segment transverse because it cuts through less myometrium
55
endometriosis:
What is it?
what does it present as?
pathology?
treatment?
- endometrial stroma and glands present outside of uterus (proinflammatory --> infertility, releases estrogen and proges)
- teenager/women with pelvic pain, women with infertility, dysmenorrhea, dyspareunia, simulate cancer clinically and radiographically (phases of healing and bleeding which can make a mass)
- uterosacral ligament nodularity
- red blue lesions, blood filled chocolate cysts, umbilical fibrous structure, adhesions
- need 2 of 3 histologic findings: bengin endometrial blands, endometrial stroma, hemosiderin laden macrophages
- nsaids, oral contraceptives, gnrh agonist
56
What are spiral arteries? What happens to them during fetal development
- spiral shaped arteries in the endometrium/myometrium
- uncoil, loosen, and widen/erode as trophoblasts invade so that nutrients from mother can go through them into the intervillous space to provide nutrients for BABY
57
anovulatory bleeding:
What causes it?
What is it a precursor to?
- prolonged estrogen stimulation due to lack of ovulation
- bleeding is due to withdrawal of estrogen due to follicles dying or estrogen breakthrough (focal fragile endometrium that estrogen can't support sloughing, not global), NOT PROGESTERONE WITHDRAWAL
- precursor to endometrial hyperplasia
- focal hyperchromasia and stromal crumbling and fibrin clumps
58
Signs and symptoms of male hypogonadism
- decreased libido
- depression
- decreased muscle mass
- decreased bone mineral density
- decreased facial/pubic hair
- fatigue
- shrinking/small testes
- infertility
- decreased spontaneous erections
- erectile dysfunction
59
clinical presentation of hydatidiform mole?
- vaginal bleeding (most common symptom!)
- high HCG (higher in complete than partial)
- hyperemesis gravida (due to HCG)
- absence of fetal heart tones
60
What LH/FSH levels should you expect in secondary hypogonadism in men?
- low LH and FSH ( no pituitary response to low testosterone)
61
What are two normal variants of puberty
- premature thelarche (before age 3, usually transient without any growth, change in LH/FSH, increase in estrogen, could be due to ovarian cyst/ transiently active ovaries)
- premature adrenarche (before age 8 in girls and 9 in boys, due to increase in weak adrenal androgens ex: DHEA, as long as no extra growth or virilization, no pathologic androgen problem)
62
Chemo medications for non-seminoma germ cell tumors?
side effects?
if this chemo fails, what is the salvage chemo?
- BEP, bleomycin, etoposide, platinum (cisplatin)
- bleomycin, pulmonary toxicity
- VIP, vinblastine, ifosfamide, platinum/cisplatin
63
Is vulvar cancer common for 20 year olds? Why or why not?
- not common for 20 year olds
- HPV takes a long time to become cervical cancer, and since most people start having sex in late teens, early 20's, not enough time to get cancer?
64
Criteria for
pre eclampsia
chronic hypertension
gestational hypertension
- hypertension after 20 weeks with proteinuria (mild, severee has symptoms) EXCEPT MOLAR PREGNANCY
- hypertension prior to 20 weeks
- hypertension after 20 weeks without proteinuria
65
If a woman has menopause before age 40, this is called _____
- primary ovarian insufficiency/failure
66
partial hydatidiform male:
What is the genetic makeup?
What is in the uterus when pregnant?
malignant potential?
what is the histology?
- aneuploidy (2 sperm, 1 egg)
- fetal/embryonic structures and focal trophoblastic proliferation and degenerating placenta
- would present like a miscarriage, no uterus enlargement
- low chance of most molar malignant process
- histology: mix of normal villi and hydropic villi with trophoblastic proliferation
67
magnesium sulfate
indications?
mechanism of action
side effects?
contraindication
- to prevent seizure in preeclampia, tocolysis, neuroprotection against cerebral palsy for preterm birth before 32 weeks
- prevents release of intracellular calcium
- cardiac arrest, respiratory depression, decreases reflexes, nausea vomiting
- renal failure, myasthenia gravis
68
How do progesterone IUD's prevent pregnancy?
- delays fertilization
- thinning/atrophy of endometrium
- thickening of cervical mucus
- inhibit sperm
- can have amenorrhea by 2 years
69
primary hypogonadism (hypergonadotrophic hypogonadism)
- men: klinefelter, radiation of testes, and anorchia
| - women: turner's, radiation of ovaries, autoimmune ovarian failure
70
What is Lichen sclerosis? What does it present as?
- benign dermatologic, NOT VAGINAL condition
- thin, white, cigarette paper skin, loss of labial architecture
- itching, pain pruritis
- can happen to anyone, but more common in older 40-50 yr olds
71
granulosa cell tumor:
what is it?
tumor marker
pathology?
presentation?
- malignant FUNCTIONAL (releases estrogen) ovarian stromal tumor
- inhibin
- immature follicle formation (call exner bodies), solid and cystic mass, hemorrhaging
- vaginal bleeding in most menopausal woman, precocious puberty in pre menarche, abdominal fullness, minor tenderness
72
What is a main symptom people with Kallman syndrome experience besides secondary hypogonadism? What is the cause of this symptom?
- anosmia
| - due to GnRH neurons not migrating from nasal placode
73
describe testosterone levels from birth to puberty
- low at birth, increases during the first year, then low until puberty when it surges
74
what nodes does the vulva drain to?
inguinal nodes (superficial then deep)
75
what is the difference between a hydrocele and spermatocele?
- hydrocele- fluid filling scrotum, can get very big
| - spermatocele- cyst off of epididmys, can have sperm in it
76
What is a urethral diverticulum? What signs/symptoms are common?
- outpouching of urethra (will bulge into vagina)
- dysuria, dyspareunia (painful sex), post void dribbling
MRI FOR IMAGING
77
Gases cross the placenta via ______
Which molecules require activate transport for crossing the placenta?
What type of transport does glucose use?
- simple diffusion (need good cardiac output, htn/preeclampsia bad)
- amino acids, calcium
- facilitated diffusion
78
What type of Hemoglobin does a fetus possess? What type of hemoglobin does a mother possess? Which one has a higher affinity for oxygen?
- fetus: Hemoglobin F
- mother: Hemoglobin A
Hemoglobin F has greater affinity for O2
79
sperm can last in the genital tract for ____ days.
5 days
80
What is the difference between intrauterine growth restriction and small for gestational age?
- IUGR- < 10 percentile for estimated gestational age (before birth)
- Small for gestational age- < 10 percentile after birth
81
placental site trophoblastic tumors:
does it metastasize to other organs?
what is it made of?
treatment?
- rarely metastasizes
- locally invasive tumor that is composed of monomorphic populations of intermediate cytotrophoblastic cells
- treatment is surgery
82
How long does parvovirus b19 last in someone?
What cells does it attack?
What can it cause in a baby?
- 12 weeks
- erythroid progenitor cells, myocardial cellsl
- hydrops fetalis (heart failure), anemia
83
If you are normal weight, how much weight should you gain during pregnancy?
- 25-35 pounds
84
describe FSH/LH levels from early infancy to pre puberty to puberty
- early infancy: low
- pre puberty- starts to have pulsatile secretions while sleeping
- puberty- have daytime peaks every 2 hours)
85
If you suspect a malignancy in the pelvic area, which imaging test should you use?
CT
| think Cancer and CT both begin with C
86
Which type of hydatidiform mole would have identifiable fetal structures and a degenerating placenta?
- Partial Hydatidiform mole
87
What is the general age of precocious puberty in girls and boys?
- girls: less than 8
| - boys: less than 9
88
Mature Cystic Ovarian Teratoma:
What is it?
Malignant Potential?
How does it present?
What are two complications of it?
- benign ovarian neoplasm with derivatives of all 3 germ cell layers present (hair, bone, teeth, skin)
- malignant potential is via the germ cell derivatives (melanoma, thyroid cancer, etc)
- USUALLY INCIDENTAL mass, pelvic pain, sometimes dysmenorrhea, ovarian torsion pain
- can cause struma ovarii or ovarian torsion
89
What is a main cause of a 46 XX disease of sexual differentiation? Describe the two ways in which it can present?
- congenital adrenal hyperplasia (21 hydroxylase deficiency)
- adrenal crisis (salt wasting)- baby very hypotensive/shock, hyponatremia, hypokalemia,
- androgen excess- ambiguous genitalia, hirsutism
90
risk factors for preeclampsia
- old
- family history
- previous history of preeclampsia
- smokerk
- already have hypertension
- DM
- obesity
- african american
- renal disease
- antiphospholipid
91
When can you administer hormone replacement therapy to a post menopausal woman?
- if a woman complains of severe, unbearable hot flashes
92
Having a singular umbilical artery in the umbilical cord instead of two can be associated with what conditions?
- aneuploidy (ex: down syndrome)
93
placental abruption:
what is it?
how does it present?
how can it be found?
is this a concern?
what puts you at risk?
- separation of uterus from placental wall (complete, partial, marginal)
- PAINFUL bleeding, fetal distress (late deccelerations)
- CLINICAL findings
- YES, lack of perfusion can kill baby
- smoking, hypertension, cocain use, multiparous, trauma, prior abruption, increase MSAFP, polyhydraminos
94
What are benefits of taking oral contraceptives?
- prevention of pregnancy
- decreased acne
- decreased amenorrhea
- decreased pelvic inflammatory disease
- decrease risk of new ovarian cysts (NOT EXISTING ONES)
95
Adenomyosis:
What is it?
What does it present as?
pathology?
Treatment?
- growth of endometrium into the myometrium
- dysmenorrhea, menorrhagia, dyspareunia, longer menstrual cycles
- globally enlarged, tender uterus, boggy uterus, normal endometrium in myometrium
- progesterone, oral contraceptives
96
pain sources during labor and delivery
- stage 1
Nerve roots: sympathetic chain; referred to dermatomes T10-L1
Paracervical and inferior hypoepigastric plexus to L2, L3
- stage 2
Parasympathetic bundle in Pudendal nerve S2,3,4
Ilioinguinal, genitofemoral, perforating branch of the posterior cutaneous nerve of the thigh, pain experienced through L2-S5 dermatomes
97
Yolk sac mnemonic
- yolk SAC
- schiller duval
- alpha feto protein
- children
98
Symptoms of epithelial ovarian cancer?
- abdominal/pelvic pain
- bloating
- fatigue
- back pain
- difficulty eating/indigestion
- nausea vomiting (gi problems due to gi being tied down by tumor)
99
peripheral precocious puberty
due to gonad/adrenal glands
- low LH/FSH and high sex steroids
- no GnRH pulse
- causes: Congenital adrenal hyperplasia, ovarian/leydig cell tumor, exogenous sex steroid, muccune alright syndrome, adrenal/hcg tumor
100
straum granulosum cells have abundant ____ receptors that stimulate the ______ of testosterone and andrestenedione into estrogen
- FSH receptors
| - aromatization
101
For the ring and the patch forms of contraception, how many weeks are "on" and how many weeks are "off"
How effective is each contraceptive?
- 3 weeks on the contraceptive
- 1 week off
patch absorbs most estrogen, increased cvd, vte, stroke
ring absorbs least estrogen, BUT same efficacy
102
Is a solitary or multifocal nodules more associated with vulvar cancer?
solitary nodule
103
Prostaglandins
indications?
what are the two types?
contraindications?
- can induce labor, postpartum hemorrhage, cervical ripening
- E: vasodilator (misoprostol)
- F: Vasoconstrictor (hemabate, postp hemorrhage)
- CI: prior uterine scar
104
What is the most common ovarian cancer associated with gonadal dysgenesis?
dysgerminoma
105
what is stress urinary incontinence?
What are treatments for it?
- small amounts of incontinence due to temporary intrabdominal pressure (laugh, sneeze, cough)
- kegels, pessary, sling, urinary bulking agent
106
oxytocin:
What is it used for?
How does it work?
side effects?
Half life?
- to induce labor contractions or to increase frequency and amplitude of contractions, post partum hemorrhage
- binds to gpcr and increase intracellular ca2+, also stimulates local prostaglandin release
- nausea, vomiting, decreased bp, increased hr, water intoxication
- 3 min
107
possible etiologies of asymmetrical intrauterine growth restriction
possible etiologies of symmetrical intrauterine growth restriction
- smoking, hypertension, type 1 dm, kidney disease, malnutrition, heart disease
- TORCH infections, constitututional small size, chromosomal abnormalities, genetic abnormalities
108
secondary hypogonadism (hypogonadotrophic hypogonadism)
- due to pituitary/hypothalamus
- males: isolated gonadotrophic deficiency ( kallman if anosmia), can be congenital with small penis
- female: anorexia and high intensity exercise (gymnastics, running, etc)
109
Does type 1 diabetes cause intrauterine growth retardation or large for gestational age babies? What about type 2 DM/gestational diabetes?
- type 1- intrauterine growth restriction
| - type 2- large for gestational age babies
110
What is recurrent pregnancy loss?
greater than 2 pregnancy losses
(first trimester, chromosomal
second trimester, autoimmune, antiphospholipid antibodies)
111
How would you distinguish between a bartholin's cyst and a skene's cyst?
- location (skene near urethra, bartholin near posterior vagina)
112
What causes adrenarche?
increase in adrenal androgens (DHEA/DHEA-S)
113
what is HELLP syndrome?
- variant of preeclampsia (may or may not have htn)
- Hemolysis
- Elevated Liver enzymes
- Low platelets
114
What hormone is responsible for smooth muscle relaxation during pregnancy? Which symptoms present as a result?
- progesterone
| - constipation (GI smooth muscle), heart burn (LES smooth muscle), urine stasis/hydronephrosis (ureter smooth muscle)?
115
uterine carcinosarcoma
What are its two components?
What are the two types?
prognosis?
pathology?
- carcinoma (epithelial) and sarcoma (connective tissue)
- homologous: sarcoma part is from uterus
heterologous: sarcoma part isn't from uterus (from muscle/bone)
- v aggressive, poor prognosis
- resembles endometroid cancer as well as serous carcinoma (forms glands and has some papillary growth/cartilage)
116
What is the key for knowing whether someone has psoriasis or eczema on their vulvar region?
- whether they have psoriasis/eczema somewhere else on their body
117
What is the chromosomal determining of gonadal sex called?
sex determination (chromosomal sex)
118
On ultrasound, how is PCOS described?
string of pearls appearance
119
What two medications are safe to use to treat preeclampsia?
For severe hypertension?
For seizure prophylaxis?
What can be recommended to prevent preeclampsia?
- aldomet or labetalol
- iv labetalol or hydrazaline
- magnesium sulfate
- low dose aspirin
120
What is the average age for thelarche? average age for testicular enlargement?
- 10 (8-13) (due to estrogen)
| - 11 (9-14) (due to gonadotropins)
121
When can you administer local estrogen?
- if a post menopausal woman complains of painful sex
122
What defines normal labor?
How does this differ from false labor?
- regular contractions with progessively dilating cervix that culminates with delivery of fetus and placenta/cord
- irregular contractions sometimes < min, no dilation of c cervix, focal pain instead of pain organized from fundus to pubis
123
What is a marker of malignant germ cell tumors?
What is the treatment/prognosis?
- alpha feto protein (AFP) or HCG
| - chemo/surgery, GOOD PROGNOSIS
124
clinical manifestations of menopause
- hot flashes (self limited 1-5 years)
- vaginal dryness (due to lack of estrogen)
- sleep disturbances
- irregular bleeding
- urinary incontinence
- depression
- bone loss
- skin changes (increased wrinkles due to decreased collagen)
- sexual dysfunction and painful sex and decreased desire
- cardiovascular dysfunction
125
What is one medication that can be used to terminate an ectopic pregnancy?
What are its contraindications?
methotrexate
```
Hemodynamic instability
Breastfeeding
Immunodeficiency (HIV, cancer, etc)
Active liver disease
Blood dyscrasia
Active lung disease
Peptic ulcer disease
```
126
3 main causes of post partum hemorrhage?
What puts you at risk?
- uterine atony, lacerations, retained placental fragments
| - previous post partum hemorrhage, vaginal delivery, episiotomy/other lacerations., augmented labor
127
what does Tanner stage B1 mean?
- refers to stage of breast development
| - B1 means that patient is completely pre-pubital, no breast bud development
128
Ovarian follicular cyst:
What is it?
Is surgery necessary to remove it?
- small follicle that failed to undergo atresia, usually simple (no solid parts) and small (hypoechoic on ultrasound)
- usually harmless and will rupture/will resolve on its own, but if it persists and gets larger, then remove
129
What are the four stages of vaginal prolapse
- > 1 cm above hymen
- < 1 cm above or below hymen
- > 1 cm below hymen
- completely OUT
130
Ovarian Neoplasms are more _____ (complex or simple?) in appearance whereas cysts are more ______ complex or simple?) in apperance.
- neoplasms- complex (solid and cystic components)
| - cysts- simple (just fluid component)
131
BRCA1 on chromosome ____
BRCA2 on chromosome 13
- 17
| - 13
132
what is arrest in regards to labor?
What is the difference between primary and secondary arrest?
- no dilation of cervix for >2 hrs
primary- never followed normal friedman curve
secondary- initially followed friedman curve and then arrested
133
Which trimester of pregnancy is nausea/vomiting the worst?
What hormone is responsible?
Which two situations would results in hyperemesis/very high HCG?
- first trimester
- HCG
- twin/triplet etc pregnancy, molar pregnancy
134
what are the four stages of giving birth?
- stage 1: labor
- stage 2: pushing
- stage 3: placenta
- stage 4: postpartum adaptation (bleeding can occur here)
135
What increases your risk for epithelial ovarian cancer?
What decreases your risk?
- increase: age, family history, BRCA/HNPCC mutation, early menarche/late menopause (HIGH CELL TURNOVER), endometriosis
- removal or ovaries/tubes
- tubal ligation
- oral contraceptive
- child bearing and breast feeding
136
3 phasehttps://www.brainscape.com/subjects/entrance-exams/graduate-entrance-exams/s of hair growth
anagen (anabolic steroid growth, scalp hair)
catogen (cat nap, forearm hair)
telogen (involution)
137
Describe why meconium could be a sign of hypoxic insult?
- bowel movements are due to parasympathetic innervation
| - if baby has bradycardia --> stimulates the vagus --> stimulates parasympathetics --> bowel movement
138
How would you distinguish between a bartholin's cyst and a bartholin's abcess?
- bartholin's cyst would be nontender, whereas the abcess would be tender and erythematous
139
Turner's Syndrome
- 45 XO
- short due to presence of only one SHOX gene
- hearing problems, webbed neck, cardiovascular problem, htn, osteoporosis
- will have normal LH/FSH until puberty, and then surge when estrogen isn't produced
140
What is lutenization?
- gene expression change and subsequently internal machinery change of follicle granulosa and theca cells in response to LH surge
- increase of LH receptors on granulosa cells
- both granulosa and theca cells will primarly make progesterone (a little estrogen and inhibin A)
141
What are the two classifications of abnormal uterine bleeding/irregular bleeding
- STRUCTURAL (PALM)
- Polyp, Adenomyosis, Leiomyoma, Malignancy/hyperplasia
- NON- STRUCTURAL (COIN)
- Coagulopathy, Ovulatory dysfunction, Iatrogenic, Not yet classified
142
As the progression of syphillis (from primary to secondary to tertiary) in the mother occur, does the risk of the fetus being infected increase or decrease
decreases
biggest risk is during primary and secondary infection
143
Gestational choriocarcinoma:
What is it?
Does it metastasize to other organs? If so, where?
How does it present histologically?
How is the prognosis?
- malignant proliferation of trophoblastic cells
- hematogenous metastases to lung, kidney, liver, cns, vagina
- NO VILLI, proliferation of both trophoblast cell types, necrosis, vascular invasion
- VERY GOOD PROGNOSIS
144
what is the treatment for syphillis? What is a possible side effect
- penicillin
- jarisch herxheimer reaction- as spirochete is killed, releases prostaglandins that cause preterm labor, bronchoconstriction, etc.
145
Endometritis:
What can cause it?
presentation?
- PID, uterine surgery/instrumentation
- fever, chills, pelvic tenderness, pus- filled endometrium, leukorrhea
- with chronic, can have plasma cells in endometrium
146
What type of abortion has a dilated cervix and some passage of fetal material?
What about full passage of fetus
- incomplete abortion
| - complete abortion
147
How many weeks after your last menstrual period can a urine pregnancy test detect a pregnancy?
- 4 weeks from LMP (2 weeks from ovulation)
148
What is a Friedman Curve?
What is the most predictable part of the curve?
For primipara and multipara, how does the most predictable part of the curve differ?
- a predictable curve of how fast cervical dilation occurs
- rate of dilation between 5 cm and 8 cm most predictable (steepest part of curve)
- primipara- 1.2 cm/hr
- multipara- 1.5 cm/hr
149
bacterial vaginosis
what causes it
three diagnostic criteria
presentation
- decrease in lactobacillus (keeps vagina acidic) --> mycoplasma, bacteroides, etc.
- ph >4.5, whiff test, clue cells
- thin vaginal discharge, fishy smell, non pruritic
150
Ovarian serous cystadenoma:
What is it?
pathology?
presentation?
- benign neoplasm, bilateral, older women
- serous fluid, unilocular, smooth lining, stromal papillae with columnar cells with cilia
- pelvic pain, pressure, distended abdomen (USE CT)
151
What does "station" refer to in pregnancy?
- where the presenting part is in reference to the ischial spines
0= ischial spine
-5 = 5 cm above ischial spine
+5 = 5 cm below ischial spine (delivery is imminent)
152
What are two medications used to induce abortion? How do they work?
- mifepristone- progesterone receptor competitor, inhibits prostaglandin dehydrogenase (makes misoprostol more effective)
- misoprostol- prostaglandin, promotes contraction of uterus and dilation of cervix
153
endometroid carcinoma type 2
what is it?
how does it present?
pathology?
genetic mutations
- estrogen independent cancer of the endometrium
- post- menopausal, bleeding, pelvic pain, vaginal discharge, pyometria, hematometria, referred leg pain
- hyperplasia of endometrium, pleomorphic, mitotic, complex, crowded, no real glands or stroma, poorly differentiated
- p53, erbB2
154
What is the development of gonads into either testes or ovary once sex has been determined (ex: formation of penis or clitoris)?
sex differentiation (phenotypic sex)
155
With each type of endometrial hyperplasia, what is the risk of progession to cancer
- simple no atypia- 1%
- complex no atypia- 5%
- simple w/ atypia- 10%
- complex w/ atypia- 25% (technically precancerous)
PENNY, NICKEL, DIME, QUARTER
156
Primordial follicles have ___ epithelium, whereas early and late primary follicles have ____ epithelium
- primordial follicles= simple squamous
- early primary follicle = simple cuboidal
- late primary follicle= stratified cuboidal
157
What are the two types of vulvar squamous cell carcinomas?
- basaloid- due to HPV 16,18, 31 (in situ --> classic vulvar intraepithelial lesion)
- keratinizing -not due to HPV, due to longstanding lichen sclerosis or squamous hyperplasia (in situ --> DIFFERENTIATED vulvar intraepithelial lesion)
158
leiomyosarcoma
what is it?
presentation?
pathology?
- high grade with high recurrence
- presents as fast growing fibroids
- not well circumscribed, atypia, necrosis, hemorrhage
-
159
Meig's syndrome
ovarian tumor (fibroma common) + ascites + pleural effusion
160
ergot alkaloids (methergine)
indication?
mechanism of action
contraindications
- post partium hemorrahge due to uterine atony
- vasoconstrictor
- hypertension
161
What are pituitary causes of late onset hypogonadism in males?
- decrease in GnRh mediated activity
- activation of cytokines (IL 1) that activate corticoadrenal axis
- decrease in LH pulse
- stress- induced LH inhibition
162
For cases of suspect testicular torsion, when should you do doppler ultrasound vs going straight for exploration surgery?
- IF <6 hrs pain and clinical symptoms significant, then go straight to surgery
- if >6 hrs pain and questionable symptoms, then doppler ultrasound
163
what is occiput anterior vs occiput posterior
- anterior: front of baby's head is facing mother's back as its being delivered
- posterior: back of baby's head is facing mother's back as its being delivered
164
if a patient presents with ambiguous genitalia and has no uterus upon ultrasound, what does this mean?
- they are an undervirilized male (AMH present, aka y chromosome present)
(if uterus present, overvirilized female)
165
Treatment of hirsuitism for PCOS?
- oral contraceptives
- spironolactone
- flutamide
- finasteride
166
signs of pregnancy loss on ultrasound?
- Crown Rump length of 7 mm or greater without cardiac activity
- Mean sac diameter of 25mm or greater and no embryo
- Absence of embryo with heartbeat 2 wks or more after U/S showing gestational sac without yolk sac
167
tumor marker for ovarian carcinoma
CA 125
168
If you want to figure out when you are close to ovulating, what lab value should you measure?
LH levels (surge is soon before ovulation)
169
what is the precursor lesion for all germ cell tumors?
Intratubular germ cell neoplasia
170
What two hormones are necessary for proper testicular descent?
- Dihydrotestosterone (DHT) and Insulin like protein 3 (Insl3)
171
What can increase SHBG levels?
- aging
- estrogens
- HIV infection
- hypERthyroidism
- anticonvulsants
172
lymph node drainage of each testis?
- right: interaorticocaval
| - left: paraaortic
173
What is the best tool to view endometrial polyps
SIS ultrasound
174
What is struma ovarii?
How does it present for an ovarian teratoma?
- mature cystic teratoma that has functioning thyroid tissue (secrete thyroid hormone)
- pelvic pain, hand tremors, weight loss, palpitations, dry skin (high thyroid hormone, low TSH)
175
Fibroma + or - thecoma:
What is it?
Pathology?
What other conditions is it associated with?
Presentation?
- benign stromal tumor, usually unilateral
- middle aged women
- homogenous proliferation of spindle cells, fibroblasts, collagen; solid, well circumscribed mass
- associated with meig's syndrome and gorlin syndrome
- usually abdominal pain and girth
176
Diaphragms, condoms, cervical caps, and other barriers should be used in conjunction with what?
spermicide
177
if a patient presents with ambiguous genitalia and has palpable gonads, what does this mean?
- they are male ( have SRY gene and Y chromosome)
| if no palpable testicles, then could be undescended testes, ovaries, or ovotestes
178
What do clomephine and letrozole do?
- decrease estrogen levels to stimulate FSH production to promote ovulation
- clomephine- selective estrogen receptor modulator
- letrozole- aromatase inhibitor
179
What are testicular causes of late onset hypogonadism in males?
- decrease in leydig cells
- decrease in leydig cell function
- age-related decrease in steroidgenesis
180
Which nerve roots in the brachial plexus are effected in erb vs. klumpke palsy?
erb- c6, c5
klumpke- c8, t1
181
Tubo-Ovarian Abcess:
What is it?
What causes it?
What does it present as?
- fallopian tube filled with fluid and infected
- severe PID/acute salpingitis (chlamydia and gonorrhea), actinomyces, and tuberculosis
- fever, cervical motion tenderness, pain, purulent discharge, on ultrasound looks like hotdog (hydrosalpinx)
182
How do copper IUD's prevent pregnancy?
- inhibits fertilization
- copper ions damage sperm motility
- can be used for emergency contraception BEFORE implantation occurs (creates inhospitable, leukocytic environment)
- can increase menstrual bleeding
183
extramammary paget disease
- infiltration of dermis with large glandular neoplastic cells (cytoplasm positive for mucin, aka adenocarcinoma cells)
- scaly, pruritic, red lesion
184
During the proliferative phase of the menstrual cycle, what is the ratio of stroma to glands?
What is the difference between the secretory glands in the later proliferative phase vs the secretory phase
- 1:1 ratio (more glands in secretory phase)
- in late proliferative phase, glands are tubular and elongated
- in secretory, glands are dilated, and filled with secretion and serrated/irregular
185
risks for type 1 endometroid cancer
- tamoxifen treatmet
-estrogen exposure
- early period
- late menopause
- obesity
- endometrial hyperplasia
- anovulation (pcos)
- family history
radiation of pelvis
186
difference between primary hsv and recurrent?
- primary : viremia, diffuse lesions, pain
| - recurrent: no viremia, focal lesions, pain (morel likely in pregnancy)
187
endometrial hyperplasia
- what causes it
- presentation?
- pathology?
- treatment?
- unopposed estrogen stimulation of the endometrium (estrogen from peripheral conversion of adipose tissue, HRT, or tumor)
- chronic anovulation from PCOS, Obesity (no progesterone opposing)
- abnormal uterine bleeding, mostmenopausal bleeding
- irregular dilated glands and some normal, < 1/3 is stroma (rest differs based on simple vs. complex vs atypia)
- PROGESTERONE, + hysterorectomy if atypia and done having children
188
what is the most common cause of postpartum hemorrhage ?
uterine atony
189
_____ is painless ulcers, whereas _____ is painful ulcers
- syphillis- painless
| - HSV- painful ulcers
190
periurethral abcess?
What is it?
How does it present?
risk factors?
How far can it spread?
- infection of male urethra and periurethral tissues
- scrotal swelling, fever, acute urinary retention, spontaneously drained abscesses, dysuria, urethral discharge
- gonorrhea, chlamydia, UTI, urinary obstruction, trauma immunocompromised
- if it breaks through bucks fascia, it can spread to buttocks and all the way up to clavicle
191
blood pressure physiologically increases during which trimester of pregnancy?
- third trimester
192
what is vasa previa? what are two things it is associated with?
- placental vessels lie above the internal os of the cervix (can rupture during fetal movement or induced rupture of membrane)
- velamentous cord, accessory placental lobe
193
Male obesity associated secondary hypogonadism (MOSH)
- low testosterone
- low or inappropriately normal LH/FSH
- BMI >30
194
what is avidity? what does low vs. high avidity mean?
- affinity/tightness of antibody to antigen
- low avidity- recent infecton
- high avdity- remote infection
195
treatment for seminoma and nonseminoma
- seminoma- surgery and radiation
- non seminoma- if stage 1, retroperitoneal lymph node dissection (RPLND)
can do surveillance if T1
- stage 2, small volume and normal markers, RPLND
large volume and elevated markers, chemo
if RPLND shows positive nodes, if small volume, surveillance, if large, chemo
196
Why do patients with Klinefelter's syndrome have small testes?
prepubertal fibrosis of the seminiferous tubules resulting in very small, firm testes
197
What can decrease SHBG levels?
- obesity
- nephrotic syndrome
- hypOthyroidism
- corticoids, progestins, androgenic steroids
198
How many years after thelarche should you experience menarche?
2-3 years
199
What are leopold's maneauvers?
- hand positioning to determine orientation of the fetus during pregnancy
- determination of the presenting part: that part of the fetus CLOSEST to the maternal cervix
200
etiologies for large for gestational age
When should you offer cesarian section?
- constitutionally large
- family history of large born babies (macrosomia)
- gestational diabetes (type 2 dm)
- beckwith wiedemann (large tongue, large body)
- if baby 4500 g and gestational dm, OR if 5000 g and no dm
201
what are the three theories of the pathogenesis of menstruation
- retrograde menstruation (goesthrough fallopian tube and into peritoneal cavity)
- lymphatic spread to distal organs
- coelomic metaplasia
202
what is the classic triad of signs of ectopic pregnancy?
- amenorrhea, abdominal pain, vaginal bleeding
203
in children/young adults, what type of ovarian tumor can be common?
- teratoma/germ cell tumor
204
What two ovarian neoplasms can cause ascites?
- fibroma and epithelial ovarian cancer
205
IUD's and sterilization work by preventing ______
fertilization
206
risk factors for vaginal prolapse
- obesity
- posture
- family history
- baby delivery
207
____ stabilizes internal wolffian structures, whereas _____ androgenizes external genitalia
- testosterone
| - dihydrotestosterone (DHT)
208
how do you define postpartum hemorrhage
- >500 ml at vaginal delivery
| - >1000 ml at c section
209
what are three reasons why a woman of reproductive age wouldn't ovulate (anovulation)?
- hypothalamus (absence of pulsatile GnRH due to stress, opioids, anorexia, high intensity exercise)
- pituitary (tumor, prolactinoma, hypothyroidism that causes increased TRH, hypopituitarism)
- ovarian failure (iatrogenic, chromosomal, premature menopause)
210
What are risk factors for aneuploidy
- increased maternal age
- increase paternal age (over 50)
- previous pregnancy with chromosome problem
- previous recurrent pregnancy loss
211
For Complete androgen insensitivity:
- what is the karyotype?
- what are the external genitalia?
- mullerian ducts present?
- wolffian ducts present?
- body features?
- 46 XY (think tall, curvaceous female)
- vagina with blind pouch, aka female externally
- mullerian ducts absent (y gene present --> sry gene present --> amh present)
- wolffian ducts absent (testosterone can't bind to androgen receptor)
- gynecomastia, scant adrenarche, primary amenorrhea, female habitus
212
What are hypothalamic causes of late onset hypogonadism in males?
- decrease in GnRH neurons
- decrease in GnRH pulse
- decrease in norepinephrine
- increase in peptide Y
213
match the following phases
```
follicular phase (ovary): ____ phase (uterus/endometrium)
luteal phase (ovary): _____ phase (uterus/endometrium)
```
- proliferative phase
| - secretory phase
214
Uterine Leiomyoma:
What is it?
What does it present as?
Pathology?
- myometrial fibroids
- enlarged uterus, can be asymptomatic, abnormal uterine bleeding, infertility, dysmenorrhea, intermenstrual bleeding, recurrent pregnancy loss
- well circumscribed, smooth muscle spindles (NO ATYPIA/MITOSIS), whorled appearance, bulky uterus, irregular contour
215
Sertoli- Leydig Cell Tumor:
What does it secrete?
pathology?
presentation?
- malignant, secretes testosterone
- solid, lobulated, yellow/orange, microscopically looks like testis and presence of leydig cells
- virilization, hirsutisim
216
causes of breech presentation
```
High parity (maternal abdominal musculature)
Poly/oligohydramnios
Uterine anomalies (Muellerian or myomas)
Abnormal placentation (previa)
Multiple gestation
Fetal anomalies
Muscular/neurologic disorders in fetus
PRETERM
```
217
what is human placental lactogen (hPL)?
- created by syncyctioblasts
- decreases mother's sensitivity to insulin
- can exacerbate likelihood gestational diabetes
218
Corpus Luteum Cyst:
What is it?
What does it look like (pathology)
Is surgery necessary?
- corpus luteum that seals off after ovulation; vessels penetrate and can cause hemorrhage inside or outside
- yellow (granulosa cells converting cholesterol), lined by granulosa cells
- surgery only if symptomatic
219
For partial androgen insensitivity:
- what is the karyotype?
- what are the external genitalia?
- mullerian ducts present?
- wolffian ducts present?
- body features?
- 46 XY
- ambiguous AS HECK external genitalia (can range from normal male to vagina with blind pouch)
- mullerian ducts absent (y gene present --> sry gene present --> amh present)
- wolffian ducts most likely present
- gynecomastia, normal to decreased adrenarche, beard
220
twin twin transfusion syndrome
- anastamoses between vasculature of twins in utero
- donor smaller than receiver
- use laser treatment to fix
221
What's the average age for puberty in females? What is the average age of menopause?
- puberty- 12 years old
| - menopause- 51 years old
222
Epithelial Ovarian Cancer:
How does it metastasize
- signs of metastasis
- pathology
- malignant epi cells slough off and into peritoneal cavity (also lymphatic and hematogenous)
- ascites, sister mary joseph nodule, irregular solid mass, septations, vascularity
- lobster claw papillae, pleomorphic, psamomma bodies
223
What lab value is the key determinant of proper embryonic growth prior to the first ultrasound?
HCG
224
Diagnostic Criteria for PCOS
1) Anovulation (< 8 periods/year)
2) Hirsuitism (F G >8)
3) Polycystic ovaries (>12 that are <10 mm in size)
4) Diagnoses of exclusion (hypothyroidism, prolactinoma, CAH
NEED 2 of 3 as well as #4
225
what is the gold standard to test for HSV?
- tissue culture (PCR is also good)
226
true/central precocious puberty
- due to pituitary/hypothalamic axis
- high LH/FSH and high sexual steroids
- GnRH pulse
- increased growth, gonadal enlargement, breast development
- advanced bone age
- can be caused by tumors, trauma/inflammation, cysts, or idiopathic
- GET IMAGING FOR MEN
227
Oral contraceptives prevent pregnancy by inhibiting ______.
Which hormone is responsible for preventing LH surge?
Which hormone is responsible for preventing FSH increase?
- ovulation
- progesterone
- estrogen
228
What are signs/symptoms of testicular torsion?
- acute onset pain, high riding testicle, horizontal lying, tender, scrotal swelling later on, decreased blood flow into testes
229
What type of abortion has a dilated cervix and bleeding?
threatened abortion
230
what are signs of delayed puberty
- no initial changes in puberty by 13 (girls) and 14 (boys)
| - 4 years between thelarche/testicular growth and menarche/end of growth
231
Side effects of Congenital rubella syndrome
- growth restriction
- cataracts
- deafness
- septal defects
pulmonary stenosis
encephalitis
mental retardation
232
What are three tumor markers for testicular cancer?
For seminoma, which tumor marker will never be elevated?
What are the half life for the markers?
- AFP, bHCG, LDH
- AFP
- AFP- 5-7 days
- HCG- 2-3 days
233
What LH/FSH levels should you expect in primary hypogonadism in men?
- high LH and FSH ( adequate pituitary response to low testosterone)
234
risk factors for vaginal prolapse
- obesity
- posture
- family history
- baby delivery
235
what is uterine didelphys?
what is the gold standard for viewing mullerian abnormalities?
- two vaginas, two uteri
- one vagina is open to the outside, other is not
- can present with pain during periods + suprapubic mass (accumulation of blood in closed vagina)
- Mullerian abnomalities = MRI
236
endometroid carcinoma type 1
what is it?
how does it present?
pathology?
genetic mutations
- estrogen dependent cancer of the endometrium
- premenopausal, obesity, anovulation, situations of estrogen excess, presents with abnormal bleeding
- hyperplasia of endometrium, pleomorphic, mitotic, complex, crowded, no real glands or stroma, well differentiated
- pten, kras mlh1
237
If a child presented with precious puberty, and you decided to do a GnRH stimulation test, what would happen to FSH/LH levels if they had central precocious puberty? What about peripheral precocious puberty?
- central precocious puberty- LH/FSH would reach pubertal levels because pituitary is already primed to GnRH pulsations
- peripheral precocious puberty- LH/FSH would remain supressed because pituitary has not been previously primed to pulsatile GnRH
238
What are the 3 types of vaginal prolapse?
anterior wall (cystocele), posterior wall (rectocele), apical prolapse
239
endometrial polyp:
What is it?
What is one common cause?
pathology?
risk for malignancy?
- masses that project into endometrial cavity
- tamoxifen treatment
- two histologic types: functional and hyperplastic/cystic (has blood vessels that allow it to grow out)
- 5% risk for malignancy, risk increases if post menopausal, >1.5 cm, or abnormal bleeding
240
What is a normal fetal heart rate?
110-160 bpm
241
What type of abortion has an dilated cervix but no passage of material
inevitable abortion
242
side effects of zika in baby? in adults?
- microcephaly, ventriculomegaly, brain destruction, retinal infection, arthrogryopis
- fever, rash, conjunctivitis, arthralgias guillan barre
243
menopause
- amenorrhea for 12 months
244
Does estrogen replacement increase bone mass or reduce bone resorption?
reduce bone resorption
245
What are decidual cells? Where do they originate from?
- originate from the endometrium, differentiate in presence of progesterone and invasion of trophoblasts
- obtain glycogen and lipid, provide nutrition before placenta fully formed
- release relaxin, prostaglandin, and prolactin
246
risk factors of endometrial hyperplasia
- obesity
- anovulation
- tamoxifen
- estrogen use
- history of breast/colon, gyn cancer
247
what are the three events/phases of the ovarian menstrual cycle
follicular phase --> ovulation --> luteal phase
248
Gorlin syndrome
basal cell carinoma + ovarian fibroma
249
What causes a skene's cyst and bartholin's cyst/abcess?
- mucus backup in the gland
| for abcess, bacteria is present during back up, bacteria that is commonly in vagina
250
For HPV screening:
What testing should you do for women under 30
What testing for you do for women over 30?
- cytology only for under 30
| - cytology and HPV for over 30
251
in men, LH causes ____ cells to release ____
- Leydig cells
| - testosterone
