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Flashcards in Naz teaches infertility Deck (49):
1

Most likely cause of anovulation

PCOS

2

Labs of PCOS

↑ Lh/ FSH ratio (LH> FSH)
↑ Testosterone

3

What is infertility

cannot get pregnant for 1 year (pts over 35 get worked up quicker)

80% of couples get pregnant in one year

4

What makes GnRH

Hypothalamus

5

When is HCG made

hCG secretion begins around the time of
implantation of blastocyst.

Blastocyst “sticks” at day 6

6

When does the heart beat?

4 weeks

also upper and lower limb buds begin to form.

4 weeks = 4 limbs and 4 heart chambers

7

When can you see the heartbeat on US

6 weeks

8

Aminoglycosides do what to baby

ototoxic

9

When do you measure FSH

Day 3 labs
(3 days into period)

Day 3 labs are
FSH and estradiol levels, AMH levels, and AFC).

10

What test do you do to see if you ovulate

LH surge at home urine kit

Basal body temperature (↑ progesterone --> ↑ temp)

if progesterone is low, so is fertility

11

Estrogen stimulates __________

endometrial proliferation.

12

Progesterone does?


maintains endometrium to support implantation.

13

Oligomenorrhea is

> 35-day cycle.

14

Polymenorrhea is?

15

Metrorrhagia

Frequent or irregular menstruation.

16

Menorrhagia

Heavy menstrual bleeding; > 80 mL blood loss or > 7 days of menses.

17

Menometrorrhagia

Heavy, irregular menstruation.

18

Day 21 serum progesterone labs help because?

Basal body temperature (↑ progesterone --> ↑ temp)

if progesterone is low, so is fertility

19

Ovarian causes of infertility

-PCOS
-Advanced maternal age
-Premature ovarian failure
-Hypothalamic amenorrhea
-Hyperprolactinemia

20

Tubal factors of infertility

-PID/ salpingitis
-Tubal ligation
-Endometriosis
-Pelvic adhesions

21

Uterine factors of infertility

-Congenital malformations
-Submucosal fibroids
-Uterine polyps
-Intrauterine synechiae (Asherman’s syndrome)

22

Cervical factors of infertility

-Müllerian duct abnormalities
-Cervical stenosis
-Cervicitis or chronic inflammation

23

List the Medications Used in the Treatment of Infertility and in Assisted Reproductive Technologies

-Clomiphene citrate
-Metformin
-HCG
-Pulsatile GnRH/ gonadorelin
- Letrozole

24

Letrozole is?

Aromatase inhibitor,
reduces androgen conversion to estrogen,
stimulates follicular development for ovulatory induction

25

gonadorelin is?

GnRH agonist, stimulates release of FSH/LH from pituitary

26

Novarel is?

Human chorionic gonadotropin

Similar structure to LH, triggers ovulation after gonadotropin folliclestimulation

27

metformin helps get pregnant via?

Insulin sensitizer, decreases insulin,testosterone, BMI; promotes ovulation

28

Clomiphene citrate is

Anti-estrogen, stimulates follicular development for ovulation induction

29

Day 3 labs are:

FSH and estradiol levels, AMH levels, and AFC

30

Clomiphene citrate works via?

-antiestrogen, binds to estrogen receptors in the hypothalamus-->
- ↑ FSH and LH -->
-follicular maturation and ovulation

31

Clomiphene citrate is best used for?

women with chronic anovulation or mild hypothalamic insufficiency after specific causes of hypothalamic dysfunction have been ruled out.

32

Human menopausal gonadotropins are used for?

a form of FSH, or FSH + LH
directly stimulate follicular maturation in patients for whom Clomid has failed,

33

ovarian Hyper-stimulation syndrome

Very dangerous
fertility stuff--> ovarian enlargement, torsion, and rupture

34

Risk factors for endometrial carcinoma include

nulliparity
late menopause
hypertension
exposure to unopposed estrogens.
*obesity confers the greatest risk of developing endometrial carcinoma,

35

Approximately 80-90% of women with endometrial carcinoma present with ?

vaginal bleeding or discharge as their only presenting symptom

36

Top Five Cancers Detected in Women:

Breast 28%
Lung 14%
Colon 10%
Uterine 6%
Ovary 3%

37

Risk factors for endometrial cancer include

late menopause
unopposed estrogen therapy
nulliparity
obesity
Tamoxifen therapy
diabetes mellitus.

38

Unopposed estrogen replacement therapy does increase the risk of endometrial cancer, but not when?

taken in combination

39

Routine eval for endometrial ca would include

chest x-ray- lungs most common site for mets

40

The recommended components of the surgical approach to an early endometrial cancer are ?

extrafascial total abdominal hysterectomy
bilateral salpingo-oophorectomy
pelvic and para-aortic lymphadenectomy.

41

The most common causes of postmenopausal bleeding are

atrophy of the endometrium (60-80%)
hormone replacement therapy (15-25%)
endometrial cancer (10-15%)
polyps (2-12%)
hyperplasia (5-10%).

Any history of vaginal bleeding requires assessment of the endometrium.

42

Tamoxifen is known to cause changes to the endometrium, including?

thickening
thus US does not help you eval if apt is getting CA from the drug
If they do get CA, likely to show symptoms

43

Dermoid tumors usually have solid components or appear echogenic on ultrasound, as they may contain ?

teeth, cartilage, bone, fat and hair

44

An intravenous pyelogram (IVP) is an x-ray examination of the?

kidneys, ureters and urinary bladder that uses iodinated contrast material injected into veins.

45

The most likely diagnosis of the adnexal mass that would also explain the finding of endometrial hyperplasia would be a?

granulosa cell tumor (sex-cord stromal tumor)

46

In all patients with advanced ovarian cancer, post-operative chemotherapy with a combination of _______________- is considered standard of care in the United States.

a taxane and platinum adjunct

47

The most common tumor found in women of all ages is the ?

dermoid. The median age of occurrence is 30 years, and 80% occur during the reproductive years. Dermoids may contain differentiated tissue from all three embryonic germ layers.

48

dermoid median age of occurrence is ?

30 years, and 80% occur during the reproductive years.

49

Dermoids may contain?

differentiated tissue from all three embryonic germ layers.

Dermoid tumors can contain teeth, hair, sweat and sebaceous glands, cartilage, bone, and fat.