OB Correlates Flashcards
1
Q
Left Ovarian vein and testicular veins drain to
A
Left renal vein
2
Q
Right ovarian and right testicular vein drains to
A
IVC
3
Q
Surgical abdomen
Board like rigidity
From hypercoagulability in pregnancy
A
Ovarian vein thrombosis
4
Q
Most common blood vessel in pelvic thrombophlebitis
A
Left Ovarian veins emptying into left renal vein
5
Q
Which anticoagulant can be given in pregnancy
A
Heparin
6
Q
APAS (hypercoagulable state) give
A
heparin
7
Q
Antidote for heparin toxicity
A
Protamine sulfate
8
Q
Most varicoceles are found on the
A
Left side bec of 90 degree drainage of left testicular vein to left renal vein
Assoc with left renal tumor
9
Q
Bridge over troubled water during hysterectomy
A
Iliac artery over ureter
10
Q
Pudendal canal aka
Transmits
A
Alcocks canal
Internal pudendal artery, vein and nerves pass
11
Q
Alcock’s canal is derived from the fascia of the muscle
A
obturator internus
12
Q
Syndrome presenting with congenital absence of uterus and vagina
A
Mullerian dysgenesis
Mayer Hauser Rokitansky Kuster syndrome
13
Q
Hypogonadism
Anosmia
A
Kallman syndrome
14
Q
Dec in levels activate puberty
A
GABA
15
Q
Causes decrease in circulating LH and prolactin
A
Dopamine
16
Q
Dec AMPLITUDE of GnRH
A
Estrogen
17
Q
Dec FREQUENCY of GnRH
A
Progesterone
18
Q
Stimulatory pulsatile/inhibitory continuous
A
Neuropeptide Y in stressful situations
19
Q
GnRH is secreted in
A
pulsatile manner
20
Q
Reproductive process begins in the
A
brain
21
Q
Low GnRH pulse frequency
A
FSH synthesis
Progesterone
22
Q
High GnRH frequency
A
LH synthesis
Progesterone
23
Q
Constant release of GnRH leads to
A
Drastic reduction of gonadotropic response
Desensitization
Downregulation
Rx: GnRH agonist (FSH)
24
Q
We test for B HCH bec the different subunit in hormones are
A
Beta !!
25
Acts on granulosa cells
FSH
26
Acts on theca cells
LH
27
Plays a role in follicle growth and maturation
FSH
28
Plays a role in ovulation
LH
29
Goals of ovarian cycle
Produce a mature follicle
| Steroidogenesis of estrogen, progesterone
30
On the follicular and midcycle the steroid produced is
estrogen
31
On the lutesl cycle the steroid produced is
progesterone (inhibitory to GnRH)
32
Causes completion of Meiosis I and becoming secondsry oocyte prior ovulation
LH surge
33
Arrest of oocyte development happens in
Metaphase
34
Non growing oocyte arresting prophase of meiosis
| Envelopes by single layer of spindle granulosa cells
Primordial follicle
35
Unilaminar or multilaminar
Primary preantral follicle
36
Change of pregranulosa layer to single layer of cuboidal cell
First change of follicle development
Unilaminar preantral follicle
37
Surrounding by zona pellucida
Complete granulosa prolif
Dependent on hormone:
And correlated with inc:
Multilaminar preantral follicle
FSH
ESTROGEN
38
Critical feature in rescuing cohort of follicles from atresia
Allows dominant follicle to emerge and pursue ovulation
Initiates steroidogeneis: estrogen production
FSH rise
39
Androgen substrate is converted into estrogen via aromatization by
FSH!
40
Gonad ind recruitment of primordial follicle from resring pool and their growth to antral stage
Regulare grabulosa cell prolif
Growth differentiation factor 9
| Bone Morphogenetic protein 15
41
Transforming growth factor B superfamily
Secretory product of granulosa cells in preantral and small antral folllicle
Inhibits premature follicle growth
Anti Mullerian Hormone
| Take anytime of the cycle
42
Inc in production of follicular fluid in intracellular space eventually forming cavity
Antral follicle
43
Granulosa cell sureounding oocyte
Cumulus oophorus
Fluid rich in hormones, gf, cytokines
44
Excessive inc in estrogen initiates this feedback on hypo
Positive
If enough, negative feedback
45
Recruitment of a cohort
Selection of dominant follicle
Growth of selected dominant follicle
Follicular phase
46
Goal of two cell system
Accelerate estrogen production with help of theca cells responding to LH to produce ANDROGEN
47
Inhibits FSH
Inhibin
48
What hormone gonadotropin peaks before ovulation
LH
Peak at 10-12h prior ovulation
Stimulates resumption of meiosis metaphsse II in 2nd meiotic division
49
Cervical mucus becomes thinner and more stretchy
Resting body temp rises 0.4 and 0.6
LH surge occurs in 24 h prior ovularion detected with home testing kit
Twinges of ovarian pain mittlesmerchz
Signs of ovulation
50
Rapid neovasc of once avasc granulosa
| Hypertrophy and inc capacity to synthesize hormones
Luteal phase
| Luteinization
51
Transformation from ruptured follicle to corpus luteum is regulated by
LH
52
Prevents involution of or rescues corpus luteum
6 weeks AOG
Detected 8-9 days postovulation
Produced by:
Peaks: 60-70d AOG 10w
HCG
| synciotrophoblasts
53
Most biologically potent naturally occuring estrogen
17B estradiol
54
Endometrial layer affected by hormones
Basalis
55
Hallmark of secretory phase in endometrium
Subnuclear vacuolization
56
Secretion or glyocgen in endometrial cavity
Secretory phase
57
Return to non pregnant state
Involution
58
Puerperium is
4-6 w postpartum
59
Episiotomies heal in
1-2 w
60
Blood volume postpartum returns to normal after
1 week
61
Cardiac ouput returns to normal after
2 weeks
62
Peripartum cardiomyopathy lasts until
6 months postpartum a dilated type
63
Injury to Lumbosacral root resulting in footdrop
Predisposed by
Obstetrical neuropathy
Increased weight
Gravid uterus
at third tri
64
Pfannenstiel cut may damage the nerve
ilioinguinal
| Iliohypogastric
65
Foot drop is caused by
Especially when positioned this way during delivery
Common peroneal fibular nerve
Stirrups
66
Numbness of lateral thigh common during pregnancy
Meralgia Paresthetica
| Lat femoral cutaneous nerve
67
Damage to femoral nerve occurs during
Prolonged hip flexion
| Weak quads problem with knee ext
68
Shedding of decidua superficialis
lochia
69
Lochia 1-3d
Rubra
70
Lochia at 4-10th day
Serosa
71
Lochia at >10d 14
Alba
72
Foul lochia indicates
Poor healing DM
Infection
Retained secundines
73
When fever persists more than 3 days despite IV antimicrobials consider
Parametrial phlegmon
74
Occurs within 10d postpartum
| Resolve in 3 days after
Postpartum blues
75
Postpartum blues
```
Fatigue
Discomfort
Apprehension on care of baby
Jealousy and dec security
Inability to satisfy husband’s needs
```
76
Delayed with lactation
bec of
return of menses
Prolactin inhibiting GnRH
77
In nonlactating mothers, menstruation returns in
7-8 w
78
Post partum check up
4-6 w
79
Pap smear after
6 months
80
38 C above
| on any 2 of the first 10d postpartum
Puerperal infection
81
Most common cause of post op fever during first 24h post op in surgery
atelectasis
82
Top cause of puerperal infection
Mastitis by
| Staph aureus
83
Most common cause of abortion
Ovular or fetal factor
| Maternal factor
84
Early fetal wastage
| Gross defect in ovum or fetus
Ovular or fetal factor
85
Most common chromosomal abnormality
Autosomal trisomy
86
Most common maternal factor inducing abortion
infection PID
87
Violin string adhesions PID spreading to abdominal cavity
Fitz Hugh Curtis Syndrome
88
Gold standard for dx of PID
Laparoscopy
89
Process of abortion started but not progressed to state from which recovery is impossible
Threatened
90
Uterine size comparable with A/G
| External os closed
Threatened abortion
91
Changes have progressed to a state from which continuation of pregnancy is impossible
Inevitable abortion
92
Inc vaginal bleeding
Aggravation of pain
Dilated internal os
Inevitable abortion
93
Sonographic evidence of nonviable pregnancy of more than 8 weeks
Missed abortion
94
Minimal bleeding, closed internal os
Missed abortion
95
Products of conception EXPELLED EN MASSE
Complete abortion
96
Hx of expulsion of fleshy mass
Subsidence of abd pain
Cervical os closed
Intact expelled fleshy mass
Complete abortion
97
Most common type of abortion
Incomplete abortion
98
Smaller uterus
Palpable tissue at os
Incomplete expelled mass
Incomplete abortion
99
Passage of tissue, incomplete do
D & C
Empty uterus
100
Minimal bleeding and cramping
| Empty uterus: utz
Complete abortion
101
Sheehan syndrome on MRI
Pituitary apoplexy/hemorrhage
102
Habitual abortion:
3 or more consecutive abortions
103
Work up for habitual abortion
```
Thyroid study
Parental karyotype
Hysterosalpingography
APAS
SLE
```
104
Most common abortifacient in PH
Misoprostol
cytototec
prostaglandin analog PGE1
Also enhances cervical ripening
vasodilator
105
PGE2 is
dynoprostone
106
Uteroplacental apoplexy
Bluish purple copper disc of uterus by extravasion into myometrium
Couvelaire uterus
107
Pregnancy is diabetogenic bec of
HPL
Placental insulinase (degrades insulin, inc resistance)
Elevated cortisol and progesterone
108
GDM is
Type IV
109
Women with high plasma glucose levels, glucosuria and ketoacidosis
Overt diabetes
110
Screening for GDM should start in
24-28 weeks in women not known to have glucose intolerance early in pregnancy
111
50g glucose load given without fasting
| Value confirmatory of GDM
>200mg/dl
112
if FBS is >130mg%?
no need to do
OGTT
Overt DM
113
GDM complication
Inc perinatal loss
| Macrosomia (hydramnios, congenital fetal malformation)
114
Congenital malformations in women with overt DM
```
Caudal regression
Situs inversus
Spina bifida hydroceph CNS defect
Anencephaly
Heart anomalies
Anal/rectal atresia
Renal anomalies (agenesis, cystic kidney and duplex ureter)
```
115
Disorder or syndrome impairing development of lower half of body
Caudal syndrome
116
Anti hypertensive assoc with renal agenesis
ACE i
117
Anticonvulsant assoc with neural tube defects
Valproic acid
118
What drug used for tx of multiple myeloma causes significant congenital anomaly of limbs
thalidomide
119
When is screening for GDM done in women at high risk?
first clinic visit
120
Blood test for DM are more apt to be abnormal than in the non pregnant state due to
inc placental lactogen
