Prolog Flashcards by Emily Holthaus

Fructose, the energy source in sperm, is absent in cases of

obstructive azoospermia

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number one genetic cause of premature ovarian failure

Fragile X

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how long after bariatric surgery to wait for pregnancy?

12-18 months

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Oral contraceptives can reduce the risk of ovarian cancer by approximately __% in BRCA1 mutation carriers

50%

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Women with exercise-induced amenorrhea have __ leptin levels than ovulatory females

lower

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normal AMH

1.5 - 6ish

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Initial evaluation of premature thelarche should include (labs)

blood estradiol and TSH levels and bone age

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whole arm exchange between acrocentric chromosomes =

robertsonian translocation

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administration of cyclic progesterone for a patient with polycystic ovary syndrome mimics

involution of the corpus luteum

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Which is better in pregnancy, bromocriptine or cabergoline?

Cabergoline

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A thrombophilia panel is indicated when losses occur after __ weeks, when __

10 weeks

when thrombosis can occur in the vasculature of the placenta.

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treatment for postpartum thyroiditis

observation

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Postpartum thyroiditis almost exclusively affects

thyroid antibody-positive women.

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The ovulation induction medication most likely to result in high-order multiple gestation

gonadotropin

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The most common form of congenital adrenal hyperplasia is deficiency in

21-hydroxylase

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genetic inheritance of CAH

autosomal recessive

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A small percentage of patients with CAH may be hyper- tensive secondary to mineralocorticoid deficiency. These patients typically have a deficiency in __ enzyme

11β-hydroxylase

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Patients who fail to achieve puberty, who are hyper- tensive, or who have primary amenorrhea should be evaluated for __ deficiency

17α-hydroxylase

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cutaneous pigmentations, polyostotic fibrous dysplasia, and multiple endocrine abnormalities

McCune Albright syndrome

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child walking with limp, hyperpigmented lesions on skin, low LH and FSH

McCune Albright syndrome

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treatment for McCune Albright

aromatase inhibitor

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Children with premature adrenarche are more likely to develop adult

PCOS

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Evaluation for premature adrenarche includes (6 labs)

DHEAS, FSH, LH, testosterone, TSH, and morning 17-hydroxyprogesterone

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2 benign conditions of the ovary that are unique to pregnancy and lead to hirsutism and virilization

Ovarian luteoma

hyperreactio luteinalis

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the presence of multiple theca-lutein cysts bilaterally due to hCG stimulation

Hyperreactio luteinalis

HRT risks in study

increased risk of stroke in estrogen only and E+P | increased risk of stroke, cardiac, breast cancer in E+P

only environmental factor proven to impact SA and and ferility

hot tub use

men heterozygous for CF have congenital absence of

vas deferens

the best chance for conception is on the day of

LH surge

Deficiency in __ secretion is a serious condition associated with Sheehan syndrome

ACTH | Because adrenal insufficiency can result in a life-threatening adrenal crisis

how to test for adrenal insufficiency

early-morning serum cortisol levels

The technique associated with IVF most likely to identify a genetically normal ongoing pregnancy is

trophectoderm biopsy

most common EMB finding in PCOS with heavy bleeding

disordered proliferative endometrium

What imaging should you use for the detection of uterine anomalies?

three dimension ultrasound

28-year-old nulligravid woman comes to your office with primary infertility. She has regular menstrual cycles. Hysterosalpingography is normal. Her partner’s repeat semen analysis confirms oligospermia. Physical examination demonstrates palpable varicoceles when standing and with Valsalva maneuver. The best next step in management for the male partner is

varicocelectomy

Ashkenazi Jewish 23-year-old nulligravid woman visits your office with irregular menstrual cycles. She is interested in becoming pregnant. She has seen her dermatologist for acne and hirsut- ism and has been shaving her chin weekly for the past 10 years. On physical examination, she has acne on her face and mild hair growth on her upper lip and chin. She shows no signs or symptoms of virilization.

Late-onset congenital adrenal hyperplasia (or nonclassic adrenal hyperplasia) --- onset of hirsutism around menarche

how to diagnose late onset CAH

morning follicular 17α-hydroxyprogesterone

mutation in Late-onset congenital adrenal hyperplasia

50–80% loss of 21-hydroxylase activity (P450c21 enzyme) due to mutations in the CYP21A2 gene

most common tumor that causes central precocious puberty

hypothalamic hamartoma

What happens in hypothalamic hamartoma

astroglial cells within the tumor release transform- ing growth factor-beta protein to induce GnRH release from the hypothalamus

three syndromes that cause peripheral precocious puberty

McCune–Albright syndrome Peutz-Jeghers syndrome silver-russell syndrome

normal FSH levels

midcycle peak 15-35 | postmenopause 24-170

describe Fragile X mutations

dynamic trinucleotide repeat (CGG) sequence mutation in the X-linked FMR1 gene at the terminal end of the long arm of the X chromosome

19-year-old nulligravid woman comes to your office with primary amenorrhea. She is 1.75 m (69 in.) tall with Tanner stage 1 breast development and Tanner stage 3 pubic hair. Her follicle- stimulating hormone level is 52 mIU/mL. Her endocrine screening is otherwise normal. Her karyotype is 46,XY diagnosis?

Swyer syndrome

gonadectomy

frequency with which patients will have at least one patent fallopian tube at 3 months after Essure microinsert placement is

less than 5%

Male Secondary hypogonadotropic hypogonadism can be caused by __ and __.

obesity and anabolic steroids

how to achieve pregnancy in Kallman syndrome

human menopausal gonadotropins

The most accurate way to evaluate insulin resistance in patients with PCOS is

hyperinsulinemic euglycemic clamp

DHEAS is almost exclusively derived from __

the adrenal glands

Name 4 commonly used bisphosphonates

alendronate sodium, ibandronate sodium, risedronate sodium, and zoledronic acid.

The earliest test that will identify a diminished ovarian reserve is

AMH

hyperandrogenism in pregnancy with bilateral ovarian enlargement, multicystic ovaries

hyperreactio luteinalis (multiple benign theca-lutein cysts)

A 19-year-old woman with primary amenorrhea and lack of breast development visits your clinic. She is 1.73 m (68 in.) tall and weighs 63.5 kg (140 lb). On physical examination, she has Tanner stage 1 breast development and Tanner stage 1 pubic hair. Genital examination reveals a cervix. Her follicle-stimulating hormone and luteinizing hormone levels are 76 mIU/mL and 64 mIU/mL, respectively. Her estradiol level is less than 20 pg/mL. The most likely diagnosis is

Swyer

Individuals with Kallmann syndrome typically have__ gonadotropin levels.

low

relative to laparoscopic-assisted surgery, robotic-assisted surgery increases her risk of

small-bowel obstruction

how to diagnose Cushing syndrome

overnight dexamethasone suppression test

FDA)-approved bioidentical hormone prescribed for menopausal symptoms

17β-estradiol

time that the window of fertilization ends is

the day of ovulation

The type of stem cells that presently hold the most promise for stem cell-based therapy for infertile patients is

induced pluripotent

the sterilization method most amenable to surgical reversal is

laparoscopic application of a band or clip

Criteria Used to Calculate the 5-Year Risk of Breast Cancer According to the Modified Gail Model

age, age at menarche, age at first live birth, number first degree relatives w breast cancer, number previous breast biopsies, whether any breast bx has shown atypical hyperplasia, race

karyotype and serum T level for: Complete androgen insensitivity syndrome (CAIS)

46,XY karyotype and serum testosterone in the male range

karyotype and serum T level for: Pure gonadal dysgenesis (Swyer syndrome)

46,XY karyotype and serum testosterone in the female range

karyotype and serum T level for: Trisomy X syndrome

47,XXX karyotype and serum testosterone in the female range

most likely genetic disorder: A 53-year-old woman was recently diagnosed with breast cancer. She has a paternal grandmother with breast and ovarian cancer and a father with prostate cancer. She is most likely to have a mutation associated with a region in exon 11 of the mutated gene.

BRCA2 mutation

most likely genetic disorder: Autosomal dominant disorder associated with mutations of the STK11 gene that causes tumors of the gastrointestinal tract, breast, ovary, cervix, and testis as well as mucocutaneous pigmentation.

Peutz–Jeghers syndrome

most likely genetic disorder: Germline mismatch mutation of the MLH6 gene that confers a higher risk of endome- trial cancer and a slightly lower risk of colorectal cancer compared with MLH1 and MSH2 mutations.

Lynch II syndrome, ie, hereditary nonpolyposis colorectal cancer

Corticosteroids increase placental production of this hormone

Corticotropin-releasing hormone (CRH)

Human placental lactogen is a product of the placenta and has __like activity.

growth hormone

most likely circulating serum level of LNG in pg/mL: 30-microgram ethinyl estradiol with 150-microgram LNG oral contraceptive (OC) pill 24 hours after ingestion

2,000–3,000

most likely circulating serum level of LNG in pg/mL: Single-dose progestin-only emergency contraceptive 2 hours after ingestion

10,000–15,000

most likely circulating serum level of LNG in pg/mL: A 5-year LNG intrauterine device (IUD)

100–200

likely diagnosis for a woman with hirsutism and High 24-hour urinary free cortisol

Cushing syndrome

likely diagnosis for a woman with hirsutism and Total testosterone level of 300 ng/dL Follicular phase morning blood tests showing 17-hydroxyprogesterone level of 488 ng/dL

Sertoli–Leydig cell tumor

laparoscopic surgery with Tachycardia, hypoxia, hypotension, and decreased end tidal carbon dioxide (CO2)

Gas embolism

Prolog Flashcards

(76 cards)