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OB/GYN > Quiz 2 > Flashcards

Quiz 2 Flashcards

1
Q

Cards 24-31 from Q1 deck

A
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2
Q

Be able to draw menstrual cycle - take to Dr. Seibert to review prior to final exam.

A
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3
Q

How does the pituitary know which one to release FSH or LH because both are stimulated by GnRH release from hypothalamus?

A

The characteristics of the Pulsitile release determines which one is released.

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4
Q

Steroids are derived from _______ and produced by ______, _____ and _______

A

Cholesterol
Ovaries, testes and adrenal cortex

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5
Q

69% of sex hormones (estrodiol and testosterone) are bound to ______
30% bound to _______
And 1% is _____

A

SHBG (sex hormone binding globulin produced by the liver)
- that’s why estrogens help with acne - they accelerate the SHBG production so less free hormones are circulating. Also helpful with menopause. ONLY with ORAL form.

Albumin
Unbound/free

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6
Q

Estrogens are derived from ________ and converted by ______

A

Androgens/testosterones
Aromatase.

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7
Q

Estrone comes from _____
Estrodiol (2) comes from ______
Estriol (3) comes from _______

A

Body fat
Ovaries
Placenta (3rd source)

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8
Q

Eggs are arrested in _______

A

Prophase I - after “crossing over occurs”

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9
Q

A woman will ovulate about ______ times in her life

A

400

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10
Q

What is AMH (anti-mullerian hormone) a measurement of?

A

Secreted by Granulosa cells - a marker of reserve.

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11
Q

Activism stimulates ______ synthesis and secretion
Inhibin ______ FSH.

A

FSH
Inhibits - you don’t want a pregnancy with 12 fetuses.

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12
Q

Granulosa cells have ______ receptors and produce ______ to convert ________ into ______
Theca cells have ______ receptors and produce ______ that are converted to ______ by _______

A

FSH
Aromatase
Androgens
Estrodiol
LH
Androgens
Estrodiol
Aromatase from Granulosa cells.

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13
Q

What is the signal for the LH surge?

A

Estrodiol positive feedback a sustained 200pgx50hours. This triggers hypothalamus to pulse out GnRH like crazy to trigger the LH surge (with a little FSH trailing behind)

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14
Q

GnRH pulses during early follicular phase = ________
GnRH pulses during mid-follicular = ______ = ______
Ovulation = ______ = _________
Post ovulation + progesterone influence = _______

A

Rapid + shallow
Increasingly rapid rate = increased FSH
Very rapid and deep = LH surge.

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15
Q

Estrogen generally has a ________ on the hypothalamus that ______ FSH release

A

Negative
Inhibits

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16
Q

Which hormone is responsible for spinnbarkeit thin stretchy cervical mucus?
Thick?

A

Estrogen. - to facilitate sperm. Swimming.
Progesterone - to form a plug and protect the uterus

17
Q

What hormone inhibits LH, relaxes myometrium and tubes, develops breast lobules and promotes the secretory endometrium?

A

Progesterone

18
Q

T/F: during early menarche (11-15) there is earlier ovulation due to the body’s sensitivity to hormones

A

True. You could get pregnant during your period.

19
Q

Follicular/proliferative phase is dominated by _______

A

FSH and E2

20
Q

Draw slide 51 - feedback loops - add to diagram

A
21
Q

When does hCG first appear?
How long does it stimulate the CL progesterone secretion?

A

9-13 days after ovulation
For 9-10 weeks or 100 days until the placenta takes over.

22
Q

What does SERM mean and what is an example?

A

Selective Estrogen Receptor
Clomiphene (Clomid) - tricks the pituitary into producing more FSH and LH (act as as anti-estrogen)

23
Q

No period by age 14 with no secondary sex characteristics is known as _________ amenorrhea.

A

Primary

24
Q

Secondary amenorrhea is absence of _____ cycles (regular period) or _____ (irregular period)

A

3
6months

25
Q

If you’re not ______ then you don’t get your period.

A

Ovulating.

26
Q

What is the progesterone challenge?

A

Give progesterone for 5-10 day. There should be withdrawal bleeding within 14 days of stopping the Pg - if this bleeding occurs, then ANOVULATION is the reason.

27
Q

What labs do you draw in amenorrhea?

A

TSH, prolactin.

28
Q

Make a flow chart for amenorrhea.

A
29
Q

If you give estrogen and Pg and you DO have withdrawal bleeding, what is the cause? if you do NOT have withdrawal bleeding?

A

Ovarian failure (not producing estrogen)
Endometrium failure (unable to respond to estrogen) OR
Ectopic production of prolactin.

30
Q

Asherman’s syndrome - do chart on this.

A
31
Q

How can we asses ovarian function?
In ovarian failure, FSH and LH will be _______
Pituitary or CNS failure, FSH and LH will be ______

A

High. (Chromosome eval. - Fragile X?)
NL or low

32
Q

What is the normal prolactin level?

A

20-100. >100 considered abnormal.

33
Q

What is going wrong with the IV compartment (hypothalamus) if there is amenorrhea?

A

Weight loss, anorexia, bulimia, exercise, stress (deployment), OCP (post-pill), Kallmann’s Syndrome (amenorrhea+anosmia).

34
Q

Compartment III - Pituitary - what could go wrong?

A

Empty Sella Syndrome - subarachnoid tissue doesn’t separate pituitary from Hypo-T

Sheehan’s syndrome - acute necrosis of pituitary (PP syndrome)
-failure of lactation, loss of pubic and axillary hair, can be life threatening.

Pituitary adenoma.

35
Q

Compartment II - ovaries - what could go wrong?

A

Turner’s Syndrome, Mosaicism, XYY Gonadal Dysgenesis, Gonadal a genesis, resistant ovary syndrome, premature ovarian failure, radiation and chemotherapy.

36
Q

Compartment I - uterine/outflow tract

A

Asherman’s
Mullerian Anomalies
Androgen Insensitivity (testicular feminization)

37
Q

Meds/herbal remedies that cause AUB

A

Warfarin, heparin, NSAIDs, hormonal contraceptives, ginkgo, ginseng, motherwort.

38
Q

PALM-COEIN

A

Structural Causes
Polyp
Adenomyosis (endometrial tissue IN the myometrium)
Leiomyoma (uterine fibroids)
Malignancy and hyperplasia

Non-structural
Coagulopathy
Ovulatory dysfunction
Endometrial
Iatrogenic
Not yet classified

39
Q

Make a card about Lynch syndrome?

A

OB/GYN (6 decks)

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