Repro Gen Flashcards
(97 cards)
1
Q
What BhCG levels is IUP visible at
A
≥ 1500-2000 Won’t see in uterus before this
2
Q
Pregnancy loss before 20th week of gestation
A
spontaneous abortion
3
Q
3 MC areas of defect for infertility
A
failure to ovulate
tubal deformity or dysfn cilia
endometriosis
4
Q
What should you check if a pt has low estrogen in reproductive yrs?
A
folliculogenesis
5
Q
atresia
A
degeneration of those ovarian follicles that do not ovulate during the menstrual cycle
6
Q
Maturation and ovulation of multiple follicles
A
fraternal twins
7
Q
one fertilized ovum splits in two
A
identical twins
8
Q
What hormone causes basal body temp to inc?
A
progesterone
9
Q
ectocervix cell comp
A
squamous epithelium
10
Q
endocervix cell comp
A
glandular epithelium
11
Q
MC genital infection
A
HPV
12
Q
Pap smear guidelines
A
start at 21 perform yearly x 3 yrs if nrml begin every 3 yrs
Age 30-65: cotesting with HPV
13
Q
What is most common cause of post menopausal bleeding?
A
atrophy
14
Q
Partial mole
A
(paternal and maternal- normal ovum fertilized by 2 sperm
69 chromosomes
15
Q
Complete mole
A
(paternal origin) - empty ovum fertilized by 2 sperm (or one that duplicates)
46 chromosomes
16
Q
High risk HPV
A
16, 18, 31, 33
17
Q
Low risk HPV
A
6, 11
18
Q
MC uterine tumor
A
Leiomyoma
19
Q
When does first ovulation occur after menarche
A
6-9 months
20
Q
How much blood loss is there in nrml meses
A
<80 mL (30-80 mL avg)
21
Q
What are are dominant hormones during follicular phase - days #1-14?
A
FSH and estrogen
22
Q
What is the dominant
hormone of the luteal phase days #14-28?
A
progesterone
23
Q
What does positive withdrawal bleed with progestin withdrawal test for secondary amenorrhea indicate
A
Endometrium is normal, normal estrogen levels, outflow tract is normal
Patient is not ovulating
24
Q
What does negative withdrawal bleed with progestin withdrawal test for secondary amenorrhea indicate
A
No endometrial proliferation
Estrogen deficiency -OR- Outflow tract abnormality
25
Which hormone causes proliferation of the endometrium?
estrogen
26
What hormone level can be checked to confirm ovulation has occurred?
progesterone
27
What is the female athlete triad?
eating disorder (anorexia), amenorrhea, osteopenia (or osteoporosis)
28
Dysmenorrhea
Painful menstrua>on, normally occurring with ovulatory cycles
29
mc reported menstrual disorder
Dysmenorrhea
30
Infertility
the inability to conceive after 1 year of unprotected intercourse
31
MC female causes of infertility
ovulatory disorder or tubal factor
32
Heterotopic pregnancy
Twin pregnancy: simultaneous intrauterine and ectopic pregnancy
33
Oligomenorrhea
dec freq >35 d
34
Polymenorrhea
inc freq <21 d
35
Menorrhagia
inc amt
| >7 d or >80 ml
36
Metrohagia
irregular interval
37
Menometrohagia
irregular interval and excessive amount
38
Hysteroscopy
Scope connected to video unit and light inserted through cervical canal to evaluate uterine cavity
can use to dx and treat
39
Pre-menopause endometrial lining
2-16mm depending on stage of
| menses
40
post-menopause endometrial lining
<5 mm
41
Hysterosalpingogram (HSG)
X-ray of uterus and fallopian tubes using fluoroscopy
Evaluate patency and architecture of fallopian tubes
Dx and treat
42
CA-125
Blood test used to indicate malignancy (biomarker)
Expressed by 80% of epithelial cell tumors
Premenopausal > 200 U/mL = concerning Postmenopausal >35 U/mL = concerning
43
Current pap recommendations (American Society for Colposcopy and Cervical Pathology)
Initiate paps @ 21yo
every 3 years for 21-29 yo
Pap with HPV co-testing every 5 years for 30-65yo
Discontinue after 65yo if adequate negative screening past 10yr and no high-grade dysplasia in the past 20yr
44
MC benign cervical neoplasm
Cervical Polyps
45
MC gyn ca in women ww
Cervical Cancer
46
When does normal menses occur and what is a normal menstrual cycle?
11-13 yo
Duration 3-7 days (avg 5d)
Blood loss <80 mL (30-80 mL)
Cycle 21-35 days (avg 28d)
47
Define primary amenorrhea
Absence of menarche by age 16 years in presence of normal pubertal development
Absence of menarche by age 14 years in absence of normal pubertal development
Absence of menarche 2 years after completion of sexual maturation
48
What are the dominant hormones during follicular phase - days #1-14?
Estrogen and FSH
49
What is the dominant
| hormone of the luteal phase days #14-28?
LH
50
What is the effect of estrogen on the endometrial lining?
causes it to proliferate
51
What is the most important step in evaluation of primary amenorrhea?
Transvaginal Ultrasound to confirm presence of uterus
52
What is necessary and sufficient for production of testes?
Y chromosome and DRY gene
53
What do sertoli cells produce?
AMH
54
What do Leydig cells produce?
Testosterone and DHT
55
What is the effect of activin on FSH
enhances FSH secretion by blocking effect of inhibin at pituitary
56
Effect of inhibin on FSH
inhibits pituitary production and release of FSH
57
Effect of testosterone
Gonadotropin Feedback
Spermatogenesis
Sexual Differentiation
Anabolic effects Libido
58
Effect of DHT
Prostate development
External Virilization
Sexual maturation at puberty
Baldness
59
The administration clomiphene (a SERM in the hypothalamus) would most likely have what effect on LH?
Increased LH synthesis from the anterior pituitary
60
What is the MC form of prostatitis?
Chronic Abacterial prostatitis
61
What is the most common cancer of internal organs in males?
prostate ca
62
Where does prostate arise from?
peripheral zone mostly posterior so easily detected on rectal exam
63
MC histology of prostate ca
adenocarcinoma
64
MC place of prostate ca mets
Vertebral bones, lung & liver
65
MC hisiology of penis carcinoma
SCC
66
MC cause of orchitis or epididymitis in male <35 yo
Chlamydia, syphilis and gonorrhea
67
MC cause of orchitis or epididymitis in male >35 yo
E. coli and Pseudomonas
68
What does BhCG have to be for home preg test to register?
> 25-50 mIU/mL
69
With US when can you see gestational sac?
yolk sac?
fetal pole?
fetal heart motion?
Gestational sac = 4-5 weeks
Yolk sac = 5 weeks
Fetal pole = 6 weeks
Fetal Heart motion (FHM) = 6.5 wks
70
How is a viable pregnancy confirmed?
fetal pole + FHM
71
```
Recommended wt gain for mother:
underweight
nrml weight
overweight
obese
```
underweight- 25-40 lbs
nrml weight- 25-35 lbs
overweight- 15-25 lbs
obese 10-20 lbs
72
What should preg woman avoid due to toxoplasmosis
undercooked meat and car litter
73
What should preg woman avoid due to listeria
Cold deli meat
Unpasteurized cheese or dairy
Unwashed fruits and vegetable
74
When should preg women avoid travel?
>36 wks
75
Freq of prenatal visits
Q 4 weeks until 28 wks
Q2weeks 28wks–36wks
Weekly at 36 wks until delivery
76
What does fundal height tell you about GA?
Corresponds to GA ± 2 cm
ie: 20 cm fundal height is 20 wks
77
When should women be offered aneuploidy screening?
< 20 wks
78
When should contractions prompt a woman in 3rd trimester to come in?
If < 37 wks (pre-term) q 15min
If > 37 wks (term) “5/1/1”
79
Ways to prevent post-term pregnancies
Sweeping of membranes
Ambulation
Intercourse
Nipple stimulation
80
When should you consider induction of labor?
Induction of labor > 41wk can be considered
| Induction of labor > 42wk recommended
81
Salpingectomy vs Salpingostomy
Salpingectomy –remove entire fallopian tube
Salpingostomy – remove pregnancy only
82
Monozygotic
1 sperm 1 egg
splits in 2
identical
83
Dizygotic
2 sperm 2 eggs
| fraternal
84
ABO and RhD ability to cross palcenta
ABO - IgM – does not cross placenta
| Rh D - IgG – crosses placenta
85
What are the cardinal mvts of labor?
1. engagement
2. descent
3. flexion
4. internal rotation
5. extension
6. external rotation
86
Stages of labor
Stage 1- Onset of labor to full dilation of the cervix
Stage 2- Fulldilation to delivery of baby (varies in length)
Stage 3- Delivery of baby to delivery of placenta (usually lasts < 30 min and takes only 2-5 mins)
Stage 4- Puerperium
87
3 ps of abnormal labor
power
passenger
pelvis
88
When would you perform a classic c-section?
preterm breech, transverse back-down fetus, distorted anatomy (e.g. leiomyomata, adhesions)
89
When should woman return to menstruation after pregnancy?
6-8 wks following delivery
90
Maternal benefits of breastfeeding
dec postpartum depression, boosts weight loss, minimizes hemorrhage
91
MC benign breast condition
Fibrocystic Breast Disease
92
chlamydia screening recommendations
Annual chlamydia all sexually active women <25
93
syphilis, HIV, chlamydia & HBV screening
pregnant women
94
Trichomonus & HPV screening
annually for HIV+ women
95
STIs to report to health dept
```
Chlamydia
Gonorrhea
Neonatalherpes
Syphilis
Chancroid
```
96
HPV vaccine
Two doses 6‐12 months apart ages 9‐14
or
Three doses at 0, 1 & 6 months ages 15‐26
97
5 ps of STI risk
partners, practices, prevention of pregnancy, prevention of STIs, past hx of STIs
