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Flashcards in Week 1 Deck (324):
1

What does the Bony Pelvis consist of

2 Hip bones
Sacrum
Coccyx

2

Each hip bone is a fusion between

- Ilium
- Ischium
- Pubis

3

What is the medial aspect of the Ilium called

Iliac fossa

4

The sacrotuberous ligament is between

The sacrum and Ischial tuberosity

5

The Sacrospinous ligament is between

The sacrum and Ischial spine

6

Which ligament is most anterior, sacrospinous or sacrotuberous?

Sacrospinous

7

What is the function of the Sacrotuberous and Sacrospinous ligaments?

Ensure the inferior part of the sacrum is not pushed superiorly when weight is suddenly loaded vertically through the vertebral colum

8

What two foraminae are formed by the Sacrotuberous and Sacrospinous ligaments?

Greater and lesser sciatic foraminae

9

The pelvic inlet is formed by what bony features?

- Sacral Promontry
- Ilium
- Superior pubic ramus
- Pubic symphysis

10

The pelvic outlet is formed by what bony features?

- Pubic symphysis
- Ischiopubic ramus
- Ischial tuberosities
- Sacrotuberous ligaments
- Coccyx

11

Where is the pelvic cavity?

Between the Pelvic inlet and pelvic floor, continous with the abdominal cavity above

12

What is the pelvic floor?

The levator ani muscle

13

What is a straddle injury

Fracture of all four pubic rami

14

In terms of Fetal skulls, what is moulding?

Refers to the movement of one bone over another to allow the fetal head to pass through the pelvis during labor

15

What are the "soft spots" of the fetal scull called?

Fontanelles

16

The anterior fontanelle has what shape?

Diamond

17

The posterior fontanelle has what shape?

Triangle

18

Where is the anterior fontanelle

In the meeting point of the coronal suture and sagittal suture

19

Where is the Posterior fontanelle

At the meeting point of the sagittal suture and the lambdoid suture

20

In terms of childbirth, what is "station"

The distance of the fetal head from the ischial spine. A negative number means the head is superior to the spine, a positive number means the head is inferior to the spines.

21

During childbirth, a baby has a negative 2 station. What does that mean?

It means that the fetal head is 2 measurments SUPERIOR to the ischial spines.

22

During childbirth, when the fetal head descends through the pelvic cavity, should the head be in the anatomical position, flexed or extended?

Flexed
Chin on chest

23

When the fetal skull leaves the pelvic cavity, the face should face?

Downward and the should be in extension

24

What is the blood supply to the ovaries

Helicine arteries enters from the broad ligament

25

What is a common site for ovarian cancer

The simple cuboidal epithelium, outermost part of the ovary

26

Where in the Ovary are the follicles

In the Cortex

27

During what stage of embryonic development does germ cells form oogonia in the ovaries

Week 6

28

Oogonia later undergo meiosis to form

Mature Oocytes (also called Ova)

29

Development of ooyctes is called

Oogenesis

30

What does a follicle consist of

The oocyte and any associated support cells

31

When is the number or germ cells in the ovaries the largest

At birth
About 1 million

32

Loss of oogonia and oocytes by an apoptosis-based process is called

Atresia

33

During what stage of Meiosis does an oocyte stop prior to birth

Prophase 1

34

What happens to the oocyte in the largest follicle a day before ovulation

Complete meiosis 1,
Produces one secondary oocyte and one polar body that is discarded

35

When is Meiosis 2 completed for a female oocyte

After ovulation
It then produces a second polar body

36

After ovulation the follicle transforms into

Corpus luteum

37

What happens to Corpus luteum if implantation does not occur

Becomes Corpus albicans

38

What protects the Corpus luteum from degeneration, what secretes it

HCG
Placenta secretes it

39

What does Corpus luteum secrete

Estrogen
Progesterone

40

What type of layer is the Endometrium

Inner secretory mucosa

41

Myometrium consists of

3 layers of smooth muscle
Collagen
Elastic tissue

42

What are the two layers of the Endometrium, difference

Stratum Functionalis
Stratum Basalis
Functionalis is is shed during menstruation

43

What are the phases of the Endometrium

Proliferative phase
Secretory phase
Menstrual phase

44

What is secreted by the endometrium during the secretory phase

Glycogen

45

The corkscrew appearance of the endometrium is during what phase

Secretory phase

46

What is the place of the cervix where cancer is common

The Squamocolumnar junction

47

What are the layers of the vagina

Non-keratinized stratified squamous epithelium
Lamina Propria
Fibromuscular layer
Tunica Adventia

48

Which hormone stimulates granulosa cells to produce Estrogen

Follicular Stimulating Hormone

49

What inhibits FSH production

Increased Estrogen
Inhibin from dominant follicle

50

What is atrestia

Periodic process in which immature ovarian follicles degenerate and are subsequently re-absorbed during the follicular phase of the menstrual cycle

51

What happens during the Luteal phase

Formation of Corpus luteum
Progesterone production increase

52

What are the Ovarian phases of the Menstrual cycle

Follicular phase
Luteal phase

53

Which hormones are released from the Pituitary to regulated menstrual cycle

FSH
LH

54

What are the Endometrial phases of the Menstrual cycle

Proliferative phase
Luteal phase
Menstruation

55

What happens during the proliferative phase to the endometrium

Growth of endometrial glands and stroma

56

Which hormones induces growth of endometrium during the proliferative phase

Estrogen

57

What happens to the Endometrium during Luteal phase

Glandular secretory activity

58

Which hormone induces changes during the Luteal phase

Progesterone

59

What happens to the endometrium during Menstruation

Arteriolar constriction and shedding of functional endometrial layer
Fibrinolysis inhibits scar tissue formation

60

How long is normal menstrual loss last?

4-6 days

61

When is menstrual flow peak normally

Day 1-2

62

What is normal menstrual loss volume and apperance

63

What is normal length of a menstrual cycle

21-35 days

64

What is IMB stand for

Intermenstrual bleeding
Bleeding between the normal menstruation periods

65

What is PCB

Postcoital bleeding
Non-menstrual bleeding that occur right after intercourse

66

Prolonged and increased menstrual flow is called

Menorrhagia

67

Regular intermenstrual bleeding is called

Metrorrhagia

68

Menses occuring at

Polymenorrhea

69

increased bleeding and frequent cycle is called

Polymenorrhagia

70

Prolonged menses and intermenstrual bleeding is called

Menometrorrhagia

71

Absence of menstruation >6 months

Amenorrhea

72

Menses at intervals of >35days

Oligomenorrhea

73

Is Menorrhagia pathological

Can be, but 50% of cases are non-organic causes

74

Which endocrine disorders may cause Menorrhagia

Hyper/hypothyroidism
Diabetes mellitus
Adrenal disease
Prolactin disorders

75

What is DUB

Dysfunctional Uterine Bleed

76

What are the two subdivisions of Dysfunctional Uterine Bleed

Anovulatory - 85%
Ovulatory

77

Who gets Anovulatory Dysfunctional Uterine Bleed

Occurs at extremes of repro life
More common in obese women

78

Who gets Ovulatory Dysfunctional Uterine Bleed

More common in age 35-45

79

What causes Ovulatory Dysfunctional Uterine Bleed

Inadequate progesterone production by corpus luteum

80

How is the cycle in Anovulatory Dysfunctional Uterine Bleed

Irregular

81

How is the cycle in Ovulatory Dysfunctional Uterine Bleed

Regular heavy periods

82

Non-surgical treatment of DUB

Progestogens
Combined OCP
Danazol
GnRH analogues
NSAIDS
Anti-fibrinolytics
Capillary wall stabilizer
Mirena IUS

83

Surgical treatment of DUB

Endometrial resection/ablation
Hysterectomy

84

Which Hormone replacement therapuy is needed after hysterectomy

Estrogen-only HRT (unless cervix is retained)

85

What is the definition of Assisted Conception Treatment (ACT)

Any Treatment which involves gametes outside the body

86

How many couples need infertility assessment in the UK

1/6 couples

87

How many live births in the UK are the result of ACT

2%

88

What is the folic acid requirement prior to conception with ACT

0.4mg/day for 12weeks

89

Which immunisation status needs to be checked prior to ACT

Rubella

90

What is the Alcohol and Weight requirements prior to ACT

Alcohol - max 4 units/week female
Weight - BMI 19-29 both sexes

91

What ACT are available

Donor insemination
Intra-Uterine Insemination (IUI)
In Vitro Fertilization (IVF)
Intra-Cytoplasmic Sperm Injection (ICSI)
Surrogacy

92

What are the indications for Intra Uterine Insemination

Unexplained infertility
mild or moderate endometriosis
mild male factor infertility

93

How is Intra Uterine Insemination done

Natural or stimulated cycle
Prepared sement inserted into uterine cavity around time of ovulation

94

What are the Indications for In Vitro Fertilization (IVF)

Unexplained infertility >2years
Pelvic disease
Anovulatory infertility
Male factor infertility
Pre-implantation genetic diagnosis

95

What pelvic diseases may cause infertility

Endometriosis
Tubal disease
Fibroids

96

What type of drug is Buserelin

Gonadotropin-releasing hormone (GnRH) agonist

97

What happens when Buserelin is taken for an extended period

Down Regulation of of GnRH receptors, reduced LH and FSH

98

What are side effects of Buserelin

Hot flushes and mood swings
Nasal irritation
Headaches

99

How is Buserelin administred

Nasal Spray
Injection

100

What are the steps of IVF

Down regulation
Ovarian Stimulation
Egg collection and fertilization
Embryo transfer
Luteal phase support

101

What type of drug is given during Ovarian Stimulation in IVF

Gonadotrophin Hormone
(Gonal-F, Menopur)

102

During Ovarian Stimulation, what does Gonadotrophin Hormone cause

Follicular development

103

Side effects of Gonadotrophin Hormone

Mild allergic reactions
Ovarian Hyper Stimulation Syndrome (OHSS)

104

What is injected to induce ovulation in IVF treatment

HCG (Ovitrelle)

105

At what time is HCG (Ovitrelle) injection given in relation to egg collection

36h prior

106

What is the HCG (Ovitrelle) injection suppose to mimic

LH surge

107

How long does a man have to be abstinence before sperm collection

72hours

108

What is looked at during Sperm assessment

Volume
Density - numbers of sperm
Motility - what proportion is moving
Progression - how well they move

109

How is sperm prepared for IVF

Removal of seminal plasma to concentrate the specimen

110

Embryo transfer is best successful at what stage of development

Blastocyst

111

At what day is the embryo a Blastocyst

Day 5

112

How many eggs can be transferred in IVF

Age 40 - 3 may be transferred in exceptional circumstances

113

What is given after insertion of embryo

Luteal phase support
Cyclogest pessaries (progesterone)

114

When is pregnancy test done after embry transfer

2 weeks post transfer

115

What are the indications for Intra Cytoplasmic Sperm Injection (ICSI)

Severe male factor infertility
Previous failed fertilization with IVF

116

What is the indication for Surgical Sperm Aspiration

Azospermia
Low motility sperm

117

How is ICSI done

Each egg is stripped
Sperm immobilized
Single sperm injected
Incubated at 37C overnight

118

What is Ovarian Hyper Stimulation Syndrome

Enlarged ovaries - Excess Follicles

119

What are the symptoms of Ovarian HyperStimulation Syndrome

Abdominal pain/bloating
Nausea/Diarrhea
Breathless
Mild/Moderate/Severe symptoms

120

What does ART stand for in relation to fertility

Assisted Reproductive Technology

121

What governing body controls Assisted Reproductive Technology

HFEA
Human Fertilisation and Embryology Authority

122

What are the steps of IVF treatment

Down regulation
Ovarian stimulation
Oocyte retrieval
Embryo transfer
Luteal support

123

Complications of ART

Multiple pregnancy
Ovarian Hyperstimulation syndrome
Ectopic pregnancy

124

What is the success rate for IVF

around 35%

125

How long can embryo research be done according to law

Up to 14 days
(when primitive streak appears)

126

Which organism is predominant in the healthy vagina? Produces what to supress other bacteria growth

Lactobacillus spp.
Lactic acid
+/- Hydrogen peroxide

127

Predisposing factors to candida infection

Recent antibiotic treatment
High Estrogen levels (pregnancy, certain contraceptives)
Poorly controlled diabetes
immunocompressed

128

Presentation of vaginal trush

Intensively itchy white vaginal discharge

129

What is the causative organism of vaginal trush

Candida albicans

130

What is the test for vaginal trush

High vaginal swab for culture

131

What is the treatment for Candida infection

Topical Clotrimazole pessary or cream
Oral fluconazole

132

How does Candida present in males

Candida balanitis
Spotty rash on head of penis

133

What are the symptoms of Bacterial Vaginosis

Thin, watery, fishy-smelling vaginal discharge

134

What is the test for Bacterial Vaginosis

pH test
Raised pH >4.5

135

What is the causative organism of Bacterial Vaginosis

Many.
Gardnerella vaginalis/Mobiluncus sp
Others including anaerobes

136

What is the treatment for Bacterial vaginosis

Metronidazole orally

137

Laboratory test for Bacterial Vaginosis

High vaginal swab
Looks for clue cells on micropsope.
Subjective and inaccurate

138

What are the classifications of Prostatitis

Acute bacterial prostatitis
Chronic Bacterial Prostatitis
Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS)

139

What are the symptoms of Acute Bacterial Prostatitis

Symptoms of UTI but may have lower abdominal pain/back/perineal/penile pain and tender prostate on examination

140

Causative organism in Acute Bacterial Prostatits

Same as UTI (E.Coli, coliforms, enterococcus sp.)
Check for STI in patients

141

Diagnostic test for Acute Bacterial Prostatitis

MSSU for C&S
+/- first pass urine for Chlamydia/Gonorrhea test

142

Treatment of Acute Bacterial Prostatitis

Ciprofloxacin for 28days
Trimethoprim for 28 days if high C.Diff risk

143

What are the most common Bacterial STI

Chlamydia
Gonorrhea
Syphilis

144

What are the most common Viral STI's

Genital Warts
Gential Herpes
Hepatitis
HIV

145

What are the most common Parasitic STI's

Trichomonas Vaginalis
Pubic lice/Crabs
Scabies

146

What organism cause Chlamydia

Chlamydia Trachomatis

147

What organism cause Gonorrhea

Neisseria Gonorrhoeae

148

What organism cause Syphilis

Treponema pallidum

149

What cause Genital warts

Human papilloma virus

150

What cause Genital herpes

Herpes Simplex virus

151

What organism cause Crabs

Phthirus pubis

152

Where does Chlamydia Trachomatis infect

Urethra, rectum, throat, eyes in male and female
Endocervix in females

153

What type of bacteria is Chlamydia trachomatis

Obligate intracellular bacteria with biphasic life cycle

154

Is Chlamydia trachomatis gram positive or negative

Neither
It does not stain with Gram Stain (no peptidoglycan in the cell wall)

155

What is the treatment for uncomplicated Chlamydia

Azithromycin (1g oral dose)

156

What type of bacteria is Neisseria gonorrhoeae

Gram negative diplococcus

157

Describe the look of Neisseria gonorrhoeae on gram film

2 kidney beans facing each other

158

Where does Neisseria gonorrhoeae infect

Urethra, rectum, throat and eyes in male and female
Endocervix in females

159

What does Fastidious organism mena

Does not survive well in less than ideal growth conditions (ie. outside the body)

160

What type of discharge, if any, is there in Gonorrhea

Purulent discharge

161

Diagnostic test for Chlamydia and Gonorrhea

Combined Nucleic Acid Amplification Test (NAAT) or PCR.
Test for both in 1 test

162

What are the samples for Chlamydia and Gonorrhea test in males

FIRST pass urine sample
NOT MSSU

163

What are the samples for Chlamydia and Gonorrhea test in females

High vaginal swab OR
Vulvo-vaginal swab (VVS) OR
Endocervical swab

164

Other test sites for Chlamydia and Gonorrhea then genitalia

Rectal (MSM)
Throat swab
Eye swabs (Especially babies)

165

For what swabs is culture of gonorrhea done

Endocervical, rectal and throat swabs
NOT HVS

166

What is the benefit of doing culture on suspected Gonorrhea

Check for antibiotic sensitivity

167

In a GP setting, what is the benefit of sending a swab for PCR/NAAT over culutre

PCR/NAAT is positive even if organism dies in transit

168

What is the treatment of Gonorrhea

Ceftriaxone Intramuscular
Azithromycin oral

169

What is the follow-up after gonorrhea treatment

Test of cure

170

Which one of Gonorrhea and Chlamydia has developed antibiotic resistance

Neisseria Gonorrhoeae

171

What disease does Treponema pallidum cause

Syphilis

172

Is Treponema Pallidum Gram +ve or -ve

Neither, it does not stain

173

What type of media is Treponema Pallidum grown on

None. cannot grow in culture media

174

What is the investigation to test for Syphilis

PCR
Serological tests to detect Antibodies

175

How many stages of Syphilis and what are they

Primary
Secondary
Latent stage
Late stage

176

What is the presentation in Primary Syphilis

Chancre

177

What happens to the organism during primary Syphilis

Organism multiplies at inoculation site and gets into bloodstream

178

Treatment for chancre during primary syphilis

Nothing (treat syphilis)
Chancre will heal without treatment

179

What happens to organism during secondary stage of Syphilis

Large number of bacteria circulating in blood with multiple manifestations at different sites

180

What is the presentation during secondary syphilis

"Snail track" mouth ulcers
Generailized rash
Flu-like symptoms
Hair loss

181

What happens to organism during Latent stage of Syphilis

Low-level multiplication of spirochaete in intima of small blood vessels

182

What is the presentation during latent stage of syphilis

No symptoms

183

What is the presentation during late stage Syphilis

Cardiovascular or neurovascular complications

184

How does the syphilis rash during secondary stage look

The rash can look like rough, red, or reddish brown spots on the palms of your hands and/or the bottoms of your feet

185

How is Syphilis diagnosed

Swab primary or secondary lesion.
Dark ground microscopy to look for spirochaetes
PCR
Serology Ab

186

What type of Serology tests are done in Syphilis, what do they indicate

Non-specific, indicate how active the disease is and response to treatment
Specific, confirms the diagnosis. Ab is present after cure

187

What are the non-specific Serology testings done in Syphilis

VDRL (Venereal Diseases Research Laboratory)
RPR (Rapid Plasma Reagin)

188

What are the specific Serological tests done in Syphilis

TPPA (T.Pallidum Particle agglutination assay)
TPHA (T.Pallidum hemagglutination assay)
IgM and IgG ELISA

189

Which is the test used for screening of Syphilis

IgG and IgM ELISA

190

Treatment of Syphilis

Injectable long-acting preperations of penicillin

191

What type of HPV most commonly cause Genital warts

6 and 11

192

What type of virus is HPV

Non-enveloped icosohedral virus containing double stranded DNA

193

How is Genital warts spread

Close genital skin contact

194

How is Genital warts diagnosed

Clinically
No routine microbiology lab test

195

What is the treatment for Genital warts

Cryotherapy
Podophyllotoxin cream/lotion

196

What age is HPV vaccine given

Age 11-13 girls

197

HPV immunization covers what strands of HPV

6, 11, 16, 18

198

How does Genital warts look

Whiter than surrounding skin with a rough surface

199

Genital herpes is caused by what strand of herpes

Herpes simlex virus 1 and 2

200

What type of virus is the Herpes simplex virus

Enveloped virus containing double-stranded DNA

201

How is Herpes simplex virus spread

Transmitted by close contact with someone shedding the virus
Genital/genital OR
Oropharyngeal/genital contact

202

What nerve endings does Herpes simplex virus get into

Sensory and autonomic nerves

203

Where is the Herpes virus when it is dormant (gential herpes)

Sacral root ganglion

204

What is the presentation of primary infection of herpes

Asymptomatic or very florid
Painful multiple small vesicles

205

Herpes simplex virus, does virus shedding occur all the time, or only during outbreaks

During outbreaks and also intermittently between symptoms

206

Where does the herpes simplex virus replicate

In dermis and epidermis

207

Diagnosis of Gential herpes, test

Swab deroofed blister and send for PCR

208

Treatment of Genital herpes

Aciclovir may be helpful if taken early enough
Pain relief

209

What is Trichomonas vaginalis

Single celled protozoal parasite that cause Trichomoniasis

210

What are the symptoms of Trichomonas vaginalis infections

Vaginal dicharge and irritation in females

211

What is the diagnosis for Trichomonas vaginalis

High vaginal swab for microscopy or PCR
No good test for males

212

Treatment for Trichomonas vaginalis

Oral Metronidazole

213

How is Trichomonas vaginalis transmitted

Sexual contact

214

What organism cause Pubic lice

Phthirus pubis

215

How is Pubic lice spread

Close genital contact

216

What are the symptoms of Pubic lice

itching in pubic area

217

What is the treatment of Pubic lice

Malathion lotion

218

What are the causes of bleeding in early pregnancy

Spontaneous miscarriage
Ectopic pregnancy
Hydatidiform mole
Lower genital tract causes

219

What is the definition of spontaneous miscarriage

Expulsion or removal of the products of conception prior to 24 weeks of gestation

220

What are the types of Spontaneous miscarriage

Threatened
Inevitable
Incomplete
Complete
Septic

221

What are the symptoms for Threatened miscarriage

Pain -ve
Bleeding not profuse, cervix closed, uterus=gestational age
FH +ve

222

What are the symptoms for Inevitable miscarriage

lower abdominal pain
heavy vaginal bleeding with clots
shock +ve
tenderness +ve
cervix open
POC may be present in cervix
FH +ve

223

What are the symptoms of Incomplete miscarriage

lower abdominal pain
heavy vaginal bleeding with clots
shock +ve
tenderness +ve
cervix open
POC may be present in cervix
FH -ve

224

What are the symptoms of Complete miscarriage

History similar to incomplete miscarriage followed by cessation of bleeding
uterus

225

What is Septic miscarriage

Infection following a miscarriage

226

What are the causes of miscarriage

Abnormal conception (chromosomal 50%)
Uterine abnormalities
Acquired diseases
Toxins
Immunological
Endocrine
Trauma
Foreign body
Psychological

227

What is it called when the uterus is heart shaped, a septum dividing the uterus into two horns

Bicornuate uterus

228

What is it called when uterus is shaped normally from outside but there is a septum dividing the uterine cavity

Uterine septum

229

Treatment of inevitable miscarriage

Allow uterus to evacuate itself
pain relief

230

Treatment of incomplete miscarriage

Blood transfusion if shock is present
Removal or POC

231

Investigations of recurrent miscarriage

Karotyping of both parents
GTT, T4, TSH
Hyeroscopy, HSG, laparoscopy, IVP

232

What is the incidence of ectopic pregnancy

1/300

233

What is the recurrence rate of extopic pregnancy

10-15%

234

What is endometriosis

Common condition where tissue that behaves like the lining of the womb (the endometrium) is found outside the womb.

235

Clinical features of Ectopic pregnancy

Lower abdominal pain
Amenorrhea
Vaginal bleeding
-shoulder tip pain, shock and syncope, abdominal guarding

236

Outcomes of Ectopic pregnancy

Tubal abortion
Tubal rupture

237

Investigations for suspected Ectopic pregnancy

Urine B-hCG pregnancy test
Paired serum B-hCG
Transvaginal ultrasound scan
Diagnostic laparoscopy

238

Difference between salpingectomy and salpingotomy

Salpingectomy - removal of tube
Salpingotomy - opening of tube and removal of ectopic pregnancy

239

Treatment of Ectopic pregnancy

Surgery
Methotrexate

240

Why is Methotrexate given in ectopic pregnancy

Stops the pregnancy from growing.
Useful if it unlocated and small

241

What is a Hydatidiform mole

Benign tumor due to a developmental anomaly in the trophoblasts of the placenta.
Also called molar pregnancy

242

What are the types of Molar pregnancies

Complete - Abnormal placenta, no fetal development
Incomplete - Abnormal placenta, some abnormal fetal development. Not viable

243

Clinical features of Hydatidiform Mole

Amenorrhea
Vaginal bleeding
Uterus > gestational age
doughy uterys
FH -ve
Hyperemesis
Pre-eclampsia

244

Appearance of Hydatidiform Mole on Utrasound

Snowstorm appearance
Grape looking cells
theca-lutein ovarian cysts

245

Treatment of Hydatidiform Mole

Evacuation of uterus
prolonged follow up urinary and serum b-hCG
Contraception during follow-up

246

What is the risk of Hydatidiform Mole

Possibility of malignant change into Choriocarcinoma

247

What is Cervical incompetence

Medical condition in which a pregnant woman's cervix begins to dilate (widen) and efface (thin) before her pregnancy has reached term. without pain

248

What is the treatment of Cervical incompetence

Only treated if it threatens the pregnancy. Surgically stabilize the cervix opening with sutures, Cervical Cerclage

249

When is Cervical Cerclage performed

Usually at 14 weeks of gestation
Removed at 36 weeks of gestation

250

What are the two primitive genital tracts called, associated with what sex

Wolffian - Male
Mullerian - Females

251

What does the fetal testes secrete

Testosterone
Mullerian inhibiting factor

252

What does the Mullerian duct form

Fallopian tube

253

What does the Wolffian duct form

Vas Deferens

254

What is Androgen insensitivity syndrome, genetics

X-linked recessive disorder
Male karotype (46XY)

255

What is androgen insensitivity syndrome, phenotype

Phenotypically woman
External genitalia female
Absence uterus and ovaries with short vagina

256

When is androgen insensitivity syndrome presentation

Present at puberty with primary amenorrhoea, lack of pubic hair

257

What is Androgen insensitivity syndrome

Syndrome where body is insensitive to androgen, testosterone has no effect on fetal development which means testes secrete it but it does not block female development or initiate male development.

258

What is the venous plexus of the male scrotum called

Pampiniform plexus

259

What is the layer that covers the testis called

Tunica vaginalis
Visceral and Parietal layer

260

What are undescended testes called

Cryptorchidism

261

What is the treatment of Cryptorchidism

Orchidopexy, surgical descend of testes, below age 14.
In adults, orchidectomy

262

Where does Spermatogenesis occur

Seminiferous tubules of testes

263

Where is Testosterone produced

Leydig cells of testes

264

What is the tip of the sperm called, what does it contain

Acrosome
Contain enzymes for penetrating the ovum

265

What are three parts of the sperm

Head
Midpiece
Tail

266

What cells controls spermatogenesis

Sertoli cells

267

What hormone increases testosterone production

Luteinizing hormone (LH)

268

What hormone stimulates spermatogenesis

Follicular stimulating hormone (FSH)
Testosterone

269

What descreases FSH release, secreted by what cells

Inhibin
Sertoli cells

270

What hormone release does testosterone decrease

GnRH from hypothalmus
LH from antior pituitary

271

Why does Sertoli cells secrete androgen binding globulin (ABG)

Binds to testosterone and keeps the concentration high in testes for spermatogenesis

272

what does Testosterone convert into, effect

Dihydrotestosterone
enlargement of male sex organs
secondary sexual characteristics
Anabolism

273

How is Gonadotrophin Releasing hormone secreted, where and when

From Hypothalmus in bursts every 2-3 hours (begins age 8-12 years)

274

What is the difference in FSH and LH production in males vs females

In males the production is non-cyclical unlike in females where it is cyclic release (monthly)

275

What is the precursor of testosterone

Cholesterol

276

What is Activin, produced by and action

Produced by Sertoli cells
Feedback on FSH, activin stimulates FSH production

277

What is prostaglandins role in semen

stimulate motility of sperm

278

What does semen contain

Fructose
Prostaglandin
Fibrinogen
Alkaline fluid
Mucus

279

What secretes mucus into semen

Bulbourethral glands

280

What produces Alkaline fluids into semen

Prostate Gland

281

What are the accessory glands to sperm

Seminal vesicles
Prostate gland
Bulbourethral gland

282

What nervous system controls erection vs ejaculation

Erection - Parasympathetic
Ejaculation - Sympathetic

283

What is the definition of male infertility

Infertility resulting from failure of the sperm to normally fertilise the egg

284

What is male infertility usually associated with

Abnormalities in semen analysis

285

What is the indication of Intra-uterine insemination (IUI)

Low sperm count

286

What is the indication for Surgical Sperm Aspiration

Azoospermia
Low motility

287

What does ICSI stand for

Intracytoplasmic Sperm Injection

288

What is the indication for ICSI

Very low sperm count

289

What is the indication for Donor sperm insemination

Azoospermia or very low sperm count
Genetic conditions
Infective conditions

290

What are the phases of the Uterine cycle

Menstrual phase
Proliferative phase
Secretory phase

291

What are the phases of the Ovarian cycle

Follicular phase
Ovulation
Luteal phase

292

Main hormone in Proliferative phase

Estrogen

293

Main hormone in Secretory phase

Progesterone

294

Menorrhagia

prolonged and increased menstrual flow

295

Metrorrhagia

regular intermenstrual bleeding

296

Polymenorrhoea

menses occurring at

297

Polymenorrhagia

increased bleeding and frequent cycle

298

Menometrorrhagia

prolonged menses and intermenstrual bleeding

299

Amenorrhoea

absence of menstruation > 6 months

300

Oligomenorrhoea

Menses at intervals of > 35 days

301

Definition of an anovulatory cycle

menstrual cycle characterized by varying degrees of menstrual intervals and the absence of ovulation and a luteal phase. In the absence of ovulation, there will be infertility.

302

What is the endometrial thickness that indicate biopsy

>4mm in post-menopause
>16mm in pre-menopause

303

Causes of AUB:Adolescence/Early reproductive life

Usually due to anovulatory cycles
Pregnancy/miscarriage
Endometritis
Bleeding disorders

304

Causes of AUB:Reproductive life/perimenopause

Pregnancy/miscarriage
DUB: anovulatory cycles, luteal phase defects,
Endometritis
Endometrial/endocervical polyp
Leiomyoma
Adenomyosis
Exogenous hormone effects
Bleeding disorders
Hyperplasia
Neoplasia: cervical, endometrial

305

Causes of AUB: Post Menopause

Atrophy
Endometrial polyp
Exogenous hormones: HRT, tamoxifen
Endometritis
Bleeding disorders
Hyperplasia
Endometrial carcinoma
Sarcoma

306

How is Sampling on the endometrium done

Endometiral pipelle
Dilation and curretage

307

Benefit of Endometrial pipelle

No anesthesia
Outpatient
Safe

308

Problems with Endometiral pipelle

Limited sample

309

When should an endometiral sample not be taken

During the menstrual phase

310

What is DUB

Dysfunctional Uterine Bleeding
Irregular uterine bleeding that reflects a disruption in the normal cyclic pattern of ovulatory hormonal stimulation to the endometiral lining (no organic cause)

311

When is Anovulatory cycles most common

At either end of reproductive life

312

What happens in anovulatory cycle

Corpus luteum does not form
Abnormal follicular development

313

Which mole has higher risk of developing into Choriocarcinoma

Complete Hydatidiform moles

314

What type of DNA is present in a complete mole

Only paternal
(Egg has lost its DNA)

315

What type of DNA is present in a incomplete mole

Paternal and Maternal
Triploid genotype (69,XXY)

316

What is AUB

Anovulatory Uterine Bleed

317

Symptoms of Endometritis

Symptoms include lower abdominal pain, fever and abnormal vaginal bleeding or discharge.

318

When does Endometrial polyps normally occur

Around and after the Menopause

319

Are endometrial polyps benign

Mostly, but endometrial carcinoma can present as a polyp

320

What is a Choriocarcinoma

Malignant tumor of trophoblast

321

What is Adenomyosis

Condition where Endometrial glands and stroma is found within the Myometrium

322

What is Leiomyoma

Benign tumor of smooth muscle, may be found in locations other than the utreus

323

What effects the growth of Leiomyomas

Estrogen

324

Done week 1

Yes