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23 Cards in this Set

  • Front
  • Back
Pill mechanism
- inhibits ovulation
- thickens cervical mucus
- decreases tubal mobility
- thins endometrium
Plan B
- is Progesterone only
- use ASAP but can be used up to 5 days
- 0.5% effective if < 12 hrs, w/ Average 1.1%
- Pros are fewer side effects, both doses can be taken at once
- Cons are less available, spotting
Yuzpe Method/Preven
– is Estrogen + progesterone
- use ASAP, but can be used up to 3-4 days
- 0.4% effective if <12 hrs), Average is 2-3.2%
- Pros are Wide range of possible pills
- Cons are GI SE’s, spotting
Copper IUD
– Use up to 8 days
– 0.1% Effectiveness
– Pros are Effective, provides contraception afterwards
– Cons are Expensive, insertion required, may have spotting
Copper IUD Mechanism
– If taken before ovulation, it Disrupts follicular development, Blocks LH surge, thus inhibiting ovulation, Thickening cervical mucus, and Inhibits tubal motility
– If taken after ovulation, it has little effect
– does not work by disrupting an implanted pregnancy
- production is stimulated by FSH and it augments FSH actions
– acts on granulosa
- stimulates granulosa proliferation, aromatase
– acts on theca
Ovarian Cycle, Early Follicular Phase
– Now estrogen starts to rise, so FSH levels start to decrease
– so there is a single dominant follicle trying to sequester all of that FSH, so it up’s the number of FSH R’s and it increases its blood vessels
Endometrial Cycle, Early Proliferative Phase
– Thin, homogeneous
– Simple, straight glands
– Very occasional mitosis
– Similar to that in prepubertal or postmenopausal women
Ovarian Cycle, Mid-Follicular Phase
FSH is going down more as Estrogen goes up more
Ovarian Cycle, Late Follicular Phas
mid-cycle surge of LH from more E
Endometrial Cycle, Late Proliferative Phase
– Much thicker due to marked growth in both glands and stroma
– Tortuous, “corkscrewed” glands
– Superficial stromal edema
– Higher, more columnar epi
– Women who don’t ovulate will just stay in proliferative phase
Ovarian Cycle, Early Luteal Phase
P starts increaseing
Endometrial Cycle, Early Secretory Phase
– Edema of superficial stroma lost
– Appearance of glycogen-rich subnuclear vacuoles
– Mitoses less common
Ovarian Cycle, Mid-Luteal Phase
P peaks then starts decreasing, E starts decreasing
Endometrial Cycle, Mid-Secretory Phase
– Edema again apparent throughout stroma
– Jagged “saw-tooth” glands
– Prominent capillaries
– Receptive to implantation
Requirements for Normal Luteal Function
– Optimal preovulatory follicular development
– luteal cell mass
– Adequate follicular phase FSH
– Tonic LH stimulation
– LDL cholesterol substrate
Ovarian Cycle, Conception
– HCG rises and women can pick it up in their blood a few days before their scheduled period
– Estrogen will increase instead of decreasing
Ovarian Cycle, Late Luteal Phase
FSH starts rising again
Endometrial Cycle, Late Secretory Phase
– Edema resorbed, causing marked shrinkage in total
– Stromal cells accumulate cytoplasm “predecidua”
– Glands dilated, filled with debris
– More common than syphilis in some places
– multiple, painful, ragged border lesions
– Tender inguinal adenopathy
– Hemophilus ducreyi requires special culture medium, <80% sensitive
– Coinfection with HIV, syphilis
Granuloma Inguinale
– Donovanosis, Calymmatobacterium granulomatis
– Beefy red, friable lesions (granulation tissue)
– Rare in the USA
– Most common transmission is anal sex
– Donovan bodies on tissue crush prep/bx!
Lymphogranuloma Venereum
– Caused by C. trachomatis serovars L1, L2, or L3
- Tender femoral/inguinal lymphadenopathy
– Proctocolitis in women & gay men, fistulas
– Unilateral
– Compliment fixation titer >1:64, or indirect immunofluoresence or biopsy
– Treat with doxycycline, aspirate buboes