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23 Cards in this Set
- Front
- Back
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Pill mechanism
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- inhibits ovulation
- thickens cervical mucus - decreases tubal mobility - thins endometrium |
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Plan B
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- 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 |
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Yuzpe Method/Preven
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– 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 |
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Copper IUD
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– Use up to 8 days
– 0.1% Effectiveness – Pros are Effective, provides contraception afterwards – Cons are Expensive, insertion required, may have spotting |
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Copper IUD Mechanism
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– 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 |
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Activin
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- production is stimulated by FSH and it augments FSH actions
– acts on granulosa |
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IGF-I
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- stimulates granulosa proliferation, aromatase
– acts on theca |
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Ovarian Cycle, Early Follicular Phase
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– 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 |
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Endometrial Cycle, Early Proliferative Phase
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– Thin, homogeneous
– Simple, straight glands – Very occasional mitosis – Similar to that in prepubertal or postmenopausal women |
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Ovarian Cycle, Mid-Follicular Phase
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FSH is going down more as Estrogen goes up more
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Ovarian Cycle, Late Follicular Phas
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mid-cycle surge of LH from more E
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Endometrial Cycle, Late Proliferative Phase
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– 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 |
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Ovarian Cycle, Early Luteal Phase
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P starts increaseing
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Endometrial Cycle, Early Secretory Phase
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– Edema of superficial stroma lost
– Appearance of glycogen-rich subnuclear vacuoles – Mitoses less common |
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Ovarian Cycle, Mid-Luteal Phase
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P peaks then starts decreasing, E starts decreasing
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Endometrial Cycle, Mid-Secretory Phase
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– Edema again apparent throughout stroma
– Jagged “saw-tooth” glands – Prominent capillaries – Receptive to implantation |
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Requirements for Normal Luteal Function
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– Optimal preovulatory follicular development
– luteal cell mass – Adequate follicular phase FSH – Tonic LH stimulation – LDL cholesterol substrate |
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Ovarian Cycle, Conception
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– HCG rises and women can pick it up in their blood a few days before their scheduled period
– Estrogen will increase instead of decreasing |
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Ovarian Cycle, Late Luteal Phase
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FSH starts rising again
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Endometrial Cycle, Late Secretory Phase
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– Edema resorbed, causing marked shrinkage in total
– Stromal cells accumulate cytoplasm “predecidua” – Glands dilated, filled with debris |
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Chancroid
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– 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 |
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Granuloma Inguinale
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– 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! |
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Lymphogranuloma Venereum
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– 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 |
