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31 Cards in this Set
- Front
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Which of the following the following is not used in evalutating ovulation: basal body temerpature, history of venereal disease, serum progesterone determination, serum estrogen determination, serial serum LH measurements, endometrial biopsy, previous pregnancies, ultrasound evalutation of follicular development.
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Which of the following the following is not used in evalutating ovulation: TRUE: basal body temerpature, ultrasound evalutation of follicular development, serum progesterone determination, serial serum LH measurements, endometrial biopsy... FASLSE: previous pregnancies, history of venereal disease, serum estrogen determination
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What are the 4 subendocrinopathies that can effect fertility?
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What are the 4 subendocrinopathies that can effect fertility? hypothyroid, hyperthyroid, hyperprolactinemia, hypergonadotropic,
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Which of the folloiwng are methods used to evalutate pelic anatomy? Hysterosalpingogram, MRI, Laparoscopy, ultrasound, CT scan, hysteroscopy
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Which of the folloiwng are methods used to evalutate pelic anatomy? Hysterosalpingogram, Laparoscopy, hysteroscopy
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Name 4 infections related to infertility? (hint: Chewing GUM)
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Name 4 infections related to infertility? (hint: Chewing GUM) chlamydia, gonococcus, ureaplasm, mycoplasma
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Which is NOT a female/male interaction that are important in evaluating infertility? Sexual intercourse, amorphic rigidity, postcoital test, female antisperm antibodies, gonadal insufficiency?
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Which is NOT a female/male interaction that are important in evaluating infertility? TRUE: Sexual intercourse, postcoital test, female antisperm antibodies, FALSE: amorphic rigidity, gonadal insufficiency?
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Which is not an areas of concern when evalulating male causes of infertility? Prostatic secretion, semen analysis, sperm penetration testing, testicular hypertrophy
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Which is not an areas of concern when evalulating male causes of infertility? TRUE: semen analysis, sperm penetration testing, FALSE: testicular hypertrophy, Prostatic secretion
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What are the 4 feature of semen analysis in evaluating male fertility? (HINT: VCMM)
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What are the 4 feature of semen analysis in evaluating male fertility? (HINT: VCMM) Volume, count, motility and morphology
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Give a short definition of endometriosis.
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Endometriosis: Ectopic endometrial-like tissues - found on ovaries, serosal surfaces of the pelvic cavity, bowel and bladder
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Which of the following are etiologies of endometriosus? Ischemic myometrial dysplasia, retrograde menstruation, serosal metaplasia, mechanical transport, lymphatic spread, endometrial perforation.
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Which of the following are etiologies of endometriosus? TRUE:retrograde menstruation, serosal metaplasia, mechanical transport, lymphatic spread, FALSE: Ischemic myometrial dysplasia, endometrial perforation.
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What are two proposed mechanisms whereby endometriosis causes infertility?
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1) increased prostaglandins in the peritoneal fluid and serium of patients with endometriosis, 2) increased pelvic and tubal macrophage content that targets the phagocytosis of sperm
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What are two symptoms of pelvic endometriosis?
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What are two symptoms of pelvic endometriosis? Dysmenorrhea (assoc/w onset of and following menstration), dyspareunia (pain during sex)
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Which of the following are NOT the physical finding of endometriosis? unilateral ovarian enlargement, widening of the os, cystic w/ minmal ovarian mobility, uterosacral nodularity, cul-de-sac nodularity, serosal degradation, visualiztions of endometrial implants on the cervical or vaginal mucosa
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Which of the following are NOT the physical finding of endometriosis? TRUE: unilateral ovarian enlargement, cystic w/ minmal ovarian mobility, uterosacral nodularity, cul-de-sac nodularity, serosal degradation, visualiztions of endometriatl implants on the cervical or vaginal mucosa, FALSE: serosal degradation,widening of the os
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How is diagnosis of endometriosis made? (HINT: Direct view of pelvic cavity by laparoscopy)
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How is diagnosis of endometriosis made? Direct view of pelvic cavity by laparoscopy: (1) "powder burns of the seosal surfaces in the peritoneal cavity, (2) opaque, bluish/brownish sponts on peritoneum, (3) Endoetrial implants are: large, firm fibrous nodules that are reddish or yellowish, wich firm reactive tissue surrounding them.
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When endometriomas are visible on ovarian tissue, what is the characteristic color?
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When endometriomas are visible on ovarian tissue, what is the characteristic color? Bluish
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In endometriosis, why is it good to examine the bowel, bladder, uterus, tubes, ovary, cul-de sac and broad ligaments?
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In endometriosis, why is it good to examine the bowel, bladder, uterus, tubes, ovary, cul-de sac and broad ligaments? To determine the severity of the disease
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Name 4 Assisted Reproductive Technologies.
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Name 4 Assisted Reproductive Technologies: (1) In-Vitro fertilization (2) Gamete Intrafallopian Tube Transfer, (3) Intrauterine Insemination, (4) Donor Oocytes
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What is the definintion of primary and secondary infertility?
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What is the definintion of primary and secondary infertility? Can't get pregnant after 12 mos: Primary = never been preg and secondary: has been preg b/4
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In women when does infertility begin?
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In women when does infertility begin? Begins at 35, and accelerates at 40
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What are the 4 factors in infertility? What are their percentages?
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Female = 33%, male = 40%, male-female=25%, idiopathic=12%
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Of the female factors in infertility, what are the causes and their relative percentages?
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Of the female factors in infertility, what are the causes and their relative percentages? Anovulation = 20%, Anatomic = 40%
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Name 5 methods of evalulating anovulation in women.
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Name 5 methods of evalulating anovulation in women: BBT (basal body temp), luteal progesterone (rises after ovulation in midluteal phase), ultrasound examination (image follicles - inconvenient), Serial LH (measured in urine and it's inconvenient - there is a surge --> followed by ovulation in 24-36 hrs), Endometrial biopsy (after ovulation $$$$)
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Name 4 subclinical endocrinopathies that may be included in the anovulation work up.
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Name 4 subclinical endocrinopathies that may be included in the anovulation work up: hypothyroid, hyperthyroid, hyperprolactin, hypergonadotropic
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Name 3 pelvic anatomy examinations that can be part of the anovulation work up.
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Name 3 pelvic anatomy examinations that can be part of the anovulation work up: hysterosalingogram, laparoscopy, hyteroscopy
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What does the hysterosalpingogram check for?
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What does the hysterosalpingogram check for? Uternine contour and Bilateral spillage --> tubal patency
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In semen analysis, what is checked and what are the values?
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In semen analysis, what is checked and what are the values? Volume= 1.5-5 mls, Count= 60 mil/ml… motility = 60%, morphology = 60%… * Note: they don't use anti-sperm Ab anymore
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What 3 things are part of the male-female work-up?
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What 3 things are part of the male-female work-up? (1) sexual intercourse: frequency and timing (2-3x /week is sufficient), (2) postcoital test (not done anymore - looks for sperm motility), (3) female anti-sperm Ab
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In the postcoidal (sims'-huhner) test, what was observed?
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In the postcoidal (sims'-huhner) test, what was observed? Ferning pattern of mucus in cervix… if present = increase in E2
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Name 4 drugs that can induce ovulation. What are possible SE?
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Name 3 drugs that can induce ovulation: clomiphene, gonadotropins, Dopamine agonists, steroids… SE: multiple pregnancy
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What is the mechanism of action of Clomiphene Citrate in the Rx of anovulation?
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What is the mechanism of action of Clomiphene Citrate in the Rx of anovulation? It is an analog of Estradiol: (1) competitive Estrodiole inhibitor @ the hypothalamus LRRH pulse generator (but has no inhibitory effect) --> pituitary --> ↑ FSH, ↑ LH --> … (2) Also it has an agonistic effect on the ovaries... BOTH LEAD TO MATURATION OF FOLLICLES --> OVULATION
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When would you give Clomiphene citrate?
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When would you give Clomiphene citrate? Follicular phase = day 6-10
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What are the 2 indications for giving Gonadotropins (for infertility)?
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What are the 2 indications for giving Gonadotropins (for infertility)? (!) hypogonadotrop-hypogonadism (male or female) (2) follicular recruitment for IVF (egg retrieval)
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