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35 Cards in this Set
- Front
- Back
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menopause
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- dec estrogen due to age-linked decline in # of ovarian follicles
- avg age of onset 51 yrs (earlier in smokers) - VERY HIGH FSH (due to no estrogen feedback) - dec estrogen; inc. LH (no surge); Inc GnRH - source of estrogen = ESTRONE from peripheral conversion |
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Klinefelter's
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- xxy
dysgenesis of seminferous tubules -> decrease inhibin -> increased FSH Abnormal Leydig cell fxn -> dec testosterone -> increased LH -> Inc estrogen - eunuchoid body shpe, gynecomastia, female hair distribution - presence of X chromosome (Barr body) - common cause of hypogonadism |
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Turner syndrome
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- XO
- ovarian dysgenesis (streak ovary w/ infertility) -> dec estrogen -> Leads to INCREASED LH and FSH - shield chest, webbing of neck, PREDUCTAL COARCTATION of the aorta - BICUSPID AORTIC VALVE - most common cause of primary ammenorrhea - no barr body |
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Double Y males
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XYY
- phenotypically normal, very tall, severe acne - antisocial behavior - Normal fertility |
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Defective androgen receptor
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Testosterone: increased
LH: increased |
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Testosterone-secreting tumor,
exogenous steroids |
Testosterone: Increased
LH: decreased |
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Primary hypogonadism
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- leydig cell dysfxn
Testosterone = decrease LH = Increased |
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Hypogonadotropic hypogonadism
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Testosterone = decreased
LH = decreased |
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Female pseudohermaphrodite
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- XX
- ovaries present but external genitalia are virilized or ambiguous - congential adrenal hyperplasia, excess adrenergic steroids |
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Male pseudohermadphrodite
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- XY
- testes present, but external genitalia are female or ambiguous - MC is androgen insensitivity syndrome (testicular feminization) |
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True hermaphrodite
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- has both male and female gonads
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Adrogen insensitivity syndrome (46, XY)
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XR
- defective androgen receptor in normal-appearing female - rudimentary vagina - presents w/ no sexual hair - remove testes to reduce malignancy - INCREASED Testosterone, estrogen, LH (vs. sex chromosome disorders) - due to no negative feedback |
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5 alpha-reductase
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AR
- ambigus genitalia until puberty - penis at 12 - internal genitalia are normal |
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Kallmann syndrome
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AD
- dec synthesis of GnRH in Ant pit - anosmia - lack of 2ndary sexual characteristics - dec FSH, LH, Testosterone, Sperm count |
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SRY gene
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- on chromosome Y
- make testes determining factor - makes testes: sertoli and leydig cell Sertoli = make MIF or antimullerian hormone -> degeneration of paramesonephric duct Testosterone = causes wolffiann duct proliferation = internal genitalia (except prostate) DHT = genital tubercle, urogenital sinus -> male external genitalia and prostate |
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Complete mole
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46, XX or XY
- very high hCG - inc uterine size - convert to choriocarcinoma - no fetal parts Components = 2 sperm + empty egg - Malignant trophoblastic disease |
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Partial Mole
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69, XXY
- inc hCG - rare choriocarcinoma; low risk of malignancy Fetal parts = Yes (partial) 2 sperm + 1 egg |
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Common causes of miscarriage
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1st wks = low progesterone (no response to B-hCG)
1st trimester = chromosal abnormalities (robertsonian translocation) 2nd trimester = bicornuate uterus (incomplete fusion of paramesonephric ducts) |
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Preclampsia
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- HTN, proteinuria, and edema
- Eclampsia = preeclampsia + seizures - caused by placental ischemia = impaired dilation of spiral arteries resulting in increase vascular tone |
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HELLP
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Hemolysis
Elevated LFTs Low Platelets - assoc w/ preeclampsia - mortality due to cerebral hemorrhage and ARDs |
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tx of preeclampsia
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- delivery of fetus
- bed rest, salt restriction Tx - IV Mg Sulfate - diazepam to prevent and treat seizure of eclampsia |
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abruptio placentae
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PAINFUL BLEEDING IN 3rd TRIMESTER
- premature detatchment of placenta - fetal death - assoc. w/ DIC - inc risk w/ smoking, HTN, cocaine |
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Placenta accreta
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MASSIVE BLEEDING AFTER DELIVERY
- defective decidual layer allow placental attachment to MYOMETRIUM - no seperation of placenta after birth Risk = prior C-section; inflammation; and placenta PREVIA |
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Placenta previa
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PAINLESS BLEEDING IN ANY TRIMESTER
- attachment of placenta to LOWER UTERINE SEGMENT - can occlude internal os Risk = Multiparity and prior C-section |
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Ectopic Prego
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- Pain w/ or w/o bleed
- Suspect w/ high hCG and sudden lower AB pain - confirm w/ US - appendicitis presentation |
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Polyhydraminos
Oligohydraminos |
Polyhydraminos = esophageal/duodenal atresia; anaencephaly
Oligohydraminos = placental insufficiency; bilateral renal agenesis; or post. urethral valves (in males) and resultant inability to excrete urine - POTTER's syndrome |
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CIN 3
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carcinoma in situ
- lateral invasion of cervical pathology = block ureters causing RF |
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Chocolate cysts
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- endometriosis
Adenomyosis = endometrium w/ in myometrium |
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Endometrial hyperplasia
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- excess estrogen stimluation
- inc risk for endometrial carcinoma - post menopausal vaginal bleeding Risk factors = anovulatory cycles, HRT, Polycystic ovarain syndrome, and granulosa cell tumor |
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Endometrial carcinoma
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MC gynecologic malignancy
- presents w/ vaginal bleeding - preceeded by endometrial hyperplasia - increase myometrial invasion -> decrease prognosis Risks = estrogen w/o progestin; obestiy; DM; HTN; nulliparity, and late menopause |
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epidemiology female cancer
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endometrial > ovarian > cervical = incidence
worst = ovarian > cervical > endometrial |
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Polycystic ovarian syndrome
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- inc LH leads to anovulation, HYPERANDROGENISM duet to deranged steroid synthesis by theca cells
- inc risk of endometrial cancer - HIGH LH, LOW FSH, HIGH TESTOSTERONE (due to LH on theca cells) |
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Tx PCOS
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weight loss
OCPs Leuprolide clomiphene Spironolacton (to tx hirsutism) |
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Theca-lutein cyst
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- bilateral/multiple
- due to GnRH stimulation - Assoc w/ choriocarcinoma and moles |
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Follicular cyst
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unruptured graafian follicle
- assoc w/ hyperestrinism and endometrial hyperplasia |
