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28 Cards in this Set
- Front
- Back
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What is the source of B-hCG?
- what else is secreted from there? |
syncytiotrophoblast of placenta
HPL (human placental lactogen) "Growth hormone of pregnancy" |
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Oocytes are arrested in which phase by the end of fetal life?
Where do they arrest awaiting fertilization? |
Prophase of Meiosis I
Metaphase of Meiosis II |
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What induces lactation after labor?
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\\maternal steroids
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What is Mittelschmerz?
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blood from ruptured follicle causes peritoneal irritation that can mimic appendicitis.
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What causes menopause?
- average age? - smoking has what affect on average age? |
\\E because of \\# of ovarian follicles.
- 51 - earlier |
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What is the sole source of estrogens after menopause?
- side effect of this? Changes to FSH, LH, GnRH? What is the confirmatory test for menopause? |
peripheral conversion of androgens into estrone (weak estrogen).
- hirsuitism from the androgens ^^FSH, ^LH (w/o surges), ^GnRH Look @ FSH lvls. |
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What is the fx of hCG?
Track the lvls throughout pregnancy. |
maintains corpeus luteum (and thus progesteron) for the 1st trimester by acting like LH (stim luteal cells).
High, peaking @ 10 wks. eventually become low as it's not needed to maintain corpus luteum in 2nd and 3rd trimesters. |
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Where does the progesterone come from in the 1st trimester?
2nd and 3rd? |
corpeus luteum, maintained by hCG.
placenta synthses it's own estriol and progesterone and the corpus luteum degenerates (hCG lvls fall!) |
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Besides pregnancy, what else can cause elevated hCG?
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hydatidiform moles, choriocarinoma, gestational trophoblastic tumors.
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Walk through the hormones of the ovulatory cycle.
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FSH stimulates follicular growth. Follicles produce Estrogen (Estradiol) in Granulosa cells. Estrogen stims proliferation of the endometrium.
Once E lvls are high enough, they stimulated B-receptors in the ant-pituitary, and start stimulating LH release (instead of inhibiting it with a-receptors). LH surge weakens follicle wall, and causes the mature follicle to get all the way to metaphase of meiosis II --> ovulation (release of 2ndary oocyte by follicle). corpeus luteum starts making shit-tons of progesterone, which puts us in the luteal phase (and corresponding secretory phase of endometrial lining). This progesterone blocks production of what corpeus lutuem needs to stay alive (FSH and LH), and eventually it atrophies --> menstruation. |
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Where does fertilization most often occur?
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ampulla of fallopian tube (widest part)
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What is the corpeus luteum?
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part of the dominant follicle that is left behind in the ovary after ovulation (release of 2ndary oocyte)
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Fertile window?
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~ 5 days before until 1–2 days after ovulation
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Most common cause of primary amenorrhea?
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Turner's syndrome
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XYY gives what?
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phtneotypicallly normal, very tall, severe acne, antisocial behavior (i/1-2% of XYY men). Normal fertility.
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Describe the pathogenesis of the sx of Klinefelter's syndrome.
- geneotype? |
dysgenesis of semineferous tubules--> \\inhibin --> ^^FSH.
Abnormal Leydig cell fx --> \\T, ^^LH --> ^^Estrogen. XXY |
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What is the cellular lining of the semineferous tubules?
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Columnar Sertoli cells (stim by FSH; produce inhibin)
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Testicular atrophy, eunuchoid body shape, tall long extremities, gynecomastia, female hair distribution. +/- developmental delay. Dz?
- see what on karyotype? |
Klinefelter's (XXY)
- Barr body |
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Short stature, female. Ovarian dysgenesis, shield chest, bicuspid aortic valve, webbing of neck (cystic hydroma).
- dz? - what causes webbing of neck? - what can be seen @ birth? - CV sx? - hormone lvls seen? |
Turner's (XO)
- lymphedema that resolves - lymphedema - preductal coarctation of the aorta. - \\E --> ^^LH and FSH. |
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Female pseudohermaphrodite = ?
Male pseudohermaphrodite =? - most common etiology? - hormone lvls of this most common cause? |
XX w/ovaries, but externally ambiguous or virulized.
XY; testicles present, but external genitalia are female or ambiguous. Most common form is androgen insensitivity syndrome. - ^^T, ^^E, and ^^LH.... it's the receptor that's busted. |
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What is a true hermaphrodite?
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46XX or 47,XXY... both testicles and ovaries are present, ambiguous genitalia.
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Ambiguous genitalia until puberty, then a penis appeared. Pt is male on the inside. dz?
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5-a-reductase deficiency.
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tx of partial and complete hydadiform moles?
- which has a bigger risk of converting to choriocarcinoma? |
dilation and curretage w/ MTX. monitor b-hCG.
- Complete moles (46 XX or XY = 2 sperm, no egg) |
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In the first few weeks of pregnancy, low progesterone lvls will cause what?
- etiology? |
miscarriage.
- no response to B-hCG to replace the LH and keep corpus luteum alive. |
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Most common cause of first trimester recurrant miscarriage?
2nd trimester? |
chromosomal abnormalities
bicornuate uterous due to incomplete fusion of paramesonephric ducts. |
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Pregnant woman presents with HA, blurred viz, abdominal pain, edema of face and extremities, altered mentation, hyperreflexia. Lab fx show thrombocytopenia, hyperuricemia.
Dz if with HTN, proteinuria, and edema? Dz if all three + seizures? Cause? - predisposing factors? Tx? May be associated with what syndrome? |
Pregnancy-induced hypertension
Pre-eclampsia Eclampsia. Placental ischemia due to impair vasodilation of spiral arteris --> increased vascular tone. - preexisting HTN, diabetes, chronic renal dz, and autoimmune disorders. HELLP syndrome (Hemolysis, Elevated LFTs, Low Platelets) (1) deliver of fetus as soon as viable. Bed rest, salt restriction, and tx of HTN (hydralazine + methyldopa 1st line) (2) IV magnesium sulfate and diazepam to prevent/tx seizures of full eclampsia. |
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What is H-EL-LP syndrome?
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Hemolysis, Elevated LFTs, Low Platelets.
seen with pre/eclampsia. |
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What is mortality in pre/eclampsia due to?
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Cerebral hemorrhage
ARDS |
