Week 10, Female Reproductive Pathophysiology Study Guide For Final

Front 1

Normal menstrual cycle

Back 1

Includes the ovarian phases (follicular and luteal) with the uterine/endometrial phases (proliferative and secretory)

Front 2

Name 2 disorders of ovulation

Back 2

1.Anovulation (no egg released) and 2.Oligoovulation (infrequent ovulation)

Front 3

Name 3 disorders of cycle length

Back 3

1. Polymenorrhea (cycles that are 21 days or sooner) 2.Oligomenorrhea (cycles that are light and more than 35 days apart) 3. Amenorrhea (amen no menstration in women of reproductive age)

Front 4

Name 2 disorders of menstrual flow

Back 4

1. Hypomenorrhea (abnormally light menstrual periods) and 2. Menorrhagia (abnormally heavy menstrual periods)

Front 5

Name 2 disorders of menstrual pain

Back 5

1.Dysmenorrhea (sharp intermittent pain) 2.Chronic Pelvic pain

Front 6

What are the possible causes of chronic pelvic pain

Back 6

1.adhesions 2.endometriosis 3.dyspareunia

Front 7

What is the Hypothalamic-Pituitary-Ovarian Axis

Back 7

The ovaries, hypothalamus, and pituitary work in harmony to produce cyclic changes in the woman's body

Front 8

What is the HPO Axis

Back 8

hypothalamus-->GnRH --->Anterior Pituitary ---> 2 PATHWAYS:(1.FSH --->Theca interna --> Estrogen---> Target Tissues) (2.LH --> Corpus luteum --> Progestin --> Target Tissue)

Front 9

What does your Hypothalamus secret (in context of menstural cycle)

Back 9

Gonadotropin releasing hormone (GnRH)

Front 10

What does your Anterior Pituitary secret (in context of menstrual cycle)

Back 10

1. FSH 2.LH 3.Prolactin

Front 11

What are the ovarian steroid sex hormones

Back 11

1. Estrogen 2. Progesterone 3. Androgens

Front 12

Where is estrogens primarily secreted

Back 12

ovaries

Front 13

Where is conversion from androgens to estrogen take place

Back 13

adipose tissue

Front 14

What are the 3 types of estrogen

Back 14

*Estrone (E1) (estrogen of menopause) **Estradiol (E2) (estrogen of cycling women) ***Estriol (E3) (estrogen of pregnancy)

Front 15

What is oogenesis

Back 15

The formation of oocytes through meiosis

Front 16

What is developed through first meiotic division

Back 16

Secondary oocyte which is ready for fertilization

Front 17

Endometriosis

Back 17

cells from the uterus go outside the uterus and have grow uterine tissue and follow the cycles of the month; can obstruct pregnancy and pain is often associated

Front 18

Infertility

Back 18

Infertility is the inability to conceive a child definition by WHO

Front 19

Menopausal syndrome

Back 19

absence of period for more than one year

Front 20

What are the 4 possible stages of Cervical dysplasia seen on a papsmear

Back 20

Low-Grade (LSIL) High-Grade (HSIL), Possibly Cancerous (magligant) and Atypical grandular cells (AGUS)

Front 21

Cervical Dysplasia

Back 21

abnormal growth of the squamous cells on the cervix

Front 22

What causes cervical dysplasia

Back 22

HPV strands 16,18,31, and 45

Front 23

What is significant about the hormone prolactin

Back 23

It is secreted from the anterior pituitary there is increasing levels secreted during pregnancy and it produces milk (it is inhibited by high levels of progesterone and estrogen)

Front 24

Where is oxytocin released and what does it do

Back 24

It is a hypothalamic hormone that is released from the posterior pituitary and it binds with receptors to stimulate contractions of uterus and alveoli (breasts)

Front 25

What are the 4 purposes of estrogen

Back 25

1.stimulates uterine enlargement 2.promotes breast ductule development 3.induces hypercoagulable state 4.stimulates increased melanin production

Front 26

what are the 3 purposes of progesterone

Back 26

1.stimulates endometrial development 2.promotes breast lobular development 3.smooth muscle relaxation

Front 27

What immunoglobulin can cross the placenta

Back 27

IgG

Front 28

What is Hyperemesis Gravidarum

Back 28

Severe nausea and vomitting during pregnancy that can lead to dehydration and increased heart rate and low bp

Front 29

Gestational diabetes what is it

Back 29

CHO intolerance of variable severity with onset or first recognition during present pregnancy

Front 30

What is the pathogenesis and epidemiology of gestational diabetes

Back 30

PATHOGENESIS: pregnancy is a "diabetogenic" state where there is naturally increased insulin resistence EPIDEMIOLOGY: occurs in 0.15-12.3% of pregnant women worldwide but increase in relative risk in African Americans, Native Americans, Latina and Asian

Front 31

What are the fetal effects in GDM

Back 31

The maternal glucose is transported to the fetus through the placenta so there is facilitated diffusion and no insulin from the mother going to the fetus which means : fetus metabolizes glucose through fetal pancreatic insulin production which starts at 10 weeks gestation

Front 32

What are the Management goals of GDM

Back 32

Management of glucose levels between 70-120 mg/dL (this correlates with decreased perinatal mortality)

Front 33

What strategies can be used to achieve management goals of GDM

Back 33

*Diet *Exercise *Insulin (as ordered)

Front 34

What are the 5 hypertensive disorders of pregnancy

Back 34

1.gestational hypertension 2.preeclampsia 3.eclampsia 4.chronic hypertension 5. chronic hypertension with superimposed preeclampsia

Front 35

What is gestational hypertension and what is absent in it

Back 35

It is the appearance of high blood pressure after mid pregnancy and it has an absence of proteinuria

Front 36

What is the most common hypertensive disorder in pregnancy

Back 36

Preeclampsia

Front 37

What is preeclampsia characterized by

Back 37

-Hypertension -Proteinuria -Generalized edema (becomes eclampsia with the onset of seizure activity)

Front 38

What is the etiology of preeclampsia

Back 38

-Cause unknown -Risk increased in (age, nulliparity, large placental mass, family history)

Front 39

What are the maternal risks for preeclampsia

Back 39

1.increased intraocular pressure leading to retinal detachment 2.Hyperreflexia, seizures 3.multisystem organ failure

Front 40

What are the fetal risks of preeclampsia

Back 40

1.Small for gestational age (SGA) 2.Preterm birth 3.Increased perinatal morbidity/mortality

Front 41

What are clinical manifestations of preeclampsia

Back 41

-Blurred vision -Headache -Scomata (blind spot) -Dyspnea (shortness of breath) -moist breath sounds -pitting edema on bedrest -epigastric pain -hyperreflexia -irritability

Front 42

What treatment is used for mild preeclampsia

Back 42

Bedrest (left lateral), diet (high protein & balanced), Moderate sodium, no diuretics, fetal status evaluations

Front 43

What treatments are used for severe preeclampsia

Back 43

may require: anticonvulsant therapy or hypertensives but only way to get rid of it is delivery of baby & observe for complication

Front 44

What is chronic hypertension in pregnancy

Back 44

BP over 140/90 prior to pregnancy, prior to 20 weeks gestation, persisting after childbirth

Front 45

What is Rh Isoimmunization

Back 45

it is Rh incompatibility where there is an antibody-antigen reaction due to the mixing of the Rh negative blood of mother with her Rh positive fetus

Front 46

What is the four step process in screening for sensitization in a pregnant woman

Back 46

1.Complete history at first prenatal visit 2.Determination of Rh status 3.Prenatal antibody screen (indirect Coomb's test and measure antibodies in blood) 4.identification of the anti-D antibody

Front 47

When is Rhogam administer

Back 47

-after any bleeding, -at 28 weeks, -after delivery if infant is rH +, indicated when there is a chance of mixing circulation *All of this is for a mother who is Rh negative

Front 48

What does Rhogam prevent

Back 48

-Antibody formation in response to fetal cells -Sensitization to the Rh antigen

Front 49

What does Rhogram destroy

Back 49

-Destroys fetal cells in the maternal circulation before sensitization has occured by blocking antibody production

Front 50

What treatment can be used in a sensitized pregnant patient

Back 50

intermittent intrauterine exchange transfusion

Front 51

What is HELLP

Back 51

Hemolysis, Elevated liver enzymes, low platelets

Front 52

What are the risks of oligohydramnios

Back 52

Restriction of fetal movement, meconium staining, and indicator of underlying problem

Front 53

What can cause oligohydramnios

Back 53

Preeclampsia, fetal kidney disease, fetal esophageal disorder

Front 54

What is oligohydramnios

Back 54

Too little amniotic fluid

Front 55

What is Polyhydramnios

Back 55

Amniotic fluid imbalance where there is too much amniotic fluid that can be attributed to large baby/diabetes or fetal kidney disease

Front 56

What are the risks of polyhydramnios

Back 56

cord entanglement and prolapse with membrane rupture

Front 57

What is chorioamnionitis

Back 57

it is an infection of the fetal membranes and amniotic fluid

Front 58

What can chorioamnionitis lead to

Back 58

premature labor and birth, maternal sepsis and fetal sepsis