Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
21 Cards in this Set
- Front
- Back
|
How does the LH surge trigger ovulation?
|
- Neutralized action of oocyte maturation inhibitor
- Induces Prostagladin endoperoxidase synthase (Prostagladin, thrombaxane & leukotriene production) - Contraction of follicular wall |
|
|
If no fertilization occured, how long does it take the corpus luteum to degenerate?
|
12 days
|
|
|
What is the lower abdominal pain that occurs in women at ovulation called?
|
Mittleschmetrz
|
|
|
What do you need to diagnosis polycystic ovarian syndrome?
|
2/3 of:
- Oligo/amenorrhea - Clinical or laboratory evidence of elevated androgens (Hirsutism, acne) - Polycystic ovaries on ultrasound |
|
|
What is the differential for polycystic ovarian syndrome? (4)
|
- Congenital adrenal hyperplasia
- Cushing's syndrome - Hyperprolactinemia - Hypothyroidism |
|
|
What is the pathogensis of PCOS?
|
- Increased GnRH cycling leading to increased LH, decreased FSH
- Increased androgens - Increased insulin |
|
|
In PCOS what are the effect of increased insulin?
|
- Direct: Works synergistically with LH to increased theca cell androgen production
- Indirect: Decreased sex-hormone binding globulin to increased circulating testosterone |
|
|
What is the fertility treatment for PCOS?
|
- Clomiphene Citrate + Progesterone + Metformin
- FSH injection - IVF - Ovarian drilling |
|
|
What is the symptomatic treatment for PCOS?
|
- OCP (Estrogen and/or progesterone)
- Anti-androgens (Cyproterone acetate, spironolactone, flutamide) |
|
|
What is the long term complication of PCOS? (5)
|
- Endometrial cancer
- Hypertension - Dyslipidemia - DM Type II - Sleep Apnea |
|
|
What is infertility?
|
- No conception after 1 year that is not irreversible
|
|
|
When should you evaluate infertility?
|
<35: After 1 year
35-40: After 6 months >40: Immediate evaluation |
|
|
What is primary infertility?
|
Couple who has never achieved a pregnancy
|
|
|
What is secondary infertility?
|
At least 1 previous conception has taken place
|
|
|
What is fecundability?
|
Probability of conceiving during 1 monthly cycle
|
|
|
What is the excepted % conceived in couple after 3, 6, 12 months?
|
3 mo: 50%
6 mo: 75% 12 mo: 95% |
|
|
What are the causes of infertility?
|
- 25% Male
- 25% Tubal cause - 25% Ovulatory - 25% Other (Ex. Uterine, cervix, immunnological) |
|
|
What are the test for ovulation? (6)
|
- Cervical mucus
- Basal body temperature - Progesterone (Day 21) - LH concentration (Ovulation detection kits) - US monitoring of follicle growth - Endometrial biopsy |
|
|
What is the stringy mucus produced around the time of ovulation?
|
Spinnbarkeit
|
|
|
How do you assess fallopian tubal patency?
|
Hysterosalpingography
|
|
|
What is the staircase approach for infertility?
|
1. Investigate
2. Treat underlying factors 3. Manage expectantly 4. Clomiphehe + IUI 5. Superovulation + IUI 6. in vitro Fertilization |
