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125 Cards in this Set
- Front
- Back
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Fecundability |
probability that a single cycle will result in a pregnancy |
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Fecundity |
probability that a single cycle will result in a live birth
more important because we really only care about the pregnancies that are carried to term |
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by age 40, how many couples are considered infertile |
1 in 4 |
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what are the two most common identifiable female factors in infertility |
ovulatory disorders (25%) and endometriosis (15%) |
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what condition accounts for 70% of ovulatory dysfunction |
PCOS- polycystic ovary syndrome |
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what is the most common endocrine disease in women |
PCOS |
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a patient presents with hirsuitism and she is obese. questioning reveals oligoovulation and hyperandrogenism. she is 36 and has no children. |
PCOS |
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PCOS |
presents with 2 out of 3: - oligoovulatoin - hyperandrogenism - polycystic ovaries |
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37 year old women and er husband have been trying to get pregnant but so far are unsuccessful. how long should they continue trying before seeing a physician.
33 yo
42 yo |
<30- 12 months
>35- 6 months
>40 come in immediately |
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what is the gold standard for tubal evaluation |
Laparoscopy and chromotubation |
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what chromosomes are BRCA 1 and 2 found on |
• BRCA1- 17q21
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what hormones drives growth of the endometrium |
estrogen |
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what hormone drives preparation of the endometrium for implantation |
progesterone |
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what role do OCP's play in cancer risk |
none except they may decrease risk of endometrioid (type 1) cancer |
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what hormone/drug combination may decrease the risk of ovarian cancer |
estrogen, progesterone, and oral contraceptives |
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estrogen/progesterone and OCP's may decrease the risk of what |
ovarian cancer |
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Call-exner bodies |
granulosa cell tumors |
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Adenomyosis |
endometriosis of the uterus |
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uterine bleeding occurring at irregular but frequent intervals, the amount being variable |
Metrorrhagia
people who are metro are irregular |
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prolonged uterine bleeding occurring at irregular intervals |
Menometrorrhagia |
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name three systemic causes of abnormal menstrual bleeding |
coagulopathies
thyroid disorders
liver disease |
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a patient comes in complaining of abnormally large menses. they are not hemodynamically stable. what will you do? |
IV premarin- to stop the bleeding by stimulating clotting |
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2nd most common cause of primary amenorrhea |
Mullerian agenesis- Mayer-Rokitansky-Kuster-Hauser |
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what are the top three causes of primary amenorrhea |
1. Gonadal dysgenesis
2. Mullerian agenesis
3. Androgen insensitivity |
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a patient presents with anosmia, color blindness, and she has never had a period |
Kallman's syndrome (CNS disorder) |
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a child presents with dome shaped papule with central umbilication on his buttocks |
molluscum cantagiosum |
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woman presents with vesicular lesion with subsequent ulceration. it is very tender |
HSV |
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Painless genital ulcer (x) |
LGV (chlamydia) Syphilis Donovanosis |
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Gonorrhea treatment |
penicillin, ceftriaxone, cefixime
azithromycin for chlamydia |
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patient presents with pruritic papule that ulcerates to form a granulomatous beefy red ulcer |
Donovanosis |
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patient presents with strawberry cervix, foul odor, irritation, discharge, and burning |
trichomoniasis |
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Painful genital ulcer |
HSV Chancroid |
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what drug contains levonorgestrel and what is the advantage of this drug |
Seasonale
Levonorgestrel has a very high binding affinity (323%) and thus we need very small doses |
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OCP's decrease the risk of what cancers |
ovarian and endometrial (TIS TRUE) |
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what contraceptive potentially has a negative effect on spine and long bone growth |
Depo-provera (IM injection)1 |
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what drugs use levonorgestrol |
Seasonale (oral) Plan B (progesterone only) Mirena |
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in natural conception what changes in body temperature or cervical mucus are we looking for |
increase in body temperature and dry cervical mucus indicate infertility
infertility resumes 3 days after rise in body temperature |
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malignant neoplasms of the prostate are most commonly what morphology |
adenocarcinoma |
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A 26 year old obese women presents with infertility, oligomenorrhea, and hirsuitism |
PCOD |
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what is the most common type of ovarian tumor |
surface epithelium |
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mutation of what is seen in Lynch syndrome |
mismatch repair genes |
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ovarian tumor with bladder-like epithelium |
Brenner tumor |
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what is a teratoma composed primarily of thyroid tissue |
struma ovarii |
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a woman presents to the clinic with abnormal vaginal bleeding, cramp-like pain shortly after a toxoplasmosis infection |
spontaneous abortion |
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a Thai refugee comes to the clinic with an abnormally high hCG |
Trophoblastic tumor (choriocarcinoma?)
Asian people are also more likely to have a molar pregnancy |
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when do we give Rhogam |
28 weeks
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what is one thing we need to do at 28 weeks gestation |
give Rhogam |
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Clomiphene Citrate |
increases FSH trying to increase the likelihood of ovulation
used to treat infertility |
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HNPCC
increases risk of what cancers |
Hereditary Non polyposis colorectal cancer
colon cancer endometrial cancer ovarian cancer |
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funicitis |
infection of the umbilical cord |
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kernicterus |
bilirubin induced brain dysfunction |
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what is a primary concern of a pregnant woman with diabtetes |
sacral agenesis |
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in what stage of labor does the cervix dilate |
stage 1 |
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what is considered a prolonged latent pahse in nulliparas and multiparas |
20 hours
14 hours |
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how much does the cervix dilate in the active phase |
it will dilate 1.5 cm/hr in multipara and 1.2 cm/hr in primipara |
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describe the second stage of delivery |
pushing phase
starts with full cervical dilation and ends with delivery |
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what drugs are used to stimulate cervical ripening and uterine contractions |
Prostaglandin drugs:
Dinoprostone Misoprostol |
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Dinoprostone |
synthetic prostaglandin used to stimulate cervical ripening and uterine contractions
also used to terminate pregnancy |
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Misoprostol |
prostaglandin analog used to stimulate cervical ripening and uterine contractions |
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what drug is most commonly used to induce labor |
oxytocin |
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Carboprost |
prostaglandin analog used to treat postpartum bleeding
causes intense vasoconstriction so we can't use it to induce contraction |
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what drugs can be given to treat postpartum bleeding |
Carboprost- causes massive vasoconstriction Ergonovine Methylergonovine |
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indomethacin |
COX inhibitor used to prevent uterine contractions
cant use before 32 weeks gestation |
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which drug used to prevent utrerine contractions cannot be used before 32 weeks gestation |
Indomethacin |
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Nifedipine |
calcium channel blocker that relaxes the uterus
causes hypotension and is not as effective as indomethacin |
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Terbutaline |
beta 2 agonist that relaxes the uterus
also activates beta-1 receptors and can thus cause tachycardia and heart palpitations
causes hyperglycemia in mother and hypoglycemia in child |
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magnesium sulfate |
approved to treat seizures in preeclampsia |
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a women presents in labor with high blood pressure and seizures.
what will you give her? |
Magnesium sulfate |
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hydroxyprogesterone |
progestin drug used to prevent preterm labor |
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estrogen increases the risk of which cancer(s)? |
endometrial |
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what affect do OCP's have on cancer? |
decreased risk of ovarian and endometrial
maybe increased risk of cervical |
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during peimenopause what hormone will increase? |
FSH
as estrogen decrease we get an increase in LH |
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what factor can lead to early onset menopause |
smoking |
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what is the gold standard in the diagnosis of osteoporosis? |
DXA scan of the lumbar spine and hips
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which drugs reduce hip fractures? |
Bisphosphonates:
Alendronate and Zolendronate |
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Premarin |
Used to treat women who are not hemodynamically stable and are actively bleeding vaginally (abnormal uterine bleeding) |
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Treatment of women with abnormal uterine bleeding (AUB), hemodynamically stable?
1. Yes 2. No |
1. IV Premarin
2. OCP's |
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what is the order of progression in the treatment of women with anovulatory DUB? |
OCP --> IUD --> Ablation --> Hysterectomy |
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what tells you an ovarian tumor is a granulosa cell tumor? |
Call-exner bodies |
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give several examples of surface epithelial tumors of the ovary (x4) |
1-2. Serous and Mucinous -Benign, malignant, and borderline -Cystadenoma, cystadenocarcinoma,
3. Endometrioid 4. Brenner |
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what is an endometriod carcinoma |
it is a type of surface epithelial ovarian tumor |
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what germ cell tumor is very responive to radiation and chemotherapy |
Dysgerminoma or testicular seminoma |
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name two factors that would identify a granulosa cell tumor (hormone and pathomnemonic) |
high estrogen (granulosa cells aromatize androgens)
call-exner bodies |
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in what condition will we need to remove the testicles before puberty due to high risk of malignancy |
androgen insensitivity |
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a woman presents with webbed neck, short stature, and no breasts
what is her condition and describe her hormone levels? |
Turner Syndrome- 45,X
hypergonadotropic (high FSH/LH) hypoestrogenic (no follicles) |
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a woman presents with ammenorrhea, anosmia, and color blindness |
Kallman's syndrome |
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Sheehan's Syndrome |
low blood pressure during delivery causes damage to the pituitary
loss of GH, FSH/LH, ACTH, TSH
causes amenorrhea |
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what do you need to do if a woman is found to have a Y chromosome |
remove the gonads due to increased risk of malignancy |
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what hormone(s) will be high in menopasue |
LH and FSH
Mostly FSH |
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woman presents with discharge, irritation, and burning of her genitals. she has a foul odor and strawberry cervix
what is her treatment? |
Trichomoniasis
Metronidazole or Tindazole |
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Micronor |
same as Camila
progesterone only OCP
norethindrone only (progesterone)
taken monthly |
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Camila |
same as micronor
progesterone only OCP
norethindrone only (progesterone)
taken monthly |
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name the 4 progesterone only OCP's |
1. Micronor/Camila 2. Implanon/Nexplanon 3. Mirena (IUD) (Levonorgestrol) 4. Depo-Provera (IM injection) |
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what might be administered in an emergency to avoid a pregnancy |
Plan B (levonogestrel)
Copper IUD |
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Loestrin |
OCP
Ethinyl estradiol Norethindrone (progesterone) |
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Ortho evra |
transdermal OCP |
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Cyproterone |
male contraceptive
blocks FSH and LH from binding to androgen receptors leading to oligospermia (low sperm count and infertility) |
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define the standard days method of contraception |
I think don't have sex between days 8-19 in your cycle |
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Battledore placenta |
placenta in which the umbilical cord attaches to the border (margin) |
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circumvallate placenta |
the fetal membrane doubles back on the fetal side around the edge of the placenta |
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typical causes of chorioamnionitis |
infection of the chorion and amnion
due to an ascending infection caused by group B strep, Neisseria, or fusobacterium |
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what is one tumor that is much more common in women from southeast asia |
gestational trophoblastic tumor |
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which trophoblastic tumor has the better outcome and is more responsive to chemo |
gestational is better
ovarian choriocarcinoma is worse |
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describe respiratory change in pregnancy |
decrease in FRC increase in TV no change in respiratory rate and vital capacity
decrease in CO2 and increase in ventilation |
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during pregnancy how often do we need to see the doctor |
every 4 weeks until week 28 every 2 weeks until week 36 weekly after week 36 |
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when should an STD test in a pregnant woman be performed |
36 weeks and maybe ealier |
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when should the hematocrit be taken |
maybe initially
24-28 weeks 36 weeks |
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what does a high AFP tell us during pregnancy and not in pregnancy |
pregnancy- neural tube defect
other- yolk sac tumor or embryonal tumor |
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describe the role of prostaglandins in labor |
they increase cervical ripening, uterine contractions, and they induce labor |
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Dinoprostone |
do you know why the dinosaurs are extinct? it's cause they didn't have a prostate gland (prostanglandin), their wan't enough ripe (cervical ripening) food and they contracted (uterine contractions) disease. now they are terminated (terminate pregnancy). |
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Misoprostol |
prostaglandin E drug used to induce contractions, labor, and cervical ripening |
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Carboprost |
prostaglanidn drug used for postpartum bleeding |
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Ergot alkyloids |
drugs used to limit postpartum bleeding |
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ergonovine |
ergot alkyloid used to limit postpartum bleeding |
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Methylergonovine |
ergot alkyloid used to limit post partum bleeding |
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waht drugs can we give to decrease postparym bleeding |
ergonaovine methylergonovine carboprost |
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Indomethacin |
prevents uterine contractions COX inhibitor only give before 32 weeks gestation because it can close the ductus arteriosus |
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Nifedipine |
calcium channel blocker that relaxes the uterus
prevent preterm labor |
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Terbutaline |
beta- agonist that relaxes the uterus
prevent preterm labor |
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how do we treat eclampsia |
Magnesium sulfate |
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what drug that prevents pre-term labor will we not give before 32 weeks getation |
Indomethacin |
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Pituitary apoplexy |
low blood pressure or hemorrhage causes infarction of the pituitary gland |
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Conn's Syndrome |
primary hyperaldosteronism
often due to an aldosterone secreting adenoma |
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Waterhouse-Friderichsen Syndrome |
hemorrhage into the adrenal gland causes adrenal insufficiency
often seen in enwborn infants after prolonger deliveries |
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Transcortin |
transporter of circulating cortisol |
