Class 11: EP, Infertility, Contraceptives

Question 1

what is the only form of contraception where ultrasound is useful?

Answer 1

IUD

Question 2

IUDs prevent implantation in the uterus. T/F?

Answer 2

true

Question 3

2 types of IUD?

Answer 3

1. copper T/paragard T380A
2. progestasert

Question 4

how does the paragard IUD work?

Answer 4

releases copper and kills sperm

Question 5

how does the progestasert IUD work?

Answer 5

releases progesterone, thickens cervical mucous so sperm can’t reach the egg; high progesterone levels can also block ovulation

Question 6

risks for IUD?

Answer 6

PID
EP
pregnancy with IUD
uterine perforation

Question 7

U/S appearance of IUD?

Answer 7

echogenic & central in UT
shadowing with entrance & exit echoes

Question 8

which phase of the menstrual cycle may an IUD not be seen in?

Answer 8

secretory phase

Question 9

what is infertility?

Answer 9

failure to conceive after 1 year of trying

Question 10

factors for male infertility (3)

Answer 10

• decreased sperm count or motility
• urethral strictures or STD
• varicoceles

Question 11

what is a varicocele?

Answer 11

dilated scrotum veins

Question 12

factors for female infertility? (6)

Answer 12

• older maternal age
• infection
• surgery
• disease
• congenital anomalies
• hormonal imbalance

Question 13

another name for ovulation induction therapy

Answer 13

assisted reproductive therapy (ART)

Question 14

purpose of ovulation induction therapy

Answer 14

stimulate the early growth of follicles for harvest

Question 15

drugs used for ovulation induction therapy

Answer 15

clomid & perganol

Question 16

what drug may be used to induce ovulation for ovulation induction therapy?

Answer 16

HCG

Question 17

what are 3 parameters to predict follicular development?

Answer 17

1. increased basal body temperature
2. watery cervical mucous
3. high estrogen levels

Question 18

4 side effects of ovulation induction therapy?

Answer 18

1. multiple pregnancies
2. ovarian hyperstimulation syndrome (OHS)
3. ectopic pregnancy
4. heterotropic pregnancy

Question 19

what is a heterotropic pregnancy

Answer 19

2 pregnancies with 1 IUP & 1 EP

Question 20

what is OHS?

Answer 20

when multiple follicles are induced, it may lead to theca lutein cysts (bilateral), enlarged ovaries, and edema of stroma

Question 21

3 methods of ART?

Answer 21

1. in-vitro fertilization with embryonic transfer
2. gamete intrafallopian transfer
3. zygote intrafallopian transfer

Question 22

what is the process for IVT-ET

Answer 22

ova & sperm are extracted and fertilized in a test tube, wait for cell division, when morulas become embryos, they’re implanted in the uterine cavity

Question 23

2 methods of retrieval for IVT-ET

Answer 23

1. laparoscopy
2. US guided retrieval

Question 24

what is GIFT?

Answer 24

gamete intrafallopian transfer
sperm & ova are placed in fallopian tube to fertilize

Question 25

indications to use GIFT?

Answer 25

- endometriosis - cervical stenosis - oligospermia - immunologic infertility - unexplained infertility for > 2 years

Question 26

what is ZIFT?

Answer 26

zygote intrafallopian transfer extract sperm & ova to fertilize in laparscopy dish & wait for zygote then transfer zygote into fallopian tube

Question 27

what defines an ectopic pregnancy?

Answer 27

the implantation of ovum outside the endometrial cavity

Question 28

what is the leading cause of maternal death in 1st trimester?

Answer 28

ectopic pregnancies

Question 29

most common location for an ectopic pregnancy?

Answer 29

ampulla of fallopian tube

Question 30

which part of the fallopian tube is the most dangerous for an EP to occur?

Answer 30

interstitial part

Question 31

5 other locations for an ectopic pregnancy besides FT?

Answer 31

1. ovaries 2. abdomen 3. interligamentous 4. cervix 5. rudimentary uterine horn

Question 32

8 causes of ectopic pregnancy?

Answer 32

1. any mechanical obstruction in FT 2. hx of EP 3. PID w salpingitis 4. tubal ligation 5. FT abnormality 6. UT & adnexal masses/adhesions 7. IUD 8. transmigration

Question 33

2 types of transmigration?

Answer 33

1. internal 2. external

Question 34

what is internal transmigration?

Answer 34

fertilized ovum migrates across the uterus to implant into opposite FT

Question 35

what is external migration?

Answer 35

fertilization occurs in cul de sac, then fimbrae from opposite FT picks up fertilized ovum & implants in opposite FT

Question 36

what proves transmigration occured?

Answer 36

seeing corpus luteum cyst on contralateral ovary

Question 37

are HCG levels higher or lower in an ectopic pregnancy compared to a normal pregnancy?

Answer 37

lower than a normal pregnancy

Question 38

3 other procedures besides U/S that can detect ectopic pregnancy?

Answer 38

1. D&C 2. culdocentesis 3. laparoscopy

Question 39

what is the gold standard in detecting EP?

Answer 39

laparoscopy

Question 40

during D&C, getting chorionic villi indicates ___ pregnancy

Answer 40

intrauterine pregnancy

Question 41

during D&C, getting only decidual tissue indicates ___ pregnancy

Answer 41

ectopic

Question 42

which cul de sac is culdocentesis performed?

Answer 42

posterior cul de sac

Question 43

what does culdocentesis help diagnose?

Answer 43

a ruptured ectopic pregnancy

Question 44

what drug can help treat an ectopic pregnancy?

Answer 44

methotrexate

Question 45

methotrexate can be used up to ___ weeks from LMP

Answer 45

6 weeks from LMP

Question 46

treatment options for tubal pregnancy? (2)

Answer 46

1. total salpingectomy 2. salpingostomy

Question 47

2 treatment options for interstitial pregnancy?

Answer 47

1. hysterectomy 2. wedge resection of uterus

Question 48

treatment option for abdominal pregnancy?

Answer 48

always surgical