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GIGU Exam 2 > Clinical Notes > Flashcards

Clinical Notes Flashcards

1
Q

What role does progesterone play in pregnancy?

Lecture: Steroid biosynthesis Correlation box p.247

A
  • Supports gestation (pregnancy) & embryogenesis
  • Is involved in the maintenance of the menstrual cycle.
  • Regulates the voltage gated calcium channels on spermatozoa
  • Prepares the uterus for implantation
  • Causes smooth muscle relaxation
  • Decreases maternal immune response

A decrease in progesterone precedes menstruation, labor & lactation

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2
Q

What is the correlation between glucocorticoids and infant respiratory distress syndrome (IRDS)

Lecture: Steroid biosynthesis Correlation box p.247

A

During delivery, a burst of glucocorticoids alters the lung structure in infants by stimulating the production of surfacants, which allows the air spaces to expand. In preterm neonates this process is defective, leading to IRDS. It can be prevented by giving glucocorticoids to expectant mothers.

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3
Q

How can licorice cause hypertension

Lecture: Steroid biosynthesis Correlation box p.247

A

Natural licorice roots contain isoflavones which are inhibitors of 11B-dehydrogeanse. This can cause hypertension due to salt retention.

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4
Q

What has Finasteride been used for?

Lecture: Steroid biosynthesis Correlation box p.247

A
  • Treat benign prostatic hyperplasia
  • Male pattern baldness (caused by accumulation of DHT in the scalp)
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5
Q

What is adrenal hyperplasia?

Lecture: Steroid Biosynthesis

A

Caused by deficiencies in the adrenal enzymes that are used to synthesize glucocorticoids which leads to the increased production of cortisol precurors and androgens from the adrenal gland

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6
Q

How can women present with adrenal hyperplasia?

Lecture: Steroid Biosynthesis

A
  • Hirsutism (excess body hair)
  • General oligomenorrhea (infrequent or light periods)
  • Infertility
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7
Q

What is Primary Aldosteronism/Conn Syndrome

Lecture: Steroid Biosynthesis

A

Adrenal glands produces excessive levels of aldosterone which causes a loss of potassium and retention of sodium leading to hypertension:

  • Body holds on to too much water
  • Increases blood volume
  • Increases blood pressure
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8
Q

What are some disorders associated with vitamin D

Lecture: Steroid biosynthesis Correlation box p.10

A

Insufficient Vitamin D

  1. Brittle bones (rickets) in children
  2. Osteomalacia in adults
  3. Hypocalcemic tetany (involuntary muscle contraction)

Excess Vitamin D

  1. Elevated calcium in blood and urine
  2. Appear dazed
  3. Loss of apetite
  4. Sarcoidosis
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9
Q

What is hypospadias

A

A common male birth defect that is a result of the failure of the urogenital (urethral) folds to close properly

Lecture: Development of the Reproductive System

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10
Q

What is Epispadias

A

Opening of the urethra on the superior aspect of the penis. Cause is unknown but may be due to improper ventral body closure or formation of too large of a cloacal membrane to be covered when it ruptures

Lecture: Development of the Reproductive System

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11
Q

What is didelphys

A

Double uterus

Lecture: Development of the Reproductive System

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12
Q

What is it called when an individual has testes but their phenotype appears female

A

46, XY DSDs

Lecture: Development of the Reproductive System

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13
Q

What are some causes of 46, XY DSDs

A
  1. Inadequate testosterone synthesis
  2. Androgen insensitivity syndrome
  3. 5 alpha-reductase deficiency
  4. Mutation in AMH or AMH receptor
    * Lecture: Development of the Reproductive System*
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14
Q

What are the characteristics of androgen insensitvity syndrome

A
  1. Common cause is loss of functional androgen receptors (X linked recessive)
  2. They have testes but no spermatogensis. Testosterone levels may be high due to a lack of negative feedback.
  3. At puberty, the testosterone is metabolized to estradiol initiating female secondary sexual characteristics
  4. Produce AMH so paramesonephric system is supressed = no uterus or uterine tube and the vagina is short and ends blindly.
  5. Testes usually found in inguinal or labial regions
  6. Increased risk of tumor formation in gonads
    * Lecture: Development of the Reproductive System*
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15
Q

What are the characteristics of 5- alpha-reducatse deficiency

A
  • Autosomal recessive
  • Have a 46 XY genotype
  • Normal testis and duct system since there is AMH and testosterone
  • Underdeveloped male external genitalia due to deficieny in DHT
  • Lecture: Development of the Reproductive System*
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16
Q

What are the characteristics of 46 XX DSDs

A
  • Presence of ovaries
  • Fetus produces excess androgens
  • Maculinzation of the female external genitalia; may even exhibit fusion of labia giving appearance of a scrotum.
  • Most common cause is congenital adrenal hyperplasia
  • Lecture: Development of the Reproductive System*
17
Q

How does Congenital adrenal hyperplasia cause of 46 XX DSDs?

A

Deficiency in 21-hydroxylase leads to excess ACTH production (lack of negative feedback). Excess ACTH causes adrenal hyperplasia and excessive production of androgens.

Lecture: Development of the Reproductive System

18
Q

What is male hypogonadism

A

A condition in which the body doesn’t produce enough of the hormone that plays a key role in masculine growth and development during puberty (testosterone) or enough sperm or both

Lecture: Male Reproductive Physiology

19
Q

Distinguish between primary and secondary hypogonadism

A

Primary: Decreased T, Increased LH

Secondary: Decreased T & Decreased or normal LH

Lecture: Male Reproductive Physiology

20
Q

What is Kallman’s syndrome?

A

GnRh neurons fail to migrate to the hypothalamus leading to delayed or absent puberty & loss of smell

Lecture: Male Reproductive Physiology

21
Q

What is Klinefelter’s syndrome (Seminiferous tubular dysgenesis)?

A

47, XXY genotype

  • Phenotypically male because of presence of Y chromosome
  • At puberty, increased gonadotropins fails to induce normal testicular growth & spermatogenesis.
  • Androgen production is usually low but gonadotropins are elevated, thereby indicating primary hypogonadism.
  • Seminiferous tubules are largely destroyed, resulting in infertile

Lecture: Male Reproductive Physiology

22
Q

What is ectopic implantation?

A

Implantation of embryo outside the fundus of uterus

  • Mostly in oviduct
  • No decidualization
  • Can cause tissue rupture and hemorrhaging
  • Lecture: Fertilization & Implantation*
23
Q

What is it called when no mentruation has occured by the age of 13 w/o secondary sexual development or by age 15 with secondary sexual development

A

Primary amenorrhea

24
Q

What is it called when there’s an absence of menstruation for 6 months or greater

A

Secondary amenorrhea

25
Q

What is it called when there are frequent periods at intervals of < 21 days

A

Polymenorrhea

26
Q

What is it called when there are heavy and/or prolonged menses (>80mL and > 7 days) occurring at regular interval

A

Menorrhagia

27
Q

What is it called when there are irregular episodes of uterine bleeding

A

Metorrhagia

28
Q

What is it called when there are heavy and irregular uterine bleeding

A

Menometrorrhagia

29
Q

What is it called when there is scant bleeding at ovulation for 1 or 2 days

A

Intermenstrual bleeding

30
Q

What is it called when menstrual cycles has a > 35 day cycles

A

Oligomenorrhea

31
Q

What is PALM COEIN used for & what does it stand for

A

Abnormal bleeding classification

P - Polyps

A - Adenomyosis

L - Leiomyoma (fibroids)

M - Malignancy & Hyperplasia

C - Coagulation

O - Ovulatory Dysfunction

E - Endometrial

I - Iatrogenic

N - Not yet classified

32
Q

What are the stages of normal pubertal development

A

TAG ME

T - Thelarche (breast development)

A - Adrenarche/Pubarche (pubic hair/axillary hair development)

G - Growth Spurt

ME - Menarche (onset of menses)

33
Q

What is it called when there’s an excess of amniotic fluid

A

(Poly)Hydramnios

34
Q

What is it called when there’s insufficient amniotic fluid

A

Oligohydramnios

GIGU Exam 2 (8 decks)

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