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EXAM 3 Flashcards

1
Q

Which hormone is released in a pulsatile manner by the hypothalamus?

A

GnRH

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2
Q

FSH and LH are released by the

A

Anterior pituitary (stimulated by GnRH)

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3
Q

FSH function

A

Gathers follicles to stimulate their growth

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4
Q

LH function

A
  • Maturation of the selected follicle

- Lutenizaiton of ruptured follicle

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5
Q

Estrogen function

A

Thicken the endometrium

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6
Q

Progesterone function

A

Stabilize the endometrium - vasodilation, stabilization

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7
Q

Which hormone dominates the first half of the menstruation cycle

A

Estrogen

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8
Q

Which hormone dominates the second half?

A

Progesterone

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9
Q

Follicular Phase time frame

A

Day 1 of menstruation to ovulation

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10
Q

What hormones are involved in the follicular phase?

A
  • Estrogen is steadily rising from the maturing follicles

- LH surge triggers ovulation

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11
Q

What happens in the luteal phase?

A

Ruptured follicle becomes the corpus luteum –> secretes progesterone to prep endometrium for implantation –> if no fertilization occurs then everything decays and lowers

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12
Q

Normal menstrual cycle

  • age
  • cycle interval
  • amount
  • length
A
  • 12.5 years
  • 21-35 days
  • 25-60 mL
  • 3-7 days
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13
Q

What is PCOS?

A

Polycystic Ovary Syndrome

  • Too much LH (and excess androgens) –> excess body/facial hair, male pattern baldness, acanthosis nigrans, acne
  • Metabolic syndrome
  • Increased risk for type 2 DM
  • Infertility, anovulation
  • IRREGULAR PERIODS
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14
Q

How are your periods in PCOS?

A

Irregular!!

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15
Q

What is AUB/DUB?

A

No LH surge –> no corpus luteum –> no progesterone –> unstable endometrium

  • Estrogen without a primed endometrium
  • EXCESS PROLIFERATION –> excess and irregular bleeding
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16
Q

Amenorrhea

A

No menses

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17
Q

Oligomenorrhea

A

Irregular scant menses

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18
Q

Dysmenorrhea

A

Painful (cramps)

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19
Q

Menorrhagia

A

Excessive in amount and duration

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20
Q

PMS

A

Luteal phase symptomology

- Anxiety, irritability, breast pain, bloating, headaches, fatigue

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21
Q

PMDD

A

More severe PMS - more affective symptoms

- Serotonin driven –> tx with SSRI

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22
Q

What neurotransmitter is involved in PMS/PMDD?

A

Serotonin

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23
Q

Normal pH of Vagina

A

3.5-4.2

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24
Q

What makes the vagina acidic?

A
  • During high levels of estrogen –> glycogen stores are deposited into the vagina –> lactobacilli eat this –> produce lactic acid (and H2O2 and O2)
  • Lactobacilli maintain acidic environment
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25
Bacterial vaginosis
- clue cells | - green discharge
26
Trochimoniasis
- erythema cervix - flagella - frothy green discharge
27
Candidiasis
- yeast | - budding
28
What % of pregnancies are unintended
51%
29
How many of those unintended pregnancies end in termination?
Half
30
5Ps
- prevention - partners - past history - protection - practices
31
What kind of language should you use for sexual history taking?
Normalizing
32
How do you test for Chlamydia?
NAAT
33
Chlamydia tx
Azithromycin, doxycycline
34
When is HSV transmitted?
During asymptomatic periods
35
What can trigger recurrences of HSV?
Stressful events
36
Symptoms of HSV
- burning, itching lesions | - prodromol symptoms may precede outbreaks
37
Which types of HPV are oncogenic
16, 18
38
Which types of HPV are non-oncogenic
6, 11
39
Most prominent menopausal symptom
hot flashes
40
4 major causes of early bleeding (before 20 weeks)
- ectopic pregnancy - implantation - spontaneous abortion - CVU
41
Spontaneous abortion is common in....
chromosomal abnormalities
42
How do you confirm spontaneous abortion
Transvaginal ultrasound
43
Symptoms of spontaneous abortion
- back ache - cramping - bleeding
44
Spontaneous abortion assessment
- gestational age - pain or painful bleeding - intermittent or constant bleeding - amount of bleeding
45
Which trimester does ectopic pregnancy bleeding occur?
1st trimester
46
Med for ectopic pregnancy
Methotrexate
47
Interventions for Early Bleeding
- determine hemodynamic stability - Rhogam - IV fluids - Labs (low CBC, low HCG) - Surgery - Recognition of loss
48
What kind of bleeding in Placenta Previa
Painless
49
What should you avoid in Placenta Previa?
Vaginal exams
50
Management for Previa
- bed rest with bathroom privileges - IV fluids - Monitor V/S, contractions, pain, blood loss - FHR - Betamethasone
51
What kind of bleeding in Placental Abruption
Painful bleeding
52
Causes of Placental Abruption
- Drugs - HTN - Cocaine
53
Symptoms of Placental Abruption
- Painful bleeding - Contractions - Premature labor
54
Bishop Scoring System
Cervical readiness for induction
55
Interventions for Prolapsed Umbilical Cord
- knees to chest | - elevate presenting part off the cord
56
Interventions for Precipitous Labor and Birth
- Apply gentle pressure to fetal head - Counter pressure on perineum - Have mom pant, blow - Support infant - Suction baby - Don't leave the patient alone
57
Mechanism of Gestational Diabetes
Hormones... - increase production of glucose - increase insulin resistance
58
Maternal and Fetal Risks of Gestational DM (4)
- fetal macrosomnia - pre term labor - mother developing DM - still birth
59
Pregnancy safe anti-hypertensives
- hydralazine | - labetalol
60
med for pre-eclampsia
- Magnesium sulfate
61
Meds for preterm labor
- Tocolytic agents | - Betamethasone
62
Signs of preterm labor
- Strong, frequent regulations - Effacement - Dilation - Rupture of membranes - short cervix = good predictor
63
What lab will be low in an ectopic pregnancy or spontaneous abortion?
B-Hcg
64
Which condition do you have the mom bed rest?
Placenta previa

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