Female Flashcards

1
Q

How does an ovarian follicle develop?

A
  • Starts as promordial follicle
  • Starts do build up the proteins around it and the nucleus gets bigger
    • more and more protein
  • As a graffian follicle, the egg has a large nucleus and is surrounded by the fluid filled antrium
    • must store lots of proteins b/c it will not receive any nutrients for about a week after it ovulates until it becomes implanted
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What surrounds the antrum?Why?

A
  • Granulosa layer- convert the androgen steroids into estrogen
  • Theca interna- where androgen steroids are made
    • it has the white blobs
  • Theca externa- connective tissue
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How does the Hypothalamic-Pituitary-Axis affect males and females?

A
  • Male
    • GnRH causes the release of LH and FSH
    • LH goes to the Leydig cell and increases testosterone synthesis
    • FSH goes to the sertoli cell and increases androgen binding protein which works with the testosterone formed in the leydig cell
    • this supports sperm development
  • Female
    • GnRH causes the release of LH and FSH
    • LH goes to the thecal cell to increase androgen synthesis
    • FSH goes to the granulosa cell and increases aromatase which turns the androgen into estrogen
    • this supports egg development
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How do you diagnose amenhorrhea?

(chart)

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Compare the three pituitary glycoprotein hormones and HCG.

A
  • TSH, FH, LH, HCG
  • All have the same alpha subunit.
  • Specificity for each hormone is found at the beta subunit and protein structure
  • HCG differs from LH only b/c it has 32 additional amino acids in its Beta-subunit
  • TSH and HCG also look very similar and can bind to the same receptors
    • cannot measure TSH during pregnancy, must look at free T3 and T4
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What causes cervical cancer?

What part of cervix is at greatest risk?

A
  • HPV is responsible for almost 100% of cervical cancer and can also cause cancer at other sites
  • The cervic transforms over the lifespan and is at greater risk during some stages than others
  • squamocolumnar junction is at greatest risk
    • at birth it is inside and is protected
    • as a young adult it is exposed
    • as an adult it is inside again and more protected
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Does the HPV vaccine prevent all cervical cancers?

A

No, pap smears are still required.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What causes endometriosis?

A
  • Endometrial cells back flow into the pelvis
    • through falopian tube, into lymph, or into blood
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is a Leiomyoma?

A
  • Uterine fibroid- not a cancer, but a smooth muscle tumor; does not metastasize
  • occur in 30-50% of women
  • can be asymptomatic or very painful
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Stats about endometrial cancer

A
  • Most common cancer of the femal reproductive system but least deadly
    • about 40,000 cases/year
    • about 7,000 deaths
  • commonly affects post-menopausal women and one of the first symptoms is bleeding
    • they get this checked out b/c they havent had a period in many years and know something must be wrong
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the different degrees of uterine prolapse?

A
  • A= normal uterus
  • B= first degree prolaps- descent of uterus within the vagina
  • C= second degree prolapse- the cervix protrudes through the introitus
  • D= third degree prolaps- the vagina is completely everted
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is cystocele?

Rectocele?

A
  • Cystocele- the bulging of the bladder through the vagina
  • Rectocele- the bulging of the rectum through the vagina
    • Ex. the chick on the cruise ship
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is salpingitis?

A
  • Inflammation of the fallopian tubes
  • almost always seen as a component of pelvic inflammatory disease
    • often caused by an infection (chlamydia, gonorrhea, tuberculosous) or endometriosis
    • also can be seen after ectopic pregnancy that has damaged the fallopian tubes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is pelvic inflammatory disease?

A
  • inflammation of the fallopian tube or the ovary or both
  • usually caused by infection or endometriosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is polycystic ovarian syndrome?

A
  • Leading cause of infertility
  • High LH and low FSH
    • LH- makes lots of androstendione
    • FSH- converts androstendione into estrogen
  • Without the FSH you have a bunch of androstendione building up, it goes into circulation
    • causes excess androgens-
    • fat will convert androstendione into estrogen and now the pituitary will think that everything is ok, plenty of estrogen
      • problem is that it is not in the ovary where it needs to be
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the symptoms of polycystic ovarian syndrome?

Treatment?

A
  • Symptoms:
    • Irregular or no menstruation
    • excess androgen
    • enlarged ovaries with multiple cysts
  • Treatment:
    • Medications to regulate menstrual cycle (oral contraceptives)
    • meds to reduce excessive hair growth
    • meds to achieve pregnancy
    • surgery
17
Q

What is the surgery for Polycystic ovarian syndrome?

A
  • laparoscopic ovarian drilling
    • popping the cysts
  • the goal is to stimulate ovulation by reducing levels of LH and androgen hormones
18
Q

Ovarian tumors:

Which one is most common and most deadly? Why?

A
  • Surface epithelial cells tumors are most common of the ovarian tumors, but overall arent that common
  • Most deadly because they go unnoticed for a really long time before they are detected
    • by then they have already metastasized
    • poor prognosis (~23,000 cases/year with about ~14,000 deaths/year)
    • Women with BRCA1 mucation have risk of 30% compared to other women with risk of 2%
19
Q

Where do teratomas come from?

A

Mature teratomas arise from germ cells and are seldom malignant

20
Q

What are the cardiovascular and hematologic changes seen in pregnancy?

A
  • Increased blood volume, RBCs
  • increased SV, HR, CO
  • decreased HCT
  • BP stays about the same but with increased venous pressure in legs
21
Q

What are the respiratory changes seen in pregnancy?

A
  • increased RR, TV, MV, PaO2, and O2 consumption
  • decreased PaCO2 (slight alkalosis), airway resistance, ERV, FRC, TLC
    • no change in VC
22
Q

What are the GI changes seen in pregnancy?

A
  • increased bile secretion, bile stasis, and gallstones
  • decreased LES tone (frequent heartburn), bilirubin (normally, unless they have cholestasis)
23
Q

What are the endocrine changes seen in pregnancy?

A
  • Increased estrogen, progesterone, cortisol, growth hormone, placental lactogen, prolactin
  • decreased bs, TSH (but normal T3/T4
24
Q

What other changes do you see druing pregnancy?

A
  • Increased GFR, pain threshold, CSF
25
Q

What is the difference between a partial molar pregnancy and a complete molar pregnancy?

A
  • Partial mole- some chorionic villi are vesicular and there is a deformed fetus present that is not viable
    • triploid (two DNA from dad, one DNA from mom)
  • Complete mole- all chorionic villi are vesicular, no fetus or embryonic tissue
    • diploid paternal dna
26
Q

What is pre-eclampsia?

A
  • Mother has HTN, proteinuria, and edema
  • happens in 5-10% of pregnancies
  • causes inadequate blood flow to the fetus
    • inadequate development of placental spiral arteries
    • fetus is starved for nutrients so it tells mom to crank up the BP
  • Develops in third trimester, can progress to eclampsia
27
Q

What is HELLP?

A
  • Hemolysis, Elevated Liver enzymes, Low Platelet count
  • complication or varient of pre eclampsia but more serious (1% mortality)
  • often involves liver problems, liver can rupture
  • DIC is seen in 20% of pts with HELLP
  • can progress to eclampsia
28
Q

What is eclampsia?

A
  • involves seizures and can be fatal
  • with current medical care, pre eclampsia and HELLP rarely progress to eclampsia
29
Q

What is placenta previa?

What are the different classifications?

Symptoms?

A
  • When the placenta is too close or covering the cervix
  • Symptoms:
    • painless vaginal bleeding
  • generally not a big issue
30
Q

What is placenta accreta/increta/percreta?

A
  • Placenta is embedded too deeply in the uterus
  • Accreta- attaches to myometrium
  • increta- invades the myometrium
  • percreta- reaches serosa
  • **this is a serious medical problem during delivery
    • removing the placenta will cause hemorrhage; often requires a total hysterectomy
31
Q

What is abrupto placenta?

A
  • premature detachment of the placenta
    • can be partial or complete
  • usually causes vaginal bleeding, but not always
  • painful
  • Obstetric emergency- significant risk to fetus and mom
    • fetus is basically holding their breath one this happens
    • mom at risk for shock, renal failure, and coagulopathies from mixing of blood
32
Q

What are the four Ts of postpartum hemorrhage?

A
  • Four t’s can be the cause of the hemorrhage
    • Tone- soft, boggy uterus
    • trauma- laceration
    • tissue- retained placenta
    • thrombin- blood not clotting
33
Q

What is uterine rupture?

A
  • Uterus ruptures
  • extremely painful
  • often happens d/t old c-section scar
  • this is an obstetric emergency- life threatening to mom and baby
    • both may have neurolgic problems d/t coagulopathy and stroke
34
Q

What is an amniotic fluid embolism?

What are the signs and symptoms?

A
  • Amniotic fluid enters maternal circulation
  • Rare
  • life threatening for mom and baby
  • Fetal cells trigger coagulation in maternal circulation
  • results in PE, can progress to DIC if pt survives long enough
  • most survivors will have long term neurological disorders