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GYN > Female Physiology > Flashcards

Female Physiology Flashcards

1
Q

How are blood levels controlled between the ovaries and the hypothalamus?

A

Feedback mechanism

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2
Q

When serum estrodiol levels fall below a certain serum concentration, the _____________ produces ___________?

A

Hypothalamus; gonadotropin releasing hormone (GnRH)

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3
Q

The ___________ and ___________respond to estrogen and progesterone levels in blood.

A

endometrium; ovaries

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4
Q

Once GnRH is released, the pituitary gland is stimulated to produce _________ and __________.

A

follicle stimulating hormone (FSH); luteinizing hormone (LH)

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5
Q

What hormone stimulates the growth and development of ovarian follicles?

A

FSH

**note: as follicles grow, increasing estradiol levels within follicles help them respond to the LH with eventual ovulation.

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6
Q

What hormone makes a follicle mature into the “graffian” or dominant follicle that ruptures causing ovulation?

A

LH

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7
Q

The bleeding and shedding of the endometrial lining that occurs at approximately monthly intervals from menarche to menopause is called?

A

mesturation

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8
Q

The onset of menses, usually occurring between 11-14 years of age, is called?

A

menarche

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9
Q

Termination of regular menses, usually occurring between 45-55 years of age, is called?

A

menopause

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10
Q

Termination of regular menses prior to age 40 is called?

A

premature menopause

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11
Q

What are the Ovarian Phases?

A
  1. Follicular Phase (days 1-14)
  2. Ovulation (day 14)
  3. Luteal Phase (day 15-28)
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12
Q

What hormone stimulates the follicular phase of the ovary?

A

FSH

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13
Q

Several follicles develop each month and the dominant follicle my be identified about day ______ when it measures _____.

A

8; 10mm

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14
Q

Any follicle > 11mm, will most likely __________.

A

ovulate

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15
Q

How will a dominate follicle grow? And what is the maximum diameter?

A

Linearly approximately 2-3mm/day

Diameter varies 15-30mm

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16
Q

What does a line of decreased reflectivity around follicle suggest?

A

ovulation will occur in 24hrs

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17
Q

What does the presence of cumulus oophorus (mural nodule within follicle) suggest?

A

ovulation will occur within 36hrs

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18
Q

For ovulation, a surge of what hormone causes rupture of follicular membrane?

A

LH

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19
Q

Sono findings that indicate ovulation has occurred are?

A

Sudden decrease in follicular size

Free fluid in Pouch of Douglas or adnexa

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20
Q

In the luteal phase of ovary, what happens to the crater left by expulsion of the ovum?

A

Becomes filled with a fatty yellowish cell type which becomes corpus luteum.

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21
Q

The corpus luteum manufactures and secretes ____________ and smaller amounts of estrogen to prepare and maintain the endometrium for _____________.

A

progesterone; implantation

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22
Q

If there is a pregnancy, what happens in regards to hormones?

A

BhC6 is produced to stimulate corpus luteum to produce progesterone.

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23
Q

If there is no pregnany, what happens in regards to hormones?

A

No BhC6, no stimulation of corpus luteum, no progesterone, decrease progesterone, destabilization of Endo, menstruation.

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24
Q

Sono findings in the luteal phase include:

A
  1. Replacement of dominant follicle with an echogenic structure representing thrombus
  2. Small irregular cystic mass with irregular thick borders and low-level echos = the blood inside
  3. Hypervascular with low resistance flow
25
Q

What are the uterine phases?

A
  1. Menstrual Phase (days 1-5)
  2. Proliferative Phase (days 6-14)
  3. Secretory Phase (days 15-28)
26
Q

The desquamation and sloughing of the superficial layer of the endometrial tissue and blood cells occurs and is expelled in form of menses is what uterine phase?

A

Menstrual Phase

27
Q

Sono findings of menstrual phase of uterus include:

A

thick, echogenic endometrium prior to start of menses.

complex appearance at beginning of menses

very thin (2mm) after menses

28
Q

What uterine phase includes: The regeneration and proliferation of Endometrium, is stimulated by estrogen which is secreted by the developing follicles?

A

Proliferative Phase

29
Q

Sono findings pf proliferative phase include:

A

“triple stripe” = tri layered endo

which is hypoechoic area around prominent midline echo.

30
Q

What happens during the secretory phase of uterus?

A
  • At ovulation the endo prepares for possible implantation of fertilized ovum.
  • Progesterone from corpus luteum causes endometrium to become edematous and spongy
  • Without BhC6 from a fertilized egg, the progesterone production from corpus luteum falls and menses begins.
31
Q

Sono findings of Secretory phase:

A

thick, echogenic endo, 14-16mm. No triple stripe

32
Q

Excessive volume during cyclic menstrual bleeding is called?

A

Hypermenorrhea (Menorrhagia)

33
Q

An abnormally small amount of menstrual bleeding is called?

A

Hypomenorrhea

34
Q

Frequent menstrual bleeding occurring less than 21 days apart is called?

A

Polymenorrhea

35
Q

Menstrual bleeding occurring more than 35 days apart is called?

A

Oligomenorrhea

36
Q

Irregular, frequent bleeding is called?

A

Metrorrhagia

37
Q

Bleeding that is irregular in both frequency and volume is called?

A

Menometrorrhagia

38
Q

Bleeding that occurs between normal cycles is called?

A

Intermenstrual bleeding

39
Q

Intermenstrual bleeding in OC or HRT is called?

A

Breakthrough Bleeding

40
Q

Bleeding after vaginal intercourse is called?

A

Postcoital bleeding

41
Q

Painful bleeding is called?

A

Dysmenorrhea

42
Q

Absence of menstrual flow is called?

A

Amenorrhea

43
Q

Amenorrhea can be Primary or Secondary which means?

A

Primary: patient has never had a period
Secondary: patient had periods but they stopped

44
Q

Bleeding occurring 1 year after menopause or at unanticipated times in HRT is called?

A

Post-menopausal bleeding

45
Q

Abnormal bleeding from an essentially normal uterus. Causes may be functional or organic, and may include endocrine disorders and many others.

A

Dysfunctional uterine bleeding (DUB)

46
Q

What are OCP’s?

A

Oral Contraceptive Pills

  • pills contain estrogen and progesterone taken everyday for 20-21 days
  • prevents ovulation, no dominant follicle
  • endo growth often surpressed, so normal cyclic endo measurements will not be observed
47
Q

What is an IUD?

A

Intrauterine Contraceptive Device

  • can last 5-10 years
  • all types are seen on ultrasound: echogenic line with posterior shadow
  • most common complication is uterine perforation
48
Q

Inability of a man or women to achieve pregnancy after at least a year of regular sexual intercourse without birth control is called?

A

Infertility

49
Q

What are the percentages of infertility?

A

40% due to female factors
40% due to male factor
5-10% due to both male and female
5-10% unexplained

50
Q

Female infertility factors include but not limited to?

A
  • anovulation & abnormal ovulation
  • tubal and transport factors
  • endometriosis
  • uterine factors (fibroids, congenital anomalies)
  • PCOD
  • Cervical factors (mucus non alkaline)
51
Q

What are the drugs for ovulation inductions? (4)

A
  1. Clomid = Clomiphene Citrate
  2. Gonadotropins
  3. Glucophage = Metformin
  4. Parlodel
52
Q

What is IVF?

A

In Vitro Fertilization

  • ovaries are stimulated to produce follicles
  • transvaginal ultrasound performed daily to monitor follicles
  • oocytes are aspirated and incubated with sperm
  • 2-4 fertilized eggs are transferred to uterine cavity
53
Q

When Embryo (or zygote) is placed into the fallopian tube (rather than the uterus, as with IVF) this is known as?

A

Zygote Intrafallopian Tube Transfer (ZIFT)

54
Q

What is it called when sperm and ova are placed into the fallopian tube?

A

Gamete Intrafallopian Tube Transfer (GIFT)

55
Q

What is it called when sperm is placed into uterus?

A

Intrauterine Insemination (IUI)

56
Q

What are 2 complications of fertility treatment?

A
  1. Ovarian Hyperstimulation Syndrome (OHSS)

2. Multiple Gestations

57
Q

A condition resulting from excessive stimulation of the ovaries is?

A

Ovarian Hyperstimuation Sydrome

58
Q

Sonographic findings of Ovarian Hyperstimulation Syndrome are?

A
  • large simple cysts with a diameter >5cm
  • bilateral
  • may have acites and pleural effusion
59
Q

What are some risks that can happen with multiple gestation’s?

A
  • increased risk to mother

- increased risk of premature delivery

GYN (6 decks)

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