FSH and LH and TSH and PRL differences in: - primary ovarian failure - Turners - functional hypothalamic amenorrhea

- POF: FSH and LH high, TSH and prl normal - Turner = high FSH and LH - FHA = decr FSH and LH, nml prl and TSH

Female Reproductive System and Breast Flashcards by Elise Wolff

Heavy menstrual bleeding with DYSMENORRHEA and chronic pelvic pain with SYMMETRICALLY enlarged uterus that is boggy and tender and MOBILE.

adenomyosis

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Heavy menstrual bleeding without chronic pelvic pain with IRREGULARLY enlarged uterus.

leiomyomata uteri (fibroids)

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Heavy menstrual bleeding with DYSMENORRHEA and chronic pelvic pain but NONTENDER, IMMOBILE uterus.

endometriosis

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tx of chlamydia and neisseria gonorrhea

chlamydia = azithro
neisseria = ceftriaxone

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BASE of labia majora - cyst at 4 or 8 o’clock position = dx?

bartholin duct cyst

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Upper anterior vagina lesion that doesn’t involve the vulva = dx?

Gartner duct cyst

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induce ovulation in PCOS how?

clomiphene citrate (selective estrogen receptor blockade at hypothalamus, so GnRH pulsatile release continues to normalize LH for ovulation surge (and FSH)

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describe TSH, T4 and T3, and free T4 changes during pregnancy

TSH decreases
T3/T4 normal
Free T4 incrases

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Beta-hCG stim what thyroid hormone in first trimester?

total t4

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severe onset ul lowe abd pain following sex or strenuous activity.
u/s shows free fluid

ruptured ovarian cyst

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severe onset ul lower abd pain, N/V. ul tender andexal mass palpated.
u/s shows enlarged ovary with decr blood flow

ovarian torsion

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LEEP does what?

removes cervical transformation zone

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endometrial bx indications BY AGE: -45yo or greater

ANY abn uterine bleeding or postmenpausal bleeding

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endometrial bx indications BY AGE:

-less than 45yo

abn uterine bleeding PLUS
unopposed estrogen (OBESITY, anovulation)
failed medical mgmt
lynch syndrome (HNP colorectal cancer)

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endometrial bx indications BY AGE:

-35y or older with:

ATYPICAL GLANDULAR CELLS ON P AP bc it can be dt either cervical or endometrial adenocarcinoma.

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pharyngitis and PID presentation - think what bug?

neisseria

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endometrial hyperplasia in postmeno (ie. from androgens) lead to what type of endometrial carcinoma?

Androgens

= Adenocarinoma

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In a stable owman with suspected ectopic: beta hcg <1500. what next?

repeat in 2 days.

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in a stable owman with suspected ectopic: beta hcg >1500. what next?

repeat in 2 days AND TVu/s

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Primary amenorrhea (>15yo w/o menarche): 
(1) uterus present --> what next?

uterus present –> FSH

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Primary amenorrhea (>15yo w/o menarche): 
(1) uterus absent --> what next?

uterus absent –> karyotype

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FSH and LH and TSH and PRL differences in:

primary ovarian failure
Turners
functional hypothalamic amenorrhea

POF: FSH and LH high, TSH and prl normal
Turner = high FSH and LH
FHA = decr FSH and LH, nml prl and TSH

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what lesion involves the vulva, perianal skin, but spares the vaginal? assoc with autoimmune (DM1, thyroid)

lichen sclerosis

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symmetric breast fullness/tenderness 3-5d post delivery = ?

engorgement

if fetal mvmts decrease... first test. MCC if that test is nonreactive?

do a NST. MCC of nonreactive is fetal sleep

if NST is nonreactive, then do what?

vibroacoustic stim

first line tx for postpartum hemorrhage

first line is oxytocin and bimanual massage.

four vax CI in pregn

VZV, live flu, MMR, HPV

accels during delivery + fetal tachycardia (baseline >160bpm) + maternal fever (>100.4) + uterin etenderness/discharge/leukocytosis --> ?

chorioamnionitis

accels during delivery + SINUSOIDAL tracings.

fetal anemia

AE of oxytocin:

SEIZURES DUE TO hyponatremia. hypotension, uterine tachysystole (abn frequent contractions >5 in 10min).

variable decels with <50% of contractions - next step

this is well tolerated by the fetus and just tx | with maternal position readjustment

at ten weeks gestation, what test can be offered to mom with high risk pregnancies?

cell free DNA testing

presents as a low abd/back pain, high freq/low amplitude cxns, firm TENDER uterus --> ?

placenta abruption

two RF for placental abruption

smoking and preeclampsia

encephalopathy, nystagmus, gait ataxia - caused by deficiency in what. what can cause this deficiency?

thiamin/B1 alcoholism or hyperemesis gravidarum

1. short cervix with hx of preterm labor? do what? | 2. shrot cervix w/o hx?

1. progesterone injections + TVUS for cervical length (Prog matinatins uterine quiescence) 2. TVUS + CL

3 first line anti-HTN drugs in preg

Hydralazine (vasodilator), nifedipine, labetalol

Hx factors that lead to significant redution in ovarian cancer risk:

BSO and OCPs

Solid masse, thick septations, ascites. involves ovary, fallopian, PERITONEUM. sx: bloating, pain, early satieyt, abd distension (ASCITES). Dx?

epithelial ovarian carcinoma

Dx? is complex multilocular mass involving tube and overy on u/s.

Tubo-ovarian abscess

What is (ectopic implantation of endometrial glabd on ovary surface show on u/s as homogenous cyst with internal echoes (ground glass).

endometriosis

RF for cerivcal cancer:

tobacco, HPV 16, 18

RF for ovarian cancer

FHx, endometriosis

Decr ovarian cancer risk

delayed menarche and early menopause

RF for endometrial cancer =

chronic anovulation, obesity (unopposed estrogen).

Decr endometrial cancer risk with:

progesteron (p-only IUD, OCP) dt differentiation of endometrial cells and prevention of hyperplasia.

progesterone wihtdrawal should cause?

mensturation if no menses, then the problem is with ESTROGEN - not endough for endometrial proliferation/build up. Low estrogen predisposes to osteo.

type of ovarian cyst assoc with: high beta-hCG levels (molar preg orin pregnancy) and RESOLVE after levels decline. Appear as multiseptated bilateral cystic masses on ultrasound.

theca lutein

type of ovarian cyst:occur in first half of menstrual cycle and asx

Follicular cysts

type of ovarian cyst: is B9 in PREMENOP AUSAL. Ultrasound shows hyperchoic nodules and calcifications. Most asx, but can include pelvic pain or pressure. High associated with OVARIAN TORSION.

dermoid ovarian cyst (mature cystic teratoma)

SERMs - MOA and names (2)

A: tamoxifen and raloxifene. they INHIBIT ESTROGEN binding. (***Tamoxife inhibits @ breast; AGONIST in uterus and bone).

what are indiations to both SERMs

A: tamoxifen - adjuvant breast cancer tx. Raloxifene for post meno osteoporosis.

Adverse effects of both SERMS

tamoxifen = endometrial hyperplasia and carcinoma (dt unopposed estrogen). Both - hto flash an VTE.

Lichen sclerosus v. atrophic vagintis - presentation and treatment?

A: Atrophic vaginitis is itchiness, VAGINAL DRYNESS, dyspareunia. Tx with topical ESTROGEN. Lichen sclerosus has cigarette-tissue like skin changes, loss of normal anatomical markers. Vulvar itching, thinning. VAGINA UNAFFECTED. Tx with topical CS.

acute pancreatits etiology: elevated alk phos, high BMI, ALT>150

gallstone pancreatitis

what classifies arrest of active labor?

A: when no cervical change for four or more hours despite adequate contractions (200 or more MVUs in 10min) or 6+ hours with inadequate cxns.

What do you do next if arrest of active labor?

A: Cesarean delivery.

when do you give oxytoci in labor?

A: Protracted (slow) labor -- with INADEQUATE cxns.