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OBGYN > GYN Basics > Flashcards

GYN Basics Flashcards

1
Q

Human Chorionic Gonadotropin(hCG) is made by —- and peaks at —.

A

placental syncytiotrophoblast, 10 weeks

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2
Q

Human Placental Lactogen(hPL) is simular to —– and causes—-.

A

GH & Prolactin, antagonizes the cellular actions of insulin = pregnancy glucose intolerance

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3
Q

Estradiol

A

dominant during reproductive years = from granulosa cells

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4
Q

Estriol

A

dominant during pregnancy = from placenta

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5
Q

Estrone

A

dominant during menopause = from adipose tissue

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6
Q

Why do you get these skin changes in prego: Striae gravidarum, spider angiomas & palmer erythema, Chadwich Sign, Linea Nigra, Chloasma.

A

Striae gravidarum = stretch makrs, spider angiomas & palmer erythema = increased skin vascularity, Chadwich Sign = bluish or purple discoloration of the vagina and cervix as a result of increased vascularity, Linea Nigra = midline pigmentation, Chloasma = blotchy pigmentation fo the nose and face

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7
Q

Changes in Prego w/CV

A

decrease BP in 1st trimester, lowest at 24wks(should never see elevated arterial bp in prego). increase in plasma volume, decrease in SVR, increase in CO(loest in supine, highest in left later pos). left sternal systolic ejection murmer

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8
Q

Changes in Prego w/Endocrine

A

increase in pituitary size and vasculitty, increase cortisol, increase in TBG due to estrogen = elevated T3/T4 total but normal free T3/T4

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9
Q

Changes in Prego w/Renal

A

increase in volume = increase in kidney size, increase GFR, dec BUN, dec Cr, glucosuria

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10
Q

Changes in Prego w/Pulmonary

A

tidal volume increases due to elevated diaphragm, residual volume decreases ==> RESPIRATORY ALKALOSIS from dec Pco2 & inc pH

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11
Q

Changes in Prego w/GI

A

decreased GI motility & gastric motility due to increased progesterone

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12
Q

Changes in Prego w/Heme

A

increase in RBC MASS; will see dillutional anemia, increased WBC count(max 16,000 @3rd trimester), normal platlets, increased coag factors from liver

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13
Q

—- murmer can be normal in prego.

A

SYSTOLIC(left sternal) = due to increase blood volume. diastolic murmers are never normal and should be investigated

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14
Q

3 in utero shunts within fetus

A
  1. Ductus Venosus: umbilical vein –> IVC
  2. Foramen Ovale: RA –> LA
  3. Ductus Arteriosus: Pulmonary A —> descending aorta
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15
Q

puberty takes — yrs to complete and is usually done by age —.

A

3-4, 16 yoa

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16
Q

dafuq do the following do for lactation: Progest, Estro, Prolac, oxytocin

A

Progest: increase lobules, alveoli
Estrogen: increase ducts
Prolac: milk production
Oxy: milk let down

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17
Q

Colostrum

A

first secretion of mammary ducts after deliver, high in protein low in fat. contains IgA for passive immunity.

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18
Q

how many days after delivery for milk production to reach appreciable levels

A

1-3d

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19
Q

estrogens effect on prolactin

A

estrogen helps ducts develop but also antagonizes positive effect of prolactin on milk production; once placenta is removed prolactin can go to work.

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20
Q

What happens wk 1 postconception?

A

implantation of the blastocysts on the endometrium

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21
Q

What happens wk 2 postconception?

A

bilaminar germ disk with epiblast and hypoblast layers; invasion of material sinusoids by syncytiotrophoblast = 1st time bhCG prego test can be positive

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22
Q

What happens wk 3 postconception?

A

trilaminar germ disk with ectoderm, mesoderm & endoderm is formed

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23
Q

What happens wk 4-8 postconception?

A

Major organs formed most important time

24
Q

after 9 wks teratogens will mostly effect..

A

organ hypertrophy and hyperplasia

25
Q

Ionizing Radiation in pregnancy

A

no single diagnostic procedure results in radiation exposure to a degree that woudl threaten the developing baby.

26
Q

Chemotherapy in prego..

A

greatest risk in first trimester; 2-3 is most resitant

27
Q

Tobaccos fx on prego

A

causes intrauterine growth restriction(IUGR)

28
Q

Fetal Alcohol Syndrome

A

midfacial hypoplasia, microcephaly, mental retardation, IUGR, short palpebral fissures, long philtrum, cardiac defects

29
Q

Cocaine use in prego

A

assoc w/placental abruption, preterm deliver, intraventricular hemorrhage, IUGR

30
Q

Marijuana use in prego

A

preterm delivery

31
Q

Diethylstilbestrol(DES) in pregnancy..

A

“estrogen” that caused T-shaped uterus, vaginal adenosis w/risk of clear cell carcinoma, cervical hood, incomplete cervix, preterm delivery

32
Q

Dilantin in pregnancy

A

aka phenytoin. can cause: fetal hydantoin syndrome(IUGR, craniofacial dysmorphism(epicanthal folds, depressed nasal bridge, oral clefts), mental retardation, microcephaly, nail hypoplasia, heart defects)

33
Q

Isotretinoin(accutane) in pregnancy

A

congenital deafness, microtia, CNS defects, congential heart defects

34
Q

Lithium in prego

A

ebsteins anomaly =atrialization of the right ventrical due to tricuspid valve being displaced down into the ventrical

35
Q

streptomycin in prego

A

inhibits 30s ribosome. Causes CN8 dmg(hearing) = hearing loss

36
Q

tetracyclin in prego

A

blocks 30s ribosome. teeth discoloration/anomalies after the 4th month

37
Q

thalidomide in prego…what does this treat?

A

tx multiple myeloma. causes: phocomelia(malformed limbs), limb retardation, ear/nasal anomalies, cardiac defects, pyloric or duodenal stenosis

38
Q

Trimethadione in prego..

A

anticonvulsant. causes: facial dysmorphisms(short upturned nose, slanted eyebrows), cardiac defects, IUGF, mental retardation

39
Q

Valproic acid(depakote) in prego

A

NTD(spina bifida), cleft lip, renal defects

40
Q

Warfarin(Coumadin) in prego

A

Chondrdysplasia(strippled dpiphysis), microcephaly, mental retardatoin, optic atrophy

41
Q

define: abortion

A

loss prior to 20 wks

42
Q

define: antepartum death

A

death between 20 wks and labor

43
Q

define: intrapartum death

A

death from onset of labor to birth

44
Q

define: perinatal death

A

death between 20 wks and 28 days of life

45
Q

define: infant death

A

death between birth and 1yr

46
Q

define: maternal death

A

death during pregnancy or within 90 days after birth

47
Q

MC trisomy causing 1st trimester lost

A

trisomy 16

48
Q

MC trisomy @term

A

21

49
Q

Klinefelter Syndrome

A

47XXY; dx usually made during puberty = tall, testicular atrophy, azopermia, gynecomastia, truncal obesity, learning disorder, AI dz, low IQ

50
Q

Down Syndrome

A

trisomy 21: mental retardation short stature, muscular hypotonia, brachycephaly, short neck, oblique orbital fissure, flat nasal bridge, small ears, nystagmus, protruding tongue, congential heart disease, duodenal atresia

51
Q

Edward Syndrome

A

trisomy 18: profound mental retardation, rocker bottom feet, clenched fist, F > M; mean survival = 14days

52
Q

Patau Syndrome

A

trisomy 13: frofound mental retardation, IUGR, Cyclopia, Proboscis, holoprosencephaly, severe cleft lip w/palate. meav survual = 2days

53
Q

AD dz’s

A

polydactyly, hunting chorea, achondroplasia, marfan, myotonic dystrophy, PCKD, NF, Osteogenesis imperfecta

54
Q

AR dz’s

A

deafness, CF, thalassemia, albinism, SS anemia, Tay-Sachs dz, PKU, CAH, Wilson

55
Q

XLR Dz’s

A

Hemophila A, Color blindness, complete androgen insensitivity, diabetes insipidus, hydrocephalus, G6PD deficiency, Duchenne muscular dystrophy

56
Q

neural tube should close by —- postconception.

A

22-28 d

57
Q

women at risk for NTD should consume —mg of folic acid. Those who are not shoudl take —mg.

A

risk = 4mg; no risk = 0.4 mg

OBGYN (25 decks)

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