GYN Chapters Flashcards
The ______ ligament supports the tubes and ovaries
broad
The ____ ligament supports the uterine fundus
round—think round like the fundus of ut
the _____ ligament supports the cervix
cardinal—c for both. cervix/cardinal
The ______ ligaments support ovaries and tubes
suspensory
What is the reason that there is a correlation between kidney and uterine anomalies?
they are both formed at the same time in utero
The largest part of the uterus is the
corpus (body)
Uterine Isthmus is also known as
lower uterine segment
Cornua is where the ___ attaches to the ______
fallopian tubes attach to uterus at the level of the horns
endometrial tissue in myometrium
adenomyosis
Sonographic findings of adenomyosis?
- enlarged heterogenous
2. myometrial cysts
Age group of adenomyosis?
older and multiparous
The most common benign tumor is the fibroid. What pts are at risk for this?
obese, black, nonsmokers, perimenopausal.
Name the different types of fibroids
- intramural- myometrium
- submucosal- endometrium
- pedunculated-at risk for torsion causing necrosis.
Cervical carcinoma is common in patients younger than ___ years of age
50
What is mittelschmerz?
ovulation pain
Ovaries are stimulated by follicle stimulated hormone released by the __________
anterior pituitary gland.
formed as dominant follicle ruptures- produced progesterone- often resolved after 16 weeks of gestation
corpus luteum
Theca Lutein cyst will have elevated ______ lab value. It is common in what kind of gestation?
HCG, common with multiple gestations
What is a dermoid a result of?
results from retention of an unfertilized ovum
What is the bright spot in a dermoid?
dermoid plug
Dermoids are composed of what?
tissue bone hari fat cartilage deeth and digestive components
Thecomas produce _____ and are common in post menopausal women
estrogen
Chocolate chip cysts are common in
endometriosis, endometrioma
What are endometriomas more at risk for?
infertility and hemorrhage
Are serous or mucinous cystadenomas more commonly bilateral?
serous
cystadenoma more common in 40-50s and pregnancy
serous cystadenoma
think serous/senior ((even tho that age isnt old :) )
Are serous or mucinous cystadenomas more common to have papillary projections?
serous
Serous cystadenocarcinomas will have an elevated _____
CA 125
Mucinous cystadenocarcinomas will have malignant ascites called ______
pseudomyxoma
metastized from GI tract, appears hyperechoic and bilateral.
Krukenberg
younger than 30, elevation of lactate dehydrogenase (similar to seminoma)
dysgerminoma
Is ovarian torsion more common on left or right?
right
- The hypothalamus located beneath the thalamus, regulates the _______ by anterior pituitary gland – Gonadotropin. L
release of hormones
H SURGES around day _____- resulting in ovulation.
14
Menopausal age is ___.
51
Why does menopause happen?
the estrogen and progesterone levels are lower therefore no follicles are seen making them smaller and become atrophic.
Polyps are linked to
infertility and longer periods
What is endometrial carcinoma linked to?
nulliparity, obesity, anovulation, between 50-65.
- for the age- think endometrial elder.. even though 50-65 is not old :) )
If a person has an elevated CA 125, is it automatically cancer? if not what else can it cause?
no
PID, fibroids, and endometriosis
presence of intrauterine adhesions or synechiae- scar formation after surgery esp a D &C, amenorrhea.
ashermanns
If you scan a patient that has fluid in Morrisons pouch and hyperemic flow around the inflamed tube, what woud this be?
salpingitis
o Thickiened irregular endo, pyosalpinx, FF, complex adnexal masses. Unable to break away ovary and tube with probe .
tubo-ovarian complex
further complication of
TOC, theres a loss of borders of mass and it is often bilateral.
If a patient is unable to conceive after 1 year of unprotected sex and possibly has PID, and a bicornuate/septate uterus, what could this indicate?
infertility.
obese pt w/ abnormal facial hair, infertility, enlarged cystic ovaries and chronic anovulation
PCOS
Patients with _________ ______ are more at risk for torsion due to the enlarged ovaries with theca lutein cysts
Ovarian Hyperstimulation
The reason we cant lay a patient all the way down who is in their 2nd or 3rd trimester is because
we can cause supine hypotensive syndrome which is the reduction of blood returning to heart due to compressed IVC
Reasons for vaginal bleeding in pregnancy
ectopic, Trophoblastic disease, miscarriage, blighted ovum, demise, and subchorionic hemmorrhage
Painless bleeding in 2nd trimester could indicate
placenta previa- covering the internal os of cervix.
Painful vaginal bleeding could be
placental abruption (premature separation of placenta from uterine wall before birth of fetus
Tell me the difference between painless vaginal bleeding and painful vaginal bleeding. What could it indicate?
Painless-placenta previa
Painful- placental abruption
triple screen is done at _______ weeks
what is it testing for?
15-20 weeks
HCG, MSAFP and estriol
types of breech
o complete (legs flexed at hip and flexion of knees)
o Frank- fetal buttock at cervix
o Footling- one foot at cervix
• Normal HCG levels DOUBLE EVERY ______ hrs in 1st trimester
48
A blastocyst consists of two parts
i. Trophoblastic cells-outer part which will become the placenta and chorion
ii. Inner part is the embryo, amnion, umbilical cord and yolk sacs.
Mother and fetus are connected thru tissue called
chorionic villi.
What week will the hintdgut, foregut and midgut be formed as well as the neural tube?
4th week
First heartbeat occurs in what week?
5th
Primary yolk sac regresses and two membranes are formed in the
4th week
How do we calculae the MSD?
L x W x H / 3
o Chorionic and amnion typically fuse middle of first trimester but may not totally fuse until
16 weeks
What is the normal heartbeat in the 6th week of gestation?
100-115
All internal external structures are forming at week
6
A rhomencephalon (hindbrain) is seen as a cyst in week ___ of gestation
7
The fetal limb buds are seen at week
7
Bowel herniation begins at week
8
Midgut migrates into umbilcal cord by week ___ if not resolved by week 12, followup is necessary
8
Placenta starts forming at week
11
The decidua basalis is the _____ contribution to placenta
maternal–
think the mother is allways boss–(bas/boss)
The chorion frondosum is t he ____ contribution to placenta
fetal…. think fetal/frondosum both start with Fs
Brain anatomy is seen at week
9-12
WHen doing the nuchal translucency test, what types of disorders can be indicative?
Trisomy 21, 18, and Turners
What weeks is the nuchal translucency done?
11-14 weeks
It shouldnt measure more than 3mm
What is a heterotopic pregnancy?
when there is an IUP and ectopic together.
What are the clinical findings of heterotopic pregnancy
vag bleeding, pain, pelvic mass, low HCG, low hematocrit
Whos more at risk for ectopic pregnancies?
o PID, multiparity, AMA, infertility treatment, HX ectopic or tubal surgery.
What medication is given for ectopics?
Methotrexate
Which type of ectopic is more common for hemmorhage?
interstitial/corneal pregnancies that are in the tube
clinical findings of fetal demise
vag bleeding with close cervix, often linked to chromosomal abnormalities
Another name for a molar pregnancy
gestational trophoblastic disease
Why do gestational trophoblastic happen?
result of abnormal combo of male and female gametes.
Clnical findings of trophoblastic disease
Elevated HCG ^, vaginal bleeding, hypertension, pre/eclampsia.
sonographic findings og Gestational trophoblastic disease
large complex mass with snowstorm appearance with cystic spaces representing chorionic villie.
New subchorionic hemorrhage will appear
hyperechoic or isoechoic
Old subchorionic hemorrhage will appear
anechoic
