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AA Y4 Finals cards NE > Gynaecology- the reproductive system > Flashcards

Gynaecology- the reproductive system Flashcards

1
Q

name the 3 main hormones involved in the follicular phase?

A
  • LH
  • FSH
  • oestrogen
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2
Q

describe the effect of oestrogen at low concentrations and at high concentrations?

A

low concentrations: inhibits release of FSH and LH

high concentrations: stimulates the release of LH

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3
Q

what does a spike in concentration of LH trigger?

what does this mark?

A

triggers ovulation

ovulation marks the beginning of the luteal phase

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4
Q

where is oestrogen released from in the follicular phase?

A

the theca granulosa cells, which surround the follicles

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5
Q

what is the main difference between primary and secondary follicles?

A

secondary follicles express receptors for FSH

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6
Q

what does the one follicle that releases the oocyte become?

A

the corpus luteum

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7
Q

name the 3 main hormones released throughout the luteal phase?

A
  • progesterone (the key one)
  • inhibin
  • oestrogen
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8
Q

what are the main roles of oestrogen?

A
  • develops endometrial thickness
  • bone and muscle growth
  • development of secondary sexual characteristics
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9
Q

what is the role of progesterone?

A

acts on tissues that have previously been acted on by oestrogen:

  • breast tissue
  • maintains endometrial thickness
  • inhibits release of GnRH
  • thickens cervical mucous
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10
Q

what is essential to allow the corpus luteum to survive past the 28 days of a normal menstrual period?

A

hGC - if there is no hGC, the corpus luteum will break down

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11
Q

what is hGC produced by?

A

the syncytiotrophoblast of the embryo

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12
Q

what is the role of inhibin?

A

released by the corpus luteum during the luteal phase

inhibits release of FSH

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13
Q

why will obese kids hit puberty earlier than normal weight kids?

A

aromatase - it is a component of adipose and is required for oestrogen production

therefore, the more adipose tissue, the higher the aromatase content

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14
Q

what events mark the start and end of the follicular phase?

A

start: menstruation
end: ovulation

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15
Q

what is required for further development of the secondary follicle?

A

FSH

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16
Q

what happens to the chromosomes of the egg when a sperm enters the egg?

A

the 23 chromosomes of the egg multiply into 2 sets

one set combine with the 23 chromosomes from the sperm to form a diploid set of 46

the other set of 23 float off to the side and create a polar body

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17
Q

how many days after ovulation does the blastocyst arrive in the uterus?

A

8-10 days

18
Q

after how many weeks gestation is the placental development complete?

A

10 weeks

19
Q

what sends signals to spiral arteries that reduces their vascular resistance and makes them more fragile?

A

trophoblast invasion of the endometrium

20
Q

what does the reduced vascular resistance and increased fragility of the spiral arteries result in?

A

increased blood flow to these areas and eventual breakdown of the arteries

this leaves pools of blood, called lacunae

21
Q

what is the role of lacunae?

A

they enable oxygen, co2 and other substances to diffuse between maternal and fetal blood

maternal blood flows into the lacunae from the uterine arteries and back out through the uterine veins

22
Q

how many weeks gestation do lacunae form?

A

20 weeks

23
Q

what happens to the oxygen when maternal and fetal blood are near each other in the placenta?

A

HbF has a greater affinity for O2 than HbA

as a result, O2 is drawn off the maternal Hb, across the placental membrane and onto the HbF

24
Q

describe the course of hGC throughout pregnancy?

A

hGC levels increase in early pregnancy

plateau at 10 weeks gestation, then start to fall

25
Q

which types of contraception should be avoided in a patient with a family history of breast cancer?

A

any hormonal contraception should be avoided

copper coil or barrier methods are preferred

26
Q

which methods of contraception should be avoided in patients with endometrial or cervical cancer?

A

avoid the intrauterine system (mirena coil)

27
Q

name 5 key risk factors that would mean the COCP is contraindicated?

A
  • migrane with aura
  • uncontrolled HT
  • history of VTE
  • aged >35 smoking >15/day
  • SLE and antiphospholipid syndrome
28
Q

does HRT prevent pregnancy?

A

no - additional contraception is required

29
Q

why should the progesterone injection be stopped before 50 years?

A

due to the risk of osteoporosis

30
Q

which form of contraception can be used to treat perimenopausal symptoms?

A

the COCP

it should be stopped once patient is 50 years

31
Q

which forms of contraception are considered safe in breastfeeding?

A

POP

implant

they can be started any time after birth

32
Q

when can the COCP be started following childbirth in a breastfeeding mother?

A

in breastfeeding mothers, the COCP should not be started before 6 weeks after childbirth

the POP and implant can be started at any point after birth

33
Q

when can a copper coil or IUS be inserted following childbirth?

A

either within 48 hours of birth or 4 weeks after birth

34
Q

what is the primary method of action of the COCP?

A

prevents ovulation

35
Q

how does the COCP prevent ovulation?

A

the oestrogen and progesterone contained in the pill exert negative feedback on the hypothalamus and ant pit

this supresses the release of GnRH, LH and FSH - ovulation is unable to occur

36
Q

how does the COCP affect periods?

A

improvement in premenstrual symptoms, menorrhagia and dysmenorrhoea

37
Q

which cancers does COCP reduce risk of, and which cancers does it increase risk of?

A

increase risk: breast and cervical

decrease: endometrial, ovarian and colon cancer

38
Q

over what BMI is the COCP contraindicated?

A

BMI > 35

39
Q

at which point in the cycle must the COCP be started to avoid having to use any barrier contraception?

A

must be started before day 5 of the cycle

barrier contraception must be used for the 1st 7 days of consistent pill use otherwise

40
Q

when switching from POP to COCP, what additional contraception is required?

A

7 days of barrier contraception

41
Q

what implications does a day of D&V have on the COCP efficacy?

A

D&V may affect absorption

therefore, a day of D&V is classed as a missed pill day

42
Q

how long before a major operation must be COCP be stopped?

A

stop taking pill 4 weeks before operation

AA Y4 Finals cards NE (40 decks)

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