Gynecology Flashcards
What does the seminal vesicle give to sperm?
Food (fructose) and clothes (semen)
What do the bulbourethral (= Cowper’s) glands secrete?
Bicarbonate
(Neutralizes lactobacilli)
What does the prostate secrete?
“the prostate HAZ is”
- hyaluronidase
- acid
- phosphatase
What is the Capacitation reaction?
Zn used to peel semen off
What is the acrosomal reaction?
Sperm release enzymes to eat corona radiata
What is the crystallization reaction?
Wall formed after 1 sperm enters (to prevent polyspermy) the egg
Where does Testosterone come from?
Adrenal gland and testicles
Where does DHT come from?
Testicles (at puberty)
What is a pseudohermaphrodite?
External genitalia problem, does not match genotype
What is a true hermaphrodite?
Internal genitalia problem => has both sexes’ genitalia
What is a female hermaphrodite?
Impossible b/c default is female
What is a female pseudohermaphrodite?
XX w/ low 21-OHase => high testosterone
What is a male hermaphrodite?
XY w/ no MIF
What is a male pseudohermaphrodite?
XY that has low 17-OHase => low testosterone
What is hirsutism?
Hairy
What is virulization?
Man-like see in female child
What is testicular feminization = androgen insensitivity syndrome?
Bad DHT receptor
-> XY w/ blind pouch, vagina
What is McCune-Albright?
Precocious sexual development
Polyostotic fibrous dysplasia = “Whorls of CT”
Pigmented skin macules = “Coast of Maine”
What is Cryptorchidism?
Testes never descended => sterility after 15 months
Incr risk of seminomas
Which stage of the menstrual cycle has the highest estrogen levels?
Follicular stage
(Has proliferative endothelium)
What stage of the menstrual cycle has the highest temperature?
Ovulatory stage
What stage of the menstrual cycle has the highest progesterone levels?
Luteal stage (has secretory endothelium)
What form of estrogen is highest at menopause?
E1 = estrone
(Made by fat)
What form of estrogen is highest in middle-age females?
E2 = estradiol
(Made by ovaries)
What form of estrogen is highest at pregnancy?
E3 = estriol
(Made by placenta)
What states have increased estrogen?
Pregnancy
Liver failure
p450 inhibition
Obesity
What is Adenomyosis?
Growth of endometrium -> myometrium
Enlarged “boggy” uterus w/ cystic areas
What does DES taken by Mom cause in her daughter?
Adenomyosis -> menorrhagia
Clear cell carcinoma of vagina
Recurrent abortions from cervical incompetence
What is Kallman’s syndrome?
No GnRH
Anosmia (cannot smell)
What is Polycystic Ovarian Syndrome?
Incr cysts: no ovulation -> no progesterone
Incr risk of endometrial carcinoma -> cannot inhibit LH
Signs: obese, hairy, acne
What is Savage’s syndrome?
Ovarian resistance to FSH/LH
What is Turner’s syndrome (XO)?
High FSH
Low E2
Ovarian dysgenesis
What does the progesterone challenge test tell you?
Bleeds => she has estrogen
No bleeding => no E2 or ovaries
Incr FSH -> ovary problem
Decr FSH -> pituitary problem
What is Sheehan’s syndrome?
Post-partum hemorrhage -> pituitary and/or hyperplasia infarcts -> no lactation
What is Asherman’s syndrome?
Previous D&C -> uterine scars
What is Oligomenorrhea?
Too few periods
What is polymenorrhea?
Too many periods
What is the most common cause of post-coital vaginal bleeding?
Cervical cancer
What is the most common cause of post-coital vaginal bleeding in pregnant women?
Endometrial cancer
What is chronic pelvic pain?
Endometriosis until proven otherwise
What is dysfunctional uterine bleeding?
Diagnosis of exclusion
Usually d/t anovulation
What is dysmenorrhea?
PGF causes painful menstrual cramps
(Teenagers miss school/work)
What is endometriosis?
Painful cyclical heavy menstrual bleeding
=> powder burns, chocolate cysts
Due to ectopic endometrial tissue
What is Kleine regnung?
Scant bleeding at ovulation
What is Menorrhagia?
Heavy menstrual bleeding
What is fibroids (= leiomyoma)?
Benign uterus smooth muscle tumor
- submucosal type => bleeding
- subserosal type => pain
What is Metrorrhagia?
Bleeding or spotting in b/w periods
What is Mittelschmerz?
Pain at ovulation
What causes syphilis?
Treponema pallidum (spirochete)
What is herpes?
dsDNA virus = HSV 1 or HSV 2
What is HPV?
dsDNA = papillomavirus
What is Chlamydia?
Obligate intracellular parasite
What causes Gonorrhea?
Gram neg diplococcus
What causes Chancroid?
H. ducreyi
What causes lymphogranuloma venereum?
Chlamydia trachomatis
What causes granuloma inguinale?
C. granulomatosis
What causes epididymitis?
Chlamydia or GC
What is condyloma lata?
Flat, fleshy warts -> ulcerate
Secondary syphilis
What is condyloma accuminata?
Verrucuous “cauliflower” warts
Koilocytes
HPV 6, 11
How does herpes present?
Primary: painful grouped vesicles on red base
Secondary: painful solitary lesion
How does syphilis present?
Primary: painless chancre (1-6 weeks)
Secondary: rash, condyloma lata (6 weeks)
Tertiary: neuro, cardio, bone (6 years)
How does Chancroid present?
Painful w/ necrotic center
Gram neg rod
“School of fish” pattern
How does lymphogranuloma venereum present?
Painless ulcers -> abscessed nodes -> genital elephantiasis
How’s does granuloma inguinale present?
Spreading ulcer
Donovan bodies
Granulation test
How does Chlamydia present?
Cervicitis (yellow pus)
Conjunctivitis
PID
How does Gonorrhea present?
Palmar pustules
Arthritis
Urethral discomfort with very purulent urethritis
What is epididymitis?
Unilateral scrotal pain
Pain decreased by lifting testes
What causes Congenital blindness?
CMV
What causes neonatal blindness?
Chlamydia
What is Lichen simplex chronicus?
Raised white lesions
Chronic scratching in vulva
What is Lichen sclerosis?
Paper-like vulva
Itching
Incr cancer risk
What is hidradenoma?
Sweat gland cysts
What causes non-bacterial fetal infections?
“TORCHS”
- toxoplasma
- others
- Rubella
- CMV
- HSV-2
- Syphilis
Non-bacterial infection:
Toxoplasma
Multiple ring-enhancing lesions
Cat urine
Parietal lobe
Non-bacterial fetal infection:
Rubella
Cataracts
Hearing loss
PDA
Meningoencephalitis
Pneumonia
“blueberry muffin” rash
Non-bacterial fetal infection:
CMV
Spastic diplegia of legs
Hepatosplenomegaly
Blindness
Central calcifications
Non-bacterial fetal infections:
HSV-2
Temporal lobe hemorrhagic encephalitis
Need C/S prophylaxis
Non-bacterial fetal infections:
Syphilis
Rhagade’s (lip fissure)
Saber shin legs
Hutchison’s razor teeth
Mulberry molars
Saddle nose
What is Paget’s disease of the breast?
Rash and ulcer around nipple
Breast cancer
What is Lobular carcinoma?
Cells line up single file
Contralateral primary
What is a Comedocarcinoma?
Multiple focal areas of necrosis
“Blackheads”
What is inflammatory carcinoma?
Infiltrates lymphatics
Pulls on Cooper’s ligaments
“Peau d’orange”
What is cystosarcoma phylloides?
“Exploding mushroom”
- Firm
- Rubbery
- Moveable
Good prognosis
What is Intraductal papilloma?
Nipple bleeding
What is ductal carcinoma?
Worst prognosis for breast cancer
What is sarcoma botyroides?
Vagina cancer
Ball of grapes appearance
What is a Sister Mary Joseph nodule?
Ovarian CA spread to umbilicus
What is Meig’s syndrome?
Pleural effusion
Ovarian fibroma
Ascites
What are the side effects of estrogen?
Weight gain
Breast tenderness
Nausea
What are the side effects of progesterone?
Acne
Depression
HTN
