Gynecology Flashcards
What does the Seminal Vesicle give to sperm?
Food (fructose) and clothes (semen)
What do the Bulbourethral =Cowper´s gland secrete?
Bicarbonate (neutraliza lactobacilli)
What does the Prostate Secrete?
“The prostate HAZ it”
Hyaluronidase
Acid Phosphatase
Zinc
What is the Capacitation reaction?
Zn used to peel semen off
What is the Acrosomal reaction?
Sperms release enzyme to eat corona radiata
What is the Crystalization Reaction?
Wall formed after 1 sperm enters (to prevent polyspermy)
Where does the testosterone come from?
Adrenal gland and testicles
Where does DHT come from?
Testicles (at puberty)
What is a Pseudohermaphrodite?
External genitalia problem
What is a True Hemaphrodite?
Internal genitalia problem => has both sexes
What is a Female Hemaphrodite?
Impossible b/c the default is female
What is a Female Pseudohemaphrodite?
XX with low 21 -OHase => high testosterone
What is male Hermaphrosite?
XY with no MIF
What is a male Pseudohermaphrodite?
XY that has low 17-OHase => low testosterone
What is Hirsutism?
Hairy
What is Virilization?
Man-like
What is testicular Feminization = Androgen Insensitivity Syndrome?
Bad DHT receptor -> XY w/blind pouch vagina
What is McCun-Albright?
Precocious sexual development, polyostotic fibrous dysplasia “whorls of CT”, “Coast of Maine”, pigmented skin macules
What is Cryptochordism?
Testes never descend => sterility after 15 months seminomas
Which stage of 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 level?
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 CA of vagina
Recurrent abortions
What is Kallman’s syndrome?
No GnRH, anosmia (can’t smell)
What is Polycystic Ovarian Syndrome?
^ Cysts: no ovulation -> no progesterone
(^ endometrial CA) -> can’t inhibit LH, 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
Not bleed=> she has no E2 or ovaries
^FSH -> Ovary problem
Low FSH -> pituitary problem
What is Sheehan syndrome?
Post-partum hemorrhage-> pituitary, 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 bleding?
Cervical cancer
What is the most common cause of vaginal bleeding in post menopause women?
Endometrial cancer
What is. Chronic Pelvic Pain?
Endometriosis until proven otherwise
What is dysfunctional uterine bleeding?
Diagnosis of exclusion, usually due to 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 regnum?
Scant bleeding at ovulation
What is menorrhagia?
Heavy menstrual bleeding
What is Fibroids= Leiomyoma?
Benign uterus SM tumor
- Submucosal type=> bleeding
- Subserosal type=> pain
What is Metrorrhagia?
Bleeding or spotting in between periods
What is Mittelschmerz?
Pain at ovulation
What causes Syphilis?
Treponema pallidum (spirochete)
What is Herpes?
ds DNA virus
What is HPV?
ds DNA virus
What is Chlamydia?
Obligate intracellular bacteria
What causes Gonorrhea?
Gram - diplococcus
What causes Chancroid?
H.ducreyi
What causes Lymphogranuloma Venerum?
Chlamydia trachomatis
What causes Granuloma inguinale?
C. Granulomatosis
What causes Epididymitis?
Chlamydia
What is Condyloma Lata?
Flat fleshy warts, ulcerate, 2 syphilis
What is Condyloma Accuminata?
Verrucous “cauliflower” warts, koilocytes, HPV 6,11
How does Herpes present?
1 grade painful grouped vesicles on red base
2 grade painful solitary lesion
How does Syphilis presents?
1 grade painless chancre (1-6 wks)
2 grade rash, condyloma lata (6wks)
3 grade neuro, cardio, bone (6yrs)
How does Chancroid present?
Painful w/ necrotic center, Gram - rod, “school of fish” pattern
How does Lymphogranuloma Venerum present?
Painless ulcers-> Abscessed nodes-> genital elephantiasis
How 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
What is Epididymitis?
Unilateral scrotal pain decreased by support
What causes. Congenital blindness?
CMV
What causes neonatal blindness?
Chlamydia
What is Lichen simplex chronicus?
Raised with lesions, chronic scratching
What is Lichen sclerosis?
Paperlike vulva, itching, cancer risk
What is Hidradenoma?
Sweat glands cysts
What causes non-bacterial fetal infections?
“TORCHS”
Toxoplasma: multiple ring-enhancing lesions, cat urine, parietal lobe
Others
Rubella: cataracts, hearing loss, PDA, meningoencephalitis, pneumonia, “blueberry muffin” rash
CMV: spastic diplegia of legs, hepatosplenomegaly, blindness, central calcifications
HSV-2: temporal lobe hemorrhagic encephalitis, need C/S prophylaxis
Syphilis: Rhagade’s (lip fissure), saber shin legs, Hutchison’s razor teeth, mulberry molars
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, most common breast CA
What is ductal carcinoma?
Worst prognosis breast cancer
What is Sarcoma botyroides?
Vagina cancer, ball of grapes
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, HA
What are the side effects of progesterone?
Acne, depression, HTN
What is the most common cause of post coital vaginal bleeding?
Placenta Previa