Gynecology and OB Flashcards
Ligament of the uterus that provides substantial uterine support
Cardinal ligament
Uterosacral
Level I
Point of reference to compute POP Pelvic Organ Prolapse scoring
Hymen
Risk factor associated to 10 fold higher odds of POP
vaginal birth
Initial incision to the parietal peritoneum to gain access to the retroperitoneal space
Round ligament
Artery that courses through round ligament
Sampson artery
Sampson artery is a branch of the
uterine artery from internal iliac
Suspensory ligament of the ovary
Infundibulopelvic ligament
with ovarian vessels
Ovarian arteries are direct branch of
Aorta
R ovarian vein drains to
IVC
L ovarian vein drains to
Lef renal
Blood vessel in cervix is located at
3 o clock
9 o clock
Most common site of cervical dysplasia
Transformation zone
Old -> new squamocolumnar junction
Ovarian artery is a branch of
Aorta
Uterine artery is a branch of the
Internal iliac artery
Water under the bridge
Uterine artery above ureter
Ligated to control hemorrhae
Internal iliac artery
Ovarian artery
Hyperflexion of the leg in lithotomy injures what nerve
Femoral nerve
Hyperflexion of the knee during lithotomy injures the
Common peroneal nerve
Most catastrophic bleeding occurs when implantation site is in the
Intramural segment (anastomosis of ovarian and uterine artery)
Preferred site to apply occlusive device such as clip for female sterilization
Isthmus
Honeycomb pattern
Snowstorm pattern
Molar pregnancy
Structures that originate from Mullerian duct
Fallopian tube
Uterus
Cervix
Absence/agenesis of Mullerian Duct
Cc: Primary amenorrhea
XX
With vagina upon IE but no cervix, uterus and fallopian tube
With ovary
Mayer Rokitansky Kuster Hauser Syndrome
Cervic
Uterus
Fallopian tube
All from Mullerian duct are lined by
Columnar epithelium
True conjugate
Obstetric conjugate
Diagonal conjugate
12
10
11.5
TOD
Subtract 1.5 - 2 cm from True conjugate
End product of follicular phase
Estrogen high
Aromatization of adrostenedione and testosterone into estrogen and progesterone is made possible by this hormone
Progesterone
LH surge is caused by
High output estrogen
Primary oocytes are arrested in this phase of meiosis I?
Prophase I
End product of luteal phase
Progesterone
Secondary arrest of primary oocyte happens in what phase of meiosis II
Metaphase
First histologic indication of progesterone
Subnuclear vacuoles
Stimulates GnRH
Neuroepinephrine
Neuropeptide Y
Glutamate
Inhibitory to GnRH
GABA
Beta endorphin
CRH
dopamine
Estrogen is secreted by
Dominant follicle of ovary
Estrogen target organs
Hypothalamus
AP
Endometrium
+ feedback
growth of endometrium
Inhibin is secreted by
Dominant follicle of ovary
Inhibin targets the
Anterior pituitary
- feedback
to inhibit FSH to promote ovulation
Progesterone is secreted by
Corpus luteum of ovary
Targets endometrium
Secretion of glands and hyperplasia
Clomiphene citrate MOA
Estrogen antagonist for anovulation to stimulate inc FSH
Letrozole
Aromatase inhibitor that inhibits enzyme that hydrolzes enzyme for aromatization
Best time to perform UTZ in AUB
Day 4-6 menstruation
= 5 mm rules out endometrial carcinoma
Endometrial biopsy is done if
age >40 years
risk factors for endometrial CA
failure of medical treatment
breast CA patient on tamoxifen with AUB
Attenuated androgen
Produces hypoestrogenic and hyperandrogenic effect
Danazol
Level II De Lancey support
Pubocervical fascia anteriorly
Rectovaginal fascia posteriorly
Levator ani (through tendinous fasciae)
Level III De Lancey Support
Perineal membrane
Relaxin is secreted by the
Corpus luteum along with progesterone
Palpable lateral bulge or soft prominence one of the locations where the uterine tube meets the uterus
Piskacek sign
Ferning is by the hormone
estrogen
Response to pregnancy/progesterone by vaginal cells
Navicular cell
Naked cell
All clotting factors are increased in pregnancy except
XI
XIII
Inc 50% of fibrinogen
All CV functions increased except
SVR
Anemia threshold in pregnancy
First - 11 g/dl
Second - 10.5 g/dl
Third - 11 g/dl
Pregnant is more prone to GERD due to laxity because of
Progesterone
Hyperemesis gravidarum tx
Doxylamine with Pyridoxine
No pregnancy >20 weeks
Nullipara
But Gravida
Iron requirement
60 mg/day elemental iron
100 mg ferrous fumarate
150 ng ferrous sulfate