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Womens health final > infertility, abortion, mult gestation > Flashcards

infertility, abortion, mult gestation Flashcards

1
Q

Fecundity

A
  • fertility
  • capacity to concieve and produce offspring
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2
Q

sterility vs infertility

A
  • sterility: inability to conceive offspring
  • infertility: diminished capacity to conceive
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3
Q

primary vs secondary infertility

A
  • primary: individual has never conceived
  • secondary: infertility after prior fertility
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4
Q

define infertility

A
  • inability to concieve after 12 months of intercourse without use of condom for women < or = 35; or 6 months in a woman > 35
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5
Q

fecundability

A
  • probability that conception will occur during a specific time period
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6
Q

basic workup for infertility involves evaluation of

A
  • ova
  • spermatozoa
  • patent oviduct
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7
Q

Mittelschmerz

A
  • Usually one-sided, lower belly pain associated with normal ovulation.
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8
Q

what cervical mucus is associated with ovulation

A
  • egg white cervical mucus
    • believed to assist in sperm transport
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9
Q

polycystic ovarian syndrome ia a condition that includes a spectrum of associated features including

A
  • hyperandrogenism - hirsuitism, acne
  • oligomenorrhea, amenorrhea
  • obesity and insulin resistance
  • polycystic ovaries on US
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10
Q

oligomenorrhea

A
  • light or infrequent menstrual periods caused by irregular sloughing of endometrium
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11
Q

hyperplastic growth of endometrium is caused by

A
  • lack of progesteron which causes unopposed estrogen exposure
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12
Q

what is the LH surge predictor kit

A
  • OTC kit that detects pre-ovulation surge in LH
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13
Q

US “string of pearl” sign is consistent with

A

polycystic ovarian syndrome

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14
Q

can hypo or hyper thyroid disrupt normal ovulation

A

both

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15
Q

if prolactin levels are persistently elevated, what imaging is recommended to rule out prolactinoma

A

MRI

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16
Q

treatment of choice for PCOS in patient who desires conception is

A
  • ovulation induction, usually with Clomid (clomiphene)
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17
Q

MOA of Clomid (clomiphene)

A
  • selective estrogen receptor modulator
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18
Q

side effects of Clomid (clomiphene)

A
  • ovarian hyper-stimulation
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19
Q

Clomid (clomiphene) is often used in conjunction with

A
  • intrauterine insemination
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20
Q

anatomic disruption or blockage of both oviducts leading to infertility is often caused by

A
  • untreated STDs/PID
  • surgical procedure
21
Q

tubal blockage can be ruled out with

A
  • hysterosalpingogram
    • evaluates patency of tubes, not necessarily function
22
Q

what are the four main categories of male factor infertility

A
  • hypothalamic pituitary dysfunction
  • primary hypogonadism
  • post-testicular defects
  • seminiferous tubule dysfunction
23
Q

what is the most common congenital abnormality causes primary hypogonadims

A
  • Klinefelters syndrome
    • 47 XXY
24
Q

what medications are used to induce abortion

A
  • Misoprostol + Mifepristone
    • effective 95-98%
25
Q

what is the most common complication of pregnancy

A

spontaneous abortion (miscarriage)

26
Q

define spontaneous abortion

A
  • pregnancy loss which occurs prior to 20 weeks
27
Q

most common cause of spontaneous abortion

A
  • abnormal karyotype
28
Q

define complete spontaneous abortion

A
  • complete passage of products of conception (POC)
29
Q

define incomplete spontaneous abortion

A
  • retention of some POC
30
Q

define threatened spontaneous abortion

A
  • bleeding with closed cervical os
31
Q

define inevitable spontaneous abortion

A
  • open os usually with bleeding
32
Q

define missed spontaneous abortion

A
  • absent heartbeat without bleeding, os is closed
33
Q

define septic spontaneous abortion

A
  • any type of spontaneous abortion associated with infected POC or endometrial lining
34
Q

define recurrent abortion

A
  • three or more consecutive pregnancy losses prior to 20 weeks
    • important cause of subfertility
35
Q

risk of subsequent spontaneous abortion is with each recurrent spontaneous abortion

A

increases

36
Q

most common causes of recurrent abortion

A
  • chromosomal abnormalities
  • uterine malformation
  • antiphospholipid antibody syndrome
37
Q

occurence of monozygotic twins is based on

A
  • random
38
Q

define Di/Di monozygotic twins

A
  • two amnions
  • two chorions
  • two placenta
39
Q

define Mono/Di monozygotic twins

A
  • two amnions
  • one chorion
  • one placenta
40
Q

define mono/mono monozygotic twins

A
  • one amnion
  • one chorion
  • one placenta
41
Q

rate of dizygotic twins increases with

A
  • increasing maternal age
42
Q

which type of twins is influences by assisted reproductive technology

A
  • Dizygotic twins
  • NOT monozygotic twins
43
Q

which complications of twin pregnancies are associated with monoamniotic twins only

A
  • cord entaglement
  • locked twins
44
Q

which type of twins has a genetic predisposition

A
  • dizygotic “fraternal twins”
45
Q

what is twin-twin transfusion syndrome

A
  • unique to monozygotic twins
  • vascular (artery to vein) communications between fetuses who share a placenta results in dircordant blood between fetuses
    • donor fetus is growth restricted
    • recipient fetus is fluid overloaded
46
Q

twin pregnancies are best determined by first trimester US so called for dichorionic and for monochorionic

A
  • dichorionic: “Lambda” or “twin peak” sign
  • monochorionic: “T” sign
47
Q

planned delivery for monozygotic twins

A
  • 34-37 weeks gestation
48
Q

planned delivery for dizygotic twins

A
  • 38-40 weeks

Womens health final (3 decks)

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