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OBGYN > Infertility and PCOS > Flashcards

Infertility and PCOS Flashcards

1
Q

What is the definition of Infertility?

A

Regular, unprotected intercourse without conception for 12 mon

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2
Q

What are risk factors of Infertility?

A

Irregular Cycles

Endometriosis

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3
Q

What factors need to be addressed in HPI of infertility Eval?

A 
Menses char
Timing/freq of intercourse
Length of infertility
Lubrication use
Dysparunia
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4
Q

What factors need to be addressed in Past OBGYN History of infertility Eval?

A

Prev pregnancies including miscarriage
STI
Pap results
Past contraception

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5
Q

What factors need to be addressed in Meical History of infertility Eval?

A 
DM
Thyroid 
Hirsuitism
Galacotorrhea
Hx of Chemo/rad
Wt Changes
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6
Q

What factors need to be addressed in Partner History?

A 
Testicular injury/torsion/inf
Cryptorchidism
Surgical Hx
Anabolic Steroids
STI
Tobacco/Alcohol
Occupation
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7
Q

What factors are assessed in the Semen analysis?

A

Volume
Morphology
Concentration
Motility

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8
Q

What are the lab studies done in Evaluation of Infertility?

A

UA, Vaginal Culture, Pap Smear, wet mount
CBC, TSH, T4, D3 FSH, prolactin, DHEA, Testosterone
BBT or ovulation LH predictor kit
Day 21 serum progesterone
Progesterone Challenge

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9
Q

What is the Purpose of Hysterosalpingogram?

A

Imaging of Fallopian tubes with contrast to assess patency

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10
Q

What is the Spinbarkeit test?

A

Test for cervical mucous consistency

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11
Q

What are the Treatments of Infertility?

A

Surgery for Endometriosis
Clomiphene(low BMI)/Letrozole (High BMI)
Progesterone
Better control of co-morbidities

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12
Q

How is Pregnancy monitored once fertilization is achieved?

A

Check Quant of hCG and serum progesterone
Progesterone Suppositories
Ultrasound

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13
Q

What are the Diagnostic Criteria and Associated conditions associated with PCOS?

A

Hyperandrogen, ovulatory dys, PCO on US

Associated: Obesity, T2DM, dyslipidemia, infert, Thyroiditis

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14
Q

What si the clinical presentation in PCOS?

A 
Menses Irregularities
Acne
Hirsuitism
Androgenic Alopecia
Obesity
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15
Q

WHat is the Biochemical PResentation of PCOS?

A

Hyperandrogen: Free Testost
LH: FSH >2
Hyperinsulinemia
Dyslipidemia

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16
Q

WHat is the Tx of PCOS?

A

1) Lessen symp of Hyperandrogen
2) Manage metabolic comorbid
3) Prevent chronic Anovulation
4) Contraception or Ovulation induction

17
Q

What is the first line Tx of PCOS? second line?

A 
#1 Lifestyle Change
Oral Contraceptives
#2 Spironolactone
18
Q

What was Metformin used for in PCOS?

A 
Dec insulin resistance
AND
Dec Free serum Test
Inc HDL
Weight loss
Restores Ovulation in 50% of PCOS Pts
19
Q

What is the Medical Tx of PCOS induced infertility?

A

No menses? Provera challenge Test
No Spon ovulation, start on day 3-5 Clomiphene
Check serum progesterone on day 21

20
Q

What are the Lifelong implications of PCOS?

A

CV disease
T2 DM
Endometrial Cancer

OBGYN (18 decks)

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