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CD3409 > Lecture 4 > Flashcards

Lecture 4 Flashcards

1
Q

what is the main source of relaxin and what does it do

A

main source is corpus luteum

-prepares body for preg and labour

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2
Q

When does relaxin levels peak in preg

A

increased up to week 12 (then stays consistent)

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3
Q

Risk associated w decreased relaxant

A

lower levels early in preg have greater risk of miscarriage, gestational hypertension, preclampsia

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4
Q

What is relaxins role in abnormal uterine bleeding

A

possible that relaxin could contribute to abnormal uterine bleeding

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5
Q

How is relaxin related to uterine fibroids

A

Research suggests that uterine fibroids may be sites of relaxin storgage/ activity

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6
Q

What conditions can relaxin be linlked to

A

endometriosis

gynelogical cancers (role in progression and metastasis)

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7
Q

ACL laxity and relaxin; when does it occur in cycle

A

There is evidence that their is increased laxity mainly in pre ovulatory phase (4-6x increase of injury)

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8
Q

What is the criteria for mentrual migraine with or without aura

A

migraine w/wo along with

–Mighraine occurring in perimentrual period (on day -2 to +3 of mentruation in at least 2/3 mentrual cycles)

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9
Q

Mentrual migraine two types and descriptions

A
  1. mentrual related migraine- attacks in the mentrual period but can also occur during the cycle

Pure mentrual migraine- attacks confined to perimentrual period only

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10
Q

etiology of mentstrual migraines

A

associated with estrogen withdrawl

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11
Q

what is the mc of anovulatory infertility

A

Polycystic ovarian syndrome

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12
Q

What is polycystic ovarian syndrome characterized by

A

Hyperandrogenism
Ovulatory dysfunction
Polycystic ovarian morphological features

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13
Q

What is features of hyperandrogegism in PCOS

A

Acne
Excess hair groth on face/body (mc)
Thinning scalp hair
Ancanthosis nigricans

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14
Q

What is ovulatory dysfunction in PCOS

A

mc fx of PCOS

-Menstrual cycles longer than 35days
Irregular or no menstrual periods
-mc cause of anovulatory infertility

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15
Q

Polycystic ovarian morphological features

A

-accumulation of enraptured follicles on the periphery of the ovaries (mislabeled cysts)

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16
Q

What is the major change in the cycle in relation to hormones in those with PCOS

A

In women with PCOS the follicles don’t ovulate such that the surge of progesterone occurs

17
Q

Imaging modality for PCOS and what will you see

A

US

-string of pearls sign suggests PCOS morphological features

18
Q

What are some associated risks with PCOS

A
  • cardiometabolic abnormalities
  • high prev of hyperlipidemia
  • hypertension
  • myocardial infarction
  • CVD
  • type 2 diabtetes
19
Q

Increased cancer risks of PCOS

A
  • Endometrial cancer (2.7x higher)
  • Uterine cancer
  • Breast cancer
  • Ovarian cancer
20
Q

what is a major syndrome associated with 33% of women with PCOS

A

metabolic syndrome

21
Q

3 main criteria for PCOS dx

A
  1. hyperandrogegism
  2. Ovulatory dysfunction (menes <21 days or >35)
  3. Polycystic ovarian morphological fx
22
Q

What are the 2 pharm tx for PCOS

A
  1. Birth control= surpasses GnRH and ovarian androgen prod
    - decrease risk of endometrial cancer
    - possivble increase in CVD tho
  2. Metformin- decreases hyperinsulemia and lowers serum test
    - helps slow abnormal hair
    - may help ovulation continue
23
Q

What is the conservative tx to PCOS

A

Weight loss via low glycemic diet
-5-10% can reduce cardiometabolic risk factors

increase exercise (>1hr day)

24
Q

What is endometriosis- age, %

A

Painful disorder that generates just before or during mentruation (often confused w primary dysmenorrhea)

  • 6-10% of reproductive women
  • most between 25-35
25
Q

pathology of endrometriosis

A

increased systemic and local pro inflammatory cytokines and growth factor
-leads to peripheral sensitization characterized by hyperalgesic state, central sensitization and myofascial pain

26
Q

Most common clinical pres of endometriosis

A
  • Adnexal masses
  • infertility
  • dysmenorrhea
  • backpain
  • painfull intercourse
  • pain during bowel mvmt
27
Q

Things that put you at increased risk of endrometriosis

A
  • menarche (early, short, heavy)
  • Nulluparity
  • low BMI
  • alchol
  • family
28
Q

4 theories of endometriosis

A
  1. Retrograde flow (endometrial tissue is deposited in unusual loc such as fallopian times etc)
  2. Embryonic seeding (areas lining the pelvic organ processes primitive cells that are able to grow and differentiate into endometrial cells outside lining)
  3. Lymphatic spread (direct transfer of endometrial tissue during surgery)
  4. Altered immune response
29
Q

pharm tx of endometriosis

A

pain meds (NSAIDS)

  • hormone therapy
  • GNRH antagonist
  • Surgery (gold standard)

CD3409 (10 decks)

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