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Obstetrics and Gynecology > OB Correlates > Flashcards

OB Correlates Flashcards

1
Q

Left Ovarian vein and testicular veins drain to

A

Left renal vein

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2
Q

Right ovarian and right testicular vein drains to

A

IVC

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3
Q

Surgical abdomen
Board like rigidity
From hypercoagulability in pregnancy

A

Ovarian vein thrombosis

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4
Q

Most common blood vessel in pelvic thrombophlebitis

A

Left Ovarian veins emptying into left renal vein

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5
Q

Which anticoagulant can be given in pregnancy

A

Heparin

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6
Q

APAS (hypercoagulable state) give

A

heparin

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7
Q

Antidote for heparin toxicity

A

Protamine sulfate

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8
Q

Most varicoceles are found on the

A

Left side bec of 90 degree drainage of left testicular vein to left renal vein

Assoc with left renal tumor

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9
Q

Bridge over troubled water during hysterectomy

A

Iliac artery over ureter

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10
Q

Pudendal canal aka

Transmits

A

Alcocks canal

Internal pudendal artery, vein and nerves pass

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11
Q

Alcock’s canal is derived from the fascia of the muscle

A

obturator internus

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12
Q

Syndrome presenting with congenital absence of uterus and vagina

A

Mullerian dysgenesis

Mayer Hauser Rokitansky Kuster syndrome

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13
Q

Hypogonadism

Anosmia

A

Kallman syndrome

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14
Q

Dec in levels activate puberty

A

GABA

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15
Q

Causes decrease in circulating LH and prolactin

A

Dopamine

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16
Q

Dec AMPLITUDE of GnRH

A

Estrogen

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17
Q

Dec FREQUENCY of GnRH

A

Progesterone

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18
Q

Stimulatory pulsatile/inhibitory continuous

A

Neuropeptide Y in stressful situations

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19
Q

GnRH is secreted in

A

pulsatile manner

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20
Q

Reproductive process begins in the

A

brain

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21
Q

Low GnRH pulse frequency

A

FSH synthesis

Progesterone

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22
Q

High GnRH frequency

A

LH synthesis

Progesterone

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23
Q

Constant release of GnRH leads to

A

Drastic reduction of gonadotropic response
Desensitization
Downregulation

Rx: GnRH agonist (FSH)

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24
Q

We test for B HCH bec the different subunit in hormones are

A

Beta !!

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25
Q

Acts on granulosa cells

A

FSH

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26
Q

Acts on theca cells

A

LH

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27
Q

Plays a role in follicle growth and maturation

A

FSH

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28
Q

Plays a role in ovulation

A

LH

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29
Q

Goals of ovarian cycle

A

Produce a mature follicle

Steroidogenesis of estrogen, progesterone

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30
Q

On the follicular and midcycle the steroid produced is

A

estrogen

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31
Q

On the lutesl cycle the steroid produced is

A

progesterone (inhibitory to GnRH)

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32
Q

Causes completion of Meiosis I and becoming secondsry oocyte prior ovulation

A

LH surge

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33
Q

Arrest of oocyte development happens in

A

Metaphase

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34
Q

Non growing oocyte arresting prophase of meiosis

Envelopes by single layer of spindle granulosa cells

A

Primordial follicle

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35
Q

Unilaminar or multilaminar

A

Primary preantral follicle

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36
Q

Change of pregranulosa layer to single layer of cuboidal cell
First change of follicle development

A

Unilaminar preantral follicle

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37
Q

Surrounding by zona pellucida
Complete granulosa prolif
Dependent on hormone:

And correlated with inc:

A

Multilaminar preantral follicle

FSH

ESTROGEN

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38
Q

Critical feature in rescuing cohort of follicles from atresia
Allows dominant follicle to emerge and pursue ovulation

Initiates steroidogeneis: estrogen production

A

FSH rise

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39
Q

Androgen substrate is converted into estrogen via aromatization by

A

FSH!

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40
Q

Gonad ind recruitment of primordial follicle from resring pool and their growth to antral stage
Regulare grabulosa cell prolif

A

Growth differentiation factor 9

Bone Morphogenetic protein 15

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41
Q

Transforming growth factor B superfamily
Secretory product of granulosa cells in preantral and small antral folllicle
Inhibits premature follicle growth

A

Anti Mullerian Hormone

Take anytime of the cycle

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42
Q

Inc in production of follicular fluid in intracellular space eventually forming cavity

A

Antral follicle

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43
Q

Granulosa cell sureounding oocyte

A

Cumulus oophorus

Fluid rich in hormones, gf, cytokines

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44
Q

Excessive inc in estrogen initiates this feedback on hypo

A

Positive

If enough, negative feedback

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45
Q

Recruitment of a cohort
Selection of dominant follicle
Growth of selected dominant follicle

A

Follicular phase

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46
Q

Goal of two cell system

A

Accelerate estrogen production with help of theca cells responding to LH to produce ANDROGEN

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47
Q

Inhibits FSH

A

Inhibin

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48
Q

What hormone gonadotropin peaks before ovulation

A

LH

Peak at 10-12h prior ovulation
Stimulates resumption of meiosis metaphsse II in 2nd meiotic division

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49
Q

Cervical mucus becomes thinner and more stretchy
Resting body temp rises 0.4 and 0.6
LH surge occurs in 24 h prior ovularion detected with home testing kit
Twinges of ovarian pain mittlesmerchz

A

Signs of ovulation

50
Q

Rapid neovasc of once avasc granulosa

Hypertrophy and inc capacity to synthesize hormones

A

Luteal phase

Luteinization

51
Q

Transformation from ruptured follicle to corpus luteum is regulated by

52
Q

Prevents involution of or rescues corpus luteum
6 weeks AOG
Detected 8-9 days postovulation
Produced by:

Peaks: 60-70d AOG 10w

A

HCG

synciotrophoblasts

53
Q

Most biologically potent naturally occuring estrogen

A

17B estradiol

54
Q

Endometrial layer affected by hormones

55
Q

Hallmark of secretory phase in endometrium

A

Subnuclear vacuolization

56
Q

Secretion or glyocgen in endometrial cavity

A

Secretory phase

57
Q

Return to non pregnant state

A

Involution

58
Q

Puerperium is

A

4-6 w postpartum

59
Q

Episiotomies heal in

60
Q

Blood volume postpartum returns to normal after

61
Q

Cardiac ouput returns to normal after

62
Q

Peripartum cardiomyopathy lasts until

A

6 months postpartum a dilated type

63
Q

Injury to Lumbosacral root resulting in footdrop

Predisposed by

A

Obstetrical neuropathy

Increased weight
Gravid uterus
at third tri

64
Q

Pfannenstiel cut may damage the nerve

A

ilioinguinal

Iliohypogastric

65
Q

Foot drop is caused by

Especially when positioned this way during delivery

A

Common peroneal fibular nerve

Stirrups

66
Q

Numbness of lateral thigh common during pregnancy

A

Meralgia Paresthetica

Lat femoral cutaneous nerve

67
Q

Damage to femoral nerve occurs during

A

Prolonged hip flexion

Weak quads problem with knee ext

68
Q

Shedding of decidua superficialis

69
Q

Lochia 1-3d

70
Q

Lochia at 4-10th day

71
Q

Lochia at >10d 14

72
Q

Foul lochia indicates

A

Poor healing DM
Infection
Retained secundines

73
Q

When fever persists more than 3 days despite IV antimicrobials consider

A

Parametrial phlegmon

74
Q

Occurs within 10d postpartum

Resolve in 3 days after

A

Postpartum blues

75
Q

Postpartum blues

A 
Fatigue
Discomfort
Apprehension on care of baby
Jealousy and dec security
Inability to satisfy husband’s needs
76
Q

Delayed with lactation

bec of

A

return of menses

Prolactin inhibiting GnRH

77
Q

In nonlactating mothers, menstruation returns in

78
Q

Post partum check up

79
Q

Pap smear after

80
Q

38 C above

on any 2 of the first 10d postpartum

A

Puerperal infection

81
Q

Most common cause of post op fever during first 24h post op in surgery

A

atelectasis

82
Q

Top cause of puerperal infection

A

Mastitis by

Staph aureus

83
Q

Most common cause of abortion

A

Ovular or fetal factor

Maternal factor

84
Q

Early fetal wastage

Gross defect in ovum or fetus

A

Ovular or fetal factor

85
Q

Most common chromosomal abnormality

A

Autosomal trisomy

86
Q

Most common maternal factor inducing abortion

A

infection PID

87
Q

Violin string adhesions PID spreading to abdominal cavity

A

Fitz Hugh Curtis Syndrome

88
Q

Gold standard for dx of PID

A

Laparoscopy

89
Q

Process of abortion started but not progressed to state from which recovery is impossible

A

Threatened

90
Q

Uterine size comparable with A/G

External os closed

A

Threatened abortion

91
Q

Changes have progressed to a state from which continuation of pregnancy is impossible

A

Inevitable abortion

92
Q

Inc vaginal bleeding
Aggravation of pain
Dilated internal os

A

Inevitable abortion

93
Q

Sonographic evidence of nonviable pregnancy of more than 8 weeks

A

Missed abortion

94
Q

Minimal bleeding, closed internal os

A

Missed abortion

95
Q

Products of conception EXPELLED EN MASSE

A

Complete abortion

96
Q

Hx of expulsion of fleshy mass
Subsidence of abd pain
Cervical os closed
Intact expelled fleshy mass

A

Complete abortion

97
Q

Most common type of abortion

A

Incomplete abortion

98
Q

Smaller uterus
Palpable tissue at os
Incomplete expelled mass

A

Incomplete abortion

99
Q

Passage of tissue, incomplete do

A

D & C

Empty uterus

100
Q

Minimal bleeding and cramping

Empty uterus: utz

A

Complete abortion

101
Q

Sheehan syndrome on MRI

A

Pituitary apoplexy/hemorrhage

102
Q

Habitual abortion:

A

3 or more consecutive abortions

103
Q

Work up for habitual abortion

A 
Thyroid study
Parental karyotype
Hysterosalpingography
APAS
SLE
104
Q

Most common abortifacient in PH

A

Misoprostol
cytototec
prostaglandin analog PGE1

Also enhances cervical ripening
vasodilator

105
Q

PGE2 is

A

dynoprostone

106
Q

Uteroplacental apoplexy

Bluish purple copper disc of uterus by extravasion into myometrium

A

Couvelaire uterus

107
Q

Pregnancy is diabetogenic bec of

A

HPL
Placental insulinase (degrades insulin, inc resistance)
Elevated cortisol and progesterone

108
Q

GDM is

109
Q

Women with high plasma glucose levels, glucosuria and ketoacidosis

A

Overt diabetes

110
Q

Screening for GDM should start in

A

24-28 weeks in women not known to have glucose intolerance early in pregnancy

111
Q

50g glucose load given without fasting

Value confirmatory of GDM

A

> 200mg/dl

112
Q

if FBS is >130mg%?

A

no need to do
OGTT
Overt DM

113
Q

GDM complication

A

Inc perinatal loss

Macrosomia (hydramnios, congenital fetal malformation)

114
Q

Congenital malformations in women with overt DM

A 
Caudal regression
Situs inversus
Spina bifida hydroceph CNS defect
Anencephaly
Heart anomalies
Anal/rectal atresia
Renal anomalies (agenesis, cystic kidney and duplex ureter)
115
Q

Disorder or syndrome impairing development of lower half of body

A

Caudal syndrome

116
Q

Anti hypertensive assoc with renal agenesis

117
Q

Anticonvulsant assoc with neural tube defects

A

Valproic acid

118
Q

What drug used for tx of multiple myeloma causes significant congenital anomaly of limbs

A

thalidomide

119
Q

When is screening for GDM done in women at high risk?

A

first clinic visit

120
Q

Blood test for DM are more apt to be abnormal than in the non pregnant state due to

A

inc placental lactogen

Obstetrics and Gynecology (18 decks)

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