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OBGYN > OBG-female physiology > Flashcards

OBG-female physiology Flashcards

1
Q

the endometrium and ovaries respond to ______ and ______ levels in the blood

A

estrogen and progesterone

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2
Q

blood levels are controlled by a ______ between the ovaries and the hypothalamus

A

feed back mechanism

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3
Q

when serum estradiol falls below a certain serum concentration, the hypothalamus produces ______

A

Gn RH = gonadotropin releasing hormone

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4
Q

the pituitary gland is then stimulated to produce ______ and ______

A

FSH = follicle stimulating hormone and LH = leuteniting hormone

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5
Q

as follicles grow, increasing estradiol levels within follicles help them ______ to the LH, with eventual ovulation

A

respond

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6
Q

the bleeding and shedding of the endometrial lining that occurs at approximately monthly intervals from menarche to menopause

A

menstruation

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7
Q

the onset of menses, usually at 11-14 years

A

menarche

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8
Q

termination of regular menses, usually between 45-55 years old

A

menopause

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9
Q

termination of regular menses prior to age 40

A

premature menopause

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10
Q

the bladder is adequately full for transabdominal pelvic US, when the dome of the bladder extends above the ______

A

uterine fundus

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11
Q

transabdominal followed by transvaginal US is the ______ for pelvic US

A

standard of care

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12
Q

what are the 3 contradictions to transvaginal US?

A

virginity, 3rd trimester bleeding, and postmenopausal vaginal stenosis (due to lack of estrogen)

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13
Q

what are the 3 ovarian phases?

A

follicular phase, ovulation, and luteal phase

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14
Q

in this ovarian phase the egg is surrounded by a fluid, FSH stimulating dominate egg (follicle), the dominate follicle (graffian follicle) moves to the surface (cortex) of the ovary

A

Follicular phase (day 1-14)

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15
Q

several follicles develop each month, the dominate follicle is identified about day ______ when it measures 10mm, size is larger than others

A

8

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16
Q

the dominate follicle grows linearly, approximately ______ per day, max diameter varies between ______

A

2-3mm, 15-30mm

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17
Q

any follicle greater than ______ will likely ovulate, a line of decreased reflectivity (hypoechoic) around the follicle suggest that ovulation will occur in ______

A

11mm, 24 hours

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18
Q

presents of cumulus oophorus (mural nodule in the follicle) suggest ovulation will within ______ hours

A

36

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19
Q

in this ovarian phase there is a surge of LH, then rupture of follicular membrane within 24-36 hours of the LH surge

A

ovulation (day 14)

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20
Q

what are the sonographic findings indicating that ovulation has occurred?

A

sudden decrease in follicular size and free fluid in pouch of douglas or adnexa

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21
Q

at this ovarian phase there is a crater left by the expulsion of the ovum, the crater is filled with a fatty, yellowish cell type (corpus luteum or “yellop body”)

A

luteal phase (day 15-28)

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22
Q

______ secretes progesterone and smaller amounts of estrogen to prepare and maintain the endometrium for implantation

A

corpus luteum

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23
Q

if there is a pregnancy, the pregnancy produces ______ (positive preg test), which stimulates the corpus luteum to produce progesterone. If not pregnant, drop in progesterone and menstruation begins

A

BhC6

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24
Q

what are the sonographic findings in luteal phase?

A

replacement of dominate follicle with an echogenic structure representing thrombus, small irregular cystic masses with irregular borders and low level echoes (the blood inside), its hypervascular with low resistance flow

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25
Q

what are the 3 uterine phase?

A

menstrual phase, proliferative phase, and secretory phase

26
Q

______ is a catabolic process in which the ends is shed if implantation does not occur

A

menstruation (day 1-5)

27
Q

______ phase is desquanation and sloughing of the superficial layer of endometrium and blood cells, expelled in the form of menses

A

menstrual

28
Q

what is the sonographic findings of the menstrual cycle?

A

thick, echogenic prior to onset of menses complex at beginning of menses very thin (2mm) after menses

29
Q

______ phase- regeneration and proliferation of endometrium, stimulates by estrogen which is secreted by the development of follicles

A

proliferative

30
Q

what are the sonographic findings in proliferative phase?

A

“triple stripe” or tri layered endometrium, hypoechoic area around prominent midline echo

31
Q

______ phase- at ovulation, the endometrium prepares for possible implantation of a fertilized ovum, progesterone from corpus luteum causes edematous, spongy endometrium

A

secretory (day 15-28)

32
Q

without BhC6 from a fertile egg, the progesterone production from corpus luteum ______, causing menses

A

falls

33
Q

what are the sonographic findings in secretory phase?

A

thick, echogenic endometrium, 14-16 mm, no triple stripe

34
Q

______ pills contain both estrogen and progesterone, taken everyday for 20-21 days to prevent ovulation, no dominate follicle. the endometrium growth often is suppressed, so endometrium measurements will not be observed

A

oral contraceptive pills

35
Q

______ can lest 5-10 years depending on the type, seen as an echogenic line with posterior shadow.

A

IUD (intra uterine contraceptive device)

36
Q

______ is the inability of a man and women to achieve a pregnancy after at least 1 year of regular sexual intercourse without birth control

A

infertility (1 in 7 american couples affected)

37
Q

what can cause infertility in females?

A

no ovulation or abnormal ovulation, transport/tubal factors (adhesion from infection), endometrioris, uterine factors like leiomyomas (fiborials), polycystic ovarial disease, and cervical mucus non alkaline

38
Q

pelvic ultrasound is first line evaluation for fertility workup, ultrasound is also used in fertility clinics to ______ and ______ follicles

A

count and evaluate

39
Q

what are the drugs for ovulation induction?

A

clonyphane citrate (clomid), stimulate released FSH or LH (gonadotropens), metformin (glucophoge), and porlodel

40
Q

with ______ ovaries are stimulated to produce follicles, transvaginal ultrasound is preformed daily to monitor follicles

A

invitrofertilization (IVF)

41
Q

which invitrofertilization, oocytes are aspirated and incubated with sperm, ______ fertilized eggs are transferred to uterine cavity

A

2-4

42
Q

with ______ embryo (zygote or ferilized egg) is placed in the fallopian tube instead of the uterus

A

Zygote Intrafallopian tube transfer (ZifT)

43
Q

with ______ sperm and ova is placed in fallopian tube

A

Gamete intrafallopian tube transfer (GIFT)

44
Q

with ______ sperm it placed into uterus

A

intrauterine insemination (IUI)

45
Q

what are the two complications of fertility treatment?

A

ovarian hyper stimulated syndrome and multiple gestations

46
Q

______ is large simple cysts with a diameter grater than 5 cm, bilateral, and may have acites and pleural effusion

A

ovarian hyper stimulated syndrome (OHSS)

47
Q

mild cases of OHSS usually resolve spontaneously following the next menstrual cycle, sever cases are associated with a mortality rate up to ______, may require hospitalization for connection of fluid/electrolyte imbalances

A

50%

48
Q

with ______ there is higher risks to mother and high premature delivery

A

multiple gestations

49
Q

excessive volume during cyclic menstrual bleeding

A

hypermenorrhea

50
Q

an abnormally small amount of menstrual bleeding

A

hypomenorrhea

51
Q

frequent menstrual bleeding occurring less than 21 days apart

A

polymenorrhea

52
Q

menstrual bleeding occurring more than 35 days apart

A

oligomenorrhea

53
Q

irregular, frequent bleeding

A

metrorrhagia

54
Q

bleeding that is irregular in both frequency and volume

A

menometrorrhagia

55
Q

bleeding that occurs between normal cycles

A

intermenstrual bleeding

56
Q

intermenstrual bleeding is OC or HRT

A

breakthrough bleeding

57
Q

bleeding after vaginal intercourse

A

postcoital bleeding

58
Q

painful bleeding

A

dysmenorrhea

59
Q

absence of menstrual flow; may be primary- patient has never had a period or secondary - patient had period but they stopped

A

amenorrhea

60
Q

bleeding occurring 1 year after menopause

A

post menopausal bleeding

61
Q

abnormal bleeding from an essentially normal uterus

A

dysfunctional uterine bleeding (DUB)

OBGYN (6 decks)

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