OBGYN Lesson 2

Question 1

What are the primary sex organs?

Answer 1

Gonads (testes, ovaries)

Question 2

What do gonads produce?

Answer 2

Sex cells (sperm, ova)

Question 3

What are the secondary sex organs?

Answer 3

Structures that provide the route by which sex cells unite (penis, vagina).

Question 4

Which parent determines the sex of the baby?

Answer 4

Male

Question 5

Turners Syndrome?

Answer 5

Female with only one X

Question 6

Klinefelter syndrome?

Answer 6

Male with XXY

Question 7

At what week does the embryo begin to differentiate into male or female?

Answer 7

6-7th week.

Question 8

What does the sex determination region on the Y chromosome have?

Answer 8

SRY gene

Question 9

What happens at 6-7 wks if a Y is present in a zygote?

Answer 9

SYR gene will begin to produce testes determining factor (TDF) which will produce male gonads.

Question 10

When does testosterone secretion begin?

Answer 10

Week 8.

Question 11

What happens when there is no Y?

Answer 11

There is no SYR gene and no TDF so embryo develops female gonads.

Question 12

How many additional week does it take to develop the external genitalia?

Answer 12

8 more weeks.

Question 13

When can you see sex of baby on US?

Answer 13

16 weeks

Question 14

What is the MCC of abnml uterine bleeding?

Answer 14

Lack of ovulation (anovulation)

Question 15

What is it called when AUB is caused by an ovulation?

Answer 15

Dysfunctional Uterine Bleeding

Question 16

What happens if a follicle forms but never releases the ovum?

Answer 16

Follicle will continue to produce estrogen encouraging endometrial proliferation beyond the nml 14 days and the lack of progesterone inhibits the thickened endometrium from shedding.

Question 17

Metorrhagia?

Answer 17

Flow that’s irregular.

Question 18

Menorrhagia?

Answer 18

Excessive flow.

Question 19

When do PMS and PMDD symptoms begin?

Answer 19

After ovulation during luteal phase and can persist up to 4 days into menstrual cycle.

Question 20

PMS?

Answer 20

Interrupt daily life and routine; 30%.

Question 21

PMDD?

Answer 21

Significant impairment; 3%.

Question 22

Tx for PMDD?

Answer 22

Hormonal contraception.
SSRIs
Severe- GnRH and suppressing entire cycle.

Question 23

Categories 1 & 2 of sexual dysfunction?

Answer 23

Disorders of desire & arousal- MC in women, increases w/ age and associated w/ depression, substance use, and meds.
TX- short term testosterone.

Question 24

Category 3?

Answer 24

Disorders of orgasm- inability of a woman to reach or achieve an orgasm. Caused by chronic illness, meds, or hormonal deficiencies.

Question 25

Category 4?

Answer 25

Disorders of pain- Woman can experience pain during arousal, at time of orgasm, or any time during intercourse. Pain may be sharp, searing or cramping. Can be internal, vaginal, deep abd, or pelvic. Caused by inadequate lubrication, low estrogen levels, and drugs/ with drying effect.

Question 26

Impaired fertility?

Answer 26

Inability to conceive after one full year of unprotected sex with the same opposite sex partner (6 months if the female is 35 years or older).

Question 27

Diagnose impaired fertility?

Answer 27

Male testing includes sperm analysis and testing.

Female testing includes determining whether:
Ovulation is occurring normally
Endometrium is responding normally to hormones
Reproductive tissues are free of tumors or infections
The woman has any chronic conditions interfering with fertilization or implantation
The reproductive tract is adequately patent to allow for passage of ovum and sperm.

Question 28

Treatment for impaired fertility?

Answer 28

Correcting the underlying pathologies or overriding the deficient system.

Question 29

Pelvic organ prolapse?

Answer 29

Endopelvic fascia and the perineal muscles like the levator ani group loses tone and strength w/ aging and may fail to maintain pelvic organs in proper position.

Question 30

Cystocele?

Answer 30

Descent of a portion of the bladder wall into the vaginal canal and is typically caused by the trauma of childbirth. It can be aggravated by vigorous activity, prolonged standing, sneezing, or coughing.

Question 31

Rectocele?

Answer 31

Bulging of the rectum and posterior vaginal wall into the vaginal canal. Women may sustain damage during childbirth that can lead to a rectocele, but symptoms typically don’t occur until years after menopause. Lifelong chronic constipation and straining may exacerbate the problem. If rectoceles are severe, defecation can be difficult.

Question 32

Uterine prolapse?

Answer 32

Descent of the cervix or entire uterus through the vaginal wall. In severe cases the uterus falls completely through the vagina and protrudes from the introitus (vaginal opening).

Question 33

Treatment for pelvic organ prolapse?

Answer 33

Pessary, which is a removable mechanical device that holds the uterus in position. The pelvic fascia may be strengthened through Kegel exercises or by estrogen therapy in menopausal women. Surgical repair with or without a hysterectomy is the treatment of last resort.