PATH - Female General

Question 1

Septate uterus

Answer 1

Incomplete resorption of *septum

DEC fertility

TX with septoplasty

Question 2

Bicornuate uterus

Answer 2

Incomplete fusion of *Müllerian ducts

INC risk of complicated pregnancy

Question 3

Uterus didelphys

Answer 3

Complete *failure of fusion–>double uterus, vagina, and cervix

Pregnancy possible

Question 4

HELLP syndrome

Answer 4

Hemolysis
Elevated Liver enzymes
Low Platelets

A manifestation of severe
preeclampsia

Blood smear shows *schistocytes

Can lead to hepatic sub capsular hematomas–>rupture–>severe hypotension

TX: immediate delivery.

Question 5

Premature ovarian failure

Answer 5

Premature atresia of ovarian follicles in women of reproductive age.

Patients present with signs
of menopause after puberty but *before age 40.

DEC estrogen
INC LH, FSH

Question 6

Polycystic ovarian syndrome (Stein-Leventhal syndrome)

Answer 6

Hyperinsulinemia and/or insulin resistance hypothesized to alter hypothalamic hormonal feedback response–>INC LH:FSH, INC androgens from theca interna cells, DEC rate of follicular maturation–>unruptured follicles (cysts) + anovulation

Common cause of subfertility in women

Enlarged, bilateral cystic ovaries

presents with amenorrhea/oligomenorrhea, hirsutism, acne, DEC fertility.

Associated with obesity

INC risk of endometrial cancer 2° to unopposed estrogen from
repeated anovulatory cycles

TX: weight reduction, OCPs, clomiphene citrate, ketoconazole, spironolactone