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Board Studying > REI > Flashcards

REI Flashcards

1
Q

Infectious contraindications to oocyte donation

A

Chlamydia or gonorrhea in the last 12 months
Hepatitis B, C
Treponemal positive syphilis
HIV

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2
Q

HSG with bilateral hydrosalpinx, management of infertility

A

bilateral salpingectomy then IVF

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3
Q

XY
Breasts (testosterone –> estradiol at puberty), no uterus
Tanner 1 pubic/axillary hair
Male testosterone level

A

Androgen insensitivity syndrome

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4
Q

46XX
Breasts, no uterus
Normal pubic/axillary hair
Normal female testosterone level

A

Mullerian agenesis

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5
Q

46XY
Uterus is present, no breast development
Delayed puberty
No gonads

A

Swyer syndrome

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6
Q

45X
Uterus is present, minimal breast development
No gonads, delayed puberty
Puberty can happen with mosaicism (45X/46XX)

A

Turner syndrome

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7
Q

Ejaculate is propelled into the bladder and the bladder neck fails to contract

A

Retrograde ejaculation

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8
Q

Treatment for retrograde ejaculation

A

Sympathomimetic agents (psuedoephedrine)
+/- parasympatholytic agents (imipramine)
To stimulate contraction of the bladder neck

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9
Q

Infertility management for insufficient sperm in the antegrade ejaculate

A

Retrograde sperm for IUI

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10
Q

How to collect sperm for retrograde IUI

A

Voided or cath sample
Alkalinize urine with oral acetazolamide, sodium carbonate, or potassium citrate
OR instill bladder with culture media, ejaculate, then void or cath specimen

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11
Q

Which treatment of pituitary adenoma is preferred in pregnancy?

A

Bromocriptine (both are safe, there’s just more data)

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12
Q

Patients that have better success after IVF with frozen embryo than fresh

A

PCOS

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13
Q

How do the rates of IVF with frozen vs fresh embryo differ (in patients without PCOS)

A

They’re similar

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14
Q

Most effective medical treatment of pituitary adenoma

A

Cabergoline

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15
Q

Testosterone and DHEAS values that are concerning for ovarian or adrenal tumor in premenopausal women

A

Testosterone >200

DHEAS >700

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16
Q

Severe form of PCOS
Overproduction of androgens by ovarian stromal cells
Progressive hirsuitism/hyperandrogenism after menopause
Treated with bilateral oophorectomy

A

Ovarian hyperthecosis

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17
Q

Contraceptive method shown to decrease the risk of ovarian cancer

A

Combined OCPs

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18
Q

Infertility management for endometriomas under 3cm

A

IVF

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19
Q

Preferred hormonal birth control in patients after bariatric surgery

A

IUD
Combined estrogen/progestin vaginal ring]
(OCPs may have worse absorption but better than nothing)

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20
Q

Most common cause of hyperandrogenism during pregnancy

A

Hyperreactio luteinalis
Bilateral cystic masses of the ovaries
Multiple gestation, GTN, CKD (reduced clearance of hcg)

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21
Q

Pathologic mechanism by which PID predisposes to ectopic pregnancy

A

Infection results in a loss of ciliated epithelial cells –> impaired intratubal transport of an embryo

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22
Q

The physiologic event that induces completion of the first meiotic division of the oocyte is the:

A

midcycle LH surge

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23
Q

LH surge causes:

A
  1. First meiotic division and creation of metaphase II oocyte
  2. Granulosa cells and outer theca cells start to favor progesterone over estrogen
  3. Progesterone receptor expression increases
  4. Follicle rupture and extrusion of the oocyte in 24-36 hours
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24
Q

When does second meiotic division of the oocyte take place?

A

Fertilization

25
Q

Treatment of asymptomatic labial adhesions in prepuberty

A

Observation (spontaneously resolve with estrogen in puberty)

26
Q

Treatment of symptomatic labial adhesions in prepuberty

A

Estrogen cream 1-2x per day for 2-6 weeks

27
Q

Female sexual interest/arousal disorder diagnostic criteria

A

Must have 3 of 6 present for 6 months

  1. Absent or reduced interest in sexual activity
  2. Absent or reduced sexual thoughts or fantasies
  3. No or reduced initiation of sexual activity and seldom receptive to partner’s attempts
  4. Absent or reduced sexual excitement in sexual encounters
  5. Absent or reduced sexual interest/arousal to external cutes
  6. Absent or reduced genital or nongenital sensations during sexual activity
28
Q

Most effective therapy for smoking cessation

A

Behavioral modification counseling

29
Q

Stats table

A 
DZ +         DZ - 
T    +    a              b
E
S    -     c              d
T
30
Q

Sensitivity

A

a / (a + c)

31
Q

Specificity

A

d / (b+d)

32
Q

Risk associated with ICSI

A

Imprinting disorders

Monozygotic twinning

33
Q

Cortisol in anorexia

A

Increased

34
Q

Main reason to diagnose an manage central precocious puberty

A

To achieve appropriate adult height (concern for accelerated bone growth and closure of epiphyseal plates)

35
Q

Size cutoff for following up on simple cyst in premenopausal patient

A

10cm

36
Q

When should sperm sample be collected

A

72 hours of abstinence

37
Q

WHO lower reference limits (5%ile) for sperm analysis

A 
15million sperm per mL
39 million sperm per ejaculate
32% progressive motility
40% total motility
4% normal morphology
58% vitality
1.5mL of ejaculate
38
Q

When to freeze oocytes in transgender patients

A

Prior to initiation of testosterone therapy

39
Q

Stem cells that are used to treat Asherman syndrome are derived from

A

Bone marrow

40
Q

Patient with PCOS and worsening hirsutism, lab test includes testosterone and

A

DHEAS

41
Q

Can delay gonadectomy until after puberty

A

Androgen insensitivity syndrome

42
Q

Gonadectomy in patients with 45X/46XY karyotype

A

Immediately (risk of gonadoblastoma)

43
Q

Risk factors for opioid addiction

A

Younger age
Certain types of illicit drug use
Tobacco use
Psychiatric comorbidities (depression, etc)

44
Q

Tests to perform with premature thelarche

A

Bone age

FSH, LH, estradiol

45
Q

Ovulation induction in patients with hypogonadotropic hypogonadism

A

Urinary human menopausal gonadotropins

46
Q

Why can’t anonymous sperm donors stay completely anonymous?

A

Direct-to-consumer genetic testing

47
Q

Nonhormonal options for vasomotor symptoms

A

SSRI
Clonidine
Gabapentin

48
Q

single catastrophic event that results in extensive locally clustered genomic rearrangements and an oscillating pattern of DNA copy number levels, all curiously restricted to one or a few chromosomes

A

Chromothripsis

how fibroids happen

49
Q

Must evaluate before attempting pregnancy with donor eggs

A

Uterine cavity (HSG, sonohysterography, etc)

50
Q

Most common chromosomal abnormality causing azospermia

A

47XXY

51
Q

Tubal ligation risk of regret age cutoff that was studied

A

30

52
Q

Uterine artery embolization for fibriods causes highest risk of

A 
Miscarriage
Preterm delivery
Malpresentation
Postpartum hemorrhage
(Myomectomy has higher risk of uterine rupture)
53
Q

Fecundability rate in one year

A

90%

54
Q

How many weeks after fertilization does neural tube form

A

3-4

55
Q

Fecundity declines significantly at what age

A

32

56
Q

What days of menstrual cycle constitutes window of implantation of the human embryo

A

20-24

57
Q

Side effects of spironolactone

A

Vomiting
PMB
Dizziness
Mastalgia

58
Q

What muscle overlies the sacrospinous ligament

A

Coccygeus

59
Q

Main support to the vagina

A

Uterosacral ligament

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