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Year 3 > Repro > Flashcards

Repro Flashcards

1
Q

What is the grafian follicle?

A

A mature fluid filled cavity in the ovary which contains the female gamete/ovum.

A fully mature grafian follicle ruptures and releases the ovum mid menstrual cycle

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2
Q

What does the grafian follicle become after ovulation?

A

Corpus luteum

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3
Q

What does the corpus luteum do?

A

Secrete progesterone for two weeks after ovulation, required for the maintenance of pregnancy

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4
Q

What does the corpus luteum become if there is no fertilisation?

A

Corpus albicans- scar on surface of ovary

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5
Q

What layer do the urogenital and reproductive systems arise?

A

Mesoderm

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6
Q

What week does sexual differentiation occur?

A

Week 7

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7
Q

What does the paramesonephric duct give rise too?

A

Uterine tubes, uterus and superior vagina

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8
Q

What does the caudal portion of the paramesonephric duct give form?

A

Fuses with the paramesonephric duct on the other side to form the uterovaginal canal (becomes uterus and superior vagina)

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9
Q

What does the mesonephric duct become in males?

A

The ductus deferens and epididymis and opening into urogenital sinus

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10
Q

What are granulosa cells?

A

A type of cell in the ovary that produces oestrogen and progesterone

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11
Q

What does presence of the SRY protein cause?

A

Stimulates formation of somatic support cells which become sertoli cells

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12
Q

What causes degeneration of the paramesonephric ducts?

A

Sertoli cells secreting anti-mullerian hormone

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13
Q

What do leydig cells do?

A

Produce testosterone to induce formation of epididymis, vas deferens and seminal vesicles

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14
Q

What is a hydrosalpinx?

A

Condition where the fallopian tube becomes blocked and fills with serous fluid near the ovary. Gives rise to distension

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15
Q

What type of cell tumours are ovarian tumours?

A

Epithelial Cell tumours

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16
Q

Treatment for pelvic inflammatory disease?

A

Ceftrixaone for gonnorhoea
Doxycycline for chlamydia
Metronidazole for anerobic

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17
Q

What emergency contraception can be taken 72 hours after unprotected sex?

A

Levorgestrel

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18
Q

What emergency contraception can be taken 120 hours (5 days) after unprotected sex?

A

Ulipristal acetate

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19
Q

What is uterine fibroid degeneration?

A

Blood supply to the fibroid is compromised leading to ischaemia and necrosis -> causes severe pain and vaginal bleeding

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20
Q

What is myomectomy and when is it used?

A

Surgery that removes fibroids when fertility is still desired

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21
Q

What is the pattern of hormones in premature ovarian failure?

A

High gonadotrophins (LH and FSH) with low oestrogen production due to lack of negative feedback on the pituatary gland.

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22
Q

What cells line the ectocervix (part of vagina continuous with cervix)

A

stratified squamous epithelium

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23
Q

What is the endocervix lined with?

A

Columnar epithelium

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24
Q

Describe an inevitable misscarriage?

A

-Spontaneous loss of pregnancy before 24 weeks
- Abdo pain, vaginal bleeding without evidence of products of conception
-Cervical os open
- fetus may be alive by miscarriage in inevitable

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25
Q

Describe a missed miscarriage

A
  • abdo pain, bleeding, passage of products of conception
  • cervical os closed
  • US showing non-viable foetus
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26
Q

Describe an incomplete miscarriage

A
  • abdo pain, vaginal bleeding, passage of products of conception
    -cervical os open so process is incomplete and foetal tissue will continue to pass
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27
Q

What hormonal treatments can be given for endometriosis

A

Combined oral contraceptive- suppressing ovulation can cause atrophy of endometrium

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28
Q

What is a complete mole?

A

One or two sperm fertilise an egg with no chromosomal content. Therefore a placenta is formed with no embryo

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29
Q

What is a partial mole?

A

Two sperm fertilise a normal egg and instead of forming twins causes an abnormal proliferation of embryonic tissue with no viable pregnancy.

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30
Q

What is the first stage of labour?

A

Cervical effacement and dilatation progressing from 0 to 10cm

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31
Q

What is HELLP syndrome

A

Haemolysis, Elevated liver enzymes, low platelets

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32
Q

What is given to initiate termination of pregnancy

A

Mifepristone- blocks the action of progesterone

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33
Q

Which ovarian tumours are most common in post-menopausal women?

A

Epithelial ovarian tumours

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34
Q

Which ovarian tumours are most common in younger women

A

Germ cells ovarian tumour

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35
Q

What is the first line tx of dysmenorrhoea?

A

Intra-uterine system

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36
Q

What is placenta increta?

A

Abnormal placentation where placenta infiltrates into myometrium and into the muscle. Not confined to decidual layer of the endometrium

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37
Q

What is placenta praevia?

A

The placenta lies over the cervical os. Results in bleeding of the placenta when stretched.

Classic painless bleeding after 20 weeks gestation

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38
Q

What is vasa praevia?

A

The foetal vessels lie over the internal os partially or completely. High risk of haemorrhage and premature rupture of membranes

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39
Q

What days of the menstrual cycle is the proliferative phase?

A

Day 5-13

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40
Q

What days of the menstrual cycle is ovulation?

A

Day 14

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41
Q

What days of the menstrual cycle is the secretory/luteal phase?

A

15-28

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42
Q

What are happens to FSH, LH and oestrogen during menopause?

A

High FSH + LH (due to decreased -ve feedback), low oestrogen

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43
Q

When should Anti-D be administered during pregnancy?

A

28 + 34 weeks

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44
Q

What is a cystocele and its symptoms?

A

Herniation of bladder into vagina
Stress incontinence symptoms and anterior wall prolapse

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45
Q

What is an enterocele and its symptoms?

A

Prolapse of small bowel into vagina.
Presents typically with posterior wall bulge and lower back pain

46
Q

What is an rectocele and its symptoms?

A

Rectum prolapse into vagina. Posterior wall bulge with pain on defecation

47
Q

What can toxoplasma gondii infection lead to in a baby?

A

chorioretinitis, hydrocephalus, seizures, visual and hearing impairment

48
Q

What is classified as primary amenorrhoea?

A

-Failure to establish menstruation by 15 years of age in girls with normal secondary sexual characteristics (such as breast development),
-or by 13 years of age in girls with no secondary sexual characteristics

49
Q

What is the combined test and when is it used?

A

Recommended test for Down Syndrome. Carried out from 11-13 weeks

Nuchal translucency using ultrasound scan
PAPP-A hormone (level reduced in pregnancy affected with Down’s syndrome)
Beta-hCG hormone (raised in pregnancy affected by Down’s syndrome)

50
Q

When is the triple test used and what does it measure?

A

Used after 13 weeks gestation

  • Beta HcG
  • AFP
    -Ue3
51
Q

At what gestation does pre-eclampsia usually present?

A

34 weeks gestation

52
Q

What does rubella infection in pregnancy lead to in the child?

A

Cararacts, microphthalmia, microcephaly and heart defects

53
Q

What can using folic acid anatagonists such as methotrexate do to your baby?

A

Birth defects such as anacephaly, hydrocephalus, cleft lip/palate, skull defects

54
Q

BMI over what is considered for prophylactic VTE treatment?

A

30

55
Q

What are the LAMBAST drugs to avoid in pregnancy?

A

Lithium, amiodarone, methotrexate, benzos, aspirin, sulfonamides, tetracyclines

56
Q

Definition of placental abruption?

A

Separation of normally implanted placenta from uterine wall

57
Q

Signs and symptoms of placental abruption?

A

Severe, continous abdo pain
Bleeding (can be concealed)
Woody, hard uterus
Can present in collapse

58
Q

Prophylactic treatment for chickenpox?

A

Acyclovir

59
Q

Initial treatment for uterine atony?

A

Uterine massage

60
Q

What is the diagnostic glucose values for gestational diabetes?

A

a fasting plasma glucose level of 5.6 mmol/litre or above or

a 2‑hour plasma glucose level of 7.8 mmol/litre or above

61
Q

When is insulin used in gestational diabetes?

A

In a fasting plasma glucose level of 7.0mmol or above

62
Q

Which HRT is required in women with a uterus?

A

Oestrogen combined with progesterone for endometrial protection

63
Q

Which HRT should women with periods go on?

A

Cyclical HRT, cyclical progesterone and regular breakthrough bleeds

64
Q

Which HRT should post-menopausal women with a uterus go on?

A

Continuous combined HRT

65
Q

What is the COOP protective against?

A

Ovarian cancer

66
Q

What abdo surgical incision is usually performed for a C-section?

A

Suprapubic incision

67
Q

Describe the broad ligament of the uterus?

A

Extends between uterus and lateral walls of pelvis
Helps maintain the uterus in correct midline position
Contains the uterine tubes and proximal part of round ligament

68
Q

Describe the round ligament of the uterus?

A

Embryological remanant
Attaches to lateral aspect of uterus
Passes through deep inguinal ring and attaches to superficial tissue of female perineum

69
Q

Describe the levator ani

A

3 skeletal muscle under voluntary control- puborectalis, pubococcygeus, iliococcygeus
Forms the majority of the pelvic diaphragm
Provides support to pelvic organs- tonic contraction and in situations of increased abdominal pressure
Supplied by nerve to levator ani eg S3,4,5

70
Q

Where does lymph from the breast drain?

A

-most drains from ipsilateral axillary lymph nodes to supraclavicular lymph nodes
-Lymph from inner breast quadrants can drain into parasternal lymph nodes
-Lymph from lower can also drain into abdo lymph nodes

71
Q

1st line ix for breast cancer in a patient under 35 with a lump

A

US

72
Q

1st line ix for breast cancer in patient over 35 with lump?

A

Mammogram

73
Q

Which medication is most effective against oestrogen positive breast cancer?

A

Tamoxifen

74
Q

Which medication is indicated in HER2 +ve breast cancers?

A

Trastruzumab

75
Q

A bishops score of what suggests the cervix is ripe and favourable?

A

7

76
Q

Tx for urge incontinence?

A

1st line- anticholingerics eg oxybutinin
2nd line- desmopressin- synthetic analogue of ADH

77
Q

What are the two antenatal scans pregnant women are offered and when?

A

Booking visit- 8-12 weeks
Anomaly scan/detailed ultrasound scan- 18-21 weeks

78
Q

What is assessed at the booking visit?

A

Haemoglobinopathies, Hep B&C, HIV, Syphilis, red cell antibodies, anaemia, number fetuses, viability, PMH, PSH, Obstetric hx, meds, allergies, SH, FH, past mental health history, FGM, BMI (& trisomy screening offered)

79
Q

What is assessed at the anomaly scan?

A

Cleft, heart, NTD, limb defects, placental site, diaphragmic hernia, abdominal wall defects, lungs abnormalities, brain abnormalities, urinary tract abnormalities

80
Q

What testing is offered if there is a high chance of trisomy?

A

NIPT testing

81
Q

Tx for baby in placenta praevia

A

Steroids if 24-35+6
MgSO4 <32w

82
Q

Mx for vasa praevia

A

Elective C-secton 35-36 before labour

83
Q

What is twin to twin tranfusion syndrome

A

Occurs in monochorionic twins due to anastamoses of umbilical vessels

84
Q

What are both twins at risk of developing in twin transfusion syndrome?

A

Heart failure and hydrops (oedema)

85
Q

In twin transfusion syndrome what is most likely to happen to the donor twin?

A

High output cardiac failure due to severe oedema

86
Q

In twin transfusion syndrome what is most likely to happen to the recipient twin?

A

Fluid overload due to excess blood volume

87
Q

When is a dating scan performed?

A

10-13 weeks

88
Q

Complications of CMV in pregnancy

A

Hearing loss, visual impairment, learning disability

89
Q

Which antibiotic is used in PPROM to reduce chances of infection

A

Erythromycin or clarithromycin

90
Q

Mx of preterm labour?

A

Dexamethasone x2 12 hours apart-> stimulate surfactant production from 33weeks +6

Magnesium sulphate for neuroprotection

91
Q

When is the COCP absolutely contraindicated in breastfeeding women?

A

Up to 6 weeks postpartum

92
Q

What mx is used in stress incontinence if pelvic floor exercises aren’t working?

A

Duloxetine- SNRI

93
Q

Time of effectiveness of all contraceptions if not taken on first day of period?

A

2 days: POP
7 days: COC, injection, implant, IUS

94
Q

What do progesterones increase the risk of?

A

Breast cancer

95
Q

When should a trial of diet and exercise changes be offered for 1-2 weeks in gestational diabetes?

A

If fasting plasma glucose less than 7mmol/L

96
Q

What does Erb’s palsy result in?

A

Adduction and internal rotation of the arm with pronation of the forearm: waiter’s tip (C5,C6)

97
Q

Tx for lichen sclerosus?

A

Clobetasol propionate- potent topical steroid

98
Q

Risk factors for placenta praevia?

A

c-section, previous termination, age >40, multiparity, assisted conception, multiple pregnancy, smoking

99
Q

Risk factors for placental abruption?

A

Pre-eclampsia/hypertension, trauma, smoking, cocaine, Medical thrombophilias, renal disease, diabetes, Polyhydramnios, Multiple pregnancy, Preterm, Abnormal placenta, Previous abruption

100
Q

Risk factors for placenta accreta?

A
  • Placenta praevia and prior caesarean delivery
    • Increased risk with multiple c/sections
101
Q

Risk factors for uterine rupture?

A
  • Previous caesarean section/uterine surgery
  • Multiparity and use of prostaglandins/syntocinon
  • Obstructed labour
102
Q

Tx of placental abruption

A

If mother haemodynamically stable then steroids
If not then emergency c-section

103
Q

A bCHG of greater than what should suggest there is a pregnancy somewhere?

A

> 1500 beta hcg

104
Q

What are the three categories of ovarian tumours?

A

-Surface epithelial cells
-Germ cell
-Sex cord/stromal

105
Q

Medical mx of a missed miscarriage?

A

Oral mifepristone then misoprostolol 48 hours later unless gestational sac passed

106
Q

Tx for CIN?

A

Large loop excision of transformation zone- electrical current to remove affected area of cervix

107
Q

Medical mx of an incomplete miscarriage?

A

Single dose of misoprostol

108
Q

What antibiotics are used in the different stages of pregnancy for UTIs?

A

1st and 2nd sem- nitrofurantoin
3rd- trimeprothin

109
Q

Which antibiotic is contraindicated in pregnancy

A

Doxycycline

110
Q

Presentation of mammary duct ectasia?

A

Thick, green, yellow dishcharge

111
Q

Presentation of intraductal papilloma

A

Bloody discharge

112
Q

When can the copper coil be used as contraception?

A

Within 5 days of the earliest expected date of ovulation

Year 3 (12 decks)

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