Repro

Question 1

What are the functions of the pelvic floor?

Answer 1

Support pelvic organs
Maintain intra-abdo pressure when coughing, sneezing
Continence
Facilitate childbirth

Question 2

Which muscles form the lateral walls of the pelvis?

Answer 2

Piriformis

Obturator internus

Question 3

Which muscles form the pelvic diaphragm/floor?

Answer 3

Coccygeus

Levator Ani

Question 4

Which muscles comprise levator ani?

Answer 4

Puborectalis
Pubococcygeus
Iliococcygeus

Question 5

What are the deep perineal muscles?

Answer 5

Deep transverse perineal
Compressor urethrae
External urethral sphincter

Question 6

What are the superficial perineal muscles?

Answer 6

Superficial perineal pouch
Superficial transverse perineal
External anal sphincter

Question 7

Which 2 muscles are in the superficial perineal pouch?

Answer 7

Bulbospongiosus

Ischiocavernosus

Question 8

What is the importance of the perineal body?

Answer 8

Attachment point of pelvic floor muscles

Question 9

How can pelvic floor function be altered during childbirth?

Answer 9

levator ani muscles stretched
pudendal n. damage
perineal body disrupted
Iatrogenic - episiotomy

Question 10

What are the consequences of pelvic floor dysfunction?

Answer 10

Prolapse

Incontinence

Question 11

What are risk factors for prolapse?

Answer 11

Age
Parity
Vaginal delivery
Post-menopause
Obesity - raised intra-abdo pressure
CT disorders

Question 12

What is episiotomy?

Answer 12

Surgical incision medic-laterally during childbirth to prevent uncontrolled perineal tear.

Question 13

What can PID cause?

Answer 13

Endometritis
Salpingitis
Tubo-ovarian abscess

Question 14

How does tubo-ovarian abscess happen from PID?

Answer 14

Adhesions cause blockage in fallopian tubes, fill with exudate.

Question 15

What are complications of PID?

Answer 15

Infertility
Ectopic pregnancy
Fitz- Hugh -Curtis syndrome - RUQ pain, peri-hepatitis after chlamydia PID

Question 16

What reduces oxytocin function prior to labour?

Answer 16

Relaxin
Progesterone
No receptors

Question 17

How does oestrogen affect myometrium muscle cells?

Answer 17

increases gap junctions - excitability

Question 18

What is the most common cause of PPH?

Answer 18

Uterine atony

Question 19

What is normal length of menstrual cycle?

Answer 19

21-35 days

Question 20

what is the normal position of the uterus?

Answer 20

Anteverted and anteflexed

Question 21

What is menopause?

Answer 21

No menstrual periods for 12 months

Question 22

What are the stages of menopause?

Answer 22

Pre-menopause - 40’s, changes in cycles, can still get pregnant
Peri-menopause
Menopause
Post-menopause - after 12 months amenorrhoea

Question 23

What is pathological menopause?

Answer 23

Before 40 years

Question 24

What is used to diagnose menopause?

Answer 24

FSH levels high (aromatase enzyme still synthesises oestrogen)

Question 25

Explain risk of endometrial carcinoma at menopause.

Answer 25

No progesterone but oestrogen still produced in body. | Unopposed oestrogen - endometrial hyperplasia.

Question 26

What happens to vagina pH at menopause?

Answer 26

Increases - less oestrogen means less glycogen

Question 27

Explain the increased CVS risk at menopause?

Answer 27

Increase LDL and VLDL, decrease HDL Increased insulin resistance Increased BP Central body fat deposition/weight gain

Question 28

What are the cardinal movements of labour?

Answer 28

``` Engage Descend and flex Internal rotation Extension x 2 Restitution Anterior shoulder Posterior shoulder ```

Question 29

What hormonal change is repsonsible for the secretion of milk after delivery?

Answer 29

Decreased oestrogen and progesterone

Question 30

What does increased fetal HR suggest?

Answer 30

Fetal movement

Question 31

What does decreased fetal HR suggest?

Answer 31

head compression | umbilical cord compression

Question 32

What is the symphysis-fundal height at 12,16,20 and 36 weeks?

Answer 32

12 - pubic symphysis 16 - mid-way to umbilicus 20 - umbilicus 36 - xiphisternum

Question 33

What are causes of oligohydramnios?

Answer 33

placental insufficiency renal impairment premature membrane rupture

Question 34

What are causes of polyhydramnios?

Answer 34

inability to swallow - CNS of tracheoesphageal septum

Question 35

When is surfactant produced?

Answer 35

Terminal sac stage - 26 weeks onwards

Question 36

What are the vascular changes that lead to erection?

Answer 36

Inhibit sympathetic constriction Parasympathetic stimulation - dilation NO released from endothelial cells and nerves (cremasteric)

Question 37

What is MOA of sildenafil?

Answer 37

Inhibits phosphodiesterase, increase cGMP to increase NO.

Question 38

What is the order of puberty events in females?

Answer 38

1. Thelarche - breast buds 2. Pubic hair 3. Growth spurt 4. Menarche -periods

Question 39

What is the order of puberty events in males?

Answer 39

1. Testicle enlargement 2. Pubic hair 3. Spermatogenesis 4. Growth spurt 5. Adult size testicles

Question 40

What influences puberty onset?

Answer 40

Photoperiod, leptins | Girls - 47kg weight

Question 41

What is the vagina developed from?

Answer 41

Paramesonephric ducts | Urogenital sinus

Question 42

What diffuses by active transport across placenta?

Answer 42

Amino acids Iron Vitamins

Question 43

What moves by facilitated diffusion across the placenta?

Answer 43

Glucose

Question 44

What is the difference between intrauterine device and intrauterine system?

Answer 44

``` IUD = copper coil IUS = plastic, progesterone secreting ```

Question 45

What is the MOA of IUD?

Answer 45

Cu is toxic to sperm and ovary Inflammation in endometrium inhibits implantation Thickens cervical mucous

Question 46

Does IUD or IUS increase bleeding?

Answer 46

IUD - copper coil increases bleeding. | IUS decreases bleeding.

Question 47

What is the MOA of IUS?

Answer 47

Prevents implantation | Thickens cervical mucous

Question 48

What are the 2 types of cervical cancer?

Answer 48

Squamous cell carcinoma (most common) | Adenocarcinoma

Question 49

What is the cancer marker used for colon cancer?

Answer 49

CEA

Question 50

What is the marker used for ovarian cancer?

Answer 50

CA-125

Question 51

What is alpha-fetoprotein marker used for?

Answer 51

Hepatocellular carcinoma | Germ cells

Question 52

Where does uterine leiomyosarcoma spread to?

Answer 52

lungs

Question 53

What marker is used for germ cell tumours?

Answer 53

AFP | hCG

Question 54

What is the difference between spermatogenesis and spermiogenesis?

Answer 54

Spermatogenesis - spermatogonia to spermatids | Spermiogenesis- spermatids to spermatozoa

Question 55

What is the function of cervical gland, how is it controlled?

Answer 55

Secretes mucous | Progesterone - thick, viscous to prevent sperm entry

Question 56

What are the main histological changes in the placenta from the first to the third trimester?

Answer 56

1. Villi increase in SA - primary to tertiary | 2. Thinning - decreased diffusion distance.

Question 57

What is a key sign of PCOS?

Answer 57

High LH:FSH ratio