Repro Flashcards
Hormone closes epiphyseal plates
estrogen
Converts androsteinedione to estrogen
aromatase in sertoli or granulosa cell
LH –> ovary
desmolase in theca cell to convert cholesterol to androsteindione
FSH –> ovary
aromatase in granulosa cell to convert androsteindione to estrogen
Estrogen form high in pregnancy
estriol
Phase of constant 14d
Luteal
Oocyte phase until ovulation
Prophase I
Oocyte phase until fertilization
Metaphase II
Implantation day
6
What secretes hCG?
trophoblast
- blood = 1wk
- urine = 2wk
Syncytiotrophoblast –> maintains CL for 1st trimester
What causes lactation?
Dec in progesterone
Prolactin maintains
Oxytocin = let down
Best test to confirm menopause
INC FSH - loss of feedback from estrogen
Klinefelter
47 XXY
Abnormal sertoli/seminiferous = dec inhibin, high FSH
Abnormal Leydig = dec T, high LH, high estrogen
Turner
45 XO
Bicuspid aortic valve, webbing, horseshoe kidney
Low estrogen –> high LH, FSH
1 cause of amenorrhea
Turner
Inc T
Inc LH
Defective androgen receptor
Inc T
Dec LH
T secreting tumor, steroids
Dec T
Inc LH
primary hypogonadism
Dec T
Dec LH
Hypogonadotropic hypogonadism
Androgen insensitivity
Normal appearing female
Rudimentary vagina
Testes in labia
NO SEXUAL HAIR
Inc T, estrogen, LH
5 alpha reductase deficiency
Males w/ ambiguous genitalia UNTIL PUBERTY
Kallmann syndrome
Defective GnRH
Anomsia, lack of secondary sex
Cluster of grapes, honeycomb uterus, snowstorm US, hCG >100,000
Mole - swelling of chorionic villi
Most = complete More = Asians, TAIWAN
Complete mole
> > > > > hCG
46 XX, XY
#1 –> choriocarcinoma/malignancy
2 sperm, EMPTY egg
Completely a mole = no fetal tissue
Completely edematous = all villi
Completely proliferated = diffuse trophoblast
Partial Mole
69 XXX, XXY, XYY
Little inc in uterine size, hCG
RARE malignancy or choriocarcinoma
2 sperm, 1 egg
HELLP syndrome & Pre-eclampsia
HTN, proteinuria, edema after 20wks
hemolysis
elevated LFTs
Low platelets
Tx = IV Mag sulfate or diazepam
Painful bleeding in 3rd trimester, painful contractions
Abruption
- DIC, smoking, HTN, cocaine use
Painless bright red bleeding in any trimester
Previa
- inc w/ multiparity, prior C-section
Polyhydramnios
Esophageal/duodenal atresia
Anencephaly
Oligohydramnios
B/L renal agenesis (Potter seqence)
Post urethral valves
HPV 16
E6 inhibits p53
HPV 18
E7 inhibits RB
Endometritis
Retained product of conception after delivery
Tx = Cefoxitin, ampicillin-sulbactam, ticarcillin-clavulanate
Cyclic bleeding, menorrhagia, dysmenorrhea, dysparenunia, infertility, chocolate cysts
Endometriosis
Glands/Stroma OUTSIDE UTERUS
Normal sized uterus (vs. adenomyosis)
Inc risk of carcinoma
Tx = Danazol
Menorrhagia, pelvic pain, dysmenorrhea, enlarged uterus
Adenomyosis - endometrium in myometrium
Uniformly enlarged uterus
Tx = hysterectomy
Endometrial hyperplasia
Post-menopausal bleeding
- inc estrogen
- risk of carcinoma
- inc in glands:stroma
1 GYN malignancy
Endometrial carcinoma
- abnormal uterine bleeding in post-menopausal
- preceded by endometrial hyperplasia
Prolonged use of estrogen w/o progestin, nulliparity, early menarche, late menopause risk for?
Endometrial carcinoma (endometrioid)
- unopposed estrogen –> carcinoma
- 50s
1 tumor in females
Leiomyoma