Repro Flashcards
1
Q
Ovary
- artery
- vein
- nerve
A
- ovarian artery off aorta
- ovarian vein
- ovarian plexus and uterine plexus
2
Q
Uterus
- artery
- vein
- nerve
A
- ovarian and uterine
- uterine v
- symp- hypogastric and para - ovarian plexus
3
Q
Cervix
- artery
- vein
A
- vaginal a, uterine a
- uterine v
4
Q
Vagina
- artery
- vein
- nerve
A
- uterine a, vaginal a
- vaginal and uterovaginal plexus
- symp: lumbar splnchnic and para: pelvic splanchnic
5
Q
Ligaments
- suspensory
- ovarian
- broad
- round
- cardinal
A
- contains ovarian vessels and nerves
- attaches ovary to lat wall of uterus;
- peritoneal fold that attaches uterus, fallopian tubes, and ovaries to wall and floor of pelvis
- from uterine horn to labia; female equivalent to sperm cord
- contains uterine a and v
6
Q
Spermatogenesis
- mitosis of spremaogonia
- 1st meosis
- 2nd meosis
- spermatogenesis
- locatoin
- stored
A
- 16 days; up to primary spermatocyte
- 24 days; for division of primary spermatocytes to form secondary spermatocyte
- few hours; engendering spermatids
- 24 days; until completed sperm cells
- in seminiferous tubules
- epididymus
7
Q
Oogenesis
- steps
A
- oogonia -> primary oocyte (till puberty)-> secondary oocyte (till fertilization)
8
Q
Menstrual cycle
- days 1-4
- days 5-13
- days 13-16
- days 16-28
- anovulatory cycles
A
- bleeding phase
- proliferative phase; increased estrogen,
- getting ready for ovulation
- ovulatory phase;
- secretory phase; implantation
- first 7 years, last 10 years
9
Q
Parts of follicle
A
- oocyte surrounded by zona pellucia, surrounded by granulosa cells
10
Q
Hormonal control of ovulation
- hypothal
- ant pit
A
- GnRH
- LH -> theca interna to produce androgen which go to granulosa cell to produce estrogen/ FSH, primary follicle (w/o antrum), secondary (w/ small antrum), graffian (w/ large antrum)
11
Q
Contraception
- MOA
- oral: kinds,
- implantable devices
- IUD
- depo
- mifepristone
- contraindication to OCP
A
- progesterone will block LH surge -> preventing ovulation
- mono: 1 fixed dose hormone throughout cycle, bi: one dose of progestin for 10 days and next 11 is higher dose -> try to mimic physiology; tri: diff dose every 7 days
- polymers embedded with progestin; irregular menstrual bleeding; 5 yrs
- placed into uters, copper -> induces inflamm reaction that prevents fertilization or implantation or hormonal version coated with progestin
- progesterone shot given every 3 months
- progesterone antagonist, has more affinity than progesterone, necrosis and expulsion of products of conception; can be used up to 70 days
- smoker over 35 yrs, hx of estrogen dependent tumor,
12
Q
Menopause
- what is it
- dx
- sxs
- tx
A
- ovary stops producing estrogen
- peri -> 30-50; meno: greater than 50
- hot flashes,
- estrogen replacement
13
Q
Fertility drug
- clomiphene: MOA
- leuprolide: MOA, indications
- perganol: MOA
A
- blocks inhibiting estrogen receptor at hypothal -> constantly releasing GnRH -> will release FSH and LH causing LH surge -> ovulation
- GnRH analog; used for fibroids, precocious puberty, prostate CA, endometriosis
- exogenous FSH and LH from urine of menopausal women; used for conceiving
14
Q
IVF
- how many in
- pregnancy rate
A
- 4 zygotes
- 60 %
15
Q
Abortificants
- mifeprisone
- plan B
A
- progesterone antagonist
- high dose of progesterone, up to 5 days after conception
16
Q
Dysfunctional Uterine Bleedins
- what is it
- MCC
- examples
- dx
- tx
A
- irregular mensturation when all other causes r/o
- anovulation
- heavy bleeding, time of period changes every month, increased length of bleeding, more than 7 days
- pregnancy test, pelvic exam, eval axis
- birth control -> reg mensturation
17
Q
PCOS
- presents with
- pathophys
- tx
- pregnancy
A
- menstrual irreg, hormonal dysregulation, increased insulin resistance, hirsutism and acne, bilateral ovarian enlargment
- progesterone deficient -> constant increase in LH, suppresed FSH -> anovulatory cyst
- lose weight, OCP -> inhibit LH helps w/ hirsutism and acne
- clomiphene -> block inhibitory estrogen receptor in hypothal and increase GnRH and add dexamethasone to supress other androgens which increases likelihood of ovulation
18
Q
Sertoli- leydig cell tumor
- what is it
- epi
- rapid onset
- histo
- dx
- tx
A
- ovarian tumor that secretes testosterone
- 20-40
- hirsutism, amenorhea, virulization
- chords of sertoli cells with hyperchromatic nuc, polygonal cell; unilateral
- high level of testosterone and low FSH/LH
- removal of affected ovary
19
Q
Mammo
- when to start
- every 2 yr
- every year
- look for
- cystic mass seen with
A
- 40
- 40-50
- 50
- calcification and siz
- cyst
20
Q
Breast Mass Mgmnt
- 1st
A
- FNA -> if clear fluid and mass disappears then benign but if persists then will need biopsy
21
Q
Breast Discharge
- bloody
- milky
A
- intraductal CA or intraductal papilloma
- galactorrhea; normal when pregnant or if on antipschotics
22
Q
Fibrocystic dx
- what is it
- manage
A
- nodular breasts, no definitive mass, affects both breasts, more prominent during progesterone phase
- reassure, no caffeine, no soda, no chocolate
23
Q
Fibroadenoma
- most common
- epi
- histo
- feeling
- side
A
- benign tumor of breast
- 20-30
- well demarcated spherical nodule, differ in sizes,
- rubbery, mobile, gets bigger w/ estrogen
- bilateral
24
Q
Intraductal carcinoma
- common
- sxs
- histo
- tx
A
- 65-75% cases
- bloody nipple discharge, fixed/ hard mass, adehered to pec, peu de orange
- well developed glands invading fibrous stroma
- surgical removal and chemo
25
Q
Familial breast CA
- mutation of
- look out
A
- BRACA1 or 2
- lots of mammograms or mastectomy
26
Q
Breast CA TX
- kinds
- repro
- post meno
A
- lumpectomy, LN eval, drugs
- tamofien, cyclophosphamide, MTX,
- tamoxifen
27
Q
Lymphangio sarcoma
- what is it
- caused by
A
- collection of blood vessels that are lined by atypical epithelial cells
- side effect of axillary lymph dissection
28
Q
Sentinal node
- what is it
- what happens
A
- first LN that receives lymph draining from tumor
- put dye in it, if no CA there then leave other LN
29
Q
HER 2 tx
A
- trastuzumab: binds to extracellular domain, pertuzumab: MAB that binds to extracellular dimerization or lapatinib: TYRK inhibitor
30
Q
Teratogens
- ACEi
- Lithium
- NSAID
- Retinoid acid
- Valproate
- Oral hypoglycemic
- Warfarin
- Tetracycline
A
- renal tubual dysgenesis
- ebstein anomaly
- premature closure of PDA, pulm HTN, congeintal heart defects
- CNS, craniofacial and cardiovascular defects
- neural tubed defects
- neonatal hypoglycemia
- agenesis of corpus callosum
- mottling of teeth