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Boards II > Repro > Flashcards

Repro Flashcards

1
Q

Ovary

  • artery
  • vein
  • nerve
A
  • ovarian artery off aorta
  • ovarian vein
  • ovarian plexus and uterine plexus
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2
Q

Uterus

  • artery
  • vein
  • nerve
A
  • ovarian and uterine
  • uterine v
  • symp- hypogastric and para - ovarian plexus
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3
Q

Cervix

  • artery
  • vein
A
  • vaginal a, uterine a

- uterine v

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4
Q

Vagina

  • artery
  • vein
  • nerve
A
  • uterine a, vaginal a
  • vaginal and uterovaginal plexus
  • symp: lumbar splnchnic and para: pelvic splanchnic
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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
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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
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7
Q

Oogenesis

- steps

A
  • oogonia -> primary oocyte (till puberty)-> secondary oocyte (till fertilization)
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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
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9
Q

Parts of follicle

A
  • oocyte surrounded by zona pellucia, surrounded by granulosa cells
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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)
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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,
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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
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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
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14
Q

IVF

  • how many in
  • pregnancy rate
A
  • 4 zygotes

- 60 %

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15
Q

Abortificants

  • mifeprisone
  • plan B
A
  • progesterone antagonist

- high dose of progesterone, up to 5 days after conception

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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

Boards II (20 decks)

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