Repro Female Flashcards
what is the microscopic finding in a leiomyoma?
monoclonal proliferation of myocytes and fibroblasts.
what is the most common cause of vaginal bleeding in post-menopausal woman with no uterine or ovarian pathological findings?
in a post-menopausal woman, aromatization of androgen to estrogen takes place in the adipocytes. this increases the level of estrogen and hence induces uterine or vaginal bleeding.
a 29 year old woman comes to the office due to an intermittent nipple discharge for the past several weeks She has had no fever or breast pain. The patient has never been pregant. An year ago, menses slowed and completely stopped. She has no other medical conditions and takes no other medications. Pt’s mother was diagnosed with metastatic breast cancer and recently died. On physical examination, white discharge is expressible from BOTH nipples. Urine hCG is negative. What is the dx?
galactorrhea - abnormal secretion of breast milk not associated with pregnancy or breast feeding. so this is due to hyperprolactinemia.
hyperprolactinemia with amenorrhea can most likely be due to prolactinoma- which is a pituitary adenoma.
pt has menorrahgia, dysmenorrhoea, endometrial gland and stroma in the myometrium, hCG is negative.
what is the dx? what is the tx?
pt has adenomyosis
treatment is GnRh agonists.
Pt is diagnosed with leiomyoma.
she is treated with leuprolide depo shots. How does this treatement affect her hormone levels?
leuprolide decrease GnRH, decrease FSH
decrease Estrogen levels.
what type of mosaicsim is seen in a patietn with clinical features of turner syndrome?
somatic mosaicism
in turner syndrome, what is the underlying chromosomal mechanical defect in the 45XO karyotype?
loss of paternal copy of X chromosome.
mutiloculated cystic hygroma with 45XO is dx of what congenital problem?
turner syndrome
in responce to rising estrogen levels, the patients myometrial cells increase the expression of genes that encode the oxyctocin receptor and connexin 43. these molecular changes most likely result in increased formation of what?
gap junctions in the myometrial cells for increased excitabality of the tissue which results in contractions during pregnancy,
state head to toe tanner symptoms and karyotype.
short stature
narrow and high arched palate
short hairline
webbed neck
widely spaced nipples
aortic coarctation
aortic dissection
bicuspid aortic valve
horseshoe kidneys
streak or atrophic ovaries
congential lymphoedema
45XO
what does hydatidiform pregnancy uterus look like on USG?
honeycomb/snowstorm/cluster of grapes
a 40 year old woman, gravida 5, para 0 at 12 weeks gestation comes to the ER with vaginal bleeding, midline pelvic pain and severe nausea and vomiting. she has a history of 4 prior first trimesters losses. pelvic examination shows a 16-week sized uterus. speculum examination reveals dark red blood in the vagina. hcg leveis is >1000000. USG shows no fetus and uterine cavity is filled with multiple small cysts. what is the karyotype of this pathology?
pt has hydatidiform cysts.
46 XX karyotype
what are the classic features of endometriosis?
dysmenorrhea, dypareunia , adnexal mass,
fibroepithelial tumor of the breast with bleeding from the nipples. What is dx?
intraductal papilloma.
what is the underlying chromosomal defect that leads to turner syndrome?
meiotic nondisjunction
