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Clin Med II > Repro Gen > Flashcards

Repro Gen Flashcards

1
Q

What BhCG levels is IUP visible at

A

≥ 1500-2000 Won’t see in uterus before this

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2
Q

Pregnancy loss before 20th week of gestation

A

spontaneous abortion

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3
Q

3 MC areas of defect for infertility

A

failure to ovulate

tubal deformity or dysfn cilia

endometriosis

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4
Q

What should you check if a pt has low estrogen in reproductive yrs?

A

folliculogenesis

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5
Q

atresia

A

degeneration of those ovarian follicles that do not ovulate during the menstrual cycle

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6
Q

Maturation and ovulation of multiple follicles

A

fraternal twins

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7
Q

one fertilized ovum splits in two

A

identical twins

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8
Q

What hormone causes basal body temp to inc?

A

progesterone

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9
Q

ectocervix cell comp

A

squamous epithelium

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10
Q

endocervix cell comp

A

glandular epithelium

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11
Q

MC genital infection

A

HPV

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12
Q

Pap smear guidelines

A

start at 21 perform yearly x 3 yrs if nrml begin every 3 yrs

Age 30-65: cotesting with HPV

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13
Q

What is most common cause of post menopausal bleeding?

A

atrophy

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14
Q

Partial mole

A

(paternal and maternal- normal ovum fertilized by 2 sperm

69 chromosomes

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15
Q

Complete mole

A

(paternal origin) - empty ovum fertilized by 2 sperm (or one that duplicates)

46 chromosomes

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16
Q

High risk HPV

A

16, 18, 31, 33

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17
Q

Low risk HPV

A

6, 11

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18
Q

MC uterine tumor

A

Leiomyoma

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19
Q

When does first ovulation occur after menarche

A

6-9 months

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20
Q

How much blood loss is there in nrml meses

A

<80 mL (30-80 mL avg)

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21
Q

What are are dominant hormones during follicular phase - days #1-14?

A

FSH and estrogen

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22
Q

What is the dominant

hormone of the luteal phase days #14-28?

A

progesterone

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23
Q

What does positive withdrawal bleed with progestin withdrawal test for secondary amenorrhea indicate

A

Endometrium is normal, normal estrogen levels, outflow tract is normal

Patient is not ovulating

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24
Q

What does negative withdrawal bleed with progestin withdrawal test for secondary amenorrhea indicate

A

No endometrial proliferation

Estrogen deficiency -OR- Outflow tract abnormality

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25
Q

Which hormone causes proliferation of the endometrium?

A

estrogen

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26
Q

What hormone level can be checked to confirm ovulation has occurred?

A

progesterone

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27
Q

What is the female athlete triad?

A

eating disorder (anorexia), amenorrhea, osteopenia (or osteoporosis)

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28
Q

Dysmenorrhea

A

Painful menstrua>on, normally occurring with ovulatory cycles

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29
Q

mc reported menstrual disorder

A

Dysmenorrhea

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30
Q

Infertility

A

the inability to conceive after 1 year of unprotected intercourse

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31
Q

MC female causes of infertility

A

ovulatory disorder or tubal factor

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32
Q

Heterotopic pregnancy

A

Twin pregnancy: simultaneous intrauterine and ectopic pregnancy

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33
Q

Oligomenorrhea

A

dec freq >35 d

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34
Q

Polymenorrhea

A

inc freq <21 d

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35
Q

Menorrhagia

A

inc amt

>7 d or >80 ml

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36
Q

Metrohagia

A

irregular interval

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37
Q

Menometrohagia

A

irregular interval and excessive amount

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38
Q

Hysteroscopy

A

Scope connected to video unit and light inserted through cervical canal to evaluate uterine cavity

can use to dx and treat

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39
Q

Pre-menopause endometrial lining

A

2-16mm depending on stage of

menses

40
Q

post-menopause endometrial lining

A

<5 mm

41
Q

Hysterosalpingogram (HSG)

A

X-ray of uterus and fallopian tubes using fluoroscopy

Evaluate patency and architecture of fallopian tubes

Dx and treat

42
Q

CA-125

A

Blood test used to indicate malignancy (biomarker)

Expressed by 80% of epithelial cell tumors

Premenopausal > 200 U/mL = concerning Postmenopausal >35 U/mL = concerning

43
Q

Current pap recommendations (American Society for Colposcopy and Cervical Pathology)

A

Initiate paps @ 21yo
every 3 years for 21-29 yo
Pap with HPV co-testing every 5 years for 30-65yo
Discontinue after 65yo if adequate negative screening past 10yr and no high-grade dysplasia in the past 20yr

44
Q

MC benign cervical neoplasm

A

Cervical Polyps

45
Q

MC gyn ca in women ww

A

Cervical Cancer

46
Q

When does normal menses occur and what is a normal menstrual cycle?

A

11-13 yo

Duration 3-7 days (avg 5d)
Blood loss <80 mL (30-80 mL)
Cycle 21-35 days (avg 28d)

47
Q

Define primary amenorrhea

A

Absence of menarche by age 16 years in presence of normal pubertal development

Absence of menarche by age 14 years in absence of normal pubertal development

Absence of menarche 2 years after completion of sexual maturation

48
Q

What are the dominant hormones during follicular phase - days #1-14?

A

Estrogen and FSH

49
Q

What is the dominant

hormone of the luteal phase days #14-28?

A

LH

50
Q

What is the effect of estrogen on the endometrial lining?

A

causes it to proliferate

51
Q

What is the most important step in evaluation of primary amenorrhea?

A

Transvaginal Ultrasound to confirm presence of uterus

52
Q

What is necessary and sufficient for production of testes?

A

Y chromosome and DRY gene

53
Q

What do sertoli cells produce?

A

AMH

54
Q

What do Leydig cells produce?

A

Testosterone and DHT

55
Q

What is the effect of activin on FSH

A

enhances FSH secretion by blocking effect of inhibin at pituitary

56
Q

Effect of inhibin on FSH

A

inhibits pituitary production and release of FSH

57
Q

Effect of testosterone

A

Gonadotropin Feedback
Spermatogenesis
Sexual Differentiation
Anabolic effects Libido

58
Q

Effect of DHT

A

Prostate development
External Virilization
Sexual maturation at puberty
Baldness

59
Q

The administration clomiphene (a SERM in the hypothalamus) would most likely have what effect on LH?

A

Increased LH synthesis from the anterior pituitary

60
Q

What is the MC form of prostatitis?

A

Chronic Abacterial prostatitis

61
Q

What is the most common cancer of internal organs in males?

A

prostate ca

62
Q

Where does prostate arise from?

A

peripheral zone mostly posterior so easily detected on rectal exam

63
Q

MC histology of prostate ca

A

adenocarcinoma

64
Q

MC place of prostate ca mets

A

Vertebral bones, lung & liver

65
Q

MC hisiology of penis carcinoma

A

SCC

66
Q

MC cause of orchitis or epididymitis in male <35 yo

A

Chlamydia, syphilis and gonorrhea

67
Q

MC cause of orchitis or epididymitis in male >35 yo

A

E. coli and Pseudomonas

68
Q

What does BhCG have to be for home preg test to register?

A

> 25-50 mIU/mL

69
Q

With US when can you see gestational sac?
yolk sac?
fetal pole?
fetal heart motion?

A

Gestational sac = 4-5 weeks
Yolk sac = 5 weeks
Fetal pole = 6 weeks
Fetal Heart motion (FHM) = 6.5 wks

70
Q

How is a viable pregnancy confirmed?

A

fetal pole + FHM

71
Q 
Recommended wt gain for mother:
underweight
nrml weight
overweight
obese
A

underweight- 25-40 lbs
nrml weight- 25-35 lbs
overweight- 15-25 lbs
obese 10-20 lbs

72
Q

What should preg woman avoid due to toxoplasmosis

A

undercooked meat and car litter

73
Q

What should preg woman avoid due to listeria

A

Cold deli meat
Unpasteurized cheese or dairy
Unwashed fruits and vegetable

74
Q

When should preg women avoid travel?

A

> 36 wks

75
Q

Freq of prenatal visits

A

Q 4 weeks until 28 wks
Q2weeks 28wks–36wks
Weekly at 36 wks until delivery

76
Q

What does fundal height tell you about GA?

A

Corresponds to GA ± 2 cm

ie: 20 cm fundal height is 20 wks

77
Q

When should women be offered aneuploidy screening?

A

< 20 wks

78
Q

When should contractions prompt a woman in 3rd trimester to come in?

A

If < 37 wks (pre-term) q 15min

If > 37 wks (term) “5/1/1”

79
Q

Ways to prevent post-term pregnancies

A

Sweeping of membranes
Ambulation
Intercourse
Nipple stimulation

80
Q

When should you consider induction of labor?

A

Induction of labor > 41wk can be considered

Induction of labor > 42wk recommended

81
Q

Salpingectomy vs Salpingostomy

A

Salpingectomy –remove entire fallopian tube

Salpingostomy – remove pregnancy only

82
Q

Monozygotic

A

1 sperm 1 egg
splits in 2
identical

83
Q

Dizygotic

A

2 sperm 2 eggs

fraternal

84
Q

ABO and RhD ability to cross palcenta

A

ABO - IgM – does not cross placenta

Rh D - IgG – crosses placenta

85
Q

What are the cardinal mvts of labor?

A
  1. engagement
  2. descent
  3. flexion
  4. internal rotation
  5. extension
  6. external rotation
86
Q

Stages of labor

A

Stage 1- Onset of labor to full dilation of the cervix
Stage 2- Fulldilation to delivery of baby (varies in length)
Stage 3- Delivery of baby to delivery of placenta (usually lasts < 30 min and takes only 2-5 mins)
Stage 4- Puerperium

87
Q

3 ps of abnormal labor

A

power
passenger
pelvis

88
Q

When would you perform a classic c-section?

A

preterm breech, transverse back-down fetus, distorted anatomy (e.g. leiomyomata, adhesions)

89
Q

When should woman return to menstruation after pregnancy?

A

6-8 wks following delivery

90
Q

Maternal benefits of breastfeeding

A

dec postpartum depression, boosts weight loss, minimizes hemorrhage

91
Q

MC benign breast condition

A

Fibrocystic Breast Disease

92
Q

chlamydia screening recommendations

A

Annual chlamydia all sexually active women <25

93
Q

syphilis, HIV, chlamydia & HBV screening

A

pregnant women

94
Q

Trichomonus & HPV screening

A

annually for HIV+ women

95
Q

STIs to report to health dept

A 
Chlamydia
Gonorrhea
Neonatalherpes
Syphilis
Chancroid
96
Q

HPV vaccine

A

Two doses 6‐12 months apart ages 9‐14
or
Three doses at 0, 1 & 6 months ages 15‐26

97
Q

5 ps of STI risk

A

partners, practices, prevention of pregnancy, prevention of STIs, past hx of STIs

Clin Med II (19 decks)

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