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Reproductive > Repro Passmed > Flashcards

Repro Passmed Flashcards

1
Q

Broad ligament attaches …

A

Lateral aspect of ovaries to the walls and floor of pelvis

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2
Q

Cardinal ligament attaches…

A

Lateral cervix to the uterosacral ligament

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3
Q

Round ligament attaches …

A

Uterus - maintains the uterus in an anteverted position

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4
Q

Uterosacral ligament

A

Uterus to anterior sacrum.

Maintains the position of the uterus in the pelvis

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5
Q

Suspensory ligament

A

Ovaries to the lateral pelvic wall#

Used as a landmark for differentiating between intraovarian and extraovarian pathology

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6
Q

Pregnant diabetics have large or small babies ?

A

Large for gestational age

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7
Q

Nulliparity =

A

Never been pregnant before

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8
Q

Nulliparity increases the likelihood of big or small babies ?

A

Small babies

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9
Q

What pregnancy supplement is recommended?

A

400mcg from before conception until 12 weeks

  • reduces risk of neural tube defects
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10
Q

Endometriosis: extra-pelvic bleeding with pain on defecation = blood accumulating where ?

A

Pouch of Douglas (rectouterine pouch)

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11
Q

Raised pH + low PCO2 in pregnancy - why ?

A

Increased pulmonary ventilation and tidal volume

(due to the effect of progesterone on respiratory centre)

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12
Q

Role of lactoferrin (in breast milk)

A

Promotes rapid absorption of iron

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13
Q

What causes nausea and vomiting in pregnancy ? (hyperemesis gravidarum)

A

Raised hCG

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14
Q

What causes hyperemesis gravidarum in trophoblastic disease ? (while pregnant)

A

There is abnormal proliferation of trophoblastic tissue (e.g. hydatiform moles, invasive moles, choriocarcinomas).
These masses secrete beta hCG - which cause nausea and vomiting

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15
Q

What causes the end of the menstrual cycle ?

A

The demise of ovarian follicles

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16
Q

Foetal macrosomia leads to which obstetric emergency ?

A

Shoulder dystocia

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17
Q

What lymph nodes does the scrotum drain to ?

A

Inguinal lymph nodes

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18
Q

Main mechanism of action of combined oral contraceptive pill ? (+ 2 additional mechanisms)

A

Inhibition of ovulation

+ thickens cervical mucous
+ thins endometrial lining

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19
Q

What cells produce and secrete testosterone in response to LH?

A

Leydig cells

(Luteinising = Leydig)

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20
Q

What is the ‘temperature method’ of contraception?

A

Temperature rises during ovulation

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21
Q

The bladder drains to which lymph nodes?

A

External iliac lymph nodes

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22
Q

The glans penis drains to which lymph nodes?

A

Inguinal lymph nodes

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23
Q

The prostate drains to which lymph nodes?

A

Internal iliac lymph nodes

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24
Q

The rectum drains to which lymph nodes?

A

Pararectal and inferior mesenteric lymph nodes

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25
Q

Prepubertal atrophic vaginitis is caused by what?

A

Lack of vaginal oestrogen causing infection-prone alkaline environment

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26
Q

Where do ectopic pregnancies tend to implant?

A

Ampulla

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27
Q

Pregnant female with hypertension on ramipril - what do you do?

A

Discontinue ramipril, start labetalol

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28
Q

What is the preferred option of delivery for a fetus in transverse lie?

A

Caesarean section

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29
Q

HELLP syndrome - what does HELLP stand for?

A

Haemolysis, Elevated Liver enzymes, Low Platelets

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30
Q

Which deficiency is most commonly responsible for neural tube defects?

A

Folic acid

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31
Q

Normogonadotropic normoestrogenic anovulation = ?

A

Polycystic ovarian syndrome

(FSH, LH, oestradiol all normal)

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32
Q

Which pregnancy hormone reduces blood pressure?

A

Progesterone (smooth muscle relaxation)

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33
Q

What is the underlying pathology behind haemolytic disease of the newborn?

A

Maternal production of IgG antibodies against foetal RBC

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34
Q

Where is beta-HCG secreted from?

A

Placenta

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35
Q

Lymphatic drainage of the breast?

A

Axillary lymph nodes

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36
Q

Which hormone stimulates the production of milk?

A

Prolactin

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37
Q

Which hormone causes contraction of the myoepithelial cells surrounding the mammary alveoli (groups are called lobules), resulting in milk ejection from the breast?

A

Oxytocin

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38
Q

What type of epithelium lines the ectocervix?

A

Stratified squamous non-keratinized epithelium

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39
Q

What muscles does the breast lie over?

A

Pectoralis major and serratus anterior

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40
Q

What is the main structure that determines the descent path of the testicle?

A

Gubernaculum

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41
Q

What part of the follicle prepares the womb for embryo implantation?

A

Granulosa cells

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42
Q

Which hormonal changes occur in the menopause?

A

Cessation of oestradiol and progesterone production

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43
Q

Lymphatic drainage of the scrotum ?

A

Inguinal lymph nodes

44
Q

Breast infection (breastfeeding) - most common organism

A

Staph aureus

45
Q

Gestational trophoblastic disease causes…

A
  1. Hyperemesis gravidarum
  2. Very high serum hCG concentrations
46
Q

Which combination of maternal and fetal Rh statuses would pose a risk of Rhesus disease?

A

Rhesus -ve mother, Rhesus +ve foetus

47
Q

Where is hCG secreted from?

A

Syncytiotrophoblast

(stimulates corpus luteum to produce progesterone)

48
Q

Failure to establish menstruation by 15 years of age in girls with normal secondary sexual characteristics (e.g. breast development)

A

Primary amenorrhoea

49
Q

Failure to establish menstruation by 13 years old in the absence of secondary sexual characteristics

A

Primary amenorrhoea

50
Q

Pelvic pain occurring during her periods, with ‘deep’ pain during intercourse and pain on defecation during this time

A

Endometriosis

(pain on defecation doesn’t occur with PID)

51
Q

2cm smooth lump in the right breast. Mobile and not fixed to the skin - no other concerning features

A

Fibroadenoma (not concerning, common in 15-25 y.o.)

52
Q

↑ HCG, ↓ PAPP-A, thickened nuchal translucency

A

Increased risk of Down’s syndrome

53
Q

What is PAPP-A?

A

Pregnancy-associated plasma protein-A

A protein produced by the placenta

Needed for the implantation process and to maintain a healthy placenta (afterbirth)

A marker measured as part of the combined pregnancy screening blood test which is offered
around 11-14 weeks of pregnancy.

54
Q

What attaches the cervix to the lateral pelvic wall?

A

Cardinal ligament

55
Q

Gestational diabetes complications

A

Macrosomia
Polyhydramnios
Shoulder dystocia
Congenital heart abnormalities
Neural tube defects
Neonatal hypoglycaemia

56
Q

PPROM, abdominal pain, uterine contractions, ‘flu-like symptoms’, fever, and foul-smelling discharge

A

Chorioamnionitis

  • infection of the amniotic fluid and fetal membranes
  • usually caused by ascending bacterial infection from the vagina and cervix
57
Q

Contraindication for labetalol

A

Asthma

58
Q

Contraindication for methyldopa

A

Depression

59
Q

Hormone used to test for female fertility

A

Day 21 progesterone (a.k.a. mid-luteal cycle progesterone)

60
Q

Smoking is a protective factor for which gynae cancer?

A

Endometrial cancer

61
Q

What causes anaemia in pregnancy?

A

Increase in plasma volume disproportionate to the increase in haemoglobin,

causing an overall decrease in haemoglobin concentration

62
Q

At what paternal age is the risk of miscarriage increased?

A

Paternal age of ≥40

63
Q

COCP increases risk of which cancers? And decreases risk of which cancers?

A

Increases: breast, cervical
Decreases: ovarian, endometrial

64
Q

Which hormone stimulates uterine contractions and is useful in post-partum haemorrhage?

A

Oxytocin

(Syntocinon = synthetic oxytocin)

65
Q

Where does fertilisation usually occur?

A

Ampulla

66
Q

Where does implantation usually occur?

A

Upper posterior wall of uterus

67
Q

Most common bacterial cause of neonatal sepsis

A

Group B strep

68
Q

Non-invasive test for trisomy

A

“Non-invasive prenatal screening test”

  • analyse small DNA fragments that circulate in the blood of a pregnant woman
  • this derives from placental cells and is usually identical to fetal DNA
69
Q

Raised FSH/LH in primary amenorrhoea

A

Turner’s syndrome

70
Q

What is the first intervention that should be used to try and overcome shoulder dystocia?

A

McRoberts manoeuvre

71
Q

What is the normal anatomical position of the uterus?

A

Anteverted and anteflexed

72
Q

Increased tidal volume in pregnancy is caused by which hormone ?

A

Progesterone

73
Q

MOA of anastrozole

A

Aromatase inhibitor

  • prevents androgen conversion to oestrogen

(“reduces peripheral oestrogen synthesis”)

74
Q

Uterovaginal prolapse is caused by damage to which ligament?

A

Uterosacral ligament (a.k.a. recto-uterine ligament)

75
Q

Menopause - why are oestrogen and progesterone prescribed?

A

Oestrogen - symptomatic relief
Progesterone - protects against oestregenic adverse effects

76
Q

Which anatomical structure must a needle pass through to drain fluid from the rectouterine pouch?

A

Posterior fornix of the vagina

77
Q

Proliferative phase of menstruation =

A

Thickening of the endometrium
due to oestrogen being secreted by the follicle

78
Q

In which region of the breast do most breast cancers arise?

A

Upper lateral

79
Q

Most common type of breast cancer?

A

Invasive ductal carcinoma

80
Q

Low-level gonadotrophins in secondary amenorrhoea

A

Hypothalamic amenorrhoea

81
Q

Origin of the testicular artery?

A

Abdominal aorta

82
Q

What hormone is responsible for ovulation

A

Luteinising hormone (LH) surge

83
Q

Which cells secrete testosterone in the testes?

A

Leydig cells

84
Q

In which uterine ligament are the fallopian tubes?

A

Broad ligament

85
Q

Postmenopausal bleeding - first investigation ?

A

Endometrial biopsy

86
Q

Menopause blood test results ?

A

High FSH, LH
Low oestrogen

87
Q

Likely cause of Erb’s palsy in the newborn?

A

Shoulder dystocia due to macrosomia

88
Q

Uterine ligament which folds over the uterus - rupture causes spontaneous haematoma and is an obstetric emergency

A

Broad ligament

89
Q

Definition of PPH

A

> 500ml blood loss

90
Q

4 Ts of PPH

A

Tone (uterine atony): the vast majority of cases
Trauma (e.g. perineal tear)
Tissue (retained placenta)
Thrombin (e.g. clotting/bleeding disorder)

91
Q

Turner’s syndrome = hyper/hypogonadotrophic hyper/hypogonadism ?

A

Hypergonadotrophic hypogonadism

(low sex steroids leads to high LH and FSH as part of a feedback response)

92
Q

Right testicular vein drains into _______ ?
Left testicular vein drains into _______ ?

A

Right = inferior vena cava
Left = left renal vein

93
Q

Why is symphysis pubis dysfunction common in late pregnancy?

A

Hormonal changes increases ligament laxity

94
Q

26 weeks pregnant - severe abdominal pain + bleeding
Older mother, high parity, the onset of clinical shock and (most importantly) a tender, hard uterus on examination

A

Placental abruption
(separation of placenta before birth)

95
Q

Ligament which attaches the ovary to the lateral pelvic wall

A

Suspensory ligament

96
Q

Why does pregnant woman’s heart rate increase?

A

Increased stroke volume

due to increased plasma volume, secondary to activation of the renin-angiotensin system

97
Q

Proliferative phase of the menstrual cycle =

A

The thickening of the endometrium in response to oestrogen secreted from the mature follicle

98
Q

Fibroids causing difficulty conceiving - where are they likely to be implanted?

A

Submucosal layer of uterus

99
Q

Most common cause of neonatal sepsis?

A

Group B strep

100
Q

Temperature method of contraception: rise in temperature = what ?

A

Ovulation

101
Q

Beta-hCG is secreted from … ?

A

Placenta

102
Q

Fitz-Hugh-Curtis syndrome = ?

A

Adhesions of liver to peritoneum

  • associated with Pelvic Inflammatory Disease (PID)
103
Q

Most common cause of sepsis in neonates ?

A

Group B Strep

104
Q

Breast cyst treatment ?

A

Should be aspirated

those which are blood stained or persistently refill should be biopsied or excised

105
Q

Low O2 + respiratory alkalosis in a pregnant woman. Why?

A

Increased pulmonary ventilation and tidal volume

106
Q
A

Reproductive (14 decks)

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