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Repro Review Flashcards

1
Q

What is the second stage of labor marked by?

A

full cervical dilation to 10cm

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2
Q

What is the active first stage of labor?

A

dilation of cervix and descent of fetal head to 0 with complete effacement

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3
Q

What is the third stage of labor?

A

placenta delivery

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4
Q

what is the fourth stage of labor?

A

maternal homeostasis stabilization

can last for up to 4 hours

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5
Q

What is the genotype of someone with androgen insensitivity syndrome?

A

46 XY

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6
Q

What labs do you see in androgen insensitivity syndrome?

A

high levels of LH and GnRH (testosterone receptors also not responding to feedback)

high levels of testosterone

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7
Q

What is a drug used to promote ovulation?

A

clomiphene citrate

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8
Q

What cell type produces estrogen ?

A

granulosa cells

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9
Q

What is the primary target of superovulation drugs?

A

increase FSH to stimulate granulosa cells to produce more estrogen

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10
Q

How does clomiphene citrate work?

A

blocks estrogen receptors in hypothalamus so the body thinks estrogen is low

leads to more GnRH and LH/FSH production

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11
Q

Regular contractions every 4-5 minutes

A

active first stage of labor

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12
Q

What is CRH produced by in pregnancy?

A

the placenta

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13
Q

Molar pregnancy

A

occurs when fertilization goes wrong

leads to abnormal proliferation of trophoblastic tissue (see elevated hCG)

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14
Q

What is a blastocyst?

A

early stage of the embryo before it implants in the uterus

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15
Q

Decidua capsularis

A

part of endometrium that surrounds the implanted embryo

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16
Q

Decidua basalis

A

interacts with the trophoblast to form the maternal portion of the placenta

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17
Q

Vasa previa

A

occurs when fetal blood vessels run or cross near the internal cervical os

leads to risk of vessel rupture and severe fetal hemorrhage if membrane ruptures

see fetal bradycardia

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18
Q

What is fetal rubella exposure associated with?

A

hearing loss, eye abnormalities, and heart defects (like a PDA)

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19
Q

What does fetal exposure to HIV result in?

A

immunodeficiency and opportunistic infections

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20
Q

What is a sign of congenital syphilis?

A

hearing loss

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21
Q

How does placenta accreta present?

A

severe bleeding at the time of delivery

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22
Q

When does endometrial atrophy occur?

A

postmenopausal women or women with long-term low estrogen levels

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23
Q

How does endometriosis present? (3)

A

chronic pain

dysmenorrhea

infertility

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24
Q

Does an ovarian cyst normally cause vaginal bleeding?

A

no

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25
What can incomplete degeneration of the paramesonephric ducts lead to?
abnormalities in fallopian tubes, uterus and upper part of vagina
26
What leads to bicornuate uterus?
incomplete fusion of paramesonephric ducts can lead to recurrent miscarriages
27
What hormone do IUDs secrete?
progestin
28
Why does ventilation increase in pregnancy?
progesterone stimulates the respiratory center in the brain lowers PaCO2 so baby can diffuse their gas
29
What do the spiral arteries normally do?
become low resistance that can supply placenta with high volume of blood
30
What does thialiodomide use lead to?
limb defects often in first 4-7 weeks of pregnancy
31
What cells produce AMH?
Sertoli cells
32
How does premature ovarian failure present?
like menopause low estradiol with elevated FSH/LH (the problem is at the level of the ovaries)
33
How does Klinefelter syndrome present
male with tall stature and female pubic hair high LH / FSH dysfunction in testes leading to low testosterone and low inhibin B
34
What is the most common cause of PRIMARY ammenorrhea?
Turner syndrome dysfunction at the level of the ovaries
35
How does Turner syndrome present?
short statures (can see aortic valve / artery problems too) high LH / FSH low estrogen
36
How can you easily determine between androgen insensitivity syndrome and 5a-reductase def?
5a-reductase presents during puberty (penis at 12) Androgen insensitivity presents later! (you have a later puberty)
37
How does 5a-reductase present?
No DHT = lack of male genitalia Testosterone builds up and is converted to estrogen which leads to external female characteristics
38
What is a buzzword for Turner syndrome?
streak-like uterus
39
What is the genotype in Turner syndrome?
46 X
40
How can you tell central vs precocious puberty?
Central = elevated LH after stim test with elevated estrogen Peripheral = no elevation in LH after stim test
41
What is the diagnostic criteria for PCOS? (two need to be present)
1) clinical or biochemical hyperandrogenism 2) evidence of oligoanovulation 3) polycystic appearing ovaries on ultrasound
42
What are signs of uterine rupture?
someone had a prior C-section intense pain and bleeding DURING delivery
43
What is a sign of liver involvement in preeclampsia?
right upper quadrant pain / enlargement indicates you are moving to HELLP syndrome
44
What is bradycardia in a fetus?
under 140 bpm
45
When do you give a pregnant person IV corticosteroids?
between weeks 24 and 33 for people at risk for preterm delivery (ex: severe preeclampsia, baby not growing properly, etc) this will stimulate surfactant production in the fetus
46
When do you give a pregnant person IV Mg?
in eclampsia or HELLP syndrome
47
What tumor can present with increased hCG levels?
choriocarcinoma
48
What is a key feature of choriocarcinoma?
can spread hematogenously to the lungs
49
When can choriocarcinoma often occur?
after some type of miscarriage
50
Does vasa previa present with pain?
no! similar to placenta previa it is painless
51
Valproic acid causes what development problems?
neural tube defects
52
Tretinoin causes what development problems?
cleft palate and cardiac abnormalities
53
What tumor can present with elevated alpha-fetoprotein?
endodermal sinus tumor (yolk sac tumor)
54
What are signs of McCune-Albright syndrome?
cafe-au-lait spots elevated testosterone with low FSH / LH precocious puberty
55
What is the cause of McCune-Albright syndome?
mosaicism
56
What is a hydatiform mole?
same as molar pregnancy trophoblastic disease from the placenta which leads to elevated hCG levels
57
Sign of complete hydatidiform mole?
snowstorm appearance NO maternal DNA
58
Sign of incomplete hydatidiform mole?
fetal parts normal amount of maternal DNA but double the amount of paternal DNA
59
How does CMV exposure present in baby?
hearing loss brain damage cerebral palsy
60
What type of carcinoma can you get if you have chronically elevated levels of estrogen?
endometrioid adenocarcinoma
61
What is another word for leiomyoma?
uterine fibroids
62
What does fried egg on histology point to?
dysgerminoma
63
What lab values are associated with dysgerminoma?
elevated hCG and LDH
64
What histology is associated with Call-Exner?
granulosa cell tumor
65
What do Call-Exner bodies look like?
coffee bean nuclei surrounding an opening
66
What does Schiller-Duval indicate?
yolk sac tumor
67
What do Schiller Duval look like on histo?
central BLOOD VESSEL surrounded by tumor cells
68
What do you see in Leydig cell tumor?
Ranke crystal on gross pathology looks like golden brown
69
What do you see on XR or meconium aspiration?
patchy infiltrate
70
How can you quickly determine difference between meconium aspiration and respiratory distress syndrome?
respiratory distress syndrome occurs in preterm births meconium aspiration occurs in babies born later
71
What does endometrioid carcinoma look like on histology?
endometrium with glands and minimal stroma
72
What does Brenner tumor look like on histology?
uroepithelium (stratified epithelium with umbrella cells) coffee bean nuclei as well
73
What can present with pseudomyxoma peritonei?
mucinous cystadenocarcinoma
74
What marker is present in all ovarian tumors (both benign and malignant)
CA-125
75
What is the prognosis of a dysgeminoma?
good prognosis
76
What is a marker for a granulosa cell tumor?
inhibin granulosa cells are producing a lot
77
How does granulosa cell tumor present in adults vs. children?
children: precocious puberty (due to estrogen secretion) adults: menstrual irregularities
78
What is associated with Meigs syndrome?
fibroma (sex cord stromal tumor)
79
What does "blue-domed cyst" on breast point to?
fibrocystic changes
80
What is treatment for mastisis ?
continued drainage of breast milk and antibiotics
81
If you have bloody nipple discharge what diagnosis is most likely?
intraductal papilloma
82
If you have skin dimpling what are you thinking?
inflammatory subtype of invasive ductal carcinoma
83
What is true of lobular carcinoma?
it lacks E-cadherin
84
what is seen on histology of acute endometritis?
Microabscesses (aggregations of neutrophils)
85
What is seen on histology in chronic endometritis?
plasma cells and lymphocytes
86
What do you see on gross pathology of endometriosis?
chocolate cyst
87
What is a sign of PID?
Chandelier sign: severe cervical motion tenderness seen in PID
88
What is the treatment for PID?
ceftriaxone and doxycycline and metronidazole
89
When should you consider Haemophilus ducreyi?
travel to endemic areas with a painful chancroid
90
What is treatment for HSV?
oral valacyclovir twice daily
91
How do you manage HSV during pregnancy?
antiviral supression at 36 weeks
92
How does bacterial vaginosis present?
thin, gray, fishy-smelling discharge often without irritation
93
If wet mount for trichamonas is negative, what should you do next?
NAAT testing
94
What is the treatment for trichamonas?
metronidazole
95
What causes bacterial vaginosis?
imbalance in the vaginal flora reduction in lactobacili and an overgrowth of anaerobic bacteria
96
How do you diagnose BV? (4)
Amsel criteria: 1) Homogeneous thing, gray white discharge 2) Vaginal pH > 4.5 3) Positive whiff test (fishy) 4) Clue cells on microscopy
97
What are two treatments for BV?
metronidazole or clindamycin cream
98
What is the clinical presentation of uterine fibroids?
heavy menstrual bleeding pelvic pressure enlarged, irregular uterus on exam
99
How can you differentiate adenomyosis from uterine fibroids?
adenomyosis also has heavy bleeding an pelvic pain but the uterus is NOT IRREGULAR on exam
100
What do you need to assess when there is heavy uterine bleeding?
CBC for iron def, anemia
101
What does uterine fibroid look like on ultrasound?
a solid, round, well-defined, hypoechoic, heterogeneous lesion within the myometrium
102
How do you treat PCOS?
diet + exercise combination oral contraceptives insulin sensitizing agents

Endocrine / MSK / Repro (8 decks)

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