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Endocrine / MSK / Repro > Repro Review > Flashcards

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
Q

What can incomplete degeneration of the paramesonephric ducts lead to?

A

abnormalities in fallopian tubes, uterus and upper part of vagina

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26
Q

What leads to bicornuate uterus?

A

incomplete fusion of paramesonephric ducts

can lead to recurrent miscarriages

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27
Q

What hormone do IUDs secrete?

A

progestin

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28
Q

Why does ventilation increase in pregnancy?

A

progesterone stimulates the respiratory center in the brain

lowers PaCO2 so baby can diffuse their gas

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29
Q

What do the spiral arteries normally do?

A

become low resistance that can supply placenta with high volume of blood

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30
Q

What does thialiodomide use lead to?

A

limb defects

often in first 4-7 weeks of pregnancy

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31
Q

What cells produce AMH?

A

Sertoli cells

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32
Q

How does premature ovarian failure present?

A

like menopause

low estradiol with elevated FSH/LH

(the problem is at the level of the ovaries)

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33
Q

How does Klinefelter syndrome present

A

male with tall stature and female pubic hair

high LH / FSH

dysfunction in testes leading to low testosterone and low inhibin B

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34
Q

What is the most common cause of PRIMARY ammenorrhea?

A

Turner syndrome

dysfunction at the level of the ovaries

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35
Q

How does Turner syndrome present?

A

short statures (can see aortic valve / artery problems too)

high LH / FSH

low estrogen

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36
Q

How can you easily determine between androgen insensitivity syndrome and 5a-reductase def?

A

5a-reductase presents during puberty (penis at 12)

Androgen insensitivity presents later! (you have a later puberty)

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37
Q

How does 5a-reductase present?

A

No DHT = lack of male genitalia

Testosterone builds up and is converted to estrogen which leads to external female characteristics

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38
Q

What is a buzzword for Turner syndrome?

A

streak-like uterus

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39
Q

What is the genotype in Turner syndrome?

A

46 X

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40
Q

How can you tell central vs precocious puberty?

A

Central = elevated LH after stim test with elevated estrogen

Peripheral = no elevation in LH after stim test

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41
Q

What is the diagnostic criteria for PCOS? (two need to be present)

A

1) clinical or biochemical hyperandrogenism

2) evidence of oligoanovulation

3) polycystic appearing ovaries on ultrasound

42
Q

What are signs of uterine rupture?

A

someone had a prior C-section

intense pain and bleeding DURING delivery

43
Q

What is a sign of liver involvement in preeclampsia?

A

right upper quadrant pain / enlargement

indicates you are moving to HELLP syndrome

44
Q

What is bradycardia in a fetus?

A

under 140 bpm

45
Q

When do you give a pregnant person IV corticosteroids?

A

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
Q

When do you give a pregnant person IV Mg?

A

in eclampsia or HELLP syndrome

47
Q

What tumor can present with increased hCG levels?

A

choriocarcinoma

48
Q

What is a key feature of choriocarcinoma?

A

can spread hematogenously to the lungs

49
Q

When can choriocarcinoma often occur?

A

after some type of miscarriage

50
Q

Does vasa previa present with pain?

A

no! similar to placenta previa it is painless

51
Q

Valproic acid causes what development problems?

A

neural tube defects

52
Q

Tretinoin causes what development problems?

A

cleft palate and cardiac abnormalities

53
Q

What tumor can present with elevated alpha-fetoprotein?

A

endodermal sinus tumor (yolk sac tumor)

54
Q

What are signs of McCune-Albright syndrome?

A

cafe-au-lait spots

elevated testosterone with low FSH / LH

precocious puberty

55
Q

What is the cause of McCune-Albright syndome?

A

mosaicism

56
Q

What is a hydatiform mole?

A

same as molar pregnancy

trophoblastic disease from the placenta which leads to elevated hCG levels

57
Q

Sign of complete hydatidiform mole?

A

snowstorm appearance

NO maternal DNA

58
Q

Sign of incomplete hydatidiform mole?

A

fetal parts

normal amount of maternal DNA but double the amount of paternal DNA

59
Q

How does CMV exposure present in baby?

A

hearing loss

brain damage

cerebral palsy

60
Q

What type of carcinoma can you get if you have chronically elevated levels of estrogen?

A

endometrioid adenocarcinoma

61
Q

What is another word for leiomyoma?

A

uterine fibroids

62
Q

What does fried egg on histology point to?

A

dysgerminoma

63
Q

What lab values are associated with dysgerminoma?

A

elevated hCG and LDH

64
Q

What histology is associated with Call-Exner?

A

granulosa cell tumor

65
Q

What do Call-Exner bodies look like?

A

coffee bean nuclei surrounding an opening

66
Q

What does Schiller-Duval indicate?

A

yolk sac tumor

67
Q

What do Schiller Duval look like on histo?

A

central BLOOD VESSEL surrounded by tumor cells

68
Q

What do you see in Leydig cell tumor?

A

Ranke crystal on gross pathology

looks like golden brown

69
Q

What do you see on XR or meconium aspiration?

A

patchy infiltrate

70
Q

How can you quickly determine difference between meconium aspiration and respiratory distress syndrome?

A

respiratory distress syndrome occurs in preterm births

meconium aspiration occurs in babies born later

71
Q

What does endometrioid carcinoma look like on histology?

A

endometrium with glands and minimal stroma

72
Q

What does Brenner tumor look like on histology?

A

uroepithelium (stratified epithelium with umbrella cells)

coffee bean nuclei as well

73
Q

What can present with pseudomyxoma peritonei?

A

mucinous cystadenocarcinoma

74
Q

What marker is present in all ovarian tumors (both benign and malignant)

A

CA-125

75
Q

What is the prognosis of a dysgeminoma?

A

good prognosis

76
Q

What is a marker for a granulosa cell tumor?

A

inhibin

granulosa cells are producing a lot

77
Q

How does granulosa cell tumor present in adults vs. children?

A

children: precocious puberty (due to estrogen secretion)

adults: menstrual irregularities

78
Q

What is associated with Meigs syndrome?

A

fibroma (sex cord stromal tumor)

79
Q

What does “blue-domed cyst” on breast point to?

A

fibrocystic changes

80
Q

What is treatment for mastisis ?

A

continued drainage of breast milk and antibiotics

81
Q

If you have bloody nipple discharge what diagnosis is most likely?

A

intraductal papilloma

82
Q

If you have skin dimpling what are you thinking?

A

inflammatory subtype of invasive ductal carcinoma

83
Q

What is true of lobular carcinoma?

A

it lacks E-cadherin

84
Q

what is seen on histology of acute endometritis?

A

Microabscesses (aggregations of neutrophils)

85
Q

What is seen on histology in chronic endometritis?

A

plasma cells and lymphocytes

86
Q

What do you see on gross pathology of endometriosis?

A

chocolate cyst

87
Q

What is a sign of PID?

A

Chandelier sign: severe cervical motion tenderness seen in PID

88
Q

What is the treatment for PID?

A

ceftriaxone and doxycycline and metronidazole

89
Q

When should you consider Haemophilus ducreyi?

A

travel to endemic areas with a painful chancroid

90
Q

What is treatment for HSV?

A

oral valacyclovir twice daily

91
Q

How do you manage HSV during pregnancy?

A

antiviral supression at 36 weeks

92
Q

How does bacterial vaginosis present?

A

thin, gray, fishy-smelling discharge

often without irritation

93
Q

If wet mount for trichamonas is negative, what should you do next?

A

NAAT testing

94
Q

What is the treatment for trichamonas?

A

metronidazole

95
Q

What causes bacterial vaginosis?

A

imbalance in the vaginal flora

reduction in lactobacili and an overgrowth of anaerobic bacteria

96
Q

How do you diagnose BV? (4)

A

Amsel criteria:

1) Homogeneous thing, gray white discharge

2) Vaginal pH > 4.5

3) Positive whiff test (fishy)

4) Clue cells on microscopy

97
Q

What are two treatments for BV?

A

metronidazole or clindamycin cream

98
Q

What is the clinical presentation of uterine fibroids?

A

heavy menstrual bleeding

pelvic pressure

enlarged, irregular uterus on exam

99
Q

How can you differentiate adenomyosis from uterine fibroids?

A

adenomyosis also has heavy bleeding an pelvic pain but the uterus is NOT IRREGULAR on exam

100
Q

What do you need to assess when there is heavy uterine bleeding?

A

CBC for iron def, anemia

101
Q

What does uterine fibroid look like on ultrasound?

A

a solid, round, well-defined, hypoechoic, heterogeneous lesion within the myometrium

102
Q

How do you treat PCOS?

A

diet + exercise

combination oral contraceptives

insulin sensitizing agents

Endocrine / MSK / Repro (8 decks)

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