Reproductive Flashcards by Barbara Beberaggi

Contraindications for estrogen/progestin OCP?

<3 weeks postpartum
Migraine with aura
Uncontrolled HTN
Active breast CA
Active liver disease
thromboembolic risk (TBQ)

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Turner sd presents as

Atrophic ovaries:
Primary amenorrhea (passed 15yo)
Short stature
Narrow,high- arched palate
Webbed neck (broad)
Broad chest- widely separated nipples
Bicuspid Ao valve
Coarctation of Ao
Horseshoe kidney

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Adenomyosis is abnormal collection of endometrial glands and stroma within the uterine myometrium characterized by uniformly or irregularly enlarged uterus?

Uniformly

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Differences between Adenomyosis - Leiomyomas - endometrial polyps

Adenmyosis: regular heavy menses + uniformly enlarged uterus
Leiomyomas: regular heavy menses + irregularly enlarged uterus
Endometrial polyps: painless, irregular menses. No uterus enlargement

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Irregular menses can occur due to

Low and irregular GnRH pulses: low FSH and LH lead to anovulation, no corpus luteum to produce progesterone, making the endometrium vasculature fragile and unstable
Excessive peripheral estrogen conversion: seen in obesity. Check BMI

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5-alpha reductase acts

Turning testosterone to DHT

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BHP types and tto

1)Epithelial - responds to 5-alpha reductase inhibitors (finasteride)
2)Stromal:
a. Smooth muscle predominance: alpha-1 blockers
b. Collagen predominance: no response to neither

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Fibromyoma (fibroid) features

-Yellow-gray tumor with capsule that separates it from myometrium
-Under mic: proliferation of muocytes and fibroblast

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Endometriosis under mic

Ectopic endometrial glands and hemosiderin-laden macrophages

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Endometrial hyperplasia/CA presents

Heavy menses + thickened endometrium NOT a mass

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Testicular CA features

Age 15-35
Painless, solid, unilat mass (always consider CA)
Does NOT transluminate on ultrasound

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Varicoceles features

Painless testicular swelling
Feel like a *bag of worms”
Grow when standing
Warm to the touch -> risk of infertility

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Target of a) Leuprolide b)finasteride c)flutamide

a) Ant pituitary- blocks LH release
b) 5-alpha reductase on peripheral tissue - blocks conversion to DHT
c) organ androgen receptor

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Polyhydramnios causes

-Impaired swallowing: GI obstruction and anencephaly (teratogenic drugs)
-Increased fetal urination: high CO (anemia)
-Maternal DM

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Drug used for post partum hemorrhage and mec

Tranexamic-plasminogen inhibition

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Drug used for post partum hemorrhage and mec

Tranexamic-plasminogen inhibition

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Prostate CA common site and exam

Peripheral zone
Transrectal ultrasound with multiple random core biopsies

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Turner sd occurs due to

Nonsisjunction un Meiosis resulting in the loss of an X chromosome

Cervical uterine CA features

Transitional zone
HPV strongest RF

Paget breast disease features

-Unilat painful, pruritic eczematous rash on nipple and areola
-undermic: intraepithial adenocarcinima cells

Theca and granulosa cells fx

Theca: androgen production under LH influence
Granulosa: androgen conversion into estrogens via aromatase under FSH influence

MTX abortive mec is by

Inhibiting DNA synthesis to destroy fetal cells. It’s a folic acid antagonist

Scrotal lymphatic drainage occurs via

Superficial inguinal lymph nodes

Penis lymphatic drainage occurs via

para-aortic lymph nodes

What does Adenomyosis look like?

Dark red endometrial tissue within myometrium (red dots)

Ischemic priapism vs non-ischemic

Non-ischemic (due to increased arterial blood flow) has Normal pH, PO2 and PCO2 levels

Gestational Choriocarcinoma features

Very high beta-hCG Suncytiotrophoblasts and cytotrophoblasts cells Metastases to lungs

Hydrocele is a collection of peritoneal fluid within

The tunica vaginalis

Varicoceles is the distension of veins that form

The pampiniform plexus

Testicular torsion presents as

Sudden, unilat scrotal pain High riding swollen mass Absent cremasteric reflex

Epididymitis features

Caused by infection (N. Gonorrhoeae) Acute scrotal pain relieved with manual elevation of testicle

Primary lymph node drainage of the uterus

Uterus • External iliac

Cervix lymph drainage

Cervix • Internal iliac

Vaginal lymph drainage

Vagina • Proximal: internal iliac • Distal: inguinofemoral

Vulvar lymph drainage

Vulva • Inguinofemoral

Ovarian lymph drainage

Ovaries • Paraaortic

If the prostatic plexus is injured, which process will be affected?

Erection

Preeclampsia is defined as

SBP > or = 140 at or passed 20 weeks of pregnancy With proteinuria or other signs of organ damage

Pathological mec of headaches or vision probs in preeclampsia

Placental ischemia -> widespread endothelia disfx -> vasospasm and vasoconstriction ->headache an vision probs

Tamoxifen use is associated to which disease

Uterine sarcoma

Leiomyomas and uterine sarcomas have similar presentations but different microscopic features

Leiomyomas: monoclonal proliferation of myocytes and fibroblasts. Uterine sarcomas: myocytes and/or endometrial stromal cells with nuclear atypia, abundant mitoses, and areas of necrosis.

Partial vs complete mole

Partial: Focal trophoblastic hyperplasia, fetal tissue present, triploid karyotype Complete: Diffuse, no fetal tissue, snowstorm pattern, diploid