Reproductive Flashcards
Contraindications for estrogen/progestin OCP?
<3 weeks postpartum
Migraine with aura
Uncontrolled HTN
Active breast CA
Active liver disease
thromboembolic risk (TBQ)
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
Adenomyosis is abnormal collection of endometrial glands and stroma within the uterine myometrium characterized by uniformly or irregularly enlarged uterus?
Uniformly
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
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
5-alpha reductase acts
Turning testosterone to DHT
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
Fibromyoma (fibroid) features
-Yellow-gray tumor with capsule that separates it from myometrium
-Under mic: proliferation of muocytes and fibroblast
Endometriosis under mic
Ectopic endometrial glands and hemosiderin-laden macrophages
Endometrial hyperplasia/CA presents
Heavy menses + thickened endometrium NOT a mass
Testicular CA features
Age 15-35
Painless, solid, unilat mass (always consider CA)
Does NOT transluminate on ultrasound
Varicoceles features
Painless testicular swelling
Feel like a *bag of worms”
Grow when standing
Warm to the touch -> risk of infertility
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
Polyhydramnios causes
-Impaired swallowing: GI obstruction and anencephaly (teratogenic drugs)
-Increased fetal urination: high CO (anemia)
-Maternal DM
Drug used for post partum hemorrhage and mec
Tranexamic-plasminogen inhibition
Drug used for post partum hemorrhage and mec
Tranexamic-plasminogen inhibition
Prostate CA common site and exam
Peripheral zone
Transrectal ultrasound with multiple random core biopsies
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
