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REI > Study guide & Fellow review > Flashcards

Study guide & Fellow review Flashcards

1
Q

AMH is AKA __

A

mullerian inhibiting substance (MIS)

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2
Q

Mullerian duct becomes:

A

tubes, uterus, upper 1/3 vagina

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3
Q

Wolffian duct becomes:

A

epididymus, vas deferens, seminal vesicles

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4
Q

What does Mullerian NOT become?

A

ovaries, lower vagina, clitoris

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5
Q

What does Wolffian duct NOT become?

A

testes, penis

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6
Q

main 2 ddx for absence of uterus

A

mullian agenesis, androgen insensitivity

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7
Q

What do sertoli cells produce

A

MIS

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8
Q

What do Leydig cells produce

A

testosterone

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9
Q

Swyers syndrome

A

XY, mutation in SRY gene, phenotypically female

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10
Q

Gonads in Swyers?

A

streak

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11
Q

androgen insensitvity

A

female phenotype but no ovaries, scant pubic hair, breast development (aromatization from T), male T level

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12
Q

Defect in MRKH

A

mutation in AMH gene or receptor

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13
Q

heritability of 5 alpha reductase deficiency

A

autosomal recessive

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14
Q

which DSD most likely to have gender dysphoria

A

5-ARD (grow penis at puberty)

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15
Q

What test do your order to r/o CAH

A

17-ohp

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16
Q

order of female puberty

A

breast (thelarche), pubic hair (adrelarchy), growth spurt,

menarche, (“TAG-men”)

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17
Q

When should menses occur by? (define delayed puberty)

A

13 w/o breast, 15 if secondary sex

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18
Q

short stature, webbed neck, shield chest, streak gonads

A

Turner’s

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19
Q

precocious puberty, cafe au lait spots, increased bone age

A

McCune Albright (upstream production of estrogen due to G protein mutations)

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20
Q

treatment for McCune Albright

A

aromatase inhibitors - testalactone (shut down production of estradiol)

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21
Q

definition of precocious puberty in girls

A

under 6 in black, under 7 in white

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22
Q

Can put precocious puberty kids on __ to prevent early growth plate fusing

A

lupron

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23
Q

Why do GnRH agonists & antagonists work to prevent LH/FSH secretion?

A

activation requires pulsatile action

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24
Q

How to improve IVF success with hydrosalpinx?

A

salpingectomy or occlude tubes before IVF

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25
Q

treatment for labial adhesion

A

estrogen cream (NOT surgical)

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26
Q

What vaccine do you NOT GET within 3 weeks before IVF

A

MMR (bc contraindicated in pregnancy)

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27
Q

What infectious disease does treating BV help prevent?

A

STDs, including HIV

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28
Q

22 yo w primary ovarian insufficiency w/ bone fractures, considering pregnancy, how to treat osteoporosis?

A

hormone replacement (don’t forget calcium, vitamin D)

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29
Q

mutations associated with lynch syndrome

A

MLH1, PMS2, MSH2, MSH6 - microsatellite instability, germ line mutation in DNA mismatch repair gene

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30
Q

most common presentation of fallopian tube carcinoma

A

postmenopausal bleeding or copious clear discharge

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31
Q

male to female transition at most risk of what disease?

A

pro-thrombotic – hyperlipidemia, PE

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32
Q

During HSG you see b/l distal occlusion, what do you do?

A

Give doxycycline x5 days

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33
Q

risk for SCD in pregnancy

A

anemia - can’t increase RBC mass as normal

34
Q

HPV type most at risk for adenocarcinoma of cervix

A

18

35
Q

If BV and has allergey to flagyl, what med?

A

intravaginal clindamycin

36
Q

NIPT cell free DNA comes from what source?

A

trophoblasts

37
Q

Peak bone mass is determined by:

A

genetics

38
Q

why don’t we see ovarian hyperstimulation syndrome anymore

A

use lupron trigger now instead of hcg

39
Q

In a hypo hypo patient how to do ovulation induction?

A

FSH

40
Q

how does clomiphene work

A

SERM

41
Q

how does letrozole work

A

shuts down aromatization, body thinks no estrogen

42
Q

PCOS ovulation induction

A

letrozole

43
Q

How does estrogen increase bone density

A

inhibits osteoclasts

44
Q

changes after menopause (up, down, same): T, androstenedione, SHBG, estradiol, estrone

A

T: down
androstenedione: down
SHBG (sex hormone binding globulin): down - so can have increased free E & T
estradiol: down
estrone: down (but relative proportion is higher)

45
Q

most success for fertility protocol: mature oocyte, immature, oocyte, tissue cryo?

A

mature oocyte

46
Q

incidence of CF highest in what ethnic group

A

white

47
Q

most common mutation in CF

A

delta F508

48
Q

age to start DXA scan

A

65

49
Q

CAH how inherited? What gene?

A

autosomal recessive, CYP2…

50
Q

what is associated with mild hyperprolactinemia?

A

endometriosis

51
Q

subfascial hematoma after myomectomy - what artery injured?

A

inferior epigastric artery

52
Q

normal cysto after surgery but found to be damaged later - why?

A

thermal spread

53
Q

How to differentiate theca lutein cysts vs luteomas

A

theca lutein cysts bilateral (result of HCG - twin pregnancy, molar pregnancy)
luteoma usually unilateral

54
Q

What is the ethical appeal behind no longer assigning female gender with surgery in the setting of ambiguous genitalia at birth? (autonomy, justice, beneficence, non maleficence)

A

autonomy

55
Q

first lab to get in workup of acromegaly?

A

IGF1

56
Q

buzzword: imprinting disorder in context of artificial reproductive technology

A

ICSI

57
Q

examples of imprinting disorder

A

Prader willi, angelman

58
Q

when do mono mono twins separate?

A

8-13 days (1-2 weeks)

59
Q

AGC on pap, normal colpo, normal ECC, normal EMB, next step?

A

cotest 12 months, but we think D&C

60
Q

infectious risk highest w what osteoporosis med

A

denosumab (skin infections & eczema)

61
Q

osteoprosis med with concern for renal damage

A

zoledronic acid

62
Q

most common bug in pyelo

A

E coli

63
Q

breast cancer with dermal ducts, what type

A

inflammatory breast cancer

64
Q

pt with endometrial hyperplasia, what type of hyst do you recommend?

A

vag hyst

65
Q

split in di-di twins?

A

0-3 days

66
Q

what kind of breast cancer has peritoneal implants?

A

lobular invasive

67
Q

what is receptor status of brca1-2 related breast cancer?

A

triple negative

68
Q

treatment of choice for pt with twin twin transufation

A

laser

69
Q

Is toxic shock due to endo or exo toxin?

A

strep pyogenes exotoxins

70
Q

paclitaxel MOA

A

stabilize microtubules

71
Q

which is most sensitive to radiation? (large bowel, small bowel, bladder)

A

small bowel

72
Q

MOA immiquimod

A

immune modulate

73
Q

if get sued new or old company or you pays?

A

old company if you have tail insurance

74
Q

Pt hasn’t seen you in 5 years

A

bill as new pt

75
Q

blueberry muffin rash

A

CMV

76
Q

CMV avidity testing reveals both IgM, IgG positive with high avidity - immune, acute, chronic?

A

re-infection w different strain or reactivation

77
Q

Who put together national practitioner database?

A

Congress

78
Q

safest hypnotic in elderly? (ativan, xanax, valium, ambien)

A

avoid benzos!

79
Q

cervical cancer marker p53? RB

A

E6 inactivates p53

E7 inactivate Rb

80
Q

what causes elevated tryptase levels?

A

allergic reaction

REI (2 decks)

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