Unit 5 Flashcards
what triggers ovulation
increased LH
What hormone do follicles produce
estrogen
what hormone does the corpeus luteum secrete
progesterone and estrogen
What keeps the uterine lining vascularized after implantation
HCGn keep corpeus luteum functioning so it can continue to produce progesterone
what ovarian cell produces androgens
Theca
what ovarian cell has receptors for LH
Theca
what ovarian cell creates estrogen from androgens
granulosa
what ovarian cell has receptors for FSH
Granulosa
In PCOS there is an excess of: LH or FSH
LH
What condition causes Acanthosis nigrans
PCOS
What is clomiphene used for
to induce ovulation in anovulation related to PCOS
PTH binds to osteoblasts or osteoclasts
osteoblasts
(Osteoblasts or osteoclasts) express RANKL and (osteoblasts or osteoclasts) bind to the RANKL
osteoblasts
osteoclasts
What role does estrogen play in osteoporosis
increased production of OPG
what does OPG do
Stops RANKL from binding to RANK on osteoclasts therefore inhibiting activation of osteoclasts
What is first line treatment for osteoporosis
bisphosphonates
what is the mechanism of action of bisphosphonates
bind to hydroxyepetite in bone and are then taken up into the osteoclasts causing osteoclasts apoptosis
What medications can cause osteonecrosis of the jaw and atypical femoral fractures
bisphosphonates
bisphosphonates may cause (increased or decreased) serum calcium
decreased
Why is PTH a treatment for osteoporosis
intermittent PTH dosing has been shown to activate osteoblasts more than it activates osteoclasts
What is the mechanism of action of denosumab
stops RANKL bind to RANK to decreased osteoclast activation
What medications predisopose people to osteoporosis (10)
anticoagulants, PPIs, corticosteroids, anti seizure meds, thyroid hormone, retinoids, MTX, loop diuretics, cyclosporin, depo
which calcium has the highest bioavailability
calcium lysinate
what class is calcitonin and when is it used
RANKL inhibitor, second line treatment for osteoporosis
when are extended combined OCPs beneficial
excessive bleeding, dysmennorrhea, endometreosis
what is an extended phase OCP
multiple or no months with a placebo week therefore fewer or no withdrawl bleedings
how do combined OCPs prevent pregnancy
inhibit ovulation
why does menopause cause increased FSH
follicular depletion means not as much estrogen so FSH increases to try to increase estrogen
why should women entering menopause have LDL levels checked
because estrogen has a protective cardiovascular effect
what class of medication can be used for hot flashes and irritability in menopause
SSRIs or SNRIs
when do women not require both progestin and estrogen in hormone therapy for menopause
hysterectomy - only require estrogen and not progestin
BV, retrograde menstratution and intercourse can all increase riks of developing _____
PID
what is hydrosalpinx and what causes it
swollen fallopian tube from PID
true or false: a history of having PID may make it harder to get pregnant
true, as scar tissue may remain in the fallopian tubes
what is fits-hugh-curtis syndrome
inflammation from PID spreads to peritoneum and then up to liver causing scar tissue
What STIs are most likely to cause PID
chlamydia and ghonorrhea
fever with abnormal vaginal discharge and pelvic pain may be ____
PID
cervical motion tenderness is an indication of _____
PID
true or false: a positive result for BV rules out the diagnosis of PID
false, BV can lead to a PID
what abx are used to treat PID
Cephalosporins and tetracyclines : 1 dose of IM ceftriaxone followed by 2 weeks of doxy and flagyl
when might surgery be necessary for PID treatment
to remove adhesions or for hydroslpinx or tubal abcess
true or false: patients with a tubo-ovarian abcess can be treated with outpatient abx
false, it will likely need surgical intervention
true of false: history of PID increases risk of ectopic pregnancy
true
the follicular phase takes place (before or after) ovulation
before
why is there sometimes no ovulation in PCOS
LH is constantly high so there is no sudden LH surge to facilitate ovulation
what condition may cause hyperplasia of ovarian theca cells
PCOS
what is the difference between primary and secondary amennorhea
primary: menstration never started. Secondary: menstration used to occur but has now stopped
what is the most common cause of amennorhea
turner syndrome
what is the most common cause of secondary amennorhea
pregnancy
pain with defecation, chronic fatigue and infertility may be symptoms of what
endometriosis
patients with dysmenorrhea who do not respond to NSAIDs should be considered for _____
endometriosis
what is gold standard for diagnosing endometriosis
laproscopy
what medication can be used for dysmenorrhea
NSAIDs
What class is alendronate and what is it used to treat
bisphosphonate for Osteoporosis
Goserelin and nafarelin are what class of medicaiton and used to treat what
GnRH agonists used to treat endometriosis
what class is Danazol and what is it used to treat
androgen receptor agonist, treats endometriosis
estrogen therapy and PTH analogues can be used to treat _____
osteoporosis
how does cholchicine work
blocks recruitment of neutrophils
