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Gyenocology

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resexuwe's version from 2017-08-07 15:42

GYNECOLOGY

 

Question Answer
What does the Seminal Vesicle give to sperm?Food (fructose) and clothes (semen)
What do the Bulbourethral = Cowper's glands secrete?Bicarbonate (neutralize lactobacilli)
What does the Prostate secrete?“The Prostate HAZ it” (1) Hyaluronidase Acid phosphatase
What is the Capacitation reaction?Zinc (Zn) used to peel semen off
What is the Acrosomal reaction?Sperm release enzymes to eat corona radiata
What is the Crystalization reaction?Wall formed after 1 sperm enters (to prevent polyspermy) the egg
Where does Testosterone come from?Adrenal gland and testicles
Where does DHT come from?Testicles (at puberty)
What is a Pseudohermaphrodite?External genitalia problem; does not match genotype
What is a True Hermaphrodite?Internal genitalia problem → has both sexes genatalia
What is a Female Hermaphrodite?Impossible b/c the default is female
What is a Female Pseudohermaphrodite?XX with low 21-OHase → High testosterone
What is a Male Hermaphrodite?XY with no MIF
What is a Male Pseudohermaphrodite?XY that has low 17-OHase → low testosterone
What is Hirsuitism?Hairy
What is Virulization?Man-like features in female child
What is Testicular Feminization = Androgen Insensitivity?Bad DHT receptor → XY with blind pouch vagina
What is McCune-Albright?Precocious sexual development, polyostotic fibrous dysplasia “Whorls of CT”, “Coast of Maine” pigmented skin macules
What is Cryptochordism?Testes never descended → sterility after 15mo, seminomas
Which stage of the menstrual cycle has the highest estrogen levels?Follicular stage (has proliferative endothelium)
What stage of the menstrual cycle has the highest temperature?Ovulatory stage
What stage of the menstural cycle has the highest progesterone levels?Luteal stage (has secretory endothelium)
What form of estrogen is highest at menopause?“E1” → Estrone (made by fat)
What form of estrogen is highest in middle-age females?E2 → Estradiol (made by ovaries)
What form of estrogen is highest at pregnancy?E3 → Estriol (made by placenta)
What states have increased estrogen?Pregnancy, liver failure, p450 inhibition, obesity
What is Adenomyosis?Growth of endometrium → myometrium, enlarged “boggy” uterus w/ cystic areas
What does DES taken by Mom causes in her daughter?(1) Adenomyosis → menorrhagia, (2) Clear cell carcinoma of Vagina, (3) Recurrent abortions from cervical incompetence
What is Kallman's syndrome?No GnRH, anosmia (can't smell)
What is Polycystic Ovarian Sndrome?Increase Cysts; No ovulation → No Progesterone, (Increase endometrial CA) → can't inhibit LH, Obese, hairy, acne
What is Savage's Syndrome?Ovarian resistance to FSH/LH
What is Turner's syndrome (XO)?1) High FSH, 2) Low E2 (estradiol), and 3) Ovarian dysgenesis
What does the Progesterone challenge test tell you?Bleeds → she has estrogen. Not Bleed → she has no E2 or Ovaries. (1) Increase FSH → Ovary problem, (2) Decrease FSH → Pituitary problem
What is Sheehan syndrome?(1) Post-partum hemorrhage → pitutitary, (2) Hyperplasia infarcts → No lactation
What is Asherman's syndrome?Previous D&C → Uterine scars
What is Oligomenorrhea?Too few periods
What is Polymenorrhea?Too many Periods
What is the MCC of post-coital vaginal bleeding?Cervical cancer
What is the MCC of post-coital vaginal bleeding in pregnant women?Placenta Previa
What is the MCC of vaginal bleeding in post-menopause women?Endometrial cancer
What is Chronic Pelvic Pain?“Endometriosis” until proven otherwise
What is Dysfunctional Uterine Bleeding?Diagnosis of exclusion, usually due to anovulation
What is Dysmenorrhea?PG-F causes painful menstrual cramps (teenagers miss school/work)
What is Endometriosis?Painful cyclical heavy menstrual bleeding → “Powder burns, chocolate cysts” due to ectopic endometrial tissue
What is Kleine Regnung?Scant bleeding at ovulation
What is Menorrhagia?Heavy Menstrual bleeding
What is Fibroids = Leiomyoma?Benign uterus smooth muscle (SM) tumor, (1) Sub-mucosal type → bleeding, (2) Sub-serosal type → Pain
What is Metrorrhagia?Bleeding or spotting in between periods
What is Mittelschmerz?Pain at ovulation
What causes Syphilis?Treponema Pallidum (Spirochete)
What is Herpes?Double stranded DNA virus (Ds DNA Virus)
What is HPV?Ds DNA virus
What is Chlamydia?Obligate intracellular parasite
What causes Gonorrhea?Gram negative (-) diplococcus
What causes Chancroid?H. Ducreyi
What causes Lymphogranuloma Venereum?Chlamydia trachomatis
What causes Granuloma Inguinale?C. granulomatosis
What causes Epididymitis?Chlamydia or GC
What is Condyloma lata?(1) Flat fleshy warts, (2) ulcerated, (3) and (sencondary syphilis)
What is Condyloma Accuminata?Verrucous “Cauliflower” warts, koilocytes, (HPV → 6, 11)
How does Herpes present?(1) primary – painful grouped vesicles on red base, (2) painful solitary lesion
How does Syphilis present?(1) primary – painless chancre (1-6 wks), (2) Secondary - rash, condyloma lata (6 wks), and (3) titiary – Neuro involvement, cardio, bone (6 yrs)
How does Chancroid present ?Painful w/ necrotic center, Gram negative (-) rods, and “School of fish” pattern
How does Lymphogranuloma Venereum present?Painless ulcers → abscessed nodes → genital elephantiasis
How does Granuloma Inguinale present?Spreading ulcers, Donovan bodies, granulation testicular
How does Chlamydia present?Cervicitis (yellow pus), conjuctivitis, PID
How does Gonorrhea present?Palmar pustules, arthritis, urethral discomfort with vary purulent urethritis
What is Epididymitis?Unilateral scortal pain, which decreased by support
What causes Congenital blindness?CMV
What causes Neonatal blindness?Chlamydia
What is Lichen simplex chronicus?Raised white lesions, chronic scratching in vulva
What is Lichen sclerosis?Paper-like vulva, itching, cancer risk
What is Hidradenoma?Sweat gland cysts
What causes Non-bacterial fetal infections?“TORCHES”, (1) Toxoplasma → multiple ring-enhancing lesions, cat urine, parietal lobe, (2) Others, (3), Rubella → Cataracts, hearing loss, PDA, meningoencephalitis, penumonia, “Blueberry muffin” rash, (4) CMV → Spastic diplegia of legs, hepatosplenomegaly, blindness, central calcifications, (5) HSV-2 → Temporal lobe hemorrhagic encephalitis, needs C/S prophylaxis, (6) Syphilis → Rhagade's (lip fissure), saber shin legs, Hutchinson's razor teeth, mulberry molars, saddle nose
What is Paget's disease of the breast?Rash and ulcer around Nipple & Breast cancer
What is Lobular carcinoma?Cells line up single file, contralateral primary
What is Comedocarcinoma?Multiple focal areas of necrosis, “blackheads”
What is inflammatory carcinoma?Infiltrates lymphatics, pulls on Cooper's ligaments, “Peau d'Orange” → dimpleling skin of the breast
What is Cystosarcoma phylloides?“Exploding mushroom”, firm, rubbery, moveable, good prognosis
What is Intraductal papilloma?Nipple bleeding
What is Ductal carcinoma?Worst prognosis breast cancer
What is Sarcoma Botyroides?Vagina Cancer, ball of grapes appearance
What is a Sister Mary Joseph Nodule?Ovarian CA spread to umbilicus
What is Meig's syndrome?Pleural effusion, ovarian fibroma, ascites
What are the S/E of Estrogen?Weight gain, Breast tenderness, Nausea
What are the S/E of Progesterone?Acne, Depression, HTN
Fluid Filled babyHydrops Fetalis
memorize

OBSTETRICS

 

Question Answer
Why do pregnant women get anemia?Dilutional effect, RBC rises 30% but volume rises 50%
What are the degrees of Vaginal lacerations?(1) 1st Degree → Skin, (2) 2nd Degree → Muscles, (3) 3rd Degree → Anus, (4) 4th Degree → Rectum
What is Vernix?Cheesy baby skin
What is Meconium?Green baby poop
What is Lochia?Endometrial slough
What is normal blood loss during a C-section?1L
How do you treat A1 Gestational DM?Diet
How do you treat A2 Gestational DM?Insulin
What are Identical twins?Egg split into perfect halves “monochorionic”
What are Fraternal twins?Multiple eggs fertilized by different sperm
What is Ovarian Hyper-stimulation Syndrome?Weight gain and enlarged ovaries after “Clomiphene use”
Who makes the Trophoblast?Baby
Who makes the Cytotrophoblast?Mom → GnRH, CRH, TSH, Inhibin
Who makes the Syncito-trophoblast?Mom and baby → HcG, HPL
When does implantation occur?1 week after fertilization
When is b-HCG found in urine?2 weeks after fertilization
What is the fx of Estrogen?Muscle relaxant, constipation, increase protein production, irritability, varicose veins
What is the fx of Progesterone?Increase Appetite, Increase Acne, dilutional anemia, quiescent uterus, pica, Hypotention, melasma
What makes Progesterone <10 week gastation?Corpus Luteum
What makes Progesterone >10 weeks gastation?Placenta
What is the fx of b-HCG?Maintains Corpus Luteum, sensitized TSHr → act hyperthyroid to (Increase BMR)
What makes b-HCG?Placenta
How fast should b-HCG rise?Doubles every 2 days until 10 weeks (when placenta is fully formed)
What is the fx of AFP?Regulates fetal intravascular volume
What is the fx of HPL?Blocks insulin receptors → sugar stays high (baby's stocking up on stuff needed for the journey)
What is the fx of Inhibin?Inhibits FSH → no menstruation
What is the fx of Oxytocin?Milk ejection, baby ejection
What is the fx of the Cortisol in pregnancy?(1) Decreases immune rejection of baby, (2) lung maturation
What are the thyroid hormone levels during pregnancy?Increase TBG → Increase T4, normal free T4 levels, Increase Total T4
When can you first detect fetal heart tone?20 Weeks
When can you tell the sex of a fetus by Ultra Sound?16 Weeks
What does an AFI <5 indicate?Oligohydramnios (cord compression)
What does an AFI >20 indicate?Polyhydramnioes (DM)
How fast should fundus height change?Uterus grows 1cm/wk
What is the pool test?Fluid in vagina
What is Ferning?Estrogen crystallizes on slide
What is Nitrazine?Shows presence of amniotic fluid
What is the risk of chorionic villus sampling?Fetal limb defects
What is the risk of amniocentesis?Abortion (2% risk)
What is a normal biophysical profile?>8
What is a biophysical profile?“Test the Baby, MAN!”, (1) Tones of the heart, (2) Breathing, (3) Movement: BPD, HC, AC, FL, (4) AFI, (5) Non-stress test (normal = “Reactive”)
What pelvis types are better for vaginal delivery?Gynecoid, Anthropoid
What pelvis types will need C/S?Platypelloid, Android
How do you predict a due date with Nagele's Rule?9 months from last menses → add 1 week
Why is Nagele's Rule inaccurate?Because it does not start from ovulation date
How do you correct Nagele's Rule for cycles >28 days?Add x days if cycle is x longer
How much weight should a pregnant women gain?1lb/week
When should intercourse be avoided during pregnancy?3rd trimester because PG-F in semen may cause uterine contractions
What are the Leopold maneuvers?(1) Feel fundus, (2) Feel baby's back, (3) Feel pelvic inlet, (4) Feel baby's head
What is Stage I of labor?Up to full dilation, (1) Latent Phase (<20h) → contractions → 4cm cervical dilation, (2) Active phase (<12h) → 4-10 cm cervical dilation (1cm/hr)
What is Stage II of labor?Full dilation → delivery, station 0 – Baby above pelvic rim (most uteri are anteverted), (1) Engage, (2) Descend, (3) Flex head, (4) Internal rotation, (5) External head, (6) Externally rotate, (7) Expulsion → LOA most common presentation
What is Stage III of labor?Delivery of Placenta (due to PG-F) blood gush → cord lengthens → fundus firms
How do you monitor baby's HR?Doppler, Scalp electrode
How do you monitor uterus?Tocodynamics, uterine pressure catheter
What Bishope's score predicts delivery will be soon?>8
What are Braxton-Hicks contractions?Irregular contractions with closed cervix
What is a Vertex presentation?Posterior fontanel (triangle shape) presents first, normal
What is a Sinciput presentation?Anterior fontanel (diamond shape) present first
What is a Face presentation?Mentum anterior → forceps delivery
What is a Compound presentation?Arm or hand on head → vaginal delivery
What is a Complete breech?Butt down, thighs, and legs flexed
What is a Frank breech?Butt down, thigh flexed, legs extended (Pancake)
What is a Footling breech?Butt down, thigh flexed, one toe is sticking out of cervical os
What is a Double footling breech?Two feet sticking out of cervical os
What is a Transverse Lie?Head is on one side, butt on the other
What is Shoulder Dystocia?Head out, shoulder stuck
Can you try vaginal delivery on a women who has had a Classic Horizontal C/S previously?No, must have C/S for all future pregnancies
Can you try vaginal delivery on a women who has had a Low Transverse C/S previously?Yes
What is early deceleration?Normal, due to head compression
What is late deceleration?Uteroplacental insufficiency b/c placenta can't provide O2/nutrients
What is Variable deceleration?Cord compression
What is Increased beat-to-beat variability?Fetal hypoxemia
What is decreased beat-to-beat variability?Acidemia
What is Pre-eclampsia?Ischemia to placenta → HTN (>140/90)
What is the treatment for Pre-eclampsia?Delivery
What is HELLP syndrome?Hepatic injury causing: (1) Hemolysis, (2) Elevated Liver enzymes, (3) Low Platelets
What is Eclampsia?HTN + Seizures
What are the symptoms of eclampsia?H/A, changes in vision, epigastric pain
What is the treatment for eclampsia?4mg Magnisium Sulfate as seizure prophylaxis
What is Chorioamnionitis?Fever, Uterine tenderness, decrease fetal HR
What are the symptoms of Amniotic Fluid Emboli?Mom just delivered baby and has SOB → PE, death (amniotic fluid → lungs)
What is Endometritis?Post-partum uterine tenderness
What is an incomplete molar pregnancy?2 sperm + 1 egg (69, XXY), has embryo parts
What is a complete molar pregnancy?2 sperm + no egg (46, XX – both paternal), no embyo
What is Pseudocyesis?Fake pregnancy with all the signs and symptoms
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