WorksheetsRepro
Total questions: 93
Worksheet time: 47mins
Name
Class
Date
1.
AUB-M Term
a)
Polyps
b)
Endometrial
c)
Coagulopathy
d)
Malignancy/hyperplasia
2.
Functional Ovarian Cysts General
a)
90% of all ovarian cancers
b)
May produce hCG or AFP - both can be used as tumor markers
c)
Can be asymptomatic or not
d)
Strong consideration should be given to oophorectomy in women with a personal or family history of epithelial ovarian cancer, primary GI tract cancer, or breast cancer
3.
Congenital Adrenal Hyperplasia General
a)
Autosomal recessive and variable penetrance
b)
Hirsutism, Regular Menses, normal circulating androgens
c)
signs of corticosteroid excess, truncal obesity, moonlike facies, glucose intolerance, skin thinning with striae, osteoporosis, proximal muscle weakness
d)
Androgen-secreting adrenal adenomas cause a rapid increase in hair growth associated with severe acne; amenorrhea; and, sometimes, virilization. In androgen-secreting adenomas, DHEA-S is usually elevated above 6 mg/mL
4.
AUB-C Term
a)
Polyps
b)
Coagulopathy
c)
Leiomyoma
d)
Adenomyosis
5.
Testosterone Characteristics
a)
weak androgen secreted in equal amounts by the adrenal glands and ovaries
b)
Receptors found in hair follicles, sebaceous glands, genital skin & elsewhere
c)
Testosterone converted within hair follicles and genital skin to dihydrotestosterone (DHT), even more potent than testosterone
d)
measured as dehydroepiandrosterone sulfate (DHEA-S) because of its longer half-life, making it a more reliable measure
6.
Other Malignant Stromal Cell Tumors Characteristics
a)
Delays menstruation by days-week, usually occuring within 2 weeks of missed period
b)
Malignant mesodermal sarcomas (carcinosarcomas) - aggressive tumors with poor survivability
c)
Excellent prognosis
d)
Histologically similar to endometrial cancer
7.
Malignant Stromal Cell Tumors General
a)
May produce hCG or AFP - both can be used as tumor markers
b)
Usually produce male or female sex steroids, but can produce adrenal steroid hormones
c)
Produce hormones and are called functioning tumors
d)
Not neoplasms, instead they are variations that arise from normal ovarian function
8.
Emotional Menopausal Symptoms
a)
Vasomotor symptoms, hot flashes, diaphoresis
b)
Backache
c)
Minor hirsutism of the face (decr e2 leads to incr T)
d)
Fatigue, irritability, apprehension, libido, insomnia, headache
9.
Smoking related Primary Ovarian Insufficiency Characteristics
a)
Metabolism of estradiol into catecholestrogens, which are anti-estrogenic
b)
Pregnancy can be facillitated by exogenous estrogen replacement
c)
Can hasten menopause by 3 to 5 years
d)
Chemo drugs that can affect membrane of ovarian follicles and hasten follicular atresia
10.
Cancer Metastatic to Ovary General
a)
Strong consideration should be given to oophorectomy in women with a personal or family history of epithelial ovarian cancer, primary GI tract cancer, or breast cancer
b)
Those present over a follicle at ovulation undergo metaplastic change, chance for malignant transformation
c)
If arises from GI tract or breast, is called a Krukenberg tumor
d)
May produce hCG or AFP - both can be used as tumor markers
11.
Polycystic Ovary Syndrome Treatment
a)
Spironolactone 25 to 100 mg/day is the most commonly used androgen blocker. Spironolactone also inhibits testosterone production by the ovary and reduces 5α-reductase activity
b)
OCP to suppress LH production and increase SHBG
c)
Nonclassic CAH can be managed easily by supplementing glucocorticoids.
d)
Clomiphene citrate if they are trying to get fertile
12.
AUB-A Term
a)
Leiomyoma
b)
Coagulopathy
c)
Endometrial
d)
Adenomyosis
13.
Primary Ovarian Insufficiency General
a)
Diagnosis has profound emotional implications
b)
1% of women who experience menopause before the age of 40
c)
At the time of birth, the female infant has approximately 1 to 2 million oocytes; by puberty, she has approximately 400,000 oocytes remaining
d)
average age for menopause in the United States is between 50 and 52 years (median 51.5), with 95% of women experiencing this event between 44 and 55 years
14.
Hyperandrogenism Cause
a)
Hypothalamic-Pituitary dysfunction
b)
CAH
c)
Mild hypothalamic amenorrhea - exercise, nutrition, stress, hypothyroidism
d)
Premature ovarian failure
15.
Malignant Germ Cell Tumors General
a)
May produce hCG or AFP - both can be used as tumor markers
b)
Can be asymptomatic or not
c)
Produce hormones and are called functioning tumors
d)
Contained in the ovarian capsule (outer surface)
16.
Enlarged Corpus Luteum Symptoms
a)
May cause acute pelvic pain if ruptured, usually self-limited
b)
Dull lower quadrant pain, missed menstrual period, adnexal enlargement
c)
abdominal fullness, abdominal or back pain, decreased energy, and urinary frequency
d)
PT presents with acute pain late in the luteal phase. Some patients present with evidence of hemoperitoneum as well as hypovolemia
17.
Hirsutism Definition
a)
masculinization of a woman, associated with marked increase in circulating testosterone
b)
terminal hair is darker, coarser and kinkier than vellus
c)
enlargement of the clitoris, followed by temporal balding, deepening of the voice, involution of the breasts, and a remodeling of the limb-shoulder girdle as well as hirsutism
d)
Distribution includes lower abdomen, periareloar, chin, upper lip, between breasts, lower back
18.
E+P Test Positive Withdrawal Bleed Normal/High FSH Cause
a)
Hypothalamic-Pituitary dysfunction
b)
Turners/Mosaicism
c)
PCOS
d)
Asherman Syndrome
19.
Sertoli Leydig Tumors aka Androblastoma General
a)
95% unilateral
b)
Testosterone secreting
c)
signs of corticosteroid excess, truncal obesity, moonlike facies, glucose intolerance, skin thinning with striae, osteoporosis, proximal muscle weakness
d)
Metabolic syndrome, risk of cardio disease, and acanthosis nigricans
20.
Normal hormone levels Cause
a)
Mild hypothalamic amenorrhea - exercise, nutrition, stress, hypothyroidism
b)
Hypothalamic-Pituitary dysfunction
c)
Mullerian abnormalities
d)
Premature ovarian failure
21.
Bladder and Urethra Menopausal Symptoms
a)
Risks of Heart Disease increase post- menopausal (Irregardless of age of menopause)
b)
Angina and coronary heart disease
c)
Stress incontinence
d)
Minor hirsutism of the face (decr e2 leads to incr T)
22.
Dihydrotestosterone Characteristics
a)
weak androgen secreted in equal amounts by the adrenal glands and ovaries
b)
Testosterone converted within hair follicles and genital skin to dihydrotestosterone (DHT), even more potent than testosterone
c)
Less SHBG means MORE free Test
d)
weak androgen secreted principally by the adrenal glands
23.
PMDD Treatment
a)
Diet change, aerobics, calcium carbonate
b)
Progesterone - anti convulsant effect
c)
gold standard of treatment is the selective serotonin reuptake inhibitors (SSRIs)
d)
Oral contraceptives
24.
Primary fallopian tube carcinoma Characteristics
a)
Overall survival rate is 35 45%
b)
symptoms of this tumor are so minimal that the tumor is often advanced before a problem is recognized
c)
Inspection and palpation of the entire peritoneal cavity are performed to determine the extent of disease. This involves palpation of the pelvis, paracolic gutters, omentum, and upper abdomen, including the liver, spleen, and undersurface of the diaphragm.
d)
mainly from the uterus and ovary
25.
Gonadotropin Resistant Ovary Syndrome Characteristics
a)
FSH binds to the follicle and provides Estradiol
b)
Chemo drugs that can affect membrane of ovarian follicles and hasten follicular atresia
c)
Pregnancy can be facillitated by exogenous estrogen replacement
d)
Can hasten menopause by 3 to 5 years
26.
Vagina Development
a)
pelvis is divided into the greater pelvis (false pelvis) and the lesser pelvis (true pelvis), which are separated by the linea terminalis
b)
infundibulopelvic ligament connects the ovary to the posterior abdominal wall and is composed mainly of the ovarian vessels
c)
By week 10 the undifferentiated gonad has developed into an ovary
d)
Traverse urogenital diaphragm and surrounded by bulbocavernosus muscles of the vulva
27.
Genital Outflow Amenorrhea Causes
a)
Prolactin-secreting pituitary adenomas
b)
Gonadal agenesis (Turner syndrome 45,XO)
c)
Mullerian Defects - Imperforate hymen, transverse vaginal septum
d)
Craniopharyngioma
28.
Primary Dysmenorrhea Cause
a)
Increased F2alpha increases smooth muscle contractions
b)
Neuromuscular pain
c)
Tuberculous salpingitis
d)
Endometriosis, adenomyosis, adhesions, pelvic inflammatory disease, uterine leiomyomata
29.
Ovarian Amenorrhea Causes
a)
Gonadal agenesis (Turner syndrome 45,XO)
b)
Mullerian Defects - Imperforate hymen, transverse vaginal septum
c)
Craniopharyngioma
d)
Anxiety
30.
Corpus Hemorrhagicum Symptoms
a)
abdominal fullness, abdominal or back pain, decreased energy, and urinary frequency
b)
Dull lower quadrant pain, missed menstrual period, adnexal enlargement
c)
Alteration of the menstrual interval result of both failed subsequent ovulation and bleeding stimulated by the large amount of estradiol produced in the follicle.
d)
PT presents with acute pain late in the luteal phase. Some patients present with evidence of hemoperitoneum as well as hypovolemia
31.
Enlarged Corpus Luteum Treatment
a)
Work up for bleeding disorder
b)
Treatment is surgical excision, rupture causes intense chemical peritonitis = surgical emergency
c)
Surgery
d)
OCP may benefit
32.
Corpus Hemorrhagicum Diagnosis
a)
Negative pregnancy test
b)
Common in PT with bleeding disorder or taking anticoagulants
c)
Absence of thick septations, soft tissue elements, or evidence of internal or external excrescences
d)
Pelvic examination findings may include unilateral tenderness with a palpable, mobile, and cystic adnexal mass
33.
AUB-C Data
a)
May cause IMB or post-coital bleeding
b)
Common cause of HMB
c)
Chronic endometritits, AV malformation, myometrial hypertrophy
d)
AUB+HMB associated with distorted endometrial cavity
34.
Menstruation and Menoupause General
a)
average age for menopause in the United States is between 50 and 52 years (median 51.5), with 95% of women experiencing this event between 44 and 55 years
b)
1% of women who experience menopause before the age of 40
c)
By 30/35 the number of oocytes 100,000
d)
Diagnosis has profound emotional implications
35.
Endometrial Cancer Type 2 Estrogen Independant Characteristics
a)
increased gland-to-stroma ratio gives the endometrium a crowded picture, frequently with glands appearing almost back-to-back
b)
Glandular and stromal elements that proliferate excessively
c)
Nonendometrioid; serous, clear cell, mucinous, squamous, transitional cell, menonephric, undifferentiated
d)
Composed of glands that resemble normal endometrial glands but that contain more solid areas, less glandular formation, and more cytologic atypia as they become less well differentiated
36.
Mucinous Cystadenoma Treatment
a)
patients past reproductive age, bilateral oophorectomy along with hysterectomy may be indicated, not only because of the chance of future malignancy but also because of the increased risk of a coexistent tumor in the contralateral ovary
b)
younger patient with smaller tumors, ovarian cystectomy may be attempted to minimize the amount of ovarian tissue removed
c)
Surgery
d)
Regress spontaneously without intervention
37.
Adrenal Methods Excess Androgen Production
a)
ACTH stimulates production of CORTISOL
b)
Sustained or increased LH secretion will increase levels of androstenedione and testosterone
c)
In obesity, conversion of Androstenedione to Testosterone increased in adipocytes
d)
Dependent on adrenal and ovarian androstenedione production
38.
Pelvis Development
a)
Ovary-determining gene is WNT4, and SRY needs to be absent
b)
pelvis is divided into the greater pelvis (false pelvis) and the lesser pelvis (true pelvis), which are separated by the linea terminalis
c)
obstetric conjugate is 1.5 to 2 cm shorter than the diagonal conjugate, it should be 11.0 cm or greater to accommodate a fetal head of normal size
d)
uterus, cervix, and vagina are formed by fusion of Mullerian ducts, creating the lumen of the uterus
39.
Theca Lutein Cysts Treatment
a)
Surgery
b)
OCP will not resolve existing, but will prevent formation of new ones
c)
Regress spontaneously without intervention
d)
OCP may benefit
40.
Secondary Dysmenorrhea Symptoms
a)
spasmodic, colicky, labor-like pain, that may radiate to the back and down the thighs
b)
Symptom onset is the beginning of menstruation and lasts hours-days
c)
Pain often lasts longer than the menstrual period
d)
Diarrhea, Nausea, Vomiting, Cephalalgia, Dizziness
41.
Adrenal Adenoma and Carcinoma General
a)
When manifested at puberty adrenarche may precede thelarche
b)
Elevated plasma 17-OH progesterone levels (> 2000 ng/dl) in classic forms
c)
obesity seems to be the common factor (seen in 50% of patients), and the acquisition of body fat coincides with the onset of PCOS
d)
Androgen-secreting adrenal adenomas cause a rapid increase in hair growth associated with severe acne; amenorrhea; and, sometimes, virilization. In androgen-secreting adenomas, DHEA-S is usually elevated above 6 mg/mL
42.
Serous Cystadenoma Characteristics
a)
Lined by granulosa cells, filled with pale yellow slimy fluid rich in estrogen
b)
hereditary ovarian cancers generally present in patients at a younger age than nonhereditary tumors
c)
Cysts have a translucent quality, indicating lack of solid component
d)
can also be elevated in endometriosis, uterine leiomyoma, cirrhosis, and other malignancies.
43.
Ovarian Methods Excess Androgen Production
a)
ACTH stimulates production of CORTISOL
b)
Dependent on adrenal and ovarian androstenedione production
c)
In obesity, conversion of Androstenedione to Testosterone increased in adipocytes
d)
Regulated by LH secretion, which stimulates theca cells to secrete androstenedione and testosterone. These androgens are precursors for estrogen production by granulosa scells via aromatase.
44.
Hypoestrogenism Normal/High FSH Cause
a)
Tuberculosis/Schistosomiasis
b)
Asherman Syndrome
c)
Testicular Feminization (AIS)
d)
Premature ovarian failure
45.
Paratubal Cysts Characteristics
a)
Benign
b)
develop in the mesosalpinx from vestigial Wolffian duct structures, tubal epithelium, and peritoneum inclusions
c)
found near the fimbriated end of the fallopian tube
d)
most appear like typical papillary serous cystadenocarcinomas of the ovary
46.
Ovarian Fibroma Histology
a)
Tumor cells are recapitulating the endocervical lining
b)
The cell type that lines the cyst is tall columnar, with a basally located nucleus, and prominent apical cytoplasmic mucin.
c)
These are hard, white/off white, well circumscribed tumors that don’t produce hormones when of pure histology
d)
Calcified, laminated structures, psammoma bodies
47.
AUB-I Data
a)
IUD, Progestin implants, hormonal contraception
b)
von Willebrand disease most common
c)
Think immature HPO-axis and Anovulation
d)
In PT with this condition, very common cause of AUB
48.
Congenital Adrenal Hyperplasia Treatment
a)
Nonclassic CAH can be managed easily by supplementing glucocorticoids.
b)
Clomiphene citrate if they are trying to get fertile
c)
Monitor Potassium levels (may rise b/c aldosterone antagonist
d)
Weight reduction to decrease androgen and return ovulatory cycles
49.
Immature teratoma Characteristics
a)
can also be elevated in endometriosis, uterine leiomyoma, cirrhosis, and other malignancies.
b)
If present in pediatric age group,it may contribute to signs and symptoms of precocious puberty, including precocious thelarche and vaginal bleeding
c)
Most take the form of endometriomas, which are ovarian cysts lined by well differentiated endometrial like glandular tissue
d)
Good prognosis with unilateral oophorectomy and chemotherapy
50.
Ovarian Cancer Histology
a)
Demoplasia reliable feature identifying as carcinoma
b)
Malignant germ cell tumors
c)
Tumor cells are recapitulating the endocervical lining
d)
Small purple-magenta rounded concretions/calcifications — psammoma bodies
51.
Endometrial Hyperplasia Complex Architecture Characteristics
a)
Normal small tubular glands are being replaced by more open, dilated glands, some of which will begin to resemble puzzle pieces, as they acquire irregular contours
b)
Abnormal proliferation of glandular elements
c)
increased gland-to-stroma ratio gives the endometrium a crowded picture, frequently with glands appearing almost back-to-back
d)
architectural change only, and by definition, there should be no cytologic atypia at high power.
52.
Bowel Disease
a)
DVT
b)
Pyelonephritis, stones
c)
Stones or Calculi
d)
IBS
53.
Ureters Disease
a)
Stones or Calculi
b)
IBS
c)
Appendicitis
d)
Pyelonephritis, stones
54.
External genitalia Development
a)
Stratified squamous of exocervix changes to columnar at tz
b)
Uterine a. passes superior to ureter and inferior to cardinal lig.
c)
Labioscrotal/genital swellings = scrotum or labia majora (f)
d)
Wolffian regress in absence of Testosterone
55.
Appendix Disease
a)
IBS
b)
Appendicitis
c)
DVT
d)
Pyelonephritis, stones
56.
Chronic Pelvic Pain Cause
a)
Chronic PID
b)
Endometriosis, adenomyosis, adhesions, pelvic inflammatory disease, uterine leiomyomata
c)
Increased uterine PGF2a and PGE2a
d)
Increased F2alpha increases smooth muscle contractions
57.
DHEA Characteristics
a)
measured as dehydroepiandrosterone sulfate (DHEA-S) because of its longer half-life, making it a more reliable measure
b)
weak androgen secreted principally by the adrenal glands
c)
Less SHBG means MORE free Test
d)
Testosterone converted within hair follicles and genital skin to dihydrotestosterone (DHT), even more potent than testosterone
58.
Skin and Mucous Menopausal Symptoms
a)
associated with significant adverse outcomes, such as hampered job productivity and sleep deprivation
b)
Risks of Heart Disease increase post- menopausal (Irregardless of age of menopause)
c)
Softer consistency
d)
vaginal epithelium, cervix, endocervix, endometrium, myometrium, and uroepithelium are estrogen-dependent tissues. With decreasing estrogen production, these tissues become atrophic, resulting in various symptoms
59.
AUB-L Data
a)
Common cause of HMB
b)
AUB+HMB associated with distorted endometrial cavity
c)
von Willebrand disease most common
d)
Endometrial carcinoma is most common gyn malignancy
60.
Follicular Cysts Diagnosis
a)
Negative pregnancy test
b)
If persists beyond 6wk consider neoplasm and possible surgery
c)
Pelvic examination findings may include unilateral tenderness with a palpable, mobile, and cystic adnexal mass
d)
Common in PT with bleeding disorder or taking anticoagulants
61.
Breasts Menopausal Symptoms
a)
Reduced support
b)
Hot flushes may be disabling during the day and even more so at night when they are a significant cause of clinical sleep disturbance
c)
Risks of Heart Disease increase post- menopausal (Irregardless of age of menopause)
d)
Fracture of the hip and wrist (bone loss, osteoporosis)
62.
Benign Cystic Teratoma Characteristics
a)
Good prognosis with unilateral oophorectomy and chemotherapy
b)
Associated with endometriosis
c)
Most common elements are ectodermal (skin, sweat and sebaceous glands, hair, sebum)
d)
Treatment is dependent on age and fertility plans, involves at least a unilateral oophorectomy and staging procedure
63.
Pelvic Kidneys Disease
a)
Pyelonephritis, stones
b)
DVT
c)
Appendicitis
d)
IBS
64.
PMDD Definition
a)
A group of physical, mood-related, behavioral changes that occur in a regular and cyclic relationship to luteal phase of menstrual cycle that do interfere with daily routine
b)
At least 5 of 11 PMS symptoms, with at least 1 being a core symptom that occurregulalrly during luteal phase
c)
Core symptoms are depressed mood, anxiety, tension, irritability, anhedonia
d)
Normal cyclic symptoms associated with ovulation that do not interfere with daily routine
65.
Internal reproductive organs Development
a)
Vagina = urogenital sinus + Mullerian ducts
b)
Lesser (true) pelvis is formed by the sacrum and coccyx posteriorly and by the ischium and pubis laterally and anteriorly
c)
External os round in nullipara, transverse slit after childbirth
d)
Remnants of mesonephric/Wolffian ducts, located on vaginal wall or broad lig
66.
Cytoreductive Surgery or Tumor Debulking Characteristics
a)
Called hydatid cysts of Morgagni
b)
most ovarian cancer presents at an advanced stage, adjunctive treatment using chemotherapy is usually necessary
c)
Profuse serosanguineous discharge is called hydrotubae profluens
d)
found near the fimbriated end of the fallopian tube
67.
Follicular Maturation Characteristics
a)
Chemo drugs that can affect membrane of ovarian follicles and hasten follicular atresia
b)
Induced and stimulated by FSH and LH
c)
LH stimulates theca cells to make androgens and estrogens, which trigger the ovulation mechansim
d)
begin screening in pmp women under 65 if they have a history of fragility fracture, weigh less than 127 lb, medical cuases of bone loss, family history of hip fracture, smoker, alcholism, RA.
68.
Serous Cystadenoma Treatment
a)
Treatment is surgical excision, rupture causes intense chemical peritonitis = surgical emergency
b)
OCP will not resolve existing, but will prevent formation of new ones
c)
Regress spontaneously without intervention
d)
younger patient with smaller tumors, ovarian cystectomy may be attempted to minimize the amount of ovarian tissue removed
69.
Hysterectomy related Primary Ovarian Insufficiency Characteristics
a)
Can hasten menopause by 3 to 5 years
b)
Chemo drugs that can affect membrane of ovarian follicles and hasten follicular atresia
c)
begin screening in pmp women under 65 if they have a history of fragility fracture, weigh less than 127 lb, medical cuases of bone loss, family history of hip fracture, smoker, alcholism, RA.
d)
Adequate nmber of follicles, but they are resistant to FSH and LH
70.
Follicular Cysts Characteristics
a)
Clinically significant when symptomatic or persist beyond one menstrual interval
b)
Also called arrhenoblastomas
c)
Adenofibroma
d)
Usually solid and derived from sex cord stroma of developing gonad
71.
Endometrial Hyperplasia Simple Architecture Characteristics
a)
Histologically, glands vary markedly in size, from small to cystically enlarged
b)
characterized by significant numbers of glandular elements that exhibit cytological atypia and disordered maturation (loss of cellular polarity, nuclear enlargement with increased nucleus-to-cytoplasm ratio, dense chromatin, and prominent nucleoli)
c)
Spontaneous onset, poor prognosis, more aggressive
d)
Abnormal proliferation of glandular elements
72.
Uterus Positions Development
a)
Uterine a. passes superior to ureter and inferior to cardinal lig.
b)
RV/RVRF position may make it difficult to determine gestational age late first trimester
c)
RF or AF uterus increases risk of uterine perforation by IUD
d)
Paramesonephric/Mullerian ducts will differentiate into female genital ducts (uterine tubes, uterus, upper vagina)
73.
AUB-A Data
a)
AUB+IMB or prolonged think inflammation and/or infection
b)
Endometrial carcinoma is most common gyn malignancy
c)
Can be cervical or endometrial
d)
In PT with this condition, very common cause of AUB
74.
AUB-P Data
a)
IUD, Progestin implants, hormonal contraception
b)
Can be cervical or endometrial
c)
Think immature HPO-axis and Anovulation
d)
von Willebrand disease most common
75.
Enlarged Corpus Luteum Treatment
a)
patients past reproductive age, bilateral oophorectomy along with hysterectomy may be indicated, not only because of the chance of future malignancy but also because of the increased risk of a coexistent tumor in the contralateral ovary
b)
Regress spontaneously without intervention
c)
OCP may benefit
d)
Surgery
76.
Uterus Positions Development
a)
obstetric conjugate is 1.5 to 2 cm shorter than the diagonal conjugate, it should be 11.0 cm or greater to accommodate a fetal head of normal size
b)
Blood supply = vaginal a. branch of internal iliac
c)
Midposition
d)
Remnants of mesonephric/Wolffian ducts, located on vaginal wall or broad lig
77.
Genital Outflow Amenorrhea Causes
a)
Turner syndrome
b)
Mullerian Agenesis - Absence of cervix, uterus, tubes, upper vagina
c)
Gonadal agenesis (Turner syndrome 45,XO)
d)
Mullerian Defects - Imperforate hymen, transverse vaginal septum
78.
Hypergonadotropic hypogonadism MoA
a)
Ovaries do not receive FSH stimulation, so E2 secretion is not signalled
b)
Gonads fail to develop, or they develop prematurely
c)
Normal, male, levels of Testosterone but receptors unable to respond
d)
Gonads unable to secrete adequate amounts of Estrogen
79.
Internal reproductive organs Development
a)
uterus, cervix, and vagina are formed by fusion of Mullerian ducts, creating the lumen of the uterus
b)
Lesser (true) pelvis is formed by the sacrum and coccyx posteriorly and by the ischium and pubis laterally and anteriorly
c)
Mesonephric/Wolffian ducts will differentiate into male genital ducts - rete testis, efferent duct, epididymis, vas deferens, seminal vesicles
d)
Uteralsacral ligament is primary support
80.
Pelvis Development
a)
Stratified squamous
b)
Blood supply = vaginal a. branch of internal iliac
c)
Remnants of mesonephric/Wolffian ducts, located on vaginal wall or broad lig
d)
greater pelvis distributes the weight of the abdominal organs and supports the pregnant uterus at term
81.
Enlarged Corpus Luteum Symptoms
a)
Dull lower quadrant pain, missed menstrual period, adnexal enlargement
b)
Alteration of the menstrual interval result of both failed subsequent ovulation and bleeding stimulated by the large amount of estradiol produced in the follicle.
c)
May cause acute pelvic pain if ruptured, usually self-limited
d)
May include mild to moderate unilateral lower abdominal pain and alteration of the menstrual interval.
82.
Hysterectomy related Primary Ovarian Insufficiency Characteristics
a)
Chemo drugs that can affect membrane of ovarian follicles and hasten follicular atresia
b)
Induced and stimulated by FSH and LH
c)
Can hasten menopause by 3 to 5 years
d)
Develop autoAb to thyroid, adrenal, ovarian or endocrine tissue that can cause failure of ovary
83.
Sertoli Leydig Tumors aka Androblastoma General
a)
Rapid onset of virilization less than six months
b)
Testosterone secreting
c)
Hirsutism, Regular Menses, normal circulating androgens
d)
Metabolic syndrome, risk of cardio disease, and acanthosis nigricans
84.
Vagina Development
a)
Genital tubercle shows up midline with labioscrotal swellings and urogenital folds on either side
b)
pelvis is divided into the greater pelvis (false pelvis) and the lesser pelvis (true pelvis), which are separated by the linea terminalis
c)
obstetric conjugate is 1.5 to 2 cm shorter than the diagonal conjugate, it should be 11.0 cm or greater to accommodate a fetal head of normal size
d)
Stratified squamous
85.
Enlarged Corpus Luteum Symptoms
a)
Dull lower quadrant pain, missed menstrual period, adnexal enlargement
b)
May cause acute pelvic pain if ruptured, usually self-limited
c)
Alteration of the menstrual interval result of both failed subsequent ovulation and bleeding stimulated by the large amount of estradiol produced in the follicle.
d)
PT presents with acute pain late in the luteal phase. Some patients present with evidence of hemoperitoneum as well as hypovolemia
86.
Normal hormone levels Cause
a)
Mild hypothalamic amenorrhea - exercise, nutrition, stress, hypothyroidism
b)
PCOS
c)
Hypothalamic-Pituitary dysfunction
d)
Hyperprolactinemia
87.
Enlarged Corpus Luteum Symptoms
a)
May cause acute pelvic pain if ruptured, usually self-limited
b)
abdominal fullness, abdominal or back pain, decreased energy, and urinary frequency
c)
PT presents with acute pain late in the luteal phase. Some patients present with evidence of hemoperitoneum as well as hypovolemia
d)
Dull lower quadrant pain, missed menstrual period, adnexal enlargement
88.
Genital Outflow Amenorrhea Causes
a)
Mullerian Agenesis - Absence of cervix, uterus, tubes, upper vagina
b)
Mullerian Defects - Imperforate hymen, transverse vaginal septum
c)
Weight loss
d)
Gonadal agenesis (Turner syndrome 45,XO)
89.
Primary Ovarian Insufficiency General
a)
By 30/35 the number of oocytes 100,000
b)
Diagnosis should be suspected in a young woman with hot flushes and other symptoms of hypoestrogenism and secondary amenorrhea
c)
1% of women who experience menopause before the age of 40
d)
At the time of birth, the female infant has approximately 1 to 2 million oocytes; by puberty, she has approximately 400,000 oocytes remaining
90.
AUB-L Data
a)
AUB+IMB or prolonged think inflammation and/or infection
b)
Think immature HPO-axis and Anovulation
c)
Classified Submucosal or Other
d)
von Willebrand disease most common
91.
Serous Cystadenoma Characteristics
a)
Contain histologic evidence of intraepithelial neoplasia
b)
Bilaterality is common, arising in about 20% of benign serous cystadenomas (and is even more common in borderline or frankly malignant serous tumors)
c)
Does not secrete sex steroids
d)
Rapidly enlarging luteal-phase cyst with spontaneous hemorrhage
92.
PMDD Definition
a)
Core symptoms are depressed mood, anxiety, tension, irritability, anhedonia
b)
At least 5 of 11 PMS symptoms, with at least 1 being a core symptom that occurregulalrly during luteal phase
c)
A group of physical, mood-related, behavioral changes that occur in a regular and cyclic relationship to luteal phase of menstrual cycle that do interfere with daily routine
d)
Seizures only occur in the perimenstrual phase of cycle
93.
Primary Ovarian Insufficiency General
a)
Diagnosis has profound emotional implications
b)
Long arm of X chromosome determines length of ovarian life, Turners syndrome is a complete loss of long arm.
c)
400 oocytes total will actually get selected and ovulate
d)
1% of women who experience menopause before the age of 40
100 %
