Term
| Name the hormone - Secreted by trophoblast, Alpha unit similar to LH & TSH, 8 days after ovulation, peaks at 60-90 days, Maintains corpus luteum for up to 8 weeks, Stimulates placental steroid production, fetal adrenal steroid production, fetal testes testosterone production. |
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Definition
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Term
| Name the hormone - GH analogue, linke to placenta, stim by IGF1, anti-insulin for baby to get glucose, angiogenic. |
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Definition
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Term
| Name the hormone - produced by CL for 7-8 weeks then placenta, level rises till delivery, uterine quiets, immune tolerance for baby. |
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Definition
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Term
| DHEA-S in converted to estriol and liver metab 16-OHDHEAS is converted to estriol in what compartment? |
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Definition
| Placenta, where half E2 and 90% E3 from fetus |
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Term
| What cardio changes occur in preggers? |
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Definition
| CO ups, BP drops, plasma volume ups, contractility and ventricular hypertrophy increase |
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Term
| Which of the following pulmonary function increase during preggers - minute volume, O2 uptake, basal metab? |
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Definition
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Term
| Hyperventilation of mother decreases RBC release of O2, what is compensation? |
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Definition
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Term
| Metab changes during preggers causes mom to use ________ for energy and fetus to use ______ and _________. |
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Definition
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Term
| Abortion increase with age and are induced by chrome abnormals of trisomy and monosomy X in what triemester most commonly? |
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Definition
| First, then second and third |
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Term
| What is the difference between incomplete and complete abortion? |
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Definition
| Incomplete has open internal os, complete has closed os |
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Term
| What is cervical incompetence? |
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Definition
| Painless cervical dialtin in 2nd trimester with prolapse into vagina, with expulsion of fetus. |
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Term
| What is hyperemesis gravidarum? |
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Definition
| Severe Morning sickness, can have bad outcome |
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Term
| At 2 weeks teratogens have all or none effect, at 3-8 weeks affects what? |
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Definition
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Term
| What is a prtial hydatidiform mole? |
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Definition
| Fertilization of one egg by two sperm |
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Term
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Definition
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Term
| In the first trimester screening test ________, _________, and nuchal transluceny. Where as 2nd trimester test AFP, HCG, unconjugated estriol, and ________ for trisomy. |
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Definition
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Term
| Ectopics normally occur in fallopian. What are risk factors? |
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Definition
| Smoker, previous exto, tubal surgery, IUD |
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Term
| T or F, Molar pregnancy is characterized histologically by abnormalities of the chorionic villi that consist of trophoblastic proliferation and edema of villous stroma. |
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Definition
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Term
| ID which is partial and complete mole: 1. 69, XXX, embryo fetus and amnion present, small size and diagnosed as missed abortion; 2. 46, XX, villous edema, absent fetus embryo, theca cysts, complication, 50% large for dates. |
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Definition
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Term
| When should you do breast exams and pelvics? |
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Definition
| After menses because progesterone causes proliferation and may obscure test; day 12-14 of cycle |
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Term
| Where aree pap smear cells taken from? |
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Definition
| Transitional zone and endocervix |
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Term
| Name this disease - preggers induced hypertension after 20 weeks gestation, proteinuria >300, visual probs, headache, epigastric pain, pulmon edema; all due to placental ischemia from no tropho invasion of spiral arteries leading to altered maternal endothelial cell function. |
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Definition
| Preeclampsia; add seizures and you have eclampsia |
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Term
| Name this - Hemolysis, Elevaed Liver Funtion ests, Low Platelets, associated with preeclampsia. |
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Definition
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Term
| What is the treatment for mild or severe preeclampsia? |
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Definition
| Mild - management, severe is delivery |
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Term
| Which fo the following are consequences of gestation DM to fetus - stillborn, decreased placental perfusion, fetal hyperglycemia, macroosmia, hypoxia, shoulder sytocia, erbs palsy. |
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Definition
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Term
| Fetal fibronectin is released by inflammatory mediators or mechanical separation at the chroirdecidual junction, what does it measure? |
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Definition
| Predicts preterm brith at 24-34 weeks |
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Term
| T or f, The longer the cerix the less likely preterm brith which is defined less than 37 weeks. |
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Definition
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Term
| Which drugs are use dto induce surfactant and alveolar development in preterms? |
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Definition
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Term
| T or f, preterm briths are rising due to multiple gestations and increased techno use. |
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Definition
| True, is also leader in infant mortality and ethinic disparity |
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Term
| Which of theo following are caused by progesterone to prevent parturition- inihbis connexin 43, CAP protein, placental CRH expression, estrogen, cytokines, prostaglandins. |
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Definition
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Term
| There are 4 phases of parturition - quiescence, activation, stimulation, involution. Describe what happens in each. |
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Definition
| 0 - lack of GAP junctiona and plenty of progesterone, 1 - increased gap junctions and coneexins from uterine stretch, maturation fo fetal HPA axis, 2- increase placental CRH, progester withdrwal, estrogen up, oxytocin and prostaglnaidns up, 3- involution via oxytocin. |
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Term
| In phase 2 of parturition, there is CRH stim, down progrestion, up estrogen, oxytocin, and prostaglidnains. Describe what they do. |
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Definition
| Placental CRH ups prostas, increased Proges A: B ration suppresses proges, estrogen increases gap junctions and connexins and oxytocin recap and MLCK, oxytocin increases phospholicase C and Ca release, prostas down progestroen and up calcium and MMP |
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Term
| Increasing myosin light chain kinase is key to labor, what promotes it and inhibs it. Include tocolytic drugs. |
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Definition
| Up - calcium, oxytocin antags; Down - cAMP, betamimetics |
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Term
| How does stress induce preterm birth? |
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Definition
| Stress makes cortisol and excess CRH which goes to placenta, makes prostags which down proges, and up calcium and MMPs causing contraction |
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Term
| What are the causes of preterm due to uterine ischemia or overdistention? |
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Definition
| Thrombin, gap junctions and connexins |
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Term
| What are the few things shown to prevent preterm birth? |
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Definition
| Smoking cessation, progesterone, antenatal cortico therapy |
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Term
| T or f, GnRH must be delivered continusously for LH and FSH to be secretes from anterior pituitary. |
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Definition
| Flase, must be pulsatile. |
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Term
| In the development of the follicle, progress beyond the primary stage depends on _______. |
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Definition
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Term
| Increasing FSH and estrogen in early menstrual ceycle cause granulose cells to express increasing amount of ________ receptors. |
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Definition
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Term
| How does estradiol and LH work to cause ovulation? |
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Definition
| E2 ups LH and FSH synthesis in pituit, but inhibs release, then surge of E2 cause LH and FSH release which triggers ovulation |
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Term
| The LH surge in women cycles cause 17-OH block in theca and granulose cells, while stiming P4 produciton. P4 causes what? |
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Definition
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Term
| T or f, Follicular development occurs in waves up to 3 cycles long and the largest follicle becomes the most sensitive to FSH and then inhibits the production of FSH to block others from becomgin as sensitive. |
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Definition
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Term
| What stage is the the first and second meitotic arrest in an oocyte? |
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Definition
| 1st is prophase in meiosis 1, 2nd is metaphase meiosis 2 when ovulation occurs |
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Term
| Why is there limitation in defining androgen levels in PCOS? |
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Definition
| No tight endongeous counter regulatory mech, no normative values, rapid suppression |
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Term
| What are the limits of defingin PCOS by hirsuitism? |
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Definition
| Subjective, less prom in old and asian, first symptom treated |
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Term
| How does hyperinsulinemia cause hyperaddrongenism? |
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Definition
| Insulin up LH and IGFr which stims Ovarian theca cells and inhibis hepatic steroid hormone binding globulin |
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Term
| What are the long term risks of PCOS? |
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Definition
| HTN, dyslipid, infertility, endometrial ca, hirsuitism, obesity, insulin resistance and T2DM |
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Term
| There are manyh labs for PCOS because you must rule out which kinds of disease? |
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Definition
| Ovulatory dysfunction, andrognen probs, insulin probs, hirsuitism causes |
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Term
| What is this disease - excessive androgens from ovaries, up LH leads oligoovulation, polycystic, obesity, insulin resistance. |
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Definition
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Term
| What is the medical treatment for PCOS for infertility, androgen suppression, hirsuitism, insuilin resistance. |
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Definition
| Clomiphene and metoformin; exercise and diet, OCPs, ketoconozole; spiroonolactone, flutamide; exercise and diet, metofrmin |
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Term
| What is the difference betw primary and second amenorrhea? |
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Definition
| 1- no menses by age 16 with sex charac, 2 - no menses for 3 cycles |
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Term
| What is diff btw meno/metrorrhagia? |
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Definition
| Regular intervals but heavy flow, irregular and heavy |
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Term
| What are the top 3 causes of primary ameno? |
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Definition
| Gonadal dysgenesis, mullerian agenesis, androgen insensivitvty (normal female, no uterus, testes, high hormones) |
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Term
| What are the most common causes of disorder of ant. pituit? |
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Definition
| Prolactinomas and adenomas |
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Term
| Which of the following can cause primary ameno - anorexia, hyperproliactin, extreme exercise due to low body fat, enzyme deficiencies, turner syndrome. |
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Definition
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Term
| What are the most common genetic disorders of ovary cauing primary and secondary ameno? |
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Definition
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Term
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Definition
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Term
| When is infertility defined? |
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Definition
| 12 months sex no baby, >35 6 months, >40 immediate eval |
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Term
| Which affect fertility, obesity or underweight? |
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Definition
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Term
| What is the most common cause of ovaulatory dysfunction? |
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Definition
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Term
| T or f, Cervical mucous charac and basal body temp correlate better with fertility than calendar. |
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Definition
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Term
| T or f, The abnormalities of the oocytes that contribute to the increased miscarriage rate are the result of abnormalities of the meiotic spindle. |
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Definition
| True, as age increases eggs crappy |
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Term
| Which of the following tests can be used to define ovarian age - basal FSH LH, clomiphene challenge, inhibin B, antral follicle count, mullerian inhib substance levels. |
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Definition
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Term
| What is the fertile window? |
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Definition
| Most coneption happens two days to zero days from ovulation |
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Term
| How do clomiphene and metformin induce ovulation and which is better? |
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Definition
| Clomid is ag/antag for estrogen recotpter and causes depletion then induces FSH/LH via hypothal, Metformin increases glucose sensitivity and downs androgens so ups FSH/LH; combo is best for ovulation not live births, CC better met |
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Term
| T or f, IVF using ART has increasing use for all fertility probs, higher success in women under 40, and works best with donor eggs not patient eggs as age increases. |
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Definition
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