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4th Quarter : 1
Units 1 - 6
| Question | Answer |
|---|---|
| How long is an average menstrual cycle? | 28 days (Moon cycle). |
| When does bleeding begin in a menstrual cycle? | No matter what, 14 days after ovulation. |
| A uterus is about the size of a woman's what? | Fist |
| When a woman bleeds during her menstrual cycle, what is being shed? | The edometrial lining. |
| What happens to the endometrial lining during ovulation? | It proliferates. |
| On a test, the answer is: | Hormones or prostaglandins. |
| What hormones drive the menstrual cycle? | Estrogen and Progesterone. |
| When menstruation occurs, are hormones low or high? | Low |
| What hormone is responsible for vascularity and vasodilatation? | Estrogen |
| Why does Progesterone increase at the end of a woman's menstrual cycle? | To relax smooth muscle and prevent miscarriage. |
| Where are Estrogen and Progesterone produced? | The ovaries. |
| Where does the egg come from during ovulation? | A follicle. |
| After expelling the egg, what happens to the follicle? | It remains and becomes the corpus luteum. |
| Corpus | Body |
| Luteum | Yellow |
| What hormones does the corpus luteum produce? | Estrogen and progesterone. |
| If pregnancy does not occur, what is the response of the corpus luteum? | It does not produce Estrogen and Progesterone. |
| When the corpus luteum stops making Estrogen and Progesterone, what happens? | Menstruation occurs. |
| Hormones are driven by: | The brain, specifically the pituitary gland. |
| Esrtogen, FSH & LH spike when? | During ovulation. |
| What hormones cause changes in the endometrium? | Estrogen and Progesterone. |
| What does a woman need to know in order to get pregnant or to prevent pregnancy? | Day of ovulation. |
| What happens to vaginal mucus during ovulation? | It becomes thin and elastic. (Spinnbarkheit) |
| What is Mittelschmerz? | The pain some women have, in association with ovulation. |
| Is the IUD an ideal choice for a woman with multiple sexual partners? | No |
| What does the cervix of an adolescent look like? | Meaty, with a band of tissue. |
| What is the #1 cause of rectal and oral cancer? | HPV |
| Anywhere a penis goes, you can get _____. | Cancer |
| How long does a woman have to take Estrogens to increase her risk of cancers? | More than 5 years. |
| A woman with a uterus needs what type of HRT? | Both Estrogen and Progesterone. |
| A woman without a uterus needs what type of HRT? | Estrogen only. |
| What hormone prevents osteoporosis? | Estrogen |
| What hormone helps with hot flashes and moodiness? | Estrogen |
| What is the definition of menopause? | One year without a period. |
| What type of birth control pills are preferred? | Monophasic |
| What hormone is always the same in pills? | Estrogen |
| What is the biggest reported SE of pills? | Nausea |
| What are some warning signs when on the pill? | Chest pain. Severe HA. Leg pain. |
| Who is the patch not recommended for? | Obese patients. |
| How many women have some PMS symptoms? | 70 - 90% |
| When does PMS occur? | 1 - 2 weeks prior to menstruation. |
| When is PMS most acute? | During the 30's. |
| How is PMS diagnosed? | H & P. 3 month journal. |
| Most successful treatments for PMS: | B6 (100 - 300mg), Ca+ (1200mg), Vit D (1000), and exercise. |
| How long does it take for oral contraceptives to work when treating PMS? | 2 - 3 months. |
| What is dysmenorrhea? | Debilitating pelvic pain at or around the time of menstruation. |
| Menstrual pain occurs how often? | In 40% of women. |
| Dysmenorrhea occurs most often at what age? | Primary: teens - early 20's. Secondary: 20's - 30's. |
| When does pain occur with dysmenorrhea? | The day before, or the first day of menstruation. |
| What causes primary dysmenorrhea? | Increased secretion and sensitivity to prostaglandins. |
| What are risk factors for primary dysmenorrhea? | Nulliparity and family history. |
| What are risk factors for secondary dysmenorrhea? | STD's, endometriosis, pelvic infection. |
| How is dysmenorrhea diagnosed? | History and presence of symptoms. |
| Special test for dysmenorrhea? | US |
| Non-pharmacologic treatments for dysmenorrhea: | Exercise, orgasm, heat, knee-chest position, rest, massage, good nutrition, stress reduction, TENS, biofeedback, decreased salt, Vit B & E. |
| Dysmenorrhea decreases with: | Age and parity. |
| Pharmacologic treatments for dysmenorrhea: | NSAIDs & oral contraceptives. |
| What is endometriosis? | Endometrial tissue is found outside the uterine cavity. |
| How many women are affected by endometriosis? | 10 - 12% of childbearing women. |
| Endometriosis occurs at what age? | 20 - 45. |
| Symptoms of endometriosis: | Pelvic pain, dysmenorrhea, dyspareunia, premenstrual spotting, infertility, and painful defecation. |
| What is dyspareunia? | Painful intercourse. |
| What causes endometriosis? | Reflux of endometrial cells through fallopian tubes. |
| Is endometriosis progressive? | Yes |
| What are risk factors for endometriosis? | Genetics, Type A personality, delayed childbearing. |
| A definitive diagnosis of endometriosis is made how? | Via direct visualization. |
| What effect does endometriosis have on CA-125 levels? | It may elevate them. |
| What imaging technique is used in identifying endometriosis? | Laporoscopy |
| What do treatments for endometriosis focus on? | Stopping progression, controlling symptoms and preserving fertility. |
| What are some treatments for endometriosis? | Pregnancy. Laser. Hysterectomy. Bilateral salpingo-oophorectomy. |
| What pharmacologic treatments are used for endometriosis? | Oral contraceptives. Androgens. Progestogens. NSAIDS. |
| What causes PID? | Microorganisms from the vagina/cervix spread to the endometrium, fallopian tubes or contiguous structures. |
| What is the leading cause of infertility? | PID |
| What infections may lead to PID? | BV, chlamydia, gonorrhea. |
| Who is at greatest risk for PID? | Adolescent, sexually active, females. (<24) |
| How often does PID result in infertility? | 10% of the time. |
| What are the s/sx of PID? | Lower abdominal tenderness, cervical motion tenderness, adnexal tenderness, F, leukocytosis, purulent vaginal & cervical discharge. |
| How might a woman with PID appear? | Very ill. |
| What are risk factors for PID? | <24 y/o, STD, hx of PID, IUD, no contraception, non-white, low SES, many partners, invasive genital procedures, smoking. |
| What appears to lessen the risk of PID? | Spermicides, barriers, OCPs in older patients & monogamous relationships. |
| Why are adolescents at a greater risk for PID? | Immature immunity, larger zones of cervical ectopy, thinner cervical mucus, greater exposure to multiple partners, and developmental characteristics (i.e. risk takers). |
| How is PID diagnosed? | Required sx: abdominal & adnexal tenderness, cervical motion tenderness. |
| What lab will be elevated with PID? | ESR, WBO (10.500). |
| Why is an HCG lab done with PID? | To rule out ectopic pregnancy. |
| What imaging technique is used with PID? | US |
| Pharmacologic treatments for PID: | Parenteral Cefoxitin + Ceftriaxone + Doxycycline (100mg bid x 14 d) |
| Do you treat the partner in the case of PID? | Yes |
| Are chlamydia and gonorrhea reportable diseases? | Yes |
| How can you prove cure with PID? | Post treatment cultures. |
| What is fibrocystic breast syndrome? | A generalized term for benign breast disorders: lumps & pain. |
| What characteristics do benign lumps have? | They are usually smooth, regular and mobile. |
| In the case of fibrocystic breast syndrome, what increases the risk for breast cancer? | Epithelial hyperplasia. |
| How common is fibrocystic breast syndrome? | 50% of women have benign symptoms sometime in their life. |
| Who has fibrocystic breast syndrome? | Menstruating women. |
| When are cysts usually seen in fibrocystic breast syndrome? | 40's |
| What are symptoms of fibrocystic breast syndrome? | Bilateral, cyclical breast pain. Palpable irregularities, fluctuate with cycle, may worsen until menopause, with pain subsiding after menstruation. Smooth masses. Bilateral breast thickening. |
| Risk factors for fibrocystic breast syndrome: | Nulliparity. Methylxanthine substances. |
| How is fibrocystic breast syndrome diagnosed? | BSE, clinical exam of lumps, needle aspiration and biopsy. |
| What lab may be performed with fibrocystic breast syndrome? | Cytology of nipple discharge. |
| What imaging techniques are used with fibrocystic breast syndrome? | Mammography & US. |
| Nonpharmacologic treatments for fibrocystic breast syndrome: | Limit Na+, reduce caffeine, cold compresses, supportive bra, removal of fibroadenoma. |
| Pharmacologic treatments for fibrocystic breast syndrome: | Vit A, B, E. Spironolactone, danazol/bromocriptine, Oral contraceptives, analgesics. |
| What is the second leading cancer cause of death in women? | Breast cancer. |
| Where are 50% of breast cancers located? | In the upper outer quadrant. |
| What role do genetics play in breast cancer? | 5% have a family history. |
| How many women will be diagnosed with breast cancer? | 1:8 |
| 95% of breast cancers occur in women over the age of __. | 40 |
| What percentage of breast cancer occurs in men? | 1% |
| What are the s/sx of breast cancer? | Palpable mass, nipple retraction, breast enlargement, color change, dimpling, bone pain, abnormal mammogram, discharge. |
| Whar are the risk factors for breast cancer? | >40, white, hx, family hx, hx of ovarian/endometrial cancer, low SES, single, nulliparity/first full-term pregnancy after 35, oophorectomy, early menarche, late menopause, high fat & protein diet, ETOH, obesity, HRT >5 yr, no breastfeeding, BRCA 1 & 2. |
| What is considered moderate alcohol intake for women? | 1/2 glass a day |
| How is breast cancer diagnosed? | BSE, clinical exam, mammogram, US, MRI. |
| What labs are tested for breast cancer? | CBC and liver function. |
| Imaging studies for breast cancer: | Mammogram, US, bonescan. |
| What treatments are used for breast cancer? | Lumpectomy, mastectomy, radiation, chemo. |
| What is removed in a radical mastectomy? | Breast, lymph nodes, and chest wall muscles. |
| SERMs (selective estrogen receptor modifiers) increase the risk of what? | Uterine cancer. |
| What is the most common cancer among women, worldwide? | Cervical cancer (It is 6th in US). |
| At what age is cervical cancer most common? | 53 |
| What are the s/sx of cervical cancer? | Irregular vaginal bleeding, post-coital bleeding, unusually foul smelling discharge, dyspareunia, pelvic pain, hematuria, rectal bleeding. |
| What is the number 1 cause of cervical cancer? | HPV 16 & 18 cause 80%. |
| Risk factors for cervical cancer: | Less than 20 y/o at first coitus, multiple sex partners, first pregnancy at young age, high parity, STDs, smoking, African-American, sex with men that have had STDs or prostatic cancer. |
| Labs for cervical cancer: | Pap, ASCUS, SIL, CIN. |
| ASCUS | Atypical squamous cells of unknown significance. |
| SIL | Squamous intraepithelial lesion. |
| CIN | Cervical intraepithelial lesion. |
| Special test for cervical cancer: | Colposcopy, biopsy, endocervical sampling. |
| During a colposcopy vinegar is painted onto the cervix to display cancerous areas, what color do they appear as? | White |
| Why may a CT be performed with cervical cancer? | To test for metastases to lymph nodes. |
| Nonpharmacologic treatments for cervical cancer: | Cryotherapy, laser conization, LEEP, total abdominal hysterectomy, radiation. |
| LEEP | Loop electrosurgical excision of the transformation zone. |
| Pharmacologic treatment of cervical cancer: | Chemo |
| If a patient has 2 documented first degree relatives with ovarian cancer, then her risk of getting ovarian cancer is __% | 50% |
| The 4th leading cause of cancer death among women is ______ cancer. | Ovarian |
| Signs and symptoms of ovarian cancer: | Early: Bloating, pelvic/abdominal pain, feel full quickly, frequent/urgent urination. Late: Pelvic mass, ascites, weight loss. |
| Risk factors for ovarian cancer: | White, at menopause/after menopause, 1/2 over 65, Hx of ovarian/breast cancer, BRCA 1 & 2, nulliparity, low parity, late childbearing, early menarche, menopause after 50, high fat diet, smoking. |
| What is the definitive diagnosis for ovarian cancer? | Surgery |
| Is CA 125 recommended for screening of ovarian cancer? | No |
| Labs for ovarian cancer: | Liver function tests, HCG, proteomic screening tests in research. |
| What imaging techniques are used for ovarian cancer? | Transvaginal US, pelvic US, mammogram, barium enema, upper GI, CT. |
| Treatments for ovarian cancer: | Surgery, radiation, chemotherapy. |
| What is PCOS (polycystic ovarian syndrome)? | An endocrine disorder. |
| A "bearded woman with diabetes" may have ____ ______ _______. | Polycystic ovarian syndrome. |
| How many women have PCOS? | 3.5 - 11% |
| A woman with PCOS may have these disorders: | Obesity, hirsutism, amenorrhea, acne, ovarian cysts, hyperinsulinemia, hyperlipidemia, HTN. |
| Women with PCOS have an increased risk of: | Breast and ovarian cancer. |
| What meds are used to treat PCOS? | Metformin and progesterone. |
| Chorion | Outermost extraembryonic membrane. |
| Cytomegalovirus | Any of a group of herpes viruses that attack and enlarge epithelial cells. |
| Embryo | From fertilization to the end of the 8th week. |
| Fetus | From 9 weeks after fertilization until birth. |
| Gamete | Sperm or ova. |
| Genotype | A person's entire genetic makeup. |
| Human chorionic gonadotropin (hCG) | A hormone excreted during the development of an embryo or fetus. |
| Meiosis | The process of cell division by which reproductive cells (gametes) are formed. |
| Mitosis | The process of cell division which results in the formation of two daughter cells, identical to the parent cell. |
| Phenotype | The expression of the genotype. |
| Teratogen | An agent, such as a virus/drug/radiation, that can cause malformations/functional damage to an embryo/fetus. |
| Zygote | The cell that is formed from the union of sperm and ova. |
| What are the 4 components of the family systems theory? | Family characteristics, family interaction, family functions, family life cycle. |
| What children are at greatest risk for abuse? | Under 1 year, especially in the 1st week. |
| Munchausen by Proxy occurs in kids under the age of __. | 6 |
| What are the 3 phases of the cycle of violence? | Tension, crisis, calm. |
| What is an example of dominance? | Brown eyes. |
| Homozygous | Same genes. |
| Heterozygous | Two different genes. |
| Autosomal | One gene controls the trait (i.e. eyes). |
| Are most traits autosomal or multisomal? | Multisomal. |
| Autosomal recessive: | Aa + Aa = AA Aa Aa aa. aa is the autosomal recessive trait (ex. cystic fibrosis). |
| Autosomal dominant: | Aa + aa = Aa Aa aa aa. Aa are affected (A being the dominant trait). aa are normal. |
| Where do sex linked traits occur? | On the X. |
| What is a mutation? | A genetic mistake. |
| How many chromosomes do we have? | 46 total, or 23 pairs. |
| Of the 23 pairs of chromosomes we have, how many are autosomal? | 22 pairs. |
| Mitosis | The division of a cell into two identical cells. |
| Meiosis | Cell divides into a haploid cell, creating sperm or ovum. |
| During what part of cell division do many genetic mistakes occur? | Meiosis |
| During the process of gametogenesis how many eggs and sperm are produced? | 1 egg, 4 sperm. |
| What gender embryo is more successful? | Female |
| What hormone peaks just before ovulation? | Estrogen |
| When ovulation occurs, how long is the egg fertile for? | 24 hrs. |
| How long are sperm alive inside the female? | 2 - 3 days. |
| Haploid + haploid = ______ | Diploid |
| What 3 days is a woman most likely to get pregnant? | From 2 days before to the day of ovulation. |
| How often should a couple have intercourse while trying to conceive? | Once a day, from 2 days before to the day of ovulation. |
| When trying to avoid pregnancy, when should a woman abstain from intercourse? | From 5 days prior to the day of ovulation. |
| How large is the inside of a fallopina tube? | The size of a strand of hair. |
| Where should fertilization occur, ideally? | In the outer 2/3 of the tube. |
| When the egg is fertilized what type of cell is it? | Diploid |
| When the egg is fertilized, what is the new cell called? | A zygote. |
| How does an egg move through the fallopian tube? | Via peristalsis. |
| When does implantation occur? | 8 - 10 days after fertilization. |
| Where should implantation occur, ideally? | In the top 2/3 of the uterus, into the endometrium. |
| What is the blastocyst? | Inner ball of cells. |
| What is the trophoblast? | Outer ball of cells. |
| What does the trophoblast develop into? | The placenta and the chorion. |
| What does the blastocyst develop into? | The amnion, the umbilical cord, and the baby. |
| What are some functions of the amniotic fluid? | Allowing symmetrical growth. Cushion & protect. Maintain an even temperature. |
| What is amniotic fluid composed of? | Uric acid, urea, skin cells, hair. |
| Is a cloudy amniotic fluid normal? | Yes |
| How many cc's of amniotic fluid does the fetus swallow and pee each day? | 400cc |
| How much does a placenta weigh? | 1 - 1.5 lb |
| How many lobules are in a placenta? | 15 - 20 |
| What side does the amnion cover? | The side facing the baby. |
| How long is an average umbilical cord? | 22" |
| How quickly can death occur if there is an insult to the umbilical cord? | 4 - 6 minutes. |
| Describe the vascularity of an umbilical cord? | 1 vein, 2 arteries. |
| In the umbilical cord, what does the vein carry? | The oxygenated blood. |
| In the umbilical cord, what do the arteries carry? | The unoxygenated blood. |
| How are nutrients absorbed into the placenta? | Via chorionic villi. |
| What drives the passage of oxygen and nutrients from mom to baby? | Mom's BP. |
| Does estrogen vasodilate or vasoconstrict? | Vasodilate |
| What 2 drugs are just too big to cross the placental barrier? | Insulin & heparin. |
| What organ functions as the fetal liver? | The placenta. |
| What functions does the placenta perform, in place of the fetal liver? | Storage of iron & glycogen. Synthesis of glucose, cholesterol, fatty acids, enzymes. |
| What does an endocrine organ do? | Produce hormones. |
| What is the target organ of hCG? | The corpus luteum. |
| What allows estrogen and progesterone to continue coming from the corpus luteum? | hCG |
| How soon after fertilization is hCG present? | 8 - 10 days. |
| What is needed in large amounts, early on, to keep the corpus luteum from shriveling and dying? | hCG |
| What hormone causes the n/v associated with pregnancy? | hCG |
| Which trimester is hCG very high during? | The 1st. |
| What is improved by hPL? | Mom's digestion. |
| Progesterone is produced by the corpus luteum, and is then taken over by the placenta at what time? | 10 - 11 weeks. |
| What hormome prevents contraction of the uterus? | Progesterone. |
| Estrogen is responsible for: | Vasodilation, improved vascularity, and growth & development of the placenta. |
| How soon can we test urine for pregnancy? | 16 days after fertilization. |
| How soon can we test blood for pregnancy? | 8 - 10 days after fertilization. |
| The 3 shunts: | Ductus venosis. Foramen ovale. Ductus arteriosis. |
| In the fetus, what side of the heart has the greater pressure? | The right. |
| How is fetal hemoglobin different? | It has a 25% greater affinity for oxygen. |
| When do shunts close? | When baby is delivered. |
| When do we count from, in terms of length of pregnancy? | From the 1st day of the last period. |
| What does teratogen mean, literally. | To make a monster. |
| What effect does high blood sugar have on a fetus? | It is a teratogen. |
| When does the pre-embryonic stage occur? | Wk 1 & 2 |
| When is the growing embryo not susceptible to teratogens? | During the pre-embryonic stage, wk 1 & 2. |
| When does the embryonic stage occur? | Wk 2 - 8 |
| When does all organ development occur? | During the embryonic stage, wks 2 - 8. |
| At what stage do teratogens have the most critical impact? | The embryonic stage. |
| When does the fetal stage occur? | Wk 8 - term. |
| What occurs during the fetal stage? | Organ refinement and growth. |
| When can a beating heart be seen on US. | 4 wks after conception. |
| When does the neural tube close? | By the 4th week after conception. |
| By when are there 4 individual heart chambers? | By 6th week after conception. |
| Hands and genitals, when? | By 8th week after conception. |
| What can be seen 20 weeks after the last menstrual period (LMP). | Lanugo, vernix, nails. |
| When can the mother feel quickening? | 20 weeks after LMP. 18 weeks in subsequent pregnancies. |
| What is the age of viability? | 24 weeks after LMP. |
| When does surfactant develop? | 28 weeks after LMP. |
| At what stage does the fetus lay down brown fat? | 32 weeks after LMP. |
| Where is brown fat found? | Around vital organs. |
| Toxoplasmosis | Protozoan infection from uncooked meats, cat feces, gardening. |
| Rubella | a.k.a. German measles. Rash often so faint that it can't be seen. |
| When is rubella a teratogen? | 1st trimester. |
| Cytomegalovirus (CMV) | Teratogen in 1st trimester. |
| HPV | Teratogen at end of pregnancy. Initial outbreak the biggest cause for concern. |
| Syphillis | Most teratogenic in 2nd trimester (wk 16 - 18). |
| What STD is most often associated with miscarriage? | Syphillis |
| Lyme disease | 1st trimester teratogen. |
| Chicken pox | 1st trimester teratogen. |
| Is it ok to use a live virus vaccine during pregnancy? | No |
| What titer is taken in all pregnancies? | Rubella |
| What vaccines are ok? | Flu, Hep B, tDap. |
| Category A | Absolutely no risk. |
| Category B | Studies on animals, no harm to animals. |
| Category C | Animal studies. Small risk. Potential cause of birth defect. |
| Category D | Birth defect in animals. Known birth defect in humans, benefit may outweigh risk. (ie. anticonvulsant) |
| Category X | Known teratogen, benefit never outweighs risk. (ie. ace inhibitor, acutane, chemo, statins) |
| Opioid cause: | Low birth wt. Baby addiction. |
| ETOH in 1st trimester causes: | Craniofacial malformation. Small eyes, smooth filtrum, thin upper lip, long & skinny stature. |
| ETOH in 2nd/3rd trimester impacts _____ development. | Brain |
| When is hyperthermia the worst in pregnancy? | 1st trimester. |
| What STD is penicillin resistant? | Gonorrhea |
| What STD may have a frothy discharge? | Trichomonas |
| What STD may have a fishy odor, with excess thin watery discharge? | BV |
| In what STD may clue cells be seen? | BV |
| When might one use the whiff test? | When screening for BV. |
| What STD causes itching, burning, dysuria in a woman? | Candida |
| What STD causes discharge from the penis, with pain & burning, also causes low abdominal pain in women? | Chlamydia |
| What STD may cause F, n/v, low abdominal pain in a woman? | PID |
| What STD may present with strawberry petechiae, and has motile parasites? | Trichomonas |
| Where can gonorrhea be tested for? | Urine, rectally, orally. |
| VDRL, RPR and darkfield microscopy for spirochetes are used to diagnose: | Syphillis |
| A diagnosis of this may be made after ruling out non-gonoccocal urethritis in a man: | Chlamydia |
| What is used to diagnose PID? | CBC, ESR, UA, clinical exam. |
| Which STD has no known treatment, other than pain relief? | HSVII |
| Doxycycline is contraindicated during pregnancy, so erythromycin may be used to treat this: | Chlamydia |
| This medication may be used to treat both trichomonas and BV: | Flagyl |
| Lg areas of warts should be biopsied in the course of this STD: | HPV |
| When taking Flagyl, no ETOH should be consumed for how long? | 24 hours |
| When taking doxycycline, it should be taken with ____ to prevent stomach upset. | Food |
| Chlamydia may cause what in newborns? | Opthalmia neonatorium. |
| What STD can cause laryngeal warts at birth? | HPV |
| How can PID affect a pregnancy? | By blocking fallopian tubes and causing ectopic pregnancies. |
| If this is left untreated, babies may get pneumonia: | Chlamydia |
| If this is present at birth, it may cause thrush: | Candida |
Created by:
NataschAnn
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