NU 665D Exam 2
1. diagnostics of vaginal cancer: -vaginal cytology
-colposcopy with acetic acid and Lugol stain
-vaginal biopsy
2. diagnostics of ovarian cancer: -TVUS
-labs: CA125
-additional imaging with concerns for mets (e.g. CT, MRI)
-paracentesis or thoracentesis for ascites, pleural effusion
3. US findings concerning for ovarian cancer: -adnexal mass with a solid com-ponent that is
not hyperechoic
-mass is nodular or papillary
-mass has Doppler demonstration of flow in the solid component
-irregularly thick septations
-ascites
4. CA-125: cancer tumor marker - ovarian cancer
-Non specific and elevated in the setting of inflammation
-Commonly elevated in other gyn conditions: e.g. PID, endometriosis, functionalovarian cysts,
fibroids
5. normal CA-125: -Normal <30
6. definition of infertility: lack of conception after 12 months of actively trying, or6 months
of actively trying in women >35 years old
7. male factors associated with infertility: -medications
-sperm production disorders
-hypogonadotropic hypogonadism
-sperm transport disorders
-idiopathic male infertility
8. female factors associated with infertility: -ovulatory dysfunction
-uterine abnormalities
-endometriosis
,-pelvic or fallopian tube adhesions
-cervical factors
9. examples of ovulatory dysfunction-related infertility: § PCOS
§ Intense exercise, eating disorders, stress
§ Hyperprolactinemia
§ Pituitary abnormality
§ Lactational amenorrhea
§ Thyroid disorders
§ Cushing's disease
§ Androgen insensitivity syndrome
§ POF
§ Turner disease
§ Liver or kidney disease
§ Meds: COC, progestins, antidepressants, corticosteroids, chemo
§ Oocyte aging
10. how does endometriosis lead to infertility?: § Anatomic distortion of uterusfrom
adhesions
§ Ovarian tissue damage by endometriomas
11. uterine abnormalities that lead to infertility: § Submucosal or cavitary fibroids
§ Uterine anomalies (congenital, Müllerian, endometrial polyps)
§ Intrauterine adhesions
12. causes of pelvic and fallopian tube adhesions re: female infertility: § PID
§ Other abdominopelvic infections such as appendicitis, TB
§ IBD
§ Hydrosalpinx
13. how do cervical factors affect female infertility?: -inability for cervix to pro-duce normal
mucus to aid oocyte transport
-stenotic os
, examples: congenital malformations or trauma
14. examples of medications that lead to male infertility: -ETOH
-marijuana
-antiandrogens
-spiro
-radiation
-anabolic steroids
15. examples of causes of inadequate sperm production: -Klinefelter syndrome
-Cryptochidism (undescended teste)
-Androgen insensitivity syndrome
-Varicocele
-Infection
-environmental toxin
-testicular torsion
-trauma
-chronic illness
16. examples of infections that may cause male infertility: -mumps orchitis
-STDs
17. examples of hypogonadic hypogonadism re: male infertility: -Head trauma
-intracranial radiation
-brain aneurysm
-pituitary or hypothalamic disorder, or tumor
-congenital GnRH deficient
-severe systemic illness
-nutritional deficiency
-morbid obesity
18. examples of impaired sperm transport: § Epididymal dysfunction
§ Ejaculatory duct problem
§ Vas deferens abnormality: congenital, infection, vasectomy
1. diagnostics of vaginal cancer: -vaginal cytology
-colposcopy with acetic acid and Lugol stain
-vaginal biopsy
2. diagnostics of ovarian cancer: -TVUS
-labs: CA125
-additional imaging with concerns for mets (e.g. CT, MRI)
-paracentesis or thoracentesis for ascites, pleural effusion
3. US findings concerning for ovarian cancer: -adnexal mass with a solid com-ponent that is
not hyperechoic
-mass is nodular or papillary
-mass has Doppler demonstration of flow in the solid component
-irregularly thick septations
-ascites
4. CA-125: cancer tumor marker - ovarian cancer
-Non specific and elevated in the setting of inflammation
-Commonly elevated in other gyn conditions: e.g. PID, endometriosis, functionalovarian cysts,
fibroids
5. normal CA-125: -Normal <30
6. definition of infertility: lack of conception after 12 months of actively trying, or6 months
of actively trying in women >35 years old
7. male factors associated with infertility: -medications
-sperm production disorders
-hypogonadotropic hypogonadism
-sperm transport disorders
-idiopathic male infertility
8. female factors associated with infertility: -ovulatory dysfunction
-uterine abnormalities
-endometriosis
,-pelvic or fallopian tube adhesions
-cervical factors
9. examples of ovulatory dysfunction-related infertility: § PCOS
§ Intense exercise, eating disorders, stress
§ Hyperprolactinemia
§ Pituitary abnormality
§ Lactational amenorrhea
§ Thyroid disorders
§ Cushing's disease
§ Androgen insensitivity syndrome
§ POF
§ Turner disease
§ Liver or kidney disease
§ Meds: COC, progestins, antidepressants, corticosteroids, chemo
§ Oocyte aging
10. how does endometriosis lead to infertility?: § Anatomic distortion of uterusfrom
adhesions
§ Ovarian tissue damage by endometriomas
11. uterine abnormalities that lead to infertility: § Submucosal or cavitary fibroids
§ Uterine anomalies (congenital, Müllerian, endometrial polyps)
§ Intrauterine adhesions
12. causes of pelvic and fallopian tube adhesions re: female infertility: § PID
§ Other abdominopelvic infections such as appendicitis, TB
§ IBD
§ Hydrosalpinx
13. how do cervical factors affect female infertility?: -inability for cervix to pro-duce normal
mucus to aid oocyte transport
-stenotic os
, examples: congenital malformations or trauma
14. examples of medications that lead to male infertility: -ETOH
-marijuana
-antiandrogens
-spiro
-radiation
-anabolic steroids
15. examples of causes of inadequate sperm production: -Klinefelter syndrome
-Cryptochidism (undescended teste)
-Androgen insensitivity syndrome
-Varicocele
-Infection
-environmental toxin
-testicular torsion
-trauma
-chronic illness
16. examples of infections that may cause male infertility: -mumps orchitis
-STDs
17. examples of hypogonadic hypogonadism re: male infertility: -Head trauma
-intracranial radiation
-brain aneurysm
-pituitary or hypothalamic disorder, or tumor
-congenital GnRH deficient
-severe systemic illness
-nutritional deficiency
-morbid obesity
18. examples of impaired sperm transport: § Epididymal dysfunction
§ Ejaculatory duct problem
§ Vas deferens abnormality: congenital, infection, vasectomy
