Staphylococcus aureus Characteristics
- Gram-Positive
- Cocci
- Catalase-Positive
- Coagulase-Positive
- Beta-Hemolytic
- Protein A Virulence Factor
- Inhibits Phagocytosis
- MRSA
- Resistant to Beta Lactams Due to Altered Penicillin Binding Proteins (PBPs)
Ovulatory Hormones I - Follicular Phase
- 0-14 Days
- GnRH Stimulates FSH and LH
- Follicle Secretes Estrogen
- Negative Feedback from Estrogen
- Increased Estrogen Leads to Positive Feedback
- FSH and LH Surge
- LH Spike Leads to Ovulation
Ovulatory Hormones II - Luteal Phase
- Days 15-28
- Corpus Luteum
- Secretes Progesterone
- Negative Feedback inhibits FSH and LH
- No pregnancy forms Corpus Albicans
- Stops Estrogen Secretion
- Endometrial Sloughing - Menses
- GnRH secretion produces new follicular phase
Menopause Lab Findings
- Decreased Estrogen
- Lack of Negative Feedback
- Increased FSH
- Increased LH
- Increased GnRH
- Small Amount of Estrogen From Androgen Conversion
- Increased Androgens = Hirsutism
Menopause Symptoms
- HAVOCS Mnemonic
- Hot Flashes
- Atrophy of Vagina
- Osteoporosis
- Coronary Artery Disease (CAD)
- Sleep disturbances
Turner Syndrome
- Female (XO)
- Short stature
- Shield Chest
- Cystic Hygroma (Webbing of Neck)
- Lymphedema in Hands and Feet
- Ovarian Dysgenesis
- Streak Ovary
- Decreased Estrogen
- Increased FSH
- Increased LH
- Dysgerminoma
- Bicuspid Aortic Valve
- Preductal Coarctation of the Aorta
- Horseshoe Kidney
- Menopause before Menarche
- Amenorrhea
Endometriosis Characteristics
- Endometrial Tissue Outside of Uterus
- Glands and Stroma
- Most Common in Ovary, Pelvis, Peritoneum and Bowels
- "Chocolate Cyst" in Ovary
- Adenomyosis
- Retrograde Flow
- Metaplastic Transformation
- Mullerianosis
Endometriosis Symptoms and Treatment
- Dysmenorrhea
- Cyclic Pelvic Pain
- Dyschezia
- Dysuria
- Dyspareunia
- 30-40% are Infertile
- Surgery
- NSAIDs
- OCPs
- Progesterone (Progestins)
- GnRH Agonists
Polycystic Ovarian Syndrome (PCOS) Mechanism
- Hyperinsulinemia Increases GnRH Pulse Frequency
- Large Increase in LH
- Small Decrease in FSH
- Increased Androgen Production From Theca-Lutein Cells
- Decreased Steroid Hormone-Binding-Globulin (SHBG) Causes Increased Free Testosterone
- Obese Patients Have Increased Estrogen
- Increased Risk of Endometrial Cancer
Polycystic Ovarian Syndrome (PCOS) Symptoms and Diagnosis
- Most Common Cause of Infertility in Women
- Amenorrhea
- Acne
- Hirsutism
- Obesity
- Enlarged, Cystic Ovaries
- LH:FSH Ratio of 3:1
- "String of Pearls" on Ultrasound
Polycystic Ovarian Syndrome (PCOS) Treatment
- Weight Loss
- Oral Contraceptives
- Clomiphene Citrate
- Anti-androgens
- Cyclic Progesterone for Endometrial Protection
- Metformin
Pelvic Inflammatory Disease (PID)
- Neisseria gonorrhoeae
- Chlamydia Trachomatis
- Cervical Motion Tenderness
- Chandelier Sign
- Salpingitis
- Tubo-ovarian abscess
- Hydrosalpinx
- Ectopic Pregnancy
- Infertility
- Adhesions
- Fitz-Hugh-Curtis Syndrome
Cervical Cancer Screening
- Women Aged 21-65 Years
- Pap Smear Every 3 Years
- Women Aged 30-65 Years
- Can Opt for Co-testing (Pap Smear + HPV Testing) Every 5 Years
- Identify Lesions
- Cryotherapy
- Loop Excision
- Cold Knife Conization
Fibroadenoma
- Most Common Benign Breast Tumor
- Stromal Tumor
- Women under 40
- Small, firm mass
- Sharp Edges
- Increased tenderness and size with Estrogen
- Biopsy
11 Beta-Hydroxylase Deficiency
- Decreased Cortisol
- Decreased Aldosterone
- Increased Sex Hormones
- Increased 11 Deoxycorticosterone (11 DOC)
- Hypertension
- Masculinization
17 Alpha Hydroxylase Deficiency
- Decreased Cortisol
- Decreased Sex Hormones
- Increased Mineralocorticoids (DOC)
- Hypertension
- Hypokalemia
- XY Externally Phenotypic Female
- No Internal Reproductive Structures Due to Mullerian Inhibitory Factor
- XX Externally Phenotypic Female
- Sexual Infantilism
21 Hydroxylase Deficiency
- Decreased Cortisol
- Increased 17 Hydroxyprogesterone
- Decreased Aldosterone
- Hypotension
- Increased Renin
- Hyperkalemia
- Female Pseudohermaphroditism
McCune-Albright Syndrome Characteristics and Presentation
- Increased Hormone Production
- Sporadic
- Mutation in GNAS Gene
- Mosaicism
- Precocious Puberty
- Cushing Syndrome
- Hyperthyroidism
- Cafe Au Lait Spots
- Fibrous Dysplasia