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الأربعاء، 25 يناير، 2012

تجميعة اسئلة الشفوى فى النساء للسنوات السابقة بقدر المستطاع (حاجة على ما قسم


تجميعة اسئلة الشفوى فى النساء للسنوات السابقة بقدر المستطاع (حاجة على ما قسم

د ممدوح
uses of ECV &procedure and complications
how deliver after coming head & causes
the only indication of breach extraction is if the 2nd twins is breach to avoid uterine contracrions
shoulder dystocia

د سعد الجيلانى
advantages of LMWH
human papilloma virus
differences between LMWH and high

د كمال
return to fertility after contracepion :1 IUD & 2 COC & 3 implanon & 4 injectable
our aim in dealing with antipartum hge is to reach to good baby without hazards to the mother

د خالد زهران
causes of bleeding
stages of preeclampsia
groups at high risk of gestational DM
PCO
hyperprolactinemia
postmenupausa $
واى حاجة فيها endocrine

د محمد عبدالله الديب
advantages of ventose to forceps
applications of ischeal spine level
infections

د مصطفى عيسى
contraceptions to cardiac patients

د عماد موسى
IUGR : classifications
differences between symetrical & asymmetrical cases
the first organ affected ----->liver
but last one ------> the brain
the main diagnostic use of hystroscope -----> abnormal uterine bleeding

د محمد هانى
sonographic criteria of down ------> detection of spina bifida
infections
complications of DM on fetus
differences between HTN & preeclampsia
edan s criteria of eclampsia
malpresentations and malpositions management

د سيد كفافى
types of placenta previa
types pf abortions
causes of abruptio placenta

د نيفين
cycle of menustruation
enumeration of ovarian tumours ( malignant & benign )
infections
non contraceptive pills of COCs
staging of the tumours

د أحمد رضا العدوى
DIC ( causes & management )
dangers of pregnancy in elder one
classifications of endometriosis

المواضيع اللى اتسأل فيها كتير
infertility
bleeding
DUB
medical Ds
carcinoma
amenorrhea
endometrosis

أسئلة متفرقة

U\S finding suggests ovarian malignancy
antiphospholipid $ criteria
causes of vesicovaginal fistula
natural mechanism protect genital tract from infection
causes of radioopaque shadow in the pelvis
causes of recurrent abortion
management of habitual abortion
clinical picture of obstructed labour
indication of cs in breech
advantage of lscs
early detection of ovulation
retained placenta
post menuposal bleeding
complications of 3rd stage of labor
complications of multiple pregnancy
Endometrial carcinoma & its patient (obese-diabetic-hypertensive)
Hormonal level as investigation of PCO
Types of breech presentation
bleeding with ovarian tumor & ammenorrhia with ovarian tumor
criteria of malignant ovarian tumor
ttt of STD ( أهم نقطة هى ttt of tow partners togather and prevent sexual intercourse )
oral cpntraceptive pills in virgin ( endometriosis & dysmenorrhea & menustral irregularities )

ودى محاضرة دمحمود حسنى مش موجوده فى الكتب ممكن يسأل فيها الله أعلم endocrinology of placenta
Unique features of the Placenta as an Endocrine Organ
• Genetically distinct from its target tissues
• Transient organ
• Hormonal concentrations far in excess of levels in non-pregnant adults
• Synthesizes hormones that are not present in the non-pregnant adult

placental hormones
Human Chorionic Gonadotropin (hCG)
• Glycoprotein similar to LH (85% homology)
• Detection of ? unit most common and specific test for pregnancy
• Converts corpus luteum of menstruation to pregnancy
• Secreted by blastocyst, can be detected in maternal blood within 24-48h after implantation
• Binds to LH receptor on luteal cells where it directs synthesis and secretion of progesterone, which maintains the corpus luteum
• Peaks at 8-12 wks of pregnancy, after which the placenta produces most of the progesterone
• Peak levels >100,000 IU/L (levels greater than 500,000 indicative of pathology)
• Secreted throughout pregnancy; t ½ 12-24h
? long t ½ may be important for maintaining early pregnancy
• Binds to TSH receptor, causing variable physiologic increase in thyroid hormone secretion
• It may play a role in morning sickness
• May stimulate secretion of relaxin
• May stimulate fetal testes to secrete testosterone

Progesterone
• Two essential roles during pregnancy
? Maintains pregnancy
? Suppresses myometrial contractions
• First produced by corpus luteum, then by trophoblasts of the placenta
• Independent of outside regulation
• Maternal serum levels correlate with size of placenta
• Precursor is maternal LDL-cholesterol
• Not further metabolized to other steroid hormones as in adult pathway
? can be converted to deoxycorticosterone (DOC), a mineralocorticoid
? 5? dihydroprogesterone can bind to GABA receptor
• By term, maternal levels up to 300mg/d (10X higher than peak luteal phase levels)
• Maternal side effects:
? inhibition of smooth muscle tone
? slowing of GI tract
? depression or mood swings
? inhibition of T-lymphocyte-mediated responses

Estrogen
• Initially produced by corpus luteum
? placenta requires both maternal (20%) and fetal (80%) precursors (DHEA-S) for synthesis
• Placenta produces 20 mg estradiol and 80 mg estriol per day at term
• Produced by syncytiotrophoblasts; primarily into maternal circulation (10x > fetal)
• Maternal effects include:
? growth of myometrium and ductal system of the breast
? enlargement of external genitalia
? softening of the symphysis pubis and pelvic ligaments
• Can lead to enhancement of myometrial contractions

Chorionic Somatomammotropin (hCS, Placental Lactogen or hPL)
• Part of the GH gene family
• Weak somatogen (1:100 of human GH), but potent lactogenic activity
• Produced in large quantities at term (1 - 2 g/d!)

Placental GH (Growth Hormone-Variant, PGH)
• Nearly identical in structure to hGH
• Identical binding to growth hormone receptor
• Not regulated by hypothalamic GHRH, but like hGH, appears be regulated by serum glucose
• Physiologic properties similar to hGH, but weaker lactogen
• Potentially responsible for precipitation of gestational diabetes
• Correlates fetal birthweight
• Maternal pituitary GH suppressed throughout the 2nd half of pregnancy

Renin, Angiotensin and Aldosterone
• Lead to volume expansion but paradoxical lowering of blood pressure
• Actions protect against normal blood loss that accompanies parturition
? average loss, 500ml
? average blood expansion in pregnancy, 3.5 - 5 L
• If hypertensive effects not naturally blocked, may lead to pregnancy-induced hypertension

Hormones of Calcium Homeostasis
• PTH falls to 50% of its non-pregnant level
• Calcitonin increases as pregnancy progresses
• 1,25-OH D doubles, likely due to increased renal production

Many other hormones are synthesized by the placenta, although their exact roles in maternal/fetal physiology remain unknown:
Prolactin
CRF
ACTH
Activin, Inhibin, Follistatin
GnRH

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