ORDER OF EVENTS AT PUBERTY

"The Prime Minister" The - Thelarche Prime - Pubarche Minister - Menarche

Progesterone: actions

 PROGESTE:
Produce cervical mucous
Relax uterine smooth muscle
Oxycotin sensitivity down
Gonadotropin [FSH, LH] secretions down
Endometrial spiral arteries and secretions up
Sustain pregnancy
Temperature up / Tit development
Excitability of myometrium down

Ovarian cancer: Risk factors

"Bright FILM"

• Breast cancer
• Family history of ovarian cancer
• Infertility
• Low parity
• Mumps

Endometriosis: Symptoms

5  “D”s

• Dysmenorrhoea
• Disorders of menstruation
• Dyspareunia
• Dyschezia
• Dull ache of abdomen

Pelvic Inflammatory Disease (PID): complications

 I FACE PID:
Infertility
Fitz-Hugh-Curitis syndrome
Abscesses
Chronic pelvic pain
Ectopic pregnancy
Peritonitis
Intestinal obstruction
Disseminated: sepsis, endocarditis, arthritis, meninigitis

Ovarian cancers: important types, by WHO classification ·

Surface:
"My Sister Began Experiencing Cancer":
Mucinous
Serous
Brenner
Endometrioid
Clear
· Germ cell:
"Doctor Examined The Ovaries":
Dysgerminoma
Endometrial sinus
Teratoma
Ovarian choriocarcinoma
· Sex cord:
"She Felt Grim":
Sertoli-Leydig
Fibroma
Granulosa-theca
· Metastatic
"Killed":
Krukenberg

Endometrial carcinoma: risk factors

 HONDA:
Hypertension
Obesity
Nulliparity
Diabetes
Age (increased)

RLQ pain: brief female differential

AEIOU:
Appendicitis/ Abscess
Ectopic pregnancy/ Endometriosis
Inflammatory disease (pelvic)/ IBD
Ovarian cyst (rupture, torsion)
Uteric colic/ Urinary stones

Dysfunctional uterine bleeding (DUB): 3 major causes

DUB:
Don't ovulate (anovulation: 90% of cases)
Unusual corpus leuteum activity (prolonged or insufficient)
Birth control pills (since increases progesterone-estrogen ratio)

postmenopausal bleeding

postmenopause
P-olyp(cervical)
O-ovarian cancer(also ca uterus ,vagina, cervix,)
S-enile vaginitis,endometritis
T-rauma
M-yoma
E- ndometrial hyperplasia
N-ot removed pessary leading 2 ulceration
O-estrogen therapy
P-yometra(intermittent)
A-fter radiation ulceration
U-rethral carbuncle
S-arcoma uterus
E-rosion in cervix

Histology in ovarian tumors

signet ring cells-krukenberg
walthard cell rests-brenners tumor
reinkes crystals-hilus cell tumor
call-exner bodies-granulosa cell tumor
schill-duoval bodies-endodermal sinus tumors
psammoma bodies-seros epithelial tumor

Vaginal pH

 Vagina has 4 labia and normal pH of vagina is about 4.

Left iliac fossa: Causes of pain

SUPER CLOT:

• Sigmoid diverticulitis
• Ureteric colic
• PID
• Ectopic pregnancy
• Rectus sheath haematoma
• Colorectal carcinoma
• Left sided lower lobe pneumonia
• Ovarian cyst (rupture, torture)
• Threatened abortion/ Testicular torsion

Rise in serum amylase: Causes

Serum amylase rises in Acute pancreatitis.
 Other causes are : ' SAM MUST MERRy '

• Serum Amylase
• Mesenteric infarction
• Upper gastrointestinal tract perforation
• Salivary gland inflammation
• Torsion of intra-abdominal viscus
• Macroamylasaemia
• Ectopic pregnancy
• Retroperitoneal haematoma
• Renal failure

Absolute C/I for IUCD

"PLEASE DONT EVER PUT CONTRACEPTIVES"

Please-Pregnancy(suspected/confirmed)
Dont-DUB
Ever-Ectopic
Put-PID
Contraceptive-Ca cervix

Alfa feto protein

alfafeto protein in pregnancy
down in downs-syndrome
high in 2O-- O-OPEN NEURAL TUBE DEFECT
O-OMPHALOCELE

Omental caking: Causes

"Omental CAking = Ovarian CA"

• In gynecology, omental caking almost always signifies ovarian cancer.
• Omental caking is the radiological (CT) finding indicative of thickened greater omentum. It is caused due to neoplastic infiltration of the greater omentum, most commonly  by metastatic ovarian, gastric, colonic, or pancreatic carcinoma.

Secondary amenorrhea: causes

 SOAP:
Stress
OCP
Anorexia
Pregnancy

Pelvic Inflammatory Disease (PID): causes, effects

"PID CAN be EPIC":
· Causes:
Chlamydia trachomatis
Actinomycetes
Neisseria gonorrhoeae
· Effects:
Ectopic
Pregnancy
Infertility
Chronic pain