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  #1  
Old 04-20-2016
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Help obs/gynae question:

at 20weeks gestation with abnormal quadrple test what wil be the next step?
amniocentesis, u/s or cell free fetal dna testing
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  #2  
Old 04-20-2016
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Quote:
Originally Posted by krishna_3228 View Post
at 20weeks gestation with abnormal quadrple test what wil be the next step?
amniocentesis, u/s or cell free fetal dna testing
Good question. I would do a cell free fetal dna testing because it more sensitive and specific for aneuploidy (especially Down and Edward)

Ultrasound sounds like a good option, if I am wrong, its probably the next best step. But I know that its not as sensitive and specific as cell free fetal dna testing

Amniocentesis is too invasive.

Anyone else has a better answer?!
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  #3  
Old 04-21-2016
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2nd trimester u/s tells us about fetal growth and anatomy while cffDNA tells us about sex and aneupoidies therefore it should be more diagnostic test than u/s am i right ?
But UW dont didnt mention which one is accurate than other
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  #4  
Old 04-21-2016
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Default relation between insulin resistance and anovulation

insulin resistance contributes to anovulation in pcos
does anyone know pathophysio: how insulin resistance causes anovulation?
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  #5  
Old 04-22-2016
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Quote:
Originally Posted by MedicalStudent93 View Post
As for the relationship between insulin resistance and anovulation. Well, we know that obesity cause anovulation. And we also know that insulin resistance is caused by obesity. Thus, we can say that obesity leads to both insulin resistance and anovulation.

Hope it helps
yup i know about this theory but what i read somewhere treatment with metformin wil help in anovulation thats y i was confused how insulin resisitance etc play a role in anovulation.i think its mechanism is unknown
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  #6  
Old 04-23-2016
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40yrs years old female brought by her husband for generalized weaknes and lightheadedness.vomiting geting worse,LMP 3months ago,on exam dry mucous membranes.bimanual exam:14 weeks size uterus.B-hcg elevated.pelvic u/s shows central heterogenous mass with numerous cystic spaces and no fetal pole.ovaries are enlarged and have musltilocular cystic apearance.what is the pathophysio: of ovaries enlargment and wht is treatment of that pathology?
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  #7  
Old 04-24-2016
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Quote:
Originally Posted by krishna_3228 View Post
40yrs years old female brought by her husband for generalized weaknes and lightheadedness.vomiting geting worse,LMP 3months ago,on exam dry mucous membranes.bimanual exam:14 weeks size uterus.B-hcg elevated.pelvic u/s shows central heterogenous mass with numerous cystic spaces and no fetal pole.ovaries are enlarged and have musltilocular cystic apearance.what is the pathophysio: of ovaries enlargment and wht is treatment of that pathology?
i think no one knows answer .
Answer : This patient ovarian findings are most likely theca lutein cysts due to ovarian hyperstimulation from high B-hcg levels.
treatment: Theca lutein ovarian cyst resolve spontaneously after the treatment of molar pregnancy
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  #8  
Old 04-25-2016
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either a persistent elevation or an insufficient attainment of estrogen levels can inhibit ovulation through a disruption of the mechanisms that induce the LH surge. To achieve the corresponding changes within the cycle, estradiol levels must rise and fall appropriately.

Insulin resistance leads to obesity. Which means more adipose tissues. Adipose tissue secretes ESTROGEN too, which leads to hyperestrogenic state, which will eventually leads to anovulation.
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  #9  
Old 04-30-2016
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Default congenital anomalies

phenytoin : it is associated with fetal hydantoin syndrome: midifacial hypoplaisa,microchephaly,cleft lip and palate,digital hypoplasia,hirustism,development delay.

congenital syphilis: at birth presents with rhinitis,heplatosplenomegaly,skin lesions.later findings: hutchinson teeth,sadle nos,keratitis,deafnes,saber shins,cnc involvmnt

fetal alcohol syndrome:midfacial hypoplasia,microcephaly,stunted growth,cns damage: mental retardation hyperactivity,learning disability
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  #10  
Old 04-30-2016
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Notes on current recommendations for Cervical/vulvar cancer
Attached Thumbnails
obs/gynae question:-cervical-cancer.pdf   obs/gynae question:-vulvar-cancer.pdf  
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  #11  
Old 05-09-2016
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Quote:
Originally Posted by krishna_3228 View Post
at 20weeks gestation with abnormal quadrple test what wil be the next step?
amniocentesis, u/s or cell free fetal dna testing

Abnormal quadruple test .. What is the Most common cause? Dating error . DO US..
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  #12  
Old 05-10-2016
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Quote:
Originally Posted by arpiyar_s View Post
Abnormal quadruple test .. What is the Most common cause?
MCC of abnormal quadruple test : Trisomies
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