HUMAN REPRODUCTION: CLINICAL, PATHOLOGIC AND PHARMACOLOGIC CORRELATIONS 2008 Course Co-Director Kirtly Parker Jones, M.D. Professor Vice Chair for Educational Affairs Department of Obstetrics and Gynecology Course Co-Director C. Matthew Peterson, M.D. Professor and Chair Department of Obstetrics and Gynecology 1 Welcome to the course on Human Reproduction. This syllabus has been recently revised to incorporate the most recent information available and to insure success on national qualifying examinations. This course is designed to be used in conjunction with our website which has interactive materials, visual displays and practice tests to assist your endeavors to master the material. Group discussions are provided to allow in-depth coverage. We encourage you to attend these sessions. For those of you who are web learners, please visit our web site that has case studies, clinical/pathological correlations, and test questions. http://libarary.med.utah.edu/kw/human_reprod 2 TABLE OF CONTENTS Page Lectures/Examination................................................................................................................................... 5 Schedule........................................................................................................................................................ 6 Faculty .......................................................................................................................................................... 9 Groups, Workshop...................................................................................................................................... 10 Life Cycle of the Ovary: Puberty, The Menstrual Cycle, and Menopause................................................ 11 Male Reproduction ..................................................................................................................................... 20 Clinical Genetics......................................................................................................................................... 30 Contraception Workshop............................................................................................................................ 35 Menstrual Disorders and Other Common Gynecology Problems .............................................................. 48 Normal Maternal Physiology: Implications for Prenatal Care ................................................................... 53 Physiology of Normal Labor and Delivery................................................................................................. 61 PIH/Obstetrical Hemorrhage Workshop..................................................................................................... 70 Infertility Workshop…. .............................................................................................................................. 75 Pharmacology of Estrogens & Progestins .................................................................................................. 85 Sexually Transmitted Diseases ................................................................................................................... 94 Fertilization, Early Pregnancy and its Disorders……… ............................................................................ 98 Prolactin: Physiology and Pathologic Associations.................................................................................. 108 Obstetrics and Gynecology Glossary........................................................................................................ 124 3 April 2008 To: UUMC Sophomores Re: Sophomore Reproductive Organ Systems Course Hello, and welcome to the upcoming Reproductive Organ Systems Course. This 8 day course is designed to provide you with information about reproductive biology and some of its clinical consequences. Medical Students learn in different ways, and have different commitments to various topics. In view of this, we have designed the course to have a base content (the syllabus) from which the examination questions are taken (except the pathology questions). This is the minimum we expect you to know and be able to use to pass the exam. In addition to the syllabus, we have lectures, workshops, and lunch-time seminars. We also have a website for more material, visual displays, and practice tests. The lectures are meant to be clinical correlates to the syllabus. They are NOT designed to follow the syllabus but are designed to be additive to help bring the physiology to clinical relevance. The workshops are designed to help you use what you have learned. The expectation is that students who attend the workshop have read the syllabus material IN ADVANCE and are ready to work to solve clinical problems. This is NOT a passive learning session – it is to see if you can use what you have learned. If you have not read the syllabus in advance, you could use your time, your fellow students’ time, and the faculty time more efficiently by using this workshop time to read. This year the Pathology and Ob/Gyn Faculty will be working together to provide clinical and pathological correlates in the Pathology Workshops. All students should visit the human reproduction website below and go to the Ovarian Tumor Seminar in preparation for this workshop. Although attendance is not mandatory for the other workshops, the Pathology Department has required attendance for their workshops, including this one. Each student will be assigned to one of the cases you will be presenting. The cases are available on Case Path and each group assigned to one case will present that case in a Clinical/Pathological Case presentation. The Pathology department will provide you with the details. The websites (medstat.med.utah/kw/human_reprod and med.utah.edu/andrology) are for those of you who are web learners and seek more information on female and male reproduction and advanced reproductive technology. The website, endotext.org , is an outstanding resource for endocrine physiology, especially reproductive endocrinology and we strongly suggest you read the appropriate chapters that pertain to the ovary, menstrual cycle, pregnancy, prolactin, reproductive disorders, and the male reproductive system. The website arhp.org is another excellent educational website in the area of contraception, sexually transmitted infections, and female reproductive health. The lunch-time brown bag (bring your own lunch or eat later) seminars are to introduce ethical and controversial issues in our field, or to provide information you probably will not receive at another time during medical school. There is no syllabus (you will not be tested on the content), but these are informational or interactive sessions on topics that may be new to you and are in the news. We look forward to this upcoming Sophomore Reproductive Organ Systems Course! Kirtly Parker Jones MD Reproductive Organ Systems Coursemaster 4 LECTURES/EXAMINATION All lectures will be held in classrooms as noted. Seminars will be as listed in the schedule. There is no single textbook that the department recommends for medical students in obstetrics and gynecology. During your junior clerkship a text is provided on loan to all students (Danforth's Obstetrics and Gynecology, Scott JR, DiSaia PH, Hammond CB, Spellacy WN, eds). Several are in the library for your optional use. Texts we recommend to our residents include the following: Obstetrics: Williams Obstetrics, IXX Edition Gynecology: Telinde's Operative Gynecology, V Edition Endocrinology: Adashi/Rock/Rosenwaks' Reproductive Endocrinology, Surgery and Technology Endocrinology: Speroff/Glass/Kase's Clinical Gynecologic Endocrinology and Infertility, V Edition Comprehensive: Current Obstetric and Gynecologic Diagnosis and Treatment, Lange Series, VIII Edition Grading and Evaluation: The final examination, which will incorporate the pathology and pharmacology exams, will account for 100% of your grade. Final examination schedules for sophomore students will be made by the Office of Student Affairs with the consultation of course directors. The sophomore examination schedules will be approved by the specific Curriculum Committee. The examination schedule will not be altered without the written consent of the course director, 100 percent approval of the class involved, and formal approval of the specific Curriculum Committee. All final examinations must be administered during the regularly scheduled examination period of that particular class unless otherwise approved by the specific Curriculum Committee. Missed Examinations by Students: Departments and/or course directors should establish their own policy concerning missed examinations by students due to brief illness, death in the family, etc. Consideration might be given to the following options: 1. Allow the student to take the original examination at a specified time with the agreement that the student will not discuss the examination with anyone prior to taking the exam. 2. Allow the student to take a make-up examination prepared by the department which is different from the original exam. 3. Not allow the student to take a make-up examination and give him either a zero grade or calculate the final overall grade by using an average of all other exams. 4. Require the student to take a National Board subject examination at the end of the quarter at his own expense, giving it the proper weight when determining the overall grade. If such an occasion arises, the student should contact the course director before