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STEP 1 > 02b: Repro > Flashcards

02b: Repro Flashcards

1
Q

Mutation in sonic hedgehog gene:

A

Holoprosencephaly (failure of L and R hemispheres to separate)
Gene is involved in anteroposterior axis patterning and CNS development

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2
Q

Hox gene mutations:

A

Appendages in wrong locations; abnormal skeletal malformations

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3
Q

Hox genes code for:

A

Transcription factors (involved in segmental organization of embryo)

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4
Q

Gastrulation occurs at week:

A

3

3 weeks = 3 layered embryonic disc

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5
Q

Which weeks of early fetal development is embryo most susceptible to teratogens?

A

3-8 (embryonic period)

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6
Q

Fetal development: heart begins to beat at which week?

A

4 (limb buds appear too)

4 weeks = 4 limbs and 4 heart chambers

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7
Q

Fetal development: when do you expect fetal movement to start?

A

Week 8 (“Gait at week 8”)

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8
Q

Fetal development: when can sex of baby be apparent?

A

Week 10 (“Tenitalia”)

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9
Q

Parotid, sweat, mammary glands arise from (ecto/meso/endo)-derm.

A

Ectoderm

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10
Q

Retina arises from neural (tube/crest).

A

Tube (all CNS)

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11
Q

List key structures that arise from neural crest

A

“MOTEL PASS” - think PNS

  1. Melanocytes
  2. Odontoblasts
  3. Thyroid cartilage
  4. Enterochromaffin cells
  5. Laryngeal cartilage
  6. Parafollicular cells of thyroid
  7. Adrenal medulla/Auerbach plexus
  8. Septum (aorticopulmonary septum)
  9. Schwann cells
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12
Q

Testes and ovaries derived from (ecto/meso/endo)-derm.

A

Mesoderm

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13
Q

The notochord function is (X). Does it have any post-natal derivatives?

A

X = induce ectoderm to form neuroectoderm (neural plate)

Only nucleus pulposus of intervertebral disc

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14
Q

Baby born with ototoxicity. You ask mom about what exposure?

A

Aminoglycosides

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15
Q

In utero DES exposure puts fetus at risk for:

A

Congenial mullerian anomalies and vaginal clear cell adenocarcinoma

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16
Q

T/F: Vaping is ok during pregnancy.

A

False - teratoginicity of smoking is due to nicotine (causes vasoconstriction) which is present in vape smoke

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17
Q

Swordfish, and certain fish types, should be avoided during pregnancy due to (X) levels, which can cause (Y).

A 
X = methylmercury
Y = neurotoxicity
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18
Q

Pregnant surgeon wears lead shield during surgery to prevent (X) exposure, which can cause (Y) in baby.

A 
X = X-ray
Y = microcephaly, intellectual disability
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19
Q

Mechanism of abnormalities in fetal alcohol syndrome are due to abnormal (X) process.

A

X = cell migration

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20
Q

It’s bhCG’s structural similarity to (X) that allows it to prompt corpus luteum to secrete (Y) during first trimester.

A 
X = LH
Y = progesterone
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21
Q

(Cyto/syncytio)-trophoblast layer is in direct contact with maternal circulation. Why doesn’t mom’s immune system attack?

A

Syncytiotrophoblasts;

Cells lack MHC-1 expression

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22
Q

T/F: Umbilical arteries are oxygen poor

A

True - return deox blood from fetal internal iliac aa to placenta

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23
Q

T/F: There are two umbilical aa and two umbilical vv.

A

False - one umbilical v

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24
Q

Yolk sac forms allantois in Week 3. Allantois becomes (X), a duct between:

A

X = urachus

Fetal bladder and umbilicus

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25
Q

Baby has urine coming out of belly button. What’s the pathogenesis?

A

Patent urachus

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26
Q

Least severe result of incomplete obliteration of urachus:

A

Vesicourachal diverticulum (outpouching of bladder)

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27
Q

Baby has poopy coming out of belly button. What’s the pathogenesis?

A

Vitelline fistula (duct fails to close)

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28
Q

Meckel diverticulum: what is duct attached to?

A

Ileum and umbilicus

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29
Q

Aortic arch I derivative:

A

Maxillary a (1st arch is MAXimal)

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30
Q

Aortic arch 2 derivative:

A

Stapedial and hyoid aa (Second is Stapedial)

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31
Q

Aortic arch 3 derivative:

A

Common carotids and proximal part of internal carotid (C = 3rd letter of alphabet)

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32
Q

Aortic arch 4 derivative:

A

Aortic arch (L) and prox subclavian (R)

4th arch for the 4 limbs (systemic blood supply)

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33
Q

Aortic arch 5 derivative:

A

Nada

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34
Q

Aortic arch 6 derivative:

A

Proximal pulm aa; and ductus arteriosus (on L)

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35
Q

L recurrent laryngeal nerve loops around (X) vessel and R loops around (Y) vessel.

A 
X = aortic arch (distal to ductus arteriosus)
Y = R subclavian a
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36
Q

List the components of the branchial apparatus, from outside to inside. State which embryonic tissue layer each is derived from)

A

CAP

  1. Clefts (ectoderm)
  2. Arches (mesoderm and neural crest)
  3. Pouches (endoderm)
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37
Q

CN associated with first branchial arch

A

Trigeminal V2, V3

Children first “chew” then “smile” then “swallow stylishly” or “simply swallow” and then “speak”

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38
Q

CN associated with second branchial arch

A

CN VII

Children first “chew” then “smile” then “swallow stylishly” or “simply swallow” and then “speak”

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39
Q

CN associated with third branchial arch

A

CN IX (“stylo”-pharyngeus innervated by glossopharyngeal n)

Children first “chew” then “smile” then “swallow stylishly” or “simply swallow” and then “speak”

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40
Q

CN associated with fourth branchial arch

A

CN X (superior laryngeal branch)

Children first “chew” then “smile” then “swallow stylishly” or “simply swallow” and then “speak”

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41
Q

CN associated with fifth branchial arch

A

Nada (regresses)

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42
Q

CN associated with sixth branchial arch

A

CN X (recurrent laryngeal branch; all intrinsic muscles of larynx except cricothyroid)

(Children first “chew” then “smile” then “swallow stylishly” or “simply swallow” and then “speak”)

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43
Q

First branchial pouch derivatives

A

“Ear, tonsils, bottom-to-top”

Middle ear cavity, eustachian tube, mastoid air cells

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44
Q

Second branchial pouch derivatives

A

“Ear, tonsils, bottom-to-top”

Lining of palatine tonsil

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45
Q

Third branchial pouch derivatives

A

“Ear, tonsils, bottom-to-top”
Third pouch gives rise to three structures

  1. Bottom parathyroids (from dorsal wings) (2)
  2. Thymus (ventral wings) (1)
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46
Q

Fourth branchial pouch derivatives

A

“Ear, tonsils, bottom-to-top”

Superior parathyroids

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47
Q

DiGeorge Syndrome: (X) chromosomal abnormality with abnormal development of (Y)

A 
X = 22q11 deletion
Y = 3rd and 4th branchial pouches
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48
Q

Main symptoms of DiGeorge syndrome

A
  1. T-cell deficiency (thymic aplasia)

2. Hypocalcemia (failed parathyroid development)

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49
Q

Cleft lip due to failure of fusion of:

A

Maxillary and medial nasal processes (formation of primary palate)

50
Q

Cleft palate due to failure of fusion of:

A
  1. Two lateral palatine shelves OR
  2. Lateral palatine shelves with nasal septum OR
  3. Lateal palatine shelves with median palatine shelf

Secondary palate formation abnormal

51
Q

Male remnant of paramesonephric duct

A

Appendix testis

52
Q

F remnant of mesonephric duct

A

Gartner duct

53
Q

Patient is 46, XY with functional Leydig cells but non-functional Sertoli cells. What internal/external sex structures would you expect?

A

Internal: M and F (no sertoli cells, no MIH so female internal genitalia sticks around)
External: M (testosterone/androgens present)

54
Q

Complete failure of fusion of paramesonephric ducts (double uterus, cervix, vag):

A

Uterus Didelphys

55
Q

Glans penis equivalent in F

A

“Glans” Clitoris

56
Q

Bulbourethral glands in (M/F) equal (X) glands in (M/F).

A

M (aka Cowper glands)
X = Bartholin
F

57
Q

Corporus cavernosum and spongiosum in M are (X) in F

A

X = vestibular bulbs

58
Q

Prostate gland in M is (X) in F

A

X = Urethral and paraurethral glands (of Skene)

59
Q

Hypospadias is due to failure of which process?

A

Fusion of urethral folds

60
Q

Epispadias is condition in which (X) and results due to abnormality in which process?

A

X = abnormal opening of penile urethra on dorsal surface of penis

Faulty positioning of genital tubercle

61
Q

Gubernaculum is composed of (X) tissue and has which function in the male?

A

X = fibrous

Anchors testes within scrotum

62
Q

Gubernaculum remnant in female

A

Ovarian and round ligaments of uterus

63
Q

Tunica vaginalis equivalent in female

A

There isn’t one… the processus vaginalis is obliterated in F

64
Q

Ovaries lymph drainage

A

Para-aortic lymph nodes (like testes)

65
Q

Body of uterus drains to which lymph nodes?

A

External iliac

66
Q

Cervix drains to which lymph nodes?

A

External and internal iliac

67
Q

Superior bladder drains to which lymph nodes?

A

External iliac

68
Q

Prostate drains to which lymph nodes?

A

Internal iliac

69
Q

Distal vagina/vulva drain into which lymph nodes?

A

Superficial inguinal

70
Q

Scrotum drains into which lymph nodes?

A

Superficial inguinal

71
Q

Glans penis drains into which lymph nodes?

A

Deep inguinal

72
Q

Distal anus drains into which lymph nodes?

A

Superficial inguinal

73
Q

Infundibulopelvic, aka (X), ligament connects which two structures?

A

X = suspensory ligament of ovary

Ovary to lateral pelvic wall

74
Q

Oopherectomy: (X) ligament must be ligated to avoid bleeding

A

X = suspensory ligament (contains ovarian vessels)

75
Q

Uterine vessels are housed in which ligament?

A

Cardinal ligament (attaches cervix to side wall of pelvis)

76
Q

Hysterectomy: (X) ligament must be ligated to avoid bleeding

A

X = cardinal (containing uterine vessels)

77
Q

Ovarian ligament attaches which structures?

A

Ovary (medial side) to lateral side of uterus

Note: contains no structures and is derivative of gubernaculum

78
Q

Vagina epithelium type

A

SSNKE

79
Q

Ectocervix epithelium type

A

SSNKE

80
Q

Endocervix epithelium type

A

Columnar

81
Q

Uterus epithelium type

A

Simple columnar (with glands)

82
Q

Fallopian tube epithelium type

A

Simple columnar, ciliated

83
Q

Ovary (outer surface) epithelium type

A

Simple cuboidal (germinal epithelium)

84
Q

Seminiferous tubules: (X) cells secrete androgen-binding protein. (Y) cells nourish developing spermatozoa.

A

X = Y = sertoli

85
Q

T/F: Testosterone production is temperature-sensitive.

A

False - unaffected by temp (but sperm production declines with high temps)

86
Q

Blood-testis barrier formed by:

A

Sertoli cells (adjacent cells have tight junctions)

87
Q

(X) cells in testes convert androgens/testosterone to estrogen.

A

X = sertoli (via aromatase)

88
Q

Female homolog to Leydig cells.

A

Theca interna cells (and granulosa cells are homolog to sertoli cells)

89
Q

T/F: Leydig and Sertoli cells line seminiferous tubules.

A

False - Sertoli cells and spermatogonia line seminiferous tubules; leydig cells located in interstitium

90
Q

Pregnancy: the indicator for fetal well-being is a 1000-fold (increase/decrease) in which hormone?

A

Increase
Estriol (placental estrogen)
Note: other estrogens (estradiol, estrone) also rise, but only by 50-fold

91
Q

At menses, when (oocyte/oogonium/ovum) completes meiosis I, it separates the genetic info (evenly/unevenly).

A

Primary oocyte

Evenly BUT cytoplasm not split equally (large cell is secondary oocyte and smaller cell becomes polar body)

92
Q

T/F: Secondary oocyte is haploid.

A

True - 1N, 2C (chromatids)

93
Q

(Estrogen/LH) surge stimulates (Estrogen/LH) release and thus ovulation.

A

Estrogen

LH

94
Q

How early after conception is at-home urine test able to detect positive pregnancy? What (exactly) being detected in these tests?

A

2 weeks (beta-hCG detectable after about 1 week in blood)

beta (specific) subunit of beta-hCG

95
Q

Gestational age calculated from (X). Embryonic age calculated from (Y).

A 
X = last menstrual period
Y = conception date (gestational age minus 2 weeks)
96
Q

RBC count increases during pregnancy. So why is female typically anemic?

A

Higher increase in plasma

97
Q

PCOS patient presents with complaints of infertility. For fertility treatment, you start a short course of (X) to assist in dominant ovarian follicle formation. Then, you introduce a single injection of (Y) to mimic LH surge.

A 
X = menotropins (mimic FSH)
Y = beta-hCG
98
Q

Apgar score determined by which features? And score under (X) requires further evaluation.

A

APGAR = Appearance, Pulse, Grimace, Activity, Respiration (each gets 0, 1, or 2 pts)

X = 7

99
Q

T/F: Testosterone responsible for differentiation of all male internal genitalia.

A

False - all except prostate (DHT)

100
Q

T/F: Testosterone responsible for male growth spurt.

A

True

101
Q

T/F: DHT responsible for penis differentiation and deepening of voice.

A

False - deepening of voice via testosterone

102
Q

T/F: Estrogen responsible for epiphyseal plate closing in men.

A

True - via action of P450 aromatase conversion of testosterone (in adipose and testes)

103
Q

Finasteride MOA

A

Inhibits 5a-reductase (reduce DHT)

“Fina for Five-a”

104
Q

“Spermiogenesis” refers to process in which (X) becomes (Y). Which steps entail this process?

A 
X = spermatids
Y = spermatozoon (mature sperm; "zoons zoom toward the egg")
  1. Loss of cytoplasmic contents
  2. Gain acrosomal cap
105
Q

Congenital heart defects commonly seen in Turner’s

A
  1. Coarction

2. Bicuspid aortic valve

106
Q

T/F: XYY fetus will die in utero.

A

False - typically normal males that may be very tall, have severe acne/learning disability/autism

107
Q

Patient presents few days post-partum with elevated beta-hCG, dyspnea, and hemoptysis. What’s at the top of your differential?

A

Choriocarcinoma

108
Q

Choriocarcinoma: malignancy of (X) cells with (Y)-appearing chorionic villi and hematogenous spread to (Z)

A 
X = trophoblasts (cyto/syncytio-trophoblasts)
Y = NO chorionic villi
Z = lungs (cannonball metastases)
109
Q

Presence of p57 indicates that hydatidiform mole is (complete/partial)

A

Partial (p57 from maternal genome, which is absent in complete mole)

110
Q

34 yo G2P1 present to the ER claiming her water broke and is now having vaginal bleeding. She denies pain, but appears distressed. Fetal heart rate is 105 bpm. Likely diagnosis and next step?

A

Vasa previa (fetal vessels run in close proximity to cervical os and may rupture)

Emergent C-section

111
Q

Vasa previa typically associated with abnormal placement/insertion of (X).

A

X = umbilical cord (“velamentous insertion”; inserts into chorioamniotic membrane instead of placenta and vessels not protected by Wharton jelly)

112
Q

Most common cause of post-partum hemorrhage

A

Uterine atony (uterus fails to contract and compress blood vessels)

113
Q

Most common infectious agent(s) in septic abortion.

A

S. aureus and G- bacilli

114
Q

Rx for gestational hypertension (pregnancy-induced)

A

“Hypertensive Moms Love Nifedipine”

  1. Hydralazine
  2. alpha-Methyldopa
  3. Labetalol
  4. Nifedipine
115
Q

Risk factors for pre-eclampsia

A
  1. PHx/FHx
  2. Nulliparity
  3. Obesity
  4. Chronic HT, diabetes, or renal disease
116
Q

Pt presenting with signs of pre-eclampsia at under 20 weeks gestation indicates:

A

molar pregnancy

117
Q

The key instigator in the pathogenesis of pre-eclampsia is:

A

Abnormal placental spiral arteries (placental hypoxia/ischemia)

118
Q

Pre-eclampsia treatment and management.

A
  1. IV Mg-sulfate (to prevent seizures)
  2. Anti-HT
  3. Delivery of baby is definitive treatment
119
Q

Pre-eclampsia can lead to either eclampsia and/or (X) syndrome, which is a manifestation of severe pre-eclampsia.

A

X = HELLP (Hemolysis, Elevated Liver enzymes, Low Platelets)

120
Q

Rx for HELLP syndrome is (X) and for eclampsia is (Y)

A

X = Y = immediate delivery

121
Q

24 yo G1P0 at 30 weeks gestation presents to the clinic complaining of dizziness, sweating, and nausea when lying down. Sitting and standing or laying down on her (R/L) improves symptoms. What’s the likely diagnosis and etiology?

A

L
Supine hypotension syndrome
Gravid uterus (usually over 20 weeks pregnant) compresses and obstructs IVC (decreasing preload)

STEP 1 (21 decks)

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