Ch 22: Female Genital Tract

Question 1

what do the primordial germ cells from the wall of the yolk sac become in females

Answer 1

ovaries

Question 2

what do the mullerian (paramesonephric ducts) become in females

Answer 2

fallopian tubes
uterus
cervix
upper vagina

Question 3

what does the urogenital sinus become in females

Answer 3

lower part of the vagina
vestibule of external genitalia

Question 4

what do the wolffian (mesonephric) ducts become in females

Answer 4

regress completely or become menonephric remnants near ovaries, tubes, and uterus

Question 5

what does the mesothelium become in females

Answer 5

epithelial lining of female internal genital tract
ovarian surface

Question 6

absence of which transcription factor leads to formation of Müllerian duct and regression of wolffian duct in females

Answer 6

SRY

Question 7

what does the urogenital sinus become in males

Answer 7

penis
scrotum
prostate gland

Question 8

what does the wolffian duct become in males

Answer 8

epididymis
vas deferens

Question 9

what type of cells do the mesothelium turn into

Answer 9

thecal cells

Question 10

what does the mesenchyme turn into

Answer 10

connective tissue - granulosa cells

Question 11

the ovaries develop from which three sources

Answer 11

mesothelium
mesenchyme
primordial germ cells

Question 12

when does the first polar body degenerate

Answer 12

between meiosis 1 and 2

Question 13

when does the second polar body degenerate

Answer 13

after the sperm fertilizes an oocyte

Question 14

explain production of female hormones

Answer 14

hypothalamus produces GnRH
anterior pituitary produces LH and FSH
LH stimulates thecal cells to make androgens
FSH stimulates granulosa cells to release make estrogens and inhibin
estrogen stimulates a follicle to mature and make its own estrogen

Question 15

what does estrogen stimulate the anterior pituitary to do

Answer 15

make more FSH and LH

Question 16

a surge of which hormone causes ovulation

Answer 16

LH

Question 17

which three hormones are secreted by the corpus lutetium

Answer 17

progesterone
estrogen
inhibin

Question 18

after 14 days of no fertilization, what happens to the corpus lutetium

Answer 18

it stops producing hormones and shrinks to become the corpus albicans

Question 19

uterine disorders are most commonly affected by which three factors

Answer 19

endocrine imbalances
complications of pregnancy
neoplastic proliferation

Question 20

what is the most common cause of dysfunctional uterine bleeding

Answer 20

hormonal disturbances

Question 21

what is dysfunctional uterine bleeding

Answer 21

disturbance of the normal cyclical process, usually due to anovulation (no release of egg)

Question 22

what causes abnormal uterine bleeding in prepuberty women

Answer 22

precocious puberty (early puberty)

Question 23

which two things cause abnormal uterine bleeding in adolescent women

Answer 23

anovulatory cycle (no release of egg)
coagulation disorders

Question 24

which three things cause abnormal uterine bleeding in women of reproductive age

Answer 24

complications of pregnancy
anatomic lesions
anovulatory cycle (no release of egg)

Question 25

which two things cause abnormal uterine bleeding in perimenopausal women

Answer 25

anovulatory cycle (no release of egg) anatomic lesions (cancer or polyps)

Question 26

which two things cause abnormal uterine bleeding in postmenopausal women

Answer 26

endometrial atrophy anatomic lesions (cancer or polyps)

Question 27

what is an anovulatory cycle

Answer 27

failure to release an egg which leads to excessive endometrial stimulation by estrogens unopposed by progesterone

Question 28

what causes anovulatory cycles

Answer 28

hormonal imbalances

Question 29

who is most susceptible to anovulatory cycles

Answer 29

women first starting their period (menarche) and perimenopausal women

Question 30

what are the two major effects of an anovulatory cycle

Answer 30

architectural changes endometrial hyperplasia

Question 31

what is endometrial hyperplasia

Answer 31

increase in number of glands relative to the stroma

Question 32

what is the most common cause of endometrial hyperplasia

Answer 32

unopposed estrogen stimulation which leads to abnormal vaginal bleeding

Question 33

what is the second most common cause of endometrial hyperplasia

Answer 33

mutation of PTEN tumor suppressor gene makes you more susceptible to endometrial cancers

Question 34

what is endometriosis

Answer 34

presence of ectopic endometrial tissue (glands and stroma) outside of the uterus

Question 35

what are the three most common locations to have endometriosis

Answer 35

ovaries uterine ligaments rectovaginal septum

Question 36

who is most commonly affected by endometriosis

Answer 36

women between the ages of 30-40

Question 37

what are the three types of endometriosis

Answer 37

superficial peritoneal ovarian deep infiltration

Question 38

which two types of endometriosis are associated with development of malignancy

Answer 38

superficial peritoneal ovarian

Question 39

what is the regurgitation theory of endometriosis

Answer 39

endometrial tissue flows through and out the tubes instead of out of the body through the vagina

Question 40

what is the benign metastasis theory of endometriosis

Answer 40

endometrial tissue spreads through blood vessels and lymphatic vessels

Question 41

what is the metaplastic theory of endometriosis

Answer 41

endometrial tissue arises from coelomic (abdominal) epithelium

Question 42

what is the extrauterine stem/progenitor cell theory

Answer 42

stem/progenitor cells from bone marrow becomes endometrial tissue

Question 43

what are the three clinical consequences of endometriosis

Answer 43

infertility dysmenorrhea (severe period cramps) pelvic pain

Question 44

what is adenomyosis

Answer 44

presence of endometrial tissue within the myometrium made of stroma with or without glands

Question 45

what are endometrial polyps

Answer 45

exophytic masses of tissue that project into the endometrial tissue can grow in the presence of estrogen

Question 46

what are the two types of endometrial polyps

Answer 46

hyperplastic atrophic

Question 47

who is most at risk for hyperplastic endometrial polyps

Answer 47

women in their 40s

Question 48

who is most at risk for atrophic endometrial polyps

Answer 48

postmenopausal women

Question 49

what are the two most common ovarian lesions

Answer 49

cysts (functional or benign) tumors

Question 50

what are follicle and luteal cysts

Answer 50

cysts filled with serous fluid and lined by a membrane

Question 51

where do follicle cysts originate from

Answer 51

unruptered Graafian follicles

Question 52

where do luteal cysts grow

Answer 52

on corpus luteum

Question 53

what is thought to cause polycystic ovarian syndrome (POS) or stein leventhal syndrome

Answer 53

dysregulation of enzymes which leads to excessive androgen production

Question 54

what are 6 characteristics of polycystic ovarian syndrome (POS) or stein leventhal syndrome

Answer 54

hyperandrogenism menstrual abnormalities polycystic ovaries chronic anovulation decreased fertility rarely virilization (male body characteristics)

Question 55

polycystic ovarian syndrome (POS) or stein leventhal syndrome is associated with which three conditions

Answer 55

obesity diabetes mellitus 2 premature atherosclerosis

Question 56

what is stromal hyperthecosis or cortical stromal hyperplasia

Answer 56

nests of thecal cells in the ovarian stroma

Question 57

who is most susceptible to stromal hyperthecosis or cortical stromal hyperplasia

Answer 57

postmenopausal women

Question 58

what are 5 characteristics of a women with stromal hyperthecosis or cortical stromal hyperplasia

Answer 58

bilateral enlarged ovary hyperandrogenism hyperinsulinemia obesity virilization

Question 59

what are the three types of ovarian tumors

Answer 59

mullerian epithelium germ cells sex cord-stromal cells

Question 60

when are women most at risk for benign ovarian tumors

Answer 60

20-45 years of age

Question 61

when are women most at risk for malignant ovarian tumors

Answer 61

45-65 years of age

Question 62

are ovarian tumors mostly benign or malignant

Answer 62

benign

Question 63

what are three classifications of epithelial tumors

Answer 63

differentiation epithelium proliferation low grade (type 1) or high grade (type 2)

Question 64

what are the three major histologic types used to differentiate epithelial tumors

Answer 64

serous mucinous endometrioid

Question 65

what are the three major epithelium proliferation classifications of tumors

Answer 65

benign malignant borderline

Question 66

what are the three main types of benign epithelial tumors

Answer 66

cystadenoma cystadenofibroma adenofibroma

Question 67

germ cell tumors make up what percentage of all ovarian tumors

Answer 67

15-20%

Question 68

what is the most common germ cell tumor in women of reproductive age

Answer 68

benign cyst teratoma

Question 69

who is most likely to have malignant germ cell tumor in women

Answer 69

young women and children

Question 70

what are the four types of germ cell tumors in females

Answer 70

dysgerminoma yolk sac tumor choriocarcinoma teratoma

Question 71

what is a dysgerminoma

Answer 71

malignant germ cell tumor of the ovary differentiates towards oogonia

Question 72

what is a yolk sac tumor in females

Answer 72

malignant germ cell tumor of the ovary differentiates towards extra embryonic yolk sac

Question 73

what is a choriocarcinoma in females

Answer 73

malignant germ cell tumor of the ovary differentiates towards placenta

Question 74

what is a teratoma

Answer 74

typically benign germ cell tumor of the ovary made of multiple germ layers

Question 75

what do sex cord-stromal tumors arise from in females

Answer 75

ovarian stroma which comes from the sex cords of the embryonic glands

Question 76

what is the most common type of malignant sex cord-stromal tumor in females and why are they so aggressive

Answer 76

granuloma cell tumors - can come back many years after resection and are hormonally active

Question 77

what are the four main types of sex cord-stromal tumors in females

Answer 77

granulosa cell tumors fibromas pure thecomas sertoli-leydig cell tumors

Question 78

what are two characteristics of fibromas

Answer 78

unilateral hormonally inactive

Question 79

are pure thecomas hormonally active

Answer 79

yes

Question 80

what are two characteristics of sertoli-leydig cell tumors in females

Answer 80

masculinization (development of male characteristics) very rarely reoccur or metastasize

Question 81

which mutation has been known to cause sertoli-leydig cell tumors in females

Answer 81

mutations in DICER1 gene