Development 2 Flashcards
What in particular should be done when assessing the karyotype in Turner’s?
Examination of at least 20 cells
Because of the likelihood of Mosaicism
How should pubertal induction be done in hypergonadotrophic hypogonadism?
Administer small doses of ethanol oestradiol (1/10 dose of COCP)
Initially at night time
Dose increased at 6 monthly intervals until breakthrough vaginal bleeding occurs
At this point, should be started on standard COCP
Long term HRT is required
What emvbryological tissue do the
A) Müllerian ducts
B) Wolffian ducts
Arise from
A) Paramesonephric
B) Mesonephric
At what gestation does sex differentiation occur?
Week 7
When the undifferentiated gonad becomes a testis or an ovary
Chromosomes determined at conception
Fetus is identifiable as male or female by 12/40
What is the treatment of cervical agenesis?
Traditional treatment: Hysterectomy
New: anastomoses of the uterus to the vagina, which preserves fertility
Women with uterine anomaly, particularly type ______ should undergo imaging of the _____
2
Renal tract
For women with Type 2 ASRM uterine anomalies, what % have associated renal malformations?
50%
What is the definition of ambiguous genitalia?
Genitalia are considered ambiguous when they have an atypical appearance and it is impossible to determine the sex of the baby by inspecting them
With ambiguous genitalia and hyperpigmentation, what diagnosis should be suspected?
CAH
Excessive production of melanocyte-stimulating hormone
What is the risk of gonadal malignancy in CAIS?
3%
Gonads can be left in situ until after puberty, and decision made with patient
What are the differences in the vulval anatomy pre-puberty?
Less prominent labia minora
Less oestrogen
What % adolescents will have a hymenal abnormality?
3%
What are 5 types of hymenal abnormalities
Imperforate Cribiform Fimbriated Hymenal bands Microperforate
What is the DDx for genital bleeding in childhood?
Vulvovaginitis Foreign body Genital trauma Neonatal oestrogen withdrawal bleed Premature menarche or precocious puberty Urethral prolapse UTI Labial adhesions Dermopathy Pinworms with excoriation from scratching Neoplasm
What are streak gonads?
Reproductive tissue replaced with functionless, fibrous tissue
Atypical development of the gonads in an embryo
