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OBGYN > Early conceptus growth and immunobiologic adaptations of pregnancy > Flashcards

Early conceptus growth and immunobiologic adaptations of pregnancy Flashcards

1
Q

Type 2 CD4+ Th cells (Th2) produce …

A

IL-4

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2
Q

Type 1 CD4+ Th cells (Th1) control …

A

Cell-Mediated Responses.

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3
Q

The placenta can release factors that suppress …

A

T-cell and NK-cell activity.

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4
Q

HLA-G serves a dual role in protecting the trophoblast

from both …

A

Cytotoxic T cells and NK-cells.

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5
Q

First-trimester pregnancy decidua is composed

predominantly of …

A

Immune cells.
(Approximately, 10% of the stromal cells are T lymphocytes, 20% are macrophages, and the main immune cell population is large granular lymphocytes or NK cells, comprising 45% of the decidual cells).

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6
Q

The adherence of the blastocyst to the endometrial

epithelium is mediated through ..

A

ligand-receptor complexes.

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7
Q

Three cytokines appear to be involved in implantation …

A

Colony-stimulating factor 1;
Leukemia inhibitory factor;
Interleukin 1.

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8
Q

Human Chorionic Gonadotrophin is essential in

stimulating …

A

the corpus luteum to produce progesterone.

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9
Q

The cortical and zona reactions are triggered after …

A

egg–sperm fusion.

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10
Q

Prior to sperm–egg interaction …

A

capacitation of the spermatozoa must occur.

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11
Q

During meiosis, the primary oocyte gives rise to four daugther cells, each receiving 22 autosomes and an X chromosome.

A

The primary spermatocyte also gives rise to four daughter cells, each receiving 22 autosomes and either an X or a Y chromosome.

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12
Q

Capacitation is characterized by …

A

the acrosome reaction, the ability to bind to the zona pellucida, and the acquisition of hypermobility.

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13
Q

The zona pellucida (ZP) is an acellular glycoprotein coat covering the ovum and consists of three principal
proteins:

A

ZP1, ZP2 and ZP3.

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14
Q

Upon Fusion of the egg and sperm membranes …

A

The cortical and zona reactions are triggered.

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15
Q

After egg-sperm fusion …

A

The oocyte will resume the second meiotic division and extrude the second polar body.

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16
Q

The morula enters the uterus 3 days after fertilization and floats inside the endometrial cavity for 2-3 days. The embryo begins implantation approximately …

A

6 days after fertilization.

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16
Q

Gametogenesis

A

Is the maturational process that produces specialozed gametes.

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17
Q

Specialized Gametes

A
  • Spermatozoon (in the male);

- Oocyte (in the female).

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18
Q

Fertilization

A

The union of individual male and female gametes.

Consists of a regulated sequence of interactions that will ultimately result in embryo development

19
Q

Proposed sequence for mammalian gamete interaction:

A
  1. Completion of capacitation in the oviductal isthmus;
  2. Admission into and through the cumulus matrix;
  3. Primary binding to ZP3 on the sperm plasma membrane;
  4. Triggering of acrossomal exocytosis;
  5. Secondary binding to ZP2 using components exposed after the acrossomal reaction;
  6. Autoactivation of proacrosin to acrosin, with attendant digestion through the ZP matrix;
  7. Binding, followed by fusion between sperm ans egg plasma membranes.
20
Q

There is fusion of the sperm and egg membranes with specific proteins mediating this process. One such fusion protein is …

A

Fertilin.

21
Q

What proteins prevent further sperm binding on the oolema?

A

ZP2 and ZP3, turning the oolema impenetrable to spermatozoa.

22
Q

How much blastomeres the morula is composed of …

A

12-16 blastomeres.

23
Q

When the blastocyst forms …

A

When approximately 60 blastomeres are present.

24
Q

The developing embryo essentially does not increase in size until …

A

The zona pellucida is shed.

25
Q

IL-4 stimulates …

A

IgE and IgG antibody production by Bcells (Th2 response).

26
Q

Type 1 CD4+ Th cells (Th1) secreat what cytokines …

A

IL-2; TFN-beta; IFN-Gama;

which stimulate cytotoxic T cells and NK cells

27
Q

Is there more suppression of immune function during

pregnancy?

A

There is no clear trend toward either the enhancent or the supperssion of immune function during pregnancy.

28
Q

In the placenta, class I antigen expression occurs in the mesenchyme of the chorionic villi as early as …

A

2.5 weeks.

29
Q

In the placenta, class II antigen expression occurs in the mesenchyme of the chorionic villi by …

A

14 weeks’ gestation.

30
Q

HLA-G inhibits and decrease …

A
  • Inhibits the proliferation of CD4+ T lymphocytes;

- Decreases decidual cell production of IFN-gama and TNF-alfa;

31
Q

What fetal cells can enter the maternal blood in early pregnancy?

A

Fetal nucleated erythrocytes and leukocytes

32
Q

The primitive endoderm arises from …

A

The Hypoblast.

33
Q

The mesoderm and the ectoderm developes from …

A

The epiblast.

34
Q

The primitive germ layers develop between …

A

Days 6 and 8.

35
Q

The embryo is completely imbedded within the endometrium by …

A

Approximately 8-9 days afrer fertilization.

36
Q

The trophoblast differentiates into two layers consisting of

A

Inner cytotrophoblast and an outer syncytiotrophoblast.

36
Q

The trophoblast differentiates into two layers consisting of

A

Inner cytotrophoblast and an outer syncytiotrophoblast.

37
Q

When the blastocyst superficially implants in the stratum compactum of the endometrium by?!

A

The end of the first week.

37
Q

When the blastocyst superficially implants in the stratum compactum of the endometrium by?!

A

The end of the first week.

38
Q

Two areas of contact between mother and fetus are established

A

1- A large surface area formed by syncytiotrophoblast of the chorionic villi that is bathed by maternal blood;
2- Within the deciduas, extravillous trophoblast that mingles directly with maternal tissues.

38
Q

Two areas of contact between mother and fetus are established

A

1- A large surface area formed by syncytiotrophoblast of the chorionic villi that is bathed by maternal blood;
2- Within the deciduas, extravillous trophoblast that mingles directly with maternal tissues.

42
Q

The interface between mother and fetus is extensed by

A

The traffic of fetal cells into the maternal circulation, carrying fetal antigens to other parts of maternal immune system, where priming responses could also occur

43
Q

There are two aways in which might happen the process in which the trophoblast cells enter the maternal circulation:

A

1- Trophoblast “buds” (called syncytial sprouts) often form on the syncytiotrophoblast surface and may break free and enter the maternal blood.
2- The endovascular cytotrophoblast that lines the spiral arteries may be carried away into the bloodstream.

44
Q

The tissue in which immune recognition of trophoblast is most like to occur

A

The decidua.

45
Q

Polyclonal antibody studies have confirmed that HLA-G protein is expressed only by

A

Extravillous cytotrophoblast

OBGYN (9 decks)

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