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ÉRS And NS > ERS > Flashcards

ERS Flashcards

1
Q

Development of the internal gonads begins from migration of what cell to where

A

PGC (primordial germ cell) arise from epiblast and migrate to genital ridges

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2
Q

How does PGC migrate

A

Throug amoeboid movement (chemotaxis)

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3
Q

Expression of results in the

A

Development of male internal reproductive organ

Degeneration of mullarian tube and growth of WolffIan tube

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4
Q

99% of acromegaly is caused by

A

Pituitary adenoma - esp overgrowth of somatotroph cells

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5
Q

When does acromegaly start to develop

A

In adults 30-50 hrs after epiphyseal plate closure

If in younger children - gigantism

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6
Q

Cushing disease result from

A

Pituitary adenoma which increases ACTH levels thereby influencing downstream secretions

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7
Q

Sertoli cells produce

A

ABP androgen binding hormone

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8
Q

Most common cause if hyperthyroidism

A

Graves diseases

Stimulating Autoimmune Ab binds to TSH receptor and activate TH production

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9
Q

Dipsogenic Diabetes instipidus cause

A

Increase in ADH level due to defect or damage in hypothalamus

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10
Q

Hashimoto disease is

A

An autoimmune disease caused by autoreactive Ab against thyroid globulin (destroy thyroid gland

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11
Q

Hyperpigmentation is a characteristic of which of the following disease

1) Cushing
2) Addison

A

Addison

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12
Q

Addison’s disease is characterised by low levels of

A

Low levels of cortisol,aldosterone and androgens

- LT endocrine disorder in which the adrenal glands don’t produce enough Steroid hormone

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13
Q

Peptide hormone receptors has intrinsic and recruited functions, state examples

A

RTKs

  • intrinsic - EGFR, insulin - pi3k, MAPK
  • recruited - GH, PRL - JAKstat
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14
Q

How does jak stat pathway work

A

Binding of the hormone to the receptor (already dimerised) - JAK Pi cytoplasmic tail of the receptor - STAT recruitment - JAK Pi STAT which allow it to translocation into the nucleus to drive transcription

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15
Q

Difference between EGFR and Insulin receptors

A

EGFR dimerises after ligand binding whilst Insulin receptor is already dimerised before binding

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16
Q

Intracellular receptors characteristics

A

Receptor can be in cytoplasm or nucleus

  • some of them are present on cell surface for more rapid release (progesterone)
  • and some of which can be orphan receptors
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17
Q

Intracellular receptors have slower response why

A

Stimulate de novo synthesis as the product cannot be stored

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18
Q

Normal sperm index (semen analysis

A 
>1.5 mL in volume
> 15 x 10^6 / mL in concentration
> 39 x 10^9 total count 
>32% motility 
> 4% normal looking morphology
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19
Q

Define teratozoospermia

A

Odd looking sperm

< 4% normal looking sperm

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20
Q

Asthenozoopermia indicates what

A

Less than 32% sperm are moving progressively (motility <32%

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21
Q

Oligozoospermia definition

A

In semen analysis there is less than 15 mil sperm/ mL (look at concentration

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22
Q

Androgen insensitivity syndrome In male results from

A

Insensitivity of testes to androgens that it secretes - can result in degeneration of wolffian duct

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23
Q

Mutation in 5a reductase results in the failure to convert what to what and the consequence of this?

A

Failure to convert testosterone to DHT (dihtdrotestosterone) affecting external reproductive organ development in males - ambiguous genitalia, virilisation at Ivette

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24
Q

Testosterone is essential in doing what In makes during puberty

A

Secondary sexual characteristics

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25
Q

KAllmann syndrome causes

A

Reproductive and smelling problems

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26
Q

What’s the pathophysiology of KAllmann syndrome

A

Failure of GnRH neurones to migrate to the hypothalamus from the olfactory bulb - body deem itself as unsuitable for pregnancies

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27
Q

Early onset of puberty (precocious puberty) age in male and female

A

Male - 9yrs

Female - 8 yrs

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28
Q

Short stature due to puberty induced premature closure of epiphyseal plate is caused by

A

Early puberty

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29
Q

Delayed puberty age for male and female

A

14 female

16 male

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30
Q

Markers for bone turnover

A

Osteonectin/calcin/pontin

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31
Q

Function of osteoblasts, osteocytes and osteoclasts

A

Osteoblasts secrete ECM and calcify the ECM
Osteocytes has long foot processes that can communicate with osteocytes and respond to stress
Osteoclasts reabsorb bone and have immune function

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32
Q

Calcification of bone is the the collagen type I interaction with

A

Hydroxyapatite

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33
Q

Most dynamic bit of the bone is the

A

Spongy bone

34
Q

Steps of bone remodelling

A
  1. Communication with osteocytes
  2. Osteoblasts receives signal and reabsorb bone which release collagen, phosphate and calcium
  3. Osteoblasts comes in and lay down matrix (refill collagen phosphate and calcium)
  4. Calcification/mineralisation of matrix forming osteoid
35
Q

Hyperparathyroidism results in

A

Increase PTH hence increase bone absorption to increase serum Ca
Can cause osteoporosis

36
Q

Rickett’s disease presentation of bendy bones is due to

A

Inability to calcify collagen with hydroxyapatite hence cannot form supportive bone
Patient also have difficulty in Ca absorption from GIT

37
Q

NIS is present on what side of membrane

A

Basolateral

To take up iodide

38
Q

Spermiation is the process of

A

Last step of spermatogenesis whereby the spermatids is released via rupture of the cytoplasmic bridges into the lumen becoming spermatozoa

39
Q

PTH is a small peptide consist of how many aa and from which aa is the biologically active bit

A

84 a pair prehormone and 1-34 aa has activity

40
Q

Goal of PTH

A

Secreted due to decrease calcium in serum hence goal is to bring Ca up

41
Q

PTH binds to PTHR which is a Gs coupled receptor present in the kidney and osteoclast, what does it do

A

Upregulates 1a Hydroxylase in kidney to convert 25hydrovitD to 1,25 deoxyhydrovitD that can act on VDR (nuclear receptor) to increase Ca absorption in gut by upregulating calbindin
Also act on osteoclast to increase bone degradation
Increase renal excretion of PO4 and increase absorption of Ca in the DCT

42
Q

FGF23 function is to

A

Decrease serum phosphate and as a result increase Ca in serum
Suppress vitD transcription

43
Q

Calcitonin action

A

Inhibit osteoclast activity and promote Ca uptake into bones

44
Q

MCT8 is important in thyroid hormone uptake esp in what type of tissue

A

In neurones

45
Q

TH receptor type

A

Type 2 intracellular receptor

Aka nuclear receptor that is already dimerised with RXR and bound to the DNA response element

46
Q

Absence or mutated MCT8 causes

A

Allan-Herndon-Dudley disease
X linked
Severe intellect defect

47
Q

Normal physiological PTH and Ca levels

A

PTH - 1.6-6.9pmol/L

Ca - 2.1 - 2.6 mM

48
Q

The histones in sperm DNA is replaced by what to inactivate transcription

A

Protamine

49
Q

Uterine tubal obstruction can be caused by

A

STIS - chlamydia - scarring

Secondary to pelvic infections

50
Q

Other female tract disorders that causes infertility

A 
Tubal obstruction due to infections (most common STIS)
Endometriosis 
Anatomical abnomalities (septate/bicornuate uterus) 
Uterine leiomyomas (benign in SMCS)
51
Q

Retrograde dysfunction can be confirmed by

A

Measuring semen in urine

52
Q

What causes retrograde ejeculatiom

A

Dysfunctional urethral sphincter

53
Q

Glucagon structure and function

A

29 aa peptide that is secreted in pro hormone form
Work on GPCR (Gs) that phosphorylstes FBPase2
Activate glycogen phosphorylase to convert glycogen to glycogen1 phosphate

54
Q

FBPase2 (active) inhibits glycolysis and stimulate gluconeogenesis

A

T

55
Q

Clomiphene is given for five days during the initial course of fertility treatment. How does it work

A

Clomiphene is an aromatise inhibitor that prevent oestrogen synthesis, allowing FSH to stimulate follicle development and also increase no of follicular development

56
Q

Intrauterine insemination IUI is a method to bypass what in infertility

A

Bypass sexual intercourse and cervical mucous to directly inject washed sperm into the uterine space via a speculum

57
Q

IVF Must undergo ovarian stimulation whereby the pituitary gland must be suppressed, how is it achieved

A

By giving GnRH antagonists or agonists to promote internalisation of receptors

58
Q

What’s the dif between IUI and IVF

A

IUI doesn’t necessarily need ovarian stimulation and requires ovulation
IVF requires reset of the HPG axis and requires stimulation of much more follicles by giving recombinant FSH and hCG (mimic LH) prevent ovulation (as it has to be extracted to inseminate in a culture dish) and implanted back afterwards

59
Q

ICSI = intracytoplasmic semen injection process

A

Same as IVF up to the insemination step. AFter extraction of eggs, sperm head is singlehandedly injected into the oocyte, bypassing the need of penetration

60
Q

Where is the 99% of Ca stored

A

Skeleton

61
Q

Function of skeleton

A

Mechanical support (protect organs)
Immune cell and blood cell production (from BM)
Store Ca2+

62
Q

What stimulate release of Ca into bloodstream

A

PTH, Steroid hormone (glucocorticoid

63
Q

Regulation of Ca and PO4 is r_________

A

Reciprocal

64
Q

Why is serum Ca important

A
  • physiological functions
    Muscle contraction
    Nerve conduction
    Adhesion of cells
65
Q

Levels of PTH in the cell

A

1.6-6.9 pimple/L

66
Q

Where is the parathyroid gland

A

Posterior or the thyroid gland, embedded into it

67
Q

FGF24 function

A

Increase excretion (decrease reabsorption of PO4) and inhibit Vit D synthesis thereby increase Ca

68
Q

PTH receptor

A

GPCR coupled to Gs in kidney and osteoblasts

69
Q

PGE2 and PGF2a function.

A

PGE2 - change collagen structure if cervix to a more loose structure (dermatan sulphate to keratin sulphate and increase glycosaminoglycan)
PGF2a - increase spikes and cervical correction

70
Q

Why does progesterone inhibit PLA2 activity during term

A

Prevent PG synthesis which can promote contraction and cervical remodelling

71
Q

Ferguson reflex

A

Postive feedback reflex that is stimulation by the increase uterine contraction and cervical distension which results in release of oxytocin thereby increasing rate and force of contraction

72
Q

Prolactin milk production

A

Positive feedback

Suction in nipples signals release of prolactin which will act on alveolar cells to secrete milk

73
Q

Oxytocin let down reflex

A

Positive reflex whereby the suction of nipples results in release of oxytocin from post pit which act on myoepithelial cells to contract and release milk

74
Q

Colostrum colour and content

A

Yellowish

Rich in proteins and antibodies for protection

75
Q

Mature milk content and colour

A

White

Rich in fat and nutrients (lactate) less proteins

76
Q

Prolactin inhibits gonadotropin secretion thereby delaying

A

Ovulation

77
Q

S/E of breast feeding

A

Osteoporosis

Ca required in milk

78
Q

Most dynamic bone is the

A

Spongy bone

79
Q

What hormone suppresses insulin action in mother during pregnancy

A

hPL

80
Q

HPL is also know as the metabolic screwdriver, why is that

A

Suppresses insulin action
Increase plasma nutrients (metabolic screwdriver) hence increase fat and aa mobilisation
Facilitate acinar gland development

ÉRS And NS (2 decks)

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