Exercise + Repro Flashcards
name 3 physiological changes that can occur with exercise training
increased GLUT 4 expression, increased muscle blood flow, increased capillary density/recruitment
3 mitochondrial adaptations to exercise
increased density and oxidative enzymes, reduced CHO use and lactate production, increased fat oxidation
impact of exercise on warfarin?
decreased INR. Warfarin less effective so more likely to clot
define sarcopenia and what is needed for diagnosis?
age-associated loss of skeletal muscle mass and function.
Diagnosis = low muscle mass + low muscle strength or low physical performance
what happens in regard to the muscle fibre types in sarcopenia and what age does this begin.
from 50 fast twitch fibres start to become replaced by slow twitch.
name 4 exercise types that can aid in healthy aging
strength training, aerobic, flexibility, balance
which type of hormones decline with age? list 3 and how they impact muscle wasting
anabolic - GH, IGF-1 and testosterone. Low levels compromise the efficiency of muscle regeneration as a consequence of damage from daily wear and tear
describe genetics and pathology of DMD
X lnked recessive causes lack of the protein dystrophin. Lack of this protein affects muscles ability to regenerate after contraction damage.
differences between DMD & BMD (clinical and molecular)
BMD less severe with later onset (adolescence or adulthood) and slower progression. Survival well into mid-late adulthood.
In BMD there is abnormal, smaller amounts of dystrophin c.f. absolutely none in DMD
non-genomic way glucocorticoids inhibit inflammation?
inhibit Arachidonic acid release
how do NSAIDS work in regard to inflammation?
inhibit COX (1&2)
4 adverse effects of NSAIDS
gastro-intestinal, increase bleeding time, renal & pulmonary
what is a coxib?
selective cox-2 inhibitor
how may NSAIDs act on renal and pulmonary systems respectively
compromise renal blood flow & bronchoconstrict
write a word equation for STI epi?
basic reproductive rate = probability of transmission per sexual partnership X rate of partner change X duration of infection
name the 5 STIs covered in the lecture?
N. Gonorrhea. Clamydia Trachomatis. Trichomonis Vaginalis (protozoa). Treponeum Palladeum (syphillus). Mycoplasma Genitalium.
what kind of bacteria is gonrorrhea?
GN diplicocci
consequences of gonorrhea in pregnany?
neonatal gonococcal opthalmia. Purulent conjunctivitis. Can lead to blidness
treatment for gonorrhea?
ceftriaxone (500 mg IV/IM) and azythromycin
serovars of Clamydia?
A-C trachoma in eye.
D-K genital Infection.
clamydia an neonate?
haemorrhagic conjunctivitis and pneumonia
what is trichmonas vaginalis? hallmark symptom?
protozoa. frothy yellow-green vaginal discharge
symptoms of syphillus.
Primary: chancre.
Secondary: rash or alapaecia.
Tertiary (10-30 years later): gummas, cardiac or neruoligcal pathology
which cell type produces testosterone?
leydig cell
first and final product of male gametogenisis?
spermatagonium and spermatazoa
cells of the seminiferous tubules?
sertoli, leydig and spermatagonium
describe the hormone cascade in male repro
Route 1: GnRH > LH > leydig cells > Testosterone > sertoli cells and body for secondary effects. Test feedback on Ant Pit and hypo
Route 2: GnRH> FSH> secondary messenger to Sertoli Cells> sprematocyte maturation. Inhibin feedback on Ant Pit
describe the difference in cervical mucus from the ovulation phase to the luteal phase
ovulation = abundant, clear non viscus mucus Luteal = thick, sticky mucous
describe 2 positive feedbacks cycle during menstruation?
in early to mid-follicular phase estorgen positive feedback on granulosa cells.
In late follicular phase and ovulation Estrogen positive on GnRH.
physiological cause of menopause
ovaries stop responding to LH and FSH > low estrogen and progesterone > eggs stop developing
how long after fertilisation does it take to reach the uterus? what is this thing called. then what happens
blastocyst reaches uterus on day 4-5. implants in endometrium days 5-9.
describe what happens to the sperm in fertilisation
sperm membrane fuses with egg membrane > sperm nucleus enters cytoplasm of egg > oocyte nucleus completes meiotic division > egg and sperm form zygote
which fetal organs does the placenta substitute for? (3)
kidneys, lungs, GIT
main hormones placenta produces (4)?
hCG, hPL, estrogen and progeserone
definition of preterm labour
labour before 37 weeks gestation
etiology of pre-eclampsia
dependant on trophoblast
treatment of pre-eclampsia? why?
delivery, irrespective of stage of pregnancy. As placenta is compromising mother, removing it will solve issue
describe the hormonal factors contributing to fetal growth(3)
IGF, thyroid and insulin promote fetal growth. GnRH not so active
which hormone inhibits fetal growth? what are the implications
glucocorticoids. stressed mother can inhibit fetal growth
which two subtypes of HPV are most likely causes of cervical cancer?
16 and 18
dif b/w early genes and late genes in HPV?
late code for capsid proteins. Early for replication etc..
what are the cytological gradings for HPV?
Low grade squamous intraepithelial lesion (LSIL).
High grade squamous intraepithelial lesion (HSIL)
what is levonorgestrel?
progesterone, older
what is significant about the newer progesterones
anti-androgenic
what is the main MOA of estrogen working as a contraceptive?
inhibits FSH
main MOA of progesterone
make endometrium unfavourable for implantation
and alters cervical mucus to create unfavourable environment for sperm. Also can inhibit LH
main concerning adverse outcome of pill
here is an increased risk of VTE (venous thromboembolism). however risk is minimal - at worst it is the same as for a pregnancy
where does oestrogen act at a receptor level?
nuclear. Sometimes membrane in rapid effect
main use of Tamoxifen? type of drug?
Palliative treatment of metastatic breast cancer. SERM - partial agonist
how do aromatase inhibitors work?
block synthesis of oestrogen from testosterone. Also block the conversion of a pre-testosterone to a dif oestrogen.
what converts testosterone to dihydrotestosterone?
5a reductase
Adverse effects of Androgens? (give 2 for males, 2 for children and 1 for athletes)
Increase LDL & decrease HDL(increase risk of coronary heart disease). Priapism.
Kids = Premature closure of epiphyseal plates or abnormal sexual maturation.
Athletes = Liver damage
what class is Cyproterone? what is its main use
steroidal antagonist for androgens. Prostate cancer
what class is FLumatide? what is it used for
Non-steroidal antagonist. Metatsatic prostate cancer
which tissues in the body have oesteogen receptors(5)?
breast, uterus, bone, CNS, Heart
ovarian epithelium? What is underneath?
simple (squamous or cubdoidal). underneath is tunica albuginea (dense connective tissue).
what stage of meiosis are primordial oocytes arrested?
prophase
describe the myometrium of the uterus
3 layers of smooth muscle. inner and outer longitudinal and middle is circular.
epithelium of endometrium
mix of ciliated and secretory simple columnar
breast milk is high in which antibody?
IgA
when do the mammary glands enlarge in the menstrual cycle? how?
during luteal phase. epithelial cells more columnar, some secretions (lumens appear), fluid accumulates in stroma connective tissue.
epithelium of Seminiferous?
stratified squamous
what 2 cells of significance in tunica (lamina) propria of Seminiferous?
myoid (smooth muscle contractile) and Leydig (
support cells for spermatogenisis
Sertoli
from where is the epididymus derived?
mesonephric duct
role of seminal vesicle
secrete fructose for energy. make sperm alkaline
Differences between euchromatin and heterochromatin?
eu = open, relaxed. Hetero = closed, condesned
what percentage of the human genome is responsible for protein coding seqeunces
1-2%
what does biallelic mean?
gene is expressed from both maternal and paternal copy
Inactivation of genes on the X chromosome and genomic imprinting is mostly determined by epigenetic mechanisms. name them (3)
Histone modifications, DNA methylation and Non-codingRNAs
what is BW syndrome? what is the majority of causes?
Beckwith-Weidemann syndrome is an imprinting disorder linked to imprinted genes on chr 11p15.5.
Majority caused by epimutations on maternal allele.
what are PW syndrom and Angelmann syndrome? what are their causes.
are imprinting disorders linked to imprinted genes on chr 15q. PWS due to deficiency of paternally expressed genes (P or paternal). AS essentially due to a deficiency of maternally expressed genes
• Currently 2 prenatal screening tests in major use are?
what conditions these tests give a risk for? what is measured? when tests are carried out? what other factors are used in providing the risk figure? the cut-off for T21?
First trimester combined screening. Tests for T21 and T18 defect. Blood taken at 10 weeks (measure analytes), ultrasound at 13 weeks. In ultrasound measure neuchal translucency (oedema behind head) and crown rump. other factors are maternal age, weight. Cut off for T21 is 1/300.
Second trimester maternal serum screening. Test for T21, 18 and neural tube defect. Blood taken at 16 week (measure analytes). also use maternal age, weight. Cut of for T21 is 1/250.
NIPT – what is analysed? What technology is used? What can be detected?
Non-Invasive Prenatal Test. Cell free fetal DNA/RNA in maternal blood
Fetal sampling procedures? how they differ?
CVS (Chorionic villus sampling) - 11 weeks, placental tissue, ultrasound, invasive - risk of miscarriage 1%.
Amnio - 15 weeks, amniotic fluid, ultrasound, invasive - risk of miscarriage half of above (.5%). if TOP requested - labour induced.
Differences between balanced and unbalanced translocations?
Translocations can be balanced (in an even exchange of material with no genetic information extra or missing, and ideally full functionality) or unbalanced (where the exchange of chromosome material is unequal resulting in extra or missing genes).
what 4 analytes are measured in 2nd trimester screening?
10 AFP.
Oestriol.
HcG.
Inhibin A.
in 2nd trimester screening what are the analyte results that give an increased risk of T21?
↓ AFP, Oestriol ↓, Hcg↑, Inhibin A↑
Robertsonian translocation?
translocation between two ACROCENTRIC (only) chromosomes (13, 14, 15, 21, 22)
Types testing for chromosomes (3)?
o FISH – fluorescent tags for specific chromosomes, interphase, fast result, looks for aneuploides.
o Karyotype – requires dividing (metaphase) cells, chromosomes stained, aligned and counted, result takes 2 weeks, looks for aneuploides and chromosomal rearrangements (but can’t see microdeletions/microduplications – resolution too low).
o Chromosomal microarray –a molecular test – looks for copy number variation (some also include SNPs) – can detect microdeletions/microduplications because resolution is higher – BUT can also get results of uncertain clinical significance.
First Trimester Combined Screening analytes? (2)
PAPP – Pregnancy associated Plasma Protein,
HcG
in Nuchal Translucency oedema should be less than what?
2mm
define obstetric haemorrhage
major = more than 1500ml blood loss sever = 2500
which extra route of excretion of drugs do pregnant women have?
lactation
2 drugs used in obstetric haemorrhage and 2 other interventions. role of drugs?
oxytocin (contracts uterus smooth mucle) and ergometrine (contracts uterus + vascular smooth muscle.
Also need IV fluid and blood transfusion
drugs used in pre-eclampsia. roles? what is contraindicated and why
Labetalol (controls hypertension) and magnesium sulphate (treats and prevents seizures).
ergometrine is contra (will increase BP)
