Female Repro Flashcards
HPV strains
1-4: Skin warts (verruca vulgaris)
6,11: genital warts (condylomata acuminata)
16,18: cervical, vaginal, vulvar and anal neoplasia –> oncogenisis is attributed to viral proteins E6 (degrades p53) and E7(inhibits retinoblastoma gene product Rb
***koilocytes are histo hallmark sign of HPV infection
Paramesonephric ducts (aka Müllerian ducts)
In females paramesonephric ducts fuse to form the Fallopian tubes, uterus, cervix and upper vagina.
Disruption of fusion can lead to Müllerian tract anomalies and renal anomalies are a common comorbidity.
Incomplete lateral fusion results in bicornuate uterus characterized by indentation of the center of the fundus
Side note: mesonephric ducts (aka Wolffian ducts)
Urogential sinus
Embryo origin of lower vagina
Caudal regression syndrome
Sacral agenesis causing lower extremity paralysis and urinary incontinence. Commonly associated with poorly controlled maternal diabetes
Prolactin during pregnancy
In pregnancy, progesterone is secreted by the corpus luteum and later by the placenta. Although prolactin secretion increases during as pregnancy progresses, high progesterone levels inhibit lactation through negative feedback on prolactin in the ant pit.
Progesterone also inhibits FSH and LH
Unilateral fetal hydronephrosis
Inadequate canalization of the ureteropelvic junction, the connection between the kidney and the ureter
- usually insignificant bc the kidney has a high compliance and accommodate large volume of water
- narrowing or kinking at UPJ causes hydronephrosis
Episiotomy
Vertical incision from the post vaginal opening to the perineal body. Transects the vaginal lining and the submucosal tissue but not the external anal sphincter or the rectal mucosa. Used to enlarge the vaginal outlet to facilitate delivery and reduce the risk of sever perineal laceration
Drug induced ammenorhea
Anti psychotic drugs (ie risperidone) inhibit dopamine D1 and D2 receptors. Blockage of D2 receptor activation results in loss of tonic inhibition of prolactin release –> hyperprolactinemia. Prolactin inhibits the release of GnRH resulting in hypogonadism and ammenorhea
Hypospadias
In males, incomplete fusion of the urethral (urogenital) folds results in abnormal opening of the urethra proximal to the glans penis along the ventral shaft of the penis
Leuprolide
GnRH analog writhe agonist properties when used in a pulsating fashion but antagonist properties when used in a continuous fashion.
Can cause transient rise in LH/FSH upon initial administration
***used for prostate CA which are usually androgen-dependent
Pelvic inflammatory disease (PID)
Most frequently caused by N. Gonorrhea and chalmydia trachomatis. Severe or inadequately treated PID can result in Fallopian tube scarring and infertility. Tx must always include coverage for both organisms w a 3rd gen cephalosporin (ceftriaxone) as well as azithromycin or doxycycline
Urachus
Remnant of the allantois that connects the bladder with the yolk sac during fetal development. Failure of the Urachus to obliterate at birth results in patent Urachus, which can facilitate discharge of urine from the umbilicus.
Small reducible umbilical hernia, minimal clear to straw-colored discharge form the umbilicus and erythema around the area
Lymphangiosarcoma
Persistent lymphedema predisposes to the development of Lymphangiosarcoma, a rare malignant neoplasm of the endothelial lining of the lymphatic channels. Most typically presents 10 yrs after radical mastectomy w axillary LN dissection for breast cancer
Phosphatidylcholine (aka Lecithin)
Component of pulmonary surfactant that is used as a measure of fetal lung maturity. Found in the amniotic fluid and rises after the 3rd trimester at which point mature type 2 pneumoctyes begin secreting surfactant
