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Human Reproduction > Final Exam Lecture > Flashcards

Final Exam Lecture Flashcards

1
Q

hemorrhage

A

severe bleeding

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2
Q

uterine atony

A

uterus does not contract

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3
Q

sepsis

A

widespread infection

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4
Q

placenta accreta

A

placenta grown into uterus

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5
Q

sustainable development goal

A

reduce global MMR to 70 per 100,000 live births

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6
Q

intimate partner violence

A

30% Of women

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7
Q

how many women will have an abortion by the age of 45

A

one in 4 women

27%

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8
Q

How does birth control prevent pregnancy

A

interfere with any step

stop the ovary from growing eggs
stop the egg from leaving the ovary
stop the egg from passing through the tube
stop the sperm from leaving the testess
stop the sperm from entering the uterus
stop a fertilized egg from landing in the uterus

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9
Q

contraception efficacy

A

how well can it work?
ideal/perfect use: method exactly as prescribed
ie: COC’s have efficacy of >99%
failure: 3:1000

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10
Q

contraception effectiveness

A

how well does it work
typical use: what happens in the real world
actual effectiveness of COC is closer to 92%
failure rate= 8%

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11
Q

estrogenic hormonal contraceptives

A

suppress FSH and LH
suppress ovulation
92-98% of cycles
endometrial changes at cellular level

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12
Q

progestinhormonal contraceptives

A

suppress LH
thicken cervical mucus
inhibit capacitation of sperm
endometrial changes

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13
Q

What are the 3 types of emergency contraceptive

A

progestin only pills

ullapristal pills

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14
Q

What are the modes of STD trasmission

A
  1. direct sexual contact
  2. vertical transmission (from infected woman to her fetus)
  3. contact with body fluids
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15
Q

Safe Sex concept

A
  1. know your partner
  2. protection
  3. vaccination
  4. limit sexual partners
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16
Q

Bacterial STDS

A

Chlamydia (most common)
gonorrhea
syphillis

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17
Q

Fungal STDS

A

candida albicans

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18
Q

Viral STDS

A

herpes simplex viruses (HSV-1 and HSV-2)
human papilloma virus
Hepatitis B
HIV

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19
Q

How many new cases of chlamydia each year in the US

A

3 million new cases

reinfection is common

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20
Q

Serovars A to C (chlamydia)
D to K
L1 to L3

A

can cause trachoma of the eyes (blindness)
can cause STI’s that are cervicitis, urethritis
can cause Lymphomogranuloma venereum

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21
Q

what is the leading cause of cervical cancer in women

A

hpv

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22
Q

what are the risks of home births

A 
transportation system
hospital access
inadequate training of attendants
risk selection
inadequate home birth attendant support
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23
Q

Gender dysphoria

A

condition where a person experiences discomfort or distress because there’s a mismatch between their biological sex (or genitalia or sex assigned at birth) and gender identity

must continue for at least 6 mos
desire must be present and verbalized

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24
Q

pros/cons of puberty blockers

A

inhibits sexual development
can prevent suicidal ideation
reduces need for other surgeries
mostly reversible

unknown evidence on bone, cardiac and cognition
loss of fertility
may complicate further surgeries

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25
Q

pros/cons of hormones

A

affirming
“passing”
reduces self-harm

loss of fertility
increased cancer risk
EBM risks unknown
lack of disclosure can cause harm

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26
Q

pros/cons of surgery

A

“whole”
sexual function
procreative gpasl

reversible
surgery risks
healing

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27
Q

infertility

A

not pregnant after 12 months of trying

6 month

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28
Q

How long does it take to get pregnant?

A

after 6 months of trying: 66%
after 12 months: 81%

per first month: 20%
13th month: 3%

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29
Q

ovarian cycle

A 
FSH/Estrogen
primordial follicle meiosis I has been arrested in the primary oocyte inside it 
corpus luteum forms
ovulation occurs 
follicle grows and matures

PROGESTIN
releases secondary oocyte/polar bodies
corpus luteum forms from the remnants of the ruptured follicle
when no pregancy occurs, the corpus luteum degenerates

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30
Q

What hormone stimulates the endometrium to grow?

A

estrogen

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31
Q

what hormone allows the embryo to transplant?

A

progesterone

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32
Q

Ovulation predictor kits

A

predict the LH surges (hormone concentration)

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33
Q

according to menstrual cycle when did ovulation occur?

A

14 days prior from latest period

ovulation (28-day cycle): day 14

ovulation (35-day cycle): day 21

9 days after a period stops

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34
Q

ovarian reserve

A

the graph of the number of eggs as a female ages

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35
Q

Which hormone is produced in the ovary?

A

AMH
produced by the cells that surround the growing eggs
the more eggs, the more cells; the more cells, the higher the AMH level (good)

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36
Q

What causes adhession of fallopian tubes

A

gonorrhea, chlamydia

intestinal or pelvic endometriosis

37
Q

Uterine Myomas

A 
fibroids
30% of women
monoclonal (come from a single abnormal gene)
benign
estrogen responsive

intrmural fibroid
submucosal fibroid
subserosal fibroid

38
Q

what are normal sperm counts?

A

> 1.5 cc volume
contains 15 million sperms per cc
40% motility
4% normal morphology

39
Q

causes of low sperm counts

A

genetic: large or small chromosomal defects
infectious: chlamydia, other assorted bacteria
congenital: absence of the vas deferens
hormonal: low gonadotropins

40
Q

Selective Estrogen Receptor Modulator

A

clomiphene

estradiol

41
Q

clomiphene

A

Blocks estrogen at the level of the brain, tricks the body into thinking there is no estrogen on board
The body responds by trying to make more estrogen
It does this by increasing the output of FSH and LH
First evaluated as a possible oral contraceptive

42
Q

IVF

A

2 weeks of injected hormones
6-7 office visits

  1. egg retrieval
  2. insemination
  3. embryo culture
  4. embryo testing
  5. embryo transfer
43
Q

Why a Elective Single Embryo Transfer

A

the average time so singleton delivery is 40 weeks
the average time for twins is 35 weeks
twins have a 7 times higher rate of Cerebral Palsy
the divorce rate is higher in parents of twins

44
Q

Euploidy

A

normal # of chromosomes

45
Q

Aneuploidy

A

abnormal # of chromosomes
trisomies, monosomies, complex abnormals

embryos from at 34 yo: 40% abnormal
from a 40% yo: 90% are abnormal

most common cause for implantation failure and miscarriage is aneuploidy

46
Q

genetic testing for

A

cystic fibrosis
spinal muscular atrophy
hemoglobinopathies
fragile x syndrome

47
Q

genotyping

A

looking for specific mutations in the gene that are common/known

even if test is negative, theres always a chance to have some rare mutation

48
Q

sequencing

A

when genotyping test is positive, entire sequence of the gene is read for mutations

49
Q

if only one partner is a carrier

A

the baby will not inherit the condition

50
Q

if both are carriers

A

there is a 25% chance of inheriting the condition

51
Q

first trimester combined screening

A

Pregnancy Associated Plasma Protein A ( PAPP-A)
BhCG
Fetal nuchal translucency (NT)
ultrasound

52
Q

Noninvasive Prenatal Test

A

can be performed as early as 9 weeks
tells the chances of the fetus having a chromosomal abnormality
screens for fetal sex
done via a maternal blood sample from the mother’s arm

53
Q

Chorionic Villus Sampling

A

at 10 weeks

1 in 100

54
Q

Amniocentesis

A

at 15 weeks

miscarriage rates: 1 in 300 to 1 in 500

55
Q

PreImplantation Genetic Screening

PGS

A

tests for chromosomal abnormality such as trisomies, monosomies and others

screes for fetal sex

56
Q

Preimplantation Genetic Diagnosis

A

specific genetic diseases

BRCA
Cystic Fibrosis

57
Q

Mosaicism

A

different cells in a single embryo

biopsy is done on the trophoblast

58
Q

CRISPR-CAS9

A

allows you to edit parts of DNA

benefits:

  • target design simplicity
  • efficiency
  • multiple genes simultaneously
59
Q

reproductive toxicology

A

studies the effects of chemicals on the reproductive and neuro-endocrine systems of:

embryo 
fetus
neonate 
child
adult
60
Q

endocrine disruptor

A

exogenous substance/mixture that alters the function of the endocrine system causing adverse heath effects on organism, its progeny, or pop.

they interfere with the sythesis, storage, release, metabolism, transport, elimination or receptor binding of endogenous hormones

61
Q

major effects of endocrine disruptors/

A

females

  • miscarriages
  • cancer
  • irregularities of menstrual cycle
  • infertility

males

  • decrease in sperm count/quality
  • cancer
  • cryptochidism
  • hypospadias
62
Q

chemicals that are ED’s

A 
DES--> SERM (ERa agonist)
BPA--> SERM (ERa agonist)
DDE--> SERM (ERa antagonist)
PCBs/Dioxines--> SERM 
DDT --> SARM (ERa antagonist/ERB agonist)
DEHP--> SARM(ar antagonist)
DBP--> SARM (ar antagonist)
B[a]P--> DNA damage
63
Q

Diethylstilbestrol (DES)

A

synthethic non-steroidal estrogen

DES daughters

  • reproductive tract malformations
  • Cancer
  • endometriosis
  • uterine fibroids
  • ectopic pregnancy

sons

  • urogenital tract abnormalities (epididymal cysts, hypospadias, cryptochoridism)
  • prostate weight
64
Q

DDT used to control malaria/typhus, insecticide/pesticide

A

“Silent Spring”

males:
- Cryptorchidism (undescended testicle)
- Urogenital malformations (including hypospadias)
- Oligospermia (low sperm count)
- Prostate cancer
- Later puberty onset and delayed testicular maturation
females:
- Preterm birth
- Subfertility (difficulty to become pregnant) later in life
- Breast cancer later in life

65
Q

Bisphenol-A (BPA)

A

baby bottles and infant formula packaging

BPA exposure has been linked to increased prostate size, benign prostate hyperplasia (BPH), reduced efficacy of prostate cancer treatment

66
Q

Polychlorinated biphenyls (PCBs)

A 
PCBs exposure was linked to:
Decreased spermatogenesis
Delayed puberty
Reduced fertility
Cancer
67
Q

Dioxins

A

Dioxins are not metabolized and build up primarily in fatty tissues over time, so even small exposures may eventually reach dangerous levels

Developmental abnormalities in the enamel of children’s teeth
Central and peripheral nervous system pathology
Thyroid disorders
Diabetes

Endometriosis
Cancer

68
Q

Phtalates

A

effects on sertoli cells:

In Utero:

  • Decreased anti-Mullerian hormone (AMH)
  • Germ cell death

Prepubertal:
-Dysruption of tight junction proteins

decreasing semen quality and male infertility

69
Q

Teratogens causing detrimental effects during pregnancy

A 
mercury
Lead
Cadmium
Arsenic
PCBs
DDT
Benzene
Carbon tetrachloride
70
Q

Thalidomide

A

used to treat morning sickness

Day 20 of pregnancy caused central brain damage
Day 21 would damage the eyes
Day 22 the ears and face
Day 24 the arms
Day 24-28 leg damage would occur if taken up to day 28

71
Q

NSAIDS

A

could harm the fetal heart by blocking the synthesis of prostaglandins that are required for keeping the ductus arteriosus open in utero

persistent pulmonary hypertension

72
Q

what else

A 
Pseudoephedrine
Guaifenesin
prozac
coffee
alcohol/smoking
drug use 
zika--> microcephaly
73
Q

what is the basis of reproductive aging in women

A

the deterioratin of oocyte folliculogenesis and sex steroid secretion

ovarian follicles are the main source of sex steroids

men do not have the same problem since their sex steroids come from leydig cells

74
Q

age-related ovarian failure stops the secretion of estradiol that maintain the sexual phenotype

A

stops the secretion of estradiol that maintain the sexual phenotype

75
Q

fetal ovary contains

oocyte activation is ongoing from fetal life to the menopause

A

the full store of

oocytes that a women will ever have

76
Q

How do we estimate follicle count (ovarian reserve) in women?

A
  • ultrasound (antral follicle count)
  • anti-mullerian hormone
  • follicle stimulating hormone on third day of menstrual cycle

antral follicle count and AMH are most accurate

77
Q

effects of advanced age on pregnancy

A
  • increased multiple pregnancies
  • increased chromosomal errors
  • increased risk of pregnancy indused hypertension
  • increased risk of gestational diabetes
  • increased risk of thromboelbolism (blot clots)
  • increased risk of preterm birth
78
Q

what causes aging in the oocyte’s nucleus?

A

telomere shortening causes aging which disrupt meiotic spindles

79
Q

telomeres

A

caps to protect chromosome ends

80
Q

what can delay oocyte aging

A

sirtuin agonists
antioxidants
freezing
avoiding smoking

81
Q

menopause

A

1 year without period with lack of ovarian follicular function

estrogen deficiency

natural;surgical

82
Q

from pre to post menopausal women will experience

A

changes in serum estradiol and follicle stimulating hormone a

83
Q

the average age of menopause is

A

51 years old

~2,000,000 women become menopausal annually

84
Q

hot flashes

A

are due to opening of skin blood vessels that causes the sudden feeling of warmth followed by compensatory sweating

kisspeptin/neurokinin

85
Q

KNDY neurons

A

new effectors of steroid hormone action in the brain

86
Q

estrogen is linked to the loss of

A

bone mineral mass–> fractures

(osteopenia/osteoporosis)

prevents cardiovascular disease (leading cause of death in women)

87
Q

morphology

A

compounding factors in human childbirth

88
Q

menopause as an adaptation

A

women become infertile to take care of the last child
stressful on older women
ensures defective eggs are not fertilized

89
Q

mother theory
grandmother theory
nonselection theory

A
  • women are programmed to live 12-15 years beyond the birth of their last child
  • women can provide resources to their grandchildren
  • an artifact of the extension of the life span

Human Reproduction (3 decks)

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