Intro lecture

Question 1

What is the difference between blastogenesis and organogenesis?

Answer 1

Blastogenesis- first month, basic structure of the body

Organogenesis- later in pregnancy

Question 2

What can cause problems in embryology?

Answer 2

Chromosomal
Infections
Medications

Question 3

What are the eponymous names of Trisomy 21, 18, 13 and 47XXY, Monosomy X?

Answer 3

Trisomy 21- Downs

Trisomy 18- Edwards (Eighteen Edwards)

Trisomy 13- Pataus

47 XXY- Klinefelters

Monosomy X- Turners

Question 4

What is the difference between placenta accreta, praevia, percreta and increta?

Answer 4

Placenta Accreta- Endometrium but not myometrium- A for Attached to endometrium

Placenta Praevia- Over the cervical Os

Placenta Percreta- Through uterine serosa into abdomen- ‘per ‘ = through

Placenta Increta- Through endometrium and myometrium- ‘In’ = into myometrium

Question 5

What is the difference between the metanephros, pronephros and mesonephros?

Answer 5

Metanephros- Deformity results in renal agenesis (structure exists at 5 weeks and higher than mesonephros- Causes permanent and functional kidney area and comes from mesoderm)

Mesonephros- Early excretory function, more caudal, gone by wk8 unless male (Vas Deferens)

Pronephros- Pronephros is the most basic of the three excretory organs that develop in vertebrates, corresponding to the first stage of kidney development. It is succeeded by the mesonephros.

Question 6

What causes bicornate uterus or CBAVD?

Answer 6

Failure of Mullerian Duct fusion causes a bicornate uterus

Mesonephric and Wolffian duct issue causes CBAVD (Congenital Bilateral Absence of Vas Deferens)

Question 7

How do Mesonephric duct and Wolffian duct degenerate?

Answer 7

Mesonephric duct (mesoderm)

Tubules develop from mesoderm which have an excretory function in wk 4-8

Tubules degenerates and not related to excretory function and is then related to male reproductive organs

Wolffian Duct- Male external genitalia, Testosterone stabilises this duct, degenerates in females

Question 8

What do Allantoic duct, ductus arteriosus, ductus venosus, umbilical vein and umbilical artery become?

Answer 8

Allantoic duct- Median Umbilical ligament- becomes umbilical cord (becomes surrounded by mesoderm)

Ductus Arteriosus - Ligamentum arteriosum

Ductus Venosus - Ligamentum venosum

Umbilical Vein- Ligamentum Teres

Umbilical Arteries

Question 9

How does the blood in the umbilical vein and artery flow?

Answer 9

Umbilical vein- Away from mum, towards baby

Umbilical artery- Away from baby, towards mum

Question 10

12yo female presents to ED with severe acute pelvic pain. She has been getting worsening monthly discomfort for the last 3 months. Likely diagnosis?

Answer 10

Imperforate Hymen- congenital abnormality- increased tissue around vaginal introitus (opening)- menstrual buildup of blood causes severe acute pain

Question 11

19yo pregnant patient presents with severe vomiting and a “large for dates” uterus. Ultrasound shows a “snowstorm” appearance. What is the karyotype?

Answer 11

46XX

Molar- duplication of genetic material

Complete mole- Empty Ovum, sperm fertilises, duplicates sperm material with no maternal genes

Partial mole- 2 sperm that fertilise ovum

Question 12

Which layers are cut through during a C section?

Answer 12

Skin

Campers fascia (fatty layer)

Scarpas fascia (deep membranous)

Rectus sheath

Rectus Muscle

Parietal peritoneum

Visceral peritoneum

Uterus

(NB: Below the arcuate line there is no posterior rectus sheath)

Question 13

What is the posterior corner of the perineal diamond/anal triangle?

Answer 13

Coccyx

Question 14

What are the parts of the perineal triangle?

Answer 14

Lateral: Inferior pubic rami and inferior ischial rami

Roof: Pelvic floor

Floor: Skin

Anteriorly: Pubic symphysis

Anal triangle: posterior diamond
Urogenital triangle: Anterior diamond

Question 15

What are the muscles of the levator ani?

Answer 15

Iliococcygeus

Puborectalis

Pubococcygeus

Question 16

Which muscle nearby is not part of the levator ani?

Answer 16

Coccygeus

Question 17

What is Herniation of bladder through levator hiatus?

Answer 17

Cystocoele

Question 18

Which hormones does NOT peak around day 14 of the menstrual cycle?

Answer 18

Progesterone

Oestrogen prepares endometrium, FSH is reduced when Oestrogen is high (Developed ovum), LH surges to cause ovulation and results in corpus luteum from follicle

Corpus luteum produces oestrogen and progesterone, progesterone maintains lining of endometrium

Death of corpus luteum and progesterone reduces and period happens

Question 19

What is the correct sequence of structures responsible for producing progesterone during pregnancy?

Answer 19

Corpus luteum -> Placenta

Question 20

What is menopause?

Answer 20

Menopause: >1 year cessation of periods

Ave age 51

Early if <40y

Question 21

23yo patient has oligomenorrhoea, excessive hair growth and high BMI. Irregular menstrual cycles since menarche (14yo) and FHx of diabetes. Diagnosis?

Answer 21

PCOS

Question 22

31 weeks pregnant, presents with painless PV bleeding. On USS, the placenta is adherent to the endometrium and implanted over cervical os. Diagnosis?

Answer 22

Placenta Praevia

Question 23

What problem is most likely associated with a patent foramen ovale?

Answer 23

Stroke- due to communication through atria with clotted blood in DVT etc.

Question 24

When does a foramen ovale close?

Answer 24

Up to 6 months after birth

Question 25

In which circumstance would an episiotomy be appropriate?

If the mother had one in a previous delivery

If the baby is known to be macrosomic

Prior to instrumental delivery

After tearing of the perineal body

Answer 25

Prior to instrumental delivery

Question 26

What is blue baby syndrome?

Answer 26

Infant methemoglobinemia is also called “blue baby syndrome.” It is a condition where a baby’s skin turns blue. This happens when there is not enough oxygen in the blood. Methemoglobinemia is a condition that some babies are born with (congenital) or some develop early in life (acquired).

Question 27

Which hormone is responsible for preparing the endometrial lining for implantation and secondary sexual characteristics?

Answer 27

Oestradiol