KEY FINAL Flashcards
1
Q
steps in spermatogenesis
A
spermatogonia (stem cells) into spermatocytes into spermatids (via 2 meiosis
spermatid matures into spermatozoa
2
Q
OPG vs RANK
A
OPG- osteoblast
RANK- osteoclast
3
Q
ejactulatory center
A
L1-L2 of spine
4
Q
nephritic vs nephrotic
A
nephritic: hematuria, inflamed,
decreased GFR leads to Na and H2O retention into edema and hypertesnion
nephrotic: proteinuria, glomerular filtration damage
decreased GFR, hypo albumin, hyper cholesterol, edema HTN
5
Q
diabetic nephropathy
A
nephrotic
increase pressure, hyperfiltration, hyperglycemia, activate RAAS, up regulate SGLT
6
Q
nephritic vs nephrotic examples
A
nephritic:
post strep/infection
IgA
membranoproliferative
nephrotic:
diabetic
minimal change
focal
membranous
7
Q
volatile vs non volatile acid
A
volatile= breath off; co2, bicarbonate buffer
non-volatile= cant breathe off
8
Q
protein buffers
A
histidine and cysteine AAs
i.e. hemoglobin
9
Q
how to make new bicarboante
A
from glutamine via GNG
10
Q
alpha vs beta intercalated cell
A
A- acidosis, secrete H+
B= alkalosis, secrete HCO3
11
Q
respiratory and metabolic acidosis and alkalosis
A
respiratory acidosis: incerase pCO2 from hypoventilate (i.e. obstructive lung)
–> kidneys will increase H+ excretion to compensate for
metabolic alkalosis: increase HCO3 i.e. diuretics, vomit
12
Q
azotemia
A
decrease GFR; nitrogenous waste
13
Q
pre renal acute kidney injury
A
impaired auto regulation, absolute hypovolemia (i.e diarrhea, hemorrhage) or effective hypovolemia (i.e. decrease cardiac output)
14
Q
chronic kidney disease
A
decrease GFR< leak albumin across filtration barrier; proteinuria
hyperfiltration at healthy nephron’s, others are damaged
enlarge capillaries to incerase blood flow and pressure
15
Q
uremia
A
azotemia and signs and sx of accumulation of metabolic waste (i.e. systemic sx from toxins in the blood)
16
Q
hypertesnion
A
increase SNS from reseting baroreceptors –> vasoconstriction, increase ADH, renin and ATII
Th17 and ILC3 increase vessel wall thickness
17
Q
phased of acute tubular necrosis
A
- initiation: decrease urine, increase BUN
- maintenance: oliguria, Na and H2o overload, metabolic acidosis
- recovery: increase urine, loss of Na K and H2o due to loss of tubular function
18
Q
urolithiasis
A
70% calcium oxalate stones
19
Q
struvite stones
A
from proteus mirabilis –>turn urea into ammonia
make staghorn calculi
basic urine and Mg+ ammonia crystals
20
Q
autosomal dominant polycystic kidney disease
A
polycystic 1 or 2 (ECM)
-calcium channels
21
Q
endosteum vs periosterum
A
end: inner with osteoblast, osteoclasts, osteoprogenitors
peri: outer with blood vessels, type 1 collagen- sharpie fibers
22
Q
osteoblast bound to bone via
A
integrins
23
Q
osteoblast make what that is a layer of collagen
A
osteoid
24
Q
osteoblasts differentiate into
A
osteocytes (trapped in lacunae), some flatten into bone lining cells, others apoptosis
25
osteoclasts make what depression
resorption/howship lacunae
26
woven bone
new, random collagen, low mineral, high osteocytes, 1st in embryo, replace with lamellar bone except skull sutures
27
lamellar bone
remodelled woven bone; layers of lamellae, parallel or concentric around canal
28
compact vs spongy bone
compact/ cortical bone is outer
spongy/ cancellous bone is inner
29
osteon/ Haversian system
central haversian canal with concentric lamallae
canal give o2 and nutrients
canals communication via volkmann canals
lacunae w osteocytes btwn successive lamella, connected by dendrite process
cement line= outer boundary of osteon
interstitial lamallae= parallel lamellae btwn osteons
30
CT compoentns
ground substance, GAGs, laminin, fibronectin, proteoglycans
31
the pluripotent stems cells from embryonic mesenchyme (mesoderm) from what in bone
chondroblasts (cartilage), fibroblasts (collagen), adipocytes, osteoblasts
32
2 types of bone formation
intrammebranous bone formation
endochondral boen frooamtion (cartalige intermediate)
33
intramembranous bone formation
no cartilage intermediate; osteoblasts differentiate from osteoprogenitors in mesenchyme and secrete osteoid
at primary ossification center
form membrane bones; mandible, maxilla, scapula, clavicle (1st bone to ossify), flat bones (frontal and parietal)
34
Endochondral bone formation
cartilage intermidate
35
aldosterone causes less potasssium
reabsorb
more excrete
36
where aldosterone from
adrenal cortex; zona glomerulosa
37
diabetic nephropathy often exhibit increased pressure across the glomerular capillary
Increased sugar in the PCT causes more reabsorption of sodium - this causes an increase in renin release during tubuloglomerular feedback
38
AT II
Angiotensin II constricts the efferent arteriole, increasing glomerular capillary pressure and promoting sodium and water reabsorption in the proximal tubule.
39
which part of nephron to help if have hyperkalemia
Distal convoluted tubule and cortical collecting duct
40
urate nephropathy (uric acid crystals)
gout
41
epiphyseal growth plate function
To facilitate longitudinal bone growth during childhood and adolescence
42
magnesium function
Magnesium acts as a cofactor for vitamin D synthesis, facilitating calcium absorption and bone mineralization
43
key finding in osteogenesis imperfecta
blue sclera
44
osteomalacia
Osteomalacia involves impaired mineralization of osteoid matrix due to vitamin D deficiency or metabolic abnormalities, affecting bone density and strength
45
ich statement accurately describes the relationship between vitamin D synthesis and bone metabolism?
Question 7 Answer
a.
Vitamin D synthesis primarily occurs in the liver and is essential for bone resorption
b.
Vitamin D synthesis is triggered by exposure to ultraviolet (UV) light and is crucial for calcium absorption in the intestines, supporting bone mineralization
c.
Vitamin D deficiency leads to decreased osteoclast activity, resulting in increased bone density
d.
Vitamin D synthesis is independent of dietary intake and primarily regulated by thyroid hormones
b.
Vitamin D synthesis is triggered by exposure to ultraviolet (UV) light and is crucial for calcium absorption in the intestines, supporting bone mineralization
46
vitamin K function
Vitamin K activates osteocalcin, a protein essential for proper bone mineralization
47
how is estrogen still made in menopause
which is low and which isnt
b.
Estrone is the main estrogen produced - it results from the aromatization of androstenedione in the liver
loss of estradiol, slight decrease in estrone
48
irregular bleeding in perimenopause
.
Absence of or infrequent ovulation results in a greater ratio of estrogen to progesterone during perimenopause, which leads to abnormal thickening of the endometrium
49
Maternal levels of sex steroids – estradiol and progesterone – are very high during pregnancy. How is the fetus protected from these high levels of sex steroids during development?
Question 2 Answer
a.
Sex steroids cannot pass through the placental barrier
b.
The placenta degrades all steroid hormones and does not synthesize them – this ensures that no “cross-over” of steroid hormones occurs between maternal and fetal circulations
c.
The fetus rapidly converts these hormones into androstenedione, a weak androgen
d.
Steroid hormones in the fetus are converted to sulfated DHEA (DHEA-S), which has limited biologic activity
d.
Steroid hormones in the fetus are converted to sulfated DHEA (DHEA-S), which has limited biologic activity
50
acrosome
it is a lysosome-like body that aids mucus penetration and fertilization of the oocyte
51
Which of the following sperm cell precursors are diploid?
Question 9 Answer
a.
Spermatogonium
b.
Spermatozoan
c.
Secondary spermatocyte
d.
Spermatid
a.
Spermatogonium
I think the spermatognonia is the first step and then turns into spermatocytes which are haploid
52
Choose the correct description of Sertoli cell activity.
Question 11 Answer
a.
Secrete inhibin, and respond primarily to FSH
b.
Secrete testosterone, and respond primarily to LH
c.
Secrete inhibin, and respond primarily to LH
d.
Secrete testosterone, and respond primarily to FSH
a.
Secrete inhibin, and respond primarily to FSH
53
Where is the histological location of a Leydig cell in the male reproductive tract?
Question 12 Answer
a.
Within the lumen of a seminiferous tubule
b.
Interspersed with the epithelial cells of the epididymis
c.
Superficial to the tunica albuginea but deep to the tunica vaginalis
d.
In the intersitial spaces between seminiferous tubules
d.
In the intersitial spaces between seminiferous tubules
54
endochondral bone formation
cartilage template
core cells --> chondrocytes (make cartilage) --> hypertrophy and calcify
peripheral cells --> fibroblasts
chondroblasts remove dead chondrocytes and form primary marrow cavity --> periosteal blood invasion --> blood vessels
osteoprogenitor deposit on calcified cartilage and turn into osteoblasts
periosteal bone collar; osteoblast on cartilage
55
ossification centers
primary ossification center (diaphysis) and secondary ossification center (epiphysis)
ossification enters enlarge and leave epiphyseal plate
56
epiphyseal palte
chondrocytes divide in proliferative zone
resting zone
zone of hypertrophy
zone of ossification (osteoprogenitors)
57
bone remodelling into secondary bone
osteoclasts erode cartilage
lymphs, nerves, blood vessels invade
osteoblasts
woven --> lamellar bone
58
bone growth; length and girth
length: chondrocytes divide at epiphyseal zone of proliferation via growth hormone
girth: proliferate osteoprogenitors in periosteum inner layer; osteoclasts remove inner and enlarge cavity
59
bone repair
chondrocytes --> callus --> primary bone
periosteum: macrophages and fibroblasts
60
chancroid male UTI cause
haemophilus ducreyi
ulcer--> lymph nodes
61
condyloma latum men UTI
secondary syphilis; treponema pallidum
62
syphilis cause and stages
treponema pallidum
primary; ulcer
secoadnary; rash and lymph
latent;
tertiary; invade CV, CNS
63
lymphogranuloma venereum (male UTI) from and stages
chlamydia trachoma's L1-L3
primary; ulcer
secondary; inguinal or femoral adenopathy
tertiary; lymph
64
epididymtiis vs orchitis
epi: positive prehn's
orch: negative prehn's
65
LUTS sx
storage sx: urgerncy, frequency, nocturia
voiding sx: weak stream, hestistnat, intermitent
post micturition sx: post dribble
66
BPH
transition zone
increase DHT
67
testosterone to DHT via
5 alpha reductase
68
inguinal and femoral hernia
weak ab muscles
69
hydrocele
spermatocele
varicocele
hematoceles
hydro- fluid
sperm- cyst with fluid and sperm
varic- vein; bag of worms
hemat- blood
70
erection SNS vs PNS
PNS: S2-S4; NO cause erection
SNS; T11-L1; NE inhibits erection
71
emission phase of sperm
seminal fluid into urethra
72
seminal fluid compoennts
spermatozoa
fructose (sperm food) and prostaglandins
enzyme, cirtic acid and zinc from prostate
73
muscles for ejaculation
bulbospongiosus muscle (bulb of penis); expel semen
ischiocavernosus muscle (lateral penis); erect and expel semen
74
ejacualtory center
L1-L2
75
peyronies disease
scar tissue in CT; curved penis
76
priapism
prolonger erection
ischemic/low flow or non-ishcmeic/high flow
77
phimosis and paraphimosis
phimosis: non retractable foreskin
para: foreskin trapped behind glans penis; impairs blood flow --> ishcemia and necrosis
78
congenital epispadias and hydrospadias
epi: dorsal urethra
hydro: ventral urthera
79
apenia
megalopenis
micropenis
no penis
big penis; high T
80
testosterone synthesis
from what
where
stimulated by
leydig cells are stimulated by LH'
convert cholesterol into testoesterone via cholesterol side chain cleavage enzyme (P450 scc)
81
meonpause
lose gonadotropin responsive oocytes
remains oocytes unresponsive to gonadotropins
accelerates via smoking
82
hormonal changes in menopause
decrease androstenedione, slight decrease in testosterone
decrease DHEA
decrease estradiol, slight decrease of estrone (but aromzation of androstenedione in fat and liver)
decrease progesterone
increase LH and FSH (lack of negative feedback)
decrease inhibin in granulosa cells; so cant decrease FSH
83
dx menopause
FSH >40
estradiol <75
84
perimenopaise
shorten menstrual cycle via follicular phase (luteal is constant)
estradiol can be high; increase FSH
sometimes anovulatory, occasional corpus luteal formation (low progesterone)
increase risk of endometrial hyperplasia bc unopposed estrogen
85
menopaseu
increase vaginal ph; more infection
trabecular bone (spine, pelvis, femur) in axial skeleton is more metabolically active and impacted by low estrogens
estrogen suppressed RANKl and stimulates OPG so lost in menopause and increase resoption
86
Rankl and opg
osteoblasts RANKL bind RANK on osteoclasts to stimulate osteoclast activity
osteoblast secrete OPG to inhibit RANKL
87
mood in menopasue
estrogen; serotonin
progesterone; GABA
88
hot flush
estrogen withdrawal hypothesis
decrease core body temp and increase pulse
vasodialte and increase persperation
defect in central thermoregualtor; narrow set point via NE, serotonin, LH surge
89
thermoregulatory center in hot flashes
rostral hypothalamus
90
vitamin D
vitamin D2 ergocalciferol from diet
vtiamin D3 cholecalciferol from skin
91
pagets disease of nipple
nipple retract
92
malignant breast carcinoma
homrone
risks and genes
stimulated by estrogen
smoking risk
familial: autosomal dominant BRCA1 and BRCA2 genes
upper outer quadrant
93
fibroadenoma
not malignant, homronal fluctuation
lump in breast
94
fibrocystic breast
apocrine metaplasia cause increase fibrous stroma
cyclic or hormonal fluctuations
95
fat necrosis in breast
hemorrhage, macrophages --> fibrosis and calcify
skin tethering (dimple) mimics carcinoma
96
duct ectasia in breast
menopause
ductal dilation and infalmmation --> fibrosis
thick secretions
nipple retraction (if fibrosis)
97
granulomatous mastitis causes in breast
mycobacteria, parasite, fungi, foreign material
98
periductal mastitis cause
keratin plug, duct obstruction, bacteria
related to smoking cigarrettes
99
acute mastitis in breast
breast feeding and nipple cracks
bacteria; strep or staph
100
menopause breat
TDLY atrophy
more adipose than fibrous tissue
101
pregnancy changes systemica
increase GFR, aldosterone, NA and H2o= edema
increase bronchodilation
increase blood volume
102
partition (childbirth)
prostaglandins; contractions
estrogen to increase oxytocin
oxytocin; contractions positive feedback
103
stages of labour
latent; infrequent contractions
active; full dilation and contraciton
2nd; dilation --> deliver baby
3rd; placenta expulsion
4th; 1 hr postpartum
104
mammogenesis
lactogenesis
galactokinesis
galactopoeisis
mammogenesis; breast develop
lactogenesis; milk produce
galactokinesis; milk eject via oxytocin
galactopoeisis; milk maintenance via prolactin
105
placenta previa
implant placenta over or near cervix in lower uterus
deliver via c section
106
placental abruption
premature detachment of placenta from uterus
107
hypertensive pregnancy
in pre eclampsia the placenta becomes ischemic
impair vasodilation and hyper coagulable
108
pre eclampsia vs eclampsia
pre: hypertesnion, proteinuria, edema
ec: Pre-eclampsia PLUS colvulsions
109
gestational trophoblastic disease
abnormal placental
1. hydratiform mole (molar): abnormal fertilization --> no fetus and need to remove
2. choricocarcinoma: tumor from placental cells i.e from molar prengnay or aborption
110
breast ; which part makes milk
terminal duct lobular unit (TDLU) which increases in luteal phase and has cyclical changes
111
aereola glands
glands of montgomery
--> secrete oily substance, antimicrobial, olfactory cue
no hair or sweat glands
112
ligament in boob
suspensory ligmant/ Cooper ligament
113
vitamin D synthesis
Skin: UVB gets 7-dehydrocholesterol into provitamin D3 --> D3 cholecalciferol
liver: hydroxylation via 25-hydroxylase into 25 hydroxyvitamin D (calcidiol or 25(OH)D)
kidney: hydroxylation via 1-alpha hydroxylase and PTH stimulation into 1,25 dihydroxyvitmain D (calciftriol or 1,25(OH)2D)
114
what is necessary to make vitamin D into calcitriol final step
PTH
115
calcitriol regulation
PTH
serum Ca2+
-->(low ca, stimulate PTH, stimulate 1 -alpha hydroxylase to increase calcitriol)
FGF23
--> (high ca2+ and FGF23 inhibit 1-alpha hydroxylase)
116
what do osteoblasts secrete
osteocalcin and osteopontin to bind ca2+ ions and make hydroxyapatite crystal (ca2+ and PO43-)
117
ca2+ regulation
PTH: low serum Ca2+ stimulates osteoclasts to increase renal reasbob and increase intestinal absrob
calcitonin (OPPOSITE TO PTH): high serum ca2+';; inhibit osteoclasts and increase bone deposition, increase urinary excretion and strop renal tubular reabsorbtion
calcitriol (vit D): increase intestine absorb; promote bone deposition
118
phosphorus impact on bone
helps osteoblast make osteocalcin and osteopontin
high levels inhibit osteoclast
pH buffer
PTH increase serum phosphorus via release from bone and reabsorb from kidneys
119
vitamin K
vitmain k1 phylloquinone from veg
vitmain K2; menoquinone from gut bacteria
120
vitamin K role
carboxylates osteocalcin (from osteoblasts) to make active so can bind Ca2+
121
PTH some role
PTH increase RANKL --> osteoclastogenesis
PTH inhibits osteoclast precursors to mature osteoblast via Runx2 and osterix
PTH alters Wnt signaling (for osteoblast activity)
122
hypoparathyroid vs hyperparathyroid
hypo: decrease bone resorption and turnover; increase BMD but abnormal structure, hypocalcermia
hyper: increase resorption and bone turnover leads to bone loss; hypercalcemia
123
boron roles in bone
increase Ca2+ absorb
collagen synthesis
increase vitamin D conversion
124
silicon roles in bone
collagen
stimulate osteoblats
inhibit collegenase
125
magnesium role in bone
deposit hydroxyapatite crystals
increase osteobalsts
inhibit osteoclasts
126
growth homrone role in bone
chondrocyte proliferation
IGF1 production
increase osteobalsts
127
estrogen in bone
increase osterobalst
decrease osteoclast
128
osteopenia vs osteoporosis
ie. aging decrease T and estrogen
Osteopenia t score: -1 to -2.4
osteoporosis <- 2.5
129
pagets disease of bone
excess breakdown and formation leads to large and weak bones
viral or genetic
increase vascularity (hyperemia)
mix of lamellar and woven bone
neurological and arthritis problems
increase alkaline phosphatase (bone turnover marker)
130
phases of pagets disease of bone
1. osteolytic phase; bone resorption and hypervascularize
2. second phase: form and resorb; replace lamellar with woven bone
3. sclerotic phase: bone resorption decrease adn get hard dense mosaic bone= burnout
131
osteogenesis imperfecta (brittle bone disease)
cause
sx
gene mutation in type I collagen
blue sclera
dentinogenesi imperfevta (weak teeth)
hearing loss
hypermobile joints
pulmonary
CV: collagen in cardiac valves and aortic wall
132
osteomylitis
bone infection
limited ROM, pus, systemic ie. septic arthritis
133
multiple myeloma
cancer affecting plasma cells (make antibodies) --> increase abnormal antibodies and crowd out normal blood cells
farmers, wood workers, petroleum
MM binds CAM in bone and induces cytokines
osteolytic lesions, stimulate osteocalsts
make monoclonal immunoglobulins
anemia, renal dysfunction, hypercalcemia, neurological
134
ankylosing spondylitis
gene?
spine and SI joint are inflamed --> TNFalpha
gene; HLA-B27
abnormal bone formation and fusion --> bamboo spine
135
osteomalacia and rickets
soft and weak bone, decease ca2+ and PO43-
hypocalcemia
vitamin D deficient (inadequate intake, malabsorption, renal disorder)
136
osteomalacia
soft and weak bones increase skeletal deformity and fracture risk
vitamin D deficinet
137
rickets
vitamin D deficient
in kids before epiphyseal fusion, effects growth
138
fracture repair
hematoma forms; rupture vessles
inflammatory phase; TNFa, IL1, IL6, IL11, IL18
granulation tissue formation; stem cells into chondrobalsts (cartilage) and fibroblasts (collagen)
callus formation; apoptosis of cartilage cells, VEGF via osteoblasts to depose bone matrix (osteoid)
bone remodel
139
relaxin
prevent myometrial contraction
via corpus luteum
140
implantation of embryo
pinopods absorb fluid
protease to help blastocyst hatch out of zona pellucida
attach/implant: laminin, fibronectin, glycoproteins
141
predicidualization
changes to stromal cells, mid luteal, prep for implantation
respond to progesterone
stromal --> decidual cells which secrete laminin, fibronectin and glycogen (feed blastocyst)
142
capacitation of sperm
remove surface glycoprotein, increase cholesterol and increase motility
leads to increase membrane fluidity so can travel through fallopian tube
143
what happens during implantation
blastocyst forms and attaches to uterine lining= complete decidualization
adhesion: trophoblasts --> cytotrophoblast --> synctiotrophoblast --> invade endometrial stroma --> secrete hCG to prevent endometrial shedding by maintaining progesterone secretion
144
secrete ____ to prevent endometrial shedding by maintaining progesterone secretion
secrete hCG to prevent endometrial shedding by maintaining progesterone secretion
145
why does fetal hemoglobin have higher affinity to oxygen than materal
2 alpha and 2 gamma chains
reduced affinity for 2,3 DPG
146
hCG
secreted by?
secreted by synctiotrophoblasts
maintain corpus lutteur to keep progesterone and prevent endometrial shedding and contraction
147
hPL (human placental lactose)
fetus uptake glucose and turn to fatty acids and ketones
148
fetus and making hormones and interact with maternal circulation
fetus doesnt synthesize estrogen (lack enzyme)
placental trophoblast make progesterone from LDL cholesterol
no 17-alpha hydroxylase to turn progesterone --> androgens
progesterone into maternal circulation turn into DHEAS then back to placenta and turns into androstenedione and testosterone
placenta has aromatase enzyme to convert testosterone --> estradiol and estrone --> back to maternal
placenta keeps steroid hormons in DHEAS to avoid excess
149
fetus and cortisol
fetus turns pregnenolone and progesterone into cortsiol and then degrade into corticosterone
shield from mom
150
epididymis secretes
H+ for acidification
reservoir for mature sperm
151
seminal vesicle secretes
store and secrete fructose rich product (energy substrate for sperm), prostaglandins, ascorbic acid, fibrinogen and thrombin like proteins
152
prostate secretes
fluid rich in acid phosphatase and protease
PSA prostate specific antigen for dissolution of seminal fluid coagulation after ejactulation
153
bubloburethral (Cowper) glands
secret mucus as lubricant into urethra upon arousal
154
Sertoli cells and leydig cells activated by what
sertoli= FSH
leydgid= LH
155
serotoli cells
activated by FSH
support germ cells in spermatogenesis; give nutrient and growth factors and proteins and hormones; barrier from bloodstream
provide AMH in fetal delveopment to get rid of wolfiann duct and turn into man
156
leydig cells
LH to make testosterone (secreted in circadian rhythm with peak in AM)
give androgenic envo for spermatogenesis
cholesterol --> testosterone (P450 scc) --> DHT (5-a reductase in periphery)
157
germ cells in ball sack
precursors to spermatozoa
158
what homrone regulates spermatogenesis
FSH
159
spermatogenesis
FSH bind and activate sertoli cells
1. spermatogonia --> primary spermatocyte or stay in resting stem cell pool
2. meiosis I= 2 secondary spermatocytes
3. meiosis II= spermatids (haploid; 23 chromosomes)
4. spermatids --> spermatozoa (mature sperm)
5. spermatozoa undergo nuclear condensation, acrosome formation, elongate tail/flagellum and give mitochondria
160
theca cell vs granulosa cell
theca cell:
via LH
cholesterol into progesterone into androgen (via 17 alpha hydroxylase) and into testosterone
--> no aromatase enzyme to make estrogen
granulosa cell:
via FSH
(and LH stimulates progesterone synthesis after ovulation)
- no 17 alpha hydrocualse to turn progesterone into androstenedione
-take the androstenedione and testosterone from tech cell and are aromatase enzyme to turn into estradiol and estrone
161
