Repro Flashcards
____ and beta HCG bind to the same receptor
LH and hCG have a similar molecular structure and share the same receptors. Injectable hCG causes an LH surge that stimulates ovarian follicular maturation and ovulation and is therefore used to induce ovulation in infertile women
Degarelix
a GnRH antagonist used in adv. prostate cancer
Abiraterone
a CYP17 inhibitor that decreases the formation of testosterone precursors, which reduces the synthesis of androgens in the testes, adrenal glands, and (cancerous) prostate tissue
leuprolide
GnRH agonist used in treatment of adv. prostate cancer (among other indications). Causes initial testosterone flare.
1st line chemo agents for testicular cancer (3)
Bleomycin; Etoposide; Cisplatin
__________typically presents with female external genitalia and male internal genitalia.
androgen insensitivity syndrome
both _______ and _________ present with bloody nipple discharge
intraductal papilloma and papillary carcinoma
upper 1/3 of vagina originates from _____1_ wherease lower 2/3 of vagina originates from___2___
- mullarian ducts
- urogenital sinus
clinical correlate: LN drainage.
top 1/3 goes to iliac nodes
bottom 2/3 goes to inguinal nodes
Each ejaculatory duct is formed by the union of the vas deferens with the duct of the seminal vesicle.
These are ejaculatory ducts.
Each ejaculatory duct is formed by the union of the vas deferens with the duct of the seminal vesicle.
The other opening on the top is the prostatic utricle
name this
rete testis
A network of small tubes in the testicle that helps move sperm cells (male reproductive cells) from the testicle to the epididymis. The epididymis is where the sperm mature and are stored.
which drugs reduce efficacy of oral contraceptives
phenytoin, rifampin, st. johns wart
Rifampin is an inducer of the cytochrome P-450 system, and it causes these enzymes to metabolize drugs such as oral contraceptives at a faster rate.
what voluntary muscles are controlled by the pudendal nerve
The external anal sphincter, along with the external urethral sphincter, levator ani, bulbospongiosus, and ischiocavernosus muscles are motor targets of the pudendal nerve.
the pudendal nerve provides sensory innervation of
Sensory innervation is to the perineum, clitoris, labia, lower vagina, penis, scrotum, and anal canal.
Gestational Age vs Embryonic Age
Length of pregnancy is from the last menstrual period (aka Gestational Age)
Embryonic Age is from time of fertilization i.e. Gestational Age less 2 weeks
list the factors that support the passage of sperm to the ampulla
Sperm transport is aided by contractions of uterus & fallopian tube -stimulated by prostaglandins in seminal fluid and oxytocin from female during orgasm
The cremasteric reflex stimulates contraction of the cremasteric muscle, an extension of the ___________muscle.
internal oblique abdominal
dartos muscle, which creates the rugose (or wrinkled) appearance of the scrotum when contracted, is derived from the __________
superficial fascia.
what is the typical clinical presentation of an Embryonal carcinoma
Embryonal carcinoma is a testicular germ cell tumor described as a hemorrhagic mass with necrosis that is painful. May be associated with elevated hCG and AFP
does adenomyosis cause infertility?
Adenomyosis is endometrial tissue within the myometrium. It is often asymptomatic but may present with menorrhagia, dyspareunia, or dysmenorrhea. However, it does not cause infertility.
Dartos fascia
a continuation of scarpa’s fascia of the abdomina wall –> superficial fascia just underneath the skin. Dartos muscle is reponsible for the rugged appearance of scrotum
what are the layers of the scrotum from outer to inner?
Some Damn Englishman Called It The Testes
use ICE TIE to remember where each part originated from in the abdomen:
Internal spermatic fascia
Cremasteric
external spermatic fascia
came from
Transversalis fascia (NOT the muscle)
Internal oblique
external oblique
what are the classic features of Kartagener syndrome
Kartagener syndrome is an autosomal recessive condition resulting in immotile cilia and subsequent infertility. Kartagener syndrome would also present with situs inversus, conductive hearing loss, recurrent sinusitis, and chronic ear infections.
what is the mechanism of the cremasteric reflex (including what nerves are involved)
The cremaster muscle originates from the internal oblique muscle. The function of the cremaster muscle is to raise and lower the testis for optimal spermatogenesis. The sensory limb of the cremaster reflex is the ilioinguinal nerve (L1 spinal cord level), which supplies the skin of the inner thigh. The motor limb of the reflex is the genitofemoral nerve (also L1). Lightly stroking the inner thigh toward the knee raises the testicle. This is referred to as the cremasteric reflex.
what drug is prescribed for syphilis and what’s the MOA
Penicillin G and related β-lactam antibiotics block cell wall synthesis by inhibiting peptidoglycan cross-linking. Specifically, these drugs inhibit bacterial transpeptidase, a penicillin-binding protein that is required for the formation of the peptide bond that cross-links the glycopeptide polymers to the growing peptidoglycan cell wall.
vasa previa vs placenta previa
Vasa previa refers to the separation of vessels that traverse the amniotic membranes from the placenta, usually occurring between lobes of a multilobed placenta or a velamentous cord insertion. It is a very rare cause of antepartum hemorrhage. Bleeding from vasa previa more commonly occurs during delivery
A 22-year-old man comes to the infertility clinic because he and his wife have been trying to conceive for the past year without success. Three years ago he had an illness marked by fever, and swelling in his face, followed by tender swelling of his testicles. He immigrated from a developing country two years ago and did not receive routine medical care as a child. His breasts are enlarged and mildly tender. The abdominal and perineal examinations are normal. Semen analyses reveal a reduced sperm count, with abnormal morphology and mobility.
What clinical picture is this?
Mumps
The patient’s infertility and abnormal sperm preceded by a febrile illness with scrotal (orchitis) and facial swelling (parotitis) suggest prior mumps infection complicated by primary hypogonadism. This damage to the testes leads to decreased sperm production
The classic histologic finding of an ovarian fibroma is __________________
the presence of collagen-rich, monomorphic spindle cells.
The patient presents with signs of abdominal pain, weight loss, and adnexal fullness. Computed tomography of the abdomen shows bilateral ovarian masses and stomach wall thickening. Biopsy results of the ovarian masses show round, mucin-secreting cells known as “signet-ring” cells. The physician then palpates the supraclavicular lymph nodes
these findings are diagnostic of Krukenberg tumors, indicative of cancer metastases to the ovaries from the stomach. In up to 70% of cases, the primary site of Krukenberg tumors is cancer of the stomach,
Gastric cancer can spread aggressively to lymph nodes and the liver. A classic sign of metastatic gastric cancer is left supraclavicular lymphadenopathy involving the Virchow lymph node.
____is the most common cause of lactational mastitis.
Staph aureus
what is the karyotype of a complete mole
karyotype of 46,XX or 46,XY
what are the contents of the deep perineal pouch
The deep perineal pouch is an anatomic space superior (deep) to the perineal membrane in the urogenital triangle of the perineum, anterior to the transverse line between the ischial tuberosities. it is partly bound on the side by the obturator fascia
Contents:
Deep transverse perineal muscle
external urethral sphincter
Urethrovaginal sphincter, compressor urethrae muscle, dorsal n. of clitoris (female)
membranous urethra, Bulbourethral glands, dorsal n. or penis (male)
conjugata vera
aka obstetrical conjugate or diagnoal conjugate
narrowest point in birth canal, bounded by pubic symphysis and sacral proinence
Which ligament is most helpful to keep the uterus in its normal pelvic place
cardinal ligament, then next the uterosacral I guess? nausheen
urethral crest
the epididymus is continuous with the vas deferense via the
tail of epididymis
what are the coverings of the erectile tissues of the penis?
The corpora cavernosa are the paired erectile tissue that forms the crura of the penis. The two corpora cavernosa fuse and form the dorsal portion of the body of the penis inferior to the pubic symphysis. They are surrounded by a thick capsule called tunica albuginea, which extends inward as a septum in the body of the penis. Intermittent openings in the septum allow these two vascular spaces to communicate.
The corpus spongiosum penis is a single erectile mass surrounded by a tunica albuginea that surrounds the spongy urethra. It expands posteriorly to form the bulb of the penis, which anchors to the perineal membrane.
in addition to the individual coverings, all the erectile tissue is also covered by deep penile fascia (bucks fascia) followed by more superficial colles (aka dartos) fascia (which contains some muscle fibers and is continuous with Scarpa’s fascia of the abdominal wall)
bucks fascia is continuous with the deep perineal fascia and aponeurosis of external oblique
Balanitis xerotica obliterans, also known as ____
lichen sclerosus, are white inflammatory patches that can affect both males and females. In males, the affected areas usually involve the foreskin and penile glans, termed specifically balanitis xerotica obliterans
Koilocytes are pathognomonic of an infection with
human papillomavirus (HPV). Condylomata acuminata, like cervical dysplasia, are caused by an infection with HPV and can therefore present with koilocytes on histopathology. Condylomata acuminata are typically associated with HPV strains 6 and 11.
identify the organ
epididymis
what are those large purple things? (prostate)
Corpora Amylacea - concretions of prostatic fluid in the lumen of some glands in older men.
Often have concentric lamellar appearance.
They gradually increase in number and size with age.
