Repro Flashcards
Role of sonic hedgehog gene
ant/post axis of limbs
mutation can cause holoprosencephaly
Role of Wnt-7 gene
dorsal/ventral axis of limbs
Role of FGF gene
mitosis of mesoderm
lengthening of limbs
Role of Homeobox genes
craniocaudal direction of embryo organization
mutations cause limbs in wronge locations
Week of gastrulation of embryo
week 3
becomes 3 layers
Teratogen timeframe susceptibility
weeks 3-8
Surface ectoderm development
adenohypophysis
lens of eye
sensory organs of ear and olfactory
parotid, sweat, mammary glands
Neuorectoderm development
neurohypophysis/brain
retina
optic nerve
spinal cord
Neural crest development
PNS chromaffin cells in adrenals parafollicular cells in thyroid bones of skull Aorticopulmonary septum nucleus pulposus
Teratogenicity of aminoglycosides
CN VIII toxicity
Teratogenicity of Diethylstilbrestrol
clear cell adenocarcinoma of vagina
Teratogenicity of Lithium
Ebstein anomaly
Teratogenicity of phenytoin
hydantoin syndrome
hypoplastic nails/fingers
microcephaly
Teratogenicity of thalidomide
limb defects/flapper limbs
Pregnancy risk with cocaine
placental abruption
Pregnancy risk with smoking
ADHD
Risk with maternal diabetes in pregnancy
congenital heart defects
neural tube defects
Excess Vit A risk with pregnancy
spontaneous abortion
Cause of dichorionic/diamniotic twins
Splitting of 2 cell stage (0-4 days)
Cause of Monochorionic/diamniotic twins
Splitting of morula
Cause of monochorionic/monoamniotic twins
Splitting of blastocyst
Role of syncytiotrophoblasts
secrete hCG (maintains pregnancy via corpus luteum)
Umbilical structure components
2 arteries (from internal iliacs) 1 vein (placenta to fetus) all 3 derived from allantois
Urachal duct
between bladder and yolk sac
Vitelline duct
between midgut and yolk sac
1st aortic arch
maxillary artery
2nd aortic arch
stapedial/hyoid arteries
3rd aortic arch
common carotid and internal carotids
4th aortic arch
aortic arch and R subclavian
6th aortic arch
pulmonary arteries and ductus arteriosus
Branchial apparatus components
clefts-ectoderm
arches-mesoderm
pouches-endoderm
1st branchial cleft
external auditory meatus
1st branchial arch
mandible/malleus/incus
muscles of mastication
CN V2 and V3
Abnormality of 1st branchial arch
Treacher collins
mandibular hypoplasia
abn facies
2nd branchial arch
Stapes/styloid/less horn of hyoid
steapdeius/stylohyoid/post digastric
CN VII
3rd branchial arch
greater horn of hyoid
stylopharyngeus
CN IX
4th-6th branchial arch
thyroid/cricoid/artenoid/corniculate/cuneiform
larynx muscles (except cricothyroid)
CN X
1st branchial pouch
middle ear/mastoid air cells
2nd branchial pouch
palatine tonsils
3rd branchial pouch
inf parathyroids/thymus
4th branchial pouch
superior parathyroids
MEN 2A
RET mutation (of neural crests cells)
pheochromocytoma
parathyroid tumor-3rd/4th pouch
parafollicular cell tumor (medullary thyroid)-4th/5th pouch
Genital embryology of males
SRY gene makes Sertoli cells secrete MIF
suppresses paramesonephric duct development
Leydig cells make androgens to develop mesonephric duct
Development of paramesonephric duct
fallopian tubes
uterus
upper vagina
Development of mesonephric duct
seminal vesicles
epidiymis
ejaculatory duct
ductus deferens
Cause of bicornuate uterus
incomplete fusion of paramesonephric ducts
Impact of 5alph-reductase deficiency
ambiguous ext genitalia until puberty
Lymph drainage of testes/ovaries
para-aortic LN
Lymph drainage of vagina/scrotum
superifical inguinal LN
Lymph drainage of uterus
external iliac LN
Contents of suspensory ligament of ovaries
ovarian vessels
ureter at risk when vessels ligated
Contents of cardinal ligament
uterine vessels
Contents of round ligament of uterus
artery of Sampson
acts as anastamosis b/t ovarian and uterine arteries
Pathway of sperm during ejaculation
SEVEn UP Seminiferous tubules Epididymis Vas deferens Ejaculatory ducts Urethra Penis
Function of Sertoli cells
stimulated by FSH produce ABP (maintains high local testosterone) produce inhibin (inhibits FSH) tight junctions protect developing sperm regulate spermatogenesis make MIF
Function of Leydig cells
stimulated by LH
secrete testosterone
unaffected by temp (Sertoli are)
Spermatogenesis
in seminiferous tubules make spermatids (1N) that under spermiogenesis
Drug inhibiting 5alpha-reductase
finasteride
Enzyme converting testosterone to estrogen
aromatase
Impact of estrogen
inhibition of FSH/LH and LH surge
SHBG production
increase HDL, decrease LDL
Tanner stages of development
1-childhood 2-pubic hair and breast buds 3-breast/penis enlargement 4-increase penis width, development of glans, raised areolae 5-adult, areolae not raised
Mittelschmerz
ruptured follicle causes peritoneal irritation
mimics appendicitis
Oogenesis
complete meiosis 1 prior to ovulation (in fetus)
meiosis 1 arrested in prophase I until ovulation
meiosis II arrested in metaphase II until fertilization
Hormones in menopause
increased FSH
decreased estrogen
Klinefelter’s syndrome
XXY
increased FSH/LH/estrogen
dysgenesis of seminiferous tubules
Turner syndrome
XO
decreased estrogen
increased FSH/LH
webbing of neck/coarctation of aorta/horseshoe kidney
Androgen insensitivity
androgen receptors not working XY phenotypic female intraabdominal testes increased testosterones/estrogen/LH
Kallman syndrome
GnRH cells and olfacotry bulb fails to migrate
decreased GnRH/FSH/LH
anosmia
lack secondary sexual characteristics
Complete Hydatidiform mole
cluster of grapes/honeycombed uterus
choriocarcinoma precursor
46 XX or XY
snowstorm appearance
Incomplete hydatidiform mole
69 XXX, XXY, or XYY
lower risk of maligancy
Sx of abruptio placentae
painful bleeding in pregnancy 3rd trimester
assc with DIC/cocaine/HTN
Sx of placenta previa
painless bleeding in any trimester
Ectopic pregnancy histo
decidualized endometrium
no chorionic villi
Cervical cancers characteristics
assc with HPV 16 and 18 koilocytic changes (raisin like nuclei) E6 binds p53 E7 binds Rb grows in basal layer
Tx for endometritis
gentamycin and clindamycin
w/ or w/o ampicillin
Endometriosis
cyclic bleeding assc with stage of menstrual cycle
chocolate cyst of ovary (due to hemorrhage)
Normal sized uterus
Adenomyosis
endometrial tissue within the myometrium
tx is hysterectomy
Endometrial carcinoma
55-65 y/o
risk with unopposed estrogen/endometrial hyperplasia/nullparity/DM/obesity
Leiomyoma of uterus
fibroid
estrogen sensitive (shrinks with menopause)
20-40 y/o
Whorled pattern of smooth muscle
Leiomyosarcoma of uterus
bulky, irregular tumor
hemorrhage and necrosis
arises de novo
Polycystic ovarian syndrome
increased LH production
anovulation/no progesterone
increased testosterone and estrogen (due to theca cells)
assc with diabetes
Ovarian dysgerminoma
sheets of uniform cells
assc with Turner syndrome
increased nCG and LDH
Choriocarcinoma
trophoblastic tissue tumor
increased hCG
no chorionic villi present
Yolk sac tumor
endodermal sinus tumor
young children
Schiller-Duval bodies (looks like glomeruli)
increased AFP and A1AT
Struma ovarii
teratoma with functional thyroid tissue
Serous cystadenocarcinoma of ovary
psammoma bodies
bilateral and malignant
Risk with ovarian mucinous cystadenocarcinoma
pseudomyxoma peritonei
accumulation of mucus in peritoneum
Brenner tumor
in ovary
transitional epithelium (normally in bladder)
yellow tan color
coffee bean nuclei
Risk with fibroma of ovary
Meigs syndrome-ascites and hydrothorax
Granulosa cell tumor of ovary
secretes estrogen
precocious puberty
Call Exner bodies
Krukenberg tumor
bilateral GI mets to ovaries
signet cells
Sarcoma botryoides
less than 5 y/o
desmin positive
grapes-like protrusions from vagina
Breast fibroadenoma
firm, mobile mass
changes size with changes in estrogen
Phyllodes tumor of breast
6th decade
leaf life projections
lg and bulky
Invasive ductal tumor of breast
rock hard
stellate morpholgy
worst prognosis
Invasive lobular tumor of breast
row of cells (Indian file)
Paget’s disease of breast
eczematous patch on nipple
lg cells with clear halos
suggestive of underlying cancer
Benign prostatic hypertrophy
over 50 y/o
lateral and middle lobes enlarged
increased PSA
tx with a1 blockers or finesteride
Result of crytorchidism
impaired spermatogenesis (due to Sertoli cells temp sensative) normal testosterone (Leydig cells not impacted)
Seminoma
homogenous testicular enlargement
fried egg appearance
increased PLAP
painless
Yolk sac tumor of testes
Schiller Duval bodies
increased AFP and A1AT
yellow, mucinous
Leydig cell tumor
contain Reinke crystals
precocious puberty in boys
golden brown color
Leuprolide
GnRH analog
infertility, use pulsatile
prostate cancer, use continuous
Finasteride
5alpha-reductase inhibitor
used in BPH
Flutamide
inhibitor of testosterone
Ketoconazole
inihibits 17,20-desmolase
inhibits steroid synthesis
for PCOS
Spironolactone
inhibits steroid binding
for PCOS
Clomiphene
estrogen agonist at hypothalamus
increased LH and FSH release
for ovulation
Tamoxifen
breast tissue antagonist
tx and prevent breast cancer
Raloxifene
estrogen agonist on bone
for osteoporosis
Mifepristone
inhibitor of progestins
for abortion
used with misoprostol
Terbutaline
beta 2 agonist to relax uterus
Tamsulosin
alpha 1 agonist for BPH
Danazol
agonist at androgen receptors
for endometriosis and hereditary angioedema
