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PPE > Repro 2 > Flashcards

Repro 2 Flashcards

1
Q

Give histology of cortex of ovary

A

primordial follicles contained

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2
Q

what is a primordial follicle

A

oocyte surrounded by single layer of squamous granulosa cells

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3
Q

state the changes that occur to oocyte from pprimordial follicle to tertiary follicle

A

pimary follicle - ZP forms. Granulosa becomes cuboid
2 follicle - stroma like theca cells recruitied, become theca exerna + interna. Increased number of granulosa cell and antrum forms between granulosa
3 follicle - theca interna expresses LH receptors and produces oestrogen. Granulosa cells become corona radiata and cumulus oophorus.

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4
Q

what is the cumulus oophorus

A

bridge of cells between granulosa cells and oocyte

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5
Q

what is layers of cells surrounding oocyte med to lat

A

oocyte surrounded by ZP surrounded by corona radiata surrounding cumulus oophorus

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6
Q

what happens to follicle after ovulation

A

GC become granulosa lutein cells, secrete prog

theca interna becomes theca lutein, secrete oest

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7
Q

what is corpus albicans

A

fibrosed corpus luteum after death

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8
Q

what are layers of uterus

A

endometrium - stratum functionalis (coiled arteries) and stratum basalis (straight arteries)
myometrium - 4 smooth musc layers

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9
Q

what are the stages of endomterial growth and what happens in each

A

proliferative - SF grows, glands coil
secretory - max thickness. Predecidual cells develop
menses - if no implantation > decreased prog > shedding

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10
Q

what type of cells are found in the endocervical canal and in vagina. what is transformation zone

A

canal - columnar
vag - strat squamous
transformation zone - columnar becomes strat squamous

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11
Q

what is the histology of vag

A

stratified squamous. No glands. mucosa, SM, muscular (smooth and skeletal)
lots of glycoproteins esp with oestrogen

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12
Q

give duct anatomy inside breast. what surrounds ducts

A

nip > lactiferous duct > major duct > minor duct > lobules

surrounded by adipose and stroma

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13
Q

how many lobules per breast

A

15-20

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14
Q

how does breasts change during puberty

A

lactiferous ducts develop and adipose deposited

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15
Q

what is outer layer of testes and ovary called

A

tunica albuginea

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16
Q

histology of testes

A

SF tubules contain sertoli cells (spermatogenesis). surrounding tubules is leydig cells (testost) and CT.

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17
Q

what connects SF tubule to rete testis

A

straight tubule

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18
Q

what epithelia is straight ST tubule and rete testis

A

both simple cuboidal

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19
Q

what connects rete testis to epididymis

A

efferent duct

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20
Q

epithelia of vas deferens

A

pseudostratified

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21
Q

histology of seminal vesicles

A

coiled glands and pseudostratified

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22
Q

what is primary sexual characteristic

A

develops before birth

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23
Q

what is order of development during female puberty

A

thelarche, adrenarche, growth, menarche, pubes, breasts

TAG

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24
Q

order of development during male puberty

A

GAS

gonad development, adrenarche, spermatogenesis, growth, genitalia, pubes

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25
Q

what causes puberty

A

GnRH from hypo

47kg weight in females

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26
Q

what causes pubic hair, libido, male genitalia, and breasts to develop

A

pubic hair and libido - androgens
male genitalia - test
breasts - oestrogen

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27
Q

what occurs in premenopause

A

decrease fertility, early/absent ovulation, decrease oestrogen and inhibin therefore increase LH and FSH (more FSH)

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28
Q

what happens in menopause

A

skin and bladder changes, hot flushes, osteoporosis, breast involution, loss vaginal rugae

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29
Q

how treat menopause and negative effects of treatment

A

HRT

-ves - DVT, breast cancer, stroke, PE, depression

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30
Q

define primary amenorrhoea

A

absence of menarche by 14 without SSC or 16 with SSC

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31
Q

define secondary amenorrhoea

A

no menses for 3 months if regular cycle or 9 months if irregular

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32
Q

primary amenorrhoea (PA) outflow tract causes

A

imperforate hymen, vaginal atresia

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33
Q

SA outflow tract causes

A

trauma, intrauterine adhesions

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34
Q

PA gonad causes

A

androgen insensitivity, gonad dysgenesis (e.g. turners)

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35
Q

SA gonad causes

A

menopause, pregnancy, PCOS

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36
Q

hypo/pit causes of PA

A

kallman syndrome

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37
Q

hypo/pit causes of SA

A

stress, sheehan syndrome (necrosis of pit due to excessive blood loss during childbirth), anorexia

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38
Q

define menorrhagia, causes and treat

A

> 80 ml bleeding or >7 days of menses
causes - PID, cancer, anovulation
treat - USS, hormones

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39
Q

define DUB, causes, pathology, treatment

A

heavy frequrent or prolonged bleeding with no obvious cause. anovulatory. NOT RELATED TO MENSES
cause - PCOS, extremes of life
pathology - No prog. Endometrium builds up continually and self sheds with erratic bleeding
manage - (prog) OCP, tamoxifen (block oest), iron

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40
Q

define dysmenorrhoea, oligomenorrhoea, premenstrual syndrome, mastalgia

A

mastalgia - boob pain
dysmenorrhoea - painful periods
oligomenorrhoea - >35 day cycle
premenstrual syndrome - physical and emotional symptoms 1-2 weeks before menses

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41
Q

give hormones secreted by ant pit and the type of hormone and cell that secretes

A

glycopeptide:
gonadotrophs - FSH and LH
thyrotrophs - TSH

polypeptide:
somatotrophs - GH
lactotrophs - prolactin
corticotrophs - ACTH

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42
Q

horomones secreted by post pit

A

oxytocin, adh

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43
Q

what does ovaries secrete horomones

A

oest, prog, test, inhibin

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44
Q

how does hypothalamus secrete GnRH and where does it go. what inhibits

A

pulsatile (once per hour) into hypophyseal portal circulation
inhibited by oest and inhibin

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45
Q

how does fsh and lh act on males and females

A

males:
fsh acts on sertoli - spermatogenesis and inhibin
lh acts on leydig - testosterone

females :
fsh acts on granulosa cells
lh acts on theca interna

46
Q

during menstrual cycle explain following hormones - oest, prog, fsh, lh

A

oestrogen - rises slowly then peaks just before lh surge. rises again with CL and then regresses post death
prog - low then rises with CL and peaks
FSH - rise in first few days then down, then peak with LH surge and down after
LH - peaks at ovulation (day 14)

47
Q

effects of estrogen on female repro

A

thickens endometrium, thin alkaline mucus at cervix, vaginal changes (thicker, elastic, glycogen)

48
Q

prog effects on female repro

A

thick acid mucus at cervix, secretory phase of endometrium, breast tissue changes

49
Q

where does PGC originate and go

A

PGC start in yolk sac > dorsal mesentery > gonads

50
Q

what happens to mesonephric and paramesonephric duct in males? what is meso and PMN aka?

A

meso - wolffian
PMN - mullerian
mesonephric duct stays due to SRY genes on Y chromosome. PMN goes due to mullerian inhibited hormone. meso duct becomes SEED - seminal vesicles, epididymis, ejaculatory duct, ductus deferens

51
Q

what happens to mesonephric and paramesonephric duct in females?

A

PMN fuses and forms uterus and vag.

52
Q

describe what happens to indifferent genitalia to become male / female

A

influenced by testosterone
genital tubercle - clit / glans
genital fold - labia minora / spongy urethra + scrotal raphe
genital swelling - labia majora / scrotum

53
Q

describe descent of testes and ovaries

A

gubernaculum pulls testes through inguinal canal. pulls ovaries to pelvi

54
Q

what is hypospadias

A

incomplete fusion of urethral folds

55
Q

difference uterus didelphys and bicornuate uterus

A

didelphys - 2 uteri horns and 2 cervixes

bicornuate - 2 uteri horns only

56
Q

what is spermatogenic wave and cycle

A

cycle - development time from spermatogona to sperm

wave - distance between 2 areas in same part of cycle

57
Q

describe spermatogenesis

A

spermatogonia > spermatocyte > spermatid > sperm

58
Q

how are ovum produced

A

PGC enter ovarian cortex. meiosis halted at primary oocytes then continue to primordial follicles in puberty

59
Q

define spontaneous abortion, preterm labour, and term labour

A

spont abortion -

60
Q

what are 3 stages of labour

A

birth canal widening > fetal expulsion > plactena expulsion

61
Q

what is fetal lie and presentation

A

lie - transvers or longitudinal (usually long)

presentation - cephalic (head) or breach (feet)

62
Q

what happens in cervical ripening? triggered by…

A

trig by prostaglandins

decrease collagen and aggregation. increase GAGs

63
Q

what happens to female repro organs during labour. what hormone released

A

cervical ripening. brachystasis (myometrium contracts more than relaxes). cervical thinning and flattening. oxytocin release

64
Q

what are early and late cotnractions during pregnancy like

A

early - not felt, every 30 mins

late - braxton hicks. less freq but increase amplitude

65
Q

how are myometrial contractions made more forceful

A

prostaglandins and oxytocin (ferguson reflex, +ve feedback)

66
Q

describe baby expulsion

A

starts longitudinally + cephalic > uterus contracts and head flexes and rotates > vag and perineum stretch due to head (risk tear) > head delivers > shoulders rotate and deliver > rest follows

67
Q

how does uterus prevent post partum hemorrhage. what can be given to help

A

uterus clamps down. oxytocin given.

68
Q

how does adult circulation take place in fetus

A

fetus takes first breath due to trauma and cold > decreased pulmonary resistances and increase arterial pO2 > FO and DA closing

69
Q

what does relaxin do

A

relaxes pelvic ligaments for delivery

70
Q

what are 4 types of hips and briefly describe

A

gynecoid - wide
anthropoid - narrow transverse, wide AP
android - narrow
platypeloid - narrow AP. wide pelvic outlet

71
Q

what are the head and breach presentation types

A

head - vertex, sinciput, brow, face

breach - front (feet by head), full (cross legs), single footing

72
Q

what instruments can be used to aid deliveruy

A

forceps, ventouse (vacuum)

73
Q

what happens to breasts during pregnancy

A

lobule and ducts hypertrophy and differentiate to produce milk

74
Q

give properties of milk soon after birth and what its called

A

colostrum - high IgG and protein, some water fat and sugars

75
Q

give properties of milk 2 weeks after birth

A

90% water, rest sugar, fas, protein (lactalbumin and lactoglobin), vit and minerals

76
Q

how is milk produced

A

suckling (neuroendocrine reflex). let down reflex (oxytocin). promoted by decreased prog and oest post birth

77
Q

benefits of breast feedin

A

bonding and babies reduce risk of infection

78
Q

what happens to breasts with age

A

breast stroma replaced with adipose

79
Q

physical properties of bresat carcinoma

A

hard, craggy and fixed breast lump

80
Q

what breast pathology would suggest endocrine disorder

A

milk discharge from nip

81
Q

what are the types of benign and malignant breast tumours and briefly explain properties

A

benign:

fibroadenoma - small and mobile. stroma tumour.

82
Q

give 2 breast development disorders

A

milk line remnants - extra nips

accessory axillary breast tissue

83
Q

symptoms, cause and treatment of acute mastitis of breast

A

staph aureus. red skin, pain, fever. antibiotics and let milk down

84
Q

what is duct ectasia

A

blocked lactiferous duct. green discharge

85
Q

what is atypical ductal hyperplasia

A

hyperplasia of 1-2 ducts. increase carcinoma risk

86
Q

what is symptoms of breast papiloma

A

ductal papilloma. increases risk of carcinma. poss nip discharge +/- blood

87
Q

give causes of gyno

A

liver cirrhosis, spironolactone, klinefelters, obesity

88
Q

breast cancer risk factors

A

age, breast feeding (decrease risk), HRT, obesity, COCP, genetics

89
Q

what types of breast carcinoma are there

A

in situ/invasive and ductal/lobar

90
Q

symptoms of pagets disease of breast

A

eczematous nip. malignant

91
Q

why peau d’orange

A

loss of lymph drainage due to malignancy

92
Q

how diagnose BC

A

mammography, USS, FNAC, biopsy, history and exam

93
Q

when is tamoxifen and Herceptin used

A

tamoxifen - if breast cancer is oestrogen receptor +ve

herceptin - Her 2 +ve BC

94
Q

what tumours metastasise to bone?

A

PB-KTL (lead kettle)

prostate, breast, kidney, thyroid, lung

95
Q

what tumours metastasise to liver

A

Cancer Sometimes Penetrates Benign Liver

Colon > stomach > pancreas > breast > lung

96
Q

what tumours metastasie to brain

A

cancer - Some Love Killing Brain Glia

skin, lungs, kidney, breast, GI

97
Q

what tumours metastise to lungs

A

Real Hardcore Cancers Fill Both My lungs

RCC, hepatocellular carcinoma, choriocarcinoma, follicular thyroid carcinoma, breast, melanoma

98
Q

cause of cervical cancer and risk factors

A

caused by HPV 16 and 18

RF - smoking, OCP, immunosuppression

99
Q

when does cervical screening occur

A

25+ yrs every 3 yrs and then every 5 50+

100
Q

What is CIN and how treat. is it malignant

A

cervical intraepithelial neoplasia
treat CIN 1 - cryotherapy
3 - excision

CIN is premalignant

101
Q

where does cervical carcninoma spread

A

locally - rectum, vag, bladder

102
Q

how treat cervical carcinoma

A

microinvasive - excision

if malignant - hysterectomy, lymph dissection, radio and chemo

103
Q

what happens in endometrial hyperplasia

A

increased gland:stroma ratio, increased risk of cancer.

104
Q

what is symptom of endometrial adenocarcinoma. what 2 types

A

post menopausal bleeding
endometrioid - invades myometrium
serous - aggressive, spreads to peritoneum

105
Q

name a myometrial tumour and symptoms

A

leiomyoma - benign and leads to fibroids.

heavy menses or dysmenorrhoea, infertility and urine freq

106
Q

symptoms of ovarian cancer

A

hormonal problems. abdo pain. distention of abdo. urinary and GI symptoms.
late presentation

107
Q

what are the 3 types of ovarian epithelial tumours and whether malignant

A

serous -
mucinous - mostly benign
endometrial - mostly malignant

108
Q

what are the 4 types of ovarian cancer

A

surface epithelial stroma, sex cord stromal, germ cell tumour, mixed

109
Q

features of germ cell tumours

A

mostly benign

teratomas

110
Q

features of ovarian sex cord stroma tumours

A

masculinising or feminising

in children can cause or delay puberty

111
Q

vulval tumours can be caused by

A

SCC, BCC, malignant melanoma, extramammary pagets

PPE (18 decks)

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