Repro 3 Flashcards
Why would we give oral contraceptives to a woman with PCOS?
In PCOS, there is hypersecretion of LH. The LH acts on the theca cells to increase production of androstenedione (androgens), which results in hirsutism. The increased LH and lack of FSH also disrupts the regular menstrual cycle, leading to amenorrhea.
Oral contraceptives are pills that contain a combination of estrogen and progesterone. Supplementing these hormones can help regulate ovulation, as well as stop the hirsutism.
What is clomiphene?
Clomiphene is an estrogen receptor inhibitor. It can be used to stimulate ovulation in a person with anovulation.
Normally, the estrogen produced by the granulosa cells of the follicle inhibits the release of FSH (and LH) through feedback inhibition. By blocking the negative feedback of estrogen, the hypothalamic–pituitary–gonadal axis is stimualted, and LH and FSH secretion are increased. This leads to the maturation of a greater number of follicles.
Which cells in the male gonads secrete testosterone?
Leydig cells
What are the effects of low testosterone in men?
decreases in:
libido
sexual hair
muscle mass
testicular volume
energy
(Everything is low with low T)
What type of pathogen is tinea cruris? What drug would you use to treat it? What is a side effect of this drug?
Fungal infection
ketoconazole
This drug directly inhibits testosterone synthesis
From what cells types do sex cord-stromal tumors arise?
Granulosa cells, theca cells, and fibroblasts.
These are a type of ovarian tumor
A 44 yo woman presents with ascites, pleural effusion and an ovarian mass. What is the mass? What is the name of her condition? How would you treat her?
The mass is a benign ovarian fibroma (a benign tumor of fibroblasts)
This woman has Meig’s syndrome, which is the traid of ovarian tumor, ascites, and pleural effusion.
Removal of the tumor resolves the symptoms.
Where in the male gonad does spermatogenesis occur?
Spermatogenesis occurs in the seminiferous tubules.
Spermatogonia (2N) are located in the most basal part of the compartment; as the germ cells develops, it moves apically. Spermatids (N) are located in the most apical part of the seminiferous tubule.
(Sperm develop from the outside of the tubule inward, so basal-side cells are 2N and apical cells are N).
What is the classic presentation of a complete hydatidiform mole?
–highly elevated ß-hCG levels
–uterine size that is larger than predicted for the length of pregnancy
–snowstorm/bag of grapes appearance of uterus on ultrasound
What is the function of oxytocin?
Dilation of the cervix and contraction of the uterus during labor.
Let-down of milk during breastfeeding.
Where is oxytocin produced and secreted?
Produced in the cell bodies of the neurons in the paraventricular nucleus of the hypothalamus.
Secreted from the posterior pituitary.
Why might we treat a woman who has PCOS with spironolactone?
Spironolactone is an anti-diuretic as well as an **anti-androgen. **In PCOS there is andorgen excess; the spironolactone will block androgen signalling, and hopefully resolve the patient’s hirsutism.
What is Kartagener’s syndrome?
A defect in the dynein arm of microtubules that results in impaired ciliary function.
It can lead to:
anosmia
infertility
recurrent upper respiratory tract infections
situs inversus (specifically, dextrocardia)
Generally speaking, what are p53 and Rb?
These are tumor suppressor genes that help regulate the cell cycle.
What is cryptorchidism?
Undecended testis (one or both)
What are the symptoms/consequences of cryptorchidism?
–Impaired spermatogenesis (sperm develop best a temperatures <37 degrees)
–increased risk for germ cell tumors, testicular cancer
–Leydig cells are unaffected, so testosterone levels can be normal
What is a varicocele?
An abnormal dilation of a testicular vein in the pampiniform plexus due to impaired drainage.
Most commonly affects adolescent and adult men.
On which side is varicocele most common? Why might there be a difference in incidence between the two sides?
The left side
The left gonadal vein drains into the left renal vein, which drians into the IVC, whereas the right gonadal vein drains directly into the IVC.
In the male, what does the genital tubercle develop into? Under the influence of what hormone?
The glans of the penis and the corpus cavernosum and **spongiosum **under the influence of DHT
In the female, what does the genital tubercle develop into, and under the influence of what hormone?
The glans clitoris and vestibular bulbs, under the influence of estrogen.
When do ß-hCG hormone levels peak?
They peak at around 9 weeks of gestation, and then decline until they reach a steady state around week 25.
What is the purpose of ß-hCG?
ß-hCG is secreted from the syncytiotrophoblast cells immediately after implantation in the endometrium to resuce the corpus luteum from regression, and to stimulate the continued production of progesterone and estradiol that are needed to maintain pregnancy.
What is hypospadias?
Opening of the urethra on the inferior surface of the penis.
Due to failure of the urethral folds to close.
What is the tunica vaginalis?
The tunica vaginalis is a serous membrane that covers the surface of the testicle and is reflected onto the internal surface of the scrotum.
