Repro Flashcards
Infant born to IVDU who develops oral thrush, lymphopenia, interstitial pneumonia in 1st year of life - what dx? what tx could have prevented this?
HIV: 3 part regime of zidovudine:
- mom 14 wks and after
- during delivery
- infant x first 6 wks of life
Malformation vs. Disruption vs. Sequence
Malformation: primary defect in development. ex: holoprosencephaly
Disruption: secondary breakdown of previously nl tissue. ex: Amniotic band syndrome. Amnion ruptures during fetal development - amniotic bands that may compress fetal limbs
Sequence: resulting from a single defect. Potter sequence.
Imperforate Anus is associated with what other congenital abnormalities?
Urogenitary tract abnormalities! (ex: meconium that doesn’t pass may pass into urethra or vagina thru fistula)
Note: VACTERL is much less common than the above.
Comedocarcinoma?
Form of DCIS with solid sheets of pleomorphic high grade cells with central necrosis.
Course of Ureter
Under gonadal vessels
Above the Ext/Common Iliac, Anterolateral to Int Iliac
Under the uterine artery, medial to ovarian vessels
Q1804
Prenatal intraventricular hemorrhage occurs due to bleeding from?
Germinal Matrix
When is hCG detectable in blood vs. urine after fertilization?
1 wk = blood (after implantation)
2 wks = urine.
What should a 3 yr old be able to do?
Gross - alternating feet stairs, tricycle
Fine - copies a circle, uses utensils
Speech - 3 word sentences, 75% intelligible
Social - knows age/gender, parallel play, imaginative play (not yet cooperative)
Q1781
What should patients be aware of after a vasectomy?
Viable sperm may still be present proximal to the ligation. About 20% of individuals still have viable sperm in ejaculate 3 months after the procedure.
What condition can cause absence of vas deferens?
Cystic Fibrosis!
What condition presents with maternal virilization?
Aromatase deficiency.
Other sx:
female 46 XX masculinization
increased levels of testosterone, androstenedione
(maternal virilization bc androgen can cross the placenta. normally placenta has aromatase)
Anti-Rh(D) immunoglobulin is what type of Ig?
IgG
Does not cause transplacental fetal hemolysis bc the amount given is much less than what is made in an immune reaction.
Baby of Mom with diabetes will have transient ______ after birth.
Hypoglycemia. Baby had compensatory insulin hypersecretion due to inc. glucose load from mom.
Mifepristone (RU-486) Mech?
Anti-Progestin
Labs values associated with Klinefelter’s?
47XXY
Increased LH and FSH:
=> Dysgenesis of seminiferous tubules -> dec. inhibin -> inc. FSH
=> Abnormal leydig -> dec. testos -> inc. LH -> Inc. estrogen
Symptoms of caudal regression and what its associated with?
Caudal Regression: agenesis of the sacrum and sometimes, lumbar spine.
- flaccid paralysis, absent reflexes
- urinary incontinence
Associated poorly controlled maternal diabetes!
Mom comes for visit at 14 wks gestation. Twins, a male and female. What type of twin placentation is most likely?
Dichorionic Diamniotic.
DIZYGOTIC since two diff sexes.
What can arise about 10 years after radical masectomy?
Lymphangiosarcoma - neoplasm of the endothelial cells of lymphatic channels
Endometritis
Infection of Endometrium after Delivery usually
- fever, leukocytosis, tender uterus, foul smelling discharge
How do seminiferous tubules and epididymis maintain high levels of testosterone?
Sertoli cells secrete ABP - androgen binding protein.
Hydrops Fetalis + hemoglobinopathy =
Alpha thalassemia.
Where is the prostate located on imaging?
Just posterior to the pubic symphysis.
Epithelium of diff parts of the female reproductive tract?
Vagina = Strat squamous, non-keratinized Ectocervix = Strat squamous, non-keratinized
Endocervix = Simple columnar
Uterus = Simple columnar, long tubular glands
Fallopian Tube = Simple columnar, with ciliated cells and few peg secretory cells
Ovary = simple cuboidal*
Cryptorchidism - clinical presentation?
Bc of the increased temp, Seminiferous tubules become atrophic and hyalinized:
- low sperm count
- decreased inhibin secretion from Sertoli cells.
Leydig cells are okay - testos and secondary sex are nl.
Should be corrected early in life to prevent damage to seminiferous tubules and prevent testicular cancer.
