Repro Flashcards
Order of the layers of the testes from out to in:
- Skin
- Dartos Fascia & Musle
- Ext spermatic fascia
- Cremasteric Fascia & muscle
- Int Spermatic Fascia
- Parietal Tunica Vaginalis
- Visceral Tunica Vaginalis
Where does fertilization occur?
In the AMpulla of the fallopian tube
How does the ureter relate to the uterine artery?
UReter passes under the uterine artery
What hormone triggers contraction of breast myoepithelium –> Lactation?
Oxytocin in response to suckling
Release of milk by epithelial cells is due to prolactin
How does cOCP affect the risks of cancer?
Increases breast and cervical
But decreases ovarian and endometrial cancers
What are the major forms of monozygotic pregnancy? (twins)
1st) 33% dichorionic where cleavage occurs before implantation
2) monochorionic diamniotic where cleavage occurs after implantation
3) monoamniotic (4%) where cleavage occurs after day 8
Main causes of PID?
Chlamydia Trachomatis
Neisseria Gonorrhoea
Presentation of PID?
lower abdominal pain fever deep dyspareunia dysuria and menstrual irregularities may occur vaginal or cervical discharge cervical excitation
perihepatitis (Fitz-Hugh Curtis Syndrome) occurs in around 10% of cases. It is characterised by right upper quadrant pain and may be confused with cholecystitis
Which of the following is a disadvantage of breastfeeding?
- Increased risk of ovarian cancer
- Increased risk of ear infection
- Increased risk of type 1 DM
- Inadequate Vit K
- Inadequate Lactoferrin
!!!Breast milk has inadequate levels of vitamin K.
Breastfeeding is protective against breast and ovarian cancer.
Breast milk has adequate levels of lactoferrin. Lactoferrin promotes rapid uptake of iron by the gut and has antibacterial properties.
Breastfeeding is associated with reduced incidences of ear infections and type 1 diabetes mellitus.
What is a hydatiform mole?
A molar pregnancy where:
- 1 sperm fertilizes an empty egg ad duplicates its own DNA –> 46 chromosomes all paternal in origin (Total Hydatiform Mole)
- 2 sperm (or 1 duplicating) fertilize a normal egg –> excess chromosomes (Partial Hydatiform mole)
When does the PoP become effective?
After 48hrs
Prepubertal Atrophic Vaginitis can occur when a girl has not yet undergone puberty, what happens in it?
Low vaginal oestrogen –> infection-prone alkaline environment, as oestrogen increases levels of lactobacilli which facilitate the conversion of glucose to lactic acid.
It is an important diagnosis to consider in any prepubertal female patient presenting with vaginal itching and discharge.
What’s the main cause of PPH?
Uterine Atony is responsible for most cases
4Ts = Tone, Trauma, Tears & thrombosis
What does the broad ligament do?
Attaches Uterus, fallopian tubes and ovaries to pelvic wall
What does the round ligament of the uterus do?
Attaches fundus of uterus to labia majora
What does the suspensory ligament of the ovary do?
Attaches ovaries to pelvic wall
What does the cardinal ligament do?
Attaches cervix to pelvic wall
What are the phases of the uterine cycle?
Day 1-4 - menstruation
Day 5-13 = Proliferative or Follicular Phases
Day 14-28 = Secretory or Luteal phase
What happens to the uterus during the proliferative phase?
Increased oestrogen leads to:
- Endometrial thickening
- endometrial glands
- vascularisation of endometrium
How do we manage shoulder dystocia?
First try Mcrobert’s Maneuvre - Mum flexes and abducts hips, thus raising pelvis and widening pelvic outlet
Which of the following is a complication of Rhesus disease in a newborn?
- FEtal Liver failure
- Kernicterus
- Hydrops Fetalis
- Myeloproliferative Disorders
Both hydrops fetalis ( fluid accumulating in compartments due to the heart pumping super hard because of the haemolysis)
And Kernicterus (due to excess unconjugated bilirubin from haemolysis)
What happens to cause Haemolytic Disease of the Newborn?
Rh -ve mum produces Anti-D Abs that target foetal red cells
What is Vasa Praevia?
Where the foetal vessels sit over the cervix, they are likely to be damaged once the membranes rupture. This is very dangerous for the baby
How do we spot vasa praevia?
Classic Triad:
- Painless PV bleeding
- Membrane rupture
- Foetal Bradycardia
Can look with an US
How do we manage Vasa Praevia?
Elective early C-section if possible to avoid membrane rupture
If not detected and the membranes rupture then do emergency C-section
How do we determine what thromboprophylaxis to use in pregnancy?
Previous VTE –> Low dose aspirin from wk 8 & 6wks postnatal
3 RFs –> LMWH from wk 28 & 6wks postnatal
3+ RFs –> LMWH immediately & 6wks postnatal
Risk factors for thromboprophylaxis in pregnancy?
Age > 35 Body mass index > 30 Parity > 3 Smoker Gross varicose veins Current pre-eclampsia Immobility Family history of unprovoked VTE Low risk thrombophilia Multiple pregnancy IVF pregnancy
What is contained in the broad ligament>
Ovaries
Fallopian Tubes
Round ligament
What are the layers of the spermatic cord?
Internal spermatic fascia (Derived from Transversalis fascia)
Cremasteric fascia (From the fascial coverings of internal oblique)
External spermatic fascia (External oblique aponeurosis)
Where does lymph from the testes and scrotum go?
Testes - Para-aortic
Scrotum - Inguinal
Which of the following results in Hypergonadotrophic Hypogonadism?
- Turner’s Syndrome
- Sheehan’s Syndrome
- Anorexia Nervosa
- Kallman’s Syndrome
Turner’s –> Gonads that are insensitive to gonadotrophs
Sheehands, Anorexia and Kallman’s all cause hypogonadotrophic Hypogonadism (i.e. the problems in the pit)
