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First Aid Diseases > Repro > Flashcards

Repro Flashcards

1
Q

Fetal development, what happens in:

Wk1, 2, 3, 3-8, 4, 8, 10

A 
1=hCG
2=bilaminar disc
3=trilaminar disc, gastrulation
3-8=embryonic period, organogenesis
4=4 limbs, neural tube closes, heart beats
8=fetus moves, looks like baby
10=genitalia look M/F
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2
Q

What is gastrulation? How does it start?

A

process to form trilaminar embryonic disc w/in wk3

- epiblast invaginates to form the primitive streak

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3
Q

Craniopharyngioma =

A

benign Rathke’s pouch tumor w/ choles crystals, calcifications

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4
Q

Parotid, sweat and mammary glands are from where?

A

Surface ectoderm

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5
Q

Adenohypophysis (ant pit) and lens of eye are from where?

A

Surface ectoderm

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6
Q

Neuroectoderm makes what 4 things?

A

Brain, SC, retina and optic n. (CNS)

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7
Q

Neural crest makes what + 3 cell types?

A

PNS and melanocytes, chromaffin cells of ad med, C cells of thyroid

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8
Q

Schwann cells, pia and arachnoid, bones of skull, odontoblasts and aorticopulm septum are made from where?

A

Neural crest

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9
Q

Mesodermal defects?

A 
VACTERL:
Vertebral defects
Anal atresia
Cardiac defects
Tracheo-Eso fistula
Renal defects
Limb defects (bone and m.)
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10
Q

Notochord induces ectoderm to form neuroectoderm (neural plate) -> forms what in adult?

A

Nucleus pulposus of intervertebral disc

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11
Q

Endoderm forms what 9 strucs?

A

Gut tube epi + lungs, liver, GB, panc, eustachian tube, thymus, parathyroid, thyroid follicular cells

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12
Q

What are the umbilical art’s in adults? What is the umbilical vein?

A

Medial umbilical ligaments

Ligamentum teres

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13
Q

When does the yolk sac form the allantois?
What does the allantois become?
If this doesn’t occur what happens?

A

Wk3
It extends into UG sinus and becomes the urachus (duct btwn bladder and yolk sac)
- Patent urachus (urine out thr um) or vesicourachal diverticulum (outpouching of bladder)

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14
Q

What is the vitelline duct?
When does it obliterate?
Failure of it to close results in (2)?

A

Omphalo-mesenteric duct, which connects yolk sac to midgut lumen
Wk7
Vitelline fistula (poo out thr umbilicus) or Meckel’s diverticulum (parietal closure, patent part attached to ileum)

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15
Q

Aortic arches become:

1st, 2nd, 3rd, 4th, 6th?

A

1=MAXillary a. (1 is MAXimal)
2=Stapedial and hyoid a’s (Second Stapedial)
3=Common Carotid and prox part of int Carotid (C is 3rd letter)
4=on L Ao arch, on R prox R subclavian a. (4 limbs, systemic a’s)
6=prox pulm a’s and on L ductus arteriosus (6 is pulm stuff)

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16
Q

Where do L and R recurrent laryngeal n’s wrap around?

A

R loops around where R branciocephalic a becomes R CC and R SC
L loops around Ao arch, caught by ductus arteriosus

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17
Q

Where are brachial (pharyngeal) apparatuses derived from?

A

CAP (outside to inside)
Clefts = ectoderm
Arches = mesoderm
Pouches = endoderm

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18
Q

Branchial clefts are derived from?
1st becomes?
2-4th become?
- if this persists?

A

Ectoderm
1=ext auditory meatus
2-4=temp cervical sinuses -> obliterated by 2nd arch mesenchyme
- persistent cervical cyst -> branchial cleft cyst in lat neck

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19
Q

1st branchial arch:

- cart? m’s? n’s?

A
  • Meckel’s cart: Mandible, Malleus, incus, spheno-Mandibular lig
  • M’s of Mastication, Mylohyoid, ant belly of digastric, tensor tympani/veli palatini
  • V2/3 = chew!
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20
Q

Treacher Collins synd =

A

1st arch neural crest fails to migrate -> mandibular hypoplasia and facial abnl’ities

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21
Q

2nd branchial arch:

- cart? m’s? n’s?

A
  • Reichert’s cart: Stapes, Styloid process, lesser horn of hyoid, Stylohyoid lig
  • M’s of facial exp’n, Stapedius, Stylohyoid, post belly of digastric
  • CNVII (facial exp’n) -> Smile!
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22
Q

3rd branchial arch:

- cart? m’s? n’s?

A
  • Cart: greater horn of hyoid
  • Stylopharyngeaus (innervated by…)
  • CN IX=glossoPHARYNGEAL (swallow STYLishly)
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23
Q

Congenital pharyngocutaneous fistua =

A

persistence of cleft and pouch -> fistula btwn tonsillar area, cleft in lat neck

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24
Q

4th branchial arch: m and n?

3+4th arches together form?

A
  • most pharyngeal constrictors, cricothyroid, levator veli palatini
  • CN X (sup laryngeal branch for swallowing)
  • post 1/3 of tongue
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25
Q

6th branchial arch: m and n?

A
  • All m’s of larynx (except cricothyroid)

- CN X (recurrent laryngeal branch for speaking)

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26
Q

CNs w/ both motor and sensory components?

A

Those which derive from branchial arches (except V2, sensory only):
V3 (1st), VII (2nd), IX (3rd), X (4+6th)

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27
Q

Branchial pouch derivatives (1-4)?

A 
Ear, tonsils, bottom-to-top:
1=ear
2=tonsils
3=dorsal (bottom: inf parathyroids)
3=ventral (to: thymus)
4=(top: sup parathyroids)
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28
Q

MEN 2A

  • mutation in
  • 3 manifestations
A 
germline RET (neural crest cells)
3P's:
- Pheo in ad medulla
- PT tumor (3/4th pharyngeal pouches)
- Parafollic cells (med thyroid ca) (from neural crest cells, 4/5th pouches)
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29
Q

Cleft lip/palate are due to?

A

Lip: maxillary and med nasal processes don’t fuse
Palate: lat palantine, nasal septum and/or med palantine don’t fuse

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30
Q

Mesonephric duct:

  • stays due to ? from ?
  • grows due to?
  • becomes?
A
  • MIF from Sertoli cells (bc of testis-determining factor)
  • Testos from Leydig cells
  • SEED: Seminal vesicles, Epididymis, Ejaculatory duct, Ductus deferens
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31
Q

What is the F equivalent of:

  • glans penis
  • corpus cavernosum and spongiosum
  • bulbourethral gl’s (of Cowper)
  • prostate
  • ventral shaft of penis (penile urethra)
  • scrotum
A
  • glans clitoris
  • vestibular bulbs
  • greater vestibular bulbs (of Bartholin)
  • urethral and paraurethral gl’s (of Skene)
  • labia minora
  • labia majora
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32
Q

3 parts of the broad ligament around the uterus?

A

Mesometrium under the lig of the ovary
Mesosalpinx over the lig of the ovary
Mesoovarium coverin the ovary

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33
Q

What cell layer makes up:

  • vagina
  • ectocervix
  • endocervix
  • uterus
  • fallopian tube
  • ovary
A
  • stratified sq epi, not keratinized
  • stratified sq epi
  • simple columnar epi
  • simple columnar epi, pseudostratified tubular glands
  • simple columnar epi, ciliated
  • simple cuboidal epi
34
Q

Pthwy of sperm during ejaculation?

A

SEVEN UP:
Seminiferous tubules -> Epididymis -> Vas deferens (seminal vesicle, prostate) -> Ejac ducts -> (nothing) -> Urethra -> Penis

35
Q

What n’s are involved in erection, emission, and ejaculation?
- what level of SC?

A

Pelvic n. (parasymp) [S2-S4]
Hypogastric n. (symp NS)
Pudendal n. [T12-L1]

36
Q

Sertoli cells:

  • secrete what 3 substances?
  • tight jxns btwn cells form?
  • purpose of cells?
  • are sensitive to?
A
  • inhibin B to inhibit FSH, ABP (androgen BP) to keep local testos level, MIF
  • bl-testis barrier
  • support/nourish developing spermatozoa
  • T: high T -> decr’d sperm prod and less inhibin (varicocele, cryptorchidism)
37
Q

Leydig cells:

  • secrete?
  • are they T sensitive?
A

Testos!

- no

38
Q

Where does estrogen come from:

  • 17b-estradiol
  • estriol
  • estrone
  • most to least potent?
A
  • ovary
  • placenta
  • adipose tissue via aromatization
  • estradiol > estrone > estriol
39
Q

FSH works on which cell? stim’s what?

LH works on which cell? stim’s what?

A

FSH on granulosa cell to make estrogen from androstenedione via aromatase
LH on theca cell to make androstenedione from choles via desmolase

40
Q

Progesterone

  • source?
  • action on LH/FSH?
  • actions on uterus?
  • decr’d proges has what affect on fertility?
  • elevation if it is indicative of?
A
  • CL, placenta, ad cortex, testes
  • inhib’s them
  • SmM relax (no contractions), decr’d estrogen R expressivity, decr’d myometrial excitation, stim’n of endometrial gl secretions and spiral art. development
  • decr’d fertility bc endometrium isn’t maintained to support implantation
  • ovulation
41
Q

Thelarche =

A

breast bud forms in Tanner stage II (vs. pubarche when pubic hair appears)

42
Q

Mittelschmerz =

A

bl from ruptured follicle or follicular enlargement causes peritoneal irritation that can mimic appendicitis

43
Q

Oogenesis:

  • Meiosis I is arrested at? as?
  • Meiosis II is arrested at? as?
  • if fertilized, becomes?
A
  • prOphase I for yrs until Ovulation; (2n, 4c), 46 sister chromatids
  • METaphase II until fertilization (2* oocytes) [An egg MET a sperm]; (1n, 2c), 23 sister chromatids
  • haploid (1n, 1c)
44
Q

hCG levels during preg are?

A

From CL until wk8, rising levels

Then placenta makes own estriol and proges, so levels decr, but come up again a little at wk30

45
Q

Menopause:

  • avg age? earlier in who?
  • confirmatory test?
  • hormonal changes are?
  • sx of menopause?
A

51, smokers
- FSH (no neg fdbk from estrogen)
- decr’d estrogen, very incr’d FSH, incr’d LH (no surge), incr’d GnRH
- Menopause causes HHAVOC:
Hirsutism (incr’d androgens), Hot flashes, Atrophy of Vagina, Osteoporosis, CAD

46
Q

How do you make estrone?

A

Androstenedione from ad cortex (although is also made in ovaries) is converte to estrone via aromatase in periph adipose cells

47
Q

Where does estriol come from?

A

Estrogen of preg; end-product of estradiol metab’n; derives from fetal ad, placenta and mat liver

48
Q

Where is DHEA from? What about DHEA-sulfate?

A

DHEA is 80% from ad cortex, rest from ovaries

DHEA-S is almost ALL from ad cortex

49
Q

During preg, incr’d pl vol does what in kidneys?

- Why do you want an incr’d pl vol?

A

Incr’s GFR, which incr’s the clearance of urea and Cr so that their serum levels are at the lower limit of nl
- to incr the P needed to pump bl into mat lake in placenta

50
Q

Do have a resp acidosis or alkalosis during preg? Why?

A

Alkalosis bc estrogen/proges stim the resp center -> decr’d PCO2 and incr’d PO2

51
Q

During preg estrogen stim’s incr’d production of what hormones?

A

T4 and cortisol, bc stim’s syn of thyroid-binding globulin and transcortin -> incr’d BPs incr’s the level of hormones, but the free fraction is still the same

52
Q

PCOS

  • due to?
  • sx?
  • incr’d risk of?
  • fdbk loop perpetuating this?
  • cysts come from?
  • trmt
A
  • incr’d pit syn of LH and decr’d syn of FSH (LH:FSH ratio >2)
  • hirsutism from incr’d LH stim’ing androgen syn
  • endometrial ca from incr’d estrogen (from aromatization of androgens)
  • incr’d estrogen -> pos fdbk on LH but neg fdbk on FSH -> more LH and less FSH
  • supp’n of FSH -> follicle degen; fluid accum’s -> subcortical cysts that enlarge the ovaries
  • OCPs or medroxyprogesterone (decr’s LH and androgenesis); spironolactone (for acne); clomiphene (for women who want to get preggers), metformin (for DM)
53
Q 
Menorrhagia = 
Metrorhagia = 
Menometrorrhagia = 
Oligomenorrhea = 
Polymenorrhea =
A
  • incr’d bl loss
  • incr’d flow and duration at irreg int’s
  • combo of meno- and metro-
  • int’s >35d
  • int’s <21d
54
Q

1* dysmenorrhea sx due to?

2* dysmenorrhea usu due to?

A

PGF2a -> incr’s uterine contractions

endometriosis

55
Q

Endometriosis =

- triad of sx?

A

functioning gl’s and stroma outside the uterus, usu in ovaries
- dysmenorrhea, dyspareunia (painful sex), infertility

56
Q

Palpable ovaries in postmenopausal woman ddx?

A

Ovarian ca until proven otherwise

57
Q

Placental layers:

  • Maternal surface?
  • Fetal surface?
A
  • cotyledons covered by decidua basalis
  • amnion around fetus, covered by chorionic plate which is made of chorionic villi (lined by trophoblastic tissue: outside syncytiotrophoblast, inside cytotrophoblast)
58
Q

HELLP synd =

  • assoc’d w/?
  • can proceed to?
A

Hemolysis, Elevated Liver nz’s, Low Plt ct

  • preeclampia/eclampsia
  • DIC
59
Q

Triad of preg labs for Down synd?

A

Low urine estriol and aFP

High bHCG

60
Q 
Preeclampia = 
Eclampsia = 
- due to?
- mortal from?
- trtmt
A

= HTN, proteinuria, edema
= preeclampsia + seizures
- placental ischemia from no vasodil of spiral art’s -> incr’d vasc tone and HTN
- cerebral hemorrhage and ARDS
- delivery; IV Mg sulfate to prevent/trt seizures

61
Q

Placenta accreta =

A

defective decidual layer allows placenta to attach to myometrium m. -> doesn’t separate after birth -> hemorrhage, often needs hysterectomy

62
Q

What do HPV 16 and 18 make to predispose one to ca?

A

HPV 16 - E6 = inhib’s p53 suppressor gene

HPV 18 - E7 = inhib’s Rb suppressor gene

63
Q

TRF (thyroid releasing factor) stim’s?

A

T4 and PRL

64
Q

Drugs that can cause gynecomastia:

A

“Some Drugs Create Awkward Knockers”
Spironolactone (displaces E from SHBG and blocks androgen Rs)
Digoxin (has E activity)
Cimetidine (DHT R antag -> more E effects)
Alcohol (destroys liver -> more E bc not broken down)
Ketoconazole (displace E from SHBG)

65
Q

Dizygotic twins in the womb are?

Monozygotic twins are usu?

A

Dichorionic diamniotic

Monochorionic diamniotic

66
Q

Chorionic villi is made of?

A

Cytotrophobl on inner layer

Syncytiotrophobl on outer layer

67
Q

Ov tumors:

  • incr’d hCG and LDH
  • incr’d hCG
  • incr’d AFP
A
  • dysgerminoma (assoc’d w/ Turner synd)
  • choriocarcinoma (no chorionic villi!, goes to bl)
  • yolk sac (endodermal sinus) tumor (Schiller-Duval bodies)
68
Q

Struma ovarii =

A

ovarian teratoma w/ functional thyroid tissue

-> hyperthyroidism

69
Q

Ov tumors:

  • psamomma bodies, malig, bilat
  • lined w/ fallopian tube-like epi, benign
  • looks like bladder, pale yellow tan, coffee bean nuc
  • assoc’d w/ pseudomyxoma peritonei
  • part of Meigs’ synd
A
  • serous cystadenocarcinoma
  • serous cystadenoma
  • Brenner tumor
  • mucinous cystadenocarcinoma (jelly belly from tumor)
  • ov fibroma (+ascites and hydrothorax)
70
Q

Ov tumors:

  • Call-Exner bodies
  • mucin-secreting signet cell
  • lined by mucus-secreting epi
A
  • granuloma cell tumor (follicles w/ Eo’ic secretions)
  • Krunkenberg tumor (GI met to ov’s, adenoca)
  • mucinous cystadenoca
71
Q

Sarcoma botryoides =

- stain for?

A

rhabdomyosarcoma in vagina of yg girls

- desmin (+) bc stains m. cells

72
Q

Vaginal tumor spreads which which LNs?

A

Lower 2/3 to inguinal LNs

Upper 1/3 to regional iliac nodes

73
Q

Br ca:

  • sm mobile firm mass w/ sharp edges
  • sm tumor in under areola
  • leaf-life projections, ct and cysts
A
  • fibroadenoma (does NOT become ca)
  • intraductal papilloma
  • Phyllodes tumor
74
Q

Br ca:

  • ductal caseous necrosis
  • stellate morpho, rock-hard
  • row of cells, bilat, mult lesions
A
  • Comedocarcinoma (type of DCIS)
  • invasive ductal (worst, most common!)
  • invasive lobular (no E-cadherin so can’t make gl’s)
75
Q

Br ca:

  • invades lymph, dimpled br skin
  • lots of lymphs, BRCA1
  • PAS+, keratin +, S100-
A
  • Inflamm (neoplastic cells block lymph)
  • medullary invasive ca
  • Paget’s dz (suggests DCIS)
76
Q

Br ca:

  • breast lumps, blue domed
  • breast lumps, calcifications
  • painless lump, calcifications
A
  • cystic fibrocystic change
  • sclerosing adenosis (fibrocystic change)
  • fat necrosis
77
Q

Cryptorchidism =

- labs?

A

undescended testis

- incr’d FSH/LH, decr’d inhibin, T decr’d if bilat and nl if unilat

78
Q

Testic ca:

  • incr’d PLAP, fried-egg appearance, malig
  • incr’d AFP
  • incr’d hCG
  • incr’d hCG and/or AFP
  • glandular/papillary, w/ bl/necrosis
A
  • seminoma (most common! homogenous gray w/ no bl/necrosis)

- yolk sac (endodermal sinus) tumor (Schiller-Duval bodies), usu kids d hCG and/or AFP)

79
Q

hCG can act on what 3 Rs?

A

TSH, FSH, and LH Rs

80
Q

Testic ca:

  • Reinke crystals, androgens
  • androblastoma from sex cord stroma
  • old man
A
  • Leydig cell (golden brown color, choles!)
  • Sertoli cell (made of tubules)
  • testic lymphoma (mets to testicles)

First Aid Diseases (16 decks)

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