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0. Step Ia > Repro from FA (quick associations) > Flashcards

Repro from FA (quick associations) Flashcards

1
Q

Fetus has renal damage: what medication (teratogen) caused that?

A

ACE inhibitors

(causes vasodilation; used for hypertension, CHF)

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2
Q

Fetus has absence of digits/multiple anomalies: what medication (teratogen) caused this?

A

Alkylating agents

(chemotherapy agents; used to damage DNA)

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3
Q

Fetus has CN VIII toxicity: what medication (teratogen) caused that?

A

Aminoglycosides

(protein synthesis inhibitors, bacteriocidal, gram-negative antibacterial)

“A MEAN GUY hit the baby on the ear”

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4
Q

Fetus has neural tube defects, cranifacial defects, fingernail hypoplasia, dev delay, IUGR: what medication (teratogen) caused that?

A

Carbamazepine

(for epilepsy and bipolar; anticonvulsant, mood stabilizer)

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5
Q

Fetus has vaginal clear cell adenocarcinoma, congenital Mullerian anomalies: what medication (teratogen) caused that?

A

Diethylstilbestrol (DES)

(synthetic nonsteroidal estrogen, thought from 1940s-1970s to cause fewer birth defects. no longer used though exposure may occur via eating beef or from breast cancer treatment)

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6
Q

Fetus has neural tube defects: what medication (teratogen) caused that?

A

Folate antagonists

(inhibit cell division, DNA/RNA synthesis and repair and protein synthesis. Proguanil, pyrimethamine and trimethoprim selectively inhibit folate’s actions in microbial organisms such as bacteria, protozoa and fungi. The majority of antifolates work by inhibiting dihydrofolate reductase (DHFR).)

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7
Q

Fetus has Ebstein abnormality (atrialized right ventricle): what medication (teratogen) caused that?

A

LIthium

(treatment for bipolar, depression, Schizoaffective)

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8
Q

Fetus has aplasia cutis congenita: what medication (teratogen) caused that?

A

Methimazole

(antithyroid, used for hyperthroidism. major SE = agranulocytosis)

Methimazole caused that hole!

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9
Q

Fetus has fetal hydantoin syndrome (microcephaly, dysmorphic craniofacial features, hypoplastic nails and distal phalanges, cardiac defects, IUGR, intellectual disability): what medication (teratogen) caused that?

A

Phenytoin

(voltage-dependent block of voltage-gated sodium channels; used for complex partial seiz and tonic-clonic)

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10
Q

Fetus has discolored teetn: what medication (teratogen) caused that?

A

Tetracyclines

(Antibiotic. It is a protein synthesis inhibitor. It is commonly used to treat acne today, and, more recently, rosacea, and is historically important in reducing the number of deaths from cholera.)

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11
Q

Fetus has limb defects (phocomelia, micromelia - ie flipper limbs): what medication (teratogen) caused that?

A

Thalidomide

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12
Q

Fetus has neural tube defects due to inhibition of maternal folate absorption: what medication (teratogen) caused that?

A

Valproate (same effect as insufficient maternal folate)

(anticonvulsant and mood-stabilizing drug, primarily in the treatment of epilepsy, bipolar disorder and prevention of migraine headaches.)

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13
Q

Fetus has bone deformities, fetal hemorrhage, abortion, opthalmologic abnormalities: what medication (teratogen) caused that?

A

Warfarin

“Don’t wage WARfarin on the baby; keep it HEPpy with Heparin” (heparin does not cross placenta)

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14
Q

Common cause of birth defects and intellectual disability

Mom used what substance?

A

Alcohol

leads to Fetal Alcohol Syndrome (CNS damage, memory/functional issues, predisposition to addictions)

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15
Q

Abnormal fetal growth and fetal addiction; placental abruption

Mom used what substance?

A

Cocaine

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16
Q

Leading cause of low birth weight in developed countries; associated with preterm labor, placental problems, IUGR, ADHD

Mom used what substance?

A

Nicotine, CO from smoking

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17
Q

Congenital goiter or hypothyroidism (cretinism)

What happened?

A

Lack or excess of iodine in utero

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18
Q

Caudal regression syndrome (anal atresia to sirenomelia), congenital heart defects, neural tube defects

What happened in utero?

A

Maternal diabetes

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19
Q

High risk for spontaneous abortions and birth defects (cleft palate, cardiac abnormalities)

What happened in utero?

A

Excess of Vit A

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20
Q

Microcephaly, Intellectual disability

What happened in utero?

A

X-rays

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21
Q

Umbilical arteries return blood from where to where?

A

Deoxygenated blood (so opposite of what you would normally think about arteries) from fetal internal iliac arteries (off of fetal descending aorta) –> placenta

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22
Q

Umbilical vein carries blood from where to where?

A

Oxygenated blood from placenta to fetus (drains into fetal IVC via liver or ductus venosus)

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23
Q

Generally, aortic arch derivatives develop into what?

A

Arterial system

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24
Q

1st aortic arch –> ?

A

Part of maxillary artery (branch of external carotid)

“1st is MAXimal”

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25
Q

2nd aortic arch –> ?

A

Stapedial artery and hyoid artery

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26
Q

3rd aortic arch –> ?

A

Common Carotid artery and prox part of internal Carotid

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27
Q

4th aortic arch –> ?

A

Left: part of aortic arch

Right: prox part of right subclavian

“4th arch –> 4 limbs ie systemic”

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28
Q

5th aortic arch –> ?

A

nothing. degenerates for the most part

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29
Q

6th aortic arch –> ?

A

proximal part of pulmonary arteries and (left side only) ductus arteriosus

30
Q

1st branchial cleft develops into what structure?

A

external auditory meatus

31
Q

2nd through 4th branchial clefts develop into what structures?

A

temporary cervical sinuses (later obliterated by proliferation of 2nd arch mesenchyme)

32
Q

what happens if there is a persistent cervical sinus?

A

there will be a branchial cleft cyst within the lateral neck

33
Q

Branchial apparatus: also called what?

consists of what?

A

aka Pharyngeal apparatus

Consists of Clefts, Arches, Pouches

34
Q

Branchial Clefts, Arches, Pouches: what embryoligical tissue is each derived from?

A

Clefts: from ectoderm

Arches: from mesoderm/NCC

Pouches: from endoderm

“CAP covers from outside to inside”

35
Q

Derivatives of the 1st Branchial Arch:

Cartilage? Muscles? Nerves?

A

Cartilage: Meckel cartilate: Mandible, Malleus, inclus, spheno-Mandibular ligament

Muscles: Muscles of Mastication (temporalis, Masseter, lateral/Medial pterygoids), Mylohyoid, anterior belly of digastric, tensor tympani, tensor veli palatini

Nerves: CN V2 and V3 (chew)

36
Q

Abnormalities of the 1st Branchial arch?

A

Treacher Collins syndrome

1st arch neural crest fails to migrate -> mandibular hypoplasia, facial abnormalities

37
Q

Derivatives of the 2nd Branchial Arch:

Cartilage? Muscles? Nerves?

A

Cartilage: Stapes, Styloid process, lesser horn of hyoid, Stylohyoid ligament

Muscles: of facial expression, Stapedius, Stylohyoid, platysma, belly of digastric

Nerves: CN VII (facial expression/smile)

38
Q

Derivatives of the 3rd Branchial Arch:

Cartilage? Muscles? Nerves?

A

Cartilage: greater horn of hyoid

Muscles: Stylopharyngeus (think of it as being innervated by the glossopharyngeal nerve)

Nerve: CN IX (glossopharyngeal nerve -> stylopharyngeus m.)

“swallow stylishly”

39
Q

Derivatives of the 4th-6th Branchial Arch:

Cartilage?

A

Cartilage: thyroid, cricoid, arytenoids, corniculate, cuneiform

(laryngeal cartilage)

40
Q

Derivatives of the 4th Branchial Arch:

Muscles? Nerves?

A

Muscles: Most pharyngeal constrictors, cricothyroid, levator veli palatini

Nerves: CN X (superior laryngeal branch) - simply swallow

41
Q

Derivatives of the 6th Branchial Arch:

Muscles? Nerves?

A

Muscles: all intrinsic muscles of larynx except cricothyroid

Nerves: CN X (recurrent laryngeal branch) - speak

42
Q

which arches make up the posterior 1/3 of the tongue?

A

Arches 3 and 4

43
Q

Abnormalities from the 2nd branchial arch?

A

Congenital pharyngocutaneous fistula: persistence of 2nd arch cleft and pouch -> fistula between tonsillar area and lateral neck

44
Q

Cleft lip… what didn’t happen?

A

Failure of fusion of maxillary and medial nasal processes (formation of 1’ palate)

45
Q

Cleft palate… what didn’t happen?

A

Failure of fusion of the two lateral palatine processes

OR

failure of fusion of lateral palatine processes with the nasal septum and/or medial palatine process (formation of 2’ palate)

46
Q

1st branchial pouch develops into what?

A

middle ear cavity, eustachian tube, mastoid air cells

endoderm-lined structures of ear

47
Q

2nd branchial pouch develops into what?

A

Epithelial lining of palatine tonsil

48
Q

3rd branchial pouch develops into what?

A

Dorsal wings develop into inferior parathyroids

Ventral wings develop into thymus

3rd pouch contributes to 3 structures (thymus, L and R inferior parathyroids…. 3rd pouch structures end up BELOW 4th pouch structures)

49
Q

4th branchial pouch develops into what?

A

Dorsal wings develop into superior parathyroids

50
Q

DiGeorge syndrome: aberrant development of what structures?

A

3rd and 4th branchial pouches

51
Q

How is Men 2A associated with branchial pouches?

A

Mutation of germline RET (neural crest cells). Parathyroid (-> tumor) is associated with 3rd/4th pharyngeal pouch. Parafollicular cells (-> medullary thyroid cancer) is derived from NCCs; associated with 4th/5th pharyngeal pouches.

52
Q

Embryo -> female: what ducts develop, which ones degenerate?

A

Paramesonephric (Mullerian) develop

Mesonephric (Wolffian) degenerate

53
Q

Embryo -> male: what signals are required? what does each one cause?

A
  • SRY gene (Y chromosome): produces testis-determining factor -> testes development)
  • Sertoli cells: secrete Mullerian inhibitory factor (MIF). suppresses dev of Paramesonephric ducts
  • Leydig cells: secrete androgens, stimulate dev of Mesonephric (Wolffian) ducts
54
Q

Mullerian ducts dev into what?

A

fallopian tubes

Uterus

upper vagina (lower vag from urogenital sinus)

55
Q

Mullerian duct abnormalities result in what?

A

anatomical defects: may be 1’ amenorrhea in females with fully developed 2’ sexual characteristics (which indicates functional ovaries)

56
Q

Wolffian ducts develop into what?

A

SEED: Seminal vesicles, Epididymus, Ejaculatory duct, Ductus deferens

57
Q

Ovary: epithelial cell type?

A

simple cuboidal aka germinal

58
Q

Fallopian tube: epithelial cell type?

A

simple columnar

has cilia to move the ova along

Peg cells secrete nutrients

59
Q

Uterus epithelial cell type?

A

simple (pseudostratified) columnar

contains tubular cells

divided into functional and basal layers

undergoes cyclic changes

60
Q

Cervix: epithelial cell type?

A
  • Simple columnar (endocervix)
  • Stratified squamous (ectocervix)
  • associated with condyloma accumulatum, adenocarcinoma, squamous cell cancer
61
Q

Vagina: epithelial cell type?

A

stratified squamous non-keratinized

contains glycogen.

associated with squamous cell cancer.

62
Q

which hormones share an identical alpha unit but have unique ß units?

A

acronym: Top-HALF

TSH, hCG, (alpha unit), LH, FSH

(remember that a urine preg test detects ß-hCG)

63
Q

cervical carcinoma: associated with what virus? what exactly causes pathology?

A

HPV 16 and HPV 18

produce E6 gene product -> inhibits p53 tumor suppressor

E7 gene product -> inhibits RB tumor suppressor

64
Q

Urothelial cell carcinoma: where does this occur?

A

lower urinary tract, usually bladder

cell type = urothelial (aka transitional)

65
Q

Urothelial cell carcinoma: risk factors?

A

cigarette smoke

naphthylamine, azo dyes (hairdressers), cyclophosphamide or phenacetin use

66
Q

Urothelial cell carcinoma: presentation?

two types?

A

painless hematuria

Flat and Papillary types

67
Q

Urothelial cell carcinoma, flat type: mutation? pathway?

A

p53 mutation

develops as high grade, then invades

68
Q

Urothelial cell carcinoma, papillary type: mutation? pathway?

A

not associated with mutation

low grade -> high grade -> invasion

69
Q

Urothelial cell carcinoma: why does it tend to be multifocal and have recurrence?

(“field defect”)

A

all of bladder cells have been bathed in carcinogens (if reason is smoking/toxins) - just a matter of time before others become cancerous

70
Q

urinary tract squamous cell carcinoma: risk factors?

A
  • Schistosoma hematobium (infection typically in Egyptian male)
  • chronic nephrolithiasis (due to irritation)
71
Q

urinary tract adenocarcinoma: classic picture?

A

embryological defect = urachial remnant - tumor at the dome of the bladder.

urachus lined by glandular cells hence adenocarcinoma.

0. Step Ia (28 decks)

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