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USMLE Step 1 > Reproduction > Flashcards

Reproduction Flashcards

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USMLE® Step 1 flashcards
1
Q

Sonic hedgehog gene

A

Produced at base of limbs in zone of polarizing activity. Involved in patterning along Anterior-posterior axis. Involved in CNS development; mutation can cause holoprosencephaly.

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2
Q

Wnt-7 gene

A

produced at apical ectodermal ridge (at distal end of each developing limb), necessary for proper organization along dorsal-ventral axis

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3
Q

FGF gene

A

produced at apical ectodermal ridge. Stimulates mitosis of underlying mesoderm, providing for lengthening of limbs

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4
Q

Homeobox (HOX) genes

A

segmental organization of embryo in craniocaudal direction, mutations cause appendages in wrong locations

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5
Q

ACE inhibitors: teratogenic effects

A

Renal damage

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6
Q

Alkylating agents: teratogenic effects

A

absence of digits, multiple anomalies

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7
Q

Aminoglycosides: teratogenic effects

A

CN VIII toxicity

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8
Q

Carbamazepine: teratogenic effects

A

Neural tube defects, craniofacial defects, fingernail hypoplasia, developmental delay, intrauterine growth restriction

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9
Q

Diethylstilbestrol (DES): teratogenic effects

A

Vaginal clear cell adenocarcinoma, congenital Mullerian abnormalities

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10
Q

Folate antagonists (methotraxate, trimethoprim, pyramethamine): teratogenic effects

A

Neural tube defects

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11
Q

Lithium: teratogenic effects

A

Ebstein’s anomaly

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12
Q

Methimazole: teratogenic effects

A

Aplasia cutis congenita

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13
Q

Phenytoin: teratogenic effects

A

Fetal hydantoin syndrome: microcephaly, messed up head, hypoplastic nails/distal phalanges, cardiac defects, intrauterine growth restriction, retardation

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14
Q

Tetracyclines: teratogenic effects

A

discolored teeth

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15
Q

Thalidomide: teratogenic effects

A

Limb defects (phocomelia, micromelia, flipper limbs)

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16
Q

Valproate: teratogenic effects

A

Inhibition of maternal folate absorption–neural tube defects

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17
Q

Warfarin: teratogenic effects

A

bone deformities, fetal hemorrhage, abortion, opthalmologic problems, use heparin instead

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18
Q

Smoking (nicotine, CO) effects on fetus

A

low birth weight, preterm labor, placental problems, IUGR, ADHD

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19
Q

Maternal diabetes

A

caudal regression syndrome, congenital heart defects, neural tube defects

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20
Q

Vitamin A excess

A

extremely high risk for spontaneous abortions and cleft palate, cardiac abnormalities

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21
Q

Aortic arch derivates: 1st

A

maxillary artery (branch of external carotid)

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22
Q

Aortic arch derivates: 2nd

A

Stapedial artery, hyoid artery

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23
Q

Aortic arch derivates: 3rd

A

Common carotid artery, proximal part of internal carotid artery

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24
Q

Aortic arch derivates: 4th

A

on left-aortic arch; on right-proximal part of right subclavian artery

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25
Q

Aortic arch derivates: 6th

A

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

26
Q

embryonic derivates of clefts, arches, pouches

A

clefts-ectoderm, arches-mesoderm, pouch-endoderm (outside to inside)

27
Q

Branchial cleft derivatives: 1st cleft

A

external auditory meatus

28
Q

Branchial cleft derivatives: 2 to 4th clefts

A

temporary cervical sinuses that are obliterated by expansion of 2nd arch mesenchyme

29
Q

Branchial arch derivatives

A

When at restaurant of the golden arches, children tend to first chew (1), then smile (2), then swallow stylishly (3) or simply swallow (4) and then speak (6)

30
Q

Branchial pouch derivatives

A

Ear (1), Tonsils (2), Bottom (3, dorsal, inferior parathyroids), To (3, ventral thymus), Top (4, superior parathyroids)

31
Q

T cell deficiency, hypocalcemia, cardiac defects

A

DiGeorge syndrome: aberrant 3/4th pouch development–>thymic aplasia, abnormal parathyroids, conotruncal cardiac defects

32
Q

MEN 2A

A

mutation of germline RET (neural crest cells): adrenal medulla, parathyroid, parafollicular cells are all neural crest derivatives

33
Q

Testis determining factor

A

SRY gene on Y chromosome

34
Q

Mullerian inhibiting factor

A

Sertoli cells secrete, supresses development of paramesonephric ducts

35
Q

Stimulates development of mesonephric ducts

A

Leydig cells secrete androgens

36
Q

Paramesonephric duct develops into:

A

Female internal structures: fallopian tubes, uterus, upper portion of vagina

37
Q

Mesonephric duct develop into:

A

male internal structures SEED: seminal vesicles, epididymis, ejaculatory duct, ductus deferens

38
Q

Primary amennorrhea with fully developed secondary sexual characteristics

A

Paramesonephric duct abnormalities–still have functioning ovaries

39
Q

incomplete fusion of paramesonephric ducts

A

bicornuate uterus–recurrent miscarriages

40
Q

Develop both male and female internal genitalia, with male external genitalia

A

No sertoli cells or lack of mullerian inhibitory factor; Leydig cells secreting testosterone are functional

41
Q

Male internal genitalia, ambiguous external genitalia

A

5-alpha reductase deficiency: inability to convert testosterone to DHT; ambiguous genitalia until puberty when increased testosterone causes masculinization

42
Q

Genital tubercle, urogenital sinus masculinization to male genitalia

A

DHT (via testosterone from Leydig cell catalyzed by 5-alpha reductase)

43
Q

Which side is varicocele more common on?

A

Left side–left gonadal vein enters left renal vein at 90 degree angle, greater left venous pressure. Right gonadal vein enters IVC directly.

44
Q

Drain into para aortic lymph nodes

A

ovaries/testis

45
Q

Drain into superficial inguinal lymph nodes

A

distal vaginal/vulva/scrotum

46
Q

Drain into obturator, external iliac and hypogastric nodes

A

proximal vagina/uterus

47
Q

connects ovaries to lateral pelvic wall

A

infundibulopelvic ligament (suspensory ligament of the ovaries) containing ovarian vesseles

48
Q

connects cervix to side wall of pelvis

A

Cardinal ligament containing uterine vessels

49
Q

connects uterine fundus to labia majora

A

Round ligament of uterus that travels through round inguinal canal above artery of Sampson

50
Q

connects uterus/fallopian tubes/ovaries to pelvic side wall

A

Broad ligament (mesosalpinx above ovarian ligament, mesovarium (over ovaries), mesometrium below ovarian ligament)

51
Q

connects medial pole of ovary to lateral uterus

A

ovarian ligament, derivative of gubernaculum

52
Q

Pathway of sperm during ejaculation

A

SEVEN UP: seminiferous tubules, epididymis, vas deferens, ejaculatory duct, (nothing), urethra, penis

53
Q

Nerve innervation during male sexual response

A

Point and Shoot: parasympathetic (pelvic nerve, erection), sympathetic (hypogastric nerve, emission), ejaculation (visceral/somatic nerves, pudendal nerve)

54
Q

secrete inhibin and androgen binding protein

A

Sertoli cells that line seminiferous tubules. Inhibin inhibits FSH. Androgen binding protein maintains local levels of testosterone. Tight junctions between sertoli cells maintain blood-testis barrier (anti autoimmune attack), support and nourish spermatazoa, produce MIF, increased temp inhibits functions, aromatase to convert testosterone/andostenedione to estrogen

55
Q

secrete testosterone in presence of LH

A

Leydig cells in the interstitium, also contain aromatase to convert T to estrogen

56
Q

Converts cholesterol to androstenedione

A

Theca cell of follicle via desmolase. LH stimulates desmolase activity. Pulsatile GnRH stimulates LH.

57
Q

Converts androstenedione to estrogens

A

Granulosa cell of follice via aromatase. FSH stimulates granulosa cell via pulsatile GnRH.

58
Q

What are stages of menstrual cycle

A

Increased estrogen (endometrial proliferation, 7 days)–>LH surge (14 days)–>ovulation–>progesterone (from corpus luteum, peaks at 21 days)–>progesterone levels fall–>menstruation at 28 days

59
Q

Primary oocytes

A

(2N, 4C) arrested in prophase I of meiosis (46 sister chromatids) until ovulation

60
Q

Secondary oocytes

A

(1N, 2C) arrested in metaphase II of meiosis until fertilization

61
Q

Exclusively breast fed infants

A

require vitamin D supplementation

62
Q

Increased FSH along with hot flashes, vaginal atrophy

A

Menopause: decreased estrogen, increased FSH, increased LH (no surge), increased GnRH

USMLE Step 1 (36 decks)

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