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S1 First aid > reproductive > Flashcards

reproductive Flashcards

1
Q

what ectoderm divided into?

A

surface ectoderm,
neural crest,
neural tube,

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2
Q

what is derived from surface ectderm?

A

epidermis, adenohypophysis( rathkes pouch), eye lens, epithelial lining of oral cavity, sensory organs, seat glans and mammary glands

cranopharyngioma

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3
Q

Neural tube derivatives are?

A

brain, (neurohypophysis, CNS neurons, oligodendrocytes, astrocytes, epedyme cells, pineal glands), retina, spinal cord

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4
Q

neural crest derivatives are?

A

Melanocytes, Odontoblasts, tracheal lining, enterochromaffine cells, leptomeninges (pia, arach.), PNS, adrenal medulla, schwann cells, spiral membrane, skull, endocardial cushining

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5
Q

endoderm derivatives are?

A

gut tube, urethra, vagina, epithelial derivatives: lung, gallbladder, thyroid, liver

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6
Q

what is the Pierre robin sequence?

A

micrognathia, glossoptisis, cleft palate, airway obstruction

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7
Q

when does hCG secreation start?

A

W1

bastocyte sticks at day 6

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8
Q

when is the bilaminar disc?

A

W2=2layers

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9
Q

Gastrulations occurs when?

A

W3=3layer

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10
Q

nural tube is formed by the neuroectoderm when?

A

W4=4limbs and 4Chambers

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11
Q

when is th fetus seen on US?

A

W6

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12
Q

fetal movement starts?

A

W8

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13
Q

genitalia formation occurs?

A

W10= tenitalia

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14
Q

persistent cervical sinus is?

A

pharyngeal cleft cyst within the lateral neck, ant. to the sternoclido.

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15
Q

What is liprolite, what is it used for?

A

GnRH anlog with agonist properties, it downregurates the GnRH receptor in the petuitory and decreases FSH and decreases LH

used for fibroids, endometriosis and infertility

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16
Q

Estrogen

A

ethinyl estridiol, DES, mestranol
binds to recepror

used in hypogonadism, ovarian failure

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17
Q

Clomiphene

A

antagonist of estrogen receptor in hypothalamus, increases release of LH and FSH

used in infertility

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18
Q

tamoxifen

A

Antagonist at breast, partial agonist at uterus, bone.

competitively inhibits estrogen binding to its receptor

Hot flashes, in.  risk of thromboembolic events (especially with tobacco smoking), and endometrial cancer. Used to treat and prevent recurrence of ER/PR ⊕ breast cancer and to prevent gynecomastia in patients undergoing prostate cancer t herapy

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19
Q

raloxifene

A

antagoinist of breast, uterus, agonist of bone

used for osteoporosis

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20
Q

aromatase deficiency

A

inhibits peripheral conversion of androgens to estrogen

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21
Q

progestin

A

bind to progesteron receptor, thickens the mucus, contraceptive

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22
Q

antiprogestins

A

mefepristine and ulipristal

competitive inhibitors of progestins at progesteron receptors, terminates pregancy

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23
Q

combined contraception

A

progestins and ethinyl estradiol, inhib. LH/FSH, thickening mucus

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24
Q

danazol

A

synthetic androgen, that acts as a partial agonist at androgen receptor

use endometriosis, heridiaty angioedema

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25
Q

endometrial hyperplasia

A

abnorm. endom. gland prolif. usual. caused by estrogen secretion

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26
Q

endometrial carcinoma

A

most commen gyn. malignancy
sy: irreg. bleeding
two types. endometriod: not estrogen stimul. early loss of pten
serous: hist: papilla and tuft,

Early pathogenic events include loss of PTEN or mismatch repair proteins.

TP53 loss

KRAS–>PIK3CA–>MLHI–>TP53–>carcinome

usul. postmenopausal

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27
Q

serous cystadenoma

A

most common ovarian neoplasm. lined with fallopian tube-like epithelum.

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28
Q

Serous cystadenoma

carcinoma

A

most common mal. ovarian neoplasm, frequenly blilateral, psamma bodies.

monitor CA 125

KRAS, PIK3CA, TP53, BRCA high grade
epithelium, columnar epithelial cilia+ mutilcystic spaces

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29
Q

What is a derivative or the paranephric duct and what is another name for it?

A

Wolffian duct,
develops into the male internal structures except the prostate, SEED, seminal vessels, epidydimis, ejauclatory duct, ductus defference,

in females remnant is the gartner duct

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30
Q

What is a derivative or the paramesonephritic (müllerian) duct?

A

devel. into female internal structures- fallopian tube, uterus, upper vagina, lower urogenital sinus,

male reminant ist the appendic testis

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31
Q

what is müllerian agenis (mayer-rokitansky-küster-hauser-syndrome?

A

may present with 1° amenorrhae ( due to lack of uterus devel. in fem with fully developed uterus 2° sex charac. (functional ovaries)

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32
Q

what is lactogen?

A

chorionic somatomammatropin,
source: is the syncytiotrophoblast of the placenta,

function: stimulates insulin production; increases insulin resistance

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33
Q

what is estrogen?

A

ovary (17ß-estradio), placenta (estridiol), adipose tissue ( estrone via aromatization)

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34
Q

leydeg cell produce?

A

(ley)dies dig testosteron

35
Q

sertoli cells serect?

A

inhibinB—-> inhibits FSH

secretion of androgen-binding proteins to maintain testosterone levels

36
Q

cleft lip is a result of?

A

failure to fuse of the maxillary and merge medial nasal process

37
Q

cleft palate is a result of?

A

failure of fusion of the two lateral palatine shelves or falure of fusion of lateral paletine shelf with the nasal septum.

38
Q

warfarin causes what in pregnant women?

A

bone deformities, fetal hemorrhage, abortion, ophthalmologic abnormalities

39
Q

aminoglycosites cause?

A

ototoxicity

40
Q

what does placental aromataze deficiency lead too?

A

inability to synthesized estrogen from androgens, leads to masculinization

41
Q

5 alpa reductase deficiency

A

autosomal recess. limited to male, inability to convert testosterone to DHT, leading to ambiguous genitalia

42
Q

kallmann syndrome is?

A

failure to complete puberty, a form of hypoganadotropic hypognadism. faillure to reslease GnRH and falure to develop olfactoric bulb.

43
Q

hydroform mole

A

cystic swelling of choroinic villi and prolif. of chori, epithel.

44
Q

choriocarcinoma

A

after prenacy, malignant trophoblastic tissue, no villi, hCg

45
Q

extrammary paget disease

A

intraepithelial adenocarcinoma

46
Q

brenner tumor

A

resembles bladder epthelium (tras. cell tumer) cofe been

47
Q

granulosa cell tumor

A

malignant stromal tumor, 50s, often produces estrogen/ progesteron, present with postmenopausal bleeding.
give granny a call
hist: Call-Exner bodies

48
Q

Ashermann syndrome

A

Adhesions and/or fibrosis of the endometrium. Presents with decreased fertility, recurrent pregnancy loss, AUB, pelvic pain. Often associated with dilation and curettage of intrauterine pregnancy

49
Q

what are benign tumors of the breast?

A

fibroadenoma
intraductal pailloma
phyllades tumor

50
Q

what is a fibroadenoma?

A

most common in women under 35, small, well defined mobile mass

51
Q

what is a intraductal pailloma?

A

small fibroepithelial tumor within the lactiferous duct, typ. beneath the areola

52
Q

what is a phyllades tumor?

A

large mass of connective tissue and cysts with leasf like lobulation

53
Q

what is a leydig cell tumor?

A

golden brown color, conteins reinke crystal (eosinonophilic cytoplasmic inclusions). Produces androgens or estrogens

54
Q

sertoli cell tumor is?

A

androblastoma from the sex cord stroma

55
Q

testicular lymphoma is?

A

most common testicular tumor in older male, not 1° cancer, it arises from metastac lymphoma to testes. aggressive

56
Q

protastic adenocarcinoma is?

A

common in males > 50 years old. posterior lobe( peripheral zone) of prostate gland, increase PSA, oteopblastic mestastisis

57
Q

leuprolide

A

leuprolide can be used in lieu of GnRH

use fibroid, endometriosis

58
Q

Testosterone, methyltestosterone

A

agonist as androgen receptors, treat hypogonadism

59
Q

finasteride

A

5alpha-reductase inhibitor, ae: gynacomastia

60
Q

flutamite

A

nonsteriodal competitive inhibitor at androgen receptor

61
Q

ketoconazole

A

inhibits steriod systhesis (inhibits 17,20-desmolase/17-alpha-hydroxylase,
ae: gynacomastia

62
Q

Spironolactone

A

inhibits steriod binding (inhibits 17,20-desmolase/17-alpha-hydroxylase,
ae: gynacomastia

63
Q

Tamsulosin

A

selective alpha1-antagonist used in BPH

64
Q

17α-hydroxylase

A

XY: ambiguous genitalia, undescended testes

XX: lacks 2° sexual development

65
Q

21-hydroxylase

A

Most common
Presents in infancy (salt wasting) or childhood (precocious puberty)

XX: virilization

66
Q

11β-hydroxylase

A

Presents in infancy (severe hypertension) or childhood (precocious puberty)

XX: virilization

Virilization is a condition in which a female develops characteristics associated with male hormones (androgens), or when a newborn has characteristics of male hormone exposure at birth.

67
Q

Congenital Adrenal Hyperplastion

A

A(aldost.) HTN T(testos)

21: 2 1
17alpha: 1 7
11beta: 1 (only HTN) 1

1=increase

68
Q

Urachus

A

Allantois forms from hindgut and extends into urogenital sinus.

Patent urachus

Total failure of urachus to obliterate—–>urine discharge from umbilicus

69
Q

Urachal cyst

A

Partial failure of urachus to obliterate; fluid-filled cavity lined with uroepithelium, between umbilicus and bladder. Cyst can become infected and present as painful mass below umbilicus

70
Q

Vesicourachal diverticulum

A

Slight failure of urachus to obliterate—–>outpouching of bladder

71
Q

Vitelline duct

A

Also called omphalomesenteric duct. Connects yolk sac to midgut lumen. Obliterates during week 7 of development

Patent vitelline duct
Total failure of vitelline duct to obliterate—–>meconium discharge from umbilicus.

Vitelline duct cyst

Partial failure of vitelline duct to obliterate. increased risk for volvulus

72
Q

Meckel diverticulum

A

Slight failure of vitelline duct to obliterate——>outpouching of ileum (true diverticulum, arrow in B).

Usually asymptomatic. May have heterotopic gastric and/or pancreatic tissue—–>melena, hematochezia, abdominal pain.

73
Q

Absence of Sertoli cells or lack of Müllerian

A

Absence of Sertoli cells or lack of Müllerian inhibitory factor—->develop both male and female internal genitalia and male external genitalia (streak gonads)

74
Q

5α-reductase deficiency

A

inability to convert testosterone into DHT—–>male internal genitalia, ambiguous external genitalia until puberty (when  increase testosterone levels cause masculinization

Testosterone/estrogen levels are normal

75
Q

Bicornuate uterus

A

Incomplete fusion of Müllerian ducts

76
Q

Menstrual cycle

A

Follicular phase can fluctuate in length.
Follicular growth is fastest during 2nd week of the follicular phase.
Luteal phase is a fixed 14 days, after which menstruation occurs.
Estrogen stimulates endometrial proliferation.
Progesterone maintains endometrium to support implantation.
decreased progesterone —-> decreased fertility.

77
Q

Hydatidiform mole

A

Cystic swelling of chorionic villi and proliferation of chorionic epithelium (only trophoblast)

increased hCG-mediated

78
Q

Complete mole

A

46,XX (most common); 46,XY

Hydropic villi

Most commonly enucleated egg + single sperm (subsequently duplicates paternal DNA

79
Q

Partial mole

A

69,X X X; 69,X X Y; 69,X Y Y

Only some villi are hydropic, focal/minimal trophoblastic proliferation

2 sperm + 1 egg

80
Q

Extramammary Paget disease

A

Intraepithelial adenocarcinoma. Carcinoma in situ, low risk of underlying carcinoma (vs Paget disease of the breast, which is always associated with underlying carcinoma).

Presents with pruritus, erythema, crusting, ulcers

81
Q

Polycystic ovarian syndrome

A

Hyperinsulinemia and/or insulin resistance hypothesized to alter hypothalamic hormonal feedback response—-> increase LH: FSH,  increases androgens (eg, testosterone) from theca interna cells,  rate of follicular maturation—> unruptured follicles (cysts) + anovulation. Common cause of  fertility in females.

Enlarged, bilateral cystic ovaries A; presents with amenorrhea/oligomenorrhea, hirsutism, acne, decreased fertility. Associated with obesity, acanthosis nigricans.  risk of endometrial cancer 2° to unopposed estrogen from repeated anovulatory cycles.

Treatment: cycle regulation via weight reduction ( decreased peripheral estrone formation), OCPs (prevent endometrial hyperplasia due to unopposed estrogen); clomiphene (ovulation induction); spironolactone, finasteride, flutamide to treat hirsutism.

82
Q

Granulosa cell tumor

A

Most common malignant sex cord stromal tumor. Predominantly occurs in females in their 50s. Often produces estrogen and/or progesterone. Presents with postmenopausal bleeding, endometrial hyperplasia, sexual precocity (in preadolescents), breast tenderness. Histology shows Call-Exner bodies (granulosa cells arranged haphazardly around collections of eosinophilic fluid, resembling primordial follicles; arrow in F). Tumor marker:  inhibin.

“Give Granny a Call.

83
Q

Adenomyosis

A

Extension of endometrial tissue (glandular) into uterine myometrium. Caused by hyperplasia of basal layer of endometrium. Presents with dysmenorrhea, AUB/HMB, and uniformly enlarged, soft, globular uterus. Treatment: GnRH agonists, hysterectomy, excision of an organized adenomyoma.

84
Q

Germ cell tumors

Seminoma

A

Malignant. Painless, homogenous testicular enlargement. Most common testicular tumor. Analogous to ovarian dysgerminoma. Does not occur in infancy. Large cells in lobules with watery cytoplasm and “fried egg” appearance on histology,  placental ALP (PALP). Highly radiosensitive. Late metastasis, excellent prognosis.

S1 First aid (20 decks)

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