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UWorld REview > Reproductive > Flashcards

Reproductive Flashcards

1
Q

role of human placental lactogen during pregnacy-produced, similar to, metabolism effects (3)

A

secreted from syncytiotrophoblast
-similar to prolactin and growth hormone
increases insulin resistance (more glucose for baby), stimulate proteolysis and lipolysis (mother uses this as fuel=more glucose for baby), and inhibits gluconeogensis (more glucose for baby).

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2
Q

what pregnany hormones can cause maternal insulin resistance?

A

human placental lactogen (hPL), placental growth hormone, estrogens, progesterone, and glucocorticoids

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3
Q

nutrients not found in breast milk

A

vitamin D-give supplements

and vit K-injection at birth to prevent hemorrhagic diseaese

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4
Q

primary oocytes are in which stage before ovulation? after ovulation?

A

before- prophase of meiosis I

after- metaphase of meiosis II

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5
Q

which hormone stimulates the production of androgens? which cells respond to this?

A

LH, theca interna cells of ovarian follicle

LH, Leydig cells secrete testosterone regardless of temperature

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6
Q

androgens are converted to estradiol where? name enzyme? which hormone controls this?

A

granulosa cells with the enzyme aromatase FSH

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7
Q

theca externa cells

A

serve as connective tissue support structure for follicle

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8
Q

which hormones prevent lactogenesis during pregnancy? (2) what do they promote?

A

estrogen progesterone. inhibit role of prolactin and after birth their levels decrease and prolactin can have it’s effect.
breast growth

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9
Q

role of hCG in pregancy- levels fall when?

A

maintain corpus luteum until placenta can make estrogen and progesterone. levels fall by mid-pregnancy

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10
Q

role of LH during pregnancy

A

none- levels are low due to feedback inhibtion of anterior pituitary gland

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11
Q

pts with fetal mutations remember taking acetominaphen during preg and pt with baby w/o mutations do not remember taking actominaphen=this type of bias

A

recall bias

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12
Q

difference between primary amenorrhea causes by imperforate hymen, hyperprolactinemia, Kallmann syndrome, Turner syndrome, pregnancy

A
  • fully developed secondary characteristics, cyclic abdominal pain, hematocolpos (vagina filled with menstrual blood-mass palpated anterior to rectum)
  • an also present with oligomenorrhea in addition to abnormal hormone levels (i.e galactorrhea, hypoestrogenemia)
  • absent secondary characteristics, an olfactory sensory defect
  • short stature, webbed neck, shielded chest, fibrotic ovaries absent sexual characteristics
  • increased hCG levels
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13
Q

does endometriosis cause amenorrhea?

A

no is causes dysmenorrhea, and dsyspareunia

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14
Q

nevi vs accessory nipples vs keloids

A
  • both raised and hyperpigmented
  • nevi and keloids do not influenced by menstrual cycle changes
  • keloids are a result of trauma to skin.
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15
Q

define anti-Rh (D) immunoglobin (RhoGAM)-consist of, used for. given when (2)?

A

consists of IgG anti-Rh(D) antibodies. give to Rh-negative mothers at 28 wks and immediately postpartum. blocks maternal immune response to fetal Rh (D) antigens

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16
Q

epithelium in ovary, fallopian tube, uterus, cervix, vagina

A
  • simple cuboidal
  • simple columnar
  • simple (pseudostratified) columnar
  • simple columnar (endocervix); stratified squamous (ectocervix)
  • stratified squamous (non-keratinized)
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17
Q

name organ associated with these epithelial features

-aka germinal epithelium, transitions to peritoneum at broad ligament of uterus

A

ovary

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18
Q

name organ associated with ciliated cells help transport egg/embryo; peg cells (secrete nutrients)

A

fallopian tube

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19
Q

name organ associated with tubular glands, a functional and basal layer, cyclic changes

A

uterus

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20
Q

name organ associated with cervical glands, cyclic changes allowing for less viscous mucus at time of ovulation

A

cervix

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21
Q

name organ associated with presence of glycogen

A

vagina

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22
Q

name associated epithelial tumors of

ovary, fallopian tube uterus, cervix, vagina

A
  • serous,mucinous, endometrioid, clear cell, brenner (urothelial)
  • rare
  • endometrial CA
  • condyloma acuminatun, squamous cell CA, adenocarcinoma
  • squamous cell CA
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23
Q

when is beta-hCG production occur? detectable in maternal serum?

A
  • after blastocyst successfully implants, usually 6 days after ovulation.
  • 8-11 days
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24
Q

after fertilization

  • 3-4 days
  • 5-6days
  • > 6 days
A
  • enters uterus as 2-8 cells embryo or multi-celled morula
  • morula becomes blastocsyst and is free floating
  • implantation occurs
25
Q

Downs due to nondisjunction in meiosis I vs meiosis II

A

failure of homologus pairs to separate (child has 3 different versions of chromosome 21)
failure of sister chromatids to separate (child has 2 different version of chromosome 21 which double the amount of one of them)

26
Q 
amino/chorion number in
-dizygotic twins
monozygotic 0-4 days
monozygotic at 4-8 days
monozygotic at 8-12 days
and monozygotic after 13 days
A
  • always dichorionic/diamniotic
  • dichorionic/diamnionic
  • monochorionic/diamniotic (after morula)
  • mono/mono (after blastocyst)
  • mono/mono conjoinedd twins (after formed embryonic disk)
27
Q

histological appearance of endometrial stroma in days. main hormone present
1-14
mid cycle
15-28

A
  • proliferative phase. compact non-edematous stroma, gland:stroma ratio less than 1, glands are straight and narrow with small lumens, controlled by estrogren
  • between proliferative and secretory phase. ovulation, coiled glands with occasional cytoplasmic vacuoles. LH surge
  • mid-secretory phase. gland:stroma ratio is 1:1, stromal edema, dilated and coiled glands with wide lumens controlled by progesterone
28
Q

Klinefelter’s syndrome has what lab values? what determines degree of feminization?

A
  • increased FSH, due to gonadal failure
  • elevated estradiol
  • estrogen:testosterone ration determines extend of feminization
29
Q

PCOS is aka

A

Stein-Leventhal Syndrome

30
Q

PCOS presents how?

A

obesity, hyperandrogenism, oligomenorrhea, infertility, and enlarged ovaries with multiple cysts

31
Q

intraductal papilloma discharge vs prolactinoma discharge

A
  • bloody or serosanginous (no problems with ovulation)

- milky discharge (also look for amenorrhea)

32
Q

what is a common cause of menstrual cycle variability in a female several years after menarche and a few years before menopause?

A

annovulation

  • can have heavy periods with spotting in between
  • no progesterone rise b/c no LH surge, leads to unopposed estrogen mediated endometrium proliferation
33
Q

which ovarian tumors secrete estrogen? how does this present in a patient? cancer risk?

A

granulosa cell and theca tumors.
hyperestrogenemic state causes endometrial hyperplasia and abnormal bleeding
-predisposed to endometrial adenocarcinoma

34
Q

rubella in mother and in neonate?

A
  • low grade fever, maculopapular rash with cephalocaudal progression, and posterior auricular and suboccipital lympadenopathy, polyarthritis and polyarthralgia are possible sequelae
  • congenital rubella is associated with senorineural deafness, cataracts and PDA
35
Q

Huctingson’s incisors and mulberry molars

A

congenital syphillus

36
Q

age at which conception is considered advanced

A

35

37
Q

unilateral erythema carcinoma and scale crust around nipple

A

Paget’s disease

38
Q

solid sheets of vescular, pleomorphic mitoticaly active cells with significant lymphoplasmacytic infiltration around and within the tumor

A

medullary carcinoma

39
Q

central acinar compression and distortion (by surrounding) fibrotic tissue and peripheral ductal dilation

A

sclerosing adenosis

40
Q

leaflike and similar to fibroadenomas-cancer risk?

A 
Phyllodes tumor (cancer risk)
-no risk with fibroadenomas
41
Q

pleomorphic solid sheets, high grade cells with central necrosis

A

comedocarcinoma

42
Q

name 4 parts of normal menstrual cycle and hormones involved

A
  • menstrual, follicular, ovulatory, and luteal
  • after menstration estrogen promotes proliferation of endometrium
  • FSH stimulates estrogen production and one dominant follicile to form in one of the ovaries
  • as follicular phase continues a progresses increasing levels of estrogen has a positive feedback on LH production
  • LH surge causes rupture of dominant follicle leading to ovulation
  • progesterone increases after LH surge to maintain endometrium (peak in mid-luteal phase)
43
Q

how is pudendal nerve block preformed? type of anesthesia. for complete perineal and genital anesthesia?

A

injecting anesthetics intravaginally in the region of the ischial spine

  • majority of perineum
  • additional blockade of genitofermoral and ilioingiunal nerves
44
Q

what drains to superficial inguinal lymph nodes?

A

-cutaneous structures inferior to umbilicus, external genitalia and anus up to pectinate line

45
Q

deep inguinal nodes

A

glans penis and ciltioris

46
Q

external iliac nodes

A

drain superficial and deep inguinal nodes and deep lymphatics of abdominal wall below umbilicus

47
Q

inferior mesenteric nodes

A

drain structures supplied by IMA. descending and sigmoid colon as well as upper part of rectum
-efferents drain to para-aortic nodes

48
Q

lymph from testes drains where? lymph from scrotum

A

para aortic nodes

superficial inguinal lymph nodes

49
Q

pts with PCOS and infertility are treated how? mech of action

A
  • clomiphene citrate
  • estrogen receptor modulator
  • decreased negative feedback inhibition on hypothalalmus from increased estrogen and allowing for increased gonadotrophin production
50
Q

name genetic cause of Turner’s syndrome? give 3 examples? which is most common?

A

mitotic error in early development

  • complete monosomy (45,X,O), mosaicism (45XO/46XX) or partial deletion of one X chromosome (46 XX)
  • mc cause is monosomy
51
Q

T or F smoking is a risk factor for CIN?

A

false, strongest risk factor is HPV infection (early first intercourse and multiple sex partners)

52
Q

endometrial glandular tissue within myometrium

A

adenomyosis

53
Q

benign pseduoencapsulated tumor of monoclonal uterine smooth muscle. swirled spindles

A

leiomyoma

54
Q

mc type of endometrial carcinoma? mc presentation?

A

adenocarcinoma

abnormal uterine bleeding in a postmenopausal woman

55
Q

normal endometrial tissue (stomal and glands) in abnormal locations

A

endometriosis

56
Q
  • cervicitis with purulent white discharge
  • gray discharge with fishy order made worse with KOH
  • vaginal puritis, white curd like discharge and labial erthema
  • yellow green foamy, foul-smelling discharge, motile trophozoties with flagellae
  • vagianal dryness, serosanginous, watery discharge and dsypareunia
A
  • N. gonorrhoeae or c. trachomatis
  • bacterial vaginosis (BV) i.e gardenerella vaginalis
  • candida albicans
  • trichomonas
  • atrophic vaginitis, seen in postmenopausal or hypoestrogenemic women
57
Q

triad of pre-elampsia

A

-HTN, edema, and proteinuria

58
Q

HELLP syndrome

A

hemolytic anemia, elevated liver enzymes and low platelets

UWorld REview (17 decks)

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