Reproductive Flashcards
week heart begins to beat & have upper & lower limb buds
week 4
gene involved in CNS development & assoc with holoprosencephaly
Sonic hedghog
Feature of holoprosencephaly: hypotelorism (eyes close together)
gene for proper organization along dorsal-ventral axis (limb development)
Wnt-7
gene for mitosis of underlying mesoderm = lengthens limbs
FGF
gene implicated if limbs are in wrong locations
Homeobox = Hox
When does hCG secretion begin?
implantation of blastocyst = 1 week
neural tube formed from what? closes when?
neuroectoderm
by week 4
when do external genitalia show male/female characteristics?
week 10
when gastrulation occurs
week 3 = 3 layers
ectoderm + mesoderm + endoderm
embryologic derivative of muscle, bone, CT, serous linings of body cavities, lymphatics, blood, wall of gut (muscle?), vagina, kidneys adrenal cortex, dermis, testes, ovaries, nucleus pulposus of IV disc
mesoderm
embryologic derivative of gut epithelium, urethra, luminal epithelium of lungs, liver, GB, pancreas, eustachian tube, thymus, parathyroid, thyroid follicular cells
endoderm
teratogen effect of aminoglycosides (gentamycin)
CN VIII toxicity (hearing loss)
teratogen that can cause vaginal clear cell adenocarcinoma
diethylstilbestrol (DES)
teratogen that discolors teeth
tetracycline
anticonvulsant that inhibits folate absorption therefore can cause neural tube defects
valproate
what medication can be used to avoid blood clots in pregnancy but not cross the placenta
heparin
Do not use warfarin because it can cause fetal abortion, hemorrhage, eye & bone abnormalities
excess of this vitamin can cause spont abortion, cleft palate, cardiac abnormalities
vit A
forms outer layer of chorionic villi and secretes hCG
syncytiotrophoblast
how many umbilical vessels are there? type of blood transported?
2 UAs -> low O2
1 UV -> high O2
think of the baby as the heart of mama to remember circulation
duct between fetal bladder and yolk sac
urachus
If this stays patent: urine discharge from umbilicus
associated with ectopic gastric mucosa & is from partial closure of vitelline duct
Meckel diverticulum
aortic arch derivative that becomes common carotid & proximal internal carotid
3rd aortic arch
3rd arch = 3rd letter of alphabet (“c”)
persistent cervical sinus
branchial cleft cyst within lateral neck
which branchial arch makes no significant developmental contributions?
5th arch
thymic aplasia (deficiency of T cells) hypocalcemia (no parathyoid glands) cardiac defects
DiGeorge syndrome
mutation of germline RET gene resulting in the 3 P’s:
pheochromocytoma
parathyroid tumor
parafollicular cell cancer (medullary cancer of thyroid)
MEN 2A
from failure of fusion of maxillary & medial nasal prominences
cleft lip
from failure of fusion of the lateral palatine processes or fusion of the lateral palatine processes with nasal septum and/or median palatine process
cleft palate
Gene on Y chromosome that produces testis determining factor (TDF)
SRY
develops into internal male structures (SEED): Seminal vesicals, Epididymis, Ejaculatory duct, Ductus Deferens
Wolffian duct (mesonephric duct)
embryologic structures that becomes male external genitalia & prostate
genital tubercle & urogenital sinus
placenta implants in lower uterus and partially or completely covers the internal os -> requires c-section delivery
placenta previa
See a “preview” of the placenta (or can feel it)
What does the placenta normally attach to?
decidua
Absence results in placenta accreta -> can’t deliver the placenta since it’s stuck -> hysterectomy
classic presentation: fibrinoid necrosis of the placental vessels
preeclampsia
preeclampsia with SEIZURES
eclampsia
Must deliver the placenta
preeclampsia with thrombotic microangiopathy involving the liver; see schistocytes
HELLP syndrome
Hemolysis
Elevated liver enzymes
Low Platelets
abnormal implantation with cystic swelling of chorionic villi and proliferation of trophoblast; uterus is bigger than normal and beta-hCG is higher than normal
hydatidiform mole
see passage of grapelike masses (if no prenatal care)
prenatal care: absent fetal heart sounds & snowstorm appearance on US
Partial Mole: fetal parts
Complete: no fetal parts
which mole has greater risk of choriocarcinoma; what would you use to screen?
complete mole
level of beta-hCG over the next year after D&C
ovarian neoplasm that contains transitional epithelium (bladder type epithelium)
Brenner tumor
What serum value can be used to monitor progression/recurrence of ovarian neoplasm?
CA-125
most common germ cell tumor in female
mature cystic teratoma
If has immature tissue, then it has potential to mets (neuroectodermal tissue is what is present in the immature)
ovarian fibroma, ascites and pleural effusion
Meigs syndrome
cystic teratoma that contains functional thyroid tissue and presents as hyperthyroidism
struma ovarii
GI malignancy that mets to ovaries (BILATERAL), causing a mucin-secreting signet ring cell adenocarcinoma
Krukenberg tumor
intraperitoneal accumulation of mucinous material from tumor of ovary or appendix
pseudomyxoma peritonei
venous drainage of the gonads
left -> left gonadal vein -> left renal vein -> IVC
right -> right gonadal vein -> IVC
lymphatic drainage of ovary/testis
para-aortic lymph nodes
lymphatic drainage of scrotum/vulva
superficial inguinal lymph nodes
ligament that contains the ovarian vessels
suspensory ligament
ligament that is the derivative of the gubernaculum
round ligament of the uterus
ligament that contains the ovaries, fallopian tubes and round ligaments of the uterus
broad ligament
3 parts: mesosalpinx, mesometrium, mesovarium
most common area for cervical cancer
transformation zone
irregular menstruation
metrorrhagia
heavy menstruation
menorrhagia
ovulation sequence (hormone)
increased estrogen -> increased GnRH receptors on anterior pituitary -> estrogen surge -> stimulation of LH release -> ovulation
what elevates body temperature during menstrual cycle
progesterone
maintains the corpus luteum for the first trimester by acting like LH
hCG
marker for menopause
elevated FSH
loss of negative feedback on FSH by estrogen (through GnRH)
causes closure of epiphyseal plates
estrogen (converted from testosterone in males)
appears female: female external genitalia, short vagina that ends in blind pouch, absent uterus & fallopian tubes, scant sexual hair, undescended testes
androgen insensitivity syndrome
hypogonadotropic hypogonadism; defective migration of GnRH cells and formation of olfactory bulb, decreased GnRH LH & FSH, anosmia, infertility
Kallmann syndrome
hypertension and proteinuria in pregnancy (after 20 weeks gestation up to 6 weeks postpartum)
preeclampsia
HPV gene product that inhibits p53 suppressor gene
E6
HPV gene product that inhibits RB tumor suppressor gene
E7
causes of endometrial hyperplasia
anovulatory cycles, HRT, PCOS, granulosa cell tumor
hyperandrogenism, hyperinsulinemia (insulin & testosterone decrease SHBG synth therefore increased free testosterone)
Presents with amenorrhea (oligomenorrhea), hirsutism, acne, infertility, obesity; LH:FSH > 2 (FSH is shut down because of feedback of peripheral conversion of androgens to estrogen)
polycystic ovarian syndrome
have increased risk of endometrial cancer from increased estrogens from aromatization of testosterone
location of highest density of breast tissue in a female
upper outer quadrant
breast tumor with large leaf-like projections; most commonly presents in 6th decade
phyllodes tumor
treatment of BPH
alpha1 antagonists: terazosin, tamsulosin (selective for receptors in prostate vs vascular)
5 alpha reductase inhibitor: finasteride
Why is varicocele more common in left testicle?
increased resistance to flow from left gonadal vein drainage into left renal vein
difference in mature teratoma in males from one in females
may be malignant
associated with priapism
trauma, sickle cell anemia, medications
tumor associated with Reinke crystals
Leydig cell tumor
nonsteroidal competitive inhibitor of androgens at testosterone receptor
flutamide
warm, enlarged breast with purulent nipple discharge in breastfeeding female: treatment & dx?
mastitis
dicloxacillin & continue breastfeeding
subareolar mass with nipple retraction
periductal mastitis
- usually from keratinization of cells blocking duct
- columnar cells converted to squamous due to Vit A deficiency in smoking
inflammation with green-brown nipple discharge
mammary duct ectasia
causes calcification on mammogram
see giant cells
fat necrosis (from saponification)
causes downregulation of GnRH receptors in pituitary when given continuously therefore decreased FSH/LH
leuprolide
Use: prostate cancer
antagonizes estrogen receptors in the hypothalamus to prevent normal feedback inhibition -> increases LH & FSH release from pituitary -> ovulation
clomiphene
used to treat ER+ breast cancer: antagonist at breast tissue but agonist at bone and uterus, increasing risk of endometrial cancer
tamoxifen
osteoporosis drug that is an agonist at bone, antagonist at uterus
raloxifene
inhibits 17 hydroxylase in steroid synthesis; causes gynecomastia
spironolactone
5 alpha reductase inhibitor used for BPH
finasteride
Virilization of mother during pregnancy due to placental transfer of excess androgens from fetus to mom
Maculinization of female fetus
Aromatase deficiency
