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Elliot Step 1 > Reproductive > Flashcards

Reproductive Flashcards

1
Q

Sertoli cells of male secrete blank during development?

A

Antimullerian hormone– causes atrophy of mullerian ducts

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2
Q

antimullerian hormone secreted by?

A

sertoli cells

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3
Q

Without testosterone, this structure fails to differentiate?

A

Wolffian ducts

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4
Q

Where is 5 alpha reductase located?

A

Prostate– converts testosterone into DHT

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5
Q

Where does GnRH come from?

A

Arcuate nuclei of hypothalamus

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6
Q

Sertoli cells secrete?

A

Inhibin– which is involved in negative feedback of FSH

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7
Q

Actions of dihydrotestoerone

A

differentiation of penis, scrotum, and prostate

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8
Q

Female external genitalia with no internal genital tract?

A

Androgen insensitivity XY–testosterone levels are elevated due to lack of negative feedback ( Testes are often found in the labia majora)

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9
Q

FSH and LH in prepubescent boy?

A

FSH>LH (after pubert LH>FSH)

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10
Q

Converts androgen to estradiol?

A

aromatase

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11
Q

FSH and LH levels during follicular phase?

A

LH and FSH are suppressed by neg feedback effect of estradiol on anterior pituitary– progesterone levels are low

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12
Q

End of follicular phase (FSH and LH)

A

Estradiol has a positive feedback effect on secretion of FSH and LH leading to the LH surge

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13
Q

Ovulation occurs as a result of?

A

Estrogen induced LH surge

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14
Q

What happens to estrogen after ovulatin?

A

Estrogen levels fall but rise again during luteal phase

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15
Q

What happens to cervical mucus during ovulaton?

A

More easily penetrable by sperm

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16
Q

Peak levels of HCG occur when?

A

9 weeks

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17
Q

How long does corpus luteum produce estradiol and progesterone for?

A

First semester– then progesterone is made by placenta and estrogens are made by the interplay of fetal adrenal gland and placenta

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18
Q

Major placental estrogen is called?

A

estriol

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19
Q

Describe the estrogen progesterone ratio that induced labor?

A

Estrogen:progesterone levels increases…. (no one knows this crap)

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20
Q

Describe prolactin production during pregnancy

A

Estrogen Stimulates prolactin production in pituitary but lactation does not occur because estrogen and progesterone block action of prolactin on the breast

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21
Q

What effects does prolactin have?

A

Inhibits GnRH and antagonizes the actions of LH and FSH on the ovaries

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22
Q

Where does adenohypophysis come from?

A

Surface ectoderm (Rathkes pouch)

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23
Q

Benign Rathkes pouch tumor with cholesterol crystals and calcification?

A

Craniopharyngiomas

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24
Q

Neuroectoderm derivatives?

A

CNS– brain, retina, optic nerve, spinal cord

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25
Q

Neural crest derivatives?

A

PNS and no neural structures nearby (melanocytes, chromaffin cells of adrenal, bones of skull, aorticopulmonary septum

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26
Q

Mesodermal defects?

A 
VACTERL
Vertebral defects
Anal atresia
Cardiac
Tracheo esophageal fistula
Renal defects
Limb defects
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27
Q

What does the notochord do to the ectoderm?

A

Induces ectoderm to form neuroectoderm (neural plate).

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28
Q

Postnatal structure of notochord?

A

nucleus pulposus

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29
Q

Agenesis vs aplasia?

A

Absent organ due to absent primordial tissue vs absent organ despite PRESENCE of primordial tissue

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30
Q

Malformation vs deformation?

A

Malformation occurs during embryonic period (intrinsic disruption) vs deformation is extrinsic and occurs after embryonic period

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31
Q

Appendages in wrong locations occurs due to defect in?

A

Homeobox

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32
Q

Fetal atrealized right ventricle?

A

Lithium

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33
Q

Vaginal clear cell adenocarcinoma of fetus?

A

DES

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34
Q

Limb defects in neonate (flipper limbs)

A

Thalidomide ( Tha LIMB domide)

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35
Q

Inhibits maternal folate absorption?

A

Valproate

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36
Q

Drug that causes placental abruption?

A

Cocaine

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37
Q

Anal atresia in neonate dt?

A

maternal diabetes

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38
Q

High risk of spontaneous abortion and birth defects in excess?

A

Vit A

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39
Q

Inner layer of chorionic villi

A

cytotophoblast

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40
Q

Outer layer or chorionic villi

A

syncytiotrophoblast

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41
Q

Desidua basalis derived from?

A

Endometrium

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42
Q

Job of umbilical arteries?

A

Return deox blood from fetal INTERNAL Iliac arteries to placenta

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43
Q

Where are umbilical blood vessels derived from?

A

Allantois

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44
Q

Meconium discharge from umbilicus?

A

Vitelline fistula

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45
Q

Another name for mullerian duct?

A

Paramesonephric duct

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46
Q

Another name for Wolffian duct?

A

Mesonephric duct

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47
Q

Describe phenotype of XY with no sertoli cells or lack of MIF?

A

Male external genitalia and both internal genitalia

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48
Q

Lack of 5 alpha reductase?

A

Male internal and ambiguous external until puberty

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49
Q

Lymphatic drainage of ovaties and tests?

A

para aortic lymph nodes

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50
Q

Distal 1/3 of vagina/scrotum lymphatic drainage?

A

superficial inguinal nodes

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51
Q

Connects overies to lateral pelvic wall?

A

Suspensory ligament

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52
Q

Connects cervix to side wall of pelvis?

A

Cardinal ligament– contains uterine vessels

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53
Q

Connects uterine fundus to labia majora?

A

Round ligament of uterus– derivative of gubernaculum

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54
Q

Connects lots of vaginal crap to pelvic side wall?

A

Broad ligament

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55
Q

Female structure with ciliated simple columnar?

A

Fallopian tubes (cilia help move egg)

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56
Q

Female structure with stratified squamous epithelium?

A

Ectocervix and Vagina– strength from stress during pregnancy

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57
Q

Female structure with simple columnar epithelium?

A

Endocervix

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58
Q

Suspensor ligaments contain?

A

Ovarian vessels

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59
Q

This ligament contains uterine vessels?

A

Cardinal ligament– be careful during ligation of vessels in hysterectomy

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60
Q

Female structure with simple cuboidal?

A

Ovary– secretory

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61
Q

NO release stimulated by what nerve during erection?

A

Pelvic nerve

62
Q

Nerve involved in ejaculation?

A

Pudendal nerve

63
Q

Germ cells of sperm productoin?

A

Spermatogonium

64
Q

Blood testes barrier formed by?

A

tight junctions of blood testis barrier– isolates gametes from autoimmune attack

65
Q

Job of leydig cells?

A

produce testosterone– found in interstitium

66
Q

ABP?

A

support spermatogenesis

67
Q

Testosterone differentiates all internal genitalia except??

A

prostate is stimulated by DHT

68
Q

Late effects of DHT?

A

Prostate, balding, sebaceous gland activity

69
Q

what happens to testosterone in adipose tissue?

A

Converted to estrogen by aromatase

70
Q

What type of estrogen is produced by a) ovary b) placenta

A

1) estradiol

2) Estriol

71
Q

Where are estrogen receptors expressed?

A

Cytoplasm– when bound by ligand they translocate to nucleus

72
Q

Stimulates spiral artery development?

A

Progesterone

73
Q

Produces thick cervical mucus to inhibit sperm entry into uterus?

A

Progesterone

74
Q

> 35 days cycle?

A

Oligomenorrhea

75
Q

Metrorrhagia?

A

frequent but irregular menstruation

76
Q

Menometrorrhagia?

A

Heavy, iregular menstruation at irregular intervals

77
Q

Rise in estrogen has what effect on anterior pituitary during ovulation?

A

Increases GnRH receptors

78
Q

Pain that mimics appendicitis

A

Mittelschmerz– blood from ruptured follicle causes periotoneal irritation

79
Q

Primary oocytes are arrested in?

A

Prophase of Meiosis I before ovulation

80
Q

Oocyte arrested in what stage until fertilization?

A

Metaphase II or meiosis II

81
Q

Elevated in HCG in men may represent?

A

Testicular germ cell tumor

82
Q

XY, external genitalia are ambiguous, testes present, looks like female?

A

Androgen insensitivity

83
Q

Decrease in LH and increase in testosterone?

A

Exogenous testosterone or tumor

84
Q

Increased LH and decreased Testosterone?

A

Primary hypogonadism

85
Q

Dec LH and Test.

A

Hypogonadotropic hypogonadism (could be Kallmans)

86
Q

Turner syndrome: Genotype? Clinical features? Hormones?

A

XO– short stature, ovarian dysgenesis (streak ovary); shield chest, bicuspid aortic valve, defects in lymphatics–>webbing of neck, lymphedema in feet and neck, PREDUCTAL coarctation of aorta, horseshoe kidney, dysgerminoma

Low estrogen leads to Increased LH and FSH

87
Q

Pt presents with short stature, bicuspid aortic valve, and a wide neck– what does she have? What is the cause of the wide neck? Kidney problems?

A

Turners– impairment of lymphatics; can also see horseshoe kidney– PREDUCTAL COARCTATION

88
Q

Ddx of primary amenorrhea?

A

Mullerian agenesis; Turners; imperforate hyman

89
Q

Women presents with high LH and FSH; has never had a period. Her distal limbs have a bluish tintt?

A

Turners

90
Q

Klinefelters is an example of what genetic process? Hormones?

A

Non-dysjunction– chromosomes do not separate

Dysgenesis of seminiferous tubules will lead to decreased inhibin and increased FSH?
Decreased testosterone will lead to increased LH and Inc estrogen

91
Q

Very tall 16 yo boy presents to your office. His mother says he’s exhibiting antisocial behavior. You notice severe acne on his face?

A

Double Y males XYY (not all are antisocial)

92
Q

Significant increase in testosterone and increase in LH– very low levels of DHT?

A

Androgen insensitivity

93
Q

Defect in Kallmans?

A

Migration of GnRH and formation of olfactory bulb

94
Q

Decreased GnRH, FSH, LH and testosterone, micropenis?

A

Kallmans (anosmia+secondary sexual characteristics)

95
Q

Components of a complete hydatidiform mole?

A

2 sperm and empty egg

96
Q

hCG in complete mole?

A

VERY high– high risk of malignant trophoblastic disease (20%)

97
Q

Fetal parts in complete mole vs partial

A

complete=no fetal parts

partial= fetal part(ial)

98
Q

Pathophys of hydatidiform mole?

A

Cystic swelling of chorionic villi and proliferation of chorionic epithelium- presents with abnormal vaginal bleeding

99
Q

Most common precursor of choriocarcinoma?

A

Complete hydatidiform mole– High b hCG

100
Q

honeycombed uterus?

A

hydatidiform mole

101
Q

Treatment of hydatidiform mole?

A

Dilation and curettage and methotrexate

102
Q

Preeclampsia?

A

HTN, proteinuria, and edema

103
Q

HTN in pregnant woman before 20 weeks suggests?

A

Molar pregnancy

104
Q

PP of Preeclampsia?

A

Placental ischemia due to impaired vasodilation of spiral arteries–>inc vascular tone– associated with HELLP

105
Q

Pregnant pt presents with headache, blurred vision, and edema?

A

Preeclampsia– also see hyperreflexia

106
Q

Painful bleeding in third trimester– associations?

A

Abruptio placentae– premature detachment– assoc with DIC (tissue factor from placenta into maternal circulation) ; increased with cocaine htn, and smoking

107
Q

Implantation into the myometrium of placenta?

A

Placenta accreta (accreta means encased in i.e. encased in myometrium)

108
Q

Painless bleeding during any trimester?

A

Placenta previa– Attachment of placenta to lower uterine segment

109
Q

Potters syndrome?

A

Pot FEL– facial abnormalitites, extremities, limbs

110
Q

PCOS hormones?

A

LH:FSH >3; high testosterone, and high estrogen from aromatization of tesosterone; low SHBG

The high LH prevents ovulation

111
Q

Treatment of acne and hirsutism in pcos patients?

A

Spironolactone

112
Q

Describe how LH causes decrease in FSH in PCOS?

A

Increased LH leads to increased androgens–>converted to estrogen in peripheral tissue–>estrogen has negative feedback on FSH

113
Q

Most common ovarian mass in young women?

A

Follicular cyst

114
Q

Ovarian cyst filled with fat, teeth, bone and cartilage?

A

Dermoid cyst

115
Q

Chocolate cyst?

A

Endometrioid cyst

116
Q

Dysgerminoma: tumor markers? Histology? Assoc?

A

Malignant Ovarian germ cell tumor

High hCG, and LDH
Sheets of uniform cells

Associated with Turners

117
Q

Choriocarcinoma is a malignancy of? tumor marker?

A

Malignancy of trophoblastic tissues; chorionic villi NOT present; see a high hCG– early hematogenous spread to lungs

118
Q

Ovarian germ cell cancer with early hematogenous spread to lungs?

A

Choriocarcinoma

119
Q

Tumor marker AFP associated with?

A

Yolk sac tumors (endodermal sinus tumors)– yellow friable mass

120
Q

Schiller Duval bodies?

A

Commonly seen in yolk sac (endodermal sinus tumor)– resemble glomeruli

121
Q

Dermoid cyst and presents with hyperthyroidism

A

Struma ovarii– teratoma with functional thyroid tissue

122
Q

HPV 16 is a blank gene product; HPV 18 is ?

A

E6 gene product that inhibits p53

18= e7 gene product that inhibits RB

123
Q

Pt. presents with inflammation of endometrium. She had a miscarriage 30 days ago. Treatment?

A

Endometritis: gentamycin and clindamycin

124
Q

Endometriosis: Histologicially?

A

endometrial glands/stroma in abnormal locations outside the uterus

125
Q

Most common Gyn malignancy?

A

Endometrial carcinoma

126
Q

Most common of all gyn tumors?

A

Leiomyoma (fibroids)

127
Q

40 yo F; Whorled patter of smooth muscle, abnormal uterine bleeding

A

Leiomyoma– most common gyn tumor around the WHORLD– no its not! Just a mnemonic– cervical cancer is more common outside the US

128
Q

Leiomyoma histology?

A

Whorled pattern

129
Q

Leiomyosarcoma–where do they arise from?

A

De novo!– see necrosis and cellular atypia

130
Q

Most common gyn cancer in US and world?

A

Endometrial in USA and Cervical in the world

131
Q

Worst prognosis in terms of gyn cancers?

A

Ovarian is worse than cervical is worse than endometrial

132
Q

Benign bilateral, overaian tumors;

A

Serous cystadenoma– lined with fallopian type epithelium

133
Q

Malignant bilateral ovarian tumors? Histology?

A

Serous cystadenocarcinoma– psamomma bodies

134
Q

Ovarian tumor with psammmoma bodies?

A

Serous cystadenocarcinoma

135
Q

Ovarian tumor that presents with ascitis

A

Mucinous cystadenocarcinoma

136
Q

Unilateral tumor of ovary. Pale yellow tan in color. Looks like bladder epithelium?

A

Brenners

137
Q

Granulosa cell tumor secretes? Histology?

A

Estrogen–>precocious puberty in kids
Call exner bodies– small follicles with eosinophilic secretions
Also see abnormal uterine bleeding

138
Q

Mucin secreting signet cell that metastasized to ovaries?

A

Krukenberg tumor

139
Q

DES exposure in utero makes women susceptible to which type of cancer?

A

Clear Cell adenocarcinoma

140
Q

Fibromas, ascitis and hydrothorax?

A

Meigs syndrome

141
Q

Epinephrine is only produced by?

A

ADRENAL GLANDS

142
Q

45 yo women with bloody nipple discharge?

A

intraductal papilloma

143
Q

Major duct of breast?

A

Fibrocystic change and ductal carcinoma

144
Q

Stroma of breast tissue?

A

Phyllodes tumor– leaf like projections

145
Q

Leaf like projections– breast?

A

Phyllodes tumor

146
Q

Breast cancer that is bilateral?

A

Lobular carcinoma

147
Q

Serous tumors of ovary are bilateral

A

freebee

148
Q

Mammography doesn’t pick up which cancers?

A

Lobular

149
Q

35 yo woman small mobile firm mass. Marble like?

A

Fibroadenoma– increased size and tenderness with estrogen– not a precursor to breast cancer

150
Q

Cleft=
Araches=
Pouches=

A

Ectoderm
Mesoderm
Endoderm

CAP coves outside from inside

151
Q

Papillary carcinoma lacks?

A

Myoepithelial cells

Elliot Step 1 (32 decks)

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