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Reproductive Flashcards

1
Q

Term for early puberty?

A

Precocious puberty

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2
Q

Gonadarche

A

Gonads start working, activation by FSH and LH

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3
Q

Adrenarche

A

Stimulated usually by aldosterone
Production of androgens by adrenal cortex
Hair growth

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4
Q

Telarche

A

Appearance of breast tissue primarily due to estradiol activity from the ovaries

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5
Q

Menarche

A

First period

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6
Q

Spermarche

A

First sperm

Due to FSH and LH via testosterone

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7
Q

Pubarche

A

Appearance of pubic hair
Primary due to androgens from Adrenal glands

Axillary hair, apocrine body odour, acne

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8
Q

Where is GnRH released from and where does it act?

A

Hypothalamus

Goes to act on anterior pituitary (gondatrophin cell)

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9
Q

What hormones inhibit the release of FSH, LH and GnRH in the female?

A

Progesterone
Androgens –> Esteogens (prim estradiol)

Inhibin only inhibits gonadotropin cell

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10
Q

What cells release Inhibin

A

Granulosa cells

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11
Q

What releases progesterone

A

Corpus Luteum

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12
Q

What releases androgens

A

Theca cells

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13
Q

Estradiol and progesterone cause…

A

Menstruation

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14
Q

Estradiol effects :

A

Breast development
Growth acceleration
Skeletal maturation

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15
Q

What is the negative feedback loop induced by LH in a male?

A

Causing leydig cells to release testosterone which inhibits GnRH release

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16
Q

What is the negative feedback loop induced by FSH in a male?

A

Causes the Sertoli cells to release Inhibin B which inhibits the gonadotropin cell

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17
Q

Effects of testosterone

A

Increased muscle mass
Penile growth
Deepened voice
Hair growth

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18
Q

Sequence of puberty in girls

A
  1. Breast development
  2. Peak height velocity reached
  3. Menarche
  4. Shortly after is termination of puberty

Pubarche before menarche

The earlier you go into puberty the less time you have for prepubescent growth

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19
Q

At which testicular size do boys start making testosterone

A

4-5cc

Followed by development of pubic hair and then sperm

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20
Q

What is the main reason for the height difference between males and females

A

Later onset and completion of puberty

Males - 16 yo
Females - 14 yo

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21
Q

What is the general age for precocious puberty in males and females

A

Less than 8 in girls (means menarche at about 10.5)

Less than 9 in boys

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22
Q

General age for delayed puberty in males and females ?

A

Over 13 for breast development and no period within 3 years of breast development

Over 14 with no testicular development or no development of muscular strength within 5 years of gonadal development

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23
Q

How is precocious puberty classified?

A

GDPP
GIPP
IPP (incomplete)

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24
Q

GDPP

A

Aka central precocious
Pituitary gland has commenced pubertal stage early

Pulsatile release

25
GIPP
Peripheral precocious | Production of excess hormones by some alternative mechanism
26
IPP
Isolated thelarche or adrenarche Or Child does not progress to menarche or spermarche
27
Cerebral palsy often causes
Early puberty
28
Too big appetite and excess leptin can cause
Early puberty
29
Hypothyroidism can cause
Early puberty
30
One cause of GIPP
Congenital adrenal hyperplasia
31
Congenital adrenal hyperplasia.. Why is the adrenal gland hyperplasia ?
Because the block in cortisol leads to increased ACTH from the pituitary gland leading to increased stimulation Can make adrenalin but not cortisol
32
Increase in production of aldosterone and oestrogen leads to
Ambiguous genitalia or feminisation
33
Cholesterol can be metabolised into..
Aldosterone Sex hormones Cortisol Enzymes?
34
Increased adrenal androgen production leads to
Isolated male hormone mediated sexual characteristics in girls or boys (pubic hair, axillary hair, acne, apocrine odour) Breast development ?
35
Size of full size ovary?
4cm^3
36
STIs have a tendency
To coexist
37
Non-gonococcal STIs include
Chlamydia Chancroid Lymphgranuloma venereum (LGV) Donovanosis
38
Yellow discharge in eye with conjunctivitis - STI?
Gonorrhoea Nisseria gonorrhoea (Mother --> baby can happen and baby gets eye conjunctivitis) Normally presents as urethral or cervical discharge, penile discharge, or sometimes at UTI Rectal discharge Sore throat
39
Gonorrhoea is
Gram negative diplococci Intracellular Nisseria gonorrhoeae Lives as commensal in lower genital tract, rectum oropharynx and eyes Males: purulent discharge, dysuria, frequency, 50% as symptomatic Females : 90% assymptimatic, important to treat because this is how it will spread Vaginal discharge, dysuria, dyspareunia, abdominal menses Investigation: gram stain the discharge, or urine collection and PCR/NAAH (ask for first part of urine not midstream as it has the urethral cells) Eye discharge Rectal discharge Sore throat /red (oral sex-->pharyngitis/infection) ^swabs/smears
40
Treatment for gonorrhoea
Cefixime (single dose) IV - ceftriaxone, cefotaxime Highly resistant --> spectinomycin Gaining resistance to: Penicillin, ciproflaxin, tetracycline - 7 day course Repeat culture after a week (If) chlamydia - co treat with azithromycin
41
Untreated gonorrhoea leads to:
Males- epididymo-orchitis, prostatitis, urethral stricture Females- salpingo-oophoritis, pelvic inflammatory disease, infertility (low vague abd pain and intermenstrual spotting) Treatment of contact is very important
42
Proctitis is
Inflammation of anus and rectum
43
Proctocolitis
Red ulcerative areas in colon and rectum
44
What sti can present as proctitis or proctocolitis
Chlamydia trachomatis
45
Chlamydia trachomatis most common presentation
Vaginal discharge UTI in males ``` Usually assymptomatic Highly infective (>50%) ``` NAAT (PCR) Not cultured because it takes too long
46
Lifecycle of chlamydia t
EB: elementary body - sporelike hard infective particle - attaches to urethral cell --> pinocytosis--> converts to reticular body(RB) RB: metabolic active form, multiplication form (organises into EBs)
47
The 4 species of chlamydia
Trachomatis - oculo genital symptoms - serovar L1, L2 , L3, : LGV - serovar A B Ba C : ocular trachoma (chronic conjunctivitis, red granules on upper eyelid) - serovar D-K : oculo genital Pneumoniae Psittaci Pecorum
48
Clinical features of chlamydia
Seen in 15-30 years ``` Women: 80% assymptimatic Post coital or intermittent bleeding Lower abd pain Purulent vaginal discharge ``` ``` Men: 50% assymptimatic Urethral discharge Dysuria Proctitis ```
49
Chlamydia diagnosis done by
Urine (morning sample) or discharge swab Endocervical or vaginal swab Screening with PCR - detects the cryptic plasmid in urine or secretions Slow to grow as obligate intracellular Tissue culture cells: gentian swab IMF: chlamydial inclusion bodies in tissue cell culture using labelled monoclonal antibodies
50
Treatment for chalmydia
Azithromycin stat dose Doxycycline for 7 days Ofloxacin Abstain from unprotected sex for a week
51
Untreated chlamydia complications
``` Females: Inflamm pelvic disease Infertility Ectopic pregnancy Premature delivery/IUGR ``` Males: Proctocolitis Epididymoorchitis, prostatitis, reactive arthritis (HLA B 27)
52
Phases of the menstrual cycle
Days 1-4 Days 5-13 (estrogen dependent) Days 13-16 Days 16-28 Menstrual phase Proliferative phase Ovulatory phase Secretory phase
53
Chalmydia most common in
Indigenous population Parts of QLD and WA Early diagnosis: NAAT's (PCR) Not cultured by routine methods
54
Clinical features of chlamydia
``` Women Assumptomatic 80% Post coital or intermittent bleeding Lower abd pain Purulent vaginal discharge ``` ``` Men Assumptomatic 50% Urethral discharge Dysuria Proctitis ```
55
Painless ulcer | Then, painful swollen inguinal lymph node (bubo)
LGV Chlamydia trachomotas serovar L1 L2 L3 Gay men Discharging lymph nodes
56
Diagnosis of LGV done by
Pus or genital swab for PCR Active lesions - biopsy - granulomatous lesion Treat as chlamydia
57
White thin Frothy copious discharge
Trichomonas vaginalis Parasite Protozoa Flagella Men : urethritis Treat both partners simultaneously Metronidazole 7d
58
Random points
Gonorrhoea - pili, arthritis, tenosynivitis and pustular or haemorrhagic skin lesions , cryptic plasmids Syphilis - plasma cells (and lymphocytes and macrophages in the gummas) and endarteritis
59
Tanner stages
P1 to P5

STUDY FOR BARRIERS (11 decks)

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