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STUDY FOR BARRIERS > Reproductive > Flashcards

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
Q

GIPP

A

Peripheral precocious

Production of excess hormones by some alternative mechanism

26
Q

IPP

A

Isolated thelarche or adrenarche
Or
Child does not progress to menarche or spermarche

27
Q

Cerebral palsy often causes

A

Early puberty

28
Q

Too big appetite and excess leptin can cause

A

Early puberty

29
Q

Hypothyroidism can cause

A

Early puberty

30
Q

One cause of GIPP

A

Congenital adrenal hyperplasia

31
Q

Congenital adrenal hyperplasia.. Why is the adrenal gland hyperplasia ?

A

Because the block in cortisol leads to increased ACTH from the pituitary gland leading to increased stimulation

Can make adrenalin but not cortisol

32
Q

Increase in production of aldosterone and oestrogen leads to

A

Ambiguous genitalia or feminisation

33
Q

Cholesterol can be metabolised into..

A

Aldosterone
Sex hormones
Cortisol

Enzymes?

34
Q

Increased adrenal androgen production leads to

A

Isolated male hormone mediated sexual characteristics in girls or boys (pubic hair, axillary hair, acne, apocrine odour)

Breast development ?

35
Q

Size of full size ovary?

A

4cm^3

36
Q

STIs have a tendency

A

To coexist

37
Q

Non-gonococcal STIs include

A

Chlamydia
Chancroid
Lymphgranuloma venereum (LGV)
Donovanosis

38
Q

Yellow discharge in eye with conjunctivitis - STI?

A

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
Q

Gonorrhoea is

A

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
Q

Treatment for gonorrhoea

A

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
Q

Untreated gonorrhoea leads to:

A

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
Q

Proctitis is

A

Inflammation of anus and rectum

43
Q

Proctocolitis

A

Red ulcerative areas in colon and rectum

44
Q

What sti can present as proctitis or proctocolitis

A

Chlamydia trachomatis

45
Q

Chlamydia trachomatis most common presentation

A

Vaginal discharge
UTI in males

Usually assymptomatic 
Highly infective (>50%)

NAAT (PCR)
Not cultured because it takes too long

46
Q

Lifecycle of chlamydia t

A

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
Q

The 4 species of chlamydia

A

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
Q

Clinical features of chlamydia

A

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
Q

Chlamydia diagnosis done by

A

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
Q

Treatment for chalmydia

A

Azithromycin stat dose
Doxycycline for 7 days
Ofloxacin

Abstain from unprotected sex for a week

51
Q

Untreated chlamydia complications

A 
Females: 
Inflamm pelvic disease 
Infertility 
Ectopic pregnancy 
Premature delivery/IUGR

Males:
Proctocolitis
Epididymoorchitis, prostatitis, reactive arthritis (HLA B 27)

52
Q

Phases of the menstrual cycle

A

Days 1-4
Days 5-13 (estrogen dependent)
Days 13-16
Days 16-28

Menstrual phase
Proliferative phase
Ovulatory phase
Secretory phase

53
Q

Chalmydia most common in

A

Indigenous population
Parts of QLD and WA

Early diagnosis: NAAT’s (PCR)
Not cultured by routine methods

54
Q

Clinical features of chlamydia

A 
Women 
Assumptomatic 80%
Post coital or intermittent bleeding 
Lower abd pain 
Purulent vaginal discharge 
Men 
Assumptomatic 50% 
Urethral discharge 
Dysuria 
Proctitis
55
Q

Painless ulcer

Then, painful swollen inguinal lymph node (bubo)

A

LGV
Chlamydia trachomotas
serovar L1 L2 L3
Gay men

Discharging lymph nodes

56
Q

Diagnosis of LGV done by

A

Pus or genital swab for PCR
Active lesions - biopsy - granulomatous lesion

Treat as chlamydia

57
Q

White thin Frothy copious discharge

A

Trichomonas vaginalis
Parasite Protozoa
Flagella

Men : urethritis

Treat both partners simultaneously
Metronidazole 7d

58
Q

Random points

A

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
Q

Tanner stages

A

P1 to P5

STUDY FOR BARRIERS (11 decks)

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