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Step 1 > Reproductive > Flashcards

Reproductive Flashcards

1
Q

sonic hedgehog gene

A

produced at base of limbs
anterioposterior axis
mutation –> holoprosencephaly

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2
Q

apical ectodermal ridge
gene
what it does

A

Wnt-7 gene, FGF gene

organisation along dorsal-ventral axis, mesoderm mitosis (lengthens limbs)

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3
Q

craniocaudal direction for appendages

A

Homeobox gene

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4
Q

when does hCG secretion start?

A

implantation of blastocyst - day 6

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5
Q

week 2 of embryo

A

2 layers - bilaminar disc

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6
Q

week 3 of embryo

A

3 layers

primitive streak

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7
Q

what does ectoderm become by the notochord?

A

neural plate

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8
Q

week 4 of embryo

A

4 limbs, 4 chambers
heart begins to beat
organogenesis
notochord closes

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9
Q

week 6 embryo

A

can detect heart beat

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10
Q

week 8 foetus

A

begins to move

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11
Q

when are sex characteristics developed?

A

week 10

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12
Q

disruption of organogenesis

A

secondary breakdown of previously normal tissue or structure

amniotic band syndrome

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13
Q

extrinsic disruption

intrinsic disruption

A

deformation (post embryonic)

malformation (embryonic 3-8 weeks)

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14
Q

terarogens pre week 3

A

all or none effects

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15
Q

tetarogens after week 8

A

growth and function affected

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16
Q

ACE inhibitor tetarogen

A

renal damage

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17
Q

alkylating agents tetarogen

A

no digits, anomalies

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18
Q

aminoglycosides tetarogen

A

ototoxicity

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19
Q

antiepileptic tetarogen

A

neural tube defect, cardiac, cleft palate, skeletal abnormality

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20
Q

diethlystilbestrol tetarogen

A

vaginal clear cell adenocarcinoma, congenital Mulllerian anomalies

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21
Q

isotretinoin tetarogen

A

multiple severe birth defects

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22
Q

lithium tetarogen

A

ebstein anomaly, apical displacement of tricuspid valve

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23
Q

methimazole tetarogen

A

aplasia cutis congenita

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24
Q

warfarin tetarogen

A

bone deformities, fetal hemorrhage, abortion, opthalmologic abnormalities

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25
Q

abnormalities from cocaine abuse

A

low birth weight, preterm birth, IUGR, placental abruption

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26
Q

smoking affects on fetus

A

low birth weight, preterm labour, placental problems, IUGR, SIDS

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27
Q

maternal diabetes

A

caudal regression syndrome, congenital heart defects, neural tube defects, macrosomia

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28
Q

methylmercury affect on fetus

A

neurotoxicity

types of seafood

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29
Q

xs vitamin A in pregnancy

A

spontaneous abortion, birth defects

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30
Q

xr during pregnancy

A

microcephaly, intellectual disability

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31
Q

fetal alcohol syndrome

A

smooth philtrum, thin vermillion boarder (upper lip), small palpebral fissures, small eye openings, limb dislocation, heart defects, heart-lung fistula, holoprosencephaly

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32
Q

monochorionic diamniotic

A

75%

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33
Q

cytotrophoblasts

A

make cells - inner layer of chorionic villi

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34
Q

syncytiotrophoblast

A

synthesise hormones - hCG

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35
Q

what doe hCG do?

A

stimulates corpus luteum to secrete progesterone during the first trimester

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36
Q

where do the umbilical arteries come from?

A

internal iliac

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37
Q

allantois

A

week 3

becomes urachus - duct between bladder and umbilicus

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38
Q

vesicourachal diverticulum

A

outpouching of bladder, slight failure of urachus to obliterate

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39
Q

viteline duct

A

omphalo-mesenteric duct - yolk sac and midgut lumen

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40
Q

vitelline fistula

A

duct doesn’t close

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41
Q

meckel diverticulum

A

partial closure of vitelline duct

patent portion attached to ileum

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42
Q

melena, abdo pain, hematochezia, young

A

meckel diverticulum

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43
Q

Rise in estrogens in pregnancy

A

50 fold estradiol and estrone

1000 fold estriol

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44
Q

What does progesterone stimulate in pregnancy?

A

Endometrial gland secretion, spiral artery development

Cervical mucus plug

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45
Q

Primary oocyte

Secondary oocyte

A

Meiosis I stopped in prophase until ovulation

Meiosis II arrested in metaphase II until fertilisation

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46
Q

Mittelschmerz

A

Mid cycle ovulation pain

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47
Q

Implantation timing

A

6 days after fertilisation

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48
Q

Difference between gestational age and embryonic age

A

2 weeks

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49
Q

Apgar score

A 
Appearance
Pulse
Grimace to pain
Activity
Respiration
1 minute and 5 minutes
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50
Q

Low birth weight

A

< 2.5kg

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51
Q

Oxytocin

A 
Uterine contraction
Milk letdown (with prolactin)
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52
Q

What increases in menopause?

A

FSH most
LH
GnRH

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53
Q

DHT stimulates

A

Differentiation on penis, scrotum, prostate

Prostate growth, balding, sebaceous gland activity

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54
Q

Exogenous testosterone

A

Inhibits axis
Decreases testicular T
Shrinking and azoospermia

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55
Q

Hypogonadism, penis, looks female

A

Kleinfelter syndrome

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56
Q

Streak ovary, shield chest, primary amenorrhea

A

Turner syndrome XO

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57
Q

Defects seen with Turner syndrome

A 
Bicuspid valve
Coarctation
Lymph defects
Cystic hygroma
Horseshoe kidney
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58
Q

Male, learning difficulty, tall, autism, acne

A

XYY

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59
Q

Exposure to androgenic steroids in pregnancy

A

Ovaries present, external genetalia virilized

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60
Q

Tested present, female genitalia

A

Testicular feminisation from androgen insensitivity

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61
Q

5a reductase deficiency

A

Ambiguous genitalia until puberty

Internal genetalia normal

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62
Q

Kallmann syndrome

A

Defective GnRH migration
Anosmia
Infertility

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63
Q

Xs uterine enlargement, early preeclampsia, vaginal bleeding

A

Hydatidiform mole

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64
Q

Honeycomb uterus, cluster of grapes, snowstorm on uterus

A

Hydatidiform mole

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65
Q

Partial mole

A

Has fetal parts

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66
Q

Karyotype 69XXX/XXY/XYY

A

Partial mole

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67
Q

Choriocarcinoma forms

A

During or after pregnancy in mother or baby

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68
Q

Post pregnancy raised bhcg, sob, hemoptysis

A

Choriocarcinoma with lung metastasis

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69
Q

Abruption

A

Separation of placenta from uterine wall

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70
Q

Placenta accepts

A

Placenta attaches to myometrium without penetrating

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71
Q

Placenta increta

A

Placenta penetrates into myometrium

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72
Q

Placenta percreta

A

Placenta perforated through myometrium into uterine serosa

Can attach to rectum or bladder

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73
Q

Placenta previa

A

Over cervix

Painless 3rd trimester bleeding

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74
Q

Vasa previa

A

Vessels over cervix

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75
Q

Membrane rupture, painless vaginal bleeding, fetal bradycardia

A

Vasa previa

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76
Q

Associated with oligohydramnios

A

Placental insufficiency, bilateral renal agenesis, posterior urethral valves, potter syndrome

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77
Q

Rx gestational htn

A 
140/90
Hydralazine
A methyldopa
Labetalol
Nifedipine
Hypertensive mums love nifedipine
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78
Q

Gestation for preeclampsia

A

Over 20 weeks

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79
Q

Rx preeclampsia

A

Anti htn
Mg sulphate
Delivery

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80
Q

HELLP

Rx

A

Hemolysis, elevated liver enzymes, low plt

Delivery

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81
Q

Pregnant + schistocytes

A

HELLP

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82
Q

Tanner stage II

A

pubic hair appears

breast buds

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83
Q

Tanner stage III

A

coarsening of pubic hair
penis length
breast size

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84
Q

Tanner stage IV

A

expansion of pubic hair
penis width
raised areolar, mound on mound breast

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85
Q

Tanner stage V

A

hair across pubis and medial thigh
penis and testis enlargement
areolar flattens, adult breast contour

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86
Q

clear cell adenocarcinoma of vagina

A

DES exposure in utero

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87
Q

vaginal squamous cell carcinoma

A

usually secondary to cervical SCC

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88
Q

spindle shaped cells, with desmin, grape like mass emerging from vagina

A

sarcoma botryoides - rhabdomyosarcoma

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89
Q

E6 gene from HPV

A

inhibits p53

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90
Q

E7 gene from HPV

A

inhibits RB supressor gene

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91
Q

koilocytes

A

cervical displasia

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92
Q

High LH and FSH, high T

A

PCOS

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93
Q

Rx PCOS

A

weight reduction, OCP, clomiphene citrate, ketoconazole, spironolactone

94
Q

follicular cyst

associated with

A

upruptured graafian follicle

high E, endometrial hyperplasia

95
Q

theca-lutein cyst caused by

associated with

A

gonadotropin stimulation

choriocarcinoma, hydatidiform moles

96
Q

malignant ovarian mass

A

epithelial

97
Q

abdo distension, bowel obstruction, pleural effusion, female 58 yrs

A

ovarian neoplasm

98
Q

neoplasm, fallopian tube like epithelium

A

serous cystadenoma

99
Q

multiloculated, mucus secreting epithelium

A

mucinous cystadenoma

100
Q

chocolate cyst

A

endometriosis

ectopic endometrial tissue

101
Q

ovarian tumour 10-30 yrs

A

mature cystic teratoma

102
Q

hyperthyroidism + abdo mass

A

struma ovarii - ovarian teratoma

103
Q

brenner tumour

A

bladder like

solid pale yellow mass

104
Q

coffee bean nuclei

A

brenner tumour

105
Q

bundles of spindle shaped fibroblasts

A

fibroma

106
Q

Meig’s syndrome

A

fibroma + ascites + hydrothorax

107
Q

uterine bleeding post menopause

A

thecoma

108
Q

thecoma

A

like granulosa cell tumours, can produce estrogen

109
Q

malignant stromal tumour of ovaries

A

granulosa cell tumour

110
Q

granulosa cell tumour causes… because

A

E and or P

111
Q

Call-Exner bodies are

found in

A

granulosa cells with eosinophilic fluid

granulosa cell tumour

112
Q

most common malignant ovarian neoplasm

A

serous cystadenocarcinoma

113
Q

most common ovarian tumour in adolescents

A

dysgerminoma

114
Q

fried egg cells, hCG and LDH raised

A

dysgerminoma

115
Q

mucin-secreting signet cell adenocarcinoma

A

Krukenberg tumours (GI mets)

116
Q

adenomyosis

A

endometrial tissue extends into uterine myometrium

117
Q

soft globaular uterus with menorrhagia

A

adenomyosis

118
Q

whorled pattern of smooth muscle bundles

A

fibroid

119
Q

RF for endometrial hyperplasia

A

anovulatory cycles, hrt, pcos, granulosa cell tumour

120
Q

most common gynae malignancy

A

endometrial carcinoma

121
Q

Rx endometritis

A

gentamicin + clindamicin +- ampicillin

122
Q

cyclical pelvic pain, bleeding, dyspareunia, dyschezia

A

endometriosis

123
Q

Rx endometriosis

A

NSAIDs, OCP, progestins, GnRH agonists, danazol, laprascopic removal

124
Q

premenstrual breast pain

A

fibrocystic change

125
Q

indraductal papilloma found

A

beneath areolar

126
Q

epithelial hyperplasia of breast tissue found in

A

terminal ductal or lobular epithelium

127
Q

calcified oil cyst

A

fat necrosis

128
Q

Gynecomastia drugs

A

Some Hormones Create Knockers

Spironolactone, Hormones, Cimetidine, Ketoconazole

129
Q

c-erbB2

A

HER-2

130
Q

populations more at risk of breast cancers

A

African-American

131
Q

comedocarcinoma

A

subtype of DCIS - central necrosis

132
Q

stellate infiltration

A

Invasive ductal carcinoma

133
Q

Indian file cells

A

invasive lobular carcinoma

134
Q

gleshy, lymphocytic infiltrate

A

medullary carcinoma

135
Q

p’eau d’orange

A

inflammatory breast cancer

136
Q

Peyronie disease

A

penis curve from fibrous plaque in tunica albuginea

137
Q

penile fracture

A

rupture of corpora cavernosa

138
Q

ischemic priapism is

Rx

A

> 4 hours

aspiration, phenylephrine, surgical decompression

139
Q

Bowen disease presents as

is

A

leukoplakia

SCC of penis

140
Q

erythroplakia of penis

A

Queyrat - glans cancer

141
Q

cryptorchidism

A

undescended testicles

142
Q

varicocoele side

A

left - gonadal vein drains to renal

143
Q

incomplete obliteration of processus vaginalis

A

congenital hydrocoele

144
Q

spermatocoele

A

cyst from dilated epididymal duct or rete testis

145
Q

most common testicular tumour

A

germ cell

146
Q

fried egg cells

A

seminoma

147
Q

raised placental ALP

A

seminoma

148
Q

testicular tumour boys under 3yr

A

yolk sac

149
Q

testicular tumour raised hCG

A

choriocarcinoma

150
Q

when are teratomas malignant?

A

in adult males

151
Q

hemorrhagic mass with necrosis

A

embryonal carcinoma

152
Q

golden brown tumour, reinke crystals

A

leydig cell

153
Q

androblastoma

A

sertoli cell tumour

154
Q

testicular cancer in older men

A

testicular lymphoma

155
Q

BPH affects

A

lateral and middle lobes

156
Q

Rx BPH

A

terazosin, tamsulosin (a1 antagonists)

finasteride (5a-reductase inhibitors)

157
Q

prostatic adenocarcinoma lobe

A

posterior (peripheral)

158
Q

clomiphene

A

blocks GnRH negative feedback

E R antagonist in hypothalamus

159
Q

ketoconazole

A

inhibits E and T production through inhibition of binding

160
Q

danazol

A

inhibits E production

partial agnoist at androgen receptors

161
Q

anastrozole

A

inhibits E production

162
Q

stops androgen receptor complex

A

fultamide, cyproterone, spironolactone

163
Q

leuprolide

A

GnRH analog
agonist when pulsatile
antagonist when constant

164
Q

use leuprolide

A

uterine fibroids, endometriosis, precocious puberty, prostate cancer, infertility

165
Q

mestranol, DES

A

estrogens

166
Q

raloxifene

A

selective E R modulator
antagonist at breast, uterus
agonist in bone

167
Q

aromatase inhibitors

A

anastrozole, exemestane

168
Q

anastrazole

A

ER +ve breast cancer postmenoapuse

169
Q

progestins mechanism

for

A

bind progesterone receptors

contraception

170
Q

progesterone + withdrawl bleeding

A

excludes anatomical defects

171
Q

-strel, norethindrone, -strol

A

progestins

172
Q

mifepristone, ulipristal

A

progestrone competitive inhibitor

for abortions

173
Q

ulipristal

A

emergency contraception

174
Q

combined contraception uses

A

progestin + ethinyl estradiol

175
Q

COCP mechanism

A

inhibits LH/FSH - prevents E surge
no LH surge
no ovulation

176
Q

Cu coil mechanism

A

local inflammation toxic to sperm and ova

177
Q

ritodrine

A

B2 agonist

178
Q

use danazol

s.e.

A

endotetriosis, hereditary angioedema

raises T, lowers HDL, hepatotoxicity

179
Q

minoxidil

A

arteriolar vasodilator

180
Q

use tadalafil

A

erectile dysfunction, pulmonary htn, BPH

181
Q

fultamide is

use

A

competitive inhibitor at androgen Rs

prostate carcinoma

182
Q

use ketoconazole, spironolactone

A

PCOD to reduce androgenic symptoms

183
Q

spironolactone

A

inhibits steroid binding, and gene expression due to T

184
Q

brachial clefts

A

ectoderm

185
Q

brachial arches

A

mesoderm and neural crest

186
Q

brachial puches

A

endoderm

187
Q

1st branchial cleft

A

external auditory meatus

188
Q

which branchial clefts are obliterated?

A

2-4

189
Q

persistant cervical sinus

A

leads to branchial cleft cyst

190
Q

1st branchial arch

A

Ms

CN V2 and 3

191
Q

2nd branchial arch

A

think S’s

CN VII

192
Q

3rd branchial arch cartilage
muscle
nerve

A

greater horn of hyoid
stylopharyngeus
CN IX

193
Q

4th-6th branchial arches

A

arytenoids, cricoid and down

CN X

194
Q

6th branchial arch nerve

A

recurrent laryngeal

195
Q

3rd and 4th branchial arches form

A

posterior 1/3 of tongue

196
Q

failure of fusion of maxillary and medial nasal processes

A

cleft lip

197
Q

failure of fusion of two lateral palatine shelves or nasal septum

A

cleft palate

198
Q

how males keep mesonephric duct

A

sertoli cells secrete mullerian inhibitory factor

leydig cells encourage mesonephric duct

199
Q

paramesonephric duct forms

A

fallopian tubes, uterus, upper portion of vagina

200
Q

mesonephric duct forms

A

seminal vesicles, epididymis, ejaculatory duct, ductus deferens

201
Q

Gartner duct

A

female retained mesonephric duct

202
Q

no MIF

A

male external, femal and male internal

203
Q

bicornuate uterus

A

incomplete fusion of mullerian ducts

204
Q

genital tubercle
male
female

A

glans penis, corpus cavernosum + spongiosum

glans clitoris, vestibular bulbs

205
Q

urogenital sinus
male
female

A

bulbourethral glands, prostate, ventral shaft of penis

greater vestibular glands, urethral and paraurethral glands, labia minora

206
Q

labioscrotal swelling

A

scrotum

labia majora

207
Q

hypospadias

A

ventral opening

failure of urethral folds to fuse

208
Q

epispadias

A

dorsal

positioning of genital tubercle

209
Q

gubernaculum in females

A

ovarian ligament + round ligament of uterus

210
Q 
lymph drainage:
ovaries/testis
uterus/cervix/bladder
prostate/cervix/corpus cavernosum/proximal vagina
distal vagina/vulva/scrotum/distal anus
glans penis
A 
para aortic
external iliac
internal iliac
superficial inguinal
deep inguinal
211
Q

infundibulopelvicligament

A

ovaries to lateral wall

contain ovarian vessels

212
Q

cardinal ligament

A

cervix to side wall of pelvis

uterine vessels

213
Q

round ligament of uterus

A

uterus to labia majora

214
Q

broad ligament

A

uterus, fallopian tubes and ovaries to side wall

contain roud ligament

215
Q

ovarian ligament

A

ovarial to uterus

216
Q

endocervix epithelium

A

simple columnar

217
Q

ovary epithelium

A

simple cuboidal

218
Q

urine in retropubic space

A

posterior urethra injury

219
Q

urine in superficial perineal space or deep fascia of Buck

A

anterior urethra injury

220
Q

perineal saddle injury

A

anterior urethra

221
Q

erection nerves

A

pelvic
sympathetic
somatic (pudendal)
Point, Squeeze and Shoot

222
Q

what does inhibin B do?

secreted by

A

inhibits FSH

sertoli cells

223
Q

blood testis barrier

A

sertoli cells

224
Q 
function leydig cells
female version
A 
secrete T (LH stimulation)
theca interna cells
225
Q

1st aortic arch

A

maxillary

226
Q

2nd aortic arch

A

stapedial and hyoid

227
Q

3rd aortic arch

A

common carotid + proximal internal carotid

228
Q

4th aortic arch

A

R subclavian, left aortic arch over ductus arteriosus

229
Q

6th aortic arch

A

pulmonary trunk, ductus arteriosus

230
Q

7th aortic arch

A

subclavians

Step 1 (18 decks)

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