Reproductive Flashcards
1
Q
sonic hedgehog gene
A
produced at base of limbs
anterioposterior axis
mutation –> holoprosencephaly
2
Q
apical ectodermal ridge
gene
what it does
A
Wnt-7 gene, FGF gene
organisation along dorsal-ventral axis, mesoderm mitosis (lengthens limbs)
3
Q
craniocaudal direction for appendages
A
Homeobox gene
4
Q
when does hCG secretion start?
A
implantation of blastocyst - day 6
5
Q
week 2 of embryo
A
2 layers - bilaminar disc
6
Q
week 3 of embryo
A
3 layers
primitive streak
7
Q
what does ectoderm become by the notochord?
A
neural plate
8
Q
week 4 of embryo
A
4 limbs, 4 chambers
heart begins to beat
organogenesis
notochord closes
9
Q
week 6 embryo
A
can detect heart beat
10
Q
week 8 foetus
A
begins to move
11
Q
when are sex characteristics developed?
A
week 10
12
Q
disruption of organogenesis
A
secondary breakdown of previously normal tissue or structure
amniotic band syndrome
13
Q
extrinsic disruption
intrinsic disruption
A
deformation (post embryonic)
malformation (embryonic 3-8 weeks)
14
Q
terarogens pre week 3
A
all or none effects
15
Q
tetarogens after week 8
A
growth and function affected
16
Q
ACE inhibitor tetarogen
A
renal damage
17
Q
alkylating agents tetarogen
A
no digits, anomalies
18
Q
aminoglycosides tetarogen
A
ototoxicity
19
Q
antiepileptic tetarogen
A
neural tube defect, cardiac, cleft palate, skeletal abnormality
20
Q
diethlystilbestrol tetarogen
A
vaginal clear cell adenocarcinoma, congenital Mulllerian anomalies
21
Q
isotretinoin tetarogen
A
multiple severe birth defects
22
Q
lithium tetarogen
A
ebstein anomaly, apical displacement of tricuspid valve
23
Q
methimazole tetarogen
A
aplasia cutis congenita
24
Q
warfarin tetarogen
A
bone deformities, fetal hemorrhage, abortion, opthalmologic abnormalities
25
abnormalities from cocaine abuse
low birth weight, preterm birth, IUGR, placental abruption
26
smoking affects on fetus
low birth weight, preterm labour, placental problems, IUGR, SIDS
27
maternal diabetes
caudal regression syndrome, congenital heart defects, neural tube defects, macrosomia
28
methylmercury affect on fetus
neurotoxicity
| types of seafood
29
xs vitamin A in pregnancy
spontaneous abortion, birth defects
30
xr during pregnancy
microcephaly, intellectual disability
31
fetal alcohol syndrome
smooth philtrum, thin vermillion boarder (upper lip), small palpebral fissures, small eye openings, limb dislocation, heart defects, heart-lung fistula, holoprosencephaly
32
monochorionic diamniotic
75%
33
cytotrophoblasts
make cells - inner layer of chorionic villi
34
syncytiotrophoblast
synthesise hormones - hCG
35
what doe hCG do?
stimulates corpus luteum to secrete progesterone during the first trimester
36
where do the umbilical arteries come from?
internal iliac
37
allantois
week 3
| becomes urachus - duct between bladder and umbilicus
38
vesicourachal diverticulum
outpouching of bladder, slight failure of urachus to obliterate
39
viteline duct
omphalo-mesenteric duct - yolk sac and midgut lumen
40
vitelline fistula
duct doesn't close
41
meckel diverticulum
partial closure of vitelline duct
| patent portion attached to ileum
42
melena, abdo pain, hematochezia, young
meckel diverticulum
43
Rise in estrogens in pregnancy
50 fold estradiol and estrone
| 1000 fold estriol
44
What does progesterone stimulate in pregnancy?
Endometrial gland secretion, spiral artery development
| Cervical mucus plug
45
Primary oocyte
| Secondary oocyte
Meiosis I stopped in prophase until ovulation
| Meiosis II arrested in metaphase II until fertilisation
46
Mittelschmerz
Mid cycle ovulation pain
47
Implantation timing
6 days after fertilisation
48
Difference between gestational age and embryonic age
2 weeks
49
Apgar score
```
Appearance
Pulse
Grimace to pain
Activity
Respiration
1 minute and 5 minutes
```
50
Low birth weight
< 2.5kg
51
Oxytocin
```
Uterine contraction
Milk letdown (with prolactin)
```
52
What increases in menopause?
FSH most
LH
GnRH
53
DHT stimulates
Differentiation on penis, scrotum, prostate
| Prostate growth, balding, sebaceous gland activity
54
Exogenous testosterone
Inhibits axis
Decreases testicular T
Shrinking and azoospermia
55
Hypogonadism, penis, looks female
Kleinfelter syndrome
56
Streak ovary, shield chest, primary amenorrhea
Turner syndrome XO
57
Defects seen with Turner syndrome
```
Bicuspid valve
Coarctation
Lymph defects
Cystic hygroma
Horseshoe kidney
```
58
Male, learning difficulty, tall, autism, acne
XYY
59
Exposure to androgenic steroids in pregnancy
Ovaries present, external genetalia virilized
60
Tested present, female genitalia
Testicular feminisation from androgen insensitivity
61
5a reductase deficiency
Ambiguous genitalia until puberty
| Internal genetalia normal
62
Kallmann syndrome
Defective GnRH migration
Anosmia
Infertility
63
Xs uterine enlargement, early preeclampsia, vaginal bleeding
Hydatidiform mole
64
Honeycomb uterus, cluster of grapes, snowstorm on uterus
Hydatidiform mole
65
Partial mole
Has fetal parts
66
Karyotype 69XXX/XXY/XYY
Partial mole
67
Choriocarcinoma forms
During or after pregnancy in mother or baby
68
Post pregnancy raised bhcg, sob, hemoptysis
Choriocarcinoma with lung metastasis
69
Abruption
Separation of placenta from uterine wall
70
Placenta accepts
Placenta attaches to myometrium without penetrating
71
Placenta increta
Placenta penetrates into myometrium
72
Placenta percreta
Placenta perforated through myometrium into uterine serosa
| Can attach to rectum or bladder
73
Placenta previa
Over cervix
| Painless 3rd trimester bleeding
74
Vasa previa
Vessels over cervix
75
Membrane rupture, painless vaginal bleeding, fetal bradycardia
Vasa previa
76
Associated with oligohydramnios
Placental insufficiency, bilateral renal agenesis, posterior urethral valves, potter syndrome
77
Rx gestational htn
```
140/90
Hydralazine
A methyldopa
Labetalol
Nifedipine
Hypertensive mums love nifedipine
```
78
Gestation for preeclampsia
Over 20 weeks
79
Rx preeclampsia
Anti htn
Mg sulphate
Delivery
80
HELLP
| Rx
Hemolysis, elevated liver enzymes, low plt
| Delivery
81
Pregnant + schistocytes
HELLP
82
Tanner stage II
pubic hair appears
| breast buds
83
Tanner stage III
coarsening of pubic hair
penis length
breast size
84
Tanner stage IV
expansion of pubic hair
penis width
raised areolar, mound on mound breast
85
Tanner stage V
hair across pubis and medial thigh
penis and testis enlargement
areolar flattens, adult breast contour
86
clear cell adenocarcinoma of vagina
DES exposure in utero
87
vaginal squamous cell carcinoma
usually secondary to cervical SCC
88
spindle shaped cells, with desmin, grape like mass emerging from vagina
sarcoma botryoides - rhabdomyosarcoma
89
E6 gene from HPV
inhibits p53
90
E7 gene from HPV
inhibits RB supressor gene
91
koilocytes
cervical displasia
92
High LH and FSH, high T
PCOS
93
Rx PCOS
weight reduction, OCP, clomiphene citrate, ketoconazole, spironolactone
94
follicular cyst
| associated with
upruptured graafian follicle
| high E, endometrial hyperplasia
95
theca-lutein cyst caused by
| associated with
gonadotropin stimulation
| choriocarcinoma, hydatidiform moles
96
malignant ovarian mass
epithelial
97
abdo distension, bowel obstruction, pleural effusion, female 58 yrs
ovarian neoplasm
98
neoplasm, fallopian tube like epithelium
serous cystadenoma
99
multiloculated, mucus secreting epithelium
mucinous cystadenoma
100
chocolate cyst
endometriosis
| ectopic endometrial tissue
101
ovarian tumour 10-30 yrs
mature cystic teratoma
102
hyperthyroidism + abdo mass
struma ovarii - ovarian teratoma
103
brenner tumour
bladder like
| solid pale yellow mass
104
coffee bean nuclei
brenner tumour
105
bundles of spindle shaped fibroblasts
fibroma
106
Meig's syndrome
fibroma + ascites + hydrothorax
107
uterine bleeding post menopause
thecoma
108
thecoma
like granulosa cell tumours, can produce estrogen
109
malignant stromal tumour of ovaries
granulosa cell tumour
110
granulosa cell tumour causes... because
E and or P
111
Call-Exner bodies are
| found in
granulosa cells with eosinophilic fluid
| granulosa cell tumour
112
most common malignant ovarian neoplasm
serous cystadenocarcinoma
113
most common ovarian tumour in adolescents
dysgerminoma
114
fried egg cells, hCG and LDH raised
dysgerminoma
115
mucin-secreting signet cell adenocarcinoma
Krukenberg tumours (GI mets)
116
adenomyosis
endometrial tissue extends into uterine myometrium
117
soft globaular uterus with menorrhagia
adenomyosis
118
whorled pattern of smooth muscle bundles
fibroid
119
RF for endometrial hyperplasia
anovulatory cycles, hrt, pcos, granulosa cell tumour
120
most common gynae malignancy
endometrial carcinoma
121
Rx endometritis
gentamicin + clindamicin +- ampicillin
122
cyclical pelvic pain, bleeding, dyspareunia, dyschezia
endometriosis
123
Rx endometriosis
NSAIDs, OCP, progestins, GnRH agonists, danazol, laprascopic removal
124
premenstrual breast pain
fibrocystic change
125
indraductal papilloma found
beneath areolar
126
epithelial hyperplasia of breast tissue found in
terminal ductal or lobular epithelium
127
calcified oil cyst
fat necrosis
128
Gynecomastia drugs
Some Hormones Create Knockers
| Spironolactone, Hormones, Cimetidine, Ketoconazole
129
c-erbB2
HER-2
130
populations more at risk of breast cancers
African-American
131
comedocarcinoma
subtype of DCIS - central necrosis
132
stellate infiltration
Invasive ductal carcinoma
133
Indian file cells
invasive lobular carcinoma
134
gleshy, lymphocytic infiltrate
medullary carcinoma
135
p'eau d'orange
inflammatory breast cancer
136
Peyronie disease
penis curve from fibrous plaque in tunica albuginea
137
penile fracture
rupture of corpora cavernosa
138
ischemic priapism is
| Rx
> 4 hours
| aspiration, phenylephrine, surgical decompression
139
Bowen disease presents as
| is
leukoplakia
| SCC of penis
140
erythroplakia of penis
Queyrat - glans cancer
141
cryptorchidism
undescended testicles
142
varicocoele side
left - gonadal vein drains to renal
143
incomplete obliteration of processus vaginalis
congenital hydrocoele
144
spermatocoele
cyst from dilated epididymal duct or rete testis
145
most common testicular tumour
germ cell
146
fried egg cells
seminoma
147
raised placental ALP
seminoma
148
testicular tumour boys under 3yr
yolk sac
149
testicular tumour raised hCG
choriocarcinoma
150
when are teratomas malignant?
in adult males
151
hemorrhagic mass with necrosis
embryonal carcinoma
152
golden brown tumour, reinke crystals
leydig cell
153
androblastoma
sertoli cell tumour
154
testicular cancer in older men
testicular lymphoma
155
BPH affects
lateral and middle lobes
156
Rx BPH
terazosin, tamsulosin (a1 antagonists)
| finasteride (5a-reductase inhibitors)
157
prostatic adenocarcinoma lobe
posterior (peripheral)
158
clomiphene
blocks GnRH negative feedback
| E R antagonist in hypothalamus
159
ketoconazole
inhibits E and T production through inhibition of binding
160
danazol
inhibits E production
| partial agnoist at androgen receptors
161
anastrozole
inhibits E production
162
stops androgen receptor complex
fultamide, cyproterone, spironolactone
163
leuprolide
GnRH analog
agonist when pulsatile
antagonist when constant
164
use leuprolide
uterine fibroids, endometriosis, precocious puberty, prostate cancer, infertility
165
mestranol, DES
estrogens
166
raloxifene
selective E R modulator
antagonist at breast, uterus
agonist in bone
167
aromatase inhibitors
anastrozole, exemestane
168
anastrazole
ER +ve breast cancer postmenoapuse
169
progestins mechanism
| for
bind progesterone receptors
| contraception
170
progesterone + withdrawl bleeding
excludes anatomical defects
171
-strel, norethindrone, -strol
progestins
172
mifepristone, ulipristal
progestrone competitive inhibitor
| for abortions
173
ulipristal
emergency contraception
174
combined contraception uses
progestin + ethinyl estradiol
175
COCP mechanism
inhibits LH/FSH - prevents E surge
no LH surge
no ovulation
176
Cu coil mechanism
local inflammation toxic to sperm and ova
177
ritodrine
B2 agonist
178
use danazol
| s.e.
endotetriosis, hereditary angioedema
| raises T, lowers HDL, hepatotoxicity
179
minoxidil
arteriolar vasodilator
180
use tadalafil
erectile dysfunction, pulmonary htn, BPH
181
fultamide is
| use
competitive inhibitor at androgen Rs
| prostate carcinoma
182
use ketoconazole, spironolactone
PCOD to reduce androgenic symptoms
183
spironolactone
inhibits steroid binding, and gene expression due to T
184
brachial clefts
ectoderm
185
brachial arches
mesoderm and neural crest
186
brachial puches
endoderm
187
1st branchial cleft
external auditory meatus
188
which branchial clefts are obliterated?
2-4
189
persistant cervical sinus
leads to branchial cleft cyst
190
1st branchial arch
Ms
| CN V2 and 3
191
2nd branchial arch
think S's
| CN VII
192
3rd branchial arch cartilage
muscle
nerve
greater horn of hyoid
stylopharyngeus
CN IX
193
4th-6th branchial arches
arytenoids, cricoid and down
| CN X
194
6th branchial arch nerve
recurrent laryngeal
195
3rd and 4th branchial arches form
posterior 1/3 of tongue
196
failure of fusion of maxillary and medial nasal processes
cleft lip
197
failure of fusion of two lateral palatine shelves or nasal septum
cleft palate
198
how males keep mesonephric duct
sertoli cells secrete mullerian inhibitory factor
| leydig cells encourage mesonephric duct
199
paramesonephric duct forms
fallopian tubes, uterus, upper portion of vagina
200
mesonephric duct forms
seminal vesicles, epididymis, ejaculatory duct, ductus deferens
201
Gartner duct
female retained mesonephric duct
202
no MIF
male external, femal and male internal
203
bicornuate uterus
incomplete fusion of mullerian ducts
204
genital tubercle
male
female
glans penis, corpus cavernosum + spongiosum
| glans clitoris, vestibular bulbs
205
urogenital sinus
male
female
bulbourethral glands, prostate, ventral shaft of penis
| greater vestibular glands, urethral and paraurethral glands, labia minora
206
labioscrotal swelling
scrotum
| labia majora
207
hypospadias
ventral opening
| failure of urethral folds to fuse
208
epispadias
dorsal
| positioning of genital tubercle
209
gubernaculum in females
ovarian ligament + round ligament of uterus
210
```
lymph drainage:
ovaries/testis
uterus/cervix/bladder
prostate/cervix/corpus cavernosum/proximal vagina
distal vagina/vulva/scrotum/distal anus
glans penis
```
```
para aortic
external iliac
internal iliac
superficial inguinal
deep inguinal
```
211
infundibulopelvicligament
ovaries to lateral wall
| contain ovarian vessels
212
cardinal ligament
cervix to side wall of pelvis
| uterine vessels
213
round ligament of uterus
uterus to labia majora
214
broad ligament
uterus, fallopian tubes and ovaries to side wall
| contain roud ligament
215
ovarian ligament
ovarial to uterus
216
endocervix epithelium
simple columnar
217
ovary epithelium
simple cuboidal
218
urine in retropubic space
posterior urethra injury
219
urine in superficial perineal space or deep fascia of Buck
anterior urethra injury
220
perineal saddle injury
anterior urethra
221
erection nerves
pelvic
sympathetic
somatic (pudendal)
Point, Squeeze and Shoot
222
what does inhibin B do?
| secreted by
inhibits FSH
| sertoli cells
223
blood testis barrier
sertoli cells
224
```
function leydig cells
female version
```
```
secrete T (LH stimulation)
theca interna cells
```
225
1st aortic arch
maxillary
226
2nd aortic arch
stapedial and hyoid
227
3rd aortic arch
common carotid + proximal internal carotid
228
4th aortic arch
R subclavian, left aortic arch over ductus arteriosus
229
6th aortic arch
pulmonary trunk, ductus arteriosus
230
7th aortic arch
subclavians
