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First Aid > Reproductive > Flashcards

Reproductive Flashcards

1
Q

sonic hedgehog

A
  • produced at base of limbs in zone of polarizing activity
  • involved in CNS development
  • causes holoprosencephaly
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2
Q

Wnt-7 gene

A
  • at apical ectodermal ridge

- for proper organization along dorsal-ventral axis

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3
Q

FGF gene

A
  • at apical ectodermal ridge
  • mitosis of underlying mesoderm
  • for lengthening of limbs
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4
Q

homeobox

A
  • segmental organization of embryo in a craniocaudal directions
  • leads to appendages in wrong location
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5
Q

agenesis

A

no organ due to absent primordial tissue

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6
Q

aplasia

A

no organ even with primordial tissue

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7
Q

effect of fetus of alkylating agents

A

absence of digits

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8
Q

effect of fetus of aminoglycosides

A

ototoxicity

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9
Q

effect of fetus of DES

A

vaginal clear cell adenocarcinoma

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10
Q

effect of fetus of lithium

A

ebstein anomaly (displacement of tricuspid valve)

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11
Q

effect of fetus of drugs

A

low birth weight, preterm labor, placental problems

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12
Q

effect of fetus of maternal diabetes

A

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

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13
Q

findings in fetal alcohol syndrome

A
  • retardation, microcephaly, smooth philtrum, thin vermillion border, small palpebral fissures, limb dislocation, heart defects, fistulas, holoprosencephaly
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14
Q

cytotrophoblast (fetal component)

A

inner layer of chorionic villi (cyto makes cells)

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15
Q

syncytiotrophoblast (fetal component)

A

synthesizes hormones like bHCG

- lacks MHC-1 expression

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16
Q

decidua basalis

A

derived from endometrium, maternal blood in lacunae

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17
Q

umbilical cord

A
  • two arteries from iliac arteries

- one vein from IVC

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18
Q

umbilical vessels are derived from…

A

allantosis

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19
Q

urachus

A

duct between fetal bladder and umbilicus

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20
Q

vitelline duct

A

connects yolk sac to mid gut lumen

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21
Q

first aortic arch derivatives

A

part of maxillary artery (1st is MAXimal)

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22
Q

second aortic arch derivatives

A

stadedial and hyoid artery (S=second)

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23
Q

third aortic arch derivatives

A

common carotid artery and proximal part of internal carotid (C is third letter)

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24
Q

fourth aortic arch derivatives

A 
left = aoritc arch
right = proximal part of right subclavian artery 
(4th = 4 limbs, systemic)
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25
Q

sixth aortic arch derivatives

A

pulmonary arteries and ductus arteriosus

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26
Q

study embryology

A

do it

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27
Q

female embryology

A

mesonephric duct degenerates and paramesonephric duct develops

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28
Q

male embryology

A
  • SRY on Y produces TDF
  • sertoli cells produce MIF that suppresses paramesonephric ducts
  • leydig cells secrete androgens stimulating mesonephric ducts
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29
Q

mullerian agenesis

A

Mayer-Rokitansky-Kuster-Hauser syndrome

  • lack of uterine development
  • primary amenorrhea
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30
Q

mesonephric vs paramesonephric ducts

A 
mesonephric = male
paramesonrphric = female
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31
Q

no sertoli cells leads to….

A

no MIF, leading to development of both male and female internal and external genetalia

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32
Q

5alpha reductase deficiency

A

cant convert to DHT, leads to male internal and ambiguous external

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33
Q

Leydig and Sertoli for sexual differentiation

A

leydig leads to male

sertoli shuts down female

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34
Q

genital tubercle

A

becomes glans penis, corpus cavernosum and spongiosum and clitoris

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35
Q

urogenital sinus

A

becomes Bartholin/Cower glands, skene’s gland and prostate, lower vagina

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36
Q

urogenital folds

A

become shaft of penis and labia minora

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37
Q

labioscrotal swelling

A

becomes scrotum and labia majora

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38
Q

difference in gonadal veins

A

left takes the longest way (renal vein to IVC)

- right is direct to IVC

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39
Q

structures to para aortic nodes

A

ovary/testes

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40
Q

structures to external iliac nodes

A

uterus/cervix/superior bladder

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41
Q

structures to internal iliac nodes

A

prostate/certix/proximal vagina

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42
Q

structures to superficial inguinal nodes

A

distal vagina, vulva, scrotum, distal anus

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43
Q

structures to deep inguinal nodes

A

glans penis

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44
Q

infundibulopelvic ligament

A

connect ovary to pelvic wall

  • contains ovarian vessels
  • close to ureter in retroperitineum
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45
Q

cardinal ligament

A
  • connects cervix to side wall of pelvis
  • contains uterine vessels
  • close to ureter
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46
Q

round ligament

A
  • uterine fundus to labia majora

- same as gubernaculum

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47
Q

ovarian ligament

A
  • uterus to ovary

- ovarian ligament latches to lateral uterus

48
Q

epithelium of ovary

A

simple cuboidal, germinal epithelium covering surface

49
Q

pathway of sperm

A 
Seminiferous tubules
Epididymis
Vas deferens
Ejaculatory ducts
Nothing
Urethra
Penis
50
Q

urethral injury in pelvic fracture

A

membranous urethra in posterior

51
Q

urethral injury in perineal straddle injury

A

bulbar urethra in anterior

52
Q

functions of sertoli cells

A
  • secrete inhibin B, androgen binding protein, MIF
  • form tight junctions
  • nourish spermatozoa
  • temperature sensitive
  • use aromatase to convert testosterone to DHT
53
Q

inhibin B

A

secreted by sertoli cells to inhibit FSH

54
Q

leydig cell function

A
  • secrete testosterone in presence of LH
55
Q

source of estrogen

A

ovary, placenta, adipose tissue

56
Q

functions of estrogen

A
  • development of genitals and breasts
  • growth of follicle, endometrial proliferation
  • upregulation of estrogen, LH and progesterone receptors
  • inhibits LH,FSH
57
Q

changes in estrogens in pregnancy

A
  • 50 fold increase in estradiol and estrone

- 1000 fold increase in estriol

58
Q

progesterone is produced by…

A

copus luteum, placenta, adrenal cortex, testes

59
Q

functions of progesterone

A
  • stimulation of spiral artery and gland secrections
  • maintain pregnancy
  • thicken cervical mucus
  • inhibit, FSH, LH
  • uterine smooth muscle relaxation
  • prevents endometrial hyperplasia
60
Q

meiosis I is arrested in…

A

prophase (until ovulation)

61
Q

meiosis II is arrested in….

A

metaphase (after fertilization)

62
Q

mittelschmerz

A

transient mid-cycle ovulatory pain associated with peritoneal irritation
- can mimic appendicitis

63
Q

gestational age

A

from date of last menstrual period

64
Q

physiologic changes in pregnancy

A
  • increase cardiac output and HR
  • anemia (more plasma and RBC, but not to same extent)
  • hypercoagulability
  • hyperventilation
65
Q

when does HCG peak in pregnancy

A

8-10 weeks

66
Q

source of HCG

A

syncytiorophoblast of placent

67
Q

function of HCG

A
  • maintains corpus luteum and progesterone fro 8-10 weeks

- same alpha subunit as LH, FSH, TSH

68
Q

hCG is high in….

A

multiple gestations, hydatidiform moles, choriocarcinomas and down syndrome

69
Q

human placental lactogen

A
  • made by syncytiotrophoblast of placenta

- stimulates insulin production, increases insulin resistance, increase in lipolysis

70
Q

APGAR

A 
Appearance (pink of blue)
Pulse (100bpm)
Grimace (cries)
Activity (movement)
Respiration (breathing)
71
Q

breastfed infants require supplementation with…

A

vitamin D

72
Q

diagnosis of menopause

A

amenorrhea for 12 months

73
Q

hormones in menopause

A

estrogen decreases, very high FSH, high LH (no surge) and high GnRH

74
Q

menopause before 40 suggests…

A

primary ovarian insufficiency

75
Q

5alpha reductase

A

converts testosterone to DHT

76
Q

aromatase

A

converts androgens to estrogens (in adipose)

77
Q

order of sperm cells

A
  1. spermatogonium
  2. primary spermatocyte
  3. meiosis I
  4. secondary spermatocyte
  5. meiosis II
  6. spermatid
    7 spermatozoan
78
Q

hormones issues in XXY

A
  • dysgenesis of tubules leads to less inhibin B and more FSH

- abnormal leydig cell function leads to less testosterone, more LH and more estrogen

79
Q

most common cause of amenorrhea

A

turner syndrome

80
Q

congenital adrenal hyperplasia

A

leads to virilization in females

81
Q

androgen insensitivity syndrome

A

ambiguous genitalia in males

82
Q

placental aromatase deficiency

A
  • cant make estrogens
  • masculinization of female
  • can have maternal virilization
83
Q

Kallman syndrome

A

failure of GnRH cells to develop

  • failure to complete puberty
  • infertility
  • no FSH, LH or testosterone
84
Q

cannonball metastases

A

in choriocarcinoma

85
Q

cause of vasa previa

A

velamentous umbilical cord insertion (cord inserts in chorioamniotic membrane rather than placenta)

86
Q

four Ts of post partum hemorrage

A

Tone (uterine atony)
Trauma (lacerations)
Thrombin (clots)
Tissue (retained products)

87
Q

associations with polyhydramnios

A
  • esophageal and duodenal atresia
  • anencephaly
  • maternal diabetes
  • anemia
  • mutiple gestations
88
Q

associations with oligohydramnios

A
  • placental insuffficiency
  • bilateral renal agenesis
  • posterior urethral valves
89
Q

cause of Potter sequence

A

oligohydromnios

90
Q

hypertensive drugs in pregnancy

A

methyldopa, labetalol, hydralazine and nifedipine

91
Q

treatment of eclampsia

A

magnesium sulfate

92
Q

preeclampsia

A

hypertension and end organ damage after 20 weeks (if before = molar pregnancy)

93
Q

cause of preeclampsia

A

abnormal spiral arteries, endothelial dysfunction, vasoconstriction and ischemia

94
Q

HELLP syndrome

A

hemolysis, elevated liver enzymes and low platelets

95
Q

incidence of gyn cancers in US

A

endometrial, ovarian, cervical

96
Q

leuprolide

A
  • GnRH agonist (pulsatile or continuous)

- for fibroids, endometriosis, precocious puberty, prostate cancer, infertility

97
Q

clomiphene

A
  • blocks estrogen receptors in hypothalamus
  • stimulates ovulation
  • treats infertility in PCOS
98
Q

tamoxifen

A
  • estrogen antagonist in breast
  • agonist in bone/uterus
  • increases endometrial cancer
99
Q

raloxifene

A

same as tamoxifen but no increase in endometrial cancer

- used to treat osteoporosis

100
Q

letrozole

A

aromatase inhibitor

  • inhibits conversion to estrogen
  • treats breast cancer
101
Q

anastrozole

A

aromatase inhibitor

102
Q

exemestane

A

aromatase inhibitor

103
Q

progestins

A
  • decrease growth and increase vascularity of endometrium, thicken cervix
  • for contraception, endometrial cancer, abnormal bleeding
104
Q

mifepristone

A

anti-progestin

- used in a abortion

105
Q

contraindications in oral contraceptives

A
  • smokers above 35, blot clots, breast cancer, lupus, cholestatic disease
106
Q

most effective emergency contraception

A

copper IUD

107
Q

terbutaline

A

beta 2 agonist to relax the uterus and decrease contractions in pregnancy

108
Q

ritodrine

A

beta 2 agonist to relax the uterus and decrease contractions in pregnancy

109
Q

danazol

A
  • partial androgen agonist

- treats endometriosis and angioedema

110
Q

used to stimulate anabolism in burns

A

testosterone

111
Q

finasteride

A

5alpha reductase inhibitor

- for BPH and baldness

112
Q

flutamide

A
  • blocks androgen receptor

- for prostate carcinoma

113
Q

ketoconazole

A
  • inhibits steroid synthesis

- used in PCOS

114
Q

spironolactone

A
  • inhibits steroid binding

- used in PCOS

115
Q

tamsulosin

A

alpha 1 antagonist used to treat BPH

116
Q

minoxidil

A

arteriolar vasodilator for male pattern baldness

First Aid (16 decks)

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