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FA note cards > Reproductive > Flashcards

Reproductive Flashcards

1
Q

Sonic hedgehog gene

A

Produced at base of limbs in zone of polarizing activity
patterning along anteroposterior axis and CNS development
Holoprosencephaly

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2
Q

Wnt-7 gene

A

Produced at apical ectodermal ridge

Organization along dorsal-ventral axis

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3
Q

FGF gene

A

Produced at apical ectodermal ridge

Stimulates mesoderm: lengthening of limbs

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4
Q

Homeobox (Hox) genes

A

Segmental organization of embryo in a craniocaudal direction.

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5
Q

Surface ectoderm becomes

A

Epidermis; adenohypophysis (from Rathke pouch); lens of eye; epithelial linings of oral cavity, sensory organs of ear, and olfactory epithelium; anal canal below the pectinate line; parotid, sweat, mammary glands

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6
Q

Neural tube becomes

A

(Ectoderm)

Brain (neurohypophysis, CNS neurons, oligo- dendrocytes, astrocytes, ependymal cells, pineal gland), retina, spinal cord

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7
Q

Neural crest become

A

(ectoderm)
PNS (dorsal root ganglia, cranial nerves, autonomic ganglia, Schwann cells), melanocytes, chromaf n cells of adrenal medulla, parafollicular (C) cells of thyroid, pia and arachnoid, bones of the skull, odontoblasts, aorticopulmonary septum, endocardial cushions, myenteric (Auerbach) plexus

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8
Q

Mesoderm becomes

A

Muscle, bone, connective tissue, serous linings of body cavities (eg, peritoneum), spleen (derived from foregut mesentery), cardiovascular structures, lymphatics, blood, wall of gut tube, upper vagina, kidneys, adrenal cortex, dermis, testes, ovaries

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9
Q

Neuroectoderm becomes

A

Neural plate; Induced by notochord from ectoderm

Nucleus pulposus of the intervertebral disc

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10
Q

Endoderm becomes

A

Gut tube epithelium (including anal canal above the pectinate line), most of urethra and lower vagina (derived from urogenital sinus), luminal epithelial derivatives (eg, lungs,
liver, gallbladder, pancreas, eustachian tube, thymus, parathyroid, thyroid follicular cells)

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11
Q

Effect of ACE inhibitors on a fetus

A

Renal damage

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12
Q

Effect of alkylating agents on a fetus

A

Absence of digits, multiple anomalies

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13
Q

Effect of diethylstilbestrol on a fetus

A

Vaginal clear cell adenocarcinoma, congenital Müllerian anomalies

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14
Q

Effect of methimazole on a fetus

A

Aplasia cutis congenita

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15
Q

Effect of thalidomide on a fetus

A

Limb defects (phocomelia, micromelia— “fipper” limbs)

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16
Q

Effect of cocaine on a fetus

A

Low birth weight, preterm birth, IUGR, placental abruption

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17
Q

Effect of smoking on a fetus

A

Low birth weight, preterm labor, placental problems, IUGR, SIDS

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18
Q

FAS

A

Pre- and postnatal developmental retardation, microcephaly, facial abnormalities (eg, smooth philtrum, thin vermillion border, small palpebral fissures), limb dislocation, heart defects
Failure of cell migration

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19
Q

Syncytiotrophoblast

A

Outer layer of chorionic villi; synthesizes and secretes hormones

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20
Q

Umbilical cord

A 
Umbilical arteries (2): return deox blood from fetal internal iliac a to placenta
Umbilical vein (1): supplies ox blood from placenta to fetus; drains into IVC via liver or via ductus venosus
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21
Q

What are umbilical arteries and vein derived from?

A

Allantois

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22
Q

Patent urachus

A

Total failure of urachus to obliterate → urine discharge from umbilicus

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23
Q

Urachal cyst

A

Partial failure of urachus to obliterate; fluid- filled cavity lined with uroepithelium, between umbilicus and bladder

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24
Q

Vesicourachal diverticulum

A

Slight failure of urachus to obliterate → outpouching of bladder

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25
Q

Vitelline duct

A

connects yolk sac to midgut lumen

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26
Q

Vitelline stula

A

Vitelline duct fails to close → meconium discharge from umbilicus

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27
Q

Meckel diverticulum

A

Partial closure of vitelline duct, with patent portion attached to ileum
Melena, hematochezia, abdominal pain

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28
Q

Derivatives of 1st aortic arch

A

Part of maxillary artery (branch of external carotid)

1st is MAXimal

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29
Q

Derivatives of 2nd aortic arch

A

Stapedial artery and hyoid artery

Second = Stapedial

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30
Q

Derivatives of 3rd aortic arch

A

Common Carotid artery and proximal part of internal Carotid artery
(C is 3rd letter)

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31
Q

Derivatives of 4th aortic arch

A

On left, aortic arch

On right, proximal part of right subclavian artery

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32
Q

Derivatives of 5th aortic arch

A

Proximal part of pulmonary arteries and (on left only) ductus arteriosus

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33
Q

Pierre Robin sequence

A

Abnormal development of 1st arch

Micrognathia, glossoptosis, cleft palate, airway obstruction

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34
Q

Treacher Collins syndrome

A

Abnormal development of 1st arch

Neural crest dysfunction: mandibular hypoplasia, facial abnormalities

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35
Q

Derivatives of 1st brachial pouch

A

Middle ear cavity, eustachian tube, mastoid air cells

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36
Q

Derivatives of 2nd brachial pouch

A

Epithelial lining of palatine tonsil

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37
Q

Derivatives of 3rd brachial pouch

A

Dorsal wings: inferior parathyroids

Ventral wings: thymus

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38
Q

Derivatives of 4th brachial pouch

A

Dorsal wings: superior parathyroids
Ventral wings: 1. ultimobranchial body
2. parafollicular (C) cells of thyroid

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39
Q

DiGeorge syndrome

A 
Chromosome 22q11 deletion
Aberrant development of 3rd and 4th pouches
T-cell deficiency (thymic aplasia) and hypocalcemia (no parathyroid development)
Cardiac defects (conotruncal anomalies)
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40
Q

Cleft lip

A

failure of fusion of the maxillary and medial nasal processes (formation of 1° palate)

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41
Q

Cleft palate

A

Failure of fusion of the two lateral palatine shelves or failure of fusion of lateral palatine shelves with the nasal septum and/or median palatine shelf (formation of 2° palate)

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42
Q

Default embryologic genital development

A

Female

Mesonephric duct degenerates and paramesonephric duct develops

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43
Q

Development of male genitalia

A
  • SRY gene on Y: testis- determining factor
  • Sertoli cells secrete Müllerian inhibitory factor: suppresses development of paramesonephric ducts
  • Leydig cells secrete androgens that stimulate development of mesonephric ducts
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44
Q

Paramesonephric (Müllerian) duct development in female

A

Internal structures: fallopian tubes, uterus, upper portion of vagina (lower portion from urogenital sinus)

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45
Q

Paramesonephric (Müllerian) duct development in males

A

Appendix testis

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46
Q

Mayer-Rokitansky- Küster-Hauser syndrome

A

Müllerian agenesis
1° amenorrhea (lack of uterine development) in females with fully developed 2° sexual characteristics (functional ovaries)

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47
Q

Mesonephric (Wolffian) duct in males becomes

A

Internal structures (except prostate): Seminal vesicles, Epididymis, Ejaculatory duct, Ductus deferens (SEED)

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48
Q

Mesonephric (Wolffian) duct in females becomes

A

Gartner duct

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49
Q

XY with dysfunction of Sertoli cells or MIF

A

Develop both male and female internal genitalia and male external genitalia

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50
Q

5α-reductase deficiency

A

Inability to convert testosterone into DHT: male internal genitalia, ambiguous external genitalia until puberty (↑ testosterone: masculinization)

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51
Q

Bicornuate uterus

A

Incomplete fusion of Müllerian duct

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52
Q

Uterus didelphys

A

Complete failure of fusion: double uterus, cervix, vagina

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53
Q

Gubernaculum remnant in males and females

A

Males: Anchors testes within scrotum
Females: Ovarian ligament + round ligament of uterus

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54
Q

Venous drainage of gonads

A

Left ovary/testis → left gonadal vein→ left renal vein → IVC

Right ovary/testis → right gonadal vein → IVC

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55
Q

What structures drain to the para-aortic lymph nodes?

A

ovaries/testes

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56
Q

What structures drain to the external iliac nodes?

A

Body of uterus/cervix/superior bladder

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57
Q

What structures drain to the internal iliac nodes?

A

Body of prostate/cervix/corpus cavernosum/proximal

vagina

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58
Q

What structures drain to the superficial inguinal nodes?

A

Body of distal vagina/ vulva/scrotum/distal anus

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59
Q

What structures drain to the deep inguinal nodes?

A

Glans penis

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60
Q

Infundibulopelvic ligament

A

aka suspensory ligament of the ovary
Connects: ovaries to pelvic wall
Contains: ovarian vessels
Ureter courses close behind

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61
Q

Cardinal ligament

A

Connects: cervix to side wall of pelvis
Contains: uterine vessels

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62
Q

Round ligament of the uterus

A

Connects: Uterine fundus to labia majora
Derivative of gubernaculum
Travels through round inguinal canal; above the artery of Sampson

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63
Q

Broad ligament

A

Connects: uterus, fallopian tubes, and ovaries to pelvic side wall
Contains: ovaries, fallopian tubes, round ligaments of uterus
Is a fold of the peritoneum

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64
Q

Ovarian ligament

A

Connects: medial pole of ovary to lateral uterus

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65
Q

Pathway of ejaculation

A 
SEVEN UP:
Seminiferous tubules
Epididymis
Vas deferens
Ejaculatory ducts
(Nothing)
Urethra
Penis
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66
Q

Autonomic innervation of the male sexual response

A

Erection: PSNS
Emission: SNS (hypogastric nerve)
Ejaculation: visceral and somatic nerves (pudendal nerve)

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67
Q

Spermatogonia

A

Germ cells
Line seminiferous tubules
Germ cell pool and produce 1° spermatocytes

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68
Q

Sertoli cells produce what?

A

Secrete inhibin B: inhibit FSH
Secrete androgen-binding protein: maintain local levels of testosterone
Produce MIF

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69
Q

What isolates gametes

from autoimmune attack?

A

Tight junctions between adjacent Sertoli cells

forming blood-testis barrier

70
Q

Functions of sertoli cells?

A

Support and nourish developing spermatozoa

Regulate spermatogenesis

71
Q

Function of leydig cells?

A

Secrete testosterone in the presence of LH

72
Q

Ovulation

A

↑ estrogen, ↑ GnRH receptors on anterior pituitary

Estrogen surge then stimulates LH release: ovulation

73
Q

What does APGAR stand for?

A

Appearance, Pulse, Grimace, Activity, Respiration

74
Q

Definition of low birth weight

A

< 2500 g

75
Q

Definition of menopause

A

amenorrhea for 12 months

76
Q

Timeline of menopause

A

Amenorrhea for 12 months
Average age at onset is 51 years (earlier in smokers)
Preceded by 4–5 years of abnormal cycles

77
Q

Hormonal changes seen in menopause

A

↓ estrogen, ↑↑ FSH, ↑ LH (no surge), ↑ GnRH

78
Q

What causes aneuploidy?

A

Most commonly due to meiotic nondisjunction

79
Q

Klinefelter syndrome

A

Testicular atrophy, eunuchoid body shape, tall, long extremities, gynecomastia, female hair distribution
Dysgenesis of seminiferous tubules: ↓ inhibin B leads to ↑ FSH
Abnormal Leydig cell function: ↓ testosterone -> ↑ LH -> ↑ estrogen

80
Q

Turner syndrome

A

Short stature, ovarian dysgenesis (streak ovary), shield chest, bicuspid aortic valve, coarctation, lymphatic defects (result in webbed neck or cystic hygroma; lymphedema in feet, hands), horseshoe kidney
Menopause before menarche

81
Q

Placental aromatase deficiency

A

Inability to synthesize estrogens from androgens
Masculinization of female infant
Maternal virilization during pregnancy

82
Q

Androgen insensitivity syndrome

A

Defect in androgen receptor resulting in normal-appearing XY female; female external genitalia w/ functioning testes

83
Q

5α-reductase de ciency

A

Ambiguous genitalia until puberty

84
Q

Kallmann syndrome

A

Failure to complete puberty; a form of hypogonadotropic hypogonadism
Defective migration of GnRH-releasing neurons

85
Q

Choriocarcinoma

A

Malignancy of trophoblastic tissue; no chorionic
villi present
Hematogenous spread to lungs: “cannonball”metastases

86
Q

Placental abruption

A

Premature separation of placenta from uterine wall before delivery
Painful bleeding

87
Q

Placenta accreta

A

Placenta attaches to myometrium without penetrating it; most common type

88
Q

Placenta increta

A

placenta penetrates into myometrium

89
Q

Placenta percreta

A

placenta penetrates (“perforates”) through myometrium and into uterine serosa (invades entire uterine wall);

90
Q

Placenta previa

A

Attachment of placenta to lower uterine segment over (or < 2 cm from) internal cervical os
Painless bleeding

91
Q

Vasa previa

A

Fetal vessels run over, or in close proximity to, cervical os

92
Q

Postpartum hemorrhage

A

Tone (uterine atony; most common)
Trauma (lacerations, incisions, uterine rupture)
Thrombin (coagulopathy)
Tissue (retained products of conception)

93
Q

Gestational hypertension

A

BP > 140/90 mm Hg after 20th week

94
Q

Treatment of gestational HTN

A

Hydralazine, α-Methyldopa, Labetalol, Nifedipine; deliver by week 37-39

95
Q

Preeclampsia

A

New-onset hypertension with either proteinuria or end-organ dysfunction after 20th week of gestation

96
Q

Cause of preelampsia

A

Caused by abnormal placental spiral arteries: endothelial dysfunction, vasoconstriction, ischemia

97
Q

Eclampsia

A

Preeclampsia + maternal seizures

98
Q

HELLP syndrome

A

Hemolysis, Elevated Liver enzymes, Low Platelets.
D/t severe preeclampsia
Schisotcytes

99
Q

Gynecologic tumor epidemiology

A

In US: endometrial > ovarian > cervical

Worldwide: cervical

100
Q

Sarcoma botryoides

A

Embryonal rhabdomyosarcoma
Girls < 4 years old; spindle-shaped cells; desmin ⊕
Presents with clear, grape-like, polypoid mass emerging from vagina

101
Q

HPV genes

A

E6 gene product (inhibits p53 suppressor gene)

E7 gene product (inhibits RB suppressor gene)

102
Q

Serous cystadenoma

A

Benign ovarian neoplasm; most common

Lined with fallopian tube–like epithelium

103
Q

Mucinous cystadenoma

A

Benign ovarian neoplasm
Multiloculated, large
Lined by mucus-secreting epithelium

104
Q

Endometrioma

A

Endometriosis within ovary with cyst formation

Chocolate cyst

105
Q

Mature cystic teratoma

A

Germ cell tumor, most common ovarian tumor in females 10–30 years old
Contains elements from all 3 germ layers

106
Q

Brenner tumor

A

Looks like bladder
Solid tumor that is pale yellow-tan and appears encapsulated
Coffee bean” nuclei on H&E

107
Q

Fibromas

A

Bundles of spindle-shaped fibroblasts

108
Q

Meigs syndrome

A

triad of ovarian broma, ascites, hydrothorax

109
Q

Thecoma

A

Like granulosa cell tumors, may produce estrogen

Abnormal uterine bleeding in a postmenopausal woman

110
Q

Granulosa cell tumor

A

Malignant ovarian neoplasm
Women in their 50s
Call-Exner bodies (granulosa cells arranged haphazardly around collections of eosinophilic fluid, resembling primordial follicles)

111
Q

Serous cystadenocarcinoma

A

Malignant ovarian neoplasm
Most common malignant ovarian neoplasm, frequently bilateral
Psammoma bodies

112
Q

Mucinous cystadenocarcinoma

A

Malignant ovarian neoplasm

Pseudomyxoma peritonei–intraperitoneal accumulation of mucinous material from ovarian or appendiceal tumor

113
Q

Immature teratoma

A

Malignant ovarian neoplasm
Aggressive, contains fetal tissue, neuroectoderm
Immature/embryonic-like neural tissue

114
Q

Dysgerminoma

A

Most common in adolescents
Equivalent to male seminoma but rarer
Sheets of uniform “fried egg” cells
hCG, LDH: tumor markers

115
Q

Yolk sac (endodermal sinus) tumor

A

Malignant ovarian neoplasms
Aggressive, in ovaries or testes and sacrococcygeal area in young children
Yellow, friable (hemorrhagic), solid mass
50% have Schiller-Duval bodies (resemble glomeruli)
AFP = tumor marker

116
Q

Krukenberg tumor

A

GI malignancy that metastasizes to ovaries

Mucin-secreting signet cell adenocarcinoma

117
Q

Endometrial polyp

A

Well-circumscribed collection of endometrial tissue within uterine wall
Painless abnormal uterine bleeding

118
Q

Adenomyosis

A

Extension of endometrial tissue (glandular) into uterine myometrium; hyperplasia of basal layer of endometrium
Presents with dysmenorrhea, menorrhagia, uniformly enlarged, soft, globular uterus

119
Q

Asherman syndrome

A

Adhesions and/or brosis of the endometrium

120
Q

Leiomyoma (fibroid)

A

Multiple discrete tumors
Benign smooth muscle tumor
Estrogen sensitive
Whorled pattern of smooth muscle bundles with well-demarcated borders

121
Q

Endometrial hyperplasia

A

Usually caused by excess estrogen stimulation

↑ risk for endometrial carcinoma

122
Q

Endometrial carcinoma

A

Most common gynecologic malignancy

Presents with vaginal bleeding

123
Q

Endometritis

A

Associated with retained products of conception following

124
Q

Endometriosis

A

Non-neoplastic endometrium-like glands/stroma outside endometrial cavity

125
Q

Fibrocystic changes in breast

A

Present with premenstrual breast pain or lumps; often bilateral and multifocal

126
Q

Sclerosing adenosis

A

Type of fibrocystic change

Acini and stromal brosis, associated with calci cations

127
Q

Epithelial hyperplasia of breast

A

Type of fibrocystic change
Cells in terminal ductal or lobular epithelium
↑ risk of carcinoma with
atypical cells

128
Q

Fat necrosis of breast

A

Benign, usually painless, lump due to injury to breast tissue
Necrotic fat and giant cells on biopsy

129
Q

Lactational mastitis

A

S aureus is most common pathogen

Treat with antibiotics and continue breastfeeding

130
Q

Fibroadenoma

A

Small, well-de ned, mobile mass; benign

Estrogen sensitive

131
Q

Intraductal papilloma

A

Small papillary tumor within lactiferous ducts, typically beneath areola; benign
Most common cause of nipple discharge

132
Q

Phyllodes tumor

A

Large mass of connective tissue and cysts with “leaf-like” lobulations

133
Q

Ductal carcinoma in situ

A

Noninvasive, malignant tumor
Fills ductal lumen
Early malignancy without basement membrane penetration

134
Q

Comedocarcinoma

A

Noninvasive, malignant tumor

Ductal, central necrosis

135
Q

Paget disease

A

Results from underlying DCIS or invasive breast cancer
Eczematous patches on nipple
Paget cells: intraepithelial adenocarcinoma cells

136
Q

Invasive ductal carcinoma

A

Invasive, malignant tumor
Firm, brous, “rock-hard” mass with sharp margins and small, glandular, duct-like cells
Can deform suspensory ligaments: dimpling of skin
“Stellate” in ltration
Most common (∼ 75% of all breast cancers)

137
Q

Invasive lobular carcinoma

A

Invasive, malignant tumor

Orderly row of cells (“single file”); ↓ E-cadherin expression

138
Q

Medullary carcinoma

A

Invasive, malignant tumor
Fleshy, cellular, lymphocytic infiltrate
Good prognosis

139
Q

Inflammatory breast cancer

A

Invasive, malignant tumor
Dermal lymphatic invasion by breast carcinoma
Peau d’orange
Poor prognosis

140
Q

Peyronie disease

A

Abnormal curvature of penis due to fibrous plaque within tunica albuginea

141
Q

Bowen disease

A

Precursor in situ lesion of penile SCC

Presents as leukoplakia in penile shaft

142
Q

Erythroplasia of Queyrat

A

Precursor in situ lesion of penile SCC

cancer of glans, presents as erythroplakia

143
Q

Bowenoid papulosis

A

Presents as reddish papules

144
Q

Cryptorchidism

A

Undescended testis

↓ inhibin B, ↑ FSH, ↑ LH; ↓ testosterone in bilateral

145
Q

Testicular torsion

A

Rotation of testicle around spermatic cord and vascular pedicle
Acute, severe pain, high-riding testis, and absent cremasteric reflex

146
Q

Varicocele

A

Dilated veins in pampiniform plexus due to ↑ venous pressure

“Bag of worms” on palpation; augmented by Valsalva

147
Q

Congenital hydrocele

A

Incomplete obliteration of processus vaginalis

Transilluminating swelling

148
Q

Spermatocele

A

Cyst due to dilated epididymal duct or rete testis

149
Q

Seminoma

A

Testicular germ cell tumor
Malignant; painless, homogenous testicular enlargement; most common
Large cells in lobules with watery cytoplasm and “fried egg” appearance
Similar to dysgerminoma in females

150
Q

Yolk sac (endodermal sinus) tumor

A

Testicular germ cell tumor
Yellow, mucinous
Aggressive malignancy of testes, analogous to ovarian yolk sac tumor
Schiller- Duval bodies resemble primitive glomeruli
↑ AFP

151
Q

Choriocarcinoma

A

Testicular germ cell tumor
Malignant, ↑ hCG
Disordered syncytiotrophoblastic and cytotrophoblastic elements
Hematogenous metas to lungs and brain

152
Q

Embryonal carcinoma

A

Testicular germ cell tumor
Malignant, hemorrhagic mass with necrosis; painful
Glandular/papillary morphology

153
Q

Leydig cell non–germ cell tumor

A

Golden brown color; contains Reinke crystals (eosinophilic cytoplasmic inclusions)
Produces androgens or estrogens

154
Q

Sertoli cell non–germ cell tumor

A

Androblastoma from sex cord stroma

155
Q

Testicular lymphoma

A

Most common testicular cancer in older men

156
Q

Benign prostatic hyperplasia

A

Smooth, elastic, rm nodular enlargementof periurethral (lateral and middle) lobes, which compress the urethra

157
Q

Prostatic adenocarcinoma

A

Arises most often from posterior lobe (peripheral zone)

Prostatic acid phosphatase (PAP) and PSA are useful tumor markers

158
Q

Clomiphene

A

Antagonist at estrogen receptors in hypothalamus: inhibits neg feedback -> ↑ LH and FSH -> ovulation

159
Q

Finasteride

A

Blocks 5α− reductase

BPH and male- pattern baldness

160
Q

Androgen-receptor complex blockers (3)

A

Flutamide
Cyproterone
Spironolactone

161
Q

Leuprolide

A

GnRH analog with agonist properties when given pulsatile

Downregulates GnRH receptor

162
Q

Tamoxifen

A

Estrogen-r antagonist at breast; agonist at bone, uterus

ER/PR ⊕ breast cancer

163
Q

Raloxifene

A

Estrogen-r antagonist at breast, uterus; agonist at bone

no increased risk of endometrial cancer

164
Q

Aromatase inhibitors

A

Anastrozole, letrozole, exemestane

ER ⊕ breast cancer in postmenopausal women

165
Q

Mifepristone, ulipristal

A

Competitive inhibitors of progestins at progesterone receptors
Abortion/ER contraception

166
Q

Terbutaline, ritodrine

A

β2-agonists that relax the uterus

167
Q

Danazol

A

Synthetic androgen that acts as partial agonist at androgen receptors
For: endometriosis, hereditary angioedema

168
Q

Flutamide

A

Nonsteroidal competitive inhibitor at androgen receptors

Prostate carcinoma

169
Q

Tamsulosin

A

α1-antagonist used to treat BPH by inhibiting smooth muscle contraction
Selective for α1A/D receptors (found on prostate) vs vascular α1B receptors

170
Q

Minoxidil

A 
Direct arteriolar vasodilator
Androgenetic alopecia (pattern baldness), severe refractory hypertension

FA note cards (16 decks)

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