Reproductive Flashcards
when do you get 3 layers?
3 weeks- 3 layers-endoderm, mesoderm, ectoderm
where does the notochord come from? where does the neural plate arise from?
notochord over midline mesoderm
neural plate comes from ectoderm
where does the neural tube come from and when does it close?
neural tube comes from neuroectoderm and closes week 4- very susceptible to teratogens
what does the ectoderm consist of?
neural tube and neural crest
what comes from the neural crest?
MMOtEL PPASS- melanocytes, myenteric (auerbach plexus), ondontoblasts, , endocardial cushions,, larygneal cartilage, parafollicular C cells of thyroid, PNS, adrenal medulla, spiral membrane (aorticpulmonary septum) schwann cells
in utero aminoglycosides?
ototoxicity
which is safe in pregnancy-warfarin or heparin?
heparin!
what is the urachus?
the allantois develops into the urachus which is the connection between the fetal bladder and umbilicus, it involutes to the median umbilical ligament (failure can be patent, cyst or vesicourachal diverticulum)
how do you remember the brachial pouches?
ear, tonsils, bottom to top ear-1 tonsils-2 inferior parathyroid-3 to-thymus superior parathyroid-4
what is 22q11 an example of?
failure of 3th-4th brachial pouches (thymus and the superior parathyroids-why you get thymic aplasia and hypocalcemia
what does 5 alpha reductase do?
converts testosterone to DHT
what causes hypospadias?
failure of urethral folds to fuse so you get urethral opening on ventral surface as opposed to epispadias which is dorsal and less common
how do you get an erection? emission? ejaculation?
erection (parasympathetic) pelvic splanchnic nerves S2-4
emission-hypogastric (sympathetic) T11-L2
ejaculation-visceral and somatic nerves
what do sertoli cells secret?
MIF-mullerian inhibitory factor- cause paramesonephric duct to degenerate and also secrete inhibin B which inhibits FSH
-homolog to female granulosa cells
what does aromatase do?
converts testosterone to estrogen
what do leydig cells do?
secrete testosterone in response to LH
homolog to the theca interna cells
what produces progesterone? what does it do?
corpus luteum, placenta, adrenal cortex, testes
- thick cervical mucus, prevents sperm entering uterus
- prevents endometrial hyperplasia
- maintains pregnancy (inhibits LH and FSH
- prevents contractions
which part of the menstrual cycle varies and what stays the same?
follicular varies, but luteal is 14 days
when does hcg peak?
week 8-10, after 8-10 weeks, the placenta secretes its own estriol and progesterone and corpus luteum degenerates
what is human placental lactogen?
increases insulin so you get lipolysis and conserve glucose and AA for fetus
what is kallman syndrome?
failure of gnRH secreting neurons so you get hypogonadotrophic hypogonadism, anosmia, low sperm count in males and amenorrhea in females
what is the difference between a complete and partial mole?
Complete: 46XX or 46XY, empty egg with 1 sperm, duplicates paternal DNA, no fetal parts, higher risk choriocarcinoma, higher hcg-snowstorm, cluster of grapes
Partial- 69XXX or XXY, XYY, fetal parts, lower hcg, smaller uterus
what is velamentous umbilical cord insertion?
inserts into the chorioamnotic membrane instead of placenta- associated with vasa previa
what is the path finding for a serous cystadenocarcinoma
psammoma bodies
what increasing with estrogen?
leiomyoma size so increased in pregnancy and decreased with menopause
What is the pattern on histology for leiomyoma?
whorled pattern of smooth muscle bundles with well demarcated borders
What are the benign breast lesions?
fibroadenoma, intraductal papilloma (in the lactiferous duct-causes discharge), phyllodes tumour (large connective tissue mass)
What is the mutation associated with breast tumours?
c-erbB2 (HER) EGF receptor
ER -, PR - Her2/Neu - is the most aggressive
What are the types of noninvasive breast cancers?
- DCIS (ductal carcinoma in situ)-microcalcifications
- Comedocarcinoma
- Paget disease (eczematous changes on nipple) underlying DCIS
What are the invasive breast cancers?
- Invasive ductal carcinoma- most common (suspensory ligament damage can cause dimpling) stellate on histology
- Invasive lobular carcinoma (often bilateral- dec e cadherin, lines of cells)
- Medullary carcinoma
- Inflammatory breast cancer (dermal invasion of the lymphatics, cooper suspensory ligament has edema so dimpling of the breast, peau d’orange
Which side is a variocele more common on and why?
L because of increased pressure into the L gonadal then renal vein
-bag of worms appearance
What is a hydrocele?
patent processus vaginalis, usually resolves within 1 year
What are the testicular germ cell tumours? (95%)
- Seminoma (most common-fried egg withlarge cells in lobules) high ALP
- Yolk sac- yellow, mucinous, schiller duval bodies, high AFP
- Choriocarcinoma (disordered syncytiotrophoblasts) high hcg
- Teratoma
- Embryonal carcinoma (hemorrhagic with necrosis)
What are the testicular non germ cell tumours? (5%)
- Leydig- golden brown, androgens and estrogen, gynecomastia
- Sertoli
- Testicular lymphoma
what do you use tamoxifen for?
ER/PR positive breast cancer
- can increase risk of endometrial cancer
- antagonist in breast, agonist in bone
what are aromatase inhibitors?
decrease conversion of testosterone to estrogen
-for ER positive breast cancer
what does progesterone do?
thickens cervical mucus, increases vascularization of endometrium, but decreases growth
what are common tocolytics?
NSAIDS, terbutaline, nifedipine
what is finasteride?
antiandrogen, decreases testosterone conversion to DHT
-can use for BPH
