Reproductive Flashcards
Alcohol consumption by mother causes
Impaired migration of neuronal and glial cell
Smooth philtrum Thin vermilion Small palpebral fissures Mental retardation and microcephaly Heart and limb defects Heart and lung fistula Holoprosencephaly
Neonatal abstinence synd
Features in newborn which suddenly are withdrawn from maternal opiate effect
Seen as diarrhoea tremors seizures high pitched crying problem sucking
Hcg therapy is used
To triger ovulation in an oocyte donor when her follicles are matured enough
Pulsatile GnRh therapy is used in
Hypogonadotropic hypogonadal anovulation to stimulate ovulation
These pts have intact pituitary and ovarian function but have problems concieving because of disordered hypothalamic GnRH secretion
Clomiphene citrate is antiestrogen
Used to stimulate ovulation in
Pts with normal gondotropin and normal prolactin and thyroid pts
They simply have ovulatory failure
Clomiphene being antiestrogen blocks the hypothalamic feedback. Gnrh increases fsh and lh increases ovulation occurs
Genetic disorder with dysgenesis of seminiferous tubules
Barr body presence in male
Fsh and estrogen are high
Inhibin b and testosterone are low
Kleinfelter syndrome
Shortened 4th metacarpal
Turners
Turners cause is
Meiotic non disjunctjon or mitotic non disjunction
Most commonly it is sperm lacking a sex chromosome— paternal loss of x or y chromosome
If mitotic non dysjunction —seen in zygote and leads to mosaicism
Gonadoblastoma in turners is seen with what type of genetics
When turners is due to mosaicism
45X/46XX
Premature ovarian failure causez
Smoking
Chemotherapy
Radiation therapy
Treatment of pid shud include
Drugs targetting both neisseria gono and chlamydia trachomatis
third gen cephalosporin and azithromycin/ doxycycline
Semen characteristics in congenital abs of vas deferens
Low sperm volume
Acidic ph of semen
Major organisms for pid
N gono
Chlamydia trachomatis
Use of flutamide in prostate cancer
Used concurrently with long acting GnRh agonist like leuprolide which initially causes lh and testosterone release transient effect
To counteract this testosterone receptor antagonist like flutamide is given
Can reduce growth of tumour and metastasis
Use of aromatase inhibitors
Anastrozole
Used in postmenopausal females with ER positive breast cancer
Inhibits peripheral conv of androgens to estrogen
Uses of finasteride
It is 5 alpfa reductase inhibitor
Prostatic hypertrophy
Male pattern baldness ( effect of DHT)
Blocks testosterone to DHt peripheral conversion
Name serms
Tamoxifen
Raloxifene
Why are tamoxifen and raloxifen called modulators
Because they have mixed agonist/ antagonist action
Side effects of serm therapy
Hot flashes
Deep vein thrombosis and others veins
Endometrial carcinoma/hyperplasia with tamoxifen only
Why is prolactinoma associated with infertility in both males and females
Because prolaction is inhibitory of GnRH SECRETION at hypothalamus
Prolactin secretion is controlled by
Trh and vip has positive role in secretion
Dopamine inhibits secretion
Testicular atrophy and gynaecomastia are seen in both anabolic steroid abuse as well as kleinfelters syndrome
What symptoms can differentiate
Acne aggressive behaviour
Male pattern baldness and early epiphyseal closure (short height) is anabolic steroid abuse
On other hand ks has azospermia, tall height, cognitive impairement, absence of secondary sexual characterisitics
Most common malignancy in struma ovarii
Papillary thy ca
Followed by
Follicular thy ca
Newborn crying tremors tachypnea sneezing diarrhoea
Increased tone points to what syndr
Neonatal abstinence syndrome
Due to withdrawal from maternal opiate effect
Treatment of neonatal abstinence syndrome
Give opiates since it is opiate withdrawal symptoms
Give morphine or methadone
Cvs manifestation of congenital rubella
PDA
peripheral pulmonic stenosis
Classic clinical triad of congenital rubella is?
SNHL— deaf child
Cataracts—- white pupils
PDA- continuous murmur in left infracl region
Who all can be given rubella live attenuated vaccine
Children 12 to 15 months
Children 4 to 6 years
Non pregnant women with negative serum rubella antibodies
Avoid preg for 1 month after this live rubella vaccine
Treatment of rubella
No drug to treat rubella once it has occured
Hiv fusion inhibitor drug is named
En-fu-viritide
Is a new fusion inhibitor approved for hiv
Interferons are used to treat
Hep B and C
hairy cell leukemia
Condyloma acuminatum
Kaposis sarcoma
Most adult women with rubella has what sequelae
Polyarthralgia
Polyarthritis
P57 is a ihc marker for
Complete mole
P57 is a imprinted gene
Hence lack of p57 is complete mole
Endodermal sinus tumours also known as yolk sac tumour of ovaries have characteristic histology known as
Schiller duval bodies which resemble glomeruli
Serum AFP is raised in yst
Fried egg cell with large round nucleus surrounded by clear cytoplasm
Which ovarian tumour is this
Dysgerminona
Hormones secreted by dysgerminoma
B hcg and LDH
Estrogen and inhibin secreting tumours of ovaries are
Granulosa cell tumours
They are sex cord stromal neoplasms
Histopatho of granulosa cell tumour of ovary is
Coffee bean groove in nucleus
Known as call-exner bodies within atypical granulosa cells
Psammoma bodies are seen in which ovarian tumour
Serous cystadenocarcinoma
Hirsuitism and clitoromegaly is seen in which rare ovarian tumour
Testosterone secreting Leydog-sertoli cell tumour
Name the types of sex cord stromal neoplasms of ovaries
1- granulosa cell tumour
2- leydig- sertoli neoplasm
Glycogen deficient vaginal epithelium
Estrogen deficiency from premature ovarian failure or menopause
Results in flatenning of labial folds and vaginal rugae causing dyspareunia
Increased endometrial gland to stromal ratio
Endometrial hyperplasia
Has intermentrual bleeding
Prostate biopsy
Large vesicular nuclei with prominent nucleoli
Prostatic adenoca
17 alpha hydroxylase inhibitor is named—— used to treat——
Abira-tirone
Used to treat advanced prostatic adenoca
To stop extratesticular androgen production from adrenal glands and tumour cells via cytop450 enz 17 alpha reductase
Which converts pregnelone and progesterone to DHEA /androstenedione
Hyperthyroidism in ovarian tumour
Struma ovarii
Biopsy of ovary shows mature thyroid tissue
Whst associated clinical features are seen in pts with complete mole
Uterus out of proportion to dates Preeclampsia Hyperthyroidism Hyperemesis Theca leutin ovarian cysts
What cells are seen in placental site gtn
Anaplastic intermediate trophoblast proliferation
Placental site trophoblastic tumour produces what hormone
HPL
Side effect of oral isoretenin therapy for cystic acne
Teratogenic Pseudotumur cerebri Hyperlipidemia Myalgia Dry skin- cheilitis
Aromatase is a key enz for conversion of androgens to estrogen
Genetic def is ar or ad
AR
Males with aromatase deficiency will have
Tall stature because no estrogen from epiphyses closure
Osteoporosis because of lack of estrogen
But no genital abn
Female fetus with aromatase def will have
Internal female organs
External genitalia are ambiguous because of no estrogen and more androgens
At puberty will have primary amenorrhoea, tall height and osteoporosis
DHT. Deficiency
Dihydrotestosterone def is seen in
5 alpha reductase def
Reduced glucocorticoids and androgen
Increased mineralocorticoids
What syndr
Congenital adrenal hyperplasia
Enz def is 17 alpha hydroxylase
Ambiguous genitalia in males with salt retention and hypertension
In what syndr
CAH with only mineralocortocoid production
Ie 17 alpha hydroxylase deficiency
Ambiguous genitalia in females
Salt wasting and hypotension
What syndrome
CAH due to 21 hydroxylase def
Here only androgens are produced hence virilisarion of female fetus
No glucocorticoid or mineralocorticoid produced hence salt wasting and hypotension
Proliferation of cytotrophoblast and syncytiotrophoblast with no villi in post partum d and c
May have lung metastasis
Usually extremely high b hcg
Choriocarcinoma
Cytotrphoblast are mononuclear
Syncytiotrophoblast are multinuclear
No villi
—-drug is used to treat trichomonal vaginitis and ——-
When pt taking this medicine takes alcohol it causes——reaction due to accumulation of —
Metronidazole
Bacterial vaginosis
Disulfiram like reaction
Accumulation of acetaldehyde
A person taking anabolic steroids shud have normal or high testosterone
If he has low testosterone
It indicates consumption of what
Synthetic androgens like tren-bolone
Causes of oligospermia
Ej duct obst—-all hormone normal
Primary hypogondasim- testo low.. gonadotropins high
Secondary hypogonadotrophic hypogonadism—- all low
Partial androgen resistence— normal fsh, high LH AND TESTOsterone
Microrganisms for acute bacterial prostatitis
All are gm negative because their fimbrae hve adhesins having specific tropism for urothelial and mucosal cells
ECOLI
PROTEUS
KLEIBSELLA
PSEUDOMONAS
Cervical infection with gm negative diplococci
Kidney shaped organism in leukocytes
Neiseeria gonoccoi
Complication of vzv
Complication of hsv 2
Vzv— post herpetic neuralgia
Hsv2– reactivation genital ulcers and lesions
Urinary analgesic for relief of dysuria
Phenazo-pyridine
What protooncogenes code for cytoplasmic signal transducer proteins
When mutated cause constitutive activation of signals and henceproliferation and malignancy
Signal transduce protein genes RAS(pancreatic cancer)
BRAF (melanoma)
