Reproductive- FA Flashcards
HER-2 has worse prognosis than Estrogen receptor positive in breast cancer. What molecule is HER-2? function?
tyrosine kinase receptor
=> promotes cell growth and proliferation
trastuzumab is antibody that targets HER-2, inhibiting cell growth
: antibody mediated cytotoxicity
Difference between partial vs. complete abruptio placentae?
complete: concealed hemorrhage
partial: apparent hemorrhage
Danazol
- MOA
- indications
- side effects
- androgen partial agonist
- endometriosis (reducing dysmenorrhea by negative feedback to FSH/LH-> inhibiting mestural cycle), hereditary angiodema
- heptatoxicity, hirsutism, masculization, also pseudomotor cerebri (so random)
Most effective emergency contraceptive?
copper IUD: local inflammation toxic to sperm and ova
Gubernaculum consists of which two ligaments in female? what is its function in male?
female- ovarian ligament and round ligament
*ligaments in upper region of uterus
male- holds testes within scrotum
Above which artery does the round ligament travel?
artery of Sampson
: tiny vessels that form anastomosis of uterine and ovarian artery
Leydig cell tumor
- histologic finding
- phenotypes- kid vs. adult
- Reinke crystals: eosinophilic cytoplasmic inclusions
- adult: gyenocomastia (estrogen from testosterone via aromatase)
- kid: precocious puberty (testosterone)
What is treatment for seizure prevention in preeclampsia? what is definitive treatment?
seizure prevention- 1st line: IV MgSO4, 2nd line: BDZ
definitive treatment: immediate delivery
*In fact, definitive treatment for all hypertensive complications of pregnancy (pre/eclampsia, HELLP) is immediate delivery of fetus
Disorders of Sex Development (DSD): explain each
- 46 XX DSD
- 46 XY DSD
- 46 XX DSD- ovary present, ambiguous external, virilization, excess androgen
- 46 XY DSD- testes present, ambiguous external (or female). Androgen insensitivity
- Bottomline: GONAD INTACT, EXTERNAL GENITALIA MESSED UP. It is matter of ANDROGEN (female- too much, male- too less)
Common theme of Klinefelter and Turner?
Hypergonotrophic hypogonadism
Klinerfelter: level of
- FSH
- LH
- estrogen
- testosteron
- FSH: high
- LH: high
- hypergonatrophic
- testosteron: low (Leydig not functioning)
- estrogen: high -> gynecomastia
- this is bit complicated. But bottomline is that
Dysgenesis of semiferous tubules
-> decreased inhibin -> high FSH -> more AROMATASE synthesis by FSH -> relative increase of estrogen by PERIPHERAL TISSUE
What estrogen form is predominant in ovary? What about adipose tissue?
17-beta estradiol (highest potency)
vs. adipose tissue: where estrone is predominant (2nd potency)
prolactin vs. oxytocin: which one induces milk letdown?
oxytocin
Clomiphene
- MOA
- indication
- side effects
- SERM, estrogen antagonist in HYPOTHALAMUS
- > reduced negative feedback -> increased FSH/LH
- > ovulation
- indicated for PCOS (anovulation)
- side effects: visual disturbance, hot flashes
Why tamsulosin is helpful in treating BPH without causing systemic vasoconstriction?
selective alpha agonist for alpha1-A/D
alpha1-B receptor is in vasculature: so no vasoconstriction
phenotype of 5alpha-reductase deficiency in male?
- internal genitalia
- external genitalia
internal genitalia intact
ambiguous external genitalia UNTIL PUBERTY
After puberty, testosterone can promotes masculinization
Role of DHT during
- early development
- late development (after puberty)
- early development
: external genitalia development, prostate DEVELOPMENT - late development (after puberty)
: balding, SEBACEOUS GLAND ACITIVTY, prostate GROWTH
Blood smear finding in HELLP syndrome?
Schistocyte
Low platelet => platelet used up for thrombi
-> shistocyte -> hemolysis
Describe gross features of fetal alcohol syndrome. These defects are due to defect in what embryological step?
- smooth philtrum
- thin vermilon border (upper lip)
- microcephaly (holoprosencephaly for severe form)
- small palpebral fissures (small eye opening)
due to cell migration defect
hCG level in ectopic pregnancy?
lower than expected rise in hCG
blood at urethral meatus. diagnosis?
urethral injury
Two different mechanisms that may cause
- anterior urethra damage
- posterior urethra damage
- anterior urethra damage: perineal straddle injury
: falling onto bicycle bar
-> bicycle bar press urethra against pubic symphysis
-> damage ANTERIOR side of urethra by pubic symphysis - posterior urethra damage: pelvic fracture
pelvic bone on posterior side can damage urethra from back
(there is good figure in picture folder)
histology
- ovary
- ectocervix
- endocervix
- transformation zone
- ovary: simple cuboidal
- ectocervix: squamous
- endocervix: columnar
- transformation zone: squamocolumnar, most common area for cervical cancer. Pap smear should have this cell type to be valid
Different mechanisms for contraception by using
- progestin
- antiprogestin
- progestin: thick cervical mucus, preventing sperm entrance => contraception before fertilization
- antiprogestin: inhibition of maintaining thick uterus wall => contraception after fertilization (termination of pregnancy)