SUGER Flashcards
epidemiology of polycystic kidney disease (PKD)
- 1 in 1000
- forms 10% of patients on renal replacement therapy (RRT)
What kind of inheritance [pattern does the PKD follow and which proteins are affected
- autosomal dominant PKD
- mutations in polycsytin 1 (85%)
- mutations in polycsytin 2 (15%)
what is an error
any preventable event that may cause orlead to patient harm (failure)
what is an adverse event
incident resulting in harm to a patient, which is not a direct result of their illness or other chance event
what is a near miss
an event which arises during care and has the potential to cause harm but fails to develop further thereby avoiding harm
what are two descriptions of error
- error of omission (e.g required action is delayed or not taken)
- error of commission (e.g wrong action is taken)
what are the two types of error (by Reason’s classification)
- skill based error (e.g dose of medication delivered late- a memory lapse) or (a wrong number on the prescription dose - slip of action)
- rule/knowledge based error (wrong formula applied to adjust dosage of antibiotic - rule based mistake) or (failing to apply NICE guidelines due to lack of awareness -knowledge based mistake)
Where does meiosis take place in males
Seminiferous tubules
What is spermiogenesis
Spermiogenesis is transformation of spermatids into spermatozoa
– sprouts tail and discards cytoplasm to become lighter
What does types A spermatogonium do
type A remain outside blood-testis barrier & produce more
daughter cells until death
What does spertogonium type B do
type B differentiate into primary spermatocytes
• cells must pass through BTB to move inward toward lumen - new tight junctions form behind these cells
• meiosis I 2 secondary spermatocytes
• meiosis II 4 spermatids
What forms the blood testis barrier
Blood-testis barrier is formed by tight junctions between and basement membrane under sertoli cells.
Time for completion of spermiogenesis
64
High levels of testosterone inhibits which hormones, what secretes testosterone
LH and Gonadotrophin releasing hormone (GnRH)
Leydig cells
High levels of inhibin inhibit which hormone, what secretes inhibin
FSH
Sertoli cells
What are the 3 parts of a tail of a spermatozoon
Tail is divided into 3 regions
– midpiece contains mitochondria around axoneme of the flagellum (produce ATP for flagellar movement)
– principal piece is axoneme surrounded by fibers
– endpiece is axoneme only and is very narrow tip of flagellum
What are the 2 parts of a spermatozoan
Head and tail
What are the 2 parts of the head of a spermatozoon
Spermatozoon
Head is pear-shaped front end
– 4 to 5 microns long structure containing the nucleus, acrosome and basal body of the tail flagellum
• nucleus contains haploid set of chromosomes
• acrosome contains enzymes that penetrate the egg
• basal body
Give the 3 accessory glands of the male reproductive organs
Seminal vesicles
Prostate gland
Bulbourethral glands
What is a normal sperm count
50-120million/ml
What sperm count is associated with infertility
<25 million/ml
List 6 other components of semen
-fructose provide energy for sperm motility
– fibrinogen
– clotting enzymes convert fibrinogen to fibrin causing semen to clot
– fibrinolysin liquefies semen within 30 minutes
– prostaglandins stimulate female peristaltic contractions
– spermine is a base stabilizing sperm pH at 7.2 to 7.6
Give the percentage of components that make up semen
60% seminal vesicle fluid, 30% prostatic & 10% sperm and trace of bulbourethral fluid
How much fluid is expelled during an orgasm in a male
2-5ml of fluid
What is capacitation
The final maturational stage of spermatozoa that takes place in the female genital tract, before spermatozoa gain the ability to fertilize oocyte.
What is the Baker Early Origin Hypothesis
The thrifty phenotype hypothesis says that reduced fetal growth is strongly associated with a number of chronic conditions later in life. This increased susceptibility results from adaptations made by the fetus in an environment limited in its supply of nutrients. These chronic conditions include coronary heart disease, stroke, diabetes, and hypertension.
How many litres of filtrate does the glomerular make a day
180L/day of filtrate
Which growth factors and cytokines provide exogenous nutrients in vivo to the embryo
Insulin-like growth factor 1 and 2 (IGF1 and IGF2)
Leukemia inhibiting factor (LIF)
What is Secondary amenorrhea
occurs when you’ve had at least one menstrual period and you stop menstruating for three months or longer.
What is Primary amenorrhea
Primary amenorrhea is the failure of menses to occur by age 16 years, in the presence of normal growth and secondary sexual characteristics
What is oligomenorrhea
Oligomenorrhea is a condition in which you have infrequent menstrual periods. It occurs in women of childbearing age. Some variation in menstruation is normal, but a woman who regularly goes more than 35 days without menstruating may be diagnosed with oligomenorrhea
What is menorrhagia
Menorrhagia is menstrual periods with abnormally heavy or prolonged bleeding
What is secondary infertility
Secondary infertility is the inability to become pregnant or to carry a baby to term after previously giving birth to a baby
What is hirsutism
Hirsutism (HUR-soot-iz-um) is a condition in women that results in excessive growth of dark or coarse hair in a male-like pattern — face, chest and back. With hirsutism, extra hair growth often arises from excess male hormones (androgens), primarily testosterone.
What is galactorrhea
Galactorrhea (guh-lack-toe-REE-uh) is a milky nipple discharge unrelated to the normal milk production of breast-feeding. Galactorrhea itself isn’t a disease, but it could be a sign of an underlying problem. It usually occurs in women, even those who have never had children or after menopause.
Give 4 symptoms associated with polycystic ovarian syndrome
Oligomenorrhoea
Hirsutism
Obesity
Depression
How many cells are present in a morula
16 cells
How many cells are within a blastocyst
200-300 cells
Difference between gigantism and acromegaly
Gigantism refers to abnormally high linear growth due to excessive action of insulin-like growth factor I (IGF-I) while the epiphyseal growth plates are open during childhood.
Acromegaly is the same disorder of IGF-I excess but occurs after the growth plate cartilage fuses in adulthood
