Week 1 Flashcards
The nephrogenic chord forms what three sequential kidney structures in the developing embryo? Which goes on to form the permanent kidneys?
- Pronephros, 2. Mesonephros (the first functioning kidneys) 3. Metanephros (which will go on to form the permanent kidney)
Lecture: 192, UG Development
Objective: 2. Describe the significance of the pronephros, mesonephros and metanephros on kidney development…
What hormone in XY fetuses is produced by Sertoli cells and leads to the regression of primordial female structures?
Anti-Mullerian hormone (AMH)
AMH is produced by Sertoli cells where it is regulated by SF1 and SOX9. It causes regression of the female Mullerian structures to the ipsilateral side
Lecture: 193b Sex Development
Objective: 4. Describe the role of hormones in development of internal and external genitalia
What two hormones prevent lactation during pregnancy? What changes after delivery of the baby to allow lactation?
Progesterone and Estrogen
Both are produced at high levels during pregnancy, when they inhibit lactation by interfering with prolactin binding on breast alveolar cells. After delivery of the baby and placenta, the progesterone and estrogen levels drop, allowing prolactin to stimulate lactation.
Lecture: 194 Breast Physiology
Objective: 3. Describe the physiologic changes that occur in the breast during pregnancy and lactation
What are 3 common sites for urinary tract stones to lodge?
1. The ureteropelvic junction (UPJ)
2. Where the ureter crosses the common iliac vessels
3. The ureterovesical junction (UVL)
Lecture: 195b Anatomy of the Pelvis
Objective: 4. Indicate the path of urine flow from the pyramids to the exterior of the body and indicate where kidney stones commonly lodge
Uterine prolapse is enabled by the weakness of what pelvic muscle?
A.Obturator Internus
B.Pubococcygeous
C.Ischiocavernosis
D.Piriformis
B. Pubococcygeus
Lecture: 195b Anatomy of the Pelvis
Objective: 1. Describe how design of the pelvis is related to obstetrics and bipedal locomotion
A patient is sent to you after an ill-defined mass is found on her most recent mammogram. Histology of a biopsy reveals strands of cells organized in single file lines extending into the stroma. Immunohistochemistry reveals that the atypical cells are E-cadherin negative. What is the most likely diagnosis?
Invasive lobular carcinoma-–it accounts for 20% of all breast cancers, is histologically characterized by strands of invasive cells organized single file and is e-cadherin negative
What two STIs can be transmitted from mother to child by both transvaginal and transplacental routes?
HIV and Herpes simplex virus (HSV) can be transmitted from mother to child by the transplacental and the transvaginal routes
Lecture: 197b Reproductive impact of STIs
Objective: 5. Explain the mechanism of transmission, outcomes and effective prevention strategies of perinatally transmitted STIs and nonSTIs
A 22-year-old man presents to your clinic after noticing a painless but eroded and indurated lesion on his penis. Upon exam you also notice non-tender inguinal lymphadenopathy. He claims to have had several sexual partners over the last couple months. What pathogen is causing his lesion and lymphadenopathy, and how should he be treated?
The patient most likely has syphilis which is caused by treponema pallidum. Penicillin G is the appropriate treatment.
Lecture: 198b Microbiology of Sexually Transmitted Diseases
Objective: 3. You should have an understanding of the disease manifestations caused by the sexually transmitted pathogens as well as tests and therapies used to diagnose and treat them
A pregnant woman presents to your clinic late in her first trimester when she begins to experience heavy vaginal bleeding and intense nausea. An ultrasound reveals the presence of small cysts in the uterus and a small and malformed conceptus. Inspection of the tissue following dilation and curettage reveals focal edematous changes to some villi surrounded by normal villi. What is the most likely karyotype of the conceptus?
The case describes a partial molar pregnancy which have a triploid karyotype of 69XXY or 69XXX
Lecture: 199b Anatomy and pathology of the placenta
Objective: 5. Distinguish the pathologic findings in partial and complete hydatidiform mole
In women struggling with infertility, what 2 oral medications are commonly used to induce ovulation and what class do they both belong to?
Clomiphene and Letrozole
Clomiphene is a selective estrogen receptor modulator (SERM) while letrozole is a non-steroidal aromatase inhibitor
Lecture: 200b Female Infertility
Objective: 4. Describe the effective therapeutic approaches to the infertile couple
In patients being treated with birth control pills that contain ethinyl estradiol and progestin what do you expect to happen to their GnRH, LH and FSH levels?
All should decrease due to negative feedback of the estrogen and progesterone on the hypothalamus and the pituitary which reduce GnRH and LH/FSH secretion respectively.
Lecture: 201b Female Reproductive Endocrinology
Objective: 5. Explain estradiol feedback on gonadotropin secretion
A 24 year old woman with obesity visits your clinic complaining of anovulation. A pregnancy test is negative but ultrasound reveals 12 follicles in the left ovary and 8 follicles in the right ovary ranging from 2-9mm in size. With only this information, does she meet the Rotterdam criteria for polycystic ovarian syndrome? If not, what else must be demonstrated?
No. To meet the Rotterdam diagnostic criteria for PCOS a female patient must exhibit 2 or more of the following criteria:
- Oligo and/or anovulation
- Clinical and/or biochemical signs of hyperandrogenism
- Ultrasound with ≥ 12 follicles in each ovary 2-9mm and or increased ovarian volume (>10 mL)
This patient meets condition 1, but not quite condition 3. Thus to meet the Rotterdam criteria, she must also demonstrate clinical and/or biochemical signs of hyperandrogenism (criteria 2).
Lecture: 202b Disorders of female reproductive endocrinology
Objective: 5. List the diagnostic criteria of PCOS
By what mechanism does the ductus arteriosus close after birth?
As the newborn begins to breath following birth, alveolar expansion decreases pulmonary vascular resistance which in turn decreases right atrial pressure and right ventricular afterload. This results in a backflow of blood through the ductus arteriosus which alters the production of prostaglandins, resulting in vasoconstriction.
Lecture: 203b Normal Pregnancy
Objective: List the unique features of fetal physiology
What is the difference between miscarriage and stillbirth?
Miscarriage is a spontaneous abortion that occurs before 20 weeks gestation while stillbirth is when a pregnancy is lost at or after 20 weeks gestation (aka intrauterine fetal demise [IUFD])
Lecture: 204b Abnormal Pregnancy
Objective: 3. Describe the difference between miscarriage and stillbirth and the common etiologies for each
By what mechanism does transition into menopause lead to osteoporosis?
Menopause is associated with a decrease in estrogen levels. Estrogen normally promotes a healthy bone density by inhibiting the differentiation of and stimulating apoptosis of osteoclasts which are responsible for bone resorption. Decreased estrogen in menopause results in an increased number and activity of osteoclasts.
Lecture: 205b Menopause and Hormone Therapy
Objective: 2. Understand the physiology of menopause and list the cardinal signs/symptoms of perimenopause
