Week 1 part 3 Flashcards
In pregancy how long is fetus carried for?
Up to 40 weeks
When does 1st trimester complete at?
12 weeks
When does 2nd trimester complete at?
28 weeks
When does 3rd trimester complete at?
40 weeks
What is the pregancy marker?
bhCG
During what days does blastocyst implant?
8 to 9 day
Is the embryo abnormal or normal in miscarriage and molar pregnancy?
Misscarriage - normal
Molar pregnancy - abnormal
Positive pregnancy urine pregnancy test, varied gestation, bleeding and cramping?
Miscarriage
What scan is gold stanrard for miscarriage?
TV ultrasound
If speculum exam shows os (opening of cervix to uterus) closed what is likely?
Threatened miscarriage
If speculum exam shows os (opening of cervix to uterus) with products sited at open os?
Inevitable miscarriage
If speculum exam shows os (opening of cervix to uterus) oipen with products in vagina what has happened?
cOMPLETE MIscarriage
Incomplete miscarriage?
Part of pregnanct lost already
Early fetal demise?
Pregnancy in situ, no heartbeat: MSD greater than 25mm
In miscarriage - why is misoprostil given?
To expel pregancy
Pain, bleeding, dizziness, collapse, shoulder tip pain, shoprt of breath? Also pallor, signs of peritonism guarding and tenderness?
Ectopic pregnancy
USS showing empty uterus, +/i mass in adenexa, free fluid in pouch of douglas?
Ectopic pregnancy
What is noted in comparitive assessment of serum bHCG in ectopic pregnancy?
48 hours apart it doubles
Overgrowth of placental tissue with chorionic villi swollen with fluid giving picture of grape like clusters?
Molar pregnancy
What does a complete mole have a 2.5% increase risk of?
Choriocarcinoma
What type of molar pregnancy is this - egg without DNA, 1 or 2 sperms fertilise, result in diploidy (paternal only)?
Complete mole
What type of molar pregnancy is this - haploid egg, 1 sperm or 2 sperms fertilising egg, result in triploidy, may have fetus?
Partial mole
Hyperemesis, varied bleeding and passage of grap like tissue, occassional SOB?
Molar pregnancy
What is seen on USS in molar pregnancy?
Snow storm appearance +/- fetius
What type of bleeding could occur 10 days post ovulation?
Implantation bleeding - bleeding is liught brownish and limited
Pooling of blood between endometriun and embryo due to seperation?
Chorionic haematoma
Name a cervical cause of bleeding in early pregnancy?
Cervical ectropion - cervix has columnar, vaginal has squamous. Cervix undergoes squamous metaplasia
Strawberry vagina?
Trichomoniasis
What chromosome has the sex determining region and causes development of testis from bipotential gonad?
Y chromosome
What are the two primitive genital tracts?
Wolffian and Mullerian ducts
What two factors cause the development of the male internal genital tract?
Testosterone and Mullerian inhibiting factor
In males what happens to the Wolffian ducts?
Repro tract
In females what happens toe the wOLFFIAN ducts?
Degenerate
In males what happens to mullerian ducts?
Degenerate
In females what happens to mullerian ducts?
Repro tract
In differentiation of external genitalia what does dihydrotestosterone stimulate?
Penis
Name an x-linked recessive disorder with male karyotype 46XY, testis develop but do not descend?
Androgen insensitivity syndrome (testicular feminisation)
In androgen insensitivity syndrome there is congential insensitivity to androgens. Androgen induction of what duct does not occur?
Wolffian duct. Mullerian inhibition occurs so born with external female enitals but no ovaries or uterus, short vagina
Why is it important testis descend?
Lower temp outside body to faciliate - spermatogenesis dartos muscle contracts in scrotal sac to lower/raise testis temp
What is cryptochidism?
Undescended testis
What should be performed in cryptochidism below age 14 to miniise risk of testciular cancer?
Orchidopexy
Where does spermatogeneisis occur?
Seminiferous tbules
Where does production of testosterone occur?
Leydig cells
In a spermatozoon - what contains enzumes for penetrating zona pelucida and thus ovum?
Acrosome
What cells form a blood-testes barrier?
Sertoli cells
What cells secrete seminiferous tubule fluid, androgen binding globulin and inhibin and activin hormones?
Sertoli cells
In hormonal control of spermatogenesis: what does LH cause leydig cells to produce?
Testosterone
In hormonal control of spermatogenesis: What acts on sertoli cell in seminiferous tubule to secrete androgen binding globulin and inhibin (decreases FSH)?
FSH
wHAT RELEASE DOES gRRH have?
Pulsatile - everye 2-3 hours
What glycoprotein acts on Leydig cells and regulates testosterone secretion?
LH
What glycoprotein acts on Sertoli cells to enhance spermatogenesis and regulates by negative feedback from inhibin?
FSH
Is production of LH and FSH cyclical in females?
Yes
What secretes inhibin and activin?
Sertoli cells - feedback on FSH (inhibin inhibits and activin stimulates)
Exit route from testes to urethra, concentrate & store sperm, site for sperm maturation
Epididymis and vas deferens
Produce semen into ejaculatory duct, supply fructose, secrete prostaglandins (stimulates motility), secrete fibrinogen (clot precursor)
seminal vesicles
Produces alkaline fluid (neutralizes vaginal acidity), produces clotting enzymes to clot semen within female
prostate gland
Secrete mucus to act as lubricant
bulbourethral glands
Erdction is under what control?
Parasympathetic - point
Ejaculation is under what control?
Sympathetic - shoot
Name an obstructive cause of male infertility?
Cystic fibrosis
What is adult normal testicular volume?
12- 25 mls
What male imnfertility is suggested if low testicular volume, reduced seconadry sexula characteristics and vas deferens present - also high LH, FSH and low testosterone?
Non-obstructive
indication for surgical sperm aspiration?
Azoospermia
When does menstrual phase of endometrium occur?
Days 1 to 3
In the proliferative phase of endometrium - what hormone causes growt?
Oestrogen
In the secretory phase of endometrium what causes secretion?
Progesterone
What investigation is indicated in abnormal uterine bleeding, endometrial ablation, investigation of infertility etc?
Endometrial sampling
What is an indication in endometrium for a biopsy?
Thickness greater than 4mm in post menopausal woman
greater than 16mm in premenopausal women
What is chronic plasmacytic endometritis associated with?
PID (gonorrhjoea, chlamydia and enteric organisms
In a misscariage what products of conception can be seen in histology?
Foetal red blood cells
Chorionic villi
caused by a single (incidence is about 90%) or two (incidence is about 10%) sperm combining with an egg which has lost its DNA (the sperm then reduplicates forming a “complete” 46 chromosome set. Only paternal DNA is present in a complete mole.
Complete mole
occurs when egg is fertilized by two sperm or by one sperm which reduplicates itself yielding the genotypes of 69,XXY (triploid). Partial moles have both maternal and paternal DNA
Partial mole
What do complete hydatidiform moles have a higher risk of developing into ?
choriocarcinoma
What is growth of leiomyoma dependent on?
Oestrogen
