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EndoRepro > Week 4 > Flashcards

Week 4 Flashcards

0
Q

When does sex determination occur? Sex differentiation?

A

Fertilization

Embryonic period

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1
Q

Three groups of organs in the reproductive system?

A

Gonads: gametes produced
Reproductive ducts: gametes pass through
External genitalia: gamete delivery and reception

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2
Q 
What class of hormones actively influences differentiation towards male?
What factor leads to regression of female ducts?
A

androgens

mullerian inhibiting factor

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3
Q

What does the embryo contain during the indifferent period?

A

pair of undifferentiated gonads
two sets of ducts-mesonephric and paramesonephric
a set of elevations and folds around the cloacal membrane

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4
Q

What is the failure of testes to descend by birth?

How is congenital hydrocoele caused?

A

Cryptorchidism

Fluid leaking into tunic vaginalis during descent

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5
Q

What is the precursor to most of the prostate?

What is the precursor to the central zone (maybe)?

A

endoderm from prostatic urethra

mesoderm

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6
Q

Absence of what causes mesonephric ducts to atrophy?

Lack of what allows paramesonephric ducts to develop?

A

testosterone

MIF

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7
Q

What is an imperforate hymen?

A

hymen forms a complete septum across vagina, discovered when child begins to menstruate

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8
Q

What causes hypospadias?

What is associated with epispadias?

A

Incomplete fusion of urethral folds leads to ventral urethral opening
Urethra and penis open dorsally, associated with bladder exstrophy

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9
Q

What causes the development of male external genitalia in fetus?

A

presence of androgens

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10
Q

Sex chromosome disorders?

A

Klinefelters (XXY), Turner’s (XO), 46, XX or XY (Z gene), ovotesticular SDS (true hermaphrodite-mosaicism), gonadal dysgensis (can’t produce androgen)

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11
Q

Common cause for 46,XX DSD (female pseudohermaphrodite)?
Common cause for 46,XY DSD (male pseudohermaphrodite)?
What causes a micropenis?

A

Congenital adrenal hyperplasia (enhanced androgen exposure)
–21 hydroxylase deficiency
Androgen insensitivity syndrome
–most causes are actually idiopathic
Insufficient androgen production during androgen surge

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12
Q

PCOS presentation in clinic?

A

chronic anovulation

hyperandrogenism

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13
Q

Good evidence for menopause?
Fair evidence?
Poor evidence?

A

Vasomotor symptoms, vag dryness, sleep disturb, depressed mood
cognitive dys, urinary incontinence, sex dysfunction
body composition, joint aches and pains

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14
Q

What is the current indication for menopausal hormone therapy?

A

symptomatic women within a decade of their last period

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15
Q

“Chocolate cyst” is associated with what condition?

A

Endometriosis

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16
Q

What mutation is type 1 endometrial (endometroid) carcinoma associated with?

A

PTEN mutation

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17
Q

What mutation is associated with type II endometrial (serous) carcinoma?

A

p53 mutation

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18
Q

Most common benign tumor in females?

A

Leiomyomas

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19
Q

Stages of puberty?

A

First is the growth spurt.
Then breasts and pubic hair growth.
Menstruation is the last stage.

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20
Q

At what age should lack of secondary sex characteristics be evaluated?
At what age should lack of menstruation be evaluated?

A

14 years

16 years

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21
Q

Breast development is the result of ____?

Pubic hair growth is the result of ____?

A

Estrogen
Testosterone (to DHT)

An intact outflow duct is also important.

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22
Q

Test for precocious:
breast development
pubic/axillary hair
menstruation

A

Estrogen, FSH
Testosterone, LH
Estrogen, FSH, LH

23
Q

Risk factor for tubal ectopic pregnancy

A

endometriosis

24
Q

Tumors of the Fallopian tubes most associated with what gene?

A

BRCA

25
Q

Most common mass of the ovary?

A

Functional cysts of the ovary

26
Q

Most common ovarian neoplasm?

A

ovarian surface epithelial tumors

27
Q

What cancer mestastizes to the ovary?

A

Breast cancer

28
Q

What STI lesions are painful?

Which are painless?

A

Painful: herpes, chancroid, lymphogranuloma venereum
Not: syphilis, molluscum, genital wart

29
Q

Unlike other DNA viruses, poxviruses (molluscum) replicate in?
What is present histologically in molluscum?

A

in the cytoplasm

large eosinophilic cytoplasmic inclusions

30
Q

Most warts are caused by what strain of HPV?

Structurally, how is it different from molluscum and herpes virus?

A 
6 and 11 (anything higher than 11 is a high risk strain)
No envelope (has a capsid)
31
Q

What STI bacteria do not gram stain?

A 
Ureaplasma urealyticum
Chlamydia trachomatis (cannot easily be seen)
32
Q

Diagnostic of Gardnerella vaginalis?

A

Clue cells (epithelial cells with multiple pleomorphic bacteria in cytoplasm)

33
Q

Risk factors for cervical neoplasia?

A

Early age at first intercourse
Multiple sex partners
Male partner with multiple previous sex partners
Persistent infection with high risk strain of HPV

34
Q

How to recognize lower to high grade carcinoma in situ of cervix?

A

The nuclear to cytoplasm ratio increases.

35
Q

What tumor suppressors do HPV E6 and E7 bind to promote DNA replication in more differentiated squamous cells?

A

p53 and Rb

36
Q

Two strains of HPV that account for 70% of cases of CIN and cervical carcinoma?

A

HPV 16 and 18

37
Q

Transition from quiescent to labor stage involves what hormonal transition?

A

Progesterone to estrogen dominance

38
Q

How does oxytocin affect parturition?

A

Increases estrogen and prostaglandins

39
Q

What do drugs that attempt to prevent preterm labor mostly try to do?

A

Preventing intracellular calcium influx

most common? maybe? Betamethasone before 34 weeks

40
Q

Major cause of post partum hemorrhage?

A

Uterine atony

Maternal spiral arteries left open after delivery of the placenta

41
Q

Most common benign breast disorder (due to repeated exposure to progesterone and estrogen during menstrual cycle)?

A

Fibroadenosis

cyst formation, slow growing masses of epithelium and CT

42
Q

90% of breast cancers involve what? And are sensitive to what?

A

Duct epithelia

Estrogen levels

43
Q

What unit of hCG provides specific activity?

What does it do?

A

Beta subunit

Prevents involution of the corpus luteum

44
Q

Elevations of hCG above baseline levels is suspicious for?

A

multiple gestation, molar pregnancy

45
Q

Which condition involved an open cervix?

Closed cervix?

A

Inevitable abortion

Threatened abortion

46
Q

What is the discriminatory zone of hCG?

A

Levels above 1500-2000

Should be able to see normal pregnancy with transvaginal ultrasound

47
Q

Complete versus partial molar pregancy

A

Partial: haploid ovum fertilized by two sperm or one sperm that duplicates
Complete: no fetal tissue or maternal DNA (hCG >100,000 or even 1,000,000)

48
Q

What is snowstorm pattern on the ultrasound indicative of?

A

complete molar pregnancy

49
Q

Drug used to treat ectopic pregnancy, hydatiform molar pregnancy, and choriocarcinoma

A

methotrexate

50
Q

Most common second trimester infections?

A

TORCH

Toxoplasmosis, other=syphilis and parvovirus, rubella, cmv, herpes simplex

51
Q

Classic triad of symptoms of toxoplasmosis in second trimester?

A

hydrocephalus, intracranial calcifications, chorioretinitis

52
Q

Congenital CMV symptoms?

A

periventricular calcifications, intrauterine growth restriction, developmental delay, microcephaly, sensorineural hearing loss, retinitis, jaundice, hepatosplenomegaly, thrombocytopenia, hypotonia

53
Q

Noninfectious second trimester complications

A

cervical insufficiency, fetal anomalies

54
Q

Third trimester complications

A

PPROM, preterm labor, placental abnormalities, intrauterine fetal demise or growth restriction, macrosomia

55
Q

What is placenta previa?
Placenta accreta?
Placenta abruption?

A

Placenta over internal cervical os, painless, implantation not secure

Placenta implantation extends into basal zone of endometrum

Hemorrhage into decidual basalis before birth, placental separation

56
Q

What are the phases of sexual response?

A

excitement, plateau, orgasm and resolution

EndoRepro (4 decks)

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