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USMLE Reproductive > Physiology > Flashcards

Physiology Flashcards

1
Q

What is the process of producing sperm called?

A

Spermatogenesis

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2
Q

What is the process called where the spermatic becomes a mature spermatozoon (looses cytoplasmic contents and gains an acrosomal cap)?

A

Spermiogenesis

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3
Q

How long does spermatogenesis take?

A

2 months

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4
Q

Where does spermatogenesis occur?

A

Seminiferous tubules

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5
Q

What are the different types of sperm cells from spermatogonia to spermatozoa?

A
  • Spermatogonium (2n 2C)
  • Primary spermatocyte (2n 4C)
  • Secondary spermatocyte (1n 2C)
  • Spermatid (1n 1C)
  • Mature spermatozoa
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6
Q

What happens when the spermatogonia turns into primary spermatocyte?

A
  • Replicates (interphase) 2C -> 4C

- Travels through the tight junction (blood-testis barrier)

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7
Q

What process happens to turn the primary spermatocyte into the secondary spermatocyte?

A

Meiosis I

- Diploid to Haploid

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8
Q

What happens to turn the secondary spermatocyte into a spermatid?

A

Meiosis II

- Essentially just mitosis but in a haploid cell (1n, 1C) cell created

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9
Q

What happens when the spermatid matures into a spermatozoa?

A

Looses cytoplasmic contents and gains an acrosomal cap

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10
Q

How does Kartagener syndrome affect fertility?

A
  • Tail mobility impaired -> infertility
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11
Q

How does Cystic fibrosis cause infertility in men?

A

Vas deferens is absent

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12
Q

Where are the different types of estrogen produced?

A
  • Ovary = 17Beta-estradiol
  • Adipose tissue = Estrone
  • Placenta = estriol
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13
Q

Name the different types of estrogen from most to least potent?

A

Estradiol > Estrone > Estriol

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14
Q

What cells does LH act on in females?

A

Theca cells

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15
Q

What does LH stimulate the conversion of in the theca cells?

A
  • Stimulates Desmolase through cAMP

- Desmolase converts cholesterol into androstenedione

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16
Q

What cells produce GnRH?

A

Arcuate nucleus and pre-optic nucleus

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17
Q

What are the stages (different cells) of oogenesis?

A
  • Oogonium
  • Primary Oocyte
  • Secondary Oocyte
  • Ovum
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18
Q

What stage of oogenesis does FSH stimulate?

A

Primary to secondary follicle

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19
Q

What stage of oogenesis is arrested for years and is completed during ovulation?

A

Prophase of Meiosis I

- Primary oocyte (2n, 4C) to Secondary oocyte (1n, 2C)

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20
Q

What stage of oogenesis is arrested until fertilisation?

A

Metaphase II of meiosis II

- Secondary oocyte (1n, 2C) into Ovum (1n, 1C)

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21
Q

What are the effects of FSH on the follicle?

A
  • Primary follicle to Secondary follicle
  • Stimulates the production of multiple layers of granulosa cells
  • Stimulates formation of zona pellucida
  • Conversion of androstrenedione to estrogen in granulosa cells
  • Follicular fluid production in secondary follicle
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22
Q

The secondary oocyte is in what type if follicle?

A

Graffian follicle

  • Primary oocyte in primary and secondary follicles
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23
Q

What are the structures called that do not become the ovum?

A

Polar bodies

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24
Q

What hormone causes an increase in temperature in women during ovulation?

A

Progesterone

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25
Q

What structure produces progesterone?

A

Corpus luteum

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26
Q

What are the functions of progesterone?

A
  • Stimulation of endometrial glandular secretions and spiral artery development
  • Production of thick cervical mucus (inhibiting sperm entry)
  • Prevention of endometrial hyperplasia
  • Increases body temp
  • Decreases estrogen receptor expression
  • Decreases gonadotropin (LH, FSH) secretion

During pregnancy

  • Maintains pregnancy
  • Decreases myometrial excitability (decreasing contraction frequency and intensity)
  • Decreases prolactin action on breasts
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27
Q

What are the 2 phases of the menstrual cycle?

A
  • Follicular phase

- Luteal phase

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28
Q

What are the effects of estrogen on LH ?

A
  • Low concentrations of estrogen inhibit LH secretion

- At high concentrations it stimulates LH secretion

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29
Q

What is the FSH level negatively correlated with?

A
  • Increased estrogen causes decreased FSH
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30
Q

What does the corpus luteum produce?

A
  • Progesterone
  • Inhibin
  • Estrogen
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31
Q

What does the corpus luteum become?

A

Corpus albicans

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32
Q

What does inhibin produced by the corpus luteum act as?

A

Decreases FSH as not needed in luteal phase

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33
Q

How does a degraded corpus luteum result in menses?

A

Corpus luteum produces progesterone

  • Progesterone maintains endometrium
  • Decreased progesterone results in endometrium degrading -> menses
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34
Q

Why is progesterone higher in luteal phase than in the follicular and why are estrogen levels maintained in the luteal phase?

A

Corpus luteum produces progesterone (and estrogen)

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35
Q

How does degradation of the corpus luteum cause the menstrual cycle to restart?

A

Corpus luteum produces progesterone -> progesterone inhibits GnRH

  • Degraded corpus luteum results in decreased progesterone thus the GnRH will rise
  • Increased GnRH will result in higher LH and FSH ->
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36
Q

What is Mittelschmerz? What is it classically associated with?

A

Transient mid-cycle ovulatory pain

- Associated with peritoneal irritation (e.g follicular swelling/rupture, fallopian tube contraction)

37
Q

What may Mittelschmerz be mistaken as?

A

Appendicitis

38
Q

What hormone levels decreasing after delivery causes an increase in prolactin?

A

Falling estrogen and progesterone levels causes prolactin to increase

39
Q

What does gravida indicate?

A

Number of pregnancies

Twins = 1 pregnancy

40
Q

What does para indicate?

A

Number of pregnancies that resulted in live births

Birth of twins = 1 para

41
Q

After how long is hCG detectable in the blood?

A

1 week after fertilization

42
Q

After how long is hCG detectable in the urine?

A

2 weeks after fertilization

43
Q

What is the difference between gestational and embryonic/developmental age?

A

Gestational - last period

Embryonic - time since fertilization

44
Q

How does pregnancy affect the cardiovascular system?

A
  • Decreased afterload (SVR)
  • Increased blood volume (preload)
  • Increased Cardiac output
  • Hemodilution - decreased oncotic pressure -> peripheral edema
45
Q

How does pregancy affect glucose levels?

A
  • Insulin resistance and hypoglycemia

- Increased lipolysis and fat utilization (to preserve glucose and amino acids for fetus)

46
Q

How does pregnancy affect the pituitary?

A

Enlargement - lactotroph hyperplasia

47
Q

As pregnancy progresses how does this affect the levels of the female reproductive hormones?

A
  • Human placental lactogen
  • Prolactin
  • Progesterone
  • Estrogen
48
Q

Levels of what globulins are increased in pregnancy?

A
  • Thyroxine binding globulin
  • Sex hormone binding globulin
  • Corticosteroid binding globulin
49
Q

How does pregnancy affect the GI system?

A
  • Decreased GI motility
  • Constipation
  • Decreased LES tone -> GERD
  • Gallblader stasis -> stones
50
Q

What aare the hematological affects of pregnancy?

A
  • Dilutional anemia (increased plasma volume) (there is also an increase in RBC mas but not in proportion)
  • Hypercoagulable state (decrease blood loss at delivery)
  • Iron and folate deficiency as micronutrient requirements increase
51
Q

How does pregnancy affect the msk system?

A
  • Lordosis (realigns centre of gravity)

- Joint laxity (facilitates fetal descent)

52
Q

How may pregnancy affect the skin?

A
  • Hyperpigmentation (melasma, linea nigra, areola darkening)
  • Striae gravidarum (stretch marks)
  • Vascular -> spider angiomas, palmar erythema, varicosities
53
Q

How does pregancy affect the renal system?

A
  • Vasodilation -> Increased renal plasma flow -> Increased GFR -> Decreased BUN and creatinine.
  • Mild glucosuria and proteinuria
  • Ureter and pelvis dilation (hydroureter, hydronephrosis) -> pyelonephritis
54
Q

How does pregnancy affect the respiratory system?

A
  • Chronic hyperventilation -> to eliminate fetal CO2
55
Q

When does the luteal-placental shift become complete?

A

8-10 weeks of gestation

- Corpus luteum has degenerated and the placenta can now make all the estriol and progesterone

56
Q

What subunit in hCG is identical to LH, FSH and TSH?

A

alpha subunit

57
Q

What subunit is unique to hCG and is detected by pregancy tests?

A

Beta subunit

58
Q

When is hCH increased?

A
  • Multiple gestations
  • Hydatidiform mole
  • Choriocarcinoma
  • Down syndrome
59
Q

When can hCG be decreased?

A
  • Ectopic pregnancy
  • Edwards syndrome
  • Patau syndrome
60
Q

What is the function of human placental lactogen (aka chorionic somatomammotropin)?

A
  • Stimulates insulin production
  • Increases insulin resitance overall
  • Gestational diabetes can occur when the pancreatic function cannot overcome the insulin resistance
61
Q

What is the Apgar score?

How many points are in the scale?

A

Assessment of newborn vital signs following delivery

- 10 point scale

62
Q

What are the different aspects of the apgar score?

A
  • Appearance (pink=2, extremities blue = 1, blue or pale = 0)
  • Pulse (>100, <100, no pulse)
  • Grimace (cries and pulls away, grimices or weak cry)
  • Activity (active movement, arms and legs flexed, no movement)
  • Respiration (strong cry, slow irregular cry, no breathing)
63
Q

What birth weight is defined as a low birth weight?

A

< 2500g

64
Q

How does prolactin affect reproductive function?

A

Decreases reproductive function

65
Q

What are the functions of oxytocin?

A
  • Milk letdown

- Uterine contractions

66
Q

What does breast milk contain (in regards to immune)?

A
  • Immunoglobulins (mostly IgA)
  • Macrophages
  • Lymphocytes
67
Q

How can breast milk benefit the child?

A
  • Reduces infant infections

- Decreased risk of developing asthma, allergies, diabetes and obesity

68
Q

What are supplements are exclusively breastfed infants recommended?

A
  • Vit D

- Iron

69
Q

What cancers are at a reduced risk after breastfeeding?

A

Breast and ovarian cancers

70
Q

How is menopause diagnoses?

A

Amenorrhea for 12 months

71
Q

Why is there a decrease in estrogen in menopause?

A

Decline in number of ovarian follicles

72
Q

When is the average age of onset of menopause?

A 
51 years (earlier in tobacco smokers)
- Usually preceded by 4-5 years of abnormal menstrual cycles
73
Q

Where is the source of estrogen after menopause?

A

Peripheral conversion of androgens -> estrone

74
Q

What hormone specifically is greatly increased in menopuase?

A

FSH (as no follicles to stimulate)

- LH and GnRH also increased

75
Q

What are the symptoms of menopause?

A

HAVOCS

  • Hot flashes
  • Atrophy of vagina
  • Osteoperosis
  • Coronary artery disease
  • Sleep disturbances
76
Q

What does meopause before the age of 40 indicate?

A

Primary ovarian insufficiency (premature ovarian failure)

- Often due to either chemo or radiotherapy

77
Q

What is the androgen produced by the adrenals called?

A

Androstenedione

78
Q

What are the functions of DHT?

A
  • Differentiation of penis scrotum and prostate

- Later - prostate growth, balding, sebaceous gland activity

79
Q

Describe the Tanner stages in men?

A 
Stage 1 
- No sexual hair 
Stage 2 
- Pubic hair appears
- Testicular enlargement 
Stage 3 
- Coarsening of pubic hair 
- Penis size/length increases 
Stage 4 
- Coarse hair across pubis sparing thigh 
- Penis width/glans increases 
Stage 5 
- Coarse hair across pubis and medial thigh 
- Penis and tested enlarge to adult size
80
Q

Describe the Tanner stages in women?

A

Stage 1
- No hair
- Flat appearing chest with raised nipple
Stage 2
- Pubic hair appears
- Breast bud forms (thelarche), mound forms
Stage 3
- Coarsening of hair
- Breast enlarges
Stage 4
- Coarse hair across pubis
- Breast enlarges, raised areola, mound on mound
Stage 5
- Coarse hair across pubis and medial thigh
- Adult breast contour + areola flattens

81
Q

When is precocious puberty defined?

A

Appearence of secondary sexual characteristics before 8 in females and 9 in males

82
Q

What sort of stature do people who go through precocious puberty have?

A

Short (due to the early closure of epiphyseal plates)

83
Q

What is central precocious puberty?

A

Due to increased GnRH secretion

  • Usually idiopathic
  • May be due to CNS tumors
84
Q

What can peripheral precious puberty be due to?

A
  • Exogenous steroids
  • Congenital adrenal hyperplasia
  • Estrogen secreting ovarian tumor (granulosa cells)
  • Leydig cell tumor
  • McCune-Albright syndrome
85
Q

When does puberty usually finish?

A

> 15 years

86
Q

What are the different types of follicle?

A
  • Primordial
  • Primary
  • Secondary
  • Graafian
87
Q

Progesterone suppresses the levels of what hormone?

A

GnRH

88
Q

How common is spontaneous abortion?

A

1/4 pregnancies

- Miscarriage of fetus (20 weeks before gestation)

USMLE Reproductive (14 decks)

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