Reproductive System Flashcards

1
Q

Provide alternative names for:

a. Female gametes

b. Male gametes

c. Together a female gamete and male gamete produce

d. Childbirth

A

a. Female gametes - Ova

b. Male gametes – sperm

c. Together a female gamete and male gamete produce – a zygote

d. Childbirth – Parturition

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2
Q

The breasts are referred to as the —– glands of the female reproductive system. Each breast contains a —– gland, which is a modified sweat gland that specialise on the production and ejection of —–. Each gland consists of 15-20 —– separated by —– tissue. The lobes contain grapelike clusters of glands called —–. Suspensory —– support the breast between the skin and the underlying —–.

A

The breasts are referred to as the accessory glands of the female reproductive system. Each breast contains a mammary gland, which is a modified sweat gland that specialise on the production and ejection of milk. Each gland consists of 15-20 lobes separated by adipose tissue. The lobes contain grapelike clusters of glands called alveoli. Suspensory ligaments support the breast between the skin and the underlying fascia.

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3
Q

Name the ‘sinuses’ which store milk in the breasts.

A

Laciferous sinuses

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4
Q

Name and describe the function of the two main hormones involved in lactation

a. Prolactin

b. Oxytocin

A

a. Prolactin
Stimulate the production of milk

b. Oxytocin
Suckling stimulates oxytocin which ejects milk

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5
Q

Name FOUR functions of the uterus.

A

a. Pathway for sperm
b. Site for zygote implantation
c. Location for foetal development
d. Contracts to initiate labour

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6
Q

Describe specifically the structure and function of the endometrium.

A
  • It is the highly vascular inner most layer of the uterus.
  • It’s role is to deliver nutrients to the embryo and support development.
  • It has two layers. Stratum Basale is a permanent base layer. Stratum Functionalis is formed from the stratum Basala and is constantly building and shedding in line with the menstrual cycle.
  • During a period the stratum functionalis sheds and then rebuilds to prepare for a fertislised egg.
  • If the egg is fertilised it is embedded in the endometrium. If it is not the endometrium will shed again during the period.
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7
Q

Name the THREE layers of the uterine wall and the two sub layers of the layer

A

.
Perimetrium – Outer visceral layer
Myometrium – 3 smoooth muscle layers
Endometrium – Highly vascular inner layer that is divided into
- Stratum Functionalis which sloughs off during menses and,
- Stratum Basalis which is a permanent layer.

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8
Q

Name ONE uterus tissue layer that contains smooth muscle.

A

The middle, and thickest, layer in the uterus is the Myometrium. It contains 3 layers of smooth muscle.

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9
Q

Name ONE ligament that holds the uterus in place.

A

The uterus is kept in place using ligaments. The most important one is the Broad Ligamentthat acts like a wrapping or casing around the front and back of the reproductive organs.

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10
Q

State which layer of the uterus sheds during menstruation.

A

Endometrium

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11
Q

Describe the difference between an ‘embryo’ and a ‘foetus’.

A

Embryo < 8 weeks
Foetus > 8 weeks

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12
Q

Describe the main role of the placenta.

A
  • Supplies the zygote/embryo/foetus with nutrients and removes waste.
  • Also supplies hormones needed to maintain the pregnancy
  • At 12 weeks it divides into a maternal and foetal creating a protective membrane to separate mother and baby foetal blood and protect against harmful organisms.
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13
Q

Explain why the placenta is described as ‘unique’.

A

It develops from two individuals (maternal part from the endometrium)

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14
Q

Explain how the placenta connects to the embryo / foetus.

A

Through the umbilical chord which provides oxygen and nutrients and removes waste.

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15
Q

Discuss the following statement:

‘The placenta is an effective barrier to all medicine and drugs’

A

It is a barrier but it is not perfect. Alcohol and many drugs can pass through it freely and cause birth defects.

Also whilst most micro organisms cannot pass through it, some can, such as HIV, measles and polio

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16
Q

State which cell type cannot cross the placenta.

A

Blood - thus keeping mother and baby blood separate but allowing the transfer of substances from the blood to one another.

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17
Q

Name 6 placental hormones and what they do.

A

Corticotropin releasing hormone (CRH)
Triggers release of cortisol from the adrenals which as an immune suppressant prevents rejection of the foetus

Human Chorionic Gonadotropin (hCG)
Only produced during pregnancy. Maintains corpus luteum for 8 weeks and increases transfer of nutrients to the foetus.

Human placental lactogen
Increases availability of glucose and lipids in the maternal blood by breaking them down

Oestrogen
Promotes growth of
- The myometrium
- Breast tissue

Progesterone
Maintains endometrial lining to sustain and nourish the foetus.
Pregnancy would not be viable without it.

Relaxin
Targets ligaments and relaxed them

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18
Q

Using definitions, compare the following placental complications:

a. Placenta praevia
b. Placenta accreta
c. Placental abruption

A

a. Placenta praevia - occurs when the placenta attaches to the lower part of the uterine wall, potentially obstructing the opening of the cervix.
Attaches too low

b. Placenta accreta - occurs when there is an abnormally deep attachment of the placenta through the endometrium in the myometrium.
Attaches too deep
Increta - invades myometrium
Percreta - through the uterine wall to, for example, the bladder

c. Placental abruption - occurs when the placenta detaches from the uterine wall and you get a rupture of the blood vessel between the two areas.

Risk factors - smoking & pre-eclampsia
Unattaches

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19
Q

Describe TWO differences between ‘monozygotic’ and dizygotic’ twins.

A

Monozygotic twins Vs Dizygotic Twins

Come from the same fertilised egg Vs One egg-one sperm

Two eggs independently implanted V Two eggs and two sperm

Identical Vs Non identical

Two embryos – one shared placenta Vs Two embryos – two placentas

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20
Q

Describe TWO functions of the fallopian tubes.

A

A route for the sperm to meet the ova
A route for the fertlised ova to reach the uterus

So … without the fallopian tubes no fertilisation and no ovum carried to the uterus.

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21
Q

Explain how the ovum travels from the ovary into the fallopian tubes.

A
  • Finger like projections called fimbriae surround the ovary and sweep the ova into the fallopian tube
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22
Q

Describe the TWO functions of the ovary.

A
  1. Produce female gametes (secondary oocytes)
  2. Secrete the sex hormones oestrogen and progesterone
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23
Q

Complete the following:

Oogenesis refers to the formation of female —– in the ovaries. Oogenesis begins in the —–. —– —– are formed from germ cells during foetal development. The formation of primary oocytes stops —– and they are surrounded by a layer of follicular cells, the entire structure is called a —– follicle. During a woman’s reproductive lifetime about —– follicles will mature and ovulate whilst the remainder —–.

A

Oogenesis refers to the formation of female ova in the ovaries.

Oogenesis begins in the foetus. Primary oocytes are formed from germ cells during foetal development.

The formation of primary oocytes stops at birth and they are surrounded by a layer of follicular cells. The entire structure is called a primordial follicle.

During a woman’s reproductive lifetime about 400 follicles will mature and ovulate whilst the remainder degenerate.

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24
Q

Describe how FSH and LH play a role in post pubertal oogenesis.

A

Every month these two pituitary hormones stimulate the development and release of a mature ovum from the ova.

Follicular Stimulating Hormones (FSH) do what it says on the label.
They stimulate the maturation of the primordial follicle &raquo_space;> to the primary follicle&raquo_space;> to the secondary follicle&raquo_space;> to the mature follicle (containing the secondary oocyte).

Then …

Lutenising hormone triggers ovulation pushing the secondary oocyte out of the mature follicle to release the egg out of the ovary.

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25
Q

List FOUR stages of the menstrual cycle (HINT – include days).

A

Day
1-5 Menstrual Phase
6-13 Pre-ovulatory phase
14 Ovulation
15-28 Post-ovulatory phase

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26
Q

Describe in detail the first half of a typical menstrual cycle (Day 1‒13).

A

Days 1-5 Menstrual Phase
In the uterus endometrium is shed. Bleeding. Menstruation. Progestogen drops
In the ovaries follicles are developing rapidly under the influence of FSH

Days 6-13 Pre-Ovulatory phase
In the uterus endometrium thickens and rebuilds. Oestrogen is rising.
In the ovaries follicles mature. FSH falls due to secretion of inhibin from the follicles which stops more follicles developing. A dominant one is pushed up till its mature stage and by the end of this period is fully formed.

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27
Q

Describe in detail the second half of a typical menstrual cycle (Day 14‒28).

A

Day 14 Ovulation Phase
High oestrogen levels stimulate LH secretion.
In the ovaries LH causes the rupture and expulsion of mature follicle. The follicles remain and form the corpus luteum.

Day 15-28 Post-Ovulatory Phase
In the ovaries, corpus luteum releases progesterone and some oestrogen to maintain the endometrium just in case there is a pregnancy.

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28
Q

Explain how the corpus luteum is formed.

A

During the ovulation phase the mature follicle ruptures and the egg is released. What remains behind are the follicles and these form the corpus luteum.

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29
Q

Describe the Corpus Luteum hormones

A

The corpus luteum is formed from the follicles remaining in the ovaries after the egg is released on day 14…
In the ovaries, corpus luteum releases progesterone and some oestrogen to maintain endometrium just in case there is a pregnancy. For the first 8 weeks this is where progesterone and Oestrogen are produced.

To maintain the corpus luteum itself, Human Chorionic Gonadotropin (hCG) is used for the first 8 weeks

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30
Q

Walk us through the menstrual cycle hormones

A

Pituitary hormones FSH and LH control the ovaries

Days 1-5 follicles are developing rapidly under the influence of FSH

Days 6-13 FSH falls which stops more follicles developing

Ovarian hormones oestrogen and progesterone control the uterus
Days 1-5 Progestogen drops

Days 6-13 Oestrogen is rising.

Day 14 High oestrogen levels stimulate LH secretion.

Day 15-28 corpus luteum releases progesterone and some oestrogen to main the endometrium just in case there is a pregnancy.

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31
Q
  1. Describe what happens (in terms of hormones and the corpus luteum) to a:

a. Fertilised egg

b. Non-fertilised egg

A

a. Fertilised egg
Zygote embeds in the uterine wall&raquo_space;> human chorionic gonadotropin (HCG) is released immediately&raquo_space;> this maintains and stimulate the corpus luteum so that it can produce oestrogen and progesterone needed for a viable pregnancy&raquo_space;> after a few weeks the placenta takes over this role of producing hCG and progesterone.

HcG is essential for a viable pregnancy.

b. Non-fertilised egg
After 14 days the corpus luteum degenerates&raquo_space;> becomes corpus albicans&raquo_space;> progesterone and oestrogen drop and a new menstrual cycle begins.

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32
Q

Name THREE hormones involved in the onset of puberty.

A

FSH
LH
Both stimulated by GnRH

The onset of puberty is marked by pulses of LH, and FSH, each triggered by a burst of GnRH .

These pulses increase over 3 to 4 years, and during the day as well as the night as puberty advances

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33
Q

List THREE body changes that typically occur during puberty.

A

Breast growth
Hair growth -pubic, underarms, arms and legs
Hips widen
Voice deepens.

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34
Q

Define the ‘menopause’.

A

When a woman has not had a period for 12 consecutive months.

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35
Q

State the normal age range for menopause.

A

45-55

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36
Q

Describe how the normal menopause develops (HINT — hormones).

A

Ovaries age and the supply of oocytes is depleted. If they are not maturing, menstrual cycles are not possible.

We get a negative feedback loop. Less oestrogen and progesterone due to a lack of a menstrual cycle, trigger more FsH and LH

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37
Q

List THREE signs / symptoms of menopause.

A

Hot flushes and increased sweating
Osteoporosis
Brain Fog
Painful sex due to vaginal drtness
Increased risk of UTI’s
Mood changes - Anxiety

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38
Q

Explain why a woman experiencing menopause is at an increased risk of osteoporosis.

A

Loss of oestrogen reduces osteoblast activity which builds bone. Osteoclast activity out of balance.

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39
Q

Explain why it is important to maintain a balanced blood glucose during menopause.

A

Hypoglycaemia can induce hot flushes

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40
Q

Briefly explain the process of IVF.

A

Artificial fertilisation of the ovum by the sperm outside of the body.
o Eggs are retrieved from the ovaries after use of a drug to stimulate oocyte development
o Incubated with sperm on a petri dish or sperm injected into egg
o Embryo transferred/implanted to the uterus

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41
Q

What is meant by an ectopic pregnancy?

A

Ectopic = abnormal location

An Ectopic pregnancy is a pregnancy taking place somewhere other than the uterus. Most commonly the fallopian tubes. It is dangerous and must be terminated.

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42
Q

Explain why a patient with breast cancer might have their axillary lymph nodes removed

A

To prevent cancer metastases via the lymph system beyond the original sight.

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43
Q

Name FOUR components of the male reproductive system.

A

Two Testes
Two Epididymides around each testicle
Two Vas Deferens
One prostate glans
One penis

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44
Q

State which nervous system stimulates erectile tissue and involuntary muscle.

A

Erectile tissue and involuntary muscle are stimulated by the Parasympathetic nervous system.

It produces nitric oxide that is a vasodilator and a key gas in erections.

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45
Q

Name TWO functions of the male urethral canal.

A

Reproductive
Urinary

46
Q

List TWO key functions of the testes.

A

Spermatogenesis
Testosterone production and secretion

47
Q

Explain the role of FSH and LH in relation to the male testes.

A

FSH regulates spermatogenesis in the testes
LH regulates testosterone production and secretion in the testes.

48
Q

Describe the role of the epididymis.

A

Where sperm matures and is stored before ejaculation

49
Q

State the ideal body temperature for spermatogenesis.

A

3 degrees below body temperature.

50
Q

Draw and label a sperm

a. Head - filled with a nucleus.

b. Acrosome - a vehicle covering the head of the sperm that contains enzymes to penetrate the egg.

c. Mitochondria

d. Flagellum (tail)

A
51
Q

Describe the role of the acrosome.

A

A vesicle covering the head of the sperm that contains enzymes to penetrate the egg.

52
Q

Describe the main role of the following in relation to seminal fluid:

a. Seminal vesicles

b. Prostate gland

A

a. Seminal vesicles
A pair of glands located behind the bladder that secrete alkaline nutrient rich seminal fluid to nourish sperm. Makes up 60% of semen.

b. Prostate gland
Secretes a thin milky fluid that contains
- nutrients for ATP production
- Lots of enzymes to break down substances into forms that sperm can use.
- anticoagulants to increase fluidity of the sperm
- Prostate specific antigen

53
Q

Explain why seminal fluid is alkaline.

A

To protect the sperm from urethral and vaginal acidity.

54
Q

Describe the main role of Bulbourethral glands
(Cowpers glands)

A

Pre- ejaculate

  • They sit at the base of the penis
  • They provide a mucousy alkaline rich secretion
  • pre ejaculate lubricates the end of the penis so that there is no friction.
55
Q

Define the following:

Dysmenorrhoea
Dyspareunia
Gynaecomastia
Menorrhagia
Amenorrhoea

A

Reproductive term: Definition:
Dysmenorrhoea: Painful periods
Dyspareunia: Pain on intercourse (female)
Gynaecomastia: Enlarged breast tissue in men
Menorrhagia: Increased menstrual bleeding
Amenorrhoea: Absence of periods

56
Q

Describe the difference between ‘primary’ and ‘secondary’ amenorrhoea.

A

Primary is when a period does not start at the expected age of onset. It is mostly a congenital condition where something fails to develop properly

Secondary is where the lack of period of 3 months in women who had previously been menstrual. Usually due to a pathology such as PCOS, stress, pituitary tumour, anorexia

57
Q

List TWO causes of secondary amenorrhoea.

A

PCOS
Pituitary tumour
Anorexia
Stress. Cortisol suppresses GnRH
Excessive exercise

58
Q

Describe the difference between ‘primary’ and ‘secondary’ dysmenorrhoea.

A

Dysmenorrhea - painful menstrual periods

In primary there does not seem to be an association with any pelvic diseases but there seems to be an excess of uterine prostaglandins which have a pro inflammatory effect and cause the myometrium to contract.

In secondary it is associated with pelvic or systemic pathologies such as endometriosis, fibroids, pelvic inflammatory disease.

59
Q

Name TWO reproductive pathologies that contribute to secondary dysmenorrhoea.

A

Endometriosis
Fibroids
Pelvic inflammatory disease

60
Q

Name the menstrual phase affected by premenstrual syndrome (PMS).

A

Luteal phase – the second half of the menstrual cycle

61
Q

List TWO causes of PMS.

A

It is a syndrome so it is not consistent but it is thought to be a hormonal imbalance:
* Rapid shifts in levels of Oestrogen and Progesterone
* Drop in progesterone in the luteal phase and increased production of prostaglandins

Progesterone imbalance can fluctuate the level of neurotransmitters such as serotonin.

62
Q

Name FIVE signs / symptoms of PMS.

A

Mood disturbances
Anxiety
Bloating
Fatigue
Insomnia

63
Q

Using definitions compare ‘pelvic inflammatory disease’ with ‘endometriosis’.

A

Pelvic inflammatory disease is an infectious and inflammatory disorder of the upper female genital tract including the uterus, fallopian tubes and ovaries.

Endometriosis is a condition where the endometrial tissue colonises in other parts of the body outside of the uterine cavity, leading the shedding and bleeding in areas that are not designed for it. It can be in the reproductive tract but also can spread to organs and ligaments etc

64
Q

List ONE infectious cause of pelvic inflammatory disease (PID).

A

Pelvic inflammatory disease (PID) is an infection of the female reproductive system which includes the womb, fallopian tubes and ovaries.

  • The infection typically results from spread of bacteria from the cervix
  • STD’s such as gonorrhoea and Chlamydia
  • Insertion of IUD
  • Non sterile abortion or delivery of a baby
65
Q

List TWO characteristic signs/symptoms of PID.

A
  • Lower abdominal pain - may increase with walking because it rotates the pelvis
  • Dyspareunia
  • Purulent discharge
  • Systemic symptoms such as malaise, fever, nausea and vomiting
66
Q

Name TWO complications of PID.

A

Ectopic pregnancy
Infertility
Septicemia

67
Q

Describe the pathophysiology of endometriosis.

A

The endometrium is the highly vascularised inner layer of the uterus. It has two layers - stratum functionalis and strutum basalis. (Stratum functionalis is what sloughs off during during menses).
In the pathology endometriosis the endometrium cells move beyond the endometrium and the uterine cavity to other areas of the body. Most commonly these would be other parts of the reproductive system such as the fallopian tubes, ovaries or pelvic cavity but it can spread to ligaments and organs, even the brain.
During the menstrual cycle when progesterone levels drop these distant endometrial cell deposits are exposed to circulating hormones and shed as they would in the uterus and bleed. This is very painful and over time can lead to scarring of the tissue and infertility.

68
Q

List TWO locations commonly affected by endometriosis.

A

Fallopian tubes, ovaries, pelvic cavity

69
Q

Describe how the following factors may contribute to endometriosis:

a. Altered immune surveillance

b. Primordial cells

c. Oestrogen dominance

A

a. Altered immune surveillance
Our immune system does not identify rogue endometrial cells outside the uterus

b. Primordial cells
Primordial cells (cells in the earliest stages of development) lining other body cavities or organs differentiate into endometrial cells.

c. Oestrogen dominance
As oestrogen is all about growth, too much circulating oestrogen can turbo charge the growth of endometrial tissue that is in the wrong place. So not responsible for putting it there in the first place but assisting with the pathophysiology of the disease.

70
Q

Name ONE hormone which is dominant in endometriosis.

A

Oestrogen

71
Q

List TWO signs / symptoms of endometriosis (not dysmenorrhoea).

A
  • Menorrhagia - heavy menstrual bleeding
  • Pelvic pain around menstruation
  • Bloating, lower back pain
  • Infertility
  • Dyspareunia
72
Q

Name TWO diagnostic procedures used to identify endometriosis.

A

Ultrasound
Laparoscopy – diagnostic and can also laser off the endometrial tissue.

73
Q

Name TWO complications of endometriosis.

A
  • Recurrent inflammation leads to the formation of fibrous tissue that can produce scar tissue.
  • Scar tissue can obstruct the uterus or the fallopian tubes which can contribute to infertility
  • Chocolate cysts
74
Q

Using definitions compare ‘fibroids’ and ‘ovarian cysts’.

A

Fibroids are benign tumours of the myometrium of the uterus. Like endometriosis it is heavily linked to raised oestrogen levels. They consist of smooth muscle and connective tissue. 50-80 are asymptomatic but it can lead to infertility.

Ovarian Cysts area fluid filled sacs within the ovary that occurs most commonly when an egg fails to ovulate and instead fills with fluid. They are often asymptomatic unless they get very large and can push on other organs such as the bladder

75
Q

State TWO causes of fibroids.

A

High rate of oestrogen
Obesity (linked to oestrogen)
Family history
Early menses

76
Q

List TWO characteristic signs / symptoms of fibroids.

A

In 50-80% of cases it is asymptomatic, but symptoms include
- menstrual changes such as increased menstrual bleeding, painful periods or spotting mid cycle
- Anaemia due to blood loss
- Pressure on the bladder or rectum can lead to increased urgency and frequency of urination, constipation
- Bloating and heaviness in the abdomen

77
Q

Explain specifically why fatigue is a common symptom with fibroids.

A

Iron deficiency anaemia due to excess (Menorrhagia) and prolonged blood loss during menses

78
Q

Name ONE investigative procedure for fibroids.

A

Ultrasound

79
Q

Define polycystic ovary syndrome (PCOS).

A

An endocrine metabolic condition associated with
- Menstrual and ovulatory dysfunction
- High androgen levels
- Insulin resistance

80
Q

Explain in detail the pathophysiology of PCOS.

A

LH:FSH Imbalance:
Women seem to have high levels of LH and at the same time FSH seems to be normal or slightly low. Really high levels of LH can cause the ovaries to start out putting male sex hormones [androgens]. These can
- suppress female reproductive functions such as the menstrual cycle,
- Produce excess sebum leading to oily skin and acne and,
- produce male hair patterns.

Insulin resistance:
High levels of insulin will suppress a protein called sex hormone-binding globulin [SHBG] which results in an increase in levels of testosterone which suppresses ovulation

81
Q

List FOUR symptoms of PCOS.

A

Lack of period – amenorrhoea
Infrequent period – oligomenorrhoea
Acne and oily skin
Mail hair patterns – Hirsutism
Alopecia/baldness
Weight gain and difficulty losing weight
Rash appearance - Acanthosis Nigricans
Anxiety and depression
Infertility

82
Q

Name TWO clinical signs associated with hyperandrogenism in PCOS.

A

Amenorrhoea
Hirsutism (mail hair patterns)
Acne and oily skin

83
Q

List ONE blood test which may be used to identify PCOS.

A

Increased androgens
Decreased SHBG
High LH and normal FSH
Elevated blood glucose levels

84
Q

Name TWO investigative procedures (not blood tests) used to identify PCOS.

A

Ultrasound
Laparoscapy

85
Q

Name ONE endocrine pathology which individuals with PCOS are at an increased risk of developing.

A

Diabetes Melitus

86
Q

State TWO locations in the body where an ectopic pregnancy may occur.

A

Fallopian tube – 97%
Ovary, cervix, abdomen

87
Q

Name TWO observational signs of breast cancer.

A

Overlying skin changes – dimpling appearance
Inverted and discharging nipple

88
Q

List TWO risk factors for the development of breast cancer.

A

Family history
Genetic mutations BRCA1 and 2
Poor diet, sedentary lifestyle, regular alcohol

89
Q

List ONE infectious cause and ONE non-infectious cause of balanitis.

A

Balanitis is pain and inflammation (swelling and irritation) of the glans (head) of the penis

Infectious: Candida Albicans

Non Infectious: Lichen sclerosus (auto immune), eczema, proriasis

90
Q

Name TWO signs / symptoms of balanitis.

A

Balanitis is pain and inflammation (swelling and irritation) of the glans (head) of the penis

Pain
Irritation
dyspareunia

91
Q

List ONE known cause of an undescended testes.

A

In most cases it is unclear but may be hormonal or structural.
It affects 30% of premature boys

92
Q

Name TWO complications of an undescended testes.

A
  1. Damaged sperm leading to infertility
  2. Testicular cancer
93
Q

State TWO risks factors for testicular cancer.

A

Undescended testes
Family History

94
Q

Describe the ‘mass’ associated with testicular cancer.

A

Hard, fixed, painless, unilateral

95
Q

Using definitions compare ‘prostatitis with ‘benign prostatic hyperplasia’.

A

Prostatitis describes inflammation of the prostrate gland. It can be infectious (bacterial) or non infectious.

Benign prostatic hyperplasia is enlargement of the protate tissue leading to compression of the urethra.

Hyperplasia is the overgrowth of cells in a healthy tissue or organ.

96
Q

List TWO risk factors for benign prostatic hyperplasia (BPH).

A

Age – very common in men over 60
Abdominal obesity
Being sedentary
Pesticides
Sympathetic activity

97
Q

Explain the role of the enzyme 5-alpha reductase in Benign prostatic hyperplasia

A

BPH is associated with an increase in activity in the enzyme 5-alpha-reductase.

5-alpha-reductase converts testosterone to dihydrotestosterone (DHT).

DHT has twice the effect on the prostrate at testosterone.

98
Q

Explain the role of DHT in benign prostatic hyperplasia.

A

Benign Prostatic Hyperplasia (BPH) is an enlargement of the prostate tissue leading to compression on the urethra.

In BPH there seems to be a large quantity of androgens, specifically DHT which is a potent androgen that has twice the effect on the prostate as testosterone causing the proliferation of prostate cells.

99
Q

List TWO signs / symptoms of BPH.

A
  • Obstructed/poor urinary flow
  • Increase urinary frequency
  • Intermittent urine flow and dribbling of urine
  • Nocturia
100
Q

Describe the significance of back pain in prostate cancer.

A

If prostate cancer metastasises it tends to spread up to the lumbar spine first because of its venous drainage. The back pain tends to be unremitting. You don’t get relief

101
Q

List ONE sign / symptom (not back pain) more suggestive of prostate cancer.

A

Nocturia
Haematuria
Same urinary symptoms as BPH

102
Q

List THREE symptoms of prostate cancer.

A

Same symptoms as BPH such as nocturia, difficulty emptying the bladder, dribbling but specifically to prostate cancer you might see
o Blood in ejaculate
o Blood in urine
o Pain in lumbar region that is not relieved might suggest metastases to the lumbar spine due to venous drainage.

103
Q

Explain what is meant by PSA.

A

The prostate secretes prostate specific antigen. It is an enzyme we can pick up on a blood test to assess the function of the prostate. If it is hyper functioning PSA increases. PSA will go up in both benign and cancerous prostate enlargement. It is therefore a sign of an underlying pathology.

104
Q

List TWO diagnostic procedures used to identify both BPH and prostate cancer.

A

Elevated PSA
Digital rectal examination

105
Q

Look at this graph of the menstrual cycle and explain:

Oestrogen and Progesteron cycle
LH and FSH cycle

A
106
Q

Name the placental hormones and their functions.

A
  1. Progesterone.
    - maintains endometrial lining to sustain and nourish the foetus
    - produced by the corpus luteum until 8 weeks
    - without progesterone of pregnancy would not be viable
  2. oestrogen.
    - promotes growth of breast tissue and myometrium
    - produced by the corpus luteum until 8 weeks
  3. human chorionic gonadotropin (hCG)
    - it’s only produced during pregnancy and therefore use for pregnancy test
    - maintains the corpus Luteum for eight weeks, which allows progesterone and oestrogen to be produced and increased transfer of nutrients to the foetus
    - related to morning sickness
    - suggestive of testicular cancer, if found in a male blood test
  4. human Placental Lactogen (hPL)
    - increase the amount of glucose and lipids in maternal blood providing energy and growth for the foetus
  5. Relaxin
    - target, ligaments and relaxes them in preparation for labour
  6. Corticotropin Releasing Hormone (CRH)
    - triggers the release of cortisol from the adrenals.
    - why? It is an immune suppressant and prevent the mother rejecting the foetus/placenta
107
Q

List 2 ways in which fallopian tubes can move ova towards the uterus.

A
  • The tubes are lined with ciliated, columnar, epithelium, which functions to help move the over towards the uterus
  • smooth muscles for peristalsis
108
Q

What is the role of inhibition in the pre-ovulatory phase?

A

Secretion of Inhibin in the pre-ovulatory phase reduces FSH, which stops other follicles developing

109
Q

What might you want to know in a case history related to the reproductive system?

A

Always ask when the last period was so that you’re not making assumptions about whether they have one. Then find out about bleeding time and cycle, amount of blood flow, duration and quality of the Blood.

Relationship with symptoms to cycle

Breast: tenderness; galactorrhea

Hirsutism and acne

Altered libido and impotence

Method of contraception

Operations

Problems with intercourse

110
Q

What does the vas deferens do?

A

a long, muscular tube that forms part of the male reproductive system. Its primary function is to transport sperm from the epididymis, where sperm are stored and matured, to the urethra during ejaculation.