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Flashcards in 3/16 Repro Deck (123):
1

Bicornuate uterus
-due to what?

incomplete fusion of paramesonephric ducts

2

Germ cell tumor & inc. T4 & T3.
-whats the connection?

Germ cell tumor releases bHCG which has same alpha-subunit as TSH (and LH & FSH).
-This acts like TSH and causes thyroid to produce more thyroxine!

*bHCG shares significant sequence homology in the beta-subunit w/TSH as well.

3

Superficial inguinal nodes
-drain what region?

-all cutaneous lymph from umbilicus to the feet including external genitalia & anus (until pectinate line).
*excludes posterior calf which drains to popliteal l.nodes.

4

main mode of action of OCPs?

suppress synth of FSH and LH.
-leads to inhibition of ovulation (no LH spike).
-also cause thickening of cervical mucus, but this is not the main mode of action.

5

Which HPV causes warts?

6 & 11

6

Which HPV can cause cervical carcinoma?

16, 18, 31, 33

7

citrate
-effect w/renal stones?

-high citrate is good, binds calcium and prevents it from precipitating.

8

direct inguinal hernia
-cause?

weakness of transversalis fascia.

9

Sonic hedgehog gene
-patterning along which axis?
-involved in development of what?
-mutation can lead to what?

-anterior-posterior axis.
-Involved in CNS development
-mutation can cause holoprosencephaly.

10

Wnt-7 gene
-Necessary for proper organization along which axis?

dorsal-ventral axis.

11

FGF gene
-function?

-Stimulates mitosis of underlying mesoderm, providing for lengthening of limbs.

12

Homeobox (Hox) genes
-involved in organization of embryo in which direction?
-mutations lead to what?

-craniocaudal direction
-Hox mutations appendages in wrong locations.

13

Bilaminar disc
-which week?

2 weeks = 2 layers

14

When is fetus most susceptible to teratogens?

Weeks 3-8, the "embryonic period".
-this is when organogenesis occurs.

15

Upper & lower limb buds begin to form
-which week?

4 weeks = 4 limbs

16

Heart begins to beat
-which week?

week 4
-4 chambers in your heart

17

Fetal cardiac activity visible by transvaginal ultrasound.
-which week?

week 6

18

Genitalia have male/female characteristics.
-which week?

week 10

19

gastrulation
-what is it?
-what starts it off?

-Process that forms the trilaminar embryonic disc.
-Establishes the ectoderm, mesoderm, and endoderm germ layers.

-Starts with the epiblast invaginating to form the primitive streak.

20

First 2 layers of the inner cell mass?
-which contributes to the embryo?

epiblast & hypoblast
-epiblast becomes the embryo

21

What is the epiblasts new cavity?

amniotic cavity
-it will eventually surround the entire embryo.

22

which sect of the mesoderm forms the parietal body cavity?

somatic/parietal lateral plate mesoderm
*Amniotic cavity follows it around & now surround the entire embryo. It disconnects from the somatic lateral plate mesoderm.

23

which sect of the mesoderm forms the gut tube/CT/smooth muscle of gut tube?

visceral/splanchnic lateral plate mesoderm

24

Neural crest origin
-which marker?
-name some structures

S-100 (+)
-melanoma
-schwannoma
-langerhan cell histiocytosis

25

Notochord
-adult derivative?

Nucleus pulposus of intervertebral disc.

26

Deformation vs malformation

Deformation = extrinsic disruption; occurs after the embryonic period.

Malformation = intrinsic disruption; occurs during the embryonic period (weeks 3–8).

27

Absence of digits
-which teratogen?

alkylating agent

28

fingernail hypoplasia
-which teratogen?

Carbamazepine, phenytoin.

29

Aplasia cutis congenita
-which teratogen?

Methimazole

30

Fetal hydantoin syndrome
-which teratogen?
-what is it?

-phenytoin
-microcephaly, dysmorphic craniofacial features, hypoplastic nails and distal phalanges, cardiac defects,
IUGR, intellectual disability

31

Caudal regression syndrome (anal atresia to
sirenomelia)
-which teratogen?

glucose
-Maternal diabetes

32

Smooth philtrum, thin upper lip
-which congenital problem?

fetal alcohol syndrome

33

hypertelorism

Abnormally increased distance between two organs or bodily parts, usually referring to an increased distance between the orbits (eyes)--orbital hypertelorism.

34

What is a chorion?

placenta

35

Dizygotic twins
-how many chorions?
-how many amniotic sacs?

-2 separate chorions
-2 separate amniotic sacs

36

Monozygotic twins
-When do you get 2 chorions (placentas)?

If they split before day 4.
-after day 4, you always get just 1 chorion (placenta).

37

Monozygotic twins
-when does the fertilized egg split into 2 zygotes?

75% of the time, day 4-8.
25% before day 4.
<1% after day 8.

38

Monozygotic twins
-at what point will they share an amniotic cavity?

If they split after 8 days, which is <1%.
-so 99% of the time, you will have 2 amniotic cavities.

39

Conjoined twins
-when do they split?
-how many chorions?
-how many amniotic sacs?

>13 days.
-monoamniotic, monochorionic.

40

Most common twinning:
-when is the split?
-how many chorions?
-how many amniotic sacs?

75% of the time, day 4-8
-Monochorionic
-Diamniotic

41

Inner layer of chorionic villi.

Cytotrophoblast
-Cytotrophoblast cells = mitotically active & serve as the stem cells for formation of the syncytiotrophoblast. The syncytiotrophoblast is mitotically inactive.

42

Outer layer of chorionic villi

Syncytiotrophoblast

43

Syncytiotrophoblast or Cytotrophoblast
-which makes bHCG?

Syncytiotrophoblast

44

Umbilical vessels
-2 of which?
-mnemonic?

2 umbilical arteries
*arteries = longer word = there are more of them.

45

Umbilical arts
-stem from which fetal arteries?

internal iliac arts.

46

Umbilical arteries and veins are derived from:

Allantois

47

urachus
-derivative of what?
-function in utero?

-allantois becomes the urachus.
-Duct connecting fetal bladder to yolk sac and allows bladder to drain waste into the yolk sac.

48

Urachal cyst
-can predispose to what cancer?

-adenocarcinoma at dome of the bladder.

49

obliterated urachus becomes what?

-median umbilical ligament.

50

Obliteration of vitelline duct
-which week?

7th week

51

Branchial clefts—derived from:

ectoderm

52

Branchial arches—derived from:

mesoderm and neural crest

53

Branchial pouches—derived from:

endoderm

54

DiGeorge syndrome
-branchial cleft, pouch, or arch problem?

-3rd & 4th POUCHES.

55

Which part of LN is not well developed in di Georges?
-mnemonic?

-l. node paracortex.
*paracortex = T cell country.

*Mr. T Pities the fool. T cells in Paracortex.

56

Cleft lip—failure of fusion of the:

-maxillary and medial nasal processes (formation of 1°
palate).

57

Cleft palate—failure of fusion of the:

-two lateral palatine processes
or
-failure of fusion of lateral palatine processes with the nasal septum and/or median palatine process.

58

Cleft palate
-how can it present?

-makes it difficult for baby to make proper suction for feeding, resulting in choking/coughing.

59

Most common breast mass in a younger woman?

fibroadenoma

60

Bicornuate uterus
-Sxs:

-recurrent miscarriages.

61

Clomiphene
-location of action?

-blocks estrogen receptors in hypothalamus.

62

Most common testicular tumor?

Seminoma 40%

63

Short palpebral fissues
-teratogen?

fetal alcohol syndrome

64

Upper portion of vagina + female internal structures made from what?

paramesonephric duct (mullerian duct)

65

Bottom 1/3 of vagina made from what?

urogenital sinus

66

Müllerian duct abnormalities result in:

-anatomical defects that may present as 1° amenorrhea in females with fully developed 2° sexual characteristics (indicator of functional ovaries).

67

Mesonephric (Wolffian) duct
-develops into what structures?
-mnemonic?

SEED
-Seminal vesicles
-Epididymis
-Ejaculatory duct
-Ductus deferens

68

No Sertoli cells or lack of Müllerian inhibitory
factor:

-develop both male and female internal genitalia and male external genitalia.
-not stopping female + you're still making male bc leydig cells still making testosterone.
-DHT will cause external male.

69

5α-reductase deficiency:

-male internal genitalia, ambiguous external genitalia until
puberty (when  testosterone levels cause inc. and cause masculinization)

70

"penis at 12" phenomenon
-a "girl" may getting an enlarged clit aroud puberty age.
-what disease can this be?

5α-reductase deficiency

71

hypospadias
-cause?
-more or less common than epispadias?

-failure of urethral folds to close.
-more common than epispadias.

72

epispadias
-cause?
-associated condition?

-faulty positioning of genital tubercle.
-Exstrophy of the bladder is associated with Epispadias.

73

Gubernaculum
-male remnant?

Anchors testes within scrotum.

74

Gubernaculum
-female remnant?

Ovarian ligament + round ligament of uterus.

75

Infundibulopelvic ligament (suspensory ligament of the
ovaries)
-contains what?

Ovarian vessels.

76

What is at risk of injury during ligation of ovarian vessels.
-when do you ligate these vessels?
-ovarian vessels contained in which ligament?

ureter
-oophorectomy
-infundibulopelvic lig. (suspensory lig of ovary).

77

Cardinal ligament
-contains what?
-ligated when? whats at risk of being damaged?

uterine vessels
-ligated during hysterectomy, watch out for ureter.

78

Round ligament of the uterus
-contains what?

-contain no major structures.
-round like 0 as in 0 structures

79

Ovarian ligament
-contains what?

-contain no major structures.
-O like 0 as in 0 important structures

80

Ovary, outer surface
-epithelial type?

-Simple cuboidal epithelium (germinal epithelium covering surface of ovary).

81

Sperm acquire motility in epididymis which is lined by:

-Pseudostratified columnar epi w/sterocilia.

82

Which n. contains para fibers for male sexual response?
-which pathway is activated?

pelvic nerve
-NO => inc. cGMP => smooth muscle relaxation => vasodilation = erection.

83

How does erection go away?

Norepinephrine => inc. [Ca2+] => smooth muscle contraction Ž=> vasoconstriction => antierectile.

84

Male sexual response: Emission
-which nerve?

Sympathetic nervous system
-hypogastric nerve.

85

Male sexual response: Ejaculation
-which nerve?

visceral and somatic nerves
-pudendal nerve.

86

What forms blood-testes barrier?
Whats its purpose?

Tight junctions between adjacent Sertoli cells form blood-testis barrier => isolate gametes from autoimmune attack.

87

Sertoli cells
-temp sensitive?
-if so, what changes?

-yes
-dec. sperm prod & dec. inhibin prod w/high temps.

88

Leydig cells
-temp sensitive?
-if so, what changes?

no

89

Leydig or Sertoli
-which one has aromatase?

Both

90

Sertoli cells need testosterone to help make sperm. If you take exogenous testosterone, will your sperm count increase?

-if you take exogenous testosterone, your sperm
count can be decreased b/c you need high LOCAL
testosterone concentration for sperm production.

91

Testosterone has neg. feedback on what?

GnRH & LH
*so indirectly also FSH

92

Inhibin (via sertoli cell) has neg. feedback on what?

FSH

93

Which estrogen made in:
Ovary:
placenta:
adipose tissue:

-ovary = 17β-estradiol
-placenta = estriol
-adipose tissue = estrone via aromatization

94

Estrogen
-inc or dec transport protein synth?

Inc

95

Estrogen
-effect on HDL?
-effect on LDL?

-inc HDL
-dec LDL

96

Potency of the estrogens? Estrone, estriol, estradiol.
-which one can be normal in a post-menopausal woman?

estradiol > estrone > estriol
-estrone may be normal in post-menopausal woman.

97

Where are estrogen receptors?

Estrogen receptors expressed in the cytoplasm; translocate to the nucleus when bound by ligand.

98

Fall in what hormone after delivery disinhibits prolactin lactation?

Fall in progesterone after delivery disinhibits PRLŽ lactation.

99

Myometrial excitability
-which hormone increases it?
-which hormone decreases it?

-estrogen increases
-progesterone decreases

*pro-gestation: you dont want myometrium contracting during gestation, that would abort the baby.

100

Which hormone inc. female's body temp?

progesterone
*pro-gestation, you got a bun in the oven, the temperature will be increased.

101

menstruation
-example of what kind of cell death?

apoptosis

102

Most common meds causing impotence?

SSRIs & sympathetic blockers

103

Fetal hydronephrosis
-where is the obstruction most commonly?

Uretopelvic junction
-last part of the ureter to canalize is where it meets the renal pelvis.

104

Where is the uretopelvic junction?

where ureter meets the renal pelvis.
-aka the start of the ureter.

105

adenomyosis
-whats uterus going to look like?

uniformly enlarged
*i wouldn't guess that it would be uniformly enlarged.

106

3 Sxs of pre-eclampsia?
-when does it usually happen?

HTN, proteinuria, edema.
-after 20th week of gestation.

107

When are peak progesterone levels seen?

mid-luteal phase

108

Luteal phase aka:

secretory phase

109

Why dont beta-lactams work against chlamydia?

bc it has no peptidoglycan cell wall

110

Fever, rash, oliguria 1-3 wks after you give a medication:
-whats the disease?
-which cells are classically seen?

drug-induced acute interstitial nephritis
-eosinophils

111

Syphillis
-what are the warts called?

condyloma lata

112

Follicular growth is fastest during ____ week of
proliferative phase.

2nd

113

Metrorrhagia
-define:

-intermenstrual bleeding: frequent but irregular menstruation.

114

Menorrhagia
-define:

-heavy menstrual bleeding: > 80 mL blood loss or > 7 days of menses.

115

Menometrorrhagia:
-define:

heavy, irregular
menstruation at irregular intervals.

116

Progesterone effect on LH

Progesterone inhibits LH.
*basis for OCPs containing progesterone.
*estrogen (unless very high level) also inhibits LH and FSH.

117

What phase are primary oocytes arrested in until ovulation?

prophase 1

118

What phase does the secndary oocyte progress to but stop at unless its fertilized?

metaphase 2

119

What phase does the oocyte have to reach before ovulation can occur?

metaphase 2
*has to be in metaphase when the sperm meets it.

120

How many chromatids do primary oocytes (prophase 1 arrest) have?

-46 chromatids: S phase has happened but mitosis has not finished.

121

secondary oocyte (meta2 arrest)
-ploidy?
-chromatids?

1N, 2C
-homologous chroms separate after meiosis 1 so you get haploid cells.

122

How long after fertilization is implantation?

6 days

123

How soon is bHCG present in blood & urine, and which cells are secreting it?

Syncytiotrophoblasts secrete hCG, which is detectable in blood 1 week after conception and on home test in urine
2 weeks after conception.