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Flashcards in 3/16 Repro Deck (123)
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1
Q
Bicornuate uterus
-due to what?
A
incomplete fusion of paramesonephric ducts
2
Q
Germ cell tumor & inc. T4 & T3.
-whats the connection?
A
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
Q
Superficial inguinal nodes
-drain what region?
A
-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
Q
main mode of action of OCPs?
A
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
Q
Which HPV causes warts?
A
6 & 11
6
Q
Which HPV can cause cervical carcinoma?
A
16, 18, 31, 33
7
Q
citrate
-effect w/renal stones?
A
-high citrate is good, binds calcium and prevents it from precipitating.
8
Q
direct inguinal hernia
-cause?
A
weakness of transversalis fascia.
9
Q
Sonic hedgehog gene
-patterning along which axis?
-involved in development of what?
-mutation can lead to what?
A
-anterior-posterior axis.
-Involved in CNS development
-mutation can cause holoprosencephaly.
10
Q
Wnt-7 gene
-Necessary for proper organization along which axis?
A
dorsal-ventral axis.
11
Q
FGF gene
-function?
A
-Stimulates mitosis of underlying mesoderm, providing for lengthening of limbs.
12
Q
Homeobox (Hox) genes
-involved in organization of embryo in which direction?
-mutations lead to what?
A
-craniocaudal direction
-Hox mutations appendages in wrong locations.
13
Q
Bilaminar disc
-which week?
A
2 weeks = 2 layers
14
Q
When is fetus most susceptible to teratogens?
A
Weeks 3-8, the "embryonic period".
-this is when organogenesis occurs.
15
Q
Upper & lower limb buds begin to form
-which week?
A
4 weeks = 4 limbs
16
Q
Heart begins to beat
-which week?
A
week 4
-4 chambers in your heart
17
Q
Fetal cardiac activity visible by transvaginal ultrasound.
-which week?
A
week 6
18
Q
Genitalia have male/female characteristics.
-which week?
A
week 10
19
Q
gastrulation
-what is it?
-what starts it off?
A
-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
Q
First 2 layers of the inner cell mass?
-which contributes to the embryo?
A
epiblast & hypoblast
-epiblast becomes the embryo
21
Q
What is the epiblasts new cavity?
A
amniotic cavity
-it will eventually surround the entire embryo.
22
Q
which sect of the mesoderm forms the parietal body cavity?
A
somatic/parietal lateral plate mesoderm
*Amniotic cavity follows it around & now surround the entire embryo. It disconnects from the somatic lateral plate mesoderm.
23
Q
which sect of the mesoderm forms the gut tube/CT/smooth muscle of gut tube?
A
visceral/splanchnic lateral plate mesoderm
24
Q
Neural crest origin
-which marker?
-name some structures
A
S-100 (+)
-melanoma
-schwannoma
-langerhan cell histiocytosis
25
Q
Notochord
-adult derivative?
A
Nucleus pulposus of intervertebral disc.
26
Q
Deformation vs malformation
A
Deformation = extrinsic disruption; occurs after the embryonic period.

Malformation = intrinsic disruption; occurs during the embryonic period (weeks 3–8).
27
Q
Absence of digits
-which teratogen?
A
alkylating agent
28
Q
fingernail hypoplasia
-which teratogen?
A
Carbamazepine, phenytoin.
29
Q
Aplasia cutis congenita
-which teratogen?
A
Methimazole
30
Q
Fetal hydantoin syndrome
-which teratogen?
-what is it?
A
-phenytoin
-microcephaly, dysmorphic craniofacial features, hypoplastic nails and distal phalanges, cardiac defects,
IUGR, intellectual disability
31
Q
Caudal regression syndrome (anal atresia to
sirenomelia)
-which teratogen?
A
glucose
-Maternal diabetes
32
Q
Smooth philtrum, thin upper lip
-which congenital problem?
A
fetal alcohol syndrome
33
Q
hypertelorism
A
Abnormally increased distance between two organs or bodily parts, usually referring to an increased distance between the orbits (eyes)--orbital hypertelorism.
34
Q
What is a chorion?
A
placenta
35
Q
Dizygotic twins
-how many chorions?
-how many amniotic sacs?
A
-2 separate chorions
-2 separate amniotic sacs
36
Q
Monozygotic twins
-When do you get 2 chorions (placentas)?
A
If they split before day 4.
-after day 4, you always get just 1 chorion (placenta).
37
Q
Monozygotic twins
-when does the fertilized egg split into 2 zygotes?
A
75% of the time, day 4-8.
25% before day 4.
<1% after day 8.
38
Q
Monozygotic twins
-at what point will they share an amniotic cavity?
A
If they split after 8 days, which is <1%.
-so 99% of the time, you will have 2 amniotic cavities.
39
Q
Conjoined twins
-when do they split?
-how many chorions?
-how many amniotic sacs?
A
>13 days.
-monoamniotic, monochorionic.
40
Q
Most common twinning:
-when is the split?
-how many chorions?
-how many amniotic sacs?
A
75% of the time, day 4-8
-Monochorionic
-Diamniotic
41
Q
Inner layer of chorionic villi.
A
Cytotrophoblast
-Cytotrophoblast cells = mitotically active & serve as the stem cells for formation of the syncytiotrophoblast. The syncytiotrophoblast is mitotically inactive.
42
Q
Outer layer of chorionic villi
A
Syncytiotrophoblast
43
Q
Syncytiotrophoblast or Cytotrophoblast
-which makes bHCG?
A
Syncytiotrophoblast
44
Q
Umbilical vessels
-2 of which?
-mnemonic?
A
2 umbilical arteries
*arteries = longer word = there are more of them.
45
Q
Umbilical arts
-stem from which fetal arteries?
A
internal iliac arts.
46
Q
Umbilical arteries and veins are derived from:
A
Allantois
47
Q
urachus
-derivative of what?
-function in utero?
A
-allantois becomes the urachus.
-Duct connecting fetal bladder to yolk sac and allows bladder to drain waste into the yolk sac.
48
Q
Urachal cyst
-can predispose to what cancer?
A
-adenocarcinoma at dome of the bladder.
49
Q
obliterated urachus becomes what?
A
-median umbilical ligament.
50
Q
Obliteration of vitelline duct
-which week?
A
7th week
51
Q
Branchial clefts—derived from:
A
ectoderm
52
Q
Branchial arches—derived from:
A
mesoderm and neural crest
53
Q
Branchial pouches—derived from:
A
endoderm
54
Q
DiGeorge syndrome
-branchial cleft, pouch, or arch problem?
A
-3rd & 4th POUCHES.
55
Q
Which part of LN is not well developed in di Georges?
-mnemonic?
A
-l. node paracortex.
*paracortex = T cell country.

*Mr. T Pities the fool. T cells in Paracortex.
56
Q
Cleft lip—failure of fusion of the:
A
-maxillary and medial nasal processes (formation of 1°
palate).
57
Q
Cleft palate—failure of fusion of the:
A
-two lateral palatine processes
or
-failure of fusion of lateral palatine processes with the nasal septum and/or median palatine process.
58
Q
Cleft palate
-how can it present?
A
-makes it difficult for baby to make proper suction for feeding, resulting in choking/coughing.
59
Q
Most common breast mass in a younger woman?
A
fibroadenoma
60
Q
Bicornuate uterus
-Sxs:
A
-recurrent miscarriages.
61
Q
Clomiphene
-location of action?
A
-blocks estrogen receptors in hypothalamus.
62
Q
Most common testicular tumor?
A
Seminoma 40%
63
Q
Short palpebral fissues
-teratogen?
A
fetal alcohol syndrome
64
Q
Upper portion of vagina + female internal structures made from what?
A
paramesonephric duct (mullerian duct)
65
Q
Bottom 1/3 of vagina made from what?
A
urogenital sinus
66
Q
Müllerian duct abnormalities result in:
A
-anatomical defects that may present as 1° amenorrhea in females with fully developed 2° sexual characteristics (indicator of functional ovaries).
67
Q
Mesonephric (Wolffian) duct
-develops into what structures?
-mnemonic?
A
SEED
-Seminal vesicles
-Epididymis
-Ejaculatory duct
-Ductus deferens
68
Q
No Sertoli cells or lack of Müllerian inhibitory
factor:
A
-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
Q
5α-reductase deficiency:
A
-male internal genitalia, ambiguous external genitalia until
puberty (when  testosterone levels cause inc. and cause masculinization)
70
Q
"penis at 12" phenomenon
-a "girl" may getting an enlarged clit aroud puberty age.
-what disease can this be?
A
5α-reductase deficiency
71
Q
hypospadias
-cause?
-more or less common than epispadias?
A
-failure of urethral folds to close.
-more common than epispadias.
72
Q
epispadias
-cause?
-associated condition?
A
-faulty positioning of genital tubercle.
-Exstrophy of the bladder is associated with Epispadias.
73
Q
Gubernaculum
-male remnant?
A
Anchors testes within scrotum.
74
Q
Gubernaculum
-female remnant?
A
Ovarian ligament + round ligament of uterus.
75
Q
Infundibulopelvic ligament (suspensory ligament of the
ovaries)
-contains what?
A
Ovarian vessels.
76
Q
What is at risk of injury during ligation of ovarian vessels.
-when do you ligate these vessels?
-ovarian vessels contained in which ligament?
A
ureter
-oophorectomy
-infundibulopelvic lig. (suspensory lig of ovary).
77
Q
Cardinal ligament
-contains what?
-ligated when? whats at risk of being damaged?
A
uterine vessels
-ligated during hysterectomy, watch out for ureter.
78
Q
Round ligament of the uterus
-contains what?
A
-contain no major structures.
-round like 0 as in 0 structures
79
Q
Ovarian ligament
-contains what?
A
-contain no major structures.
-O like 0 as in 0 important structures
80
Q
Ovary, outer surface
-epithelial type?
A
-Simple cuboidal epithelium (germinal epithelium covering surface of ovary).
81
Q
Sperm acquire motility in epididymis which is lined by:
A
-Pseudostratified columnar epi w/sterocilia.
82
Q
Which n. contains para fibers for male sexual response?
-which pathway is activated?
A
pelvic nerve
-NO => inc. cGMP => smooth muscle relaxation => vasodilation = erection.
83
Q
How does erection go away?
A
Norepinephrine => inc. [Ca2+] => smooth muscle contraction Ž=> vasoconstriction => antierectile.
84
Q
Male sexual response: Emission
-which nerve?
A
Sympathetic nervous system
-hypogastric nerve.
85
Q
Male sexual response: Ejaculation
-which nerve?
A
visceral and somatic nerves
-pudendal nerve.
86
Q
What forms blood-testes barrier?
Whats its purpose?
A
Tight junctions between adjacent Sertoli cells form blood-testis barrier => isolate gametes from autoimmune attack.
87
Q
Sertoli cells
-temp sensitive?
-if so, what changes?
A
-yes
-dec. sperm prod & dec. inhibin prod w/high temps.
88
Q
Leydig cells
-temp sensitive?
-if so, what changes?
A
no
89
Q
Leydig or Sertoli
-which one has aromatase?
A
Both
90
Q
Sertoli cells need testosterone to help make sperm. If you take exogenous testosterone, will your sperm count increase?
A
-if you take exogenous testosterone, your sperm
count can be decreased b/c you need high LOCAL
testosterone concentration for sperm production.
91
Q
Testosterone has neg. feedback on what?
A
GnRH & LH
*so indirectly also FSH
92
Q
Inhibin (via sertoli cell) has neg. feedback on what?
A
FSH
93
Q
Which estrogen made in:
Ovary:
placenta:
adipose tissue:
A
-ovary = 17β-estradiol
-placenta = estriol
-adipose tissue = estrone via aromatization
94
Q
Estrogen
-inc or dec transport protein synth?
A
Inc
95
Q
Estrogen
-effect on HDL?
-effect on LDL?
A
-inc HDL
-dec LDL
96
Q
Potency of the estrogens? Estrone, estriol, estradiol.
-which one can be normal in a post-menopausal woman?
A
estradiol > estrone > estriol
-estrone may be normal in post-menopausal woman.
97
Q
Where are estrogen receptors?
A
Estrogen receptors expressed in the cytoplasm; translocate to the nucleus when bound by ligand.
98
Q
Fall in what hormone after delivery disinhibits prolactin lactation?
A
Fall in progesterone after delivery disinhibits PRLŽ lactation.
99
Q
Myometrial excitability
-which hormone increases it?
-which hormone decreases it?
A
-estrogen increases
-progesterone decreases

*pro-gestation: you dont want myometrium contracting during gestation, that would abort the baby.
100
Q
Which hormone inc. female's body temp?
A
progesterone
*pro-gestation, you got a bun in the oven, the temperature will be increased.
101
Q
menstruation
-example of what kind of cell death?
A
apoptosis
102
Q
Most common meds causing impotence?
A
SSRIs & sympathetic blockers
103
Q
Fetal hydronephrosis
-where is the obstruction most commonly?
A
Uretopelvic junction
-last part of the ureter to canalize is where it meets the renal pelvis.
104
Q
Where is the uretopelvic junction?
A
where ureter meets the renal pelvis.
-aka the start of the ureter.
105
Q
adenomyosis
-whats uterus going to look like?
A
uniformly enlarged
*i wouldn't guess that it would be uniformly enlarged.
106
Q
3 Sxs of pre-eclampsia?
-when does it usually happen?
A
HTN, proteinuria, edema.
-after 20th week of gestation.
107
Q
When are peak progesterone levels seen?
A
mid-luteal phase
108
Q
Luteal phase aka:
A
secretory phase
109
Q
Why dont beta-lactams work against chlamydia?
A
bc it has no peptidoglycan cell wall
110
Q
Fever, rash, oliguria 1-3 wks after you give a medication:
-whats the disease?
-which cells are classically seen?
A
drug-induced acute interstitial nephritis
-eosinophils
111
Q
Syphillis
-what are the warts called?
A
condyloma lata
112
Q
Follicular growth is fastest during ____ week of
proliferative phase.
A
2nd
113
Q
Metrorrhagia
-define:
A
-intermenstrual bleeding: frequent but irregular menstruation.
114
Q
Menorrhagia
-define:
A
-heavy menstrual bleeding: > 80 mL blood loss or > 7 days of menses.
115
Q
Menometrorrhagia:
-define:
A
heavy, irregular
menstruation at irregular intervals.
116
Q
Progesterone effect on LH
A
Progesterone inhibits LH.
*basis for OCPs containing progesterone.
*estrogen (unless very high level) also inhibits LH and FSH.
117
Q
What phase are primary oocytes arrested in until ovulation?
A
prophase 1
118
Q
What phase does the secndary oocyte progress to but stop at unless its fertilized?
A
metaphase 2
119
Q
What phase does the oocyte have to reach before ovulation can occur?
A
metaphase 2
*has to be in metaphase when the sperm meets it.
120
Q
How many chromatids do primary oocytes (prophase 1 arrest) have?
A
-46 chromatids: S phase has happened but mitosis has not finished.
121
Q
secondary oocyte (meta2 arrest)
-ploidy?
-chromatids?
A
1N, 2C
-homologous chroms separate after meiosis 1 so you get haploid cells.
122
Q
How long after fertilization is implantation?
A
6 days
123
Q
How soon is bHCG present in blood & urine, and which cells are secreting it?
A
Syncytiotrophoblasts secrete hCG, which is detectable in blood 1 week after conception and on home test in urine
2 weeks after conception.