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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.