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Endocrine and Reproductive system > Endocrine and reproductive teach > Flashcards

Endocrine and reproductive teach Flashcards

1
Q

A 48yr old presents to day surgery for bilateral saplingo-oophorectomy. Which ligament would the surgeon have to open to access the ovaries and Fallopian tubes

A

Broad ligament

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2
Q

Broad ligament

A

Connects interns, Fallopian tubes and ovaries to the pelvic wall

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3
Q

Suspensory ligaments of the ovaries

A

Connects ovaries to the lateral pelvic wall

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4
Q

Ovarian ligament

A

Connects ovaries to uterus

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5
Q

Central perineal tendon

A

Provides the main structural support to the uterus - damage to this associated with pelvic organ prolapse

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6
Q

During ejaculation the bladder sphincter contracts this prevents what

A

Urine mixing with the semen

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7
Q

Where is the most likely place for fertilisation to occur

A

Ampulla

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8
Q

What nerve supplies the Breast

A

Branch of intercostal T4-6

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9
Q

Main arterial branch to Breast

A

Internal mammary artery

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10
Q

What does prolactin do in the breast

A

Causes milk production

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11
Q

What does oxytocin do in the breast

A

Cause contraction of myoepithial cells surrounding the mammary alveoli to reusult in milk ejection from the breast

Suckling of baby stimulates mechanoreceptoes in the nipple which results in the release of both prolactin and oxytocin form the pituitary gland

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12
Q

The breast itself lies on a layer of pectoral fascia and the following muscles

A

Pec major
Serratus anterior
External oblique

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13
Q

Spermatogeneis

A

Process of germ cell to mature sperm

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14
Q

Spermatocytogeneis

A

Germ cell to spermatid

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15
Q

Spermiogenesis

A

Spermatid to mature sperm - golgi phase, across mall phase, tail phase and maturation phase

Released from sertoli into lumenn of seminiferous tubules and transported to epididymis and then gas deferesjs where they become motile

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16
Q

Spermiation

A

Mature spermatid are made motile

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17
Q

How are sperm made fertile

A

Low levels of FPP and heparin remove glycoproteins coat over the acrosome and make it fertile

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18
Q

what cell in the pituitary release growth hormone and are stimulated by GnRH

A

somatotropes

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19
Q

what basophils cells in the anterior pituitary secrete ACTH are stimulated by CRH

A

corticotropes

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20
Q

what cells in the anterior pituitary are stimulated by TRH and release TSH

A

thyrotropes

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21
Q

what cells in the anterior pituitary release LH and FHS and are stimulated by GnRH

A

Gonadotropes

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22
Q

what cells secrete prolactin and are under inhibitory control by dopamine

A

Lactotropes

23
Q

what days of the menstrual cycle signify the secretory phase

A

15-28

progesterone luteal phase
ovulation - day 14, due to oestrogen , induced LH surge

24
Q

what cells readily produce androgens but have limited capacity to convert them into estrogens

A

Theca cells ( associated with ovarian follicles)

25
Q

what cells contain the enzyme aromatase so they can covert androgens into oestrogen’s but they cannot produce androgens in the first place

A

Granulosa cells

26
Q

what hormone stumuleastes thecal cells to stimulate androgen production

A

LH

27
Q

what hormone stimulates granulosa cells to promote conversion of androgen

A

FSH

28
Q

describe high and low level of oestrogen effects on other hormones

A

Oestrogen on a low level has -ve feedback on pituitary for LH and FSH, oestrogen on a high level has positive feedback on hypothalamus- which will ultimately result in the spike of LH- that’s whats thought to happen (Oestrogen usually has a negative feedback on LH.

However, in high concentrations, oestrogen appears to have positive feedback causing release of LH.)

So, something to understand: small/rising, moderate levels of estrogen will cause -ve feedback loop - inhibiting LH BUT high levels of estrogen will result in positive feedback loop

29
Q

in what phase does the spike in LH cause ovulation and stimulates the development of the corpus lute which then begins producing progesterone. FSH also spikes, progesterone release at higher level has a positive feedback effect in FSH release. The function of this rise is not known .Oestrogen level decline immediately after Lh spike. ( maybe because follicle is no longer producing oestrogen and progesterone inhibits the synthesis of oestrogen.

A

ovulatory phase

30
Q

in what phase does FSH and LH levels fall due to negative feedback
corpus lute continues to produce progesterone and tis thickens the endometrium further to prepare for implantation
progesterone also thickens the cervical mucus to prevent further sperm adn bacteria from entering the uterus
CL produces oestrogen that why there is a small rise in luteal phase.

A

luteal phase

If fertilisation and implantation do not occur then the corpus luteum degenerates (and stops releasing progesterone). Due to reduced FSH and LH, oestrogen levels also decrease. Reduced levels of oestrogen and progesterone causes the endometrium to shed which starts the cycle again
If fertilisation and implantation do occur then human chorionic gonadotrophin (HCG) is released which stimulates the corpus luteum. The corpus luteum then continues to produce progesterone to support the pregnancy until the pregnancy/ placenta can make its own hormones

31
Q

The sperm penetrates the corona radiata (outer layer of ovum) via membrane-bound enzymes in the plasma membrane of the head of the sperm.
What receptors to they bind to on the zona pellucida (next inner layer of ovum)?

A

ZP3 (zona-pellucida sperm binding protein 3) receptors

sperm penetrates corona radiate and binds to ZP3 receptors on bona pellucida. This trigger acrosome reaction reaction ( hydrolytic enzymes) released into bona pellucida. Enzymes digest bona pellucida creating pathway for membrane to ovum - sperm fuse. Spermatids stimulates release of of enzymes stored in cortical granules in the ovum , which in turn, inactivate ZP3 receptors and Harden like bona pellucida leading to the block to polyspermy.

32
Q

You are an eager third-year medical student watching the delivery of a term infant who is delivered vaginally to a gravida 1 para 1 mother. His Apgar score at 1 minute is 9 and at 5 minutes is 10. There are no complications during delivery. Postnatally, it is discovered that the ductus arteriosus has remained patent.
What is the mechanism behind the normal closure of this structure?

A

Decreased prostaglandin concentration

33
Q

what vessels shunts oxygenated blood away from major organs like the liver in fatal circulation

A

ductus venous

34
Q 
after birth what do all the vessels form 
ductus arteriosus 
foramen ovale 
ductus venous 
umbilical vein 
umbilical arteires
A 
ligamentum arteriosum 
fossa ovalis 
ligamentum venosum 
ligamentum teres 
medial umbilical ligaments
35
Q

what non-selective COX inhibitors is used to close patent arteriosus in neonates and premature infants

A

indomethacin

36
Q

why must you not give NSAIDs to pregnant women

A

because it stops PGE2 as it maintains shunts

ductus arteriosus closes with first breath

37
Q

why can’t you use a COX inhibitor such as an NSAID to pregnant women

A

inhibits the production of prostaglandins

38
Q

You’re a medical student on placement with the GP in early December and a patient comes in who has noticed that she has gained quite an intense tan even though she hasn’t had a sunbed in months or been abroad. The GP examines her legs and this is what she sees:
What can this be a sign of?

A

Addison’s

39
Q

Cushing syndrome is high cortisol what can they present as

A

Weight gain
Purple striae
Hirsutism - growth of male like hair
lemon on a stick

40
Q

Addison’s ( adrenal insufficiency) presents as what

A

Fatigue
Weight loss
Hyperpigmentation

41
Q

primary hyperaldosteronism ( conns) presents as what

A

Treatment resistant hypertension

42
Q

You’re a 2nd year medical student who is at a GP placement and a lady in her mid-forties explains that she has been feeling very tired all the time, has gained weight and has noticed that her skin is very dry.
What could be the pathology here?

A

Hashimoto thyroiditis

43
Q

level of the thyroid gland

A

C5-T1

44
Q

follicular cels release what

A

T3,4

45
Q

hypothyroidism symptoms

A

lethargy/fatigue, weight gain, cold intolerance, bradycardia, slow reflexes + speech, dry skin/thinning hair, myxoedema

LOW T3
LOW T4
HIGH TSH

46
Q

hyperthyoridism - graves

A

Weight loss, heat intolerance, tremor, tachycardia, muscle weakness, diarrhoea, goitre, eye signs (exophthalmos)

HIGH T3
HIGH T4
LOW TSH

47
Q

You’re on placement in A+E and are shadowing a Junior Dr. All is calm and serene until a major haemorrhage call is made suddenly. You rush to the scene with the doctor to find a patient bleeding out and in need of some blood. The patient is blood type B, however the hospital have none at hand.

What does the team do?

A

Gives the patient O negative blood for the time being

48
Q

what hormone does this

Smooth muscle relaxation- prevents fetal expulsion- inhibits oxytocin
Cervical plug formation- microbial barrier
Respiratory centre- hyperventilation
Renin-angiotensin- Na+ reabsorption
Inhibits action of prolactin - stops milk production
Lobular tissue development

A

progesterone

Progesterone increases sensitivity to co2- central chemoreceptros cause hyperventilation to decrease co2

Progesterone causes aldosterone to increase as otherwise sodium loss would be too high- causes sodium ion and water reabsorption- fluid into interstitium- swollen ankles

49
Q

what hormones does this

Myometrial cell growth - for growing fetus
Oxytocin receptor insertion- prepares for labour
PGE2 production stimulated- softens cervix
Breast duct development
Inhibits action of prolactin - stops milk production

A

oestrogen

50
Q

what hormone does this

Nipple stimulation- enhances further prolactin release
Breast tissue development during pregnancy
Suppresses ovulation
Post delivery milk production

A

prolactin

51
Q

what hormone

Uterine contractions during labour
Post delivery milk ejection

A

oxytocin

52
Q

what is turners syndrome

A

X in females

Web necking, widely spaced nipples, short stature, early loss of ovarian function

53
Q

what is klinefelters syndrome

A

XXY in males

Infertile, small testicles

54
Q

what is pre eclampsia

A

Placental vessels fail to develop normally —> placental perfusion inadequate —> interpreted as shock from blood loss —> vasoconstricting substances released —> hypertension and proteinuria!!!

Endocrine and Reproductive system (21 decks)

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