Endocrinology and Reproduction

Question 1

what ligament would a surgeon have to open to access the ovaries and Fallopian tubes

Answer 1

broad ligament

Question 2

suspensory ligament of the ovaries

Answer 2

connects ovaries to the lateral pelvic wall

Question 3

ovarian ligament

Answer 3

connects ovaries to the uterus

Question 4

central perineal tendon

Answer 4

provides the main structural support to the uterus -damage Is commonly associated with the development of pelvic organ prolapse

Question 5

epididymis

Answer 5

functions to concentrate sperm that is produced in the seminiferous tubules by removing testicular fluids
the epididymis also serves as the location where sperm mature and develop a capacity to swim

Question 6

seminal vesicle

Answer 6

adds nutrients which provide the energy needed for the sperm to swim
it also secretes prostaglandins, which trigger uterine contractions that help move the sperm towards the egg

Question 7

prostate gland

Answer 7

secreted alkaline fluids which help to neutralise the vaginal acids
a localised pH change from 4 to 6 functions to assist sperm motility

Question 8

nerve supply of the breast

Answer 8

branches of intercostal nerves from T4-T6

Question 9

arterial supply of the breast

Answer 9

internal mammary(thoracic) artery 
external mammary artery 
anterior intercostal arteira 
thoraco-acromial artery

Question 10

venous drainage of breast

Answer 10

superficial venous plexus to subclavian, axillary and intercostal veins

Question 11

lymph supply of breast

Answer 11

70% axillary nodes

Question 12

lactation of the breast

Answer 12

two hormones in stimulating lactation are :
prolactin-causes milk secretion
oxytocin-causes contraction of the myoepithelial cells surrounding the mammary alveoli

Question 13

spermatogenesis

Answer 13

process of germ cell->mature sperm

Question 14

spermatocytogenesis

Answer 14

germ cell->spermatids

cell division by mitosis and meiosis

Question 15

spermiogenesis

Answer 15

spermiogenesis-germ cell->mature sperm -gogli phase,acrosomal phase, tail phase ,maturation phase
mature spermatozoa are released from the protective Sertoli cells into lumen of seminiferous tubules -mature but not motile

Question 16

spermiation

Answer 16

transported to the epididymis and spend some time there and then travel in vas deferens-become motile

Question 17

capacitation

Answer 17

makes them fertile-low levels of FPP and heparin remove glycoprotein coat over acrosome and make it FERTILE

Question 18

what produces oxytocin and ADH hormones

Answer 18

posterior pituitary

Question 19

what hormones does the anterior pituitary produce

Answer 19

HG,ACTH,TSH,LH+FSH,prolactin

Question 20

what hormones does the hypothalamus release

Answer 20

GnRH, CRH, TRH

Question 21

anterior pituitary

Answer 21

somatotropin release HG
corticotropes release ACTH
thyrotropes release TSH
Gonadotropes release LH+FSH

Question 22

what is responsible for ovulation

Answer 22

Luteinising hormone LH surge

Question 23

inhibin

Answer 23

selectively inhibits FSH secretion by acting on the anterior pituitary

Question 24

follicular phase day 1-14

Answer 24

day 1-oestrogen and progesterone are low causing the endometrium to breakdown and shed
pulsatile release of GnRH causes slightly increased levels of FSH which stimulates the development of several follicles in the ovaries.
oestrogen inhibits maturation of the other follicles and thickens the endometrium and thins cervical mucus
FSH levels fall slightly due to the negative feedback of oestrogen and inhibin produced by the developing follicle
stimulates LH spike

Question 25

Ovulatory Phase 16-32 hours

Answer 25

spike in LH causes ovulation and stimulates the development of the corpus luteum which then produces progesterone
Oestrogen levels decline immediately prior to LH spike
Progesterone levels rise and have negative feedback on hypothalamus

Question 26

Luteal Phase (13-14 days)

Answer 26

FSH and LH levels fail due to negative feedback
Corpus luteum continues to produce progesterone and this thickens endometrium further to prepare for implantations
Progesterone also thickens cervical mucus to prevent further sperm from entering the uterus

Question 27

the sperm penetrates the corona radiata via membrane-bound enzymes in the plasma membrane of the head of the sperm. What receptors do they bind to on the zona pellucid

Answer 27

ZP3 (zona-pellucida sperm binding protein 3) receptors

Question 28

fertilisation

Answer 28

1-the fertilising sperm penetrates the corona radiata via membrane-bound enzymes in the plasma membrane of its head and binds to ZP3 receptors on the zona pellucida
2-binding of the sperm to these receptors triggers the acromosome reaction, in which hydrolytic enzymes in the acrosome are released on the zona pellucida
3-the acrosomal enzymes digest the zona pellucida,creating a pathway to the plasma membrane of the ovum.when the sperm reaches the ovum ,the plasma membrane of the two cells fuse
4-the sperm head with its DNA enters the ovum cytoplasm
5-the sperm stimulates release of enzymes stored in cortical granules in the ovum ,which in turn , inactivates ZP3 receptors and hardens the zona pellucida leadingsg to the block polyspemy

Question 29

cushing’s

Answer 29

high cortisol

• due to iatrogenic causes:long term steroid use
• due to disease:pituitary adenoma
• weight gain
• purple striae
• hirsutism

Question 30

Addison’s (adrenal insufficiency )

Answer 30

mainly autoimmune 
destruction of adrenal gland 
fatigue 
weight loss
hyperpigmentation

Question 31

Primary hyperaldosteronism

Answer 31

conn’s
adrenal tumour/bilateral adrenal hyperplasia
treatment resistant
hypertension

Question 32

thyroid facts

Answer 32

follicular cells release T3and T4
C5-T1
lies behind the sternohyoid and the sternothyroid
divided into two lobes by the isthmus

Question 33

hypothyroidism

Answer 33

hashimotos
weight gain , bradycardia, dry skin , cold intolerance
low T3, low T4
high TSH

Question 34

graves disease -hyperthyroidism

Answer 34

weight loss, heat intolerance, tremor , tachycardia ,muscle weakness , goitre, eye signs
high T3 high T4
low TSH

Question 35

what is the universal blood group

Answer 35

o negative

Question 36

haemolytic disease of the newborn

Answer 36

the creation of anti-Rh antibodies in subsequent pregnancies where the baby is rhesus positive,there is risk of Rh+ agglutination and haemolysis of metal blood
-treatment is anti-D immunoglobulins

Question 37

progesterone

Answer 37

smooth muscle relaxation-prevents fatal 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

Question 38

oestrogen

Answer 38

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

Question 39

prolactin

Answer 39

nipple stimulation-enhances further prolactin release
breast tissue development during pregnancy
suppresses ovulation
post delivery milk production

Question 40

oxytocin

Answer 40

uterine contractions during labour

post delivery milk ejection

Question 41

Turner syndrome

Answer 41

X in females

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

Question 42

Klinefelter’s syndrome

Answer 42

XXY in males

infertile, small testicles

Question 43

pre-eclampsia

Answer 43

placental vessels fail to develop normally->placental perfusion inadequate->interpreted as shock from blood loss->vasoconstriction substances released->hypertension and pro