Repro

Question 1

Causes of abnormal uterine bleeding?

Answer 1

Polyps
Adenomyosis
Leiomyoma (fibroids)
Malignancy and hyperplasia

Coagulopathy
Ovulatory dysfunction
Endometrial
Iatrogenic
Not yet classfied (eg DUB)

Question 2

What gland supplies the majority of semen?

Answer 2

seminal vesicles

Question 3

Where does final sperm maturation occur?

Answer 3

Epididymis

Question 4

Origin of arterial supply to testes?

Answer 4

Abdominal aorta, inferior to SMA and superior to IMA

Question 5

List the coverings of the spermatic cord from superficial to deep

Answer 5

External oblique
Internal oblique
Transversus abdominus
Transversalis fascia

Question 6

Where do the VD and seminal vesicles both drain?

Answer 6

Internal and external iliac nodes

Question 7

Where would you find first mets of testicular cancer?

Answer 7

Para aortic nodes

Question 8

Other name for bulbourethral gland?

Answer 8

Cowper’s

Question 9

Origin for arterial supply to ovaries?

Answer 9

AA, inferior to SMA and superior to IMA

Question 10

Where do lymphatics of the body of the uterus drain?

Answer 10

Internal iliac

Question 11

Lymph node drainage of ovaries?

Answer 11

Para-aortic (same as testes)

Question 12

Lymph node drainage of lower 3rd of vagina?

Answer 12

Superficial inguinal

Question 13

Which structure is the lateral fornix of the vagina most closely related to?

Answer 13

Ureter

Question 14

Which ligament is a remnant of the gubernaculum?

Answer 14

Round ligament

Question 15

Which ligament transmits blood vessels to the ovary?

Answer 15

Suspensory ligament of the ovary

Question 16

Normal position of uterus?

Answer 16

Anteverted and anteflexed

Question 17

What does the gubernaculum connect the developing testes to?

Answer 17

The scrotum

Question 18

Pt presents with primary amenorrhea, external female genitalia and XY karyotype- diagnosis?

Answer 18

AIS- testes develop so biologically male but androgen receptors not working so look phenotypically female

Question 19

What tissue do the gonads develop from?

Answer 19

Intermediate mesoderm in the abdomen

Question 20

Which structure does the VD develop from?

Answer 20

Mesonephric duct

Question 21

Which structure does the uterus develop from?

Answer 21

Paramesonephric duct

Question 22

What are the only haploid cells?

Answer 22

gametes

Question 23

How do germ cells appear?

Answer 23

Separate group of cells three weeks after conception

Question 24

Which 2 muscles are part of the superficial perineal muscle group?

Answer 24

Bulbospongiosus and ischiocavernosus

Question 25

Symptom of middle compartment prolapse?

Answer 25

Sensation of something 'coming down' | - uterine prolapse

Question 26

Symptoms of posterior compartment prolapse?

Answer 26

Faecal incontinence / constipation - rectocoele

Question 27

Symptoms of anterior compartment prolapse?

Answer 27

Incomplete bladder emptying and urinary frequency - cystocoele/urethrocoele

Question 28

What does oestrogen promote to aid movement of the oocyte?

Answer 28

Uterine tube secretions, motility and ciliary function

Question 29

Normal duration of the menstrual cycle?

Answer 29

21-35 days 14 day luteal phase 7-21 day follicular phase

Question 30

Pt is a 15 year old boy who is not as 'well developed' as his friends w/ low levels of GnRH and normal levels of LH and FSH - likely diagnosis?

Answer 30

Constitutional delay due to hypogonadotrophic hypogonadism - normal puberty should eventually start (hypothalamus / ant.pituitary pathology can also cause this picture but much rarer)

Question 31

Pt is a 15 year old boy who is not as 'well developed' as his friends w/ high levels of GnRH and high levels of LH and FSH - likely diagnosis?

Answer 31

gonadal defect - gonad is not responding by producing testosterone so no negative feedback

Question 32

Age for earliest sign of puberty in boys?

Answer 32

14

Question 33

Age for earliest sign of puberty in girls?

Answer 33

13

Question 34

What surpresses FSH in the mid follicular phase?

Answer 34

Rising inhibin levels

Question 35

Name for irregular periods?

Answer 35

Metrorrhagia

Question 36

Expected hormone and pH findings in menopausal women?

Answer 36

Decreased oestradiol (less follicles), elevated FSH (trying to stimulate follicles) , vaginal pH maintained below 4.5

Question 37

Most likely infective organism for vaginitis and thin grey fishy discharge?

Answer 37

Gardnerella vaginalis

Question 38

Normal vagina pH?

Answer 38

3.5-4.5

Question 39

Which organism can cause conjunctivitis in newborns?

Answer 39

Chlamydia trachomatis

Question 40

Most common causes of PID?

Answer 40

Gonorrhoea and chlamydia

Question 41

Mechanism of progesterone implant?

Answer 41

Prevents ovulation

Question 42

Mechanism of progesterone only pill?

Answer 42

Thickening cervical mucus

Question 43

Commonest cause of female infertility AND irregular unpredictable upper GI bleeding ?

Answer 43

Anovulation

Question 44

Cause of primary (never been able to ovulate) and secondary (stopped being able to) anovulation?

Answer 44

primary- dysgenetic gonads, hypothyroidism | secondary- PCOS, pregnancy, stress

Question 45

Infertility and hx of PID- what investigation do you do?

Answer 45

Hysterosalpingogram to look for tubal patency

Question 46

Name for when a fertilised ovum invades the myometrium?

Answer 46

Placenta accreta

Question 47

Cause of heart rate accelerations in utero?

Answer 47

fetal movement

Question 48

Normal foetal pO2?

Answer 48

4kPa

Question 49

``` Most common fundal height at : A. 12 weeks B. 16 weeks C. 20 weeks D. 36 weeks ```

Answer 49

A. pubic symphysis B. midway between pubis and umbilicus C. umbilicus D. xiphisternum

Question 50

PPH with hx of pre-eclampsia, low Hb, platelets and fibrinogen and raised D-Dimer- diagnosis?

Answer 50

DIC

Question 51

What is responsible for a - milk ejection and b - milk secretion?

Answer 51

a- oxytocin b - prolactin

Question 52

Risk factors for endometrial cancer?

Answer 52

Hx of PCOS and increased years of menstruation - more shedding

Question 53

Most significant risk factor for development of germ cell tumours?

Answer 53

Cryptorchidism (undescended testes)