Repro

Question 1

Which microorganism causes conjunctivitis in newborns?

Answer 1

Chlamyydia Trachomatis

Question 2

What is the primary mechanism of action of the progesterone implant?

Answer 2

Prevention of ovulation (not thickening of mucus)

Question 3

What is the primary mechanism of action of the progesterone only pill?

Answer 3

Thickening of cervical mucus

Question 4

What is a possible cause of secondary anovulation?

Answer 4

Polycystic Ovarian Syndrome (PCOS)

Question 5

What is a possible cause of primary anovulation?

Answer 5

Dysgenetic gonads

Question 6

A woman is having infertility tests. What process is responsible for the production of acellular mucus with low viscosity and high stretchibility?

Answer 6

Oestrogen action on cervical glands

Question 7

What changes are seen in maternal resp rate in pregnancy?

Answer 7

Unchanged

Question 8

What changes are seen in maternal minute ventilation in pregnancy?

Answer 8

Increase by 50%

Question 9

What changes are seen in maternal creatinine clearance in pregnancy?

Answer 9

Increase by 50%

Question 10

What changes are seen overall in maternal blood pressure in pregnancy?

Answer 10

No change (sometimes slight decrease)

Question 11

A woman is seen at 32 weeks gestation. Her BP is 150/80 with evidence of proteinuria ++ on urine dip. What complication to the fetus is most common in this conditon?

Answer 11

Oligohydramnios (low amniotic fluid volume)

Question 12

How soon after fertilisation can human chorionic gonadotropin be detected in maternal urine? (pregnancy test)

Answer 12

14 days

Question 13

Which prenatal diagnostic test has the highest risk of pregnancy loss?

Answer 13

Chorionic Villus Sampling

Question 14

What is the most common fundal height at 36 weeks’ gestation?

Answer 14

Xiphisternum (smallest/lowest part of sternum)

Question 15

What is the most common fundal height at 20 weeks’ gestation?

Answer 15

Umbilicus

Question 16

What is the most common fundal height at 16 weeks’ gestation?

Answer 16

Mid-way between pubis and umbilicus

Question 17

What is the most common fundal height at 12 weeks’ gestation?

Answer 17

Pubic symphisis

Question 18

What supplement do you need to give pregnant women to help development of the fetal nervous system and prevent neural tube defects?

Answer 18

Folic acid

Question 19

A woman has Hb, platelets and fibrinogen are reduced but D-dimer is raised. What is the most common cause for her PPH?

Answer 19

Disseminated Intravascular Coagulation

Question 20

Which hormone is responsible for milk ejection?

Answer 20

Oxytocin

Question 21

Which hormone is responsible for milk secretion?

Answer 21

Prolactin

Question 22

What hormonal change is responsible for the secretion of milk after delivery?

Answer 22

Decreased progesterone and oestrogen

Question 23

What is the most common invasive cancer of the female genital tract?

Answer 23

Endometrial adenocarcinoma

Question 24

What are risk factors for the development of endometrial cancer?

Answer 24

• History of PCOS
• Increased years of menstruation

Question 25

What is the most significant risk factor for the development of germ cell tumours?

Answer 25

Cryptorchidism (undescended testicle)

Question 26

A 62 year old post-menopausal women reports a small lump in her vulva. She reports a 10 year history of vulval itching. What is the most likely diagnosis in this case?

Answer 26

Vulval Cancer

Question 27

Which lymph nodes does the uterus drain into?

Answer 27

Body - External iliac arteries Fundus - para-aortic & superficial inguinal

Question 28

Which lymph nodes does the ovary drain into?

Answer 28

Para-aortic

Question 29

Which lymph nodes does the lower third of the vagina drain into?

Answer 29

Superficial inguinal nodes

Question 30

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

Answer 30

Ureter

Question 31

At which junction is the internal os of the cervix located?

Answer 31

Body & cervix of the uterus

Question 32

What is the external os?

Answer 32

Opening between the cervix and vagina

Question 33

From which tissues do the gonads develop from?

Answer 33

Intermediate mesoderm in the abdomen

Question 34

What part of the developing follicle directly surrounds the developing oocyte?

Answer 34

Granulosa cells

Question 35

What muscles make up the superficial perineal muscles?

Answer 35

Bulbospongiosus Ischiocavernous

Question 36

What muscles make up the levator ani muscles? (deep muscles)

Answer 36

Puborectalis (front - rectum) Pubococcygeus (front - coccyx) Iliococcygeus (ischial spine - coccyx)

Question 37

What is the primary hormone responsible for triggering ovulation?

Answer 37

LH

Question 38

At what age should the first sign of male puberty be seen and what it is?

Answer 38

14 years latest - testicular enlargement

Question 39

At what age should the first sign of female puberty be seen and what it is?

Answer 39

13 years at latest - breast bud development

Question 40

What hormone stimulates endometrial proliferation and at what point of the cycle does that occur?

Answer 40

Oestrogen - proliferative phase

Question 41

What system allows the hypothalamus and anterior pituitary to communicate?

Answer 41

Hypothalamic-hypophyseal portal system

Question 42

What are the FSH, oestradiol and vaginal pH findings for menopausal women?

Answer 42

FSH - High Oestradiol - Decreased Vaginal pH - > 4.5

Question 43

Which investigation is used to asses the uterus and fallopian tubes?

Answer 43

Hysterosalpingogram

Question 44

What is the normal fetal pO2?

Answer 44

4kPa

Question 45

What nerve supplies the levator ani?

Answer 45

Pudendeal nerve

Question 46

How does the perineal body function to maintain pelvic organ support?

Answer 46

Central point for attachment of the perineal muscles

Question 47

Give some risk factors for pelvic organ prolapse?

Answer 47

Vaginal delivery of childbirth Obesity Occupational - heavy lifting Gynae surgery Menopause

Question 48

Why can vaginal delivery cause pelvic floor dysfuction?

Answer 48

Stretching of pudendal nerve Stretch/damage to pelvic floor musculature Injury to perineal body

Question 49

What is the normal sperm count and normal range of volume in ejaculate?

Answer 49

20-200 10^6 per ml 2-4 ml

Question 50

What is the difference between spermatogenesis and spermiogenesis?

Answer 50

Spermatogenesis - Formation of spermatids from spermatogonia in seminiferous tubules Spermiogenesis - Formation of spermatazoa from spermatids in seminiferous tubules

Question 51

Which cells drive the differentiation of the gonad to form the testis and where in the embryo do they come from?

Answer 51

Primordial germ cells from the yolk sac

Question 52

Define CIN and give some risk factors for it

Answer 52

Dysplasia of squamous cells within the cervical epithelium HPV infection Early first pregnancy Multiple births Smoking

Question 53

What is the function of cervical glands and what hormone activates them?

Answer 53

Produces thick, sticky mucus to prevent further sperm or microoaganisms (progesterone)

Question 54

Where is the transformational zone of the cervix found?

Answer 54

External os

Question 55

What is the lymphatic drainage of the cervix?

Answer 55

Superior - Internal iliac nodes Inferior Sacral nodes

Question 56

Which cells secrete HCG?

Answer 56

Syncitiotrophoblasts (2 weeks after implantation)

Question 57

What is the changes to the placenta from 1st to 3rd trimester?

Answer 57

Syncitiotrophoblast - thins Cytotrophoblasts - disappears

Question 58

How can a pregnant woman develop anaemia during the 2nd trimester?

Answer 58

Expansion of plasma volume is greater than the increase in red cell mass (Dilutional/physiological anaemia of pregnancy)

Question 59

What's the lymphatic drainage of the vas defernes and seminal vesicles?

Answer 59

Internal and external iliac nodes

Question 60

What's the lymphatic drainage of the testis?

Answer 60

Para-aortic nodes

Question 61

What's the lymphatic drainage of the testis?

Answer 61

Para-aortic nodes

Question 62

Are germ cells haploid or diploid?

Answer 62

Diploid (have chromosomes from each parent)

Question 63

Is the entire endometrium shed during menstruation?

Answer 63

No

Question 64

A girl with amenorrhea has secondary sexual characteristics and her hormones are all in normal range, what is the cause?

Answer 64

Outflow tract obstruction

Question 65

What's the urogenital hiatus?

Answer 65

An anterior gap which allows passage of the urethra (and Vagina in females)

Question 66

How does the mother allow sufficient Ca to the fetus?

Answer 66

By increasing synthesis of 1,25 vitamin D3

Question 67

What's the most likely place for testicular cancer to metastasis?

Answer 67

Brain Liver Lung

Question 68

Which gene and chromsome is important for gonadal differentiation?

Answer 68

SRY gene on the Y chromosome

Question 69

What's the order of female puberty?

Answer 69

1. Thelarche 2. Adrenarche 3. Menarche

Question 70

FSH and LH - what cells do they act on and what is the function of these cells?

Answer 70

FSH – stimulates granulosa cells which convert androgen to oestrogen LH – stimulates theca interna cells which release androgens. LH surge leads to ovulation.

Question 71

What adaptions does the fetus have for optimal oxygen transport?

Answer 71

Lower PaO2 than mother HbF has greater affinity for O2 Double Bohr effect Increased maternal production of 2,3DPG (less maternal affinity for o2)

Question 72

What swabs can you use for a patient presenting with vaginal discharge?

Answer 72

Vulvo-vaginal - chlamydia & gonnorhoea (asymptomatic) High vaginal (posterior fornix) - CD, BV Endocervical - chlamydia & gonnorhoea (symptomatic)

Question 73

Risk factors for candiadisis?

Answer 73

Oestrogen medication (^yeast growth) Diabetes/HIV (immunosupressed) Antibitoic usage

Question 74

Anti fungal treatments (candidiasis)?

Answer 74

Nystatin Fluconazole

Question 75

What causes syphilis and give some features of the microorganism?

Answer 75

Treponema Pallidum (Spiral - not a normal commensal of body)

Question 76

What is the difference between syphillus and herpes?

Answer 76

Syphillus - painless ulcer (HIV associated) Herpes (HSV 2) - painful ulcer

Question 77

What is Prehn's sign and what does it show?

Answer 77

Pain relieved when the testis is elevated (+ve = Epididymo-orchitis)

Question 78

How would you know a patient has trichomoniasis (trichomonas vaginalis)? What's the treatment?

Answer 78

Mobile protozoa Yellow, offensive discharge Increased vaginal pH METRONIDAZOLE

Question 79

What test to diagnose a STI in men and why?

Answer 79

First catch urine (urethra has sexual and urinal properties in men)

Question 80

What's a non-STI cause of PID?

Answer 80

Bacterial Vaginosis (Gardinella vaginalis)

Question 81

Why can PID increase risk of ectopic pregnancy?

Answer 81

Salpingitis (fallopian tube inflammation) causes adhesions blocking the fallopian tube so implantation occurs in ampulla

Question 82

Why can PID cause secondary peritonitis?

Answer 82

Fallopian tube is open to peritoneum at fimbrae

Question 83

What are some complication of PID?

Answer 83

Peritonitis Fitz-Hugh Curtis syndrome (peri-hepatitis) Ectopic pregnancy Subfertility

Question 84

What hormone change is responsible for the suppression of FSH release?

Answer 84

Rise in Inhibin levels