Repro 2 Flashcards
1
Q
Give histology of cortex of ovary
A
primordial follicles contained
2
Q
what is a primordial follicle
A
oocyte surrounded by single layer of squamous granulosa cells
3
Q
state the changes that occur to oocyte from pprimordial follicle to tertiary follicle
A
pimary follicle - ZP forms. Granulosa becomes cuboid
2 follicle - stroma like theca cells recruitied, become theca exerna + interna. Increased number of granulosa cell and antrum forms between granulosa
3 follicle - theca interna expresses LH receptors and produces oestrogen. Granulosa cells become corona radiata and cumulus oophorus.
4
Q
what is the cumulus oophorus
A
bridge of cells between granulosa cells and oocyte
5
Q
what is layers of cells surrounding oocyte med to lat
A
oocyte surrounded by ZP surrounded by corona radiata surrounding cumulus oophorus
6
Q
what happens to follicle after ovulation
A
GC become granulosa lutein cells, secrete prog
theca interna becomes theca lutein, secrete oest
7
Q
what is corpus albicans
A
fibrosed corpus luteum after death
8
Q
what are layers of uterus
A
endometrium - stratum functionalis (coiled arteries) and stratum basalis (straight arteries)
myometrium - 4 smooth musc layers
9
Q
what are the stages of endomterial growth and what happens in each
A
proliferative - SF grows, glands coil
secretory - max thickness. Predecidual cells develop
menses - if no implantation > decreased prog > shedding
10
Q
what type of cells are found in the endocervical canal and in vagina. what is transformation zone
A
canal - columnar
vag - strat squamous
transformation zone - columnar becomes strat squamous
11
Q
what is the histology of vag
A
stratified squamous. No glands. mucosa, SM, muscular (smooth and skeletal)
lots of glycoproteins esp with oestrogen
12
Q
give duct anatomy inside breast. what surrounds ducts
A
nip > lactiferous duct > major duct > minor duct > lobules
surrounded by adipose and stroma
13
Q
how many lobules per breast
A
15-20
14
Q
how does breasts change during puberty
A
lactiferous ducts develop and adipose deposited
15
Q
what is outer layer of testes and ovary called
A
tunica albuginea
16
Q
histology of testes
A
SF tubules contain sertoli cells (spermatogenesis). surrounding tubules is leydig cells (testost) and CT.
17
Q
what connects SF tubule to rete testis
A
straight tubule
18
Q
what epithelia is straight ST tubule and rete testis
A
both simple cuboidal
19
Q
what connects rete testis to epididymis
A
efferent duct
20
Q
epithelia of vas deferens
A
pseudostratified
21
Q
histology of seminal vesicles
A
coiled glands and pseudostratified
22
Q
what is primary sexual characteristic
A
develops before birth
23
Q
what is order of development during female puberty
A
thelarche, adrenarche, growth, menarche, pubes, breasts
TAG
24
Q
order of development during male puberty
A
GAS
gonad development, adrenarche, spermatogenesis, growth, genitalia, pubes
25
what causes puberty
GnRH from hypo
| 47kg weight in females
26
what causes pubic hair, libido, male genitalia, and breasts to develop
pubic hair and libido - androgens
male genitalia - test
breasts - oestrogen
27
what occurs in premenopause
decrease fertility, early/absent ovulation, decrease oestrogen and inhibin therefore increase LH and FSH (more FSH)
28
what happens in menopause
skin and bladder changes, hot flushes, osteoporosis, breast involution, loss vaginal rugae
29
how treat menopause and negative effects of treatment
HRT
| -ves - DVT, breast cancer, stroke, PE, depression
30
define primary amenorrhoea
absence of menarche by 14 without SSC or 16 with SSC
31
define secondary amenorrhoea
no menses for 3 months if regular cycle or 9 months if irregular
32
primary amenorrhoea (PA) outflow tract causes
imperforate hymen, vaginal atresia
33
SA outflow tract causes
trauma, intrauterine adhesions
34
PA gonad causes
androgen insensitivity, gonad dysgenesis (e.g. turners)
35
SA gonad causes
menopause, pregnancy, PCOS
36
hypo/pit causes of PA
kallman syndrome
37
hypo/pit causes of SA
stress, sheehan syndrome (necrosis of pit due to excessive blood loss during childbirth), anorexia
38
define menorrhagia, causes and treat
>80 ml bleeding or >7 days of menses
causes - PID, cancer, anovulation
treat - USS, hormones
39
define DUB, causes, pathology, treatment
heavy frequrent or prolonged bleeding with no obvious cause. anovulatory. NOT RELATED TO MENSES
cause - PCOS, extremes of life
pathology - No prog. Endometrium builds up continually and self sheds with erratic bleeding
manage - (prog) OCP, tamoxifen (block oest), iron
40
define dysmenorrhoea, oligomenorrhoea, premenstrual syndrome, mastalgia
mastalgia - boob pain
dysmenorrhoea - painful periods
oligomenorrhoea - >35 day cycle
premenstrual syndrome - physical and emotional symptoms 1-2 weeks before menses
41
give hormones secreted by ant pit and the type of hormone and cell that secretes
glycopeptide:
gonadotrophs - FSH and LH
thyrotrophs - TSH
polypeptide:
somatotrophs - GH
lactotrophs - prolactin
corticotrophs - ACTH
42
horomones secreted by post pit
oxytocin, adh
43
what does ovaries secrete horomones
oest, prog, test, inhibin
44
how does hypothalamus secrete GnRH and where does it go. what inhibits
pulsatile (once per hour) into hypophyseal portal circulation
inhibited by oest and inhibin
45
how does fsh and lh act on males and females
males:
fsh acts on sertoli - spermatogenesis and inhibin
lh acts on leydig - testosterone
females :
fsh acts on granulosa cells
lh acts on theca interna
46
during menstrual cycle explain following hormones - oest, prog, fsh, lh
oestrogen - rises slowly then peaks just before lh surge. rises again with CL and then regresses post death
prog - low then rises with CL and peaks
FSH - rise in first few days then down, then peak with LH surge and down after
LH - peaks at ovulation (day 14)
47
effects of estrogen on female repro
thickens endometrium, thin alkaline mucus at cervix, vaginal changes (thicker, elastic, glycogen)
48
prog effects on female repro
thick acid mucus at cervix, secretory phase of endometrium, breast tissue changes
49
where does PGC originate and go
PGC start in yolk sac > dorsal mesentery > gonads
50
what happens to mesonephric and paramesonephric duct in males? what is meso and PMN aka?
meso - wolffian
PMN - mullerian
mesonephric duct stays due to SRY genes on Y chromosome. PMN goes due to mullerian inhibited hormone. meso duct becomes SEED - seminal vesicles, epididymis, ejaculatory duct, ductus deferens
51
what happens to mesonephric and paramesonephric duct in females?
PMN fuses and forms uterus and vag.
52
describe what happens to indifferent genitalia to become male / female
influenced by testosterone
genital tubercle - clit / glans
genital fold - labia minora / spongy urethra + scrotal raphe
genital swelling - labia majora / scrotum
53
describe descent of testes and ovaries
gubernaculum pulls testes through inguinal canal. pulls ovaries to pelvi
54
what is hypospadias
incomplete fusion of urethral folds
55
difference uterus didelphys and bicornuate uterus
didelphys - 2 uteri horns and 2 cervixes
| bicornuate - 2 uteri horns only
56
what is spermatogenic wave and cycle
cycle - development time from spermatogona to sperm
wave - distance between 2 areas in same part of cycle
57
describe spermatogenesis
spermatogonia > spermatocyte > spermatid > sperm
58
how are ovum produced
PGC enter ovarian cortex. meiosis halted at primary oocytes then continue to primordial follicles in puberty
59
define spontaneous abortion, preterm labour, and term labour
spont abortion -
60
what are 3 stages of labour
birth canal widening > fetal expulsion > plactena expulsion
61
what is fetal lie and presentation
lie - transvers or longitudinal (usually long)
| presentation - cephalic (head) or breach (feet)
62
what happens in cervical ripening? triggered by...
trig by prostaglandins
| decrease collagen and aggregation. increase GAGs
63
what happens to female repro organs during labour. what hormone released
cervical ripening. brachystasis (myometrium contracts more than relaxes). cervical thinning and flattening. oxytocin release
64
what are early and late cotnractions during pregnancy like
early - not felt, every 30 mins
| late - braxton hicks. less freq but increase amplitude
65
how are myometrial contractions made more forceful
prostaglandins and oxytocin (ferguson reflex, +ve feedback)
66
describe baby expulsion
starts longitudinally + cephalic > uterus contracts and head flexes and rotates > vag and perineum stretch due to head (risk tear) > head delivers > shoulders rotate and deliver > rest follows
67
how does uterus prevent post partum hemorrhage. what can be given to help
uterus clamps down. oxytocin given.
68
how does adult circulation take place in fetus
fetus takes first breath due to trauma and cold > decreased pulmonary resistances and increase arterial pO2 > FO and DA closing
69
what does relaxin do
relaxes pelvic ligaments for delivery
70
what are 4 types of hips and briefly describe
gynecoid - wide
anthropoid - narrow transverse, wide AP
android - narrow
platypeloid - narrow AP. wide pelvic outlet
71
what are the head and breach presentation types
head - vertex, sinciput, brow, face
| breach - front (feet by head), full (cross legs), single footing
72
what instruments can be used to aid deliveruy
forceps, ventouse (vacuum)
73
what happens to breasts during pregnancy
lobule and ducts hypertrophy and differentiate to produce milk
74
give properties of milk soon after birth and what its called
colostrum - high IgG and protein, some water fat and sugars
75
give properties of milk 2 weeks after birth
90% water, rest sugar, fas, protein (lactalbumin and lactoglobin), vit and minerals
76
how is milk produced
suckling (neuroendocrine reflex). let down reflex (oxytocin). promoted by decreased prog and oest post birth
77
benefits of breast feedin
bonding and babies reduce risk of infection
78
what happens to breasts with age
breast stroma replaced with adipose
79
physical properties of bresat carcinoma
hard, craggy and fixed breast lump
80
what breast pathology would suggest endocrine disorder
milk discharge from nip
81
what are the types of benign and malignant breast tumours and briefly explain properties
benign:
| fibroadenoma - small and mobile. stroma tumour.
82
give 2 breast development disorders
milk line remnants - extra nips
| accessory axillary breast tissue
83
symptoms, cause and treatment of acute mastitis of breast
staph aureus. red skin, pain, fever. antibiotics and let milk down
84
what is duct ectasia
blocked lactiferous duct. green discharge
85
what is atypical ductal hyperplasia
hyperplasia of 1-2 ducts. increase carcinoma risk
86
what is symptoms of breast papiloma
ductal papilloma. increases risk of carcinma. poss nip discharge +/- blood
87
give causes of gyno
liver cirrhosis, spironolactone, klinefelters, obesity
88
breast cancer risk factors
age, breast feeding (decrease risk), HRT, obesity, COCP, genetics
89
what types of breast carcinoma are there
in situ/invasive and ductal/lobar
90
symptoms of pagets disease of breast
eczematous nip. malignant
91
why peau d'orange
loss of lymph drainage due to malignancy
92
how diagnose BC
mammography, USS, FNAC, biopsy, history and exam
93
when is tamoxifen and Herceptin used
tamoxifen - if breast cancer is oestrogen receptor +ve
| herceptin - Her 2 +ve BC
94
what tumours metastasise to bone?
PB-KTL (lead kettle)
| prostate, breast, kidney, thyroid, lung
95
what tumours metastasise to liver
Cancer Sometimes Penetrates Benign Liver
| Colon > stomach > pancreas > breast > lung
96
what tumours metastasie to brain
cancer - Some Love Killing Brain Glia
| skin, lungs, kidney, breast, GI
97
what tumours metastise to lungs
Real Hardcore Cancers Fill Both My lungs
| RCC, hepatocellular carcinoma, choriocarcinoma, follicular thyroid carcinoma, breast, melanoma
98
cause of cervical cancer and risk factors
caused by HPV 16 and 18
| RF - smoking, OCP, immunosuppression
99
when does cervical screening occur
25+ yrs every 3 yrs and then every 5 50+
100
What is CIN and how treat. is it malignant
cervical intraepithelial neoplasia
treat CIN 1 - cryotherapy
3 - excision
CIN is premalignant
101
where does cervical carcninoma spread
locally - rectum, vag, bladder
102
how treat cervical carcinoma
microinvasive - excision
| if malignant - hysterectomy, lymph dissection, radio and chemo
103
what happens in endometrial hyperplasia
increased gland:stroma ratio, increased risk of cancer.
104
what is symptom of endometrial adenocarcinoma. what 2 types
post menopausal bleeding
endometrioid - invades myometrium
serous - aggressive, spreads to peritoneum
105
name a myometrial tumour and symptoms
leiomyoma - benign and leads to fibroids.
| heavy menses or dysmenorrhoea, infertility and urine freq
106
symptoms of ovarian cancer
hormonal problems. abdo pain. distention of abdo. urinary and GI symptoms.
late presentation
107
what are the 3 types of ovarian epithelial tumours and whether malignant
serous -
mucinous - mostly benign
endometrial - mostly malignant
108
what are the 4 types of ovarian cancer
surface epithelial stroma, sex cord stromal, germ cell tumour, mixed
109
features of germ cell tumours
mostly benign
| teratomas
110
features of ovarian sex cord stroma tumours
masculinising or feminising
| in children can cause or delay puberty
111
vulval tumours can be caused by
SCC, BCC, malignant melanoma, extramammary pagets
