Repro Flashcards Preview

Step 1 Flash Cards > Repro > Flashcards

Flashcards in Repro Deck (69):
1

Shh

produced at base of limbs, involved an AP axis
- CNS development, defect --> holoprosencephaly

2

Wnt-7 gene

important at distal end of developing limb
- necessary for dorsal-ventral axis

3

FGF gene

- stimualtes mitosis of underlying mesoderm
- lengthening of limbs

4

Hox genes

- they code for transcription regulators that are important in cranial-caudal organization

5

neural tube closes

week 4

6

mesodermal defects - VACTERL

-vertebral, anal atresia, cardiac defects, T-E fistulas, renal defects, limb defects

7

teratogenicity of ACEi

renal damage

8

teratogenicity of aminoglycosides

CN VIII tox

9

teratogenicity of carbamezapine

NT defects, craniofacial defects, fingernail hypoplasia, DD, IUGR

10

teratogenicity of Lithium

Ebstein anomaly

11

teratogenicity of phenytoin

fetal hydantoin syndrome: microcephaly, dysmorphic craniofacial features, hypoplastic nails and distal phalanges, cardiac defects, IUGR, intellectual disability

12

teratogenicity of tetracyclines

discolored teeth

13

thalidomide

causes limb defects

14

valproate teratogenicity

neural tube defects

15

maternal diabetes effect on infant

caudal regression syndrome (anal atresia to sirenomelia), congenital heart defects, neural tube defects

16

1st aortic arch derivative

maxillary artery

17

2nd aortic arch derivative

stapedial artery and hyoid artery

18

3rd aortic arch derivative

common carotid and proximal ext carotid
C = 3rd letter of alphabet

19

4th aortic arch derivative

L- aortic arch, R - subclavian artery

20

6th aortic arch derivative

pulmonary arteries and ductus arteriosus

21

branchial apparatus derivatives

CAP
- cleft - ectoderm
- arch - mesoderm
- pouch - endoderm

22

branchial cleft derivatives

- the 1st becomes the external auditory meatus, and the rest obliterate
- can get a brachial cleft cyst within the lateral neck if they do not obliterate

23

1st branchial arch derivatives

- Meckel's cartilage: Mandible, Malleus, incus, spheno-Mandibular ligament
- Muscles of Mastication, mylohyoid
- V2 and V3 innervation

24

2nd branchial arch derivatives

- Reichert cartilage: Stapes, Styloid process, Stylohyoid ligament
- muscles of facial expression, stapedius, styloid , platySma
- CN VII

25

3rd branchial arch derivatives

- hyoid cartilage
- stylopharyngeus muscle
- glossopharyngeal nerve

26

4th-6th branchial arch derivatives

- thyroid, cricoid, arytenoid cartiledges
- 4th does pharyngeal constrictors, 6th does all intrinsic muscles of larynx except cricothyroid
- 4th innervated by superior laryngeal branch of CNX, 6th by recurrent laryngeal branch

27

1st branchial pouch derivatives

- middle ear cavity, eustachian tube, mastoid air cells

28

2nd branchial pouch derivatives

- epithelial lining of palatine tonsil

29

3rd branchial pouch derivatives

- dorsal --> inteferior parathyroids
- ventral --> thymus

30

4th branchial pouch derivatives

- dorsal --> superior parathyroids

31

male genital embryology

- SRY gene produces testes determining factor --> testes
- sertoli cells secrete Mullerian inhibitory factor (suppresses paramesonephric duct)
- leydig cells secrete androgens to stimulate development of mesonephric ducts

32

sertoli cell deficiency

male and female internal genitalia, male external due to normal DHT

33

5 alpha reductase deficiency

male internal genitalia (because sertoli cells suppress female) but ambiguous external until puberty

34

sertoli cell function

- secrete inhibin (inhibits FSH)
- secretes androgen-binding protein - maintains local levels of testosterone
- tight junctions prevent AI attack of gametes
- regulates spermatogenesis
- secretes MIF in development
- temperature sensitive

35

leydig cell function

secrete testosterone in response to LH

36

theca cell function

converts cholesterol to androstenedione in response to LH

37

granulosa cell function

converts androstenedione to estogens (via aromatase) in response to FSH

38

Tanner Stages

I - prepubertal
II - pubic hair appears, breast buds form
III - pubic hair darkens/becomes curly, penis lengthens, breasts enlarge
IV - penis widens, darker scrotal skin, development of glans, raised areolae
V - adult, flat areolae

39

oogenesis

- arrested in prophase of meiosis I until ovulation
- then arrested in metaphase of meiosis II until fertilization

40

human placental lactogen

secreted by the syncytiotrophoblasts and increases maternal insulin resistance so that blood sugar stays high for baby
- this is the cause of gestational diabetes

41

hCG functions

- maintains the corpus luteum in the first trimester
- hCG is increased in multiple gestations, Downs, and moles/choriocarcinoma

42

Klinefelter Syndrome

- XXY
- testicular atrophy, euchnoid body habitus, tall with long extremities, gynecomastia, female hair distribution
- developmental delay
- decreased inhibin and testosterone leads to increased FSH and LH

43

Turner Syndrome

- dont forget about the cystic hygroma (post neck mass with cystic spaces separated by connective tissue)
- can result from mitotic or meiotic error

44

aromatase deficiency

cannot synthesize estrogens from androgens
- masculinization of female infants, increased testosterone and androstenedione
- can have maternal virilization during pregnancy

45

5a reductase deficiency

- cannot convert test to DHT
- normal male internal sex organs, ambiguous external genitalia until puberty
- test/est normal, LH normal or increased

46

Kallman syndrome

- mutation in Kal-1 gene or fibroblast growth factor receptor-1 gene
- defective migration of GnRH cells
- anosmia, hypogonadism, +/- midline defects, delayed puberty

47

Complete Mole

46 XX or XY, all paternal
- one sperm, empty egg
- significantly increased bHCG, can convert to trophoblastic disease
- vaginal bleeding, enlarged uterus, pre-eclampsia, hyperemesis, hyperthyroidism
- "cluster of grapes" and "snowstorm"

48

Partial Mole

XXY or XXX
- high/normal bHCG, uterus is normal size, there ARE fetal parts
- 2 sperm + 1 egg, low risk of malignancy
- presents with vaginal bleeding and pain

49

HPV 16 and 18 mechanism of causing cancer

E6 gene product inhibits p53
and
E7 gene product inhibits Rb suppressor gene

50

endometritis organism/treatment

bacteroides is most common
- treat with gent + clinda

51

PCOS

- amenorrhea/oligomenorrhea, hirsuitism, acne
- associated with obesity and endometrial cancer
- treat with weight reduction, OCPs, antiandrogens
- give clomiphene citrate for infertility (SERM that blocks negative feedback of circulating estrogen)
- increased LH and FSH, LH:FSH 3:1

52

mature cystic teratoma (dermoid cyst)

- germ cell tumor in women 20-30 years old with all 3 germ layers
- can present with pain 2/2 torsion if they get large
- can contain functional thyroid tissue - struma ovarii
- 10% bilateral

53

Brenner tumor

- looks like bladder (urothelium)
- solid tumor that is pale yellow-tan in color and appears encapsulated
-"coffee bean" nuclei on H+E stain

54

Fibromas

- bundles of spindle-shaped fibroblasts, pulling sensation in groin
- associated wtih Meigs syndrome - ovarian fibroma, ascites and pleural effusion

55

granulosa cell tumor

- produce estrogen and/or progesterone
- present with estrogen excess at various ages
- Call-Exner bodies

56

dysgerminoma

most common in adolescents
- "fried egg" cells, hCG and LDH are tumor markers

57

choriocarcinoma

- rare, malignant trophoblastic tissue with no chorionic villi
- abnormal bHCG, shortness of breath, hemoptysis
- hematogenous spread to the lungs, very responsive to chemotherapy

58

yolk sac/endodermal sinus tumor

- aggressive in the ovaries or testes in young kids
- yellow friable solid mass
- 50% have Schiller Duval bodies that resemble glomeruli
- AFP is tumor marker

59

Krukenberg tumor

- GI malignancy that mets to the ovaries
- causes a mucin-secreting signet cell adenocarcinoma

60

fibroadenoma

- tumor of fibrous tissue and glands
- most common benign neoplasm of the breast, usually premenopausal women
- responds to estrogen
- well-circumscribed mobile, marble like mass
- no increased risk for cancer

61

intraductal papilloma

- papillary growth into a duct that is characterized by fibrovascular projections lined by epithelial and myoepithelial cells
- presents as bloody nipple discharge in a premenopausal woman

62

phyllodes tumor

- fibroadenoma like tumor with overgrowth of fibrous component that leads to "leaf-like" projections
- most common in post menopausal women
- can be malignant in some cases

63

DCIS

- malignant proliferation of cells that doesnt penetrate the basement membrane
- usually presents as calcification on mammo, no mass
- comedocarcinoma is a subtype where cells necrose and calcify (high grade cells with central calcification)
- becomes paget disease when it extends to the nipple (eczematous patches on the nipple with large cells in the epidermis with clear halo)

64

invasive ductal carcinoma

- firm, fibrous, rock-hard mass with sharp margins and small, glandular duct-like cells
- "stellate" infiltration
- worst and most invasive, most common of all breast cancers

65

medullary carcinoma

- subtype of ductal carcinoma that is fleshy, cellular with lymphocytic infiltrate
- good prognosis

66

inflammatory breast cancer

- dermal lymphatic invasion by ductal carcinoma leads to edema and Peau d'orange
- 50% survival at 5 years

67

invasive lobular carcinoma

- orderly row of cells - single file line due to no E-cadherin, doesnt form ducts
- often bilateral with multiple lesions in the same location

68

LCIS

- malignant proliferation of cells in lobules with no invasion of basemente membrane
- usually incidental finding because no calcifications or mass
- cells lack E-cadherin
- often multifocal and bilateral
- treat with tamoxifen

69

acute mastitis

- usually due to staph aureus
- treat with dicloxacillin and keep breast feeding