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Flashcards in Repro Deck (104):
1

Gene produced at base of limbs (In ZPA) that is important for patterning along anterior posterior axis

Sonic hedgehog gene

2

Gene produced at apical ectodermal ridge necessary for proper organization along dorsal-ventral axis

Wnt-7 gene

3

Gene produced at apical ectodermal ridge that stimulates mitosis of underlying mesoderm and provides lengthening of limbs

FGF gene

4

Gene involved in organization of embryo in craniocaudal direction

Homeobox (HOX) genes

5

Mutation that results in appendages in wrong locations

Hox gene mutations

6

When does hCG secretion begin?

1 week after fertilization; around the time of implantation of blastocyst which is day 6

7

a. When is the embryo 2 layers?
b. When is the embryo 3 layers?

a. Within week 2 of development
b. Within week 3 (primitive streak, notochord, mesoderm neural plate begin to form)

8

When does neural tube close?

By week 4

9

What happens during week 4 of embryogenesis?

Heart begins to beat
Upper and lower limb buds begin to form

10

When is fetal cardiac activity visible by transvaginal ultrasound?

By week 6

11

When do genitalia have male or female characteristics during fetal development?

By week 10

12

Surface ectoderm derivatives

Epidermis
Adenohypophysis
Lens of eye
Epithelial linings of oral cavity
Sensory organs of ear
Olfactory epithelium
Anal canal below the pectinate line
Parotid, sweat, mammary glands

13

Extrinsic disruption; occurs after embryonic period

Deformation

14

Secondary breakdown of previously normal tissue or structure. Example?

Disruption; amniotic band syndrome

15

Intrinsic disruption; occurs during embryonic period

Malformation

16

Abnormality resulting from a single primary embryologic event

Sequence (Potter sequence)

17

Causes of increased AFP

neural tube defect
multiple gestation
incorrect dating
abdominal wall defect

18

Fetal component of placenta

Cytotrophoblast - inner layer; makes cells
Synctiotrophoblast - outer layer of chorionic villi - secretes hCG

19

Why is the Synctiotrophoblast not attacked by the maternal immune system?

It lacks MHC-I expression

20

Maternal component of placenta

Decidua basalis; derived from endometrium; maternal blood in the lacunae

21

What is the urachus?
Anomalies associated with urachus?

In the 3rd week the yolk sac forms the allantois that extends into the urogenital sinus. The allantois becomes the urachus = a duct between fetal bladder and yolk sac
- Patent urachus: total failure of urachus to obliterate --> urine discharge from umbilicus
-Urachul cyst: partial failure of urachus to obliterate; fluid filled cavity lined with uroepithelium between umbilicus and bladder
-Vesicourachal diverticulum: slight failure of urachus to obliterate --> outpouching of bladder

22

Complications of urachul cyst

Adenocarcinoma, infection

23

What is the vitelline duct?
Associated anomalies?

Vitelline duct connects the yolk sac to the midgut lumen
-Vitelline fistula: if vitelline duct fails to close--> meconium discharge from umbilicus
-Meckel diverticulum: partial closure of vitelline duct with patent portion attached to ileum --> causes melon, hematochezia, abdominal pain

24

Female homologs of:
a. Glans penis
b. corpus cavernosum and spongiosum
c. bulbourethral glands
d. prostate gland
e. ventral shaft of penis
f. scrotum

a. glans clitoris
b. vestibular bulbs
c. greater vestibular glands of Bartholin
d. urethral and paraurethral glands of Skene
e. labia minora
f. labia majora

25

Failure of urethral folds to fuse

Hypospadias (abnormal opening on ventral surface)

26

Hypospadias associations

Cryptorchidism
Inguinal hernia

27

Epispadias associations

Exstrophy of bladder

28

Pathway of sperm ejaculation

Seminiferous tubules
Epididymis
Vas deferens
Ejaculatory ducts
(nothing)
Urethra
Penis

29

Cause of urine leaking beneath deep fascia of Buck

Anterior penile urethra injury

30

Source of:
a. estradiol
b. estriol
c. estrone

a. ovary
b. placenta
c. adipose tissue

31

Functions of progesterone

Maintenance of pregnancy
Decreased myometrial excitability
Production of thick cervical mucus, which inhibits sperm entry into uterus
Increased body temp
Inhibition of gonadotropins
Uterine smooth muscle relaxation
Decreased estrogen receptor expression
Prevents endometrial hyperplasia

32

Which phase of menstrual cycle varies in length? And which is set?

Follicular phase (proliferative) varies
Secretory phase (luteal) is always 14 days

33

What layers are shed during menstruation?

Stratum compactum and stratum spongiosum

34

What hormones have the same alpha subunit?

hCG, LH, FSH, TSH

35

hCG levels in fetal anomalies

hCG increased in multiple gestations, hydatidiform moles, choriocarcinomas, down syndrome
hCG decreased in ectopic/failing pregnancy, edward syndrome, patau syndrome

36

Source of estrogen after menopause

Peripheral conversion of androgens to estrone

37

Hormone to measure if you suspect menopause

FSH levels are drastically increased from loss of negative feedback due to decreased estrogen)

38

Where are androgens converted to estrogen and by which enzyme?

Adipose tissue and testis by P-450 aromatase

39

Hypogonadotropic hypogonadism

Kallmann syndrome --> from defective migration of GnRH cells and formation of olfactory bulb --> anosmia, decreased GnRH, FSH, LH, testosterone and infertility

40

Normal appearing female with rudimentary vagina; no uterus or fallopian tubes. (Structure felt in labia majora)

Androgen insensitivity syndrome (46 X, Y)
Breast development from testosterone converted to estradiol

41

Maternal virilization

Aromatase deficiency (fetal androgens cross placenta)

42

Masculinization of female infant with increased serum testosterone and androstenedione

Aromatase deficiency

43

Hydatidiform mole with increase of malignancy

Higher risk with complete mole (15-20%)

44

a. Karyotype of complete mole
b. Karyotype of partial mole

a. 46,XX or 46XY (enucleated egg + single sperm; sperm divides)
b. 69 XXX, 69 XXY, 69 XYY (2 sperm + 1 egg)

45

Honeycombed uterus or clusters of grapes

Complete mole (46 XX or 46 XY)

46

preventing seizures in pre-eclampsia

IV magnesium sulfate

47

Decreased deep tendon reflexes
Pulmonary edema
Cardiac conduction defect
AMS

IV Mg toxicity

48

Complication of HELLP syndrome

Hepatic subcapsular hematomas --> rupture --> severe hypotension

49

Pregnant woman with anemia, RUQ pain, jaundice, bruising

HELLP

50

Painless third trimester bleeding

Placenta previa

51

Vaginal tumor + for desmin

Sarcoma botryoides (rhabdomyosarcoma variant)

52

Clear, grape-like polypoid mass emerging from vagina

Sarcoma botryoides

53

Ovarian tumor with mucus secreting epithelium (like intestine)

Mucinous cystadenoma

54

What is a Dermoid cyst?

Mature cystic teratoma

55

Ovarian tumor that looks like bladder; coffee bean nuclei

Brenner tumor

56

Triad of ovarian fibroma, ascites and hydrothorax

Meigs syndrome

57

Tissue most common in immature teratoma

Neuroectoderm/ neural tissue

58

Call-Exner bodies

Granulosa cell tumor (resemble primordial follicles)

59

Psammoma bodies and ovarian tumor

Serous cystadenocarcinoma

60

Pseudomyxoma peritonei

Mucinous cystadenocarcinoma

61

Uniform fried egg cells
hCG and LDH

Dysgerminoma

62

Increased bhCG, shortness of breath, hemoptysis

Choriocarcinoma (hematogenous spread to lungs)

63

Yellow, friable mass
Schiller-Duval bodies (resemble glomeruli)
AFP tumor marker

Yolk sac (endodermal sinus) tumor

64

Mucin-secreting signet cell adenocarcinoma

Krukenberg tumor (GI malignancy that metastasizes to ovaries)

65

Whorled pattern of smooth muscle bundles with well-demarcated borders

Leiomyoma (fibroid)

66

Extension of endometrial tissue into uterine myometrium

Adenomyosis

67

Tender, boggy, enlarged uterus; dyspareunia

Adenomyosis

68

Cause of endometriosis

Retrograde flow
Metaplastic transformation of multipotent cells
Transportation of endometrial tissue via lymphatic system

69

Dyschezia

Pain with defecation

70

Danazol

Partial agonist at androgen receptors; used for endometriosis, hereditary angioedema (counteracts effects of estrogen)

71

Treatment for endometritis

Gentamicin + Clindamycin (with or without ampicillin)

72

Small, mobile firm mass with sharp edges in breast
Increases with estrogen

Fibroadenoma (most common in those

73

Small breast tumor that grows in lactiferous ducts (beneath areola) - benign

Intraductal papilloma

74

Benign tumor with serous or blood nipple discharge

Intraductal papilloma

75

Large, bulky mass of connective tissue and cysts (leaf like projections) - benign breast tumor

Phyllodes tumor (5th decade)

76

Inflammation of duct; green nipple discharge, in post menopausal women

Mamillary duct ectasia

77

Increased acini and interlobular fibrosis of breast
Calcifications

Sclerosing adenosis - benign (increased risk of developing cancer)

78

Ductal, central necrosis - noninvasive breast tumor

Comedocarcinoma

79

Drugs that cause Gynecomastia (Some Drugs Create Awesome Knockers)

Spironolactone
Digoxin
Cimetidine
Alcohol
Ketoconazole

80

Invasive breast tumor with reactive, desmoplastic stroma surrounding invasive glands

Invasive ductal cancer

81

Peau d'orange

Dermal lymphatic invasion by breast carcinoma (inflammatory)

82

Indian file orderly row of cells (due to decreased E-cadherin expression)

Invasive lobular breast cancer

83

Causes of Priapism

Trauma
Sickle cell disease
Medications (Sildenafil, Trazodone)

84

Leukoplakia on penile shaft

Bowen disease (squamous cell carcinoma)

85

Erythroplakia on penis

Etyrhoplasia of Queyrat (SCC); cancer of glans

86

Reddish papules on penis

Bowenoid papulosis (carcinoma in situ)

87

Cause of congenital hydrocele

Incomplete obliteration of processus vaginalis

88

Most common testicular tumor in boys

Yolk sac (endodermal sinus) tumor; Increased AFP, Schiller duval bodies (look like glomeruli)

89

Ovarian/testicular tumor with signs of hyperthyroidism

Choriocarcinoma; bhCG is structurally similar to LH, FSH, TSH

90

Painful testicular tumor

Embryonal carcinoma; most often mixed
Increased hCG and normal AFP levels (or increased if mixed)

91

Testicular tumor with Reinke crystals

Leydig cell tumor

92

What cells have fried egg appearance?

Koilocytes of HPV
Oligodendrogliomas
Seminomas/Dysgerminomas

93

Which parts of prostate does BPH affect?

Lateral and middle - the periurethral part

94

Osteoblastic metastases in bone

Prostatic adenocarcinoma metastases

95

Clomiphene mechanism

Antagonist at estrogen receptors in hypothalamus --> prevents normal feedback inhibition and increased release of LH/FSH

96

Raloxifene mechanism and S/E

Antagonist at breast, uterus; agonist at bone
Increased risk of thromboembolic events but no increased risk of endometrial cancer

97

Anastrazole/Exemestane

Aromatase inhibitors used in post menopausal women with ER + breast cancer (S/E = osteoporosis)

98

Mifepristone mechanism

Competitive inhibitor of progestins at progesterone receptors used for termination of pregnancy in combo with misoprostol (PGE1)

99

Terbutaline, Ritodrine

B2 agonists that relax the uterus
Used to decrease contraction frequency in women during labor

100

Finasteride mechanism and use

5 alpha reductase inhibitor; used for BPH and male pattern baldness (decreases conversion of testosterone to DHT)

101

Flutamide mechanism and use

Non-steroidal competitive inhibitor of androgen receptors
Used for prostate carcinoma

102

Ketoconazole mechanism

Inhibits steroids synthesis (inhibits 17,20 desmolase)

103

Minoxidil mechanism

Direct arteriolar vasodilator used for androgenetic alopecia and severe refractory hypertension

104

Blood nipple discharge differential

Intraductal papilloma - benign
Invasive papillary carcinoma - malignant