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Flashcards in Repro Deck (11):
1

Direct vs Indirect inguinal hernias
-what PE finding will help you distinguish between the two
-relation to inferior epigastric artery
-layers

Both: pass through the superficial inguinal ring
-both produce a cough in the groin when a person coughs

Indirect: pass through deep inguinal ring too (lateral to inferior epigastric artery)
-covered by all 3 layers of spermatic fascia

Direct: does not pass through deep inguinal ring (medial to inferior epigastric artery)
-covered by only the external spermatic fascia

PE: have pt cough a 2nd time while compressing the deep inguinal ring
-if it prevents the hernia from descending -> must pass through deep inguinal ring -> indirect hernia

2

Failure of what to close causes an indirect inguinal hernia

Processes vaginalis -> persistent connection between abdominal cavity and inguinal canal
-associated with hydroceles

3

When do hCG levels decrease and why

2nd trimester -> placental progesterone can maintain pregnancy by then

4

What causes insulin resistance in pregnant mothers w/ no history of diabetes

Placental growth hormone
-has anti-insulin effects
-aids in placental maturation

5

What hormone is in charge of
-male external genitalia
-male internal genitalia
-female external genitalia
-female internal genitalia

Male
- external genitalia: Dihydrotestosterone via leydig cells
- internal genitalia: testosterone via wolffian duct

Female
- external genitalia: estriadiol via ovaries
- internal genitalia: paramesonephric duct

6

What drug inhibits 5alpha-reductase and can lead to abnml male external genitalia if used during pregnancy

Finasteride

7

What results in a a congenital hydrocele

Failure of obliteration of processes vaginalis

8

14 year old girl has never menstruated before
- 46 XY karyotype
-labs: elevated testosterone and LH
-PE: vagina but no uterus is palpable

Defect?

Androgen insensitivity syndrome
- testosterone is produced but cannot bind to receptor
-internal genitalia and external genitalia need Testosterone and DHT to be produced -> ambiguous genitalia
- famle internal genitalia is not present due to nml AMG

9

When will the startle reflex (making aloud noise will startle the baby and cause them to extended and abduct their arms w/ fingers spread) disappear

1-2 months
3-6 months
8-10 months

3- 6 months

10

What do these become
-ureteric bud
- allantois
- mesonephric duct

Ureteric bud: induces development of metanephros -> kidney

Allantois: urinary bladder (urachus -> median umbilical ligament)

Mesonephric duct: internal male genitalia

11

What hormone stimulates release of testosterone from leydig cells

LH