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USMLE Step 1 > Reproduction > Flashcards

Flashcards in Reproduction Deck (62):
1

Sonic hedgehog gene

Produced at base of limbs in zone of polarizing activity. Involved in patterning along Anterior-posterior axis. Involved in CNS development; mutation can cause holoprosencephaly.

2

Wnt-7 gene

produced at apical ectodermal ridge (at distal end of each developing limb), necessary for proper organization along dorsal-ventral axis

3

FGF gene

produced at apical ectodermal ridge. Stimulates mitosis of underlying mesoderm, providing for lengthening of limbs

4

Homeobox (HOX) genes

segmental organization of embryo in craniocaudal direction, mutations cause appendages in wrong locations

5

ACE inhibitors: teratogenic effects

Renal damage

6

Alkylating agents: teratogenic effects

absence of digits, multiple anomalies

7

Aminoglycosides: teratogenic effects

CN VIII toxicity

8

Carbamazepine: teratogenic effects

Neural tube defects, craniofacial defects, fingernail hypoplasia, developmental delay, intrauterine growth restriction

9

Diethylstilbestrol (DES): teratogenic effects

Vaginal clear cell adenocarcinoma, congenital Mullerian abnormalities

10

Folate antagonists (methotraxate, trimethoprim, pyramethamine): teratogenic effects

Neural tube defects

11

Lithium: teratogenic effects

Ebstein's anomaly

12

Methimazole: teratogenic effects

Aplasia cutis congenita

13

Phenytoin: teratogenic effects

Fetal hydantoin syndrome: microcephaly, messed up head, hypoplastic nails/distal phalanges, cardiac defects, intrauterine growth restriction, retardation

14

Tetracyclines: teratogenic effects

discolored teeth

15

Thalidomide: teratogenic effects

Limb defects (phocomelia, micromelia, flipper limbs)

16

Valproate: teratogenic effects

Inhibition of maternal folate absorption--neural tube defects

17

Warfarin: teratogenic effects

bone deformities, fetal hemorrhage, abortion, opthalmologic problems, use heparin instead

18

Smoking (nicotine, CO) effects on fetus

low birth weight, preterm labor, placental problems, IUGR, ADHD

19

Maternal diabetes

caudal regression syndrome, congenital heart defects, neural tube defects

20

Vitamin A excess

extremely high risk for spontaneous abortions and cleft palate, cardiac abnormalities

21

Aortic arch derivates: 1st

maxillary artery (branch of external carotid)

22

Aortic arch derivates: 2nd

Stapedial artery, hyoid artery

23

Aortic arch derivates: 3rd

Common carotid artery, proximal part of internal carotid artery

24

Aortic arch derivates: 4th

on left-aortic arch; on right-proximal part of right subclavian artery

25

Aortic arch derivates: 6th

proximal part of pulmonary arteries and ductus arteriosus (on left only)

26

embryonic derivates of clefts, arches, pouches

clefts-ectoderm, arches-mesoderm, pouch-endoderm (outside to inside)

27

Branchial cleft derivatives: 1st cleft

external auditory meatus

28

Branchial cleft derivatives: 2 to 4th clefts

temporary cervical sinuses that are obliterated by expansion of 2nd arch mesenchyme

29

Branchial arch derivatives

When at restaurant of the golden arches, children tend to first chew (1), then smile (2), then swallow stylishly (3) or simply swallow (4) and then speak (6)

30

Branchial pouch derivatives

Ear (1), Tonsils (2), Bottom (3, dorsal, inferior parathyroids), To (3, ventral thymus), Top (4, superior parathyroids)

31

T cell deficiency, hypocalcemia, cardiac defects

DiGeorge syndrome: aberrant 3/4th pouch development-->thymic aplasia, abnormal parathyroids, conotruncal cardiac defects

32

MEN 2A

mutation of germline RET (neural crest cells): adrenal medulla, parathyroid, parafollicular cells are all neural crest derivatives

33

Testis determining factor

SRY gene on Y chromosome

34

Mullerian inhibiting factor

Sertoli cells secrete, supresses development of paramesonephric ducts

35

Stimulates development of mesonephric ducts

Leydig cells secrete androgens

36

Paramesonephric duct develops into:

Female internal structures: fallopian tubes, uterus, upper portion of vagina

37

Mesonephric duct develop into:

male internal structures SEED: seminal vesicles, epididymis, ejaculatory duct, ductus deferens

38

Primary amennorrhea with fully developed secondary sexual characteristics

Paramesonephric duct abnormalities--still have functioning ovaries

39

incomplete fusion of paramesonephric ducts

bicornuate uterus--recurrent miscarriages

40

Develop both male and female internal genitalia, with male external genitalia

No sertoli cells or lack of mullerian inhibitory factor; Leydig cells secreting testosterone are functional

41

Male internal genitalia, ambiguous external genitalia

5-alpha reductase deficiency: inability to convert testosterone to DHT; ambiguous genitalia until puberty when increased testosterone causes masculinization

42

Genital tubercle, urogenital sinus masculinization to male genitalia

DHT (via testosterone from Leydig cell catalyzed by 5-alpha reductase)

43

Which side is varicocele more common on?

Left side--left gonadal vein enters left renal vein at 90 degree angle, greater left venous pressure. Right gonadal vein enters IVC directly.

44

Drain into para aortic lymph nodes

ovaries/testis

45

Drain into superficial inguinal lymph nodes

distal vaginal/vulva/scrotum

46

Drain into obturator, external iliac and hypogastric nodes

proximal vagina/uterus

47

connects ovaries to lateral pelvic wall

infundibulopelvic ligament (suspensory ligament of the ovaries) containing ovarian vesseles

48

connects cervix to side wall of pelvis

Cardinal ligament containing uterine vessels

49

connects uterine fundus to labia majora

Round ligament of uterus that travels through round inguinal canal above artery of Sampson

50

connects uterus/fallopian tubes/ovaries to pelvic side wall

Broad ligament (mesosalpinx above ovarian ligament, mesovarium (over ovaries), mesometrium below ovarian ligament)

51

connects medial pole of ovary to lateral uterus

ovarian ligament, derivative of gubernaculum

52

Pathway of sperm during ejaculation

SEVEN UP: seminiferous tubules, epididymis, vas deferens, ejaculatory duct, (nothing), urethra, penis

53

Nerve innervation during male sexual response

Point and Shoot: parasympathetic (pelvic nerve, erection), sympathetic (hypogastric nerve, emission), ejaculation (visceral/somatic nerves, pudendal nerve)

54

secrete inhibin and androgen binding protein

Sertoli cells that line seminiferous tubules. Inhibin inhibits FSH. Androgen binding protein maintains local levels of testosterone. Tight junctions between sertoli cells maintain blood-testis barrier (anti autoimmune attack), support and nourish spermatazoa, produce MIF, increased temp inhibits functions, aromatase to convert testosterone/andostenedione to estrogen

55

secrete testosterone in presence of LH

Leydig cells in the interstitium, also contain aromatase to convert T to estrogen

56

Converts cholesterol to androstenedione

Theca cell of follicle via desmolase. LH stimulates desmolase activity. Pulsatile GnRH stimulates LH.

57

Converts androstenedione to estrogens

Granulosa cell of follice via aromatase. FSH stimulates granulosa cell via pulsatile GnRH.

58

What are stages of menstrual cycle

Increased estrogen (endometrial proliferation, 7 days)-->LH surge (14 days)-->ovulation-->progesterone (from corpus luteum, peaks at 21 days)-->progesterone levels fall-->menstruation at 28 days

59

Primary oocytes

(2N, 4C) arrested in prophase I of meiosis (46 sister chromatids) until ovulation

60

Secondary oocytes

(1N, 2C) arrested in metaphase II of meiosis until fertilization

61

Exclusively breast fed infants

require vitamin D supplementation

62

Increased FSH along with hot flashes, vaginal atrophy

Menopause: decreased estrogen, increased FSH, increased LH (no surge), increased GnRH