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Flashcards in Reproductive Deck (85):
1

week heart begins to beat & have upper & lower limb buds

week 4

2

gene involved in CNS development & assoc with holoprosencephaly

Sonic hedghog
Feature of holoprosencephaly: hypotelorism (eyes close together)

3

gene for proper organization along dorsal-ventral axis (limb development)

Wnt-7

4

gene for mitosis of underlying mesoderm = lengthens limbs

FGF

5

gene implicated if limbs are in wrong locations

Homeobox = Hox

6

When does hCG secretion begin?

implantation of blastocyst = 1 week

7

neural tube formed from what? closes when?

neuroectoderm
by week 4

8

when do external genitalia show male/female characteristics?

week 10

9

when gastrulation occurs

week 3 = 3 layers
ectoderm + mesoderm + endoderm

10

embryologic derivative of muscle, bone, CT, serous linings of body cavities, lymphatics, blood, wall of gut (muscle?), vagina, kidneys adrenal cortex, dermis, testes, ovaries, nucleus pulposus of IV disc

mesoderm

11

embryologic derivative of gut epithelium, urethra, luminal epithelium of lungs, liver, GB, pancreas, eustachian tube, thymus, parathyroid, thyroid follicular cells

endoderm

12

teratogen effect of aminoglycosides (gentamycin)

CN VIII toxicity (hearing loss)

13

teratogen that can cause vaginal clear cell adenocarcinoma

diethylstilbestrol (DES)

14

teratogen that discolors teeth

tetracycline

15

anticonvulsant that inhibits folate absorption therefore can cause neural tube defects

valproate

16

what medication can be used to avoid blood clots in pregnancy but not cross the placenta

heparin
Do not use warfarin because it can cause fetal abortion, hemorrhage, eye & bone abnormalities

17

excess of this vitamin can cause spont abortion, cleft palate, cardiac abnormalities

vit A

18

forms outer layer of chorionic villi and secretes hCG

syncytiotrophoblast

19

how many umbilical vessels are there? type of blood transported?

2 UAs -> low O2
1 UV -> high O2
think of the baby as the heart of mama to remember circulation

20

duct between fetal bladder and yolk sac

urachus
If this stays patent: urine discharge from umbilicus

21

associated with ectopic gastric mucosa & is from partial closure of vitelline duct

Meckel diverticulum

22

aortic arch derivative that becomes common carotid & proximal internal carotid

3rd aortic arch
3rd arch = 3rd letter of alphabet ("c")

23

persistent cervical sinus

branchial cleft cyst within lateral neck

24

which branchial arch makes no significant developmental contributions?

5th arch

25

thymic aplasia (deficiency of T cells)
hypocalcemia (no parathyoid glands)
cardiac defects

DiGeorge syndrome

26

mutation of germline RET gene resulting in the 3 P's:
pheochromocytoma
parathyroid tumor
parafollicular cell cancer (medullary cancer of thyroid)

MEN 2A

27

from failure of fusion of maxillary & medial nasal prominences

cleft lip

28

from failure of fusion of the lateral palatine processes or fusion of the lateral palatine processes with nasal septum and/or median palatine process

cleft palate

29

Gene on Y chromosome that produces testis determining factor (TDF)

SRY

30

develops into internal male structures (SEED): Seminal vesicals, Epididymis, Ejaculatory duct, Ductus Deferens

Wolffian duct (mesonephric duct)

31

embryologic structures that becomes male external genitalia & prostate

genital tubercle & urogenital sinus

32

placenta implants in lower uterus and partially or completely covers the internal os -> requires c-section delivery

placenta previa
See a "preview" of the placenta (or can feel it)

33

What does the placenta normally attach to?

decidua
Absence results in placenta accreta -> can't deliver the placenta since it's stuck -> hysterectomy

34

classic presentation: fibrinoid necrosis of the placental vessels

preeclampsia

35

preeclampsia with SEIZURES

eclampsia
Must deliver the placenta

36

preeclampsia with thrombotic microangiopathy involving the liver; see schistocytes

HELLP syndrome
Hemolysis
Elevated liver enzymes
Low Platelets

37

abnormal implantation with cystic swelling of chorionic villi and proliferation of trophoblast; uterus is bigger than normal and beta-hCG is higher than normal

hydatidiform mole
see passage of grapelike masses (if no prenatal care)
prenatal care: absent fetal heart sounds & snowstorm appearance on US
Partial Mole: fetal parts
Complete: no fetal parts

38

which mole has greater risk of choriocarcinoma; what would you use to screen?

complete mole
level of beta-hCG over the next year after D&C

39

ovarian neoplasm that contains transitional epithelium (bladder type epithelium)

Brenner tumor

40

What serum value can be used to monitor progression/recurrence of ovarian neoplasm?

CA-125

41

most common germ cell tumor in female

mature cystic teratoma
If has immature tissue, then it has potential to mets (neuroectodermal tissue is what is present in the immature)

42

ovarian fibroma, ascites and pleural effusion

Meigs syndrome

43

cystic teratoma that contains functional thyroid tissue and presents as hyperthyroidism

struma ovarii

44

GI malignancy that mets to ovaries (BILATERAL), causing a mucin-secreting signet ring cell adenocarcinoma

Krukenberg tumor

45

intraperitoneal accumulation of mucinous material from tumor of ovary or appendix

pseudomyxoma peritonei

46

venous drainage of the gonads

left -> left gonadal vein -> left renal vein -> IVC
right -> right gonadal vein -> IVC

47

lymphatic drainage of ovary/testis

para-aortic lymph nodes

48

lymphatic drainage of scrotum/vulva

superficial inguinal lymph nodes

49

ligament that contains the ovarian vessels

suspensory ligament

50

ligament that is the derivative of the gubernaculum

round ligament of the uterus

51

ligament that contains the ovaries, fallopian tubes and round ligaments of the uterus

broad ligament
3 parts: mesosalpinx, mesometrium, mesovarium

52

most common area for cervical cancer

transformation zone

53

irregular menstruation

metrorrhagia

54

heavy menstruation

menorrhagia

55

ovulation sequence (hormone)

increased estrogen -> increased GnRH receptors on anterior pituitary -> estrogen surge -> stimulation of LH release -> ovulation

56

what elevates body temperature during menstrual cycle

progesterone

57

maintains the corpus luteum for the first trimester by acting like LH

hCG

58

marker for menopause

elevated FSH
loss of negative feedback on FSH by estrogen (through GnRH)

59

causes closure of epiphyseal plates

estrogen (converted from testosterone in males)

60

appears female: female external genitalia, short vagina that ends in blind pouch, absent uterus & fallopian tubes, scant sexual hair, undescended testes

androgen insensitivity syndrome

61

hypogonadotropic hypogonadism; defective migration of GnRH cells and formation of olfactory bulb, decreased GnRH LH & FSH, anosmia, infertility

Kallmann syndrome

62

hypertension and proteinuria in pregnancy (after 20 weeks gestation up to 6 weeks postpartum)

preeclampsia

63

HPV gene product that inhibits p53 suppressor gene

E6

64

HPV gene product that inhibits RB tumor suppressor gene

E7

65

causes of endometrial hyperplasia

anovulatory cycles, HRT, PCOS, granulosa cell tumor

66

hyperandrogenism, hyperinsulinemia (insulin & testosterone decrease SHBG synth therefore increased free testosterone)
Presents with amenorrhea (oligomenorrhea), hirsutism, acne, infertility, obesity; LH:FSH > 2 (FSH is shut down because of feedback of peripheral conversion of androgens to estrogen)

polycystic ovarian syndrome
have increased risk of endometrial cancer from increased estrogens from aromatization of testosterone

67

location of highest density of breast tissue in a female

upper outer quadrant

68

breast tumor with large leaf-like projections; most commonly presents in 6th decade

phyllodes tumor

69

treatment of BPH

alpha1 antagonists: terazosin, tamsulosin (selective for receptors in prostate vs vascular)
5 alpha reductase inhibitor: finasteride

70

Why is varicocele more common in left testicle?

increased resistance to flow from left gonadal vein drainage into left renal vein

71

difference in mature teratoma in males from one in females

may be malignant

72

associated with priapism

trauma, sickle cell anemia, medications

73

tumor associated with Reinke crystals

Leydig cell tumor

74

nonsteroidal competitive inhibitor of androgens at testosterone receptor

flutamide

75

warm, enlarged breast with purulent nipple discharge in breastfeeding female: treatment & dx?

mastitis
dicloxacillin & continue breastfeeding

76

subareolar mass with nipple retraction

periductal mastitis
-usually from keratinization of cells blocking duct
-columnar cells converted to squamous due to Vit A deficiency in smoking

77

inflammation with green-brown nipple discharge

mammary duct ectasia

78

causes calcification on mammogram
see giant cells

fat necrosis (from saponification)

79

causes downregulation of GnRH receptors in pituitary when given continuously therefore decreased FSH/LH

leuprolide
Use: prostate cancer

80

antagonizes estrogen receptors in the hypothalamus to prevent normal feedback inhibition -> increases LH & FSH release from pituitary -> ovulation

clomiphene

81

used to treat ER+ breast cancer: antagonist at breast tissue but agonist at bone and uterus, increasing risk of endometrial cancer

tamoxifen

82

osteoporosis drug that is an agonist at bone, antagonist at uterus

raloxifene

83

inhibits 17 hydroxylase in steroid synthesis; causes gynecomastia

spironolactone

84

5 alpha reductase inhibitor used for BPH

finasteride

85

Virilization of mother during pregnancy due to placental transfer of excess androgens from fetus to mom
Maculinization of female fetus

Aromatase deficiency