Reproductive Flashcards Preview

USMLE Step 1: Things I Cannot Remember > Reproductive > Flashcards

Flashcards in Reproductive Deck (22):
1

Sonic hedgehog gene (Shh)

  • Patterning along anterior-posterior axis
  • CNS development
  • Mutations ⇒ holoprosencephaly

2

Wnt-7 gene

Proper organization along dorsal-ventral axis

3

FGF gene

Stimulates mitosis of underlying mesoderm ⇒ lengthening of limbs

4

Homeobox genes

  • segmental organization in a cranial-caudal direction
  • code for transcription factors
  • Hox mutation ⇒ appendages in wrong location

5

What is gastrulation?

Process that forms the trilaminar disc (week 3)

  • establishes ectoderm, mesoderm and endoderm 

6

What are the VACTERL defects?

Mesodermal defects:

  1. Vertebral
  2. Anal atresia
  3. Cardiac 
  4. Tracheo-Esophageal
  5. Renal
  6. Limb (bone and muscle)

7

When is the pregnancy most vunerable to teratogens?

Embryonic period (organogenesis):  3rd - 8th weeks

  • Before ⇒ "all or none" effects
  • After ⇒ growth and function affected

 

8

Teratogenic Medications

  1. ACE inhibitors
  2. Alkylating agents
  3. Aminoglycosides
  4. Carbamazepines
  5. Diethylstillbestrol
  6. Folate antagonists
  7. Isotretinoin
  8. Lithium
  9. Methimazole
  10. Phenytoin
  11. Tetracyclines
  12. Thalidomide
  13. Valproate
  14. Warfarin

9

What is the leading cause of intellectual disability in the US?

Fetal alcohol syndrome

10

What causes the defects seen in FAS?

Failure of cell migration

  • pre- and postnatal developmental retardation
  • microcephaly
  • facial abnormalities
  • limb dislocation
  • heart defects
  • Most severe ⇒ heart-lung fistulas & holoprosencephaly

11

Placenta

  • Fetal component
  • Maternal component

  • Fetal component
    1. Cytotrophoblast ⇒ Inner layer
      • Makes cells
    2. Syncytiotrophoblast ⇒ Outer layer
      • secretes hCG
      • Lacks MHC-1 expression ⇒ dec. chance of attack by maternal immune system
  • Maternal component
    • Decidua basalis ⇒ derived from the endometrium
      • maternal blood in the lacunae

12

What are the complications that can arise from the vitelline duct?

  1. Vitelline fistula ⇒ failure to close
    • meconium discharge from umbilicus
  2. Meckel's diverticulum ⇒ partial closure w/ patent portion attached to ileum (true diverticulum)
    • melena
    • hematochezia
    • abdominal pain

13

Aortic Arch derivatives:

  • 1st Arch
  • 2nd Arch
  • 3rd Arch
  • 4th Arch
  • 6th Arch

  • 1st Arch ⇒ Maxillary artery
  • 2nd Arch ⇒ Stapedial artery
  • 3rd Arch ⇒ Common carotid artery & proximal ICA
  • 4th Arch ⇒ aortic arch (left); proximal right subclavian artery
  • 6th Arch ⇒ proximal pulmonary arteries & ductus arteriosus

14

How is the branchial apparatus composed?

CAP

  1. Clefts ⇒ ectoderm
  2. Archs ⇒ mesoderm
  3. Pouches⇒ endoderm

15

Branchial cleft derivatives

  • 1st
  • 2nd - 4th 
  • Persistent cervical sinus ⇒ 

  • 1st ⇒ external auditory meatus
  • 2nd - 4th ⇒ temporary cervical sinuses
  • Persistent cervical sinus ⇒ branchial clefts w/in the lateral neck 
    • (compare this to thyroglossal duct cyst)

16

Failure of fusion of the maxillary and medial nasal processes ⇒ 

cleft lip

17

Failure of fusion of two lateral palatine processes ⇒ 

cleft palate

18

Failure of fusion of lateral palatine processes w/ nasal septum and/or median platine process ⇒ 

secondary cleft palate

19

33 year old woman comes in for her normal pap smear.  What is found?

Q image thumb

Koilocyte

  • cervical dysplasia ⇒ invasive cervical carcinoma

20

What is the most common ovarian mass in young women?

follicular cyst

  • distention of unruptured graffian follicle
  • associated with hyperestrogenism & endometrial hyperplasia

21

What ovarian cysts can be caused by excess gonadotropin stimulation?

theca-lutin cysts

  • often bilateral/multiple
  • associated with choriocarcinoma & hydatidiform moles

22