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Reproductive > Reproductive > Flashcards

Reproductive Flashcards

1
Q

Sonic hedgehog

A

Produced at base of limbs in zone of polarizing activity. Involved in patterning along anterior posterior axis. Mutatation can cause holoprosencephaly.

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2
Q

Wnt-7

A

Produced at apical ectodermal ridge (thickened ectoderm at distal end of each developing limb). Necessary for proper development along dorsal-ventral axis

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3
Q

FGF

A

Produced at apical ectodermal ridge. Stimulates mitosis of underlying mesoderm, providing for lengthing of limbs.

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4
Q

Homeobox (Hox)

A

Involved in segmental organization of embryo in craniocaudal direction. Hox mutations lead to appendages in the wrong locations.

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5
Q

Day 0

A

Fertilization by sperm forming zygote, initiating embryogenesis.

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6
Q

Within week 1

A

hCG secretion (from syncitiotrophoblast) begins after implantation of blastocyst: detectable in blood at 1 week, in urine at 2 weeks

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7
Q

Within week 2

A

Bilaminar disc (epiblast, hypoblast). 2 weeks = 2 layers

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8
Q

Within week 3

A

Trilaminar disc. 3 weeks = 3 layers. Gastrulation. Primitive streak, notocord, mesoderm and its organization, and neural plate begins to form.

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9
Q

Weeks 3-8 (Embryonic period)

A

Neural tube formed by neuroectoderm and closes by week 4. Organogenesis. Extremely suceptible to teratogens.

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10
Q

Week 4

A

Heart begins to beat. Upper and lower limb buds form. 4 weeks = 4 limbs.

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11
Q

Week 8 (start of fetal period)

A

Fetal movement. Looks like a baby.

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12
Q

Week 10

A

Genitalia have male/female characteristics

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13
Q

Gastrulation

A

Process that forms the trilaminar embryonic disc. Establishes the ectoderm, mesoderm, and endoderm. (Epiblast invaginates to form the primitive streak)

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14
Q

From which derm layer does Craniopharyngioma derive?

A

Adenohypophysis (Rathke’s pouch) Surface Ectoderm: Tumor has cholesterol crystals and calcifications.

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15
Q

What is the notochord?

A

Mesodermal structure tha induces the ectoderm to form neuroectoderm. (only postnatal derivative is nucleus pulposus)

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16
Q

What are the mesodermal defects?

A

Vertebral defects, Anal atresia, Cardiac defects, Tracheo-esophageal fistula, Renal defects, Limb defects.

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17
Q

Agenesis

A

Absent organ due to absent primordial tissue

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18
Q

Aplasia

A

Absent organ despite present primordial tissue

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19
Q

Deformation

A

Extrinsic disruption; occurs after the embryonic period.

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20
Q

Hypoplasia

A

Incomplete organ development; primordial tissue present

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21
Q

Malformation

A

Intrinsic disruption; occurs during the embryonic period.

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22
Q

Teratogens

A

Weeks 3-8 most affected (organogenesis). Before 3 all or none effect. After 8 growth or function effect.

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23
Q

ACE inhibitors

A

Renal damage

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24
Q

Alkylating agents

A

Absence of digits, multiple anomalies

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25
Q

Aminoglycosides

A

CN VIII toxicity

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26
Q

Carbamazepine

A

Neural tube defects, craniofacial defects, fingernail hypoplasia, developmental delay, IUGR (IntraUterine Growth Restrictino)

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27
Q

Diethylstilbestrol (DES)

A

Vaginal clear cell adenocarcinoma, congenital Mullerian anomalies

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28
Q

Folate antagonists

A

Neural tube defects

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29
Q

Lithium

A

Ebstein’s anomaly (atrialized right ventricle)

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30
Q

Phenytoin

A

Fetal hydantoin syndrome: microcephaly, dysmorphic craniofacial features, hypoplastic nails and distal phalanges, cardiac defects, IUGR, mental retardation.

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31
Q

Tetracylcines

A

Discolored teeth

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32
Q

Thalidomide

A

Limb defects (Phocomelia)

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33
Q

Valproate

A

Inhibition of maternal folate absorption (neuarl tube defects)

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34
Q

Warfarin

A

Bone deformaties, fetal hemorrhage, abortion, ophthalmologic abnormalities.

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35
Q

Alcohol

A

FAS (leading cause of birth defects and mental retardation)

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36
Q

Cocaine

A

Abnormal fetal development and fetal addiction: placental abruption (placenta separates from uterus)

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37
Q

Smoking (nicotine and CO)

A

Preterm labor, placental problems, IUGR, ADHD

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38
Q

Iodide (lack or excess)

A

Congenital goiter or cretinism

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39
Q

Maternal diabetes

A

Caudal regression syndrome (anal atresia to sirenomelia), congenital heart defects, neural tube defects

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40
Q

Vitamin A excess

A

Extremely high risk for spontaneous abortion and birth defects (cleft palate, cardiac abnormalities)

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41
Q

X-rays

A

Microcephaly, mental retardation

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42
Q

FAS

A

mental retardation, development delay, microcephaly, holoprosencephaly, facial abnormalities, limb dislocation, heart nad lung fistulas

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43
Q

Urachal duct

A

3rd week yolk sac makes allantois. Allantois becomes urachus (a duct between bladder and yolk sac

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44
Q

Patent urachus

A

urine discharge from umbilicus

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45
Q

vesicourachal diverticulum

A

outpouching of bladder

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46
Q

Vitelline duct

A

7th week obliterates vitellin duct (omphalo-mesenteric duct) connects yolk sac to midgut lumen

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47
Q

Vitelline fistula

A

meconium discharge from umbilicus

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48
Q

Meckel’s diverticulum

A

partial closure of vitelline duct with patent protion attached to ileum. May have ectopic gastric mucosa leading to melena, periumbilical pain, and ulcer

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49
Q

1st aortic arch derivatives

A

Part of maxillary artery

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50
Q

2nd aortic arch derivatives

A

Stapedial artery and hyoid artery

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51
Q

3rd aortic arch derivatives

A

Common Carotid artery and proximal internal carotid

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52
Q

4th aortic arch derivatives

A

Aortic arch, proximal part of right subclavian

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53
Q

6th aortic arch derivatives

A

Proximal part of pulmonary arteries and ductus arteriosus

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54
Q

What are branchial (pharyngeal) clefts (grooves) derived from?

A

ectoderm

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55
Q

What are branchial (pharyngeal) arches derived from?

A

mesoderm AND neural crest

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56
Q

What are branchial (pharyngeal) pouches derived from?

A

Endoderm

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57
Q

What is the 1st branchial (pharyngeal) cleft derivative?

A

external auditory meatus

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58
Q

What are the 2-4 branchial (pharyngeal) cleft derivative?

A

temporary cervical sinuses obliterated by proliferation of 2nd arch mesenchyme (if persist, cyst in lateral neck)

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59
Q

What are the 1st branchial (pharyngeal) ARCH derivatives?

A

Meckel’s cartilage: mandible, malleus, incus, sphenomandibular ligament; temporalis, masseter, pterygoids, mylohyoid, anterior belly of digastric, tensor tympani, tensor veli palatini; CN V2 and V3

60
Q

What is Treacher-Collins syndrome

A

1st-arch fails to migrate causing mandibular hypoplasia, facial abnormalities

61
Q

What are the 2nd branchial (pharyngeal) ARCH derivatives?

A

Reichert’s cartilage: Stapes, Styloid process, lesser horn of hyoid, Stylohyoid ligament; Stapedius, Stylohyoid, Posterior belly of digastric; CN VII

62
Q

What are the 3rd branchial (pharyngeal) ARCH derivatives?

A

Greater horn of hyoid; Stylopharyngeus; CN IX

63
Q

What is congenital pharyngo-cutaneous fistula?

A

Persistance of 3rd cleft and pouch leads to fistula between tonsillar area causes a cleft in lateral neck.

64
Q

What are the 4th branchial (pharyngeal) ARCH derivatives?

A

thyroid, cricoid, arytenoids, corniculate, cuneiform; 4 is most pharyngeal constrictors, cricothyroid, levator veli palatini. 4 is CN X (superior laryngeal branch).

65
Q

What are the 6th branchial (pharyngeal) ARCH derivatives?

A

thyroid, cricoid, arytenoids, corniculate, cuneiform; 6 is all intrinsic muslce of larynx except cricothyroid; 6 is CN X (recurrent laryngeal branch)

66
Q

What forms posterior 1/3 of tongue?

A

Arches 3 and 4

67
Q

What happens to arch 5?

A

makes no developmental contributions

68
Q

What are the 1st branchial (pharyngeal) POUCH derivatives?

A

middle ear cavity, eustachian tube, mastoid air cells. Endoderm-lined structures of ear.

69
Q

What are the 2nd branchial (pharyngeal) POUCH derivatives?

A

Epithelial lining of palatine tonsil

70
Q

What are the 3rd branchial (pharyngeal) POUCH derivatives?

A

Dorsal wings are INFERIOR parathyroids, Ventral wings are thymus

71
Q

What are the 4th branchial (pharyngeal) POUCH derivatives?

A

Dorsal wings are SUPERIOR parathyroids

72
Q

Di George

A

3rd and 4th pouches fail to develop

73
Q

MEN 2A

A

germline RET (neural crest) mutation: adrenal medulla (pheo), parathyroid tumor (3rd and 4th pouches), parafollicular cells (medullary thyroid cancer) neural crest in 4th and 5th pouches

74
Q

What do Sertoli cells secrete (in response to testis-determining factor)?

A

Mullerian Inhibitory Factor (MIF)

75
Q

What do Leydig cells secrete?

A

Androgens

76
Q

What happens if no Sertoli cells or no MIF?

A

male and femal inside, male outside

77
Q

What happens if no 5-alpha- reductase

A

male inside, ambiguous outside until puberty

78
Q

Genital tubercle

A

glans penis/corpus cavernosum and spongiosum: glans clitoris/ vestibular bulbs

79
Q

Urogenital sinus

A

Bulbourethral glands (of Cowper)/prostate : Greater vestibular glands (of Bartholin)/ Urethral and paraurethral glands (of Skene)

80
Q

Urogenital folds

A

Ventral shaft of penis (penile urethra) : Labia minora

81
Q

Labioscrotal swelling

A

Scrotum : Labiam majora

82
Q

What causes hypospadias?

A

failure of urethral folds to close

83
Q

What causes epispadias?

A

faulty positioning of genital tubercle (associated with exstrophy of the bladder)

84
Q

Which side is varicocele more common?

A

Left gonadal vein drains into left renal vein (increased venous pressure on left side)

85
Q

What is the lymphatic drainage of ovaries/testes?

A

para-aortic lymphnodes (retroperitoneal)

86
Q

Emission

A

Sympathetic nerve (hypogastric) movement of semen to ejaculatory ducts

87
Q

Ejaculation

A

Visceral and somatic (pudendal)

88
Q

What is the function of Sertoli cells?

A

Secrete inhibin (inhibits FSH), secrete ABP (maintains local levels of testosterone), for blood testes barrier, nourish spermatozoa, regulate spermatogenesis, produce MIF, TEMP-sensitive (low sperm count and low inhibin with increased TEMP)

89
Q

What is the function of Leydig cells?

A

Testosterone production (unaffected by temperature)

90
Q

What does LH do in a male?

A

stimulates Leydig cells to make testosterone

91
Q

What does FSH do in a male?

A

Stimulates Sertoli cells to make ABP and inhibin

92
Q

What happens with exogenous testosterone?

A

inhibition of HPGonadal axis, intratesticular testosterone decreases (testicle size decreases) and azospermia

93
Q

How does testosterone close physis at puberty?

A

aromatase converts it to estrogen

94
Q

Why do men go bald with age?

A

low testosterone leads to increased 5-alpha-reductase leads to more DHT (same reason for BPH, oily skin, and big scrotum)

95
Q

Potency of estrogens?

A

estradiol (17-beta-estradiol in ovary) > estrone (aromitization in adipose) > estriol (placenta)

96
Q

Why do women have favorable LDL/HDL ratios?

A

estrogen increases SHBG leading to increase in HDL decrease in LDL

97
Q

Where does progesterone come from?

A

corpus luteum, placenta, adrenal cortex, testes

98
Q

What are the functions of progesterone?

A

Stimulation of endometrium (glands and arteries), decrease myometrial excitability, produce thick cervical mucous, raise body temp, inhibit LH and FSH, uterine relaxation, decrease estrogen receptor

99
Q

Tanner Stages?

A

I is child, II is pubarche; breast buds, III is pubic hair darkens and curls/penis size/length increases; breasts enlarge, IV is increase in penis width darker scrotum, development of glans; raised areolae V is adult; areola are no longer raised.

100
Q

Oligomenorrhea

A

> 35-day cycle

101
Q

Polymenorrhea

A

< 21-day cycle

102
Q

Metrorrhagia

A

frequent but irregular mensturation

103
Q

Menometrorrhagia

A

heavy, irregular menstration at irregular intervals

104
Q

The cycle in words:

A

FSH > follicle development > increased estrogen > LH surge > Ovulation > Progesterone (from corpus luteum) >progesterone falls > menstruation

105
Q

What is Mittelschmerz?

A

blood from ruptured follicle or follicular enlargement causes peritoneal irritation (can mimic appendicitis)

106
Q

What is the best test to confirm menopause?

A

FSH level is WAY up because of lost negative feedback from estrogen.

107
Q

High testosterone High LH

A

Defective androgen receptor

108
Q

High testosterone low LH

A

Testosterone secreting tumor, exogenous steroids

109
Q

low testosterone High LH

A

primary hypogonadism

110
Q

low testosterone low LH

A

Hypogonadotropic hypogonadism

111
Q

Female pseudohermaphrodite

A

XX, ovaries, virilized externally (excessive inappropriate early exposure ot androgens (eg, congenital adrenal hyperplasia, exogenous adminstration)

112
Q

Male pseudohermaphrodite

A

XY, testes, feminized externally(androgen insensitivity syndrome)

113
Q

True hermaphroditism

A

Ovary and teste tissue present (46XX or 47XXY) (super rare)

114
Q

Androgen insensitivity syndrome

A

46XY, defective androgen receptor. Normal appearing female (testes in labia majora)

115
Q

5-alpha-reductase deficiency

A

Autosomal recessive. XY, ambiguous genitalia until puberty

116
Q

Kallman syndrome

A

defective migration of GnRH and defective olfactory bulb. Anosmia, lack of sex characteristics, low everything

117
Q

How do you treat a mole?

A

D and C plus methotrexate

118
Q

Preeclampsia

A

HTN, proteinuria, edema

119
Q

Eclampsia

A

preeclampsia plus seizures

120
Q

HELLP

A

Hemolysis, Elevated Liver enzymes, Low Platelets: maternal cerebral hemorrhage and ARDS

121
Q

Leuprolide

A

GnRH analogue. Infertility (pulsitile), prostate cancer, uterine fibroids, precocious puberty (continuous): Antiandrogen, nausea, vomiting

122
Q

Testosterone, methyl testosterone

A

Stimulates anabolism to promote recovery following burn or injury

123
Q

Finasteride

A

5-alpha-reductase inhibitor: BPH and male pattern baldness

124
Q

Flutamide

A

competitive inhibitor of androgens at testosterone receptor: prostate cancer

125
Q

Ketoconazole

A

Inhibits 17,20-desmolase (steroid synthesis) : PCOS

126
Q

Spironolactone

A

Inhibits steroid binding : hirsutism in PCOS

127
Q

Ethinyl estradiol, DES, mestranol

A

bind ER. HRT, androgen-dependent prostate cancer. (DES in utero > clear cell cancer of vagina)

128
Q

clomiphene

A

SERM: partial agonist at ER in hypT thus preventing feedback inhibition of LH and FSH release. Treats infertility

129
Q

tamoxifen

A

SERM: antagonist at breast ER (breast cancer treatment)

130
Q

raloxifene

A

SERM: Agonist at bone ER (osteoporosis)

131
Q

Anastrozole/ exemestane

A

Aromatase inhibitors (postmenopausal with breast cancer)

132
Q

Progestins

A

bind progesteron receptor (OCPs, endometrial cancer, abnormal uterine bleeding)

133
Q

Mifeprostone (RU-486)

A

Competitive inhibitor at PR. (induce abortion with misoprostol) Toxicity: heavy bleeding, N/V/A, ab pain

134
Q

Terbutaline

A

Beta-2-agonist to relax the uterus

135
Q

Tamsulosin

A

Highly selective alpha-1a,d-agonist to relax smooth muscle in urethral sphincter

136
Q

Sildenafil, vardenafil

A

Inhibit phosphodiesterase 5 > increased cGMP > smooth muscle relaxation in corpus cavernosum: First hot and heavy then HEADACHE, HEARTBURN, HYPOTENSION

137
Q

Danazol

A

partial agonist at androgen receptors (endometriosis and hereditary angioedema)

138
Q

Gynecologic malignancy incidence

A

endometrial > ovarian > cervical

139
Q

Gynecologic malignancy prognosis

A

Worst is ovarian > cervical > endometrial

140
Q

Most common causes of anovulation

A

pregnancy, PCOS, obesity, HPO axis abnormalities, premature ovarian failure, hyperprolacinemia, thyroid disorders, eating disorders, Cushing’s syndrome, adrenal insufficiency

141
Q

What is Meigs’ syndrome?

A

ovarian fibroma, ascites, and hydrothorax

142
Q

Paget’s disease or breast abscess. Location?

A

Nipple

143
Q

Intraductal papilloma, breast abscess, mastitis. Location?

A

Lactiferous sinus

144
Q

Fibrocystic change, ductal cancer. Location?

A

Major duct

145
Q

Tubular carcinomat. Location?

A

Terminal duct

146
Q

Lobular carcinoma, sclerosing adenosis. Location?

A

Lobules

147
Q

Fibroadenoma, phyllodes tumor. Location?

A

Stroma

Reproductive (1 decks)

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