Reproductive Flashcards by Vipashyana Jadav

Alcohol consumption by mother causes

Impaired migration of neuronal and glial cell

Smooth philtrum
Thin vermilion
Small palpebral fissures
Mental retardation and microcephaly
Heart and limb defects
Heart and lung fistula
Holoprosencephaly

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Neonatal abstinence synd

Features in newborn which suddenly are withdrawn from maternal opiate effect
Seen as diarrhoea tremors seizures high pitched crying problem sucking

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Hcg therapy is used

To triger ovulation in an oocyte donor when her follicles are matured enough

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Pulsatile GnRh therapy is used in

Hypogonadotropic hypogonadal anovulation to stimulate ovulation

These pts have intact pituitary and ovarian function but have problems concieving because of disordered hypothalamic GnRH secretion

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Clomiphene citrate is antiestrogen

Used to stimulate ovulation in

Pts with normal gondotropin and normal prolactin and thyroid pts
They simply have ovulatory failure

Clomiphene being antiestrogen blocks the hypothalamic feedback. Gnrh increases fsh and lh increases ovulation occurs

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Genetic disorder with dysgenesis of seminiferous tubules
Barr body presence in male
Fsh and estrogen are high
Inhibin b and testosterone are low

Kleinfelter syndrome

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Shortened 4th metacarpal

Turners

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Turners cause is

Meiotic non disjunctjon or mitotic non disjunction
Most commonly it is sperm lacking a sex chromosome— paternal loss of x or y chromosome

If mitotic non dysjunction —seen in zygote and leads to mosaicism

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Gonadoblastoma in turners is seen with what type of genetics

When turners is due to mosaicism

45X/46XX

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Premature ovarian failure causez

Smoking
Chemotherapy
Radiation therapy

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Treatment of pid shud include

Drugs targetting both neisseria gono and chlamydia trachomatis

third gen cephalosporin and azithromycin/ doxycycline

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Semen characteristics in congenital abs of vas deferens

Low sperm volume

Acidic ph of semen

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Major organisms for pid

N gono

Chlamydia trachomatis

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Use of flutamide in prostate cancer

Used concurrently with long acting GnRh agonist like leuprolide which initially causes lh and testosterone release transient effect
To counteract this testosterone receptor antagonist like flutamide is given
Can reduce growth of tumour and metastasis

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Use of aromatase inhibitors

Anastrozole
Used in postmenopausal females with ER positive breast cancer
Inhibits peripheral conv of androgens to estrogen

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Uses of finasteride

It is 5 alpfa reductase inhibitor

Prostatic hypertrophy
Male pattern baldness ( effect of DHT)

Blocks testosterone to DHt peripheral conversion

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Name serms

Tamoxifen

Raloxifene

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Why are tamoxifen and raloxifen called modulators

Because they have mixed agonist/ antagonist action

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Side effects of serm therapy

Hot flashes

Deep vein thrombosis and others veins

Endometrial carcinoma/hyperplasia with tamoxifen only

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Why is prolactinoma associated with infertility in both males and females

Because prolaction is inhibitory of GnRH SECRETION at hypothalamus

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Prolactin secretion is controlled by

Trh and vip has positive role in secretion

Dopamine inhibits secretion

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Testicular atrophy and gynaecomastia are seen in both anabolic steroid abuse as well as kleinfelters syndrome

What symptoms can differentiate

Acne aggressive behaviour
Male pattern baldness and early epiphyseal closure (short height) is anabolic steroid abuse

On other hand ks has azospermia, tall height, cognitive impairement, absence of secondary sexual characterisitics

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Most common malignancy in struma ovarii

Papillary thy ca
Followed by
Follicular thy ca

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Newborn crying tremors tachypnea sneezing diarrhoea

Increased tone points to what syndr

Neonatal abstinence syndrome

Due to withdrawal from maternal opiate effect

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Treatment of neonatal abstinence syndrome

Give opiates since it is opiate withdrawal symptoms Give morphine or methadone

Cvs manifestation of congenital rubella

PDA | peripheral pulmonic stenosis

Classic clinical triad of congenital rubella is?

SNHL— deaf child Cataracts—- white pupils PDA- continuous murmur in left infracl region

Who all can be given rubella live attenuated vaccine

Children 12 to 15 months Children 4 to 6 years Non pregnant women with negative serum rubella antibodies Avoid preg for 1 month after this live rubella vaccine

Treatment of rubella

No drug to treat rubella once it has occured

Hiv fusion inhibitor drug is named

En-fu-viritide | Is a new fusion inhibitor approved for hiv

Interferons are used to treat

Hep B and C hairy cell leukemia Condyloma acuminatum Kaposis sarcoma

Most adult women with rubella has what sequelae

Polyarthralgia | Polyarthritis

P57 is a ihc marker for

Complete mole P57 is a imprinted gene Hence lack of p57 is complete mole

Endodermal sinus tumours also known as yolk sac tumour of ovaries have characteristic histology known as

Schiller duval bodies which resemble glomeruli Serum AFP is raised in yst

Fried egg cell with large round nucleus surrounded by clear cytoplasm Which ovarian tumour is this

Dysgerminona

Hormones secreted by dysgerminoma

B hcg and LDH

Estrogen and inhibin secreting tumours of ovaries are

Granulosa cell tumours | They are sex cord stromal neoplasms

Histopatho of granulosa cell tumour of ovary is

Coffee bean groove in nucleus | Known as call-exner bodies within atypical granulosa cells

Psammoma bodies are seen in which ovarian tumour

Serous cystadenocarcinoma

Hirsuitism and clitoromegaly is seen in which rare ovarian tumour

Testosterone secreting Leydog-sertoli cell tumour

Name the types of sex cord stromal neoplasms of ovaries

1- granulosa cell tumour | 2- leydig- sertoli neoplasm

Glycogen deficient vaginal epithelium

Estrogen deficiency from premature ovarian failure or menopause Results in flatenning of labial folds and vaginal rugae causing dyspareunia

Increased endometrial gland to stromal ratio

Endometrial hyperplasia | Has intermentrual bleeding

Prostate biopsy | Large vesicular nuclei with prominent nucleoli

Prostatic adenoca

17 alpha hydroxylase inhibitor is named—— used to treat——

Abira-tirone Used to treat advanced prostatic adenoca To stop extratesticular androgen production from adrenal glands and tumour cells via cytop450 enz 17 alpha reductase Which converts pregnelone and progesterone to DHEA /androstenedione

Hyperthyroidism in ovarian tumour

Struma ovarii | Biopsy of ovary shows mature thyroid tissue

Whst associated clinical features are seen in pts with complete mole

``` Uterus out of proportion to dates Preeclampsia Hyperthyroidism Hyperemesis Theca leutin ovarian cysts ```

What cells are seen in placental site gtn

Anaplastic intermediate trophoblast proliferation

Placental site trophoblastic tumour produces what hormone

HPL

Side effect of oral isoretenin therapy for cystic acne

``` Teratogenic Pseudotumur cerebri Hyperlipidemia Myalgia Dry skin- cheilitis ```

Aromatase is a key enz for conversion of androgens to estrogen Genetic def is ar or ad

Males with aromatase deficiency will have

Tall stature because no estrogen from epiphyses closure Osteoporosis because of lack of estrogen But no genital abn

Female fetus with aromatase def will have

Internal female organs External genitalia are ambiguous because of no estrogen and more androgens At puberty will have primary amenorrhoea, tall height and osteoporosis

DHT. Deficiency | Dihydrotestosterone def is seen in

5 alpha reductase def

Reduced glucocorticoids and androgen Increased mineralocorticoids What syndr

Congenital adrenal hyperplasia | Enz def is 17 alpha hydroxylase

Ambiguous genitalia in males with salt retention and hypertension In what syndr

CAH with only mineralocortocoid production | Ie 17 alpha hydroxylase deficiency

Ambiguous genitalia in females Salt wasting and hypotension What syndrome

CAH due to 21 hydroxylase def Here only androgens are produced hence virilisarion of female fetus No glucocorticoid or mineralocorticoid produced hence salt wasting and hypotension

Proliferation of cytotrophoblast and syncytiotrophoblast with no villi in post partum d and c May have lung metastasis Usually extremely high b hcg

Choriocarcinoma Cytotrphoblast are mononuclear Syncytiotrophoblast are multinuclear No villi

—-drug is used to treat trichomonal vaginitis and ——- When pt taking this medicine takes alcohol it causes——reaction due to accumulation of —

Metronidazole Bacterial vaginosis Disulfiram like reaction Accumulation of acetaldehyde

A person taking anabolic steroids shud have normal or high testosterone If he has low testosterone It indicates consumption of what

Synthetic androgens like tren-bolone

Causes of oligospermia

Ej duct obst—-all hormone normal Primary hypogondasim- testo low.. gonadotropins high Secondary hypogonadotrophic hypogonadism—- all low Partial androgen resistence— normal fsh, high LH AND TESTOsterone

Microrganisms for acute bacterial prostatitis

All are gm negative because their fimbrae hve adhesins having specific tropism for urothelial and mucosal cells ECOLI PROTEUS KLEIBSELLA PSEUDOMONAS

Cervical infection with gm negative diplococci | Kidney shaped organism in leukocytes

Neiseeria gonoccoi

Complication of vzv | Complication of hsv 2

Vzv— post herpetic neuralgia | Hsv2– reactivation genital ulcers and lesions

Urinary analgesic for relief of dysuria

Phenazo-pyridine

What protooncogenes code for cytoplasmic signal transducer proteins When mutated cause constitutive activation of signals and henceproliferation and malignancy

Signal transduce protein genes RAS(pancreatic cancer) | BRAF (melanoma)