Reproductive Gynaecology

Question 1

TRUE/FALSE

The reproductive cycle is entirely variable, therefore it is impossible to predict onset of the next mensturation

Answer 1

FALSE

Although cycle duration is variable there is a fixed 14 days from ovulation to onset

Question 2

What are the 3 layers of the blastocyst?

Answer 2

Embryocele
Trophoblast
Blastocele

Question 3

What hormone stimulates ovarian follicle development and granulose cells to produce oestrogen?

Answer 3

FSH

Question 4

What two things in the follicular phase inhibit FSH production (in order to cause atresia to all but the dominant follicle)

Answer 4

^ Oestrogens

Inhibit by dominant follicle

Question 5

What hormone surges 24-48h prior to ovulation?

Answer 5

LH

Question 6

What 3 things happen in the luteal phase post ovulation?

Answer 6

Formation of corpus luteum
Progesterone production
Luteolysis

Question 7

What hormone in the proliferative phase of the endometrial cycle induces growth go endometrial glands and storm?

Answer 7

Oestrogen

Question 8

What is the predominant hormone in the luteal phase?

Answer 8

Progesterone

Question 9

What inhibits scar tissue formation in mensturation?

Answer 9

Firbinolysis

Question 10

TRUE/FALSE

Glands and stroma in the secretory phase become more torturous

Answer 10

TRUE

Question 11

What does post-menopausal endometrium look like?

Answer 11

non-cycling, inactive, thin and atrophic

Question 12

How is the functional endometrial layer shed off?

Answer 12

As it outgrows the blood supply (the spiral arteries collapse)

Question 13

What endometrial thickness in postmenopausal women would indicate that a biopsy is needed?

Answer 13

> 4mm

Question 14

What is the average premenopausal endometrial thickness?

Answer 14

16mm

Question 15

The corpus luteum function is to drive the ———- endothelium

Answer 15

Secretory endothelium

Question 16

What 3 reasons make an endometrial biopsy difficult to interpret?

Answer 16

1. Constant changes during reproductive life
2. Changes due to hormone therapy
3. Lack of clinical data

Question 17

What are the two ways to get an endometrial sample using hysteroscopy?

Answer 17

1. Endometrial pipelle

2. Dilation and Curettage

Question 18

What 4 things is it important to check for evidence of on biopsy?

Answer 18

Endometriosis
Hyperplasia
Malignancy
Haemorrhage

Question 19

TRUE/FASLE

The undifferentiated gonads of XX and XY are identical, can form ovaries or testes

Answer 19

TRUE

Question 20

What 2 things do fetal testes secrete in order to stop ovaries developing?

Answer 20

Testerone

Mullerian Inhibiting Factor

Question 21

What are the names of the 2 primitive genital tracts?

Answer 21

Wolffian duct

Mullerian duct

Question 22

In Males which primitive genital tract remains?

Answer 22

Wolffian duct

Question 23

In Females which primitive genital tract remains?

Answer 23

Mullerian duct

Question 24

How early into development foes differentiation of external genitalia begin?

Answer 24

9WKS

Question 25

From what age are you able to differentiate male from female on scan?

Answer 25

16wks

Question 26

What do those with androgen insensitivity syndrome phenotypically look like?

Answer 26

Female genitalia Absence of ovaries/uterus Lack of pubic hair

Question 27

How do you treat Androgen insensitivity syndrome?

Answer 27

Remove testes to prevent development of seminoma

Question 28

Why is it important that the testes descend?

Answer 28

Lower temperature outside body to regulate spermatogenesis | Nervous reflex triggers dartos muscle contraction in scrotal sac

Question 29

TRUE/FALSE | Those with cryptoorchism are infertile

Answer 29

FALSE | Commonly reduced sperm count nut if unilateral then usually fertile

Question 30

Epididymus is located posterior to the testes TRUE/FALSE

Answer 30

TRUE

Question 31

What 3 things could be the cause of small/difficult to palpate testes?

Answer 31

Cryptoorchism Kallmanns Kleinfelters

Question 32

What is spermatogenesis?

Answer 32

Process by which haploid spermatozoa develop from germ cells in the seminiferous tubules of the testes

Question 33

How long does it take from undifferentiated diploid germ cells to multiply and be transformed into haploid spermatozoa?

Answer 33

3 months

Question 34

What are the two function of testis?

Answer 34

1-Spermatogenesis | 2-Production of testosterone

Question 35

What in the testis produces testosterone?

Answer 35

Leydig cells

Question 36

What in the testis produces sperm?

Answer 36

Seminiferous Tubules

Question 37

Why is the acrosome important?

Answer 37

It contains enzymes for penetrating the ovum

Question 38

6 functions of sertoli cells

Answer 38

1. Form blood-testes barrier 2. Provide nutrients for developing cells 3. Phagocytosis 4. Secrete seminiferous tubule fluid 5. Secrete androgen binding globulin 6. Secrete inhibit and activin hormones

Question 39

How often is GnRH realised from the hypothalamus?

Answer 39

Every 2-3 hours

Question 40

What does GnRH stimulate the anterior pituitary to produce?

Answer 40

LH | FSH

Question 41

What is GnRH under negative feedback from?

Answer 41

Testosterone

Question 42

What does LH act on in males?

Answer 42

Leydig cells | regulate testosterone secretion

Question 43

What does FSH act on in males?

Answer 43

Sertoli cells | to enhance spermatogenesis

Question 44

What are the effects of testosterone on an adult?

Answer 44

``` Controls spermatogenesis Secondary sexual characteristics Lidido Penile erection Aggressive behaviour ```

Question 45

Where are the Sertoli cells located?

Answer 45

Seminiferous tubule

Question 46

Where does fertilisation tend to happen?

Answer 46

Ampullary region of the fallopian tube

Question 47

What forms 90% of the ejaculate volume?

Answer 47

seminal fluid

Question 48

Why is seminal fluid alkaline?

Answer 48

To buffer vaginal acidity

Question 49

What part of the male anatomy concentrates and stores sperm and is the site for its maturation?

Answer 49

Epididymus and vas deferens

Question 50

Seminal vesicles produce semen into ejaculatory duct. What 3 others things are secreted alongside it and why?

Answer 50

Fructuose- Energy for sperm Prostaglandins- Stimulate motility Fibrinogen- Clot precursor

Question 51

What 2 things does the prostate gland produce?

Answer 51

Alkaline fluid | Clotting enzymes

Question 52

What do the bulbourethral glands secrete and why?

Answer 52

Mucous-lubricant

Question 53

What is the route of sperm from the testes?

Answer 53

``` Testes Epididymus Vas deferens Ejaculatory duct Urethra ```

Question 54

Erection is under which type of control?

Answer 54

Parasympathetic

Question 55

What happens during erection?

Answer 55

Corpus cavenosum fills with blood

Question 56

How is semen expelled from the urethra?

Answer 56

Contraction of accessory sex glands

Question 57

Ejaculation is under what type of control?

Answer 57

Sympathetic

Question 58

What 3 things may cause retrograde ejaculation?

Answer 58

1. Diabetes 2. Prostatic surgery 3. Anticholinergic drugs