Reproductive System

Question 1

Provide alternative names for:

a. Female gametes

b. Male gametes

c. Together a female gamete and male gamete produce

d. Childbirth

Answer 1

a. Female gametes - Ova

b. Male gametes – sperm

c. Together a female gamete and male gamete produce – a zygote

d. Childbirth – Parturition

Question 2

The breasts are referred to as the —– glands of the female reproductive system. Each breast contains a —– gland, which is a modified sweat gland that specialise on the production and ejection of —–. Each gland consists of 15-20 —– separated by —– tissue. The lobes contain grapelike clusters of glands called —–. Suspensory —– support the breast between the skin and the underlying —–.

Answer 2

The breasts are referred to as the accessory glands of the female reproductive system. Each breast contains a mammary gland, which is a modified sweat gland that specialise on the production and ejection of milk. Each gland consists of 15-20 lobes separated by adipose tissue. The lobes contain grapelike clusters of glands called alveoli. Suspensory ligaments support the breast between the skin and the underlying fascia.

Question 3

Name the ‘sinuses’ which store milk in the breasts.

Answer 3

Laciferous sinuses

Question 4

Name and describe the function of the two main hormones involved in lactation

a. Prolactin

b. Oxytocin

Answer 4

a. Prolactin
Stimulate the production of milk

b. Oxytocin
Suckling stimulates oxytocin which ejects milk

Question 5

Name FOUR functions of the uterus.

Answer 5

a. Pathway for sperm
b. Site for zygote implantation
c. Location for foetal development
d. Contracts to initiate labour

Question 6

Describe specifically the structure and function of the endometrium.

Answer 6

• It is the highly vascular inner most layer of the uterus.
• It’s role is to deliver nutrients to the embryo and support development.
• It has two layers. Stratum Basale is a permanent base layer. Stratum Functionalis is formed from the stratum Basala and is constantly building and shedding in line with the menstrual cycle.
• During a period the stratum functionalis sheds and then rebuilds to prepare for a fertislised egg.
• If the egg is fertilised it is embedded in the endometrium. If it is not the endometrium will shed again during the period.

Question 7

Name the THREE layers of the uterine wall and the two sub layers of the layer

Answer 7

.
Perimetrium – Outer visceral layer
Myometrium – 3 smoooth muscle layers
Endometrium – Highly vascular inner layer that is divided into
- Stratum Functionalis which sloughs off during menses and,
- Stratum Basalis which is a permanent layer.

Question 8

Name ONE uterus tissue layer that contains smooth muscle.

Answer 8

The middle, and thickest, layer in the uterus is the Myometrium. It contains 3 layers of smooth muscle.

Question 9

Name ONE ligament that holds the uterus in place.

Answer 9

The uterus is kept in place using ligaments. The most important one is the Broad Ligamentthat acts like a wrapping or casing around the front and back of the reproductive organs.

Question 10

State which layer of the uterus sheds during menstruation.

Answer 10

Endometrium

Question 11

Describe the difference between an ‘embryo’ and a ‘foetus’.

Answer 11

Embryo < 8 weeks
Foetus > 8 weeks

Question 12

Describe the main role of the placenta.

Answer 12

• Supplies the zygote/embryo/foetus with nutrients and removes waste.
• Also supplies hormones needed to maintain the pregnancy
• At 12 weeks it divides into a maternal and foetal creating a protective membrane to separate mother and baby foetal blood and protect against harmful organisms.

Question 13

Explain why the placenta is described as ‘unique’.

Answer 13

It develops from two individuals (maternal part from the endometrium)

Question 14

Explain how the placenta connects to the embryo / foetus.

Answer 14

Through the umbilical chord which provides oxygen and nutrients and removes waste.

Question 15

Discuss the following statement:

‘The placenta is an effective barrier to all medicine and drugs’

Answer 15

It is a barrier but it is not perfect. Alcohol and many drugs can pass through it freely and cause birth defects.

Also whilst most micro organisms cannot pass through it, some can, such as HIV, measles and polio

Question 16

State which cell type cannot cross the placenta.

Answer 16

Blood - thus keeping mother and baby blood separate but allowing the transfer of substances from the blood to one another.

Question 17

Name 6 placental hormones and what they do.

Answer 17

Corticotropin releasing hormone (CRH)
Triggers release of cortisol from the adrenals which as an immune suppressant prevents rejection of the foetus

Human Chorionic Gonadotropin (hCG)
Only produced during pregnancy. Maintains corpus luteum for 8 weeks and increases transfer of nutrients to the foetus.

Human placental lactogen
Increases availability of glucose and lipids in the maternal blood by breaking them down

Oestrogen
Promotes growth of
- The myometrium
- Breast tissue

Progesterone
Maintains endometrial lining to sustain and nourish the foetus.
Pregnancy would not be viable without it.

Relaxin
Targets ligaments and relaxed them

Question 18

Using definitions, compare the following placental complications:

a. Placenta praevia
b. Placenta accreta
c. Placental abruption

Answer 18

a. Placenta praevia - occurs when the placenta attaches to the lower part of the uterine wall, potentially obstructing the opening of the cervix.
Attaches too low

b. Placenta accreta - occurs when there is an abnormally deep attachment of the placenta through the endometrium in the myometrium.
Attaches too deep
Increta - invades myometrium
Percreta - through the uterine wall to, for example, the bladder

c. Placental abruption - occurs when the placenta detaches from the uterine wall and you get a rupture of the blood vessel between the two areas.

Risk factors - smoking & pre-eclampsia
Unattaches

Question 19

Describe TWO differences between ‘monozygotic’ and dizygotic’ twins.

Answer 19

Monozygotic twins Vs Dizygotic Twins

Come from the same fertilised egg Vs One egg-one sperm

Two eggs independently implanted V Two eggs and two sperm

Identical Vs Non identical

Two embryos – one shared placenta Vs Two embryos – two placentas

Question 20

Describe TWO functions of the fallopian tubes.

Answer 20

A route for the sperm to meet the ova
A route for the fertlised ova to reach the uterus

So … without the fallopian tubes no fertilisation and no ovum carried to the uterus.

Question 21

Explain how the ovum travels from the ovary into the fallopian tubes.

Answer 21

• Finger like projections called fimbriae surround the ovary and sweep the ova into the fallopian tube

Question 22

Describe the TWO functions of the ovary.

Answer 22

1. Produce female gametes (secondary oocytes)
2. Secrete the sex hormones oestrogen and progesterone

Question 23

Complete the following:

Oogenesis refers to the formation of female —– in the ovaries. Oogenesis begins in the —–. —– —– are formed from germ cells during foetal development. The formation of primary oocytes stops —– and they are surrounded by a layer of follicular cells, the entire structure is called a —– follicle. During a woman’s reproductive lifetime about —– follicles will mature and ovulate whilst the remainder —–.

Answer 23

Oogenesis refers to the formation of female ova in the ovaries.

Oogenesis begins in the foetus. Primary oocytes are formed from germ cells during foetal development.

The formation of primary oocytes stops at birth and they are surrounded by a layer of follicular cells. The entire structure is called a primordial follicle.

During a woman’s reproductive lifetime about 400 follicles will mature and ovulate whilst the remainder degenerate.

Question 24

Describe how FSH and LH play a role in post pubertal oogenesis.

Answer 24

Every month these two pituitary hormones stimulate the development and release of a mature ovum from the ova.

Follicular Stimulating Hormones (FSH) do what it says on the label.
They stimulate the maturation of the primordial follicle &raquo_space;> to the primary follicle&raquo_space;> to the secondary follicle&raquo_space;> to the mature follicle (containing the secondary oocyte).

Then …

Lutenising hormone triggers ovulation pushing the secondary oocyte out of the mature follicle to release the egg out of the ovary.

Question 25

List FOUR stages of the menstrual cycle (HINT – include days).

Answer 25

Day 1-5 Menstrual Phase 6-13 Pre-ovulatory phase 14 Ovulation 15-28 Post-ovulatory phase

Question 26

Describe in detail the first half of a typical menstrual cycle (Day 1‒13).

Answer 26

**Days 1-5 Menstrual Phase** In the uterus endometrium is shed. Bleeding. Menstruation. Progestogen drops In the ovaries follicles are developing rapidly under the influence of FSH **Days 6-13 Pre-Ovulatory phase** In the uterus endometrium thickens and rebuilds. Oestrogen is rising. In the ovaries follicles mature. FSH falls due to secretion of inhibin from the follicles which stops more follicles developing. A dominant one is pushed up till its mature stage and by the end of this period is fully formed.

Question 27

Describe in detail the second half of a typical menstrual cycle (Day 14‒28).

Answer 27

**Day 14 Ovulation Phase** High oestrogen levels stimulate LH secretion. In the ovaries LH causes the rupture and expulsion of mature follicle. The follicles remain and form the corpus luteum. **Day 15-28 Post-Ovulatory Phase** In the ovaries, corpus luteum releases progesterone and some oestrogen to maintain the endometrium just in case there is a pregnancy.

Question 28

Explain how the corpus luteum is formed.

Answer 28

During the ovulation phase the mature follicle ruptures and the egg is released. What remains behind are the follicles and these form the corpus luteum.

Question 29

Describe the Corpus Luteum hormones

Answer 29

The corpus luteum is formed from the follicles remaining in the ovaries after the egg is released on day 14... In the ovaries, corpus luteum releases **progesterone** and some **oestrogen** to maintain endometrium just in case there is a pregnancy. For the first 8 weeks this is where progesterone and Oestrogen are produced. To maintain the corpus luteum itself, **Human Chorionic Gonadotropin (hCG)** is used for the first 8 weeks

Question 30

Walk us through the menstrual cycle hormones

Answer 30

**Pituitary hormones FSH and LH control the ovaries** Days 1-5 follicles are developing rapidly under the influence of FSH Days 6-13 FSH falls which stops more follicles developing **Ovarian hormones oestrogen and progesterone control the uterus** Days 1-5 Progestogen drops Days 6-13 Oestrogen is rising. Day 14 High oestrogen levels stimulate LH secretion. Day 15-28 corpus luteum releases progesterone and some oestrogen to main the endometrium just in case there is a pregnancy.

Question 31

12. Describe what happens (in terms of hormones and the corpus luteum) to a: a. Fertilised egg b. Non-fertilised egg

Answer 31

a. Fertilised egg Zygote embeds in the uterine wall >>> human chorionic gonadotropin (HCG) is released immediately >>> this maintains and stimulate the corpus luteum so that it can produce oestrogen and progesterone needed for a viable pregnancy >>> after a few weeks the placenta takes over this role of producing hCG and progesterone. HcG is essential for a viable pregnancy. b. Non-fertilised egg After 14 days the corpus luteum degenerates >>> becomes corpus albicans >>> progesterone and oestrogen drop and a new menstrual cycle begins.

Question 32

Name THREE hormones involved in the onset of puberty.

Answer 32

FSH LH Both stimulated by GnRH The onset of puberty is marked by pulses of LH, and FSH, each triggered by a burst of GnRH . These pulses increase over 3 to 4 years, and during the day as well as the night as puberty advances

Question 33

List THREE body changes that typically occur during puberty.

Answer 33

Breast growth Hair growth -pubic, underarms, arms and legs Hips widen Voice deepens.

Question 34

Define the ‘menopause’.

Answer 34

When a woman has not had a period for 12 consecutive months.

Question 35

State the normal age range for menopause.

Answer 35

45-55

Question 36

Describe how the normal menopause develops (HINT — hormones).

Answer 36

Ovaries age and the supply of oocytes is depleted. If they are not maturing, menstrual cycles are not possible. We get a negative feedback loop. Less oestrogen and progesterone due to a lack of a menstrual cycle, trigger more FsH and LH

Question 37

List THREE signs / symptoms of menopause.

Answer 37

Hot flushes and increased sweating Osteoporosis Brain Fog Painful sex due to vaginal drtness Increased risk of UTI’s Mood changes - Anxiety

Question 38

Explain why a woman experiencing menopause is at an increased risk of osteoporosis.

Answer 38

Loss of oestrogen reduces osteoblast activity which builds bone. Osteoclast activity out of balance.

Question 39

Explain why it is important to maintain a balanced blood glucose during menopause.

Answer 39

Hypoglycaemia can induce hot flushes

Question 40

Briefly explain the process of IVF.

Answer 40

Artificial fertilisation of the ovum by the sperm outside of the body. o Eggs are retrieved from the ovaries after use of a drug to stimulate oocyte development o Incubated with sperm on a petri dish or sperm injected into egg o Embryo transferred/implanted to the uterus

Question 41

What is meant by an ectopic pregnancy?

Answer 41

Ectopic = abnormal location An Ectopic pregnancy is a pregnancy taking place somewhere other than the uterus. Most commonly the fallopian tubes. It is dangerous and must be terminated.

Question 42

Explain why a patient with breast cancer might have their axillary lymph nodes removed

Answer 42

To prevent cancer metastases via the lymph system beyond the original sight.

Question 43

Name FOUR components of the male reproductive system.

Answer 43

Two Testes Two Epididymides around each testicle Two Vas Deferens One prostate glans One penis

Question 44

State which nervous system stimulates erectile tissue and involuntary muscle.

Answer 44

Erectile tissue and involuntary muscle are stimulated by the Parasympathetic nervous system. It produces nitric oxide that is a vasodilator and a key gas in erections.

Question 45

Name TWO functions of the male urethral canal.

Answer 45

Reproductive Urinary

Question 46

List TWO key functions of the testes.

Answer 46

Spermatogenesis Testosterone production and secretion

Question 47

Explain the role of FSH and LH in relation to the male testes.

Answer 47

FSH regulates spermatogenesis in the testes LH regulates testosterone production and secretion in the testes.

Question 48

Describe the role of the epididymis.

Answer 48

Where sperm matures and is stored before ejaculation

Question 49

State the ideal body temperature for spermatogenesis.

Answer 49

3 degrees below body temperature.

Question 50

Draw and label a sperm a. Head - filled with a nucleus. b. Acrosome - a vehicle covering the head of the sperm that contains enzymes to penetrate the egg. c. Mitochondria d. Flagellum (tail)

Answer 50

Question 51

Describe the role of the acrosome.

Answer 51

A vesicle covering the head of the sperm that contains enzymes to penetrate the egg.

Question 52

Describe the main role of the following in relation to seminal fluid: a. Seminal vesicles b. Prostate gland

Answer 52

a. Seminal vesicles A pair of glands located behind the bladder that secrete alkaline nutrient rich seminal fluid to nourish sperm. Makes up 60% of semen. b. Prostate gland Secretes a thin milky fluid that contains - nutrients for ATP production - Lots of enzymes to break down substances into forms that sperm can use. - anticoagulants to increase fluidity of the sperm - Prostate specific antigen

Question 53

Explain why seminal fluid is alkaline.

Answer 53

To protect the sperm from urethral and vaginal acidity.

Question 54

Describe the main role of Bulbourethral glands (Cowpers glands)

Answer 54

Pre- ejaculate * They sit at the base of the penis * They provide a mucousy alkaline rich secretion * pre ejaculate lubricates the end of the penis so that there is no friction.

Question 55

Define the following: Dysmenorrhoea Dyspareunia Gynaecomastia Menorrhagia Amenorrhoea

Answer 55

Reproductive term: Definition: Dysmenorrhoea: Painful periods Dyspareunia: Pain on intercourse (female) Gynaecomastia: Enlarged breast tissue in men Menorrhagia: Increased menstrual bleeding Amenorrhoea: Absence of periods

Question 56

Describe the difference between ‘primary’ and ‘secondary’ amenorrhoea.

Answer 56

Primary is when a period does not start at the expected age of onset. It is mostly a congenital condition where something fails to develop properly Secondary is where the lack of period of 3 months in women who had previously been menstrual. Usually due to a pathology such as PCOS, stress, pituitary tumour, anorexia

Question 57

List TWO causes of secondary amenorrhoea.

Answer 57

PCOS Pituitary tumour Anorexia Stress. Cortisol suppresses GnRH Excessive exercise

Question 58

Describe the difference between ‘primary’ and ‘secondary’ dysmenorrhoea.

Answer 58

Dysmenorrhea - painful menstrual periods In primary there does not seem to be an association with any pelvic diseases but there seems to be an excess of uterine prostaglandins which have a pro inflammatory effect and cause the myometrium to contract. In secondary it is associated with pelvic or systemic pathologies such as endometriosis, fibroids, pelvic inflammatory disease.

Question 59

Name TWO reproductive pathologies that contribute to secondary dysmenorrhoea.

Answer 59

Endometriosis Fibroids Pelvic inflammatory disease

Question 60

Name the menstrual phase affected by premenstrual syndrome (PMS).

Answer 60

Luteal phase – the second half of the menstrual cycle

Question 61

List TWO causes of PMS.

Answer 61

It is a syndrome so it is not consistent but it is thought to be a hormonal imbalance: * Rapid shifts in levels of Oestrogen and Progesterone * Drop in progesterone in the luteal phase and increased production of prostaglandins **Progesterone imbalance can fluctuate the level of neurotransmitters such as serotonin.**

Question 62

Name FIVE signs / symptoms of PMS.

Answer 62

Mood disturbances Anxiety Bloating Fatigue Insomnia

Question 63

Using definitions compare ‘pelvic inflammatory disease’ with ‘endometriosis’.

Answer 63

Pelvic inflammatory disease is an infectious and inflammatory disorder of the upper female genital tract including the uterus, fallopian tubes and ovaries. Endometriosis is a condition where the endometrial tissue colonises in other parts of the body outside of the uterine cavity, leading the shedding and bleeding in areas that are not designed for it. It can be in the reproductive tract but also can spread to organs and ligaments etc

Question 64

List ONE infectious cause of pelvic inflammatory disease (PID).

Answer 64

Pelvic inflammatory disease (PID) is an infection of the female reproductive system which includes the womb, fallopian tubes and ovaries. * The infection typically results from spread of bacteria from the cervix * STD’s such as gonorrhoea and Chlamydia * Insertion of IUD * Non sterile abortion or delivery of a baby

Question 65

List TWO characteristic signs/symptoms of PID.

Answer 65

* Lower abdominal pain - may increase with walking because it rotates the pelvis * Dyspareunia * Purulent discharge * Systemic symptoms such as malaise, fever, nausea and vomiting

Question 66

Name TWO complications of PID.

Answer 66

Ectopic pregnancy Infertility Septicemia

Question 67

Describe the pathophysiology of endometriosis.

Answer 67

The endometrium is the highly vascularised inner layer of the uterus. It has two layers - stratum functionalis and strutum basalis. (Stratum functionalis is what sloughs off during during menses). In the pathology endometriosis the endometrium cells move beyond the endometrium and the uterine cavity to other areas of the body. Most commonly these would be other parts of the reproductive system such as the fallopian tubes, ovaries or pelvic cavity but it can spread to ligaments and organs, even the brain. During the menstrual cycle when progesterone levels drop these distant endometrial cell deposits are exposed to circulating hormones and shed as they would in the uterus and bleed. This is very painful and over time can lead to scarring of the tissue and infertility.

Question 68

List TWO locations commonly affected by endometriosis.

Answer 68

Fallopian tubes, ovaries, pelvic cavity

Question 69

Describe how the following factors may contribute to endometriosis: a. Altered immune surveillance b. Primordial cells c. Oestrogen dominance

Answer 69

a. Altered immune surveillance Our immune system does not identify rogue endometrial cells outside the uterus b. Primordial cells Primordial cells (cells in the earliest stages of development) lining other body cavities or organs differentiate into endometrial cells. c. Oestrogen dominance As oestrogen is all about growth, too much circulating oestrogen can turbo charge the growth of endometrial tissue that is in the wrong place. So not responsible for putting it there in the first place but assisting with the pathophysiology of the disease.

Question 70

Name ONE hormone which is dominant in endometriosis.

Answer 70

Oestrogen

Question 71

List TWO signs / symptoms of endometriosis (not dysmenorrhoea).

Answer 71

* Menorrhagia - heavy menstrual bleeding * Pelvic pain around menstruation * Bloating, lower back pain * Infertility * Dyspareunia

Question 72

Name TWO diagnostic procedures used to identify endometriosis.

Answer 72

Ultrasound Laparoscopy – diagnostic and can also laser off the endometrial tissue.

Question 73

Name TWO complications of endometriosis.

Answer 73

* Recurrent inflammation leads to the formation of fibrous tissue that can produce scar tissue. * Scar tissue can obstruct the uterus or the fallopian tubes which can contribute to infertility * Chocolate cysts

Question 74

Using definitions compare ‘fibroids’ and ‘ovarian cysts’.

Answer 74

Fibroids are benign tumours of the myometrium of the uterus. Like endometriosis it is heavily linked to raised oestrogen levels. They consist of smooth muscle and connective tissue. 50-80 are asymptomatic but it can lead to infertility. Ovarian Cysts area fluid filled sacs within the ovary that occurs most commonly when an egg fails to ovulate and instead fills with fluid. They are often asymptomatic unless they get very large and can push on other organs such as the bladder

Question 75

State TWO causes of fibroids.

Answer 75

High rate of oestrogen Obesity (linked to oestrogen) Family history Early menses

Question 76

List TWO characteristic signs / symptoms of fibroids.

Answer 76

In 50-80% of cases it is asymptomatic, but symptoms include - menstrual changes such as increased menstrual bleeding, painful periods or spotting mid cycle - Anaemia due to blood loss - Pressure on the bladder or rectum can lead to increased urgency and frequency of urination, constipation - Bloating and heaviness in the abdomen

Question 77

Explain specifically why fatigue is a common symptom with fibroids.

Answer 77

Iron deficiency anaemia due to excess (Menorrhagia) and prolonged blood loss during menses

Question 78

Name ONE investigative procedure for fibroids.

Answer 78

Ultrasound

Question 79

Define polycystic ovary syndrome (PCOS).

Answer 79

An endocrine metabolic condition associated with - Menstrual and ovulatory dysfunction - High androgen levels - Insulin resistance

Question 80

Explain in detail the pathophysiology of PCOS.

Answer 80

LH:FSH Imbalance: Women seem to have high levels of LH and at the same time FSH seems to be normal or slightly low. Really high levels of LH can cause the ovaries to start out putting male sex hormones [androgens]. These can - suppress female reproductive functions such as the menstrual cycle, - Produce excess sebum leading to oily skin and acne and, - produce male hair patterns. Insulin resistance: High levels of insulin will suppress a protein called sex hormone-binding globulin [SHBG] which results in an increase in levels of testosterone which suppresses ovulation

Question 81

List FOUR symptoms of PCOS.

Answer 81

Lack of period – amenorrhoea Infrequent period – oligomenorrhoea Acne and oily skin Mail hair patterns – Hirsutism Alopecia/baldness Weight gain and difficulty losing weight Rash appearance - Acanthosis Nigricans Anxiety and depression Infertility

Question 82

Name TWO clinical signs associated with hyperandrogenism in PCOS.

Answer 82

Amenorrhoea Hirsutism (mail hair patterns) Acne and oily skin

Question 83

List ONE blood test which may be used to identify PCOS.

Answer 83

Increased androgens Decreased SHBG High LH and normal FSH Elevated blood glucose levels

Question 84

Name TWO investigative procedures (not blood tests) used to identify PCOS.

Answer 84

Ultrasound Laparoscapy

Question 85

Name ONE endocrine pathology which individuals with PCOS are at an increased risk of developing.

Answer 85

Diabetes Melitus

Question 86

State TWO locations in the body where an ectopic pregnancy may occur.

Answer 86

Fallopian tube – 97% Ovary, cervix, abdomen

Question 87

Name TWO observational signs of breast cancer.

Answer 87

Overlying skin changes – dimpling appearance Inverted and discharging nipple

Question 88

List TWO risk factors for the development of breast cancer.

Answer 88

Family history Genetic mutations BRCA1 and 2 Poor diet, sedentary lifestyle, regular alcohol

Question 89

List ONE infectious cause and ONE non-infectious cause of balanitis.

Answer 89

Balanitis is pain and inflammation (swelling and irritation) of the glans (head) of the penis Infectious: Candida Albicans Non Infectious: Lichen sclerosus (auto immune), eczema, proriasis

Question 90

Name TWO signs / symptoms of balanitis.

Answer 90

Balanitis is pain and inflammation (swelling and irritation) of the glans (head) of the penis Pain Irritation dyspareunia

Question 91

List ONE known cause of an undescended testes.

Answer 91

In most cases it is unclear but may be hormonal or structural. It affects 30% of premature boys

Question 92

Name TWO complications of an undescended testes.

Answer 92

1. Damaged sperm leading to infertility 2. Testicular cancer

Question 93

State TWO risks factors for testicular cancer.

Answer 93

Undescended testes Family History

Question 94

Describe the ‘mass’ associated with testicular cancer.

Answer 94

Hard, fixed, painless, unilateral

Question 95

Using definitions compare ‘prostatitis with ‘benign prostatic hyperplasia’.

Answer 95

Prostatitis describes inflammation of the prostrate gland. It can be infectious (bacterial) or non infectious. Benign prostatic hyperplasia is enlargement of the protate tissue leading to compression of the urethra. Hyperplasia is the overgrowth of cells in a healthy tissue or organ.

Question 96

List TWO risk factors for benign prostatic hyperplasia (BPH).

Answer 96

Age – very common in men over 60 Abdominal obesity Being sedentary Pesticides Sympathetic activity

Question 97

Explain the role of the enzyme 5-alpha reductase in Benign prostatic hyperplasia

Answer 97

BPH is associated with an increase in activity in the enzyme 5-alpha-reductase. 5-alpha-reductase converts testosterone to dihydrotestosterone (DHT). DHT has twice the effect on the prostrate at testosterone.

Question 98

Explain the role of DHT in benign prostatic hyperplasia.

Answer 98

Benign Prostatic Hyperplasia (BPH) is an enlargement of the prostate tissue leading to compression on the urethra. In BPH there seems to be a large quantity of androgens, specifically DHT which is a potent androgen that has twice the effect on the prostate as testosterone causing the proliferation of prostate cells.

Question 99

List TWO signs / symptoms of BPH.

Answer 99

- Obstructed/poor urinary flow - Increase urinary frequency - Intermittent urine flow and dribbling of urine - Nocturia

Question 100

Describe the significance of back pain in prostate cancer.

Answer 100

If prostate cancer metastasises it tends to spread up to the lumbar spine first because of its venous drainage. The back pain tends to be unremitting. You don't get relief

Question 101

List ONE sign / symptom (not back pain) more suggestive of prostate cancer.

Answer 101

Nocturia Haematuria Same urinary symptoms as BPH

Question 102

List THREE symptoms of prostate cancer.

Answer 102

Same symptoms as BPH such as nocturia, difficulty emptying the bladder, dribbling but specifically to prostate cancer you might see o Blood in ejaculate o Blood in urine o Pain in lumbar region that is not relieved might suggest metastases to the lumbar spine due to venous drainage.

Question 103

Explain what is meant by PSA.

Answer 103

The prostate secretes prostate specific antigen. It is an enzyme we can pick up on a blood test to assess the function of the prostate. If it is hyper functioning PSA increases. PSA will go up in both benign and cancerous prostate enlargement. It is therefore a sign of an underlying pathology.

Question 104

List TWO diagnostic procedures used to identify both BPH and prostate cancer.

Answer 104

Elevated PSA Digital rectal examination

Question 105

Look at this graph of the menstrual cycle and explain: Oestrogen and Progesteron cycle LH and FSH cycle

Answer 105

Question 106

Name the placental hormones and their functions.

Answer 106

1. Progesterone. - **maintains endometrial lining** to sustain and nourish the foetus - produced by the corpus luteum until 8 weeks - without progesterone of pregnancy would not be viable 2. oestrogen. - **promotes growth of breast tissue and myometrium** - produced by the corpus luteum until 8 weeks 3. human chorionic gonadotropin (hCG) - it’s only produced during pregnancy and therefore use for pregnancy test - **maintains the corpus Luteum for eight weeks**, which allows progesterone and oestrogen to be produced and increased transfer of nutrients to the foetus - related to morning sickness - suggestive of testicular cancer, if found in a male blood test 4. human Placental Lactogen (hPL) - increase the amount of glucose and lipids in maternal blood providing energy and growth for the foetus 5. Relaxin - target, ligaments and relaxes them in preparation for labour 6. Corticotropin Releasing Hormone (CRH) - triggers the release of cortisol from the adrenals. - why? It is an immune suppressant and prevent the mother rejecting the foetus/placenta

Question 107

List 2 ways in which fallopian tubes can move ova towards the uterus.

Answer 107

- The tubes are lined with ciliated, columnar, epithelium, which functions to help move the over towards the uterus - smooth muscles for peristalsis

Question 108

What is the role of inhibition in the pre-ovulatory phase?

Answer 108

Secretion of Inhibin in the pre-ovulatory phase reduces FSH, which stops other follicles developing

Question 109

What might you want to know in a case history related to the reproductive system?

Answer 109

Always ask when the last period was so that you’re not making assumptions about whether they have one. Then find out about bleeding time and cycle, amount of blood flow, duration and quality of the Blood. Relationship with symptoms to cycle Breast: tenderness; galactorrhea Hirsutism and acne Altered libido and impotence Method of contraception Operations Problems with intercourse

Question 110

What does the vas deferens do?

Answer 110

a long, muscular tube that forms part of the male reproductive system. Its primary function is to transport sperm from the epididymis, where sperm are stored and matured, to the urethra during ejaculation.