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Yr 2.0 Sem 3 > Reproductive System > Flashcards

Reproductive System Flashcards

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1
Q

What’s the point of sexual reproduction?

A

Introduces genetic diversity

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2
Q

Which endocrine axis is responsible for the development of secondary sexual characteristics?

A

The Hypothalamic-Pituitary-Gonadal axis

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3
Q

Why is being male a risk factor for inguinal hernia?

A

Vas deferens passes through the inguinal canal

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4
Q

Where does sperm mature?

A

Sperm matures in the epididymis

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5
Q

Where does spermatogensis occur?

A

Spermatogenesis occurs in the seminiferous tubules

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6
Q

Which lymph nodes do the testes drain to?

A

Para-aortic

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7
Q

Describe how testicular torsion can lead to infarction

A

Testis twists on the spermatic cord, occluding the veins supplying it. This causes a build up of blood within the testis, the increased pressure of which occludes the arteries.

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8
Q

What predisposes to testicular torsion?

A

Bell-Clapper deformity

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9
Q

What 3 fascial layers are cut through during a vasectomy?

A

External fascia, cremasteric fascia and internal fascia

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10
Q

What 3 arteries travel in the spermatic cord?

A

Cremasteric artery, testicular artery and artery to vas

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11
Q

Which nerve supplies the muscle fibers within the fascia of the spermatic cord?

A

Nerve to cremaster

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12
Q

Why is a vasectomy performed with a scrotal approach?

A

To avoid the ureter which passes beneath the vas in the pelvis

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13
Q

Where is most of the fluid in ejaculate produced?

A

The seminal vesicles!

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14
Q

Why are the secretions of the prostate alkaline?

A

To neutralize the acidic female reproductive tract in copulation, creating a more favourable environment for the sperm

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15
Q

Why can you detect prostate cancer via a digital rectal exam?

A

Prostate cancers tend to form in the peripheral zone which sits just anterior to the rectum. They also tend to have a craggy hard consistency.

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16
Q

Why is benign prostatic hyperplasia more likely to be the cause of problems with urinary flow in males than prostate cancer?

A

BPH occurs in transitional zone where it can easily compress the urethra. Prostate cancers tend to be in the peripheral zone which is not directly adjacent to the urethra.

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17
Q

How can smoking cause impotence?

A

Can cause vascular disease which can affect blood supply to the penis

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18
Q

2 Embryology What does the gubernaculum do?

A

Aids decent of gonads into pelvic region

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19
Q

2 What would happen to the developing external genitalia if there is insensitivity to androgens?

A

If stimulation from dihydro-testosterone is blocked the genital tubercle will not elongate and the genital folds will not fuse. These will develop to form clitoris and labia respectively, i.e. female external genitalia.

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20
Q

2 How does the presence of a Y chromosome prompt development of male genitalia?

A

Its SRY region influences the indifferent gonads to become testes.

These then produce testosterone, stimulating development of penis and scrotum.

Androgens from the testes also stimulate development of Wolffian / paramesonephric duct into epididymis, vas deferens and rete testis.

Also secretes Mullerian Inhibitory hormone which suppresses development of mesonephric / Mullerian ducts.

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21
Q

2 How might a septate, heart shaped or double uterus develop?

A

Partial or complete failure of paramesonephric / Mullerian ducts to fuse as they develop into uterus (and upper 1/3 of vagina).

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22
Q

2 What is the transformational zone of the cervix?

A

Area between the internal and external os in which the epithelium changes from non-keratinised stratified squamous to simple cuboidal. (Moves towards internal os with age.)

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23
Q

2 Why does the vaginal epithelium have glycogen inclusions?

A

To support the resident lactobacilli which maintain the low pH of the vagina, protecting from inappropriate microbe growth.

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24
Q

2 Name the phases an ovarian follicle goes through if it develops

A

Primordial follicle -> primary follicle -> pre-antral -> antral -> mature / Graafian (degenerates into -> corpus luteum -> corpus albicans)

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25
2 What is the normal positioning of the uterus?
Anteverted and anteflexed
26
2 Why is the ureter vulnerable in a hysterectomy?
Ureter passes under uterine artery which will be clamped during this operation.
27
2 What is the clinical relevance of the greater vestibular / Bartholin glands?
Can become enlarged if infected and can impinge on rectum. | Location of most vulvar adenomas
28
2 What are the 3 parts of the broad ligament and where are they located?
Mesometrium - over uterus, attaching to post. pelvic wall Mesosalpinx - encloses and hangs off uterine tubes and contains suspensory ligament of ovary Mesovarium - attaches to the hilum of the ovary, supporting it and enclosing its neurovascular supply
29
2 Which cells in the ovary secrete progesterone?
Granulosa lutein cells
30
2 Which cells of mature / Graafian follicle are needed to produce oestradiol?
Theca intera (secrete androgens), and granulosa cells (aromatise into oestrogen)
31
2 What type/s of glands does the cervix have?
Cervix has mucous and serous glands
32
3 Name the cells of each stage of spermatogenesis
Spermatogonium, 1' spermatocytes, 2' spermatocytes, spermatids, spermatozoa
33
3 Why is capacitation of sperm needed to allow fertilisation to occur?
Remove glycoproteins and cholesterol to allow binding to zona pellucida and activation of sperm signally pathways.
34
3 Differentiate between the spermatic cycle and the spermatic wave
Cycle is time taken for reappearance of same stage of spermatogenesis in a given segment of seminiferous tubule Wave is distance between parts of seminiferous tubules at which spermatogenesis is in the same stage
35
3 When do oocytes complete meiosis 2?
Only on fertilisation, otherwise stay arrested in meiosis 1.
36
3 What does Androgen Binding Globulin do?
Retains testosterone within seminiferous tubules
37
Yr1 List the 3 ways meiosis introduces genetic variation
Crossing over of bivalents in prophase Independent assortment of chromatids at metaphase Random segregation of chromosomes when cells become haploid
38
3 Why does progesterone usually drop at the end of the menstrual cycle?
The corpus luteum producing it degenerates after 14 days if no fertilisation has occurred.
39
3 In females, where is inhibin produced and what does it do?
Granulosa cells of developed ovarian follicle produce inhibin which exerts negative feedback on hypothalamus.
40
3 What's the normal onset puberty range for boys and girls?
Boys - 10-14 years old | Girls - 9-13 years old
41
3 What is the first sign of puberty, in girls, and in boys?
Girls - thelarche / breast bud development | Boys - increased testicular volume
42
3 What is the underlying mechanism for the onset of puberty?
Gradually increasing pulsatile release of GnRH and thus increasing activation of hypothalmic-pituitary-gonadal axis.
43
3 What scale can you use to assess pubertal development?
Tanner scale
44
11 What is generally the cause of most vulval cancers?
Longstanding inflammatory and hyperplastic conditions of the vulva, such as lichen sclerosis
45
11 Which strain of HPV is related to vulval cancers?
HPV16
46
11 Where would you expect a vulval cancer to spread?
Inguinal, pelvic iliac and para-aortic lymph nodes | Later, lungs and liver
47
11 Which type of endometrial adenocarcinoma is more common?
Endometrioid endometrial adenocarcinomas
48
11 Why does serous endometrial adenocarcinoma tend to have a worse prognosis?
More aggressive, tend to exfoliate and travels through Fallopian tubes to settle on peritoneal surfaces
49
11 What is the most common age range in patients presenting with endometrial cancer?
Over 40, usually 55-75 year olds
50
11 Explain why we don't give unopposed oestrogen with women with uteruses
Prolonged oestrogen stimulates development of endometrial hyperplasia which is a frequent precursor to adenocarcinoma.
51
11 What's the 10 year survival like for endometrial cancer? Suggest why this might be
``` Really good (75%) Often present early as symptoms are post-menopausal or irregular bleeding. ```
52
11 What would endometrial hyperplasia look like on histology?
Increased gland : stroma
53
11 What are the symptoms of a uterine leiomyosarcoma?
Heavy / painful periods, urinary frequency, infertility. | Metastatic symptoms esp lung - persistent cough, haemyptsis, shortness of breath etc
54
11 Does the presence of fibroids / leiomyoma increase your risk of uterine cancer and why?
No, malignant transformation rarely occurs
55
11 What age group has the peak incidence of uterine leiomyosarcoma?
40-60 year olds = peak incidence of uterine leiomyosarcomas
56
11 Which classification of testicular tumours is most common?
Germ cell tumours (95%)
57
11 Give 2 markers that can be used for germ cell tumours
AFP (alpha foetal protein - yolk sac tumours or mixed) | hCG (human chorionic gonadotrophin -choriocarcinomas or mixed)
58
11 What is the pre-invasive precursor for testicular germ cell tumours / seminomas & non-seminomas?
Intratubular germ cell neoplasia
59
11 Which tumour marker is used for ovarian cancer?
CA 125
60
11 Suggest why the 10 year survival rate for malignant ovarian cancer patients is quite low?
Tends to have metastasised before causing symptoms so patients will often present late
61
11 Are ovarian cancers likely to be functional (produce hormones)?
No, most aren't
62
11 Besides benign, borderline and malignant, how would you classify a Mullerian / epithelial ovarian tumour?
Serous, mucinous or endometrioid
63
11 Suggest why serous ovarian cancer often causes ascites
Friable mass, often spreads to peritoneal surfaces and omentum (where the metastatic cells induce overproduction of peritoneal fluid)
64
11 Give 3 risk factors for Mullerian /epithelial ovarian tumours
Lots of ovulations: Not taking oral contraceptive pill / Nulliparity or low parity etc Smoking Endometriosis
65
11 In what type of ovarian tumour might you find hair or teeth?
Mature / benign teratomas, also known as dermoid cysts
66
11 What is struma ovarii?
Struma ovarii = monodermal benign ovarian teratoma consisting of mature and functional thryoid tissue
67
11 What's the most likely source of metastases in the ovary?
Mets in ovary most likely from = Uterus, cervix, contralateral ovary, pelvic peritoneum
68
11 Which type of ovarian tumour would you suspect in a patient with breast atrophy, voice changes and amenorrhoea?
Sertoli-Leydig cell tumours
69
11 Why is immunosuppression a risk factor for cervical cancer?
Neoplasia and hence carcinoma of cervix induced by infection with high risk strains of HPV. Immuno-suppressed patients more likely to internalise the virus into cells and infection is more likely to be prolonged due to their inadequate immune response.
70
11 If a lady's partner has carcinoma of the penis why is she more at risk of cervical cancer?
Both induced by infection with the HPV virus which is transmitted sexually.
71
11 Why is screening for cervical cancer still necessary if you have had the vaccine?
Vaccination doesn't protect against all types of HPV that are high risk of causing cancer. Also some may have inadequate immune response to vaccine.
72
11 Why is cervical cancer screening successful? Give 3 reasons
Cervix easily accessible for sampling and visual examination Slow progression from neoplasm to cancer allowing time for intervention Pap test detects low stage and precursor changes
73
11 How would you treat a high grade cervical neoplasm?
Cone biopsy or large loop excision of transformational zone
74
11 What is the prognosis for a CINI (grade 1 cervical epithelial neoplasm)
Good, most cases regress spontaneously, small proportion progress to CINII
75
11 What is the average age of presentation for invasive cervical carcinoma?
45 years old
76
11 How can HPV cause cancer?
HPV 16 and 18 produce viral proteins E6 and E7 which interfere with tumour suppressor genes.
77
11 To which lymph nodes does cervical cancer typically spread to?
Para-cervical, pelvic and para-aortic

Yr 2.0 Sem 3 (5 decks)

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