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N552 Patho > Sex > Flashcards

Sex Flashcards

1
Q

Up until week ___ of fetal development, men and women are basically the same (undifferentiated)

A

Week 8

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2
Q

SRY (sex-determining region of the Y chromosome) develops _____ hormone, causing degeneration of female structure and development of male structures. If you don’t have SRY, then what degenerates?

A

Anti-mullerian hormone
If you don’t have SRY, wolffian ducts degenerate (they would otherwise lead to epididymis, vas deferens, seminal vesicle structures)

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3
Q

What makes up the testes? What type of cells?

A 
Seminiferous tubules (stroll cells, spermatogonia)
Interstitial Leydig cells
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4
Q

What makes up the excretory ducts of the male reproductive system? What goes through there?

A

Ductus epididymis, ductus (vas) deferens, ampulla, urethra

SPERM goes through there, it is made in the testes

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5
Q

What makes up the accessory glands that sperm does not travel through?

A

Seminal vesicles
Prostate
Bulbourethral (Cowper’s) gland

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6
Q

Leydig cells make what?

A

Steroid hormone- testosterone

Cellular picture they have white spots (these are fats to make cholesterol to make steroids)

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7
Q

Male: LH stimulates ____ cells to produce ____

A

Leydig cells to produce testosterone

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8
Q

Male: FSH stimulates ____ cells to produce ____

A

Sertoli cells to produce sperm

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9
Q

Testosterone plus FSH stimulates ____ cells to produce ____

A

Sertoli cells to produce sperm

Sperm comes from spermatogonia

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10
Q

What is spermatogonia?

A

A stem cell that gives rise to sperm cell; after mitosis, one daughter cell remains a stem cell and the other daughter becomes four sperm cells

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11
Q

1 primary spermatocyte produces how many sperm?

A

4 sperm
One daughter cell becomes primary spermatocyte, undergoes two rounds of meiosis to produce secondary spermatocytes → early spermatid cells→ late spermatid cells (1 primary spermatocyte →4 sperm)

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12
Q

Testes and ovaries are immune-privileged, meaning what?

A

These organs don’t mature until puberty
If B and T cells memory cells against them develop before puberty we could get antibodies made against them later on
Blood-testes barrier formed by tight junction on Sertoli cells

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13
Q

hCG resembles ____, so it stimulates Leydig cells to produce testosterone

A

LH

Taking hCG with testosterone prevents testicular atrophy, also will test positive for pregnancy

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14
Q

BPH: benign prostatic hyperplasia

What is the problem? What zone of the prostate does it effect?

A

Epithelial cells replicate
Only problem is compression of the urethra, leads to slower flow in urine and possible obstruction
Starts in the central zone, compresses urtethra sooner

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15
Q

Carcinoma of prostate

A

Starts in peripheral zone, will grow a lot before causing urinary symptoms (slow flow)
Note: More men die WITH prostate cancer than FROM prostate cancer, age of diagnosis is the big factor

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16
Q

T/F: Digital rectal exam is to determine if someone has BPH

A

FALSE, they look for carcinoma in the peripheral zone of the prostate
Every guy has BPH, so we don’t care, also BPH is in the central zone, so we couldn’t feel it

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17
Q

STI vs. STD

A

STI: they are infectious, spreading it, whether they have symptoms or not
STD: they have symptoms
These are spread by body fluids: sex, blood

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18
Q

Genital herpes: HHV2

A

Once you get it, you can’t get rid of it

Painful superficial lesions, re-occur in same place, starts with vesicles

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19
Q

Chancroid H ducreyi

A

Bigger, deeper ulcerations

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20
Q

Syphilis

A

Causes chancres, painless lesions

Shows spirochetes on dark field examination (shows light around the specimen)

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21
Q

HHV1 vs HHV2

A

HHV1 on the face, coldsores (90% of population)
HHV2 below the waist, genital herpes (1% of population)
You CAN get either in either place, but these are where they are most common
Note: HSV2 and HHV2 are SAME virus

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22
Q

Can we get rid of these HHV1/2 viruses?

A

No bc to kill the virus we have to kill the nerve

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23
Q

What is the difference in ulceration between syphillis, herpes, and chancroid?

A

Herpes is the smallest (less than 1 cm)
Then syphillis (1.5-2 cm)
Charcroid is the largest ulceration (over 2 cm)

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24
Q

Chlamydia

A

Hard to detect (Intracellular bacteria)
Usually asymptomatic (treatable, but they never know they have it)
Problem: causes pelvic inflammatory disease, which leads to infertility (second leading cause of infertility)

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25
Q

Genital warts (condylomata acuminata): three ways to kill them? Causes?

A

Freeze
Burn
Acid
Caused from HPV

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26
Q

Gonorrhea: what is it? Symptoms? Treatment? This one is less common

A 
Gram-negative diplococci
Pain and burning sensation felt during urination
Males have white/yellow discharge 
Females have green/yellow discharge
Can be asymptomatic
Treat with antibiotics
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27
Q

Trichomonas vaginalis: what is it? Symptoms?

A

Most common pathologic protozoan infection in the world
Infects men and women equally, but men are asymptomatic and women get inc pH (from 3 to 6) in vagina leading to E coli and candida albicans

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28
Q

Scabies

A

Small arachnids, they like soft, warm, tight skin so they are found where clothing is tight
Symptoms: itching

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29
Q

Test question: Which STD has the smallest ulceration?

A

HERPES

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30
Q

Test question: Which gene is associated with testicular cancer?

A

BRCA-1

31
Q

Scabies: what is it? What symptoms and where?

A

Small arachnids; they like soft, warm, tight skin so they are found where clothing is tight
Symptoms: itching

32
Q

Pubic/crab lice

A

They are super tiny lice (not the same as head lice)

33
Q

Women are born with ___ eggs, only ____ are used and not defective,

A

2 million

Only 500 work

34
Q

What is the path of the egg meeting the sperm?

A

Every month about 2 dozen primordial follicles will start growing, ONE will take over and suppress the other. At mid-cycle follicle will rupture, egg released into pelvis, egg drawn into fallopian tubes and into the uterus. (Fallopian tubes lined by cilia that move it towards uterus). Sperm ideally meets egg at ampulla of fallopian tube but can meet egg anywhere along the way

35
Q

Development of ovarian follicle?

A

First, the primordial follicles (egg surrounded by single layer of squamous epithelial cells)
Each cycle, about 2 dozen of primordial follicles start developing and become secondary follicles. As one egg gets a lead over the others, it secretes factors that suppress others, and develops into a Graafian (mature) follicle, a fluid-filled follicle with egg
mid cycle: surface will rupture (ovary not covered by capsule), egg released into pelvis, fallopian tube catches and draws it in

36
Q

Innermost layer of the ovarian follicle are _____ cells
Outer most are _____ cells
What are Cumulus oophorus?

A

Inner- granulosa cells
Outer- theca cells, theca interna and externa
Cumulus oophorus: cells surrounding the egg that remain surrounding egg even after release

37
Q

A mature/Graafian follicle becomes ____ if it is fertilized and ____ if it is not fertilized?

A 
Corpus luteum (yellow body), which produces primarily progesterone after ovulation
If fertilization does NOT occur the corpus luteum degenerates into corpus albicans
Note: at autopsy you can count number of corpus albicans = number of times woman ovulated
38
Q

Theca externa vs. theca interna vs. granulosa layer of an ovarian follicle?

A

Theca externa is connective tissue
Theca interna makes androgens
Granulosa layer converts androgens into estrogens

39
Q

Female: LH stimulates its receptors to produce ____ in the ____ cell

A

Androgens

In the Thecal cell

40
Q

Female: FSH stimulates its receptors to produce _____, which converts androgen into _____ in the _____ cell

A

Produce aromatase
Converts androgen into estrogen
In the granulosa cell

41
Q

What happens in the Pre-ovulatory (follicular phase/proliferative phase)?

A

Follicle developing and endometrium proliferating (regrowing)
“Grow, grow, grow”

42
Q

What happens in the Post-ovulatory (luteal phase/secretory phase)?

A

After ovulation the follicle becomes corpus luteum, endometrium awaits implantation
“Wait, wait, wait”

43
Q

For regulation of the cycle, we use ____ feedback. Mid-cycle, to release the egg, we use ____ feedback.

A

Negative feedback to hypothalamus decreases FSH and LH (regulation)
Mid cycle, estrogen will have positive feedback on hypothalamus and get powerful spike of FSH + LH at mid cycle causing release of egg. Birth control inhibits this mid-cycle event.

44
Q

After ovulation _____ causes follicle of the month to turn into corpus luteum which produces estrogen and progesterone

A

LH

45
Q

Progesterone effects?

A

Supports endometrium, when progesterone is withdrawn, endometrium sloughs off

46
Q

If fertilization occurs and there is implantation, “placenta” will produce ____, which will continue stimulating production of progesterone

A

hCG
Remember, hCG looks like LH, FSH, TSH, the beta strand is the difference (alpha strand is the same)
Chorion (the fetal contribution to the placenta) produces hCG

47
Q

TSH levels in pregnancy

A

LOW bc hCG binds to those receptors

So check T3 and T4 if you’re worried about the tyroid, these develop the nervous system

48
Q

Cervical cancer: causes?

A

HPV messes with your tumor suppressor gene with chronic infection, usually rather asymptomatic

49
Q

Gardicil?

A

Protects against HPV, which will protect against cervical cancer
It’s anti-viral not anti-cancer med

50
Q

____ cells in uterus
_____ cells in vagina
Transition occurs in cervix

A

Columnar cells in uterus

Stratified squamous in vagina

51
Q

HPV hangs out with what cells/ what area?

A

Vagina, stratified squamous cells

52
Q

Why do we do pap smears?

A

Necessary even with the vaccine because still 30% of HPV not covered by vaccine, can still cause cancer
Looking for dysplastic cells (cells with large nuclei)

53
Q

Endometriosis

A

Endometrial tissue grows and sloughs off as usual, but the cells grow in abnormal places, like the abdomen/ pelvis, usually due to retrograde movement in the fallopian tubes
Tx birth control pills

54
Q

Leiomyomas (uterine fibroids)

A

Fairly common (30-50% of women), benign tumor of the smooth muscle. Painful and may bleed
Don’t have tendency to become cancerous
Increase with age
If severe, may cause infertility

55
Q

What is the most common female reproductive tract cancer?

A

Endometrial cancer
Lower death rate than most cancers
Clinical finding: bleeding, happens mostly in post-menopausal women

56
Q

Uterine prolapse

A

Muscle and ligament layer weakens uterus can start to fall out, they get uterine slings

57
Q

Cystocele/ rectocele

A

Bladder prolapse
Rectal prolapse
Same mechanism as uterine prolapse, weak muscle

58
Q

Salpingitis

A

Salpinx is fallopian tube
Inflammation/infection of salpinx
Usually part of PID; caused by endometriosis, chlamydia, gonorrhea, TB infections
Increases chances of ectopic pregnancy (chronic inflammation leads to scarring and egg unable to get through, but sperm is small and can still travel through)

59
Q

2nd leading cause of infertility in US? Leading cause?

A 
Chlamydia #2
#1 is PCOS
60
Q

PID (pelvic inflammatory disease)?

A

Inflammation of either or both of fallopian tube or ovary

61
Q

PCOS causes?

A

High LH and low FSH stimulates androstenedione which gets into circulation → women starts growing facial hair, we can convert androgens to estrogens → converted to estrone (type of estrogen) in peripheral fat, negative feedback to hypothalamus – represents “enough” estrogen and decreases FSH, but the estrogen is NOT in ovary

62
Q

PCOS symptoms?

A

Enlarged ovaries with cysts, excessive androgens, irregular or no menstruation
Usually happens in obese women with high insulin levels, metabolic syndrome, diabetes

63
Q

PCOS treatment?

A

MAIN TX: Birth control for 3 months to even the levels, then try to get pregnant
OTHER
Regulate mentral cycle: Progesterone, metformin
Dec hair growth: spironolactone (blocks androgen), finasteride, flutamide, eflornithine, hair removal
Pregnancy: clomiphene (grumpy)
Surgery

64
Q

Ovarian cancer: what is mortality rate like? What gene increases risk?

A

High death rate because of late detection

Women with BRCA1 mutation have greatly increased lifetime risk

65
Q

Teratoma (monster-tumor)

A

Germ cell tumor, rarely malignant
Germ cell will partially differentiate, can grow hair and teeth, people are born with them, and notice when it gets big
Can occur in men or women (germ cells)

66
Q

Ectopic pregnancy: what is it, what can it cause, what symptoms?

A

Any pregnancy outside the body of the uterus (usually fallopian tube)
Will not go to term due to insufficient blood supply
Can destroy fallopian tube and potentially cause exsanguination (bleeding to death)
Symptom: Lower abdominal pain (that’s why we always test abd pain pts for pregnancy)

67
Q

Hydatidiform mole (Molar pregnancy): complete mole vs partial mole

A

Complete mole: egg has NO maternal DNA, two sperm get in and provide all DNA (have 46 chromosomes) diploid paternal DNA, produces a lot of hCG, can grow quite large, but there is no fetus, tx: cut it out
Partial mole: normal egg, but two sperm get 69 chromosomes (triploid fetus), there is a fetus, rarely go to term, don’t survive long if born

68
Q

Pre-eclampsia: symptoms, how common?

A

Hypertension
Proteinuria
Edema
5-10% of pregnancies

69
Q

Pre-eclampsia: pathophysiology

A

Chorionic villi bore into endometrium and nutrients from maternal circulation diffuses into chorion and carried to fetus, if didn’t penetrate as far → less surface area → less diffusion → less nutrients to fetus
As fetus develops at fast rate, nutrient demand is high, in third trimester placenta can’t give it enough nutrients, placenta isn’t getting enough maternal blood flow, inc BP

70
Q

Eclampsia

A

Involves seizures, can be fatal

With current medical care, pre-eclampsia doesn’t advance often

71
Q

Why might someone have amenorrhea?

A 
Pregnant
hCG-secreting tumor (trophoblastic)
Hyperprolactinemia from pituitary lesion or hypothalamic lesion
Hypothyroid
Anovulation
Ovarian failure
End organ problem
72
Q

Breast cancer

A

BSE is inaccurate in older women because lumps aren’t usually cancer
Mostly occurs in armpit quadrant, lymph involvement

73
Q

Women with _____ have lifetime risk of 85%

A

BRCA1 mutation

N552 Patho (13 decks)

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