Shit - Repro Flashcards
(108 cards)
1
Q
FAS mutations
A
limb dislocation, heart defects (PDA, VSD, ASD), Tetrallogy, heart-lung fistulas, holoprosencephaly.
2
Q
syncitiotrophoblast role
A
Secrete bHCG which looks like LH, so corpus luteum is stimulated to keep making progesterone and not regress (sustains pregnancy). Eventually the placenta will take over progesterone (and estrogen) production role.
3
Q
Syncytiotroph cell marker
A
NO MHC-I - prevents attack by maternal system
4
Q
umbilical artery vs vein: carry, #, derived from, problems
A
Umbilical arteries (2) = deO2 from baby's internal iliac Umbilical vein (1) = O2 blood from placenta to baby liver/ductus venosus.
Derived from allantoid (form yolk sac)
1 artery (2-vessel cord) = congenital/chromosomal abnormalities
5
Q
Urachus
A
from yolk sac from allantois
connects urogenital sinus to yolk sac
Fail to fust: fistula (bellybutton pee), cyst, vesicourachal diverticulum
6
Q
vitelline duct
A
= omphalomesenteric duct
connects midgut to yolk sac
Fail to fuse = fistula (bellybutton poo), cyst, or meckel’s diverticulum
7
Q
MEckel’s sequale
A
infection. heterotopic gastritis (choristoma) heterotopic pancreatic (choristoma)
8
Q
Digeorge =
A
missing 3rd and 4th pouches
3 = thymus + inferior parathyroids
4 = C-cells + superior parathyroids
Parathyroids always from the dorsal wings; other = ventral
9
Q
Cleft lip = failure of:
A
1’ palate
maxillary and medial NASAL processes
10
Q
Cleft palate = failure of:
A
2’ palate
2 lateral PALATNE processes; or lateral PALATINE process with nasal SEPTUM or medial PALATINE process
11
Q
congenital torticolis: s/s
A
neck, dip dysplasia, matatarsal adductus, talipes equinovarus
12
Q
SRY
A
makes TDF –> grow testes
13
Q
MIF
A
from sertoli cells, inhibit mullein (paramesonephric) duct system
14
Q
Testosterone (embyo)
A
From leydig, makes internal male genetalia (except prostate)
15
Q
Missing MIF or sertoli
A
Male from leydig side, but no regression of internal female genetalia
16
Q
Missing 5-a-reductase
A
can’t turn testosterone to DHT, so internal male, external ambicuous until puberty, puberty = massive testosterone spike which promotes 2’ male sex characteristics
17
Q
Uterus malformations: order of severity
A
septate, bicorunate, didelphys (double everything)
18
Q
Mullerian agenesis (Maybe-Rokitansky-Kuster-Hauser)
A
Mullerian duct does not develop.
Ovaries and short blind vagina present.
1’ amenorrhea, no uterus/tubes
19
Q
genital tubercle
A
glans (both), shaft, vestibular bulbs
Malposition = epispadias
20
Q
urogenital sinus
A
Senke and bartholin
bulbourethral (cowpers) and prostate
21
Q
urogenital folds
A
labia minora and ventral penis
Fait to fuse urethral fods = hypospadias
22
Q
associations with hypospadias
A
cryptorchidism and inguinal hernia
23
Q
associations with epispadias
A
bladder exstrophy
24
Q
use of misoprostol (PGE1 analog) with mifepristone
A
sensitizes myometrium to mifepristone; also causes abdominal cramping/pain
25
gland penis and clitoris lymph drainage
deep inguinal
26
broad ligament
connects everything to pelvic SIDE wall
27
Nerves of boners
```
Erection = S2-S4 pelvic splanchnics (PSNS to hindgut)
Emission = SNS hypogastrics
Ejaculation = visceral and somatic nerves (pudendal)
```
28
Male cell affected by temperature
Stroll ONLY (so T fine)
29
enzymes in granulosa vs theca cells
```
granulosa = aromatase
theca = desmolase
```
* after ovulation, granolas get LH-R; bring in cholesterol to make PROGESTINS
30
Estrogens from where?
```
Estradiol = ovary
Estrone = fat
Estriol = placenta *test of fetal well-being; placenta makes it from fetal adrenal DHEA to liver A/T
```
31
Estrogen levels in pregnancy
Estradiol and estrone increase 50x
| Estriol increases 1000x
32
Hormone that increases body temperature
progesterone
33
Hormones on gonadotropins
Estrogen inhibits LH
Inhibin inhibits FSH
Progesterone inhibits both LH and FSH
34
Progesterone on estrogen
down regulated estrogen receptors (prevents unopposed estrogen and thus endometrial hyperplasia/CA)
35
Basic preeclampsia s/s
HTN, proteinuria, edema
36
Vaginal agenesis aka mullerian aplasia
mullein failure with short vagina and no or rudimentary uterus and tubes; no uterus = 1' amenorrhea. Ovaries present, so full female 2' sexual characteristics.
37
AIS
look female, but male internal structures. So internal testes, and minimal pubic/axillary hair because insensitive to androgens
38
Kartageners vs CF infertility
```
Kartgeners = immotile cilia
CF = congenital absence of vas def
```
39
Turner via:
Loss of paternal X
40
Poli vs oligo - menorrhagia
```
oligo = few bleeds .: LONG cycle >35d
poly = many bleeds .: SHORT cycle
```
41
stage of oocyte and chromosome contents
birth to ovulation = MIPI = 2N4C
ovulation to fertilization = MIIMII = 1N2C
post-fertilization = complete MII = 1N1C
42
Estrogen positive feedback mechanism
Estrogen induces GnRH receptors on the AP
43
Mittelschmerz
mid-cycle pain from peritoneal irritation (i.e. follicle swelling, tubal contraction); ddx = appendicitis
44
post-ovulatoin dates: fertilization (conception), implantation, bHCG detectoin
```
1d = fertilization (24h viable; sperm = 72)
6d = implant
d7 = blood bHCG
d14 = urine bHCG
```
45
What hormone(s) inhibit lactation during pregnancy
Progesterone AND estrogen
46
why don't you get pregnant while breastfeeding?
prolactin inhibits GnRH release (only if baby feeds on demand)
47
what is in breast milk, and what diseases does it prevent
IgA, Macro, Lympho.
Baby: asthma, allergies, DM, obesity
Mom: breast and ovarian CA
48
where doe sP come from throughout pregnancy:
pre-conception = CL via LH
conception - week 8/10 = CL via syncitiotrophoblasts acting like LH; identical alpha units on LH, FSH, hCG, and TSH (.: preg test looks for beta subunit of hCG (b-hCG))
week 8/10- end = placenta (makes P and E)
49
high vs low hCG and what it means:
```
high = twins, h. mole, chorioCA, downs
low = patau, edwards, failing/ectopic pregnancy
```
50
hPL job and outcome
inhibits maternal glucose uptake (give glucose to baby) and induces lipolysis (to feed mother with KB and FFA).
Increased by maternal hypoglycaemia, and can cause gestational DM
51
best marker of menopause
high FSH (no estrogen to feedback)
52
chromosome numbers in sperm development
```
gonium = 2N2C
1'cyte = 2N4C
2'cyte = 1N2C
tid = 1N1C
```
53
late DHT effects
prostate growth, balding, sebaceous gland activity
54
where is aromatase found in males:
adipose and testes (sertoli)
55
Hormone levels in XXY
High LH and FSH
Low T and Inhibin (destruction and hyalinization of seminiferous tubules)
High E
56
Turners: what is missing, hormone levels
Missing: ovaries (streaky), period (via hormones), barr body
Hormones: low E, high LH and FSH
57
how to get XYY male + s/s
non-disfunction at dad M-II
| s/s = tall, acne, LD, autism-spectrum
58
M-I vs M-II nonductionction; terminology
```
M-I = homologous chromosomes fail to separate = different
M-II = sister chromatids fail to separate = identical
```
59
Maternal virilizatoin during pregnancy
fetus has aromatase deficiency; testosterone crosses the placenta
60
Kallmans genes and s/s
LOF of Kal-I, FGFR-1, GPR-54, GnRH-Rs
| Anosmia, infertile, midline defects, long armspan, unlit. renal agenesis, syndactyly
61
complete mole:
XX or YY (empty egg + usually 1 sperm that then duplicates).
Dad controls placenta, so only see trophoblasts.
S/s = 1st trimester bleeding, very high hCG, enlarged uterus, hyperemesis, pre-eclampsia, hyperthyroidism, theca-lutein cysts, honeycomb/grapes/US snowstorm
62
partial mole =
69 so maternal also so both placental and fetal parts.
| bleeding + abd pain
63
Gestational HTN =
>140/90 after week 20; NO other s/s
64
Pre-eclampsia s/s + mechanism
Gestational HTN + proteinuria or end-organ dysfunction.
| Via abnormal placental spiral arteries
65
pre-eclampsia drugs =
antiHTN (a-methyldopa, hydralazine, labetalol, nifedipine).
| IV Mg-sulfate to prevent seizures (eclampsia)
66
HELLP: s/s + rx
pre-eclampsia + Hemolysis, Elevated Liver enz, Low Platelets. Can cause hepatic sub-capsular hematomas
Rx = delivery
67
Eclampsia s/s + rx
pre-exlampsia + seizures
Die from stroke, intracranial bleed, ARDS
Rx = IV Mg-sulfate + delivery
68
Painful vs painless 3rd trimester vaginal bleeding in pregnancy
```
painless = placenta previa
painful = placenta abruptio
```
69
vasa previa: mechaism, s/s
usually via velamentous cord (into amino-chorio then to placenta rather than straight into placenta)
PainLESS bleeding, membrane rupture, fetal bradycardia (
70
Random cases of poly and oligohydramnios:
```
Poly = maternal DM, fetal anemia
Oligo = placental insufficiency
```
71
Incidence of tumours vs mortality
Incidence (USA) = endometrial > ovarian > cervical
| Mortality = ovarian > cervical > endometrial
72
Vagina tumours (3)
SqCC - 2' from cervical from HPV
Clear cell AdenoCA - from adenosis from columnar remnants, via DES
Sarcoma botryoides -
73
E6 and E7
E6 - degrades p53
| E7 - displaces TFs on Rb
74
Lichen sclerosis vs lichen simplex chronicus
Sclerosis = thin epi, fibrosed derm, parchment, risk SqCCA
| simplex chronicus = leathery from itching
75
PCOS treatment
weight loss, spironolactone, ketoconazole, OCP, clomiphene citrate (blocks E-R @ hypo to increase LH and FSH to induce ovulation)
76
Follicular vs theca-lutein cyst associations
```
follicular = high estrogen, endometrial hyperplasia
theca-lutein = chorio-CA and H mole
```
77
Random RF and preventative factor for ovarian tumours
```
RF = HNPCC (also for endometrial CA)
Protective = tubal ligation
```
78
Benign ovarian neoplasms with buzzwords
Serous cystadenoma - columnar
Mucinous cystadenoma - multiloculated
Endometrioma - chocolate cyst
Dermoid - 3 layers; can be struma ovarii
Brenner - urothelium, coffee bean nuclei, encapsulated tumour
Fibroma -spindle; Meigs = fibroma, ascites, hydrothorax
Thecoma - estrogen
79
Malignant ovarian neoplasms with buzzwords
Immature teratoma - neuroectoderm
Granulosa - Estrogen/Progesterone; Call-exner bodies
Serous cystadenocarcinoma - psammoma bodies
Mucinous cystadenocarcinoma - pseudomyxomaperitonei (can also be from appendix)
Dysgerminoma - hCG and LDH
ChorioCA - hCG, early lung mets (SOB, hemoptysis)
Yolk sac - Schiller-Duvall (like glomeruli), AFP, ovaries/testies or sacrococcygeal
Krukenberg - mets, signet ring
80
Leiomyoma vs adenomyosis
```
Leio = irregularly enlarged; whorled
Adeno = uniformly enlarged; SM hypertrophy and hyperplasia around hyperplaised endometrial basal layer
```
81
Asherman's syndrome
2' amenorhhea via stratum basale loss (i.e. D+C)
82
Intraductal papilloma: where, s/s
lactiferous duct .: serous/bloody nipple discharge (but benign)
83
FCC with sclerosing adenosis
calcifications
84
Lactation mastitis: bug and Rx
s. aureus; dicloxacillin
85
gynecomastic drugs:
Spironolactone, Digoxin, Cimetidine, Alcohol, Ketoconazole
86
Triple negative breast cancer
Black, more aggressive
87
Most important prognostic factor
axillary LN mets
88
Comedocarcinoma
Type of DCIS with central necrosis
89
rock hard breast mass with sharp margins, small glandular cells, stellate infiltration
invasive ductal CA. Most invasive, worst, MC
90
Indian file
Invasive stromal
91
Subtypes of invasive ductal:
Tubular
Mucinous
Inflammatory: peau d'orange, blocked dermal lymph drainage
Medullary: lymphocytic infiltrate
92
Peyronie
fibrous plaque in tunica albuguinea (surrounds cavernosae)
93
causes and rx of priapism
```
cause = sildenafil, trazodone
rx = phenylepherine direct, manual, aspirate
```
94
SqCell penis:
```
Bowens = leukoplakia
Queyrat = erythroplakia (cancer of gland)
Bowenoid = CIS
```
95
Wxtragonadal germcell tumours: location in adults and kids
Adults = retroperitoneum, mediastinum, pineal gland, suprasellar
Kids = sacrococcygeal teratoma
96
LGV via
Chlamydia L1-L3
| necrotizing granulomas
97
fluctuant scrotal cyst
spermatocele
98
Seminoma: who, marker
men in 30s (MC tumor).
ALP
Dysgerminoma = hCG and LDH]
99
yolk sac: who, marker, histo
boys
100
chorio in men s/s
gynecomastic and hyperthyroidism
101
teratoma in men
mature may malignant, hCG, AFP
102
embryonal CA
malignant, hemorhagic, necrosis, PAINFUL, usually mixed
103
Lydig cell tumours
reinke crystals, golden brown, androgens or estrogens
104
BPH lobes and zone
Lateral and middle LOBES
Periurethral ZONE
HyperPLASIA
105
Acute vs chronic prostatitis
```
Acute = bacterial (e. coli)
chronic = bacterial or abacterial (MC)
```
106
Prostate Ca lobe and zone
Posterior LOBE
| Peripheral ZONE
107
Prostate CA markers and grading
PPAP and PSA (increase total, decrease free fraction)
| Grading via Gleason = architechture (not atypia)
108
Prostate CA bone mets =
Osteoblastic .: sclerotic lesions
