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Flashcards in Repro 2 Deck (111):
1

Give histology of cortex of ovary

primordial follicles contained

2

what is a primordial follicle

oocyte surrounded by single layer of squamous granulosa cells

3

state the changes that occur to oocyte from pprimordial follicle to tertiary follicle

pimary follicle - ZP forms. Granulosa becomes cuboid
2 follicle - stroma like theca cells recruitied, become theca exerna + interna. Increased number of granulosa cell and antrum forms between granulosa
3 follicle - theca interna expresses LH receptors and produces oestrogen. Granulosa cells become corona radiata and cumulus oophorus.

4

what is the cumulus oophorus

bridge of cells between granulosa cells and oocyte

5

what is layers of cells surrounding oocyte med to lat

oocyte surrounded by ZP surrounded by corona radiata surrounding cumulus oophorus

6

what happens to follicle after ovulation

GC become granulosa lutein cells, secrete prog
theca interna becomes theca lutein, secrete oest

7

what is corpus albicans

fibrosed corpus luteum after death

8

what are layers of uterus

endometrium - stratum functionalis (coiled arteries) and stratum basalis (straight arteries)
myometrium - 4 smooth musc layers

9

what are the stages of endomterial growth and what happens in each

proliferative - SF grows, glands coil
secretory - max thickness. Predecidual cells develop
menses - if no implantation > decreased prog > shedding

10

what type of cells are found in the endocervical canal and in vagina. what is transformation zone

canal - columnar
vag - strat squamous
transformation zone - columnar becomes strat squamous

11

what is the histology of vag

stratified squamous. No glands. mucosa, SM, muscular (smooth and skeletal)
lots of glycoproteins esp with oestrogen

12

give duct anatomy inside breast. what surrounds ducts

nip > lactiferous duct > major duct > minor duct > lobules
surrounded by adipose and stroma

13

how many lobules per breast

15-20

14

how does breasts change during puberty

lactiferous ducts develop and adipose deposited

15

what is outer layer of testes and ovary called

tunica albuginea

16

histology of testes

SF tubules contain sertoli cells (spermatogenesis). surrounding tubules is leydig cells (testost) and CT.

17

what connects SF tubule to rete testis

straight tubule

18

what epithelia is straight ST tubule and rete testis

both simple cuboidal

19

what connects rete testis to epididymis

efferent duct

20

epithelia of vas deferens

pseudostratified

21

histology of seminal vesicles

coiled glands and pseudostratified

22

what is primary sexual characteristic

develops before birth

23

what is order of development during female puberty

thelarche, adrenarche, growth, menarche, pubes, breasts
TAG

24

order of development during male puberty

GAS
gonad development, adrenarche, spermatogenesis, growth, genitalia, pubes

25

what causes puberty

GnRH from hypo
47kg weight in females

26

what causes pubic hair, libido, male genitalia, and breasts to develop

pubic hair and libido - androgens
male genitalia - test
breasts - oestrogen

27

what occurs in premenopause

decrease fertility, early/absent ovulation, decrease oestrogen and inhibin therefore increase LH and FSH (more FSH)

28

what happens in menopause

skin and bladder changes, hot flushes, osteoporosis, breast involution, loss vaginal rugae

29

how treat menopause and negative effects of treatment

HRT
-ves - DVT, breast cancer, stroke, PE, depression

30

define primary amenorrhoea

absence of menarche by 14 without SSC or 16 with SSC

31

define secondary amenorrhoea

no menses for 3 months if regular cycle or 9 months if irregular

32

primary amenorrhoea (PA) outflow tract causes

imperforate hymen, vaginal atresia

33

SA outflow tract causes

trauma, intrauterine adhesions

34

PA gonad causes

androgen insensitivity, gonad dysgenesis (e.g. turners)

35

SA gonad causes

menopause, pregnancy, PCOS

36

hypo/pit causes of PA

kallman syndrome

37

hypo/pit causes of SA

stress, sheehan syndrome (necrosis of pit due to excessive blood loss during childbirth), anorexia

38

define menorrhagia, causes and treat

>80 ml bleeding or >7 days of menses
causes - PID, cancer, anovulation
treat - USS, hormones

39

define DUB, causes, pathology, treatment

heavy frequrent or prolonged bleeding with no obvious cause. anovulatory. NOT RELATED TO MENSES
cause - PCOS, extremes of life
pathology - No prog. Endometrium builds up continually and self sheds with erratic bleeding
manage - (prog) OCP, tamoxifen (block oest), iron

40

define dysmenorrhoea, oligomenorrhoea, premenstrual syndrome, mastalgia

mastalgia - boob pain
dysmenorrhoea - painful periods
oligomenorrhoea - >35 day cycle
premenstrual syndrome - physical and emotional symptoms 1-2 weeks before menses

41

give hormones secreted by ant pit and the type of hormone and cell that secretes

glycopeptide:
gonadotrophs - FSH and LH
thyrotrophs - TSH

polypeptide:
somatotrophs - GH
lactotrophs - prolactin
corticotrophs - ACTH

42

horomones secreted by post pit

oxytocin, adh

43

what does ovaries secrete horomones

oest, prog, test, inhibin

44

how does hypothalamus secrete GnRH and where does it go. what inhibits

pulsatile (once per hour) into hypophyseal portal circulation
inhibited by oest and inhibin

45

how does fsh and lh act on males and females

males:
fsh acts on sertoli - spermatogenesis and inhibin
lh acts on leydig - testosterone

females :
fsh acts on granulosa cells
lh acts on theca interna

46

during menstrual cycle explain following hormones - oest, prog, fsh, lh

oestrogen - rises slowly then peaks just before lh surge. rises again with CL and then regresses post death
prog - low then rises with CL and peaks
FSH - rise in first few days then down, then peak with LH surge and down after
LH - peaks at ovulation (day 14)

47

effects of estrogen on female repro

thickens endometrium, thin alkaline mucus at cervix, vaginal changes (thicker, elastic, glycogen)

48

prog effects on female repro

thick acid mucus at cervix, secretory phase of endometrium, breast tissue changes

49

where does PGC originate and go

PGC start in yolk sac > dorsal mesentery > gonads

50

what happens to mesonephric and paramesonephric duct in males? what is meso and PMN aka?

meso - wolffian
PMN - mullerian
mesonephric duct stays due to SRY genes on Y chromosome. PMN goes due to mullerian inhibited hormone. meso duct becomes SEED - seminal vesicles, epididymis, ejaculatory duct, ductus deferens

51

what happens to mesonephric and paramesonephric duct in females?

PMN fuses and forms uterus and vag.

52

describe what happens to indifferent genitalia to become male / female

influenced by testosterone
genital tubercle - clit / glans
genital fold - labia minora / spongy urethra + scrotal raphe
genital swelling - labia majora / scrotum

53

describe descent of testes and ovaries

gubernaculum pulls testes through inguinal canal. pulls ovaries to pelvi

54

what is hypospadias

incomplete fusion of urethral folds

55

difference uterus didelphys and bicornuate uterus

didelphys - 2 uteri horns and 2 cervixes
bicornuate - 2 uteri horns only

56

what is spermatogenic wave and cycle

cycle - development time from spermatogona to sperm

wave - distance between 2 areas in same part of cycle

57

describe spermatogenesis

spermatogonia > spermatocyte > spermatid > sperm

58

how are ovum produced

PGC enter ovarian cortex. meiosis halted at primary oocytes then continue to primordial follicles in puberty

59

define spontaneous abortion, preterm labour, and term labour

spont abortion -

60

what are 3 stages of labour

birth canal widening > fetal expulsion > plactena expulsion

61

what is fetal lie and presentation

lie - transvers or longitudinal (usually long)
presentation - cephalic (head) or breach (feet)

62

what happens in cervical ripening? triggered by...

trig by prostaglandins
decrease collagen and aggregation. increase GAGs

63

what happens to female repro organs during labour. what hormone released

cervical ripening. brachystasis (myometrium contracts more than relaxes). cervical thinning and flattening. oxytocin release

64

what are early and late cotnractions during pregnancy like

early - not felt, every 30 mins
late - braxton hicks. less freq but increase amplitude

65

how are myometrial contractions made more forceful

prostaglandins and oxytocin (ferguson reflex, +ve feedback)

66

describe baby expulsion

starts longitudinally + cephalic > uterus contracts and head flexes and rotates > vag and perineum stretch due to head (risk tear) > head delivers > shoulders rotate and deliver > rest follows

67

how does uterus prevent post partum hemorrhage. what can be given to help

uterus clamps down. oxytocin given.

68

how does adult circulation take place in fetus

fetus takes first breath due to trauma and cold > decreased pulmonary resistances and increase arterial pO2 > FO and DA closing

69

what does relaxin do

relaxes pelvic ligaments for delivery

70

what are 4 types of hips and briefly describe

gynecoid - wide
anthropoid - narrow transverse, wide AP
android - narrow
platypeloid - narrow AP. wide pelvic outlet

71

what are the head and breach presentation types

head - vertex, sinciput, brow, face
breach - front (feet by head), full (cross legs), single footing

72

what instruments can be used to aid deliveruy

forceps, ventouse (vacuum)

73

what happens to breasts during pregnancy

lobule and ducts hypertrophy and differentiate to produce milk

74

give properties of milk soon after birth and what its called

colostrum - high IgG and protein, some water fat and sugars

75

give properties of milk 2 weeks after birth

90% water, rest sugar, fas, protein (lactalbumin and lactoglobin), vit and minerals

76

how is milk produced

suckling (neuroendocrine reflex). let down reflex (oxytocin). promoted by decreased prog and oest post birth

77

benefits of breast feedin

bonding and babies reduce risk of infection

78

what happens to breasts with age

breast stroma replaced with adipose

79

physical properties of bresat carcinoma

hard, craggy and fixed breast lump

80

what breast pathology would suggest endocrine disorder

milk discharge from nip

81

what are the types of benign and malignant breast tumours and briefly explain properties

benign:
fibroadenoma - small and mobile. stroma tumour.

82

give 2 breast development disorders

milk line remnants - extra nips
accessory axillary breast tissue

83

symptoms, cause and treatment of acute mastitis of breast

staph aureus. red skin, pain, fever. antibiotics and let milk down

84

what is duct ectasia

blocked lactiferous duct. green discharge

85

what is atypical ductal hyperplasia

hyperplasia of 1-2 ducts. increase carcinoma risk

86

what is symptoms of breast papiloma

ductal papilloma. increases risk of carcinma. poss nip discharge +/- blood

87

give causes of gyno

liver cirrhosis, spironolactone, klinefelters, obesity

88

breast cancer risk factors

age, breast feeding (decrease risk), HRT, obesity, COCP, genetics

89

what types of breast carcinoma are there

in situ/invasive and ductal/lobar

90

symptoms of pagets disease of breast

eczematous nip. malignant

91

why peau d'orange

loss of lymph drainage due to malignancy

92

how diagnose BC

mammography, USS, FNAC, biopsy, history and exam

93

when is tamoxifen and Herceptin used

tamoxifen - if breast cancer is oestrogen receptor +ve
herceptin - Her 2 +ve BC

94

what tumours metastasise to bone?

PB-KTL (lead kettle)
prostate, breast, kidney, thyroid, lung

95

what tumours metastasise to liver

Cancer Sometimes Penetrates Benign Liver
Colon > stomach > pancreas > breast > lung

96

what tumours metastasie to brain

cancer - Some Love Killing Brain Glia
skin, lungs, kidney, breast, GI

97

what tumours metastise to lungs

Real Hardcore Cancers Fill Both My lungs
RCC, hepatocellular carcinoma, choriocarcinoma, follicular thyroid carcinoma, breast, melanoma

98

cause of cervical cancer and risk factors

caused by HPV 16 and 18
RF - smoking, OCP, immunosuppression

99

when does cervical screening occur

25+ yrs every 3 yrs and then every 5 50+

100

What is CIN and how treat. is it malignant

cervical intraepithelial neoplasia
treat CIN 1 - cryotherapy
3 - excision

CIN is premalignant

101

where does cervical carcninoma spread

locally - rectum, vag, bladder

102

how treat cervical carcinoma

microinvasive - excision
if malignant - hysterectomy, lymph dissection, radio and chemo

103

what happens in endometrial hyperplasia

increased gland:stroma ratio, increased risk of cancer.

104

what is symptom of endometrial adenocarcinoma. what 2 types

post menopausal bleeding
endometrioid - invades myometrium
serous - aggressive, spreads to peritoneum

105

name a myometrial tumour and symptoms

leiomyoma - benign and leads to fibroids.
heavy menses or dysmenorrhoea, infertility and urine freq

106

symptoms of ovarian cancer

hormonal problems. abdo pain. distention of abdo. urinary and GI symptoms.
late presentation

107

what are the 3 types of ovarian epithelial tumours and whether malignant

serous -
mucinous - mostly benign
endometrial - mostly malignant

108

what are the 4 types of ovarian cancer

surface epithelial stroma, sex cord stromal, germ cell tumour, mixed

109

features of germ cell tumours

mostly benign
teratomas

110

features of ovarian sex cord stroma tumours

masculinising or feminising
in children can cause or delay puberty

111

vulval tumours can be caused by

SCC, BCC, malignant melanoma, extramammary pagets