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What phase are oocytes stuck in until puberty?
- Prophase of Meiosis I
- Pairing up and recombination happens here.
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What is a common cause of
- 1st trimester loss
- 2nd
- 3rd
Chromosomal abnormalities are a common cause of 1st trimester pregnancy loss.
Chorioamnionitis is an important cause of 2nd and 3rd trimester loss
Abruptio placenta and placenta previa cause 3rd trimester loss.
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Progression of CIN 3 cervical dysplasia in 2 years?
- 60% persist at same level
- 30% regress
- 10% progress to invasive squamos cell carcinoma
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What is the narrowest part of the urethra?
The membranous section
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What exits out of greater sciatic foramen and goes into the lesser sciatic foramen?
- Pudendal nerve
- internal pudendal vessels
- nerve to obturator internus
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What is the function of the cells that are kept in the seminiferous tubules?
- These are the Sertoli cells
- FX:
- support and protect spermatozoa
- phagocytosis
- Androgen binding protein (from FSH stimulation)
- Anti-Mullerian hormone
- inhibin and transferrin
- Estradiol
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What differences occur above and below the pectinate line?
- Above the pectinate line:
- Lymph drainage to inferior mesenteric lymph nodes
- superior rectal artery -> superior rectal veins -> portal system
- Inferior hypogastric plexus innervation
- BELOW the pectinate line:
- Lymph drainage to superficial inguinal lymph nodes
- inferior rectal arteries -> caval system
- inferior rectal nerves innervation
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Describe the ductus epididymis
- Begins at the termination of the ductuli efferentes and is lined by a pseudostratified columnar epithelium, which has principal cells that possess nonmotile stereocilia.
- Funciton: fluid resoprtion and secrete glycerophosphocholine(inhibits capacitation)
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Describe the seminal vesicle
Stimulated by testosterone
- Contains:
- Mucosa muscularis (inner circular & outer longitudinal)
- elastic fibers
- cuboidal or nonciliated pseudostratified epithelium
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Where does the inferior rectal, middle rectal artery, and superior rectal artery come from?
Internal pudendal artery -> inferior rectal artery
Internal iliac artery -> middle rectal artery
Inferior mesenteric artery -> superior rectal artery
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What is the origin of the ovarian artery and how does it get to the ovary?
Abdominal aorta gives rise to the ovarian artery which is carried to the ovary via the suspensory ligament of the ovary. (from ovary to wall of pelvis)
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Which section of this mature graafian follicle is responsible for producing androstenedione?
The theca interna produces androstenendione (via LH stimulation) which goes to the granulosa layer to get converted to estradiol (via FSH stimulation) which is responsible for the FSH inhibition and LH surge.
Also happens in the secondary follicle
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Describe Klinefelter Syndrome
47 XXY via nondisjunction of either M1 or M2
Symptoms: developmental delay, learning problems(slight reduction in IQ), infertility
- TX: androgens
- - improve virilization and bone density but worsens gynecomastia.
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Describe Philadelphia chromosome
Translocation of 9:22 in which abl-bcr gets fused -> chronic myelogenous leukemia
- fever, bone pain, splenomegaly, increased WBC count
- Leads to blast crisis = bone marrow failure
- TX:
- bone marrow transplant
- tyrosine kinase inhibitors - no GH and insulin
- Hydroxyurea- inhibits dNTP synthesis
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Which tumor marker is expressed in submucosal tumor within the uterine body that are well demarcated and have a whorled pattern on cut surface?
This is leiyomyoma and the marker is smooth muscle actin.
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What antibodies are present in colostrum and milk?
IgA
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What connects the seminiferous tubules to the rete testis?
Tubuli recti
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What is contained in the superficial perineal pouch for males and females?
Males- root of penis and bulbous urethra
Females: clitoris, bulbs of vestibule, greater vestibular glands
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What structures are influenced by DHT ?
- prostate
- beard
- sebum
- penis, scrotum, urethra
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Explain how the stratum functionales is shed during the menstrual cycle.
Spiral arteries constrict -> necrosis of stratum functionales -> spiral arteries dilate -> rupture and blood discharge
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Describe Fragile X syndrome
- X linked recessive (trinucleotide repeat disease)
- maternal bias
- loss of function (FRM1 gene -> FMRP)
- leading inherited mental retardation
- Female carriers -> 20% premature ovarian failure
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How does complete androgen resistance present?
XY individual with female phenotype (breast development but not pubic and axillary hair changes and absence of a cervix or uterus.
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Describe the epithelium of the oviduct
Lined by simple columnar epithelium composed of ciliated cells and peg cells but no goblet cells.
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What are the arteries of the anterior internal iliac?
- obturator
- inferior gluteal
- umbilical
- uterine
- vaginal
- inferior vesicle
- middle rectal
- internal pudendal
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Why is it rare for a female to present with Duchenne Muscular dystrophy?
DMD is a x-linked recessive progressive myopathy
In order for a female to be a manifesting heterozygote she would have to have skewed X inactivation.
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What is the Hardy Weinberg Equation for genetics ?
p2 + 2pq + q2= 1
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Chorion maintains hCG levels until when?
Until the 10th week when the placenta takes over.
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Describe the production of estriol in the placenta
- Mother cholesterol ->
- Placenta pregnolone ->
- Fetus DHEA-S -> 16-OH DHEA-S ->
- Placenta estriol -> mother
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What is a complete mole?
- Karyotype 46, XX or rarely 46,XY
- Grapelike, multicystic villi but no fetal tissue
- 2% risk of developing choriocarcioma
- High levels of serum hGG, can lead to N/V
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What is a partial mole?
- Karyotype 69,XXX or 69XXY
- wide range of villous size; often contain fetal tissue
- little risk of choriocarcinoma
- hCG not so high -> rarely N/V
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What are the associations with Down Syndrome?
- Acute myeloblastic leukemia in newborns
- acute lymphoblastic leukemia in older children
- epilepsy
- cardiac congenital malformations (ASD, VSD, tetralogy of Fallot, & PDA)
- duodenal atresia and imperforate anus
- acquired autoimmune hypothyroidism
- boys are infertile
- Alzheimer in mid adulthood
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What is the difference between Camper fascia and Scarpa fascia?
- Campers = superficial fascial layer
- - subcutaneous w/ fat
- Scarpa = deeper and no fat
- - just fibrous tissue
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What are the symptoms of congenital toxoplasmosis and how would you this infection?
- TRIAD:
- chorioretinitis
- hydrocephalus
- intracranial calcfications
TX: pyrimethamine and sulfadiazine (inhibit folate pathway)
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18 year old presents with low grade fever followed by maculopapular rash that begins on the hands and feet and spreads centripetally to the trunk. What is the disease?
This is Rocky Mountain Spotted Fever caused by Rickettsia rickettsiae transmitted by wood tick Dermacentor.
Also presents with hepatosplenomegaly, thrombocytopenia, and disseminated intravascular coagulation.
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