CM- Endo -5- Gonads lect 13-14

Question Answer
What duct in fetal gonadal development is called paramesonphrenic and which is mesonephric paramesonephric= mullerian
mesonephric= wolffian
where do seminiferous tubules devlope in male fetal development develop in internal part of gonadal ridge and become continous w/ wolffian duct
what does the vas defrens develop from develops from wolffian duct
What do sertoli cells do in male gonadal development secrete mullerian inhibiting substance that causes regression of mullerian duct
What virilizes the wolffian ducts testosterone produced by testes
what does 5 alpha reductase do to testosterone turns it into dihydrotestosterone DHT
what does DHT do in male gonadal development modulates differentiation of male external genitalia
what does the mullerian duct develop into during female gonadal development develops into fallopian tube
what does the cuadal prortion on mullerian duct develop into forms uterine canal
if the mullerian ducts don't fuse during fetal development what can result congenital defect known as uterus bicornis
what does the wolffian duct do in female gonadal development it degenerates and forms the broad ligament
wht do the genital swellings develop into in males and females males-scrotal swellings
females-labia majora
What does the genital tubercle develop into in males develops into penis, urethral fold forms corpus spongiosum and remains unfused only at the tip to form urethral opening
what does the genital tubercle develop into in the female forms clitoris urethral folds don't fuse and become labia minora, Genetal swellings also remain unfused and form labia majora
what is it called when a persons genotype doesn't match their phenotype (ie male XY with a vagina) pseudohermaphrodites
what is a true hermaphrodite has both ovaries and testicular tissue.
What is hypospadias urethral opening on the ventral surface of penis
what is epispadias urethral opening on the dorsal side of the penis
What can happen clinically if you have urethral defects obstruction of flow leading to frequent UTI's
if near base of penis normal ejaculation can be hampered or blocked leading to sterility
What guides the testes into the scrotum gubernaculum
what is it called if the testes fail to descend cryptorchidism
what is spermatogenesis development of male gametes, (sperm) via meiosis
in female gamete development what is the cell called that doesn't develop ultimately into oocyte polar body
Meisosis disorder where you end up with only 1 x chromosome Turner's syndrome
Your patient is short, low set ears and fish like mouths and has puffiness of the dorsum of the hands and feet. You are already pretty confident of your dx and to confirm it have the patient make a fist what is your dx and what did you see turner's syndrome patient has a short fourth metacarpal so has knuckle, knuckle dimple knuckle
What fails to develop in turners syndrome and what is the genotypical problem in turner's syndrome ovaries patient only has one X chromosome
what is the most common sex chromosome abnormality Kleinfelter's syndrome
What is the genotypical problem in kleinfelters male has y chromosome and 2 X chromosomes
Your wife just gave birth and you are concerned your son may have kleinfelters what should you look for generally no defect is noticeable at birth expresses itself chiefly during puberty
Why do kleinfelters patients often have azoospermia and infertility FSH and LH increase but the seminiferous tubules don't enlarge resulting in firm atrophic testes which eventually lead to sterilization
What clinical features might you notice during puberty of kleinfelters patient diminished facial and chest hair, gynecomastia due to elevated LH and fact that leydig cells can't produce testosterone = estradiol and breast development
Upper extremities grow longer than lower extremities
intellectual impairment (dissocial behavior)
Since you don't get testosterone development in kleinfelters what happens to the Penis is it underdeveloped during puberty
What is the tx for kleinfelters give them testosterone replacement therapy
what is the signal from the hypothalamus that controls FSH and LH release from anterior pituitary GNRH
What is the signal for sertoli cells FSH which tells them to bind testosterone and stimulate spermatogeneisis
What does LH doe in male gamete development binds interstitial cells and stimulates them to secrete testosterone and small amounts of estrogen
What does rising levels of testosterone in the blood do to GnRH, FSH and LH inhibits them
What signal shuts off the anterior pituitary when sperm count is high inhibin
what signals male pubertal development of glands, ducts, penis, causing them to grow and assume adult function what happens if you don't get this signal testosterone if not all will atrophy
what promote secondary sex charachteristics in males testosterone
In women what hormone is the Basis for sex drive (libido) testosterone
In men what hormone is the basis for sex drive (libido) testosterone
Why don't girls ovulate until puberty ovaries secrete small amounts of estrogen that inhibit hypothalamic release of GnRH. At puberty the hypothalmus become less sensitive to estrogen and releases GnRH stimulating secretion of FSH and LH from ant. pituitary starting puberty in girls
what is menarche menstrual cycle
How many phases are there in the ovarian cycle and name them three phases, follicular phase, Ovulatory Phase, Luteal Phase
What phase occurs in the first ten days of the ovarian cycle and is started by FSH action on the ovary. Follicular phase, primordial follicle surrounding pirmordial oocyte is activated by the FSH to secrete estrogen
what are the actions of estrogen (secreted by follicle) on the cervix widens cervix and changes mucus consistency to allow sperm in
How does the follicle create estrogen follicle enlarges and forms zona granulose around oocyte until it forms the theca folliculi. LH targets thecal cells to produce androgen and FSH converts androgens to estrogen in the granulosa cells
Why do FSH and LH levels fall after development of the follicle rising estrogen levels have negative feedback on pituitary and FSH and LH secretion
Why do you get and LH surge in ovarian cycle critical high concentration of estrogen causes replaces negative feedback at pituitary with positive feedback causing LH to surge
When does meiosis one finish with developing first polar body in oocyte development in women after follicle develops
When does the ovulatory phase begin in the ovarian cycle at about day 14 the LH surge from the positive feedback from estrogen causes ovary to release ripened egg
What happens to the follicle during ovulatory phase follicle matures into a graafian follicle and bulges from the external ovarian surface. LH surge causes its wall to rupture and release the secondary oocyte into the peritoneal cavity
Some women can feel the egg actual being released from the follicle into the peritoneal cavity what is this called mittleschmerz sign
During ovarian cycle is there only one follicle that develops yes and no, generally only one will fully develop but you have multiple follicles at different stages of development they will degenerate with the principle follicle and are called atretic follicles
what are atretic follicles follicles that were developing along with the principle follicle that don't develop completely
How common is it that more than one oocyte will be secreted 1-2% may result in twins
What is the final phase of the ovarina cycle when the follicle starts to secrete progesterone luteal phase, follicle actual becomes known as the corpus luteum
What is the role of progesterone prepares uterine lining to nourish fertilized egg
If a fertilized egg implant in the uterus what signal is generated to keep the uterus wall intact and keep the corpus luteum going for a copule more months HCG
What secretes the estrogen and progesterone required to maintain the pregnancy after the corpus luteum has degenerated the placenta itself
What are the three phases of the uterine cycle menstrual phase, proliferative phase, secretory phase
what is the menstrual phase of the uterine cycle thickened endometrium detaches from uterine wall and passes out of the vagina
what is the proliferative phase of the uterine cycle uterus wall become highly vascularized stimulated by estrogen from follicle. Also progesterone receptors are inserted in endometrial cells
what is the secretory phase in the uterine cycle progesterone causes spiral arteries to elaborate and coil, glands enlarge and secrete glycogen to sustain embryo if fertilized egg implants
if you have endometrial stroma in abnormal locations outside the uterus what is this called endometriosis
what are the clinical features of endometriosis severe dysmenorrhea
pelvic pain
pain with defecation
infertility can develop from the scar tissue
heavy or irregular menstruation
What is the tx for endometriosis if women wants to get pregnant can use drugs that lower hormone levels.
Danazol and Depo-provera (when pregnancy is not wanted)
Laproscopic laser- cauterize and excise abnormal endometrial tissue
-total hysterectomy ( works 90% of the time)
What is the most common type of lesions on the ovaries ovarian functional or benign cysts
what are functional ovarian cysts unruptured graafian follicles they can get as large as 2cm and are painful if they rupture and leak their serous fluid into the peritoneal cavity
What is the tx for ovarian cysts ablation by laser or electrocautery if ruptures are frequent
What is an ovarian pahtology that can lead to hirsutism caused by high levels of LH leading to increased ovarian androgens that cause the hirsutism Polycystic ovarian syndrome
Why do patients with polycystic ovarian syndrome have higher risk of endometrial cancer they have high levels of androgen especially estrogen which leads to endometrial hyperplasia increasing risk of endometrial cancer
what are the clinical features of polycystic ovarian syndrome oligomennorrhea
persistent anovulation
obesity (40%)
Hirsutism (70%)
insulin resistance
Your patient has hirsutism what do you need to do to confirm it is from polycystic ovarian syndrome draw labs looking for
Testosterone- high
LH:FSH ratio: >3:1
Cortisol: NL
what is the tx for polycystic ovarian syndrome endometrial biopsy r/o malignancy
oral birth control pills
spironolactone-competes with androgens for receptor binding site
Why is metformin useful in tx of polycystic ovarian syndrome can be sued to decrease insulin resistance because insulin resistance and obesity are major problems in polycystic ovarian syndrome
Should an ovarian tumor be a huge concern for a patient. Not likely 80% are benign but most ovarian malignancy go unnoticed until they have metastazied
What are serous tumors ovarian tumor 75% benign tumor is often on ovarian surface more likely to extend into peritoneal cavity and cause intestinal obstruction.
if tumor is resected 90-100% 5 yr survival
what ovarain neoplasm accoutns for 25% of them and appear mostly in middle adulthood filled with sticky gelatinous fluid mucinous tumors

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