Block 7 Reproduction Creighton Univ W Xpl Pt 3

Probably the most important ones for histology to remember are the "back to back" glands and the loss of basal cells. PSA is important in that its rate of change is helpful in guiding therapy. It is a sensitive, but not specific test for prostate cancer.

The only option that fits all of the woman's symptoms is a ruptured ectopic pregnancy. One in every 150 pregnancies is an ectopic pregnancy, and 90% of those are in the fallopian tubes. Neisseria gonorrhoeae can cause pelvic inflammatory disease leading to scarring of the fallopian tubes, which predisposes to ectopic pregnancy. Appendicitis is possible, but the facts that she is afebrile with lower left pain make it less likely. Moreover, appendicitis tends to occur in adolescents and young adults. This woman's lowering blood pressure indicates that she is bleeding into the abdominal cavity. This is clearly a medical emergency.

All of the glands mentioned in the options (prostate, epididymis, seminal vesicles, and bulbourethral) contribute fluids to semen. Semen is a mixture of sperm cells and various fluids from different glands in the male reproductive system. The prostate gland secretes a milky fluid that helps nourish and protect the sperm. The seminal vesicles produce a fluid that provides energy for the sperm. The bulbourethral glands secrete a clear fluid that lubricates the urethra for the passage of sperm. The epididymis, although not a gland, is a structure that stores and matures sperm. Therefore, all of the mentioned glands contribute to the formation of semen.

Both estrogen and progesterone are involved in maintaining pregnancy, especially after HCG begins to drop in the second trimester. Estrogen can either have positive or negative feedback on LH and FSH. Progesterone has negative feedback on LH and FSH. Secondary sex characteristics are driven by estrogen.

Removing both fallopian tubes is a bilateral salpingectomy. Dr. Khandalavala made sure to write in big bold letters that tubal ligation should not be done if a patient wants children in the future

Leydig cell tumors are known for their hormonal effects. They can cause precocious puberty and gynecomastia, although the most common symptom is simply testicular swelling. Sertoli cell tumors can also produce these hormonal effects. Spermatocytic seminomas tend to occur in senior citizens. It is slow growing and prognosis is excellent. Neither choriocarcinoma or teratoma have hormonal effects.

The functionalis is the protion of the endometrium that varies throughout the menstrual cycle. It is built up in response to estrogen and sloughed off as both estrogen and progesterone are cut off (all from the corpus luteum). The basalis is essentially unaffected.

PTH is normally secreted in response to low ionized calcium levels in the plasma. PTH causes bone resorption to restore normal calcium levels. However, intermittent PTH causes the opposite effect.

St. John's Wort, rifampin, antiepileptic drugs, and anti-HIV drugs are known to induce the cytochrome P450 system in the liver. This results in an increased metabolism of drugs that go through this pathway, such as estrogens. Therefore, their effectiveness is decreased, and unwanted pregnancy may occur. Here's a link to the National Library of Medicine talking about the effects of St. John's Wort.

Estrogen has beneficial effects on both cholesterol and lipoproteins, so the 30 year old has increased HDL, with decreased LDLs and lipoproteins. This helps explain why women have a greater risk for cardiovascular disease after menopause. However, as illustrated in the Women's Health Initiative, estrogen plus progesterone may increase the risk of coronary heart disease if given to healthy postmenopausal women.

The seminal vesicles are in close proximity to the prostate, unlike any of the options listed. A crystal clear distinction between the two is that only the prostate will have concretions.

Estrogen tends to oppose the action of PTH, resulting in increased bone formation (or decreased resorption). Estrogens increases many clotting factors and decreases AT III. Lipid profiles often change, although estrogen tends to increase HDL, while progestins decrease HDL.

Toxemia of pregnancy tends to occur in the third trimester in primiparas. It is diagnosed as preeclampsia by the gradual onset of hypertension, edema, and proteinuria. Upon CNS involvement (such as seizures), the condition is termed eclampsia. Toxemia resolves spontaneously after the birth of the baby.

Normally, before ovulation, the corpus luteum produces only estrogen to prepare the uterus. After ovulation, the corpus luteum normally produces both estrogen and progesterone. If pregnancy occurs, human chorianic gonadotropin (HCG) from the placenta prevents the corpus luteum from atrophy. If pregnancy doesn't occur, the corpus luteum simply regresses and estrogen and progesterone production drop. In the anovulatory cycle, the corpus luteum continues to produce estrogen. This continued bath in estrogen causes the symptoms of menometrorrhagia (excessive bleeding at irregular intervals).

The sperm can live for about 3 to 5 days, while the egg is viable for less than one day. Therefore, the highest chance for conception occurs if the sperm is already present when ovulation occurs. This has been backed up in the literature (Barrett et al., Population Studies 1969). see slide 7 of Khandalavala's lecture on natural family planning.

It is probably an early primary follicle since it has a single layer of cuboidal graulosa cells. The zona pelucida forms at this stage. A late primary follicle would likely have a granulosa layer many cells thick.

The low risk HPV include 6 and 11. The high risk HPV include 16 and 18. Patients often spontaneously regress from CIN I. Gardasil® only protects before infection of HPV 6, 11, 16, and 18.

This is a primordial follicle, covered by flat epithelial cells. Primordial follicles are arrested in prophase I. Leading up to ovulation, 15 primordial follicles progress to metaphase II. One of these will be released from a Graafian follicle as a secondary oocyte.

Conditions which contraindicate oral contraceptives include breast cancer, history of DVT or PE, coronary artery disease, liver disease, and (of course) pregnancy.

Once the basement membrane has been broken (invasive squamous carcinoma) the Pap smear will show oddly shaped cells. These can be described as spindle cells or tadpole cells. The highly dysplastic CIN III cells will also be present since they immediately preceded the invasion of the basement membrane. Answers A and B are CIN I and II, respectively.