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What factors determine sexual differentiation in a fetus?

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1

What factors determine sexual differentiation in a fetus?

Sex chromosomes, gonads, and hormone-induced organ growth.

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2

Sexual differentiation in a fetus is determined by:

A) Nutrition

B) Sex chromosomes, gonads, and hormones

C) Physical activity

D) Temperature

Correct Answer: B

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3

Q: A newborn shows ambiguous genitalia at birth. What is the best initial investigation?

A) Chromosomal analysis (karyotyping)

Correct Answer: Chromosomal analysis

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4

What role does the SRY gene play in sexual development?

The SRY gene on the Y chromosome directs the undifferentiated gonad to become a testis.

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5

Q: Which gene is essential for male gonadal development?

A) XX gene

B) SRY gene

C) YY gene

D) TT gene

Correct Answer: B

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6

Front: At what week does gonadal differentiation begin?

Around the 7th week of gestation.

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7

What is the role of testosterone in male genital development?

Testosterone promotes male genital development, especially under the influence of Leydig cells.

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8

Q: What is the gonadal outcome in the absence of a Y chromosome?

A) Testes

B) Ovary

C) Wolffian duct

D) Mullerian duct

Correct Answer: B

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9

Q: When does a female fetus reach its maximum number of primordial follicles?

A) At birth

B) During puberty

C) 20 weeks of gestation

D) 30 weeks of gestation

Correct Answer: C

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10

What do Wolffian ducts develop into under the influence of testosterone?

Back: They develop into male internal genitalia like the epididymis, vas deferens, and seminal vesicles.

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11

A) 2nd week

B) 4th week

C) 6th week

D) 8th week

Correct Answer: B

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12

Q2: Primordial germ cells migrate to the gonadal ridges by which week?

A) 3rd week

B) 5th week

C) 7th week

D) 9th week

Correct Answer: B

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13

Q1: Primitive sex cords form in the embryo at which week?

A) 4th week

B) 6th week

C) 8th week

D) 10th week

Correct Answer: B

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14

Q2: By which week does gonadal differentiation occur?

A) 5th week

B) 7th week

C) 9th week

D) 11th wee

Correct Answer: B

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15

Q1: By which week are the Müllerian and Wolffian ducts present in all embryos?

A) 4th week

B) 6th week

C) 8th week

D) 10th week

Correct Answer: C

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16

Front: How are the uterus and fallopian tubes formed?

Back: By the fusion of paramesonephric (Müllerian) ducts.

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17

Q1: The external genitalia can be distinguished as male or female by which week?

A) 9th week

B) 12th week

C) 16th week

D) 20th week

Correct Answer: C

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18

Q2: What hormone influences the development of male external genitalia?

A) Estrogen

B) Dihydrotestosterone

C) Progesterone

D) Cortisol

Correct Answer: B

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19

Q1: What is the role of Leydig cells in male development?

A) Inhibit Müllerian ducts

B) Produce testosterone

C) Develop the prostate

D) Form ovaries

Correct Answer: B

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20

Q2: Testosterone impacts the development of:

A) Female external genitalia

B) Male genitalia and secondary characteristics

C) Mullerian ducts

D) Both male and female genitalia equally

Correct Answer: B

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21

Front: What does the bipotential gonad develop into in the presence of the Y chromosome?

Back: It develops into a testis.

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22

Front: What are Disorders of Sex Development (DSD)?

Back: Conditions where the typical development of chromosomal, gonadal, or anatomical sex does not occur.

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23

Front: Name three categories of DSD.

Back: (1) Sex chromosome DSD, (2) 46,XY DSD, and (3) 46,XX DSD.

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24

Q2: DSDs may result from abnormalities in:

A) Nervous system

B) Chromosomal, gonadal, or hormonal development

C) Digestive system

D) Cardiovascular structure

Correct Answer: B

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26

Q: An infant is diagnosed with ambiguous genitalia at birth. What is the first line of investigation?

A) Karyotyping

B) Ultrasound

C) Physical therapy

D) Routine blood test

Correct Answer: A

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27

Q1: Intersexuality involves:

A) Clear male or female genitalia

B) Ambiguous or mixed sex characteristics

C) Only male characteristics

D) None of the above

Correct Answer: B

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28

Q1: Which of the following is NOT a classification of DSD?

A) 46,XY DSD

B) 46,XX DSD

C) Turner syndrome

D) Sex chromosome DSD

Correct Answe

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29

What are the common causes of DSD?

Disruptions in gonadal differentiation, abnormal fetal sex steroid production or action.

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30

What is female pseudohermaphroditism?

Back: A condition where an individual with female chromosomes (46,XX) has masculinized external genitalia due to excess androgen exposure.

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31

Q1: Female pseudohermaphroditism is typically caused by:

A) Chromosomal abnormalities

B) Excess androgen exposure

C) Lack of hormone influence

D) None of the above

Correct Answer: B

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32

Front: What causes male pseudohermaphroditism?

Back: Primary gonadal deficit, androgen insensitivity, or defects in testosterone synthesis.

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33

Front: What is Turner syndrome?

Back: A condition in females characterized by a 45,XO karyotype leading to short stature and ovarian dysgenesis.

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34

What is mixed gonadal dysgenesis?

Back: A condition where an individual has both ovarian and testicular tissue, often with ambiguous genitalia.

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35

Q1: Mixed gonadal dysgenesis can include:

A) Only testes

B) Only ovaries

C) Both ovarian and testicular tissue

D) None of the above

Correct Answer: C

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36

Front: What are common investigations for DSD?

Back: Karyotyping, examination of genitalia, imaging, hormone analysis, and psychological assessment.

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37

Q1: Which of the following is a sign of ambiguous genitalia?

A) Fully developed male genitalia

B) Hypospadias and undescended testes

C) Normal female genitalia

D) Both A and C

Correct Answer: B

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38

Correct Answer:

Correct Answer: C

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39

Front: What hormones are typically analyzed in DSD investigations?

Back: Testosterone, estrogen, AMH, and other sex hormones.

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40

Q1: Which hormone is crucial to evaluate in cases of suspected androgen insensitivity?

A) Estrogen

B) Testosterone

C) Cortisol

D) Progesterone

Correct Answer: B

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41

What internal genitalia are absent in Complete Androgen Insensitivity Syndrome (CAIS)?

Back: Uterus and fallopian tubes

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42

What is Androgen Insensitivity Syndrome?

A condition where the body cannot respond to androgens, leading to female characteristics despite an XY karyotype.

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43

Q1: Which chromosome pattern is associated with AIS?

A) 46,XX

B) 46,XY

C) 47,XXY

D) 45,XO

Correct Answer:

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44
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45

What is Swyer syndrome?

A form of gonadal dysgenesis in 46,XY individuals where the gonads remain as streak gonads, and female genitalia develop.

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46

Q1: In Swyer syndrome, which structure develops normally?

A) Testes

B) Streak gonads

C) Uterus

D) Male genitalia

Correct Answer: C

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47

Primary amenorrhea may be caused by:

A) Turner syndrome

B) AIS

C) Swyer syndrome

D) All of the above

Correct Answer: D

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48

Q1: The enzyme deficiency commonly associated with ambiguous genitalia is:

A) 17-hydroxylase

B) 21-hydroxylase

C) 5-alpha reductase

D) Androgen synthase

Correct Answer: B

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49

Front: What is the main treatment for CAH?

Cortisol replacement therapy and androgen control.

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50

Q1: Treatment for CAH aims to:

A) Increase estrogen levels

B) Replace cortisol and reduce androgen effects

C) Eliminate testosterone

D) None of the above

Correct Answer: B

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51

What is a common cause of ambiguous genitalia in females?

Congenital adrenal hyperplasia, often due to 21-hydroxylase deficiency.

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52

Which karyotype is commonly associated with CAH in females?

Back: 46,Which karyotype is commonly associated with CAH in females?

Back: 46,XX..

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53

Q1: CAH leads to increased production of:

A) Estrogen

B) Androgens

C) Progesterone

D) Insulin

Correct Answer: B

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54
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55

What are typical genital characteristics in females with CAH?

Virilized or masculinized external genitalia, but female internal genitalia like uterus and ovaries.

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56

Q1: In CAH, the internal genitalia in females typically includes:

A) Testes

B) Scrotum

C) Uterus and ovaries

D) Epididymis

Correct Answer: C

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57

Q1: Which prenatal treatment may reduce CAH symptoms in a female fetus?

A) Testosterone

B) Dexamethasone

C) Estrogen

D) Progesterone

Correct Answer: B

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58

ملخص: يناقش حالة Mixed Gonadal Dysgenesis، والتي قد تتضمن خصية على جانب واحد ومبيض أو غدة غير مكتملة على الجانب الآخر.

Front: What does mixed gonadal dysgenesis typically involve?

Presence of one testis and either a streak gonad or an ovary on the opposite side.

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59

Q1: Mixed gonadal dysgenesis often leads to:

A) Normal male genitalia

B) Ambiguous genitalia

C) Only female genitalia

D) Only male genitalia

Correct Answer: B

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60

ملخص: يوضح True Hermaphroditism الذي يشمل تواجد أنسجة مبيضية وخصوية معاً في نفس الفرد.

Q1: True hermaphroditism is characterized by the presence of:

A) Only testes

B) Both ovarian and testicular tissues

C) Only ovaries

D) No gonadal tissue

Correct Answer: B

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62

Front: Name a common long-term complication in individuals with DSD.

Osteoporosis or psychological challenges.

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63

Front: What physical characteristics are associated with Turner syndrome?

Back: Short stature, webbed neck, shield chest, and gonadal dysgenesis.

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64

Q1: Klinefelter syndrome often results in:

A) Ovarian dysgenesis

B) Male infertility

C) Short stature

D) Webbed neck

Correct Answer: B

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65

Q1: The primary diagnostic tool for Turner and Klinefelter syndromes is:

A) Hormone assay

B) Physical examination

C) Karyotype analysis

D) Ultrasound

Correct Answer: C

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66

Front: What are common treatments for Turner syndrome?

Back: Growth hormone therapy and estrogen replacement.

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67

Which hormone is essential for treating Turner syndrome to induce puberty?

A) Cortisol

B) Estrogen

C) Testosterone

D) Thyroid hormone

Correct Answer: B

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68

What is a primary treatment for Klinefelter syndrome?

Testosterone replacement therapy.

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69

Q1: Which fertility treatment can help women with Turner syndrome have children?

A) Natural conception

B) Testosterone therapy

C) IVF with donor egg

D) Growth hormone therapy

Correct Answer: C

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70

Q1: One major complication associated with untreated DSD is:

A) Improved fertility

B) Increased bone density

C) Psychological distress

D) None of the above

Correct Answer: C

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71
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