Patho Reproductive & STDs

What gene triggers male gonadal development?

SRY gene on the Y chromosome; it directs testis development.

What is the HPG axis sequence?

Hypothalamus releases GnRH → pituitary releases FSH/LH → gonads produce sex hormones.

What does FSH do in females?

Stimulates ovarian follicle development.

What does the LH surge do in females?

Triggers ovulation.

What does estrogen do during the follicular phase?

Stimulates proliferation and thickening of the endometrium.

What does progesterone do during the luteal phase?

Prepares and maintains the endometrium for implantation.

What does the corpus luteum produce?

Primarily progesterone, plus estrogen, after ovulation.

What happens to the corpus luteum if pregnancy does not occur?

It degenerates; estrogen and progesterone fall, triggering menstruation.

Where does fertilization usually occur?

In the ampulla of the fallopian tube.

What is the endometrium?

The inner uterine lining; the site of implantation.

What is the myometrium?

The muscular middle uterine layer; contracts during childbirth.

What is the perimetrium?

The outer serous layer of the uterus.

What is the function of fimbriae?

Help capture the ovum after ovulation.

What maintains the normal acidic vaginal environment?

Lactobacilli, which help inhibit pathogen overgrowth.

What is menarche?

The first menstrual period.

What is menopause?

Permanent cessation of menstruation marking the end of reproductive years.

What is the function of prolactin?

Stimulates milk production.

What is the function of oxytocin in lactation?

Causes milk ejection (let-down) by contracting myoepithelial cells.

Which testicular cells produce testosterone?

Leydig cells, stimulated by LH.

Which testicular cells support spermatogenesis?

Sertoli cells, stimulated by FSH.

What does inhibin from Sertoli cells do?

Suppresses FSH secretion.

Where does spermatogenesis occur?

In the seminiferous tubules of the testes.

How many chromosomes are in a haploid sperm cell?

23 chromosomes.

What is the main function of the epididymis?

Sperm maturation and storage.

Why are testes located in the scrotum?

Sperm production requires a temperature cooler than core body temperature.

What causes penile erection physiologically?

Parasympathetic signaling and nitric oxide cause vasodilation and increased erectile blood flow.

What is the difference between emission and ejaculation?

Emission moves semen into the urethra; ejaculation expels it through the urethra.

What is androgen insensitivity syndrome?

A 46,XY individual has a female phenotype because tissues cannot respond normally to androgens.

What is delayed puberty in girls by the slide criteria?

No secondary sex characteristics by 13, or no menarche by 15–16 years.

What is central precocious puberty?

Premature activation of the normal GnRH-dependent HPG axis.

What is peripheral precocious puberty?

Sex hormones are produced independently of GnRH/gonadotropin stimulation.

What causes primary dysmenorrhea?

Prostaglandin release in ovulatory cycles causes painful uterine contractions.

What is secondary dysmenorrhea?

Menstrual pain caused by underlying pelvic pathology.

What is primary amenorrhea?

Menstruation has not begun by the age thresholds specified in the slides.

What is secondary amenorrhea?

Menstruation stops after previously occurring; pregnancy is an important cause to exclude.

What are common causes of secondary amenorrhea?

Pregnancy, anovulation/PCOS, weight loss, excessive exercise, malnutrition, thyroid or pituitary disorders.

What is abnormal uterine bleeding (AUB)?

Bleeding abnormal in frequency, regularity, duration, or volume.

What is menorrhagia?

Excessive or heavy menstrual bleeding.

What is metrorrhagia?

Irregular bleeding between menstrual periods.

What is menometrorrhagia?

Both irregular and excessive uterine bleeding.

What are key features of PCOS?

Ovulatory dysfunction, androgen excess, and/or polycystic ovarian morphology; diagnosis uses clinical criteria.

Why can PCOS increase endometrial hyperplasia risk?

Chronic anovulation can cause unopposed estrogen stimulation without progesterone.

What is PID?

Ascending infection/inflammation of the upper female reproductive tract.

What exam findings support PID?

Cervical motion, uterine, or adnexal tenderness in an at-risk patient.

What are major complications of PID?

Tubal scarring, infertility, chronic pelvic pain, and increased ectopic pregnancy risk.

What is salpingitis?

Inflammation of the fallopian tubes.

What is oophoritis?

Inflammation of the ovaries.

What is a Bartholin cyst?

Fluid accumulation caused by obstruction of a Bartholin gland duct.

What is a cystocele?

Bladder protrusion into the anterior vaginal wall.

What is a rectocele?

Rectum protrusion into the posterior vaginal wall.

What is an enterocele?

Herniation of a peritoneal sac, often containing small bowel, into the vaginal area.

What is uterine prolapse?

Descent of the cervix and/or uterus into the vaginal canal.

What is a leiomyoma (fibroid)?

A benign smooth-muscle tumor arising in the uterine myometrium.

Where can uterine fibroids be located?

Subserosal (outer), intramural (myometrium), or submucosal (beneath endometrium).

What is adenomyosis?

Endometrial glands and stroma located within the myometrium.

What is endometriosis?

Endometrial-like tissue located outside the uterus; it can cause inflammation, adhesions, pain, and infertility.

What is the key difference between adenomyosis and endometriosis?

Adenomyosis is within uterine muscle; endometriosis is outside the uterus.

What is the usual cause of cervical cancer?

Persistent infection with high-risk HPV.

What does carcinoma in situ mean?

Abnormal malignant cells remain confined to the epithelium and have not invaded through the basement membrane.

What is the major endometrial cancer risk mechanism?

Unopposed estrogen causing prolonged endometrial proliferation and possible hyperplasia.

What are common symptoms that may suggest ovarian cancer?

Persistent bloating/distension, pelvic or abdominal pain, appetite loss, and early satiety.

What is galactorrhea?

Milky nipple discharge unrelated to pregnancy or breastfeeding, often associated with elevated prolactin.

What is dyspareunia?

Painful sexual intercourse.

What is vaginismus?

Involuntary vaginal muscle spasm associated with attempted penetration.

What is anorgasmia?

Inability or persistent difficulty achieving orgasm.

What is the key breast-cancer distinction between DCIS and invasive cancer?

DCIS remains within ducts; invasive cancer has crossed the basement membrane.

Which inherited genes are important breast and ovarian cancer susceptibility genes?

BRCA1 and BRCA2.

What is delayed puberty in boys by the slide criteria?

Absence of secondary sexual characteristics by age 14.

What is hypergonadotropism in delayed puberty?

Elevated FSH and LH, suggesting gonadal dysfunction.

What is hypogonadotropism in delayed puberty?

Low FSH and LH, suggesting hypothalamic or pituitary dysfunction.

What is urethritis?

Inflammation of the urethra; may be infectious or noninfectious.

What is a urethral stricture?

Fibrotic scar-related narrowing of the urethra causing obstructed urinary flow.

What is phimosis?

Foreskin cannot be retracted over the glans.

What is paraphimosis?

Retracted foreskin cannot be returned over the glans; severe cases are an emergency.

What is Peyronie disease?

Fibrous plaques in erectile tissue cause penile curvature, sometimes with painful erections.

What is priapism?

Prolonged painful erection unrelated to sexual arousal; a urologic emergency.

What is balanitis?

Inflammation of the glans penis, sometimes with foreskin inflammation.

What is a varicocele?

Dilation of veins in the spermatic cord; often feels like a bag of worms.

What is a hydrocele?

Fluid accumulation around the testis within the tunica vaginalis.

What is a spermatocele?

A benign fluid-filled cyst arising from the epididymis.

What is cryptorchidism?

Failure of one or both testes to descend into the scrotum.

What are important risks of cryptorchidism?

Increased risk of infertility and testicular cancer.

What is testicular torsion?

Twisting of the spermatic cord compromises testicular blood flow; surgical emergency.

What is orchitis?

Inflammation of the testis.

What is epididymitis?

Inflammation of the epididymis, often due to ascending infection.

What is a classic presentation of testicular cancer?

Painless testicular enlargement or mass, especially in a younger adult.

What is BPH?

Benign prostate enlargement that compresses the urethra and causes lower urinary tract symptoms.

What are common BPH symptoms?

Hesitancy, weak stream, frequency, urgency, and incomplete emptying.

What is prostatitis?

Inflammation of the prostate; may be bacterial or nonbacterial/chronic pelvic pain syndrome.

How does prostate cancer often present early?

It may be asymptomatic; urinary symptoms are not required.

What are four broad causes of erectile dysfunction?

Vascular, endocrine, neurologic, and medication/iatrogenic factors.

Which hormones and cells are essential for spermatogenesis?

FSH acts on Sertoli cells; LH stimulates Leydig cells to produce testosterone.

What is gynecomastia?

Male breast glandular tissue enlargement associated with an altered estrogen-to-testosterone balance.

What organism causes gonorrhea?

Neisseria gonorrhoeae.

What is a typical male presentation of gonorrhea?

Dysuria and purulent penile discharge.

What serious reproductive complication can gonorrhea cause in women?

PID with possible tubal scarring and infertility.

What organism causes syphilis?

Treponema pallidum, a spirochete.

What is the hallmark of primary syphilis?

A firm, painless chancre with regional lymphadenopathy.

What characterizes secondary syphilis?

Systemic symptoms, generalized lymphadenopathy, rash, and condylomata lata.

What characterizes latent syphilis?

No symptoms, but serologic evidence of infection remains.