the most promising way to achieve pregnancy in a woman with Turner syndrome☆In vitro fertilization of Turner syndrome patients with an ovum provided by a related or anonymous donor results in pregnancy rates approaching 60%.
(Pregnancy can occur spontaneously in some patients with Turner syndrome, but the risk of spontaneous abortion, Down syndrome and Turner syndrome are all increased in such cases.) reproductiveobstetricsUWorld HirotoShishido
mechanism of endometrial hyperplasia in postmenopausal obese womanSmall amounts of androgens continue to be produced in the ovaries and adrenal glands after menopause. In obese women, these androgens (eg, androstenedione) are readily converted to estrogens (eg, estrone) by the aromatase enzyme found in adipose tissue.
However, ovarian progesterone production remains low; therefore, the unopposed estrogen causes unregulated endom etrial proliferation and subsequent endometrial hyperplasia. reproductiveUWorld HirotoShishido
which part of urethra commonly injuredanterior urethral injury: perineal straddle injury→ bulbar urethra
neural tube defect
testα-fetoprotein (AFP) in amniotic fluid and maternal serum (except spina bifida occulta = normal AFP)☆acetylcholinesterase (AChE) in amniotic fluid is a helpful confirmatory test. reproductiveUWorld HirotoShishido
Hydatid of Morgagni¥Sertoli cells produce Müllerian inhibitory factor (MIF), which leads to suppression of the paramesonephric ducts and their degeneration into appendix testes (also known as hydatid of Morgagni).
benign breast diseases which increase risk of carcinomasclerosing adenosis(slightly increase the risk), epithelial hyperplasia(both are subtypes of fibrocystic changes)
in which ages of woman have propensity to have fibroadenoma
risk factors of themmyxoid stromal proliferation compressing the ducts the slits(black arrow)
common in woman <35yo
the epithelial content is estrogen-sensitive, resulting in size increase ★with OCP use ,☆pregnancy , or the luteal phase of the menstrual cycle reproductiveUWorld step2CKbreast surgery HirotoShishido
Picturefat necrosis
liquefactive necrosis of adipocytes(black arrow) and hemorrhage(green arrow)
effects of maternal diabetes to an infant☆macrosomia, ☆transient neonatal hypoglycemia(☆due to islet cell hyperplasia, typically resolves within 3-7 days of birth)
sexual play between children who vary in age (no matter what their sex)Sexual play by an older child can suggest that ☆recently he has been sexually abused by an adult and is replicating what has been done to him with the younger one. behavioral sciencereproductive HirotoShishido
Elevation of the uterusThe tenting effect, elevation of the uterus in the pelvic cavity, begins during the excitement phase of the sexual response cycle in women. behavioral sciencereproductive HirotoShishido
exogenous anabolic steroid abuse
manifestation(fat-free mass, muscle strength,
and performance)
acne, ☆increased Hb and Hct(due to suppression of hepcidin and an elevated risk for intestinal iron absorption)
→contraindicated with hematocrit>=50%
placental aromatase deficiencyInability to synthesize estrogens from androgens.
Masculinization of female (46,XX DSD) infants (ambiguous genitalia),serum testosterone and androstenedione.
☆★Can present with maternal virilization during pregnancy (fetal androgens cross the placenta). reproductiveUWorldUWorld step2CK HirotoShishido
which histological pattern of BPH does best respond to finasteride?predominant epithelial hyperplasia>> predominant stromal hyperplasia(collagen or smooth muscle predominance) reproductiveurologyUWorld HirotoShishido
vastectomy and viable spermpatient will have viable sperm in distal vas for 3 months and at least 20 ejaculations following vastectomy reproductiveurologyUWorld HirotoShishido
FSH and inhibin in the patient with 1 testicle(Sertoli cells are present within the seminiferous tubules of the testes.)
In patients with 1 testicle, the mass of Sertoli cells is significantly reduced. Therefore, the circulating ☆levels of inhibin B are likely to be low in these patients. Low inhibin B levels will not provide adequate negative feedback on FSH secretion, thus ☆FSH levels will tend to be elevated in males who only have 1 testicle. reproductiveUWorld HirotoShishido
