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53 Cards in this Set
- Front
- Back
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As a pathologist, you are examining a slide form the seminiferous tubules of an infertile male. There are only primary spermatocytes and spermatogonia seen. What 2 phases of spermatogenesis are not occuring?
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spermatocyte and spermatid phase are not happening, only spermatogiona phase is
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A patient has recently traveled to a 3rd world country and had Clostridium Perfingens toxin in his system. Why is he infertile?
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Attack tight junctions between sertoli cells. blood-testis barrier is broken. immune system attacks "non-self" developing sperm
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An infertiles patient has non-motile sperm. What structure is likely damaged?
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epididymis
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In an infertile male, his sperm is unable to bind to the zona pellucida. What stage of speramtogenesis, specifically, was poorly done?
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Golgi, cap or acrosomal are needed to have proper capacitation
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A patient has sperm that are unable to penetrate the corona radiata. Will capacitation still occur?
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No, sperm must penetrate the corona radiata to get to the pellucida. capacitation occurs on pellucida
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An infertile male patient never developed a gubernaculum testes. Diagnosis? Why is he infertile?
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he has cryptorchidism. no gubernaculum = no descending of tested = high temperature of testes in abdominal cavity = no sperm production
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A body builder complains of infertility. He has been using steroids for years. What cells are no longer being stimulated? (be specific)
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Leydig cells and gonadotrophs in the adenohypophysis. steroids decrease LH production in males' pituitary. Leydig cells respond to LH and make testosterone to maintain the testes. no LH= no testes/testosterone
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Why might we see lipofuschin in Sertoli cells?
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they are post-mitotic/long-lived
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An infertile patient is seen to have normal levels of LH in the blood, but low levels of FSH in the blood. There is there is no damage to the anterior pituitary, What cells are likely to be hyperactive?
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Sertoli cells secret inhibin that shuts off FSH. hyperfunction of sertoli cells = high inhibin = low FSH= low Androgen binding protein also= poor sperm.
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An infertile male has decreased sperm motility. The epididymis and testes functioning perfectly fine and the sperm quality is perfectly. Damage to what other structure may be responsible for immotile sperm?
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Seminal vesicles provide fructose metabolite for sperm energy
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A patient is seen to have very high serine protease levels in the blood. What prostate zone is likely affected?
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Peripheral is where carinoma occurs. serine protease = PSA
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A patient is secreting very highly concentrated semen. What structure is likely damaged?
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Prostate is responsible for liquifying semen/sperm (uses citric acid and fibrinolysin)
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A patient has erectile dysfunction. He is seen to have damage to the parasympathetics S2, S3, S4. Would you give him viagara?
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No, viagara can only work if parasympathetics can initiate mechanism. para sympathetics must be intact to release Nitric oxide to stimulate guanylate cyclase to make cGMP in smooth muscle cells. viagara just helps guanylate cyclase's function by preventing cGMP degradation (inhibits phosphodiesterase)
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A patient is diagnosed with ovarian cancer. What layer of the ovary is likely affected?
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Germinal layer (granulosa)
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A patient with damage to the anterior pituitary will still have what types of follicles in the ovary?
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primordial follicles grow independent of gonadotropin stimulation
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An infertile female patient has normal LH levels, but low FSH levels. If a patient is taking progesterone shots, why will only the proliferative menstrual phase be prevented?
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FSH is needed to convert androgens (made by theca interna) into estrogen in the granulosum cells. estrogen is needed for the proliferatitiono f stratum functionale
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Why is the theca externa important after the LH surge?
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is contracts to help expel the Graffian follicle
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A patient has high levels of HCG in the urine, but an empty uterus. Why is it highly unlikely that the fetus is in the Pouch of Douglas?
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follicles that are in the peritoneal cavity usually degrade quickly before they can be fertilized.
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A hypertensive female patient is on non-thrombogenic medications to prevent atherosclerosis. She is having difficulty getting pregnant. What structure during menstruation might not be forming properly as a result of her medications?
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corpus lutem must form clot (corpus hemmoragicum) first before it can reform after rupture. potential problems can occur is corpus luteum cannot form and secrete estrogen and progesterone
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A patient trying to get pregnant has no HCG in her urine. What structure forms from her corpus luteum as a result?
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corpus albicans (white scar) forms from corpus luteum without HCG stimulation
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A patient is newly pregnant. What hormone is found in her urine now? Where did it come from?
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HCG from chorionic trophoblasts
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A female patient has high HCG in her urine, but her uterus is empty. What epithelium is found in the area where the fertilized egg is likely sitting?
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Oviduct has columnar (ciliated and non-ciliated). ectopic pregnancy can also occur in pouch of douglas rarely (mesothelium)
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A female patient is currently producing high levels of progesterone. What event triggers this during menstruation?
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LH surge causes follicle rupture. Endometrium wants to begin secretory phase to prepare for implanatation and progesterone is made
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A female patient has high levels of estrogen in her body. What phase of the ovarian cycle is likely occuring?
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Follicular phase correlates with proliferation phase of endometrium/menstrual cycle
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A female patient has high levels of progesterone in her body. What phase of the ovarian cycle is likely occuring?
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luteal phase. progesterone peaks after LH surge to cause secretory phase.
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As a pathologist you are examining slides of vaginal wall. Why do you know that it is not an esophagus sample?
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Vagina has glycogen stored in the strat. squamous non-keratinized (stains lighter) and vagina has no submucosa
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A patient has a pap smear performed. What cells do we expect in the histology? Where are they from?
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We expect to see squamous cells from the cervix
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A female patient with high HCG levels is having trouble maintaining estrogen/progesterone levels. What cells is likely damaged?
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corpus luteum of pregnancy
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A patient recently gave birth and is currently lactating. She wants fertility treatment to get pregnant again. Why would you advise against this?
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prolactin inhibits LH. Birth causes decrease of estrogen/progesterone. If we gave fertility treatment we would risk lactation and nutrition to the newborn
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A patient recently gave birth and is currently lactating. She is unable to get pregnant and wants fertility treatment to get pregnant again. Even though this is a bad idea, what drug might you consider to administer to her to increase her chances of pregnancy?
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dopamine inhibits prolactin. prolactin inhibits LH. No LH= no pregnancy/estrogen/progesterone. So dopamine would prevent prolactin from ruining the system
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A patient presents in the ER with an elevated heart rate, pulse, BP, respiration. What class of hormones are responsible for this? Where are they made?
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amino acid analogues (catecholamines) form adrenal medulla
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A patient suffers head trauma as a young child. Neuroectoderm is damaged. Why might this patient have hypotonic urine?
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neuroectoderm = posterior pituitary. ADH is stored and released from here (herring bodies). no ADH= central diabetes insipidus
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A female patient is having trouble during childbirth. It is difficult for her to push the child out. What areas of the hypothalamus could be damaged?
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Paraventricular/supraoptic nuclei produce oxytocin. herring bodies are part of the post. pit.
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A patient is having trouble regulating their blood hormone levels. What part of the hypothalamus might be directly responsible for this?
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median eminence is a break in the blood-brain barrier to allow for regulation of hormones
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A young patient has excessive bone growth. Where is the molecule directly responsible for this made?
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Somatomedin C (IGF-1) from the liver. GH is not DIRECTLY responsible
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An adult patient has difficulty talking, chewing and has sleep apneas. Describe his bone growth?
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Appositional since the growth plate has closed/ossified
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As a pathologist, there is a slide of pars nervosa. Is there myelin present? Where are the neuron bodies found?
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no myelin, bodies in the PVN/supraoptic nuclei
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A patient has hypotonic urine. Glomerular filtration rate is appropriate. There are high ADH levels. There are appropriate levels of ADH receptors in the kidney. What is the dysfunction?
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Nephrogenic Diabetes insipidus. there is a deficit in aquaporin 2 receptors. nephrogenic DI is due to poor ADH or Aquaporin receptors. aldosterone pathway is fine due to proper GFR
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A patient suffers severe head trauma. Luckily he has no direct hypothalmus or pituitary damage. But he still has diabetes insipidus. What structure is damaged?
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hypophyseal stalk. hormones from hypothalamus cannot reach pituitary, ADH cannot be stored/released from herring bodies
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A patient has trouble sleeping. What is distinctive about the damaged cells under a microscope? Why can radiologists see this on X-ray?
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brain sand (corpora aranacea) of the pineal gland. contains calcium = shows on x-ray
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A patient constantly feels cold, has weight gain and myexedema. His TRH, TSH levels are high. And iodine levels are high. What dysfunction could be responsible for this dysfunction?
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No t3/t4 probably related to thyroid peroxidase dysfunction (iodine cannot enter colloid)
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A patient is having difficulty lowering blood calcium levels. Where are these dysfunctional cells derived from?
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C cells in thyroid (make calcitonin) are neural crest derived
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A female patient just gave birth. She is having excessive dopamine secretions from the hypothalamus. What hormone might you give her to help with lactation?
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dopamine inhibits prolactin, but high TRH can help prolactin production. oxytocin also helps
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A male presents with lactating breasts. Prolactin is not typically made in males. What might we expect to see regarding his metabolism?
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prolactin in males = High TRH = LOW T3/T4 (remember feedback!) = hypothyroidism = slow metabolism
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A patient presents with exopthalmos, goiter and heat intolerance, despite having no TSH. What is the diagnosis?
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Graves disease
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A patient has myexedema, cold intolerance and goiter, despite having high iodine levels. What is the diagnosis?
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Hashimoto's disease. auto- antibodies against thyroid peroxidase = no iodine into colloid = no t3/t4
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A patient has parathyroid cancer. During surgery, why should the surgeon not remove the entire gland?
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PTH is only made here! removal of PTH gland = no calcium release into blood = fatal
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A patient presents with a weak immune system due to high levels of cortisol. The adrenal glands appear swollen. What part of the gland is cancerous?
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zona fasciculata makes cortisol
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A patient with lung cancer is seen to have masculinization, high cortisol and aldosterone levels. What is your diagnosis?
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Cushing's SYNDROME. ectopic ACTH production (not from pituitary). lungs produce ACTH. exogenous acth = syndrome. hyperfunction of adrenal glands
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A patient has a cancer of the adenohypohysis. What diagnosis explain the increased aldosterone, cortisol and masculinization?
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Cushings Disease. high ACTH from pituitary
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A lethargic patient is having difficulty raising his blood glucose levels. What cells of the pancreas might be damaged?
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alpha cells of islets of langerhans make glucagon
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A patient has damage to the somatotrophes in the adenohypohysis. Why might they still be able to grow?
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Delta cells of the pancreas (islets) secrete small amounts of GH
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Why is diabetes mellitus type 1 called an auto immune disease?
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anitbodies attack the islet's beta cells
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