Gynaecology Pg No 141 -150
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Questions and Answers

What is a common cause of ambiguous genitalia in XX individuals?

  • Turner's syndrome
  • Testicular Feminization
  • Kallman syndrome
  • Congenital Adrenal Hyperplasia (CAH) (correct)

    • In the absence of testosterone, a male (XY) individual will develop female external genitalia.

    True

    What hormone is responsible for the growth of the uterus during puberty?

    Estrogen

    An individual with a poorly developed uterus due to low estrogen levels is said to have a __________ uterus.

    <p>hypoplastic</p> Signup and view all the answers

    Match the following genitalia derivatives with their corresponding sexes:

    <p>Genital tubercle = Clitoris Labioscrotal swelling = Scrotum Genital fold = Penile urethra</p> Signup and view all the answers

    What is the primary type of sling material used in Sling Sx/Cervicopexy?

    <p>Mersilene tape</p> Signup and view all the answers

    The success rate of the Anterior (Purandare) sling is higher than that of the Posterior (Shirodkar) sling.

    <p>False</p> Signup and view all the answers

    What is the type of sling used in the Anterior (Purandare) sling procedure?

    <p>Dynamic sling</p> Signup and view all the answers

    One complication of the Posterior (Shirodkar) sling is ____ injury to the genitofemoral nerve.

    <p>injury</p> Signup and view all the answers

    Match the following types of slings with their characteristics:

    <p>Anterior (Purandare) = Dynamic sling, low success rate, less complications Posterior (Shirodkar) = Static sling, high success rate, can cause intestinal obstruction</p> Signup and view all the answers

    Which of the following is a symptom of vaginal prolapse?

    <p>Feeling of vaginal fullness</p> Signup and view all the answers

    Decubitus ulcers are caused primarily by friction.

    <p>False</p> Signup and view all the answers

    What is the primary goal of Kegel's Exercise?

    <p>Strengthening pelvic floor muscles</p> Signup and view all the answers

    The surgical procedure for cystocele and urethrocele is called ______________.

    <p>anterior colporrhaphy</p> Signup and view all the answers

    Match each symptom to its associated condition:

    <p>Incomplete voiding of urine = Cystocele/urethrocele Something coming out of vagina = Vaginal prolapse Low backache = Stretching of uterosacral ligaments Rectocele = Bowel symptoms</p> Signup and view all the answers

    What does the surgical procedure anterior colporrhaphy specifically address?

    <p>Cystocele</p> Signup and view all the answers

    Vaginal hysterectomy involves the removal of the uterus through the abdomen.

    <p>False</p> Signup and view all the answers

    What is the purpose of uterosacral suspension?

    <p>To prevent vault prolapse</p> Signup and view all the answers

    The procedure performed to correct rectocele is called __________.

    <p>posterior colporrhaphy</p> Signup and view all the answers

    Match the gynecological procedure with its corresponding definition:

    <p>Anterior colporrhaphy = A surgical procedure to correct a cystocele Pelvic floor repair = A repair to support and strengthen the pelvic floor muscles McCull culdoplasty = A procedure to prevent enterocele Vaginal hysterectomy = Surgical removal of the uterus via the vagina</p> Signup and view all the answers

    What leads to the formation of internal genital organs in females?

    <p>Growth of Müllerian duct</p> Signup and view all the answers

    The absence of the SRY gene leads to the development of male external genitalia.

    <p>False</p> Signup and view all the answers

    What are the remnants of the Wolffian duct?

    <p>Epoophoron, Paroophoron, Gartner's duct</p> Signup and view all the answers

    The upper vagina is derived from the __________ duct.

    <p>Müllerian</p> Signup and view all the answers

    Match the following conditions with their associated features:

    <p>Turner syndrome = Incomplete ovarian development Streak gonads = Underdeveloped gonads 46 XX = Normal female sexual development MIS/AMH = Acts on Müllerian duct</p> Signup and view all the answers

    Which of the following is the best method for vault prolapse?

    <p>Sacral Colpopexy</p> Signup and view all the answers

    Uterosacral Suspension is considered difficult to perform.

    <p>False</p> Signup and view all the answers

    What examination technique should be performed to check the degree of prolapse?

    <p>Valsalva maneuver</p> Signup and view all the answers

    In sacral colpopexy, a mesh is placed between the sacrum and the __________.

    <p>vaginal vault</p> Signup and view all the answers

    Match the following clinical examination steps with their appropriate objective:

    <p>Put prolapsed part in normal position = Assess anatomical alignment Check for sulcus = Evaluate structural integrity Measure total uterovaginal length = Determine prolapse extent Perform P/V Examination = Examine uterine size and position</p> Signup and view all the answers

    What is the primary surgical procedure recommended for a reproductive-age female who does not require future childbearing?

    <p>Fothergill repair</p> Signup and view all the answers

    Sacrohysteropexy can be performed on women who wish to retain their uterus and have future childbearing plans.

    <p>True</p> Signup and view all the answers

    What complication is associated with Fothergill surgery?

    <p>Cervical stenosis</p> Signup and view all the answers

    Lefort's colpocleisis involves stitching the anterior and posterior walls of the __________.

    <p>vagina</p> Signup and view all the answers

    Match the types of prolapse management with their specific characteristics:

    <p>Fothergill repair = Cervical amputation and plication of cardinal ligament Sacrohysteropexy = Recommended for future childbearing Lefort's colpocleisis = Stitching of vaginal walls Shirodkar modification = Only plication of cardinal ligament</p> Signup and view all the answers

    What determines the development of male gonads?

    <p>Presence of the SRY gene</p> Signup and view all the answers

    Females develop testes if the SRY gene is present.

    <p>False</p> Signup and view all the answers

    What are the two types of ducts present during the intrauterine period?

    <p>Mullerian duct and Wolffian duct</p> Signup and view all the answers

    The primary micronutrient necessary for the function of the SRY gene is __________.

    <p>Zinc</p> Signup and view all the answers

    Match the following sex determination methods to their characteristics:

    <p>Appearance of external genitalia = Most common method but can be ambiguous Karyotyping = Best method for chromosomal assessment Y chromosome presence = Indicates male development Barr bodies = Reflects the number of X chromosomes</p> Signup and view all the answers

    Which sex chromosome configuration corresponds to Turner syndrome?

    <p>45,XO</p> Signup and view all the answers

    The Wolffian duct contributes to the development of female internal organs.

    <p>False</p> Signup and view all the answers

    Which internal organs develop from the Mullerian duct?

    <p>Fallopian tubes, uterus, cervix, vagina (upper part)</p> Signup and view all the answers

    What is the primary function of Sertoli cells?

    <p>Inhibit Mullerian duct development</p> Signup and view all the answers

    Leydig cells are located inside the blood-testis barrier.

    <p>False</p> Signup and view all the answers

    What gene is most critical for the formation of testes in males?

    <p>SRY</p> Signup and view all the answers

    The process of masculinization of external genitalia is primarily mediated by __________.

    <p>Dihydrotestosterone</p> Signup and view all the answers

    Match the following cells with their functions:

    <p>Sertoli cells = Contain receptors for SRY Leydig cells = Promotes Wolffian duct growth</p> Signup and view all the answers

    What is the recommended management for a prolapse in an elderly female who is unfit for surgery?

    <p>Ring pessary</p> Signup and view all the answers

    A ring pessary can be used during pregnancy until the end of the third trimester.

    <p>False</p> Signup and view all the answers

    What procedure is used to prevent vault prolapse during a vaginal hysterectomy?

    <p>Uterosacral suspension</p> Signup and view all the answers

    The surgical procedure not effective for vault prolapse but can resolve stress urinary incontinence is called __________ colposuspension.

    <p>Burch</p> Signup and view all the answers

    Match the following management techniques with their corresponding conditions:

    <p>Ring pessary = Prolapse in elderly women Vaginal surgery = Vault prolapse management Sacrospinous fixation = Prevention of vault prolapse Abdominal surgery = Management of prolapse in pregnancy</p> Signup and view all the answers

    Study Notes

    Development of Internal Genitalia

    • Gonads are bipotential and develop from the genital ridge at 5-6 weeks of intrauterine life.
    • They can develop into either testes (male gonads) or ovaries (female gonads) based on the presence or absence of the SRY gene.
    • The SRY gene, also known as the testis-determining factor, is located on the Y chromosome.
    • The presence of the SRY gene leads to male development, and its absence leads to female development.
    • Zinc is a micronutrient necessary for sex determination.

    Internal Genital Organs

    • During the early intrauterine period, two pairs of genital ducts develop: the Mullerian duct (paramesonephric duct) and the Wolffian duct (mesonephric duct).
    • The Mullerian duct is derived from the coelomic epithelium and contributes to the formation of the Fallopian tubes, uterus, cervix, and upper part of the vagina.
    • The Wolffian duct originates from the intermediate mesoderm and develops into the seminal vesicles, epididymis, ejaculatory duct, and vas deferens in males.

    Sex Determination

    • Sex can typically be determined based on the appearance of external genitalia.
    • Karyotyping is considered the most reliable method: it assesses the number and structure of chromosomes.
    • Turner syndrome, characterized by the karyotype 45,XO, is a female condition.
    • Klinefelter syndrome, characterized by the karyotype 47,XXY, is a male condition.
    • The presence or absence of the Y chromosome can also be used for sex determination.
    • The number of Barr bodies (one less than the number of X chromosomes) corresponds to the sex.

    Role of Estrogen

    • Estrogen promotes the growth of the uterus during puberty.
    • Low estrogen levels due to conditions like Turner's syndrome or Kallman syndrome can lead to a hypoplastic (poorly developed) uterus.

    Development of External Genitalia

    • Testosterone plays a crucial role in the development of external genitalia.
    • Structures such as the genital tubercle, labioscrotal swelling, and genital folds develop into different male and female genitalia based on the presence or absence of testosterone.
    • The presence of testosterone leads to the formation of the penis, scrotum, and penile urethra in males.
    • In the absence of testosterone, these structures develop into the clitoris, labia majora, and labia minora in females.

    Sources of Testosterone

    • The primary source of testosterone in males is the testes and adrenal glands.
    • In females, testosterone is primarily produced by the adrenal glands and converted to estrogen by the enzyme aromatase.

    Ambiguous Genitalia

    • Ambiguous genitalia denotes external genitalia that do not clearly indicate the sex of the individual.
    • This can be caused by various factors, including:
      • Low levels of testosterone in individuals with either XY or XX chromosomes.
      • Congenital Adrenal Hyperplasia (CAH): In XX individuals
      • Partial Androgen Insensitivity Syndrome: In XY individuals.
    • Commonly observed features include:
      • Undetermined sex of the external genitalia
      • Clitoromegaly
      • Micropenis
      • Labio scrotal fold/fusion
      • Bifid scrotum

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    Description

    Explore the intricate process of internal genitalia development during fetal life. This quiz covers key topics like the role of the SRY gene, the differentiation of gonads, and the formation of critical reproductive structures from the Mullerian and Wolffian ducts.

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