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Questions and Answers
What is a common cause of ambiguous genitalia in XX individuals?
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.
In the absence of testosterone, a male (XY) individual will develop female external genitalia.
True (A)
What hormone is responsible for the growth of the uterus during puberty?
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.
An individual with a poorly developed uterus due to low estrogen levels is said to have a __________ uterus.
Match the following genitalia derivatives with their corresponding sexes:
Match the following genitalia derivatives with their corresponding sexes:
What is the primary type of sling material used in Sling Sx/Cervicopexy?
What is the primary type of sling material used in Sling Sx/Cervicopexy?
The success rate of the Anterior (Purandare) sling is higher than that of the Posterior (Shirodkar) sling.
The success rate of the Anterior (Purandare) sling is higher than that of the Posterior (Shirodkar) sling.
What is the type of sling used in the Anterior (Purandare) sling procedure?
What is the type of sling used in the Anterior (Purandare) sling procedure?
One complication of the Posterior (Shirodkar) sling is ____ injury to the genitofemoral nerve.
One complication of the Posterior (Shirodkar) sling is ____ injury to the genitofemoral nerve.
Match the following types of slings with their characteristics:
Match the following types of slings with their characteristics:
Which of the following is a symptom of vaginal prolapse?
Which of the following is a symptom of vaginal prolapse?
Decubitus ulcers are caused primarily by friction.
Decubitus ulcers are caused primarily by friction.
What is the primary goal of Kegel's Exercise?
What is the primary goal of Kegel's Exercise?
The surgical procedure for cystocele and urethrocele is called ______________.
The surgical procedure for cystocele and urethrocele is called ______________.
Match each symptom to its associated condition:
Match each symptom to its associated condition:
What does the surgical procedure anterior colporrhaphy specifically address?
What does the surgical procedure anterior colporrhaphy specifically address?
Vaginal hysterectomy involves the removal of the uterus through the abdomen.
Vaginal hysterectomy involves the removal of the uterus through the abdomen.
What is the purpose of uterosacral suspension?
What is the purpose of uterosacral suspension?
The procedure performed to correct rectocele is called __________.
The procedure performed to correct rectocele is called __________.
Match the gynecological procedure with its corresponding definition:
Match the gynecological procedure with its corresponding definition:
What leads to the formation of internal genital organs in females?
What leads to the formation of internal genital organs in females?
The absence of the SRY gene leads to the development of male external genitalia.
The absence of the SRY gene leads to the development of male external genitalia.
What are the remnants of the Wolffian duct?
What are the remnants of the Wolffian duct?
The upper vagina is derived from the __________ duct.
The upper vagina is derived from the __________ duct.
Match the following conditions with their associated features:
Match the following conditions with their associated features:
Which of the following is the best method for vault prolapse?
Which of the following is the best method for vault prolapse?
Uterosacral Suspension is considered difficult to perform.
Uterosacral Suspension is considered difficult to perform.
What examination technique should be performed to check the degree of prolapse?
What examination technique should be performed to check the degree of prolapse?
In sacral colpopexy, a mesh is placed between the sacrum and the __________.
In sacral colpopexy, a mesh is placed between the sacrum and the __________.
Match the following clinical examination steps with their appropriate objective:
Match the following clinical examination steps with their appropriate objective:
What is the primary surgical procedure recommended for a reproductive-age female who does not require future childbearing?
What is the primary surgical procedure recommended for a reproductive-age female who does not require future childbearing?
Sacrohysteropexy can be performed on women who wish to retain their uterus and have future childbearing plans.
Sacrohysteropexy can be performed on women who wish to retain their uterus and have future childbearing plans.
What complication is associated with Fothergill surgery?
What complication is associated with Fothergill surgery?
Lefort's colpocleisis involves stitching the anterior and posterior walls of the __________.
Lefort's colpocleisis involves stitching the anterior and posterior walls of the __________.
Match the types of prolapse management with their specific characteristics:
Match the types of prolapse management with their specific characteristics:
What determines the development of male gonads?
What determines the development of male gonads?
Females develop testes if the SRY gene is present.
Females develop testes if the SRY gene is present.
What are the two types of ducts present during the intrauterine period?
What are the two types of ducts present during the intrauterine period?
The primary micronutrient necessary for the function of the SRY gene is __________.
The primary micronutrient necessary for the function of the SRY gene is __________.
Match the following sex determination methods to their characteristics:
Match the following sex determination methods to their characteristics:
Which sex chromosome configuration corresponds to Turner syndrome?
Which sex chromosome configuration corresponds to Turner syndrome?
The Wolffian duct contributes to the development of female internal organs.
The Wolffian duct contributes to the development of female internal organs.
Which internal organs develop from the Mullerian duct?
Which internal organs develop from the Mullerian duct?
What is the primary function of Sertoli cells?
What is the primary function of Sertoli cells?
Leydig cells are located inside the blood-testis barrier.
Leydig cells are located inside the blood-testis barrier.
What gene is most critical for the formation of testes in males?
What gene is most critical for the formation of testes in males?
The process of masculinization of external genitalia is primarily mediated by __________.
The process of masculinization of external genitalia is primarily mediated by __________.
Match the following cells with their functions:
Match the following cells with their functions:
What is the recommended management for a prolapse in an elderly female who is unfit for surgery?
What is the recommended management for a prolapse in an elderly female who is unfit for surgery?
A ring pessary can be used during pregnancy until the end of the third trimester.
A ring pessary can be used during pregnancy until the end of the third trimester.
What procedure is used to prevent vault prolapse during a vaginal hysterectomy?
What procedure is used to prevent vault prolapse during a vaginal hysterectomy?
The surgical procedure not effective for vault prolapse but can resolve stress urinary incontinence is called __________ colposuspension.
The surgical procedure not effective for vault prolapse but can resolve stress urinary incontinence is called __________ colposuspension.
Match the following management techniques with their corresponding conditions:
Match the following management techniques with their corresponding conditions:
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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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