Written exam Bachelor in Medicine/MedIS. Exam date: Time: 09:00-11:00. Important information:

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1 Written exam 2016 Course title: Program: Semester: Reproductive endocrinology Bachelor in Medicine/MedIS 4 semester Exam date: Time: 09:00-11:00 Evaluation form 7-point scale Important information: Remember to bring your student identification card Remember to put your student number not your name or cpr no on all sheets that you hand in for evaluation (if written exam) Remember to hand in the assignment if you leave the exam before it has ended No written aid, PC, mobile phone or any form of communication are allowed during exam It will be considered cheating or attempting to cheat if the technical equipment of the student is communicating or trying to communicate with other equipment not relevant to the exam, without an explicit permission. Before the beginning of the exam, the student should make sure that all communication devices in the equipment at the exam are turned off. The exam or part of the exam may be in English (please note that dictionaries will not be provided) Your paper must be handed in on paper in hand written form Take time to organize your thoughts so that you write logically and explain processes in proper order. Try to be succinct. Don t write information, which is not pertinent to the question. You don t need additional paper, there is plenty of space on the exam sets. Write legibly. Indicate the answers by letters rather than crosses. 1

2 1 Name three theories/concepts that attempt to explain biological basis for different sexual orientation (homosexuality). 1. Defect of dimorphic brain centers 2. Imbalance of sex hormones during prenatal period 3. Factor that is associated with female fertility, previous birth of a boy (production of anti-y antibodies that effect the dimorphic centers) Genetic/epigenetic factors Max points : 3 2 What are the essential parts of spermatozoon and what do they contain? 1. Head nucleus, acrosome 2. Middle piece - mitochondria 3. Tail/principal piece - axoneme Max points : 6 3 Describe the process of ejaculation. 1. Under the control of sympathetic system from the T12-L2 segments and supplying hypogastric plexus, the semen is produced and ejected. 2. The ejection is facilited by bulbospongiosus and pubococcygeus muscles under the control of a spinal reflex at the level of the spinal nerves S2-4 via the pudendal nerve. Max points : 2 2

3 4 Topic: Muscles of pelvis Options: A M. gemmellus sup. B M. quadratus femoris C M. piriformis D M. iliopsoas E M. pubococcygeus F M. obturatorius int. G M. gemmellus inf. H M. levator ani Lead in: For each of the statements below identify the most appropriate item/items from the list above. Attaches to crista intertrochanterica Attaches to trochanter major/fossa trochanterica B A, C, F, G Max points: 5 5 In otherwise healthy subjects unable to have children name 5 most likely conditions in the reproductive system that lead to infertility. 1. Defect of oogenesis/ovulation 2. Defect of tube patency 3. Hostile cervix 4. Sperm motility 5. Sperm morphology Sperm low count, sperm antibodies female Max points : 5 3

4 6 What is the definition of a case-control study? A study that compares patients who have a disease or outcome of interest (cases) with patients who do not have the disease or outcome (controls), and looks back retrospectively to compare how frequently the exposure to a risk factor is present in each group to determine the relationship between the risk factor and the disease. Case control studies are observational because no intervention is attempted and no attempt is made to alter the course of the disease. The goal is to retrospectively determine the exposure to the risk factor of interest from each of the two groups of individuals: cases and controls. These studies are designed to estimate odds. Case control studies are also known as "retrospective studies" and "case-referent studies." Max points : 3 7 An error during the fusion of Müllerian ducts may lead to the development of malformed uterus. Give three examples of such defect. 1. Uterus didelphys 2. Uterus bicornis bicollis 3. Atresia of cervix Uterus arcuatus, uterus bicornis unicollis, uterus septatus/subseptatus Max points : 3 8 Name the most important side effects associated with abuse of anabolic steroids in women. 1. Menstrual irregularities, infertility 2. Reduced breasts, increased clitoris, deeper voice 3. Acne, oily skin, male type alopecia, excess of facial and/or body hair 4. Cardiovascular complications (high blood pressure, heart attack, stroke, high LDL 5. Liver disease, liver cancer 6. Change in behavior (irritability, aggression, mania, delusions) Reduced/increased libido, stunt growth in teens Max points : 6 4

5 9 What is hypospadias and explain what is the reason for this defect. 1. Urethra opens on the ventral side of penis. 2. Failure of the closure of urethral /urethrogenital fold. Max points : 2 10 Female reproductive system. Identify all labeled structures. What is the name of this multicellular structure? 1. Theca folliculi 2. Ovarian stroma 3. Nucleus 4. Granulosa cells, zona granulosa 5. Zona pellucida 6. Cytoplasm, primary oocyte Answer to question: Growing/multilayer primary follicle. Max points : 7 5

6 11 Name the phases of ovarian and endometrial cycles. 1. Follicular 2. Ovulation 3. Luteal 4. Menstrual 5. Proliferative 6. Secretory Max points : 6 12 The development of what accessory sex organs is supported by androgens in males? 1. Epididymis 2. Ductus deferens 3. Seminal vesicles 4. Bulbourethral gland 5. Prostate Penis, scrotum Max points : 5 13 On what chromosome the gene for TDF (Testis-determining factor) is located and what is its role? Is there a synonymous designation for this gene? 1. Y chromosome 2. Determines the development of testis. 3. SRY 6

7 Max points : 3 14 The boys on the picture are 2½ old. One of them suffers from adrenogenital syndrome (congenital adrenal hyperplasia). Identify whether it is the boy A or B that is affected and explain the pathogenetic mechanism that underlies the boy s appearance. A B 1. A 2. Defect of 21-hydroxylase 3. Cortisol insuficiency 4. Increase of ACTH 5. Overproduction of androgens that lead to masculinization Max points : 5 Total 61 points 7

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