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

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1 Written re-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 Please insert the answer from the multiple choice questions in this table. Make sure the letters you mark you answers to the questions are identical to those in this table. A discrepancy renders the answer invalid! Question Answer Points 1 E 2.1 B 2.2 E 2.3 D 2.4 H 3 D 4 E Total points 2

3 1 Utriculus prostaticus is remnant of which one of the following? A Ovary descent B Testis descent C Mesonephros D Kidney ascent E Paramesonephros E Max points : 1 2 Topic: The four following embryonic structures undergo development depending the hormonal stimulation. Identify into which organs/structures they develop in estrogen environment. Options: A Penis B Clitoris C Scrotum D Labium majus E Labium minus F Peno-scrotal raphe G Urethra H Vestibulum vaginae Lead in: For each of the items below identify the most appropriate item from the list above Genital tubercle B 2.2 Urethral fold E 2.3. Labioscrotal swelling D 2.4. Urogenital grove H Max points: 4 3

4 3 What is the frequency of reproductive failure? A 30% B 45% C 50% D 65% D E 80% Max points : 1 4 The uterine defect in the image results from which of the following? A Fusion of labia minora B Defect of the fusion of mesonephric ducts C Defect of the fusion of urogenital folds D Defect of the fusion of ureters E Defect of the fusion of paramesonephric ducts E F Development of sinovaginal bulbus Max points : 1 5 What is the definition of randomized study? A study design that randomly assigns participants into an experimental group or a control group. As the study is conducted, the only expected difference between the control and experimental groups in a randomized controlled trial (RCT) is the outcome variable being studied. Max points : 3 4

5 6 The development of what secondary sex characteristics is supported by androgens? 1. Facial, axillary, pubic hair 2. Larynx 3. Body size and proportion (bones, muscle/fat distribution, waist/hip ratio), 4. Skin more rigid in males, eccrine/sebaceous glands Max points : 4 7 Topic: Effect of hormones on sexual differentiation Complete androgen insensitivity sy. (CAIS) manifests itself in male patients (XY) who do not undergo masculinization during in utero period. Lead in: Based on this syndrome answer the following 4 questions. 7.1 To which hormone the target tissue is not responsive? Dihydrotestosterone Max points : 1 Opnåede points 5

6 7.2 Describe the internal genitals. 1. Gonads: testis - cryptorchism 2. Accessory sex organs - underdeveloped 3. 2/3 of vagina present/no uterus Max points : 3 Opnåede points 7.3 Describe external genitals 1. Female vulva labia 2. Clitoris Max points : 2 Opnåede points 7.4 Describe secondary sex characteristics 1. Breasts 2. Female hair pattern 3. Larynx Body size and proportion (bones, muscle/fat distribution, waist/hip ratio), Max points : 3 Opnåede points 6

7 8 What are the phases of spermiogenesis? 1. Golgi 2. Acrosomal 3. Maturation Max points : 3 9 By what cells is the MIF (Müllerian inhibitory factor) produced and its action inhibits development of what organs? 1. Sertoli cells 2. Uterine tubes 3. Uterus Upper third of vagina Max points : 3 10 Hydrocele can sometimes be found in the scrotum. Describe a process through which formation of this structure takes place. 1. During the descent of testis, a peritoneal exvagination processus vaginalis follows the gonad. 2. Incomplete obliteration/degeneration of processus vaginalis leaves behind a cyst hydrocele. Max points : 2 11 What is the origin of Gartner s cyst and where it can be found? 1. Vestige of mesonephric/wolfian duct 2. In association with vagina (vaginal cyst) Max points : 2 7

8 12 Female reproductive system. Identify all labeled structures. What is the name of this multicellular structure? Ovarian stroma, connective tissue Theca externa 3. Theca interna 4. Granulosa cell 5. Cytoplasm, nucleus, primary oocyte 6. Antrum folliculi, liquor folliculi 7. Cumulus oophorus Answer to question: Secundary, antral follicle Max points : 8 8

9 Re-exam Male reproductive system. Identify all labeled structures. What is the name of this organ? Stroma, connective tissue + smooth muscle 2. Smooth muscle 3. Pseudostratified columnar epithelium 4. Basal cells 5. Principal cells 6. Stereocilia 7. Spermatozoae + secretions Answer to question: Epididymis Max points : 8 9

10 14 Name seven differences between male and female bony pelvis Pelvic inlet heart (males) vs oval (females) shaped Pelvic outlet and inlet are larger in females Pubic arch (subpubic angle) wider in females o vs 70 o. Sacral promontory is less imposing into the pelvic cavity, sacrum is shorter and wider, coccyx is more moveable Acetabulum larger in males and faces laterally, more wider apart in females and faces more medially/anteriorly, the latter also applies to ischial tuberosities Bones taller and thicker in males Pelvis is more shallow and ilia less sloped in females The anterior iliac spines are more widely separated in females In females, the obturator foramina are oval in shape and smaller in size than the male circular foramina Sciatic notches are wider and shallower in females and the spines of the ischia project less inward Max points : 7 10

11 15 Draw a scheme with identified structures of an embryo in the stage of partially implanted blastocyst (days 7-7.5). Cytotrophoblast Syncytiotrophoblast Amnioblast Epiblast Hypoblast Amniotic cavity Blastocyst cavity Max points : 7 Opnåede points 11

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