Written exam 2015 Course title: Programme: Semester: Reproductive endocrinology Bachelor in Medicine/MedIS 4 semester Exam date: 10-06-15 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 and 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 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 What is the cost and how many attempts in IVF treatment are there provided through public healthcare? 1. 5.040 DKr/cycle + max. 15.000 DKr for medication/year 2. 3 attempts 2 Describe the mode of action of GnRH agonist (Leuprolide) and the resulting effect. 1. Activation and subsequent desensitization of GnRH receptors in the pituitary gland. 2. Initial stimulation of gonadotropins succeeded by their suppression, which leads to reduction of sex steroids. 3 Name two receptors on the surface of blastocyst that mediate attachment and invasion. 1. Selectin 2. Integrin 4 In what the retroverted or retroflexed uterus differs from the normal one? Retroverted: The angle between vaginal and cervical axes bigger than normal. Retroflexed: The angle between cervical and uterine axes bigger than normal. 1
5 Which of the following has a role in treating erectile dysfunction? A Phosphodiesterase inhibitors A B Phosphodiesterase activators C Phosphokinase inhibitors D Phosphokinase activators E Application of heat F Application of pressure G Application of vacuum G H Application of electric current I Implantation of electrostimulator J Implantation of inflatable prosthesis J K Implantation or flexible prosthesis K Max points : 4 6 Which one of the following is not involved in the chain of molecular events leading to erection? A NO B Acetylcholine C cgmp D Phosphodiesterase D E Closure of Ca2+ channels Max points : 1 7 Describe the position of ovary in the abdominal cavity during early development, the process through which it assumes the final position, and the final position. 1. High in the abdominal cavity, retroperitoneally, as a part of urogenital ridge 2. Descends laterally and frontally following the fold (future lig. latum) with the paramesonephric ducts, and/or the process is controlled by gubernaculum, the vestige of which is lig. ovarii proprium and lig. teres uteri. 3. Resides in the pelvis on the dorsal aspect of lig. Latum (fossa ovarica, mesovarium, lig. suspensorium ovarii). Max points : 3 2
8 Topic: Pelvic anatomy Options: A Arteria glutealis sup. B Nerve to m. obturatorius int. C Nervus cutaneus femoris post. D Nervus glutealis sup. E Nervus obturatorius F Nervus femoralis G Nervus ischiadicus H Arteria obturatoria I Nervus pudendus (pudendi) J Arteria pudenda int. Lead in: For each of the statements below identify the most appropriate item/items from the list above. Passes through foramen ischiadicum majus. Passes through foramen obturatum. Max points: 9 A, B, C, D, G, I, J E, H 9 Define parametrium and uterine adnexa. Parametrium: Connective tissue of the pelvic floor, namely lig. latum. Uterine adnexa: Ovary, uterine tubes, ligaments 10 What is the developmental origin of Gartner s cyst? Mesonephric (Wolfian) duct Max points : 1 3
11 Draw a scheme and characterize changes in the levels of gonadotropins and ovarian hormones during the menstrual cycle. Preovulatory period 1. FSH low and sharply peaks at ovulation. 2. LH low and sharply peaks at ovulation. 3. Estrogen slowly rises and sharply peak shortly before ovulation. 4. Progesterone low/not present. Postovulatory period 1. FSH declines. 2. LH declines but present to support corpus luteum early on. 3. Estrogen drops sharply but then rises and declines towards the end. 4. Pogesterone rises and declines towards the end. Max points : 8 4
12 Name the three principal layers of the uterine wall. 1. Endometrium 2. Myometrium 3. Perimetrium Max points : 3 13 Name the phases of the first and second meiotic division. First: Prophase, metaphase, anaphase, telophase Second: Metaphase, anaphase, telophase 14 Name and describe the phases of spermiogenesis. 1. Golgi synthesis of acrosomal enzymes 2. Acrosomal formation of acrosomal vesicle 3. Maturation organization of mitochondria, growth of flagellum, shedding of residual bodies Max points : 3 5
15 Identify structures in the image. 1. Spermatids 2. Sertoli cells 3. Spermatocyte 4. Spermatogonium 5. Myoid cell 6. Capillary 7. Residual body 8. Occluding junction/blood-testis barrier Max points : 8 6
16 Identify structures in the image. 1. Atretic follicle 2. Mature graafian follicle 3. Primordial/primary follicles 4. Germinal epithelium/tunica albuginea 5. Corpus luteum/albicans 6. Primary/growing follicle 7. Cortical region 8. Medullary region Max points : 8 7
Total 60 points 8
Possible hormone profiles, question 11 9
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