Sommereksamen Titel på kursus: Reproduktionsorganernes endokrinologi Bacheloruddannelsen i Medicin/Medicin med industriel specialisering

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1 Sommereksamen 2014 Titel på kursus: Reproduktionsorganernes endokrinologi Uddannelse: Bacheloruddannelsen i Medicin/Medicin med industriel specialisering Semester: 4. semester Eksamensdato: 4. juni 2014 Tid: kl Bedømmelsesform 7-trins-skala Vigtige oplysninger: Husk at opgive studienummer ikke navn og cpr.nr. på alle ark, der skal medtages i bedømmelsen Husk at aflevere besvarelsen, også hvis du forlader eksamen, før den er slut Øvrige hjælpemidler er ikke tilladt Det er tilladt at skrive besvarelsen på dansk eller engelsk Ingen former for kommunikation er tilladt Læs opmærksomt og giv dig tid til at organisere dine tanker så du kan skrive logisk og forklare processerne i rigtig rækkefølge. Prøv at skrive kortfattet. Skriv ikke information, som ikke er relevant ift. spørgsmålet. Du har ikke brug for ekstra papir, da der er rigeligt med plads på eksamenssættet. Skriv tydeligt og ved besvarelsen af MCQ opgaver, brug bogstaver og ikke krydser. 1

2 1 Describe what secretions make up ejaculate and what are their major characteristics 1. Testicular secretion Small proportion, acidic from Sertoli cells 2. Secretion from seminal vesicles, 70%, fructose 3. Secretion from prostate, 30%, alkaline 4. Secretion from bulbourethral gland, small proportion, mucine Max points : 8 2 Which one of the following is involved in the molecular events leading to erection? A Acetylcholine A B Norepinephrine C Serotonine D Dopamine E Nitrous oxide 3 Which one of the following molecules is not involved in blastocyt adhesion and implantation? A Integrin B Cadherin B C Selectin D Fibronectin E Laminin 2

3 4 During synthesis of sex hormones, changes that are specific for a particular position or part of molecule take place. Describe chemical modifications at following locations. You may use a drawing. 1. C17 of pregnenolone Hydroxylation 2. C3 of pregnenolone Dehydrogenation/oxidation 3. First ring of androgens on path to estrogens Aromatization 4. First ring of testosterone to increase its activity Reduction Max points : 4 5 Name four methods of barrier contraception Condom, female condom, cervical cap, diaphragm, contraceptive sponge, spermicide Max points : 4 6 Which one of the following is involved in relaxation of penile trabecular muscles? A Inhibition of NO2 synthase B Inhibition of guanylate cyclase C Inhibition of phosphodiesterase C D Activation of calcium flux E Activation of myosin phosphorylation 3

4 7 Erection results from one of the following: A Relaxation of arteriae helicinae penis A B Relaxation of arteria dorsalis penis C Contraction of arteria dorsalis penis D Relaxation of arteria profunda penis E Contraction of arteriae helicinae penis 8 Regarding the emergency contraceptive (EC) pills (morning-after pills) answer the following: Name the types of EC pills based on their hormonal contents 1. Progestin-only pills 2. Combined progestin and estrogen pills Name two mechanisms through which the EC pills exert their effect Disruption of ovulation, fertilization, implantation Name two side effects associated with EC pills 1. Nausea, vomiting, abdominal pain 2. Progestogen withdrawal bleeding Max points : 6 9 Describe major steps of in vitro fertilization (IVF) long protocol. 1. Suppression of gonadotropins 2. Superovulation using gonadotropin preparations 3. Withdrawal of mature eggs and their fertilization 4. Insertion of the best embryo in uterus Max points : 4 4

5 10 Which one of the following is correct with respect to the duration of first meiotic division of primary spermatocyte? A 3 days B 3 weeks B C 3 months D 3 years E 30 years 11 Which two substances activate Sertoli cells and through which substance the Sertoli cells accomplish negative feedback? 1. FSH + testosterone 2. Inhibin Max points : 3 12 Name muscles that constitute pelvic diaphragm. 1. M. pubococcygeus/illiococcygeus (levator ani) 2. M. coccygeus Max points : 2 13 Describe the effect of estrogen antagonist (Clomiphene) at hypothalamus. Stimulation of gonadotropins 5

6 14 Topic: Hormonal contraception Options: A Decrease incidence of ovarian and endometrial cancer B Increase incidence of ovarian and endometrial cancer C Slightly decrease incidence of breast cancer D Slightly increased incidence of breast cancer E Have no effect on incidence of breast cancer F Decrease risk of deep vein thrombosis G Increase risk of deep vein thrombosis H Have no effect on deep vein thrombosis I Are associated with a higher incidence of breakthrough (midcycle) bleeding J May reduce amount of breast milk Lead in: For each of the items below identify the most appropriate item/items from the list above. Progestogen only contraceptives Combined contraceptives E, H, I A, D, G, J Max points: 7 15 Name male internal and external sex organs (genitalia). Internal: Testis, epididymis, vas deferens, seminal vesicles, ductus ejaculatorius, prostate, bulbourethral gland, urethra External: Penis, scrotum Max points : 8 16 In flaccid state, the dominant signaling is for the penis provided from one of the following: A Plexus lumbalis B Plexus sacralis C Plexus hypogastricus inferior D Plexus epigastricus E Plexus hypogastricus superior E 6

7 17 What is processus vaginalis and what is its vestige? 1. Peritoneal outpouching associated with a descent of testis 2. Tunica vaginalis Max points : 2 18 Give six examples of secondary sex characteristics and explain the difference between the males and females Hair body, face, scalp Larynx/voice Muscle, bone, mass and strength Stature males taller, larger, shoulders broader Face square by males Hands, feet, nose larger by males Subcutaneous fat mass and distribution higher women, around buttock, thighs, hips Skin thicker, rigid, coarse due to less subcutaneous fat and more collagen in males Waist to hip ratio, low in women Breast growth Increased sebaceous/sweat glands, body odor, acne by males Max points : 6 Total 61 points 7