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STEP 1 > 02c: Repro/Onc > Flashcards

02c: Repro/Onc Flashcards

1
Q

Squamous cell carcinoma of vag is most often secondary to:

A

Squamous cell carcinoma of cervix

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2
Q

3 yo girl presents with clear, grape-like, polypoid mass emerging from vagina. Diagnosis is (X) and histology will likely show:

A

X = sarcoma botryoides (vaginal embryonal rhabdomyosarcoma variant)

Spindle cells, desmin positive

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3
Q

List the genes produced by HPV 16/18 in cervical cancer and the function of the product of each

A
  1. E6 (inhibits p53)

2. E7 (inhibits RB)

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4
Q

RFs for cervical cancer

A
  1. Multiple sexual partners (#1)
  2. Smoking
  3. Lack of barrier contraception
  4. HIV
  5. Sex at young age
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5
Q

T/F: The complications stemming from anovulation are related to high estrogen levels

A

True - no ovulation, no progesterone increase; persistently elevated estrogen (prolonged proliferative phase)

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6
Q

(Cushing syndrome/Addison’s) is associated with anovulation

A

Both

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7
Q

Pathogenesis of PCOS: (X) is hypothesized to alter HPA feedback, causing (high/low/normal) LH, (high/low/normal) FSH, (high/low/normal) androgens.

A

X = hyperinsulinemia and/or insulin resistance

All high

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8
Q

T/F: Progesterone is high in PCOS.

A

False - low

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9
Q

PCOS: high risk of (X) malignancy

A

X = endometrial cancer (due to unopposed estrogen from anovulatory cycles)

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10
Q

PCOS: Rx that addresses endometrial hyperplasia and unopposed estrogen

A

OCPs (oral progesterone)

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11
Q

PCOS: Rx that addresses infertility

A
  1. Clomiphene - a SERM

2. Metformin

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12
Q

PCOS: Rx that addresses hirsutism

A

Anti-androgens (spironolactone, ketoconazole)

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13
Q

Firable cervix and positive nucleic acid amplification test

A

Gonococcal cervicitis

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14
Q

Most common ovarian mass in young women

A

Follicular (unilateral) cyst - distension of unrupture graafian follicle

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15
Q

(X) ovarian cysts are often bilateral and associated with which diseases?

A

X = theca-lutein

Choriocarcinoma/moles

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16
Q

T/F: Most common adnexal mass in woman over 55 is ovarian neoplasm

A

True

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17
Q

Which PHx puts woman at risk for ovarian cancer?

A
  1. Endometriosis
  2. PCOS
  3. Breast cancer (if BRCA1/2)
  4. Lynch syndrome
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18
Q

Why does past pregnancy (increase/decrease) risk of ovarian neoplasm?

A

Decrease;

Less ovulatory cycles means less disruption/trauma and repair to ovary surface

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19
Q

Ovarian neoplasm histology: cuboidal cells in rosette pattern around eosinophilic fluid; coffee bean nuclei

A

Call-Exner bodies (granulosa cell tumor)

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20
Q

Most common ovarian neoplasm

A

Serous cystadenoma

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21
Q

Psudomyxoma peritonei refers to which phenomenon? Which ovarian neoplasm causes this?

A

Intraperitoneal accumulation of mucinous material from ovarian or appendiceal tumor

Mucinous cystadenocarcinoma

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22
Q

Ovarian neoplasm histology: Sheets of uniform “fried egg” cells. Which tumor? Which marker would you test for?

A

Dysgerminoma;

beta-hCG and LDH

23
Q

High AFP and yellow, friable, solid mass in either ovaries or testes. Diagnosis? Expected histology?

A

Yolk sac tumor;

Schiller-Duval bodies (resemble glomeruli)

24
Q

Endometritis Rx typically includes:

A

Gentamicin, clindamycin; maybe ampicillin

25
Q

Drug Rx for adenomyosis may include:

A

GnRH agonists

26
Q

T/F: Endometriosis can lead to infertility

A

True - local inflammation can cause adhesion formation and interferes with ovulation/fallopian tube function

27
Q

Lactational mastitis: most likely culprit is (X) and treatment is (Y)

A 
X = S. aureus
Y = antibiotics and keep breast-feeding
28
Q

T/F: Fibrocystic change more common in pre-menopausal women under 35 and fibroadenoma more common in pre-menopausal women over 35.

A

False - vice versa

29
Q

T/F: Fibroadenomas are painful masses.

A

True

30
Q

Breast lump biopsy: benign-appearing cellular and myxoid stroma with epithelium-lined glandular and cystic spaces.

A

Fibroadenoma

31
Q

Painless bloody discharge from nipple with no associated skin change. Most likely diagnosis:

A

Intraductal papilloma (small papillary tumor within lactiferous duct; bleeding occurs due to twisting of vascular stalk of papilloma)

32
Q

T/F: No increase risk of cancer with fibroadenoma and intraductal papilloma.

A

False - increased risk with intraductal papilloma (slight, 1.5-2x)

33
Q

Drugs that cause gynecomastia

A

“Some Hormones Create Knockers”

  1. Spironolactone
  2. Hormones (GnRH agonists)
  3. Cimetidine
  4. Ketoconazole
34
Q

Gynecomastia can be treated with:

A

Tamoxifen

35
Q

Most important prognostic factor in early-stage breast cancer.

A

Axillary lymph node metastasis

36
Q

Breast cancer histology: orderly rows of single-file cells. This is due to (up/down)-regulation of (X).

A

Invasive lobular carcinoma

Down-regulation
X = E-cadherin

37
Q

Inflammatory breast cancer: invasion into (X) and neoplastic cells block (Y).

A 
X = dermal lymphatics
Y = lymphatic drainage
38
Q

24 yo male with painful and abnormal upward curvature of penis. Denies any discharge. Likely diagnosis is (X) and pathogenesis is:

A

X = peyronie disease

Fibrous plaque within tunica albuginea (surg repair indicated)

39
Q

Ischemic (painful) priapism should be treated with:

A

Corporal aspiration/shunt, intra-cavernosal phenylephrine, or surgical decompression

40
Q

Ischemic (painful) priapism associated with which disease?

A

SSD (sickled RBCs block venous drainage of corpus cavernosum vascular channels)

41
Q

T/F: Unilateral cryptochordism does not affect hormone levels.

A

False - Sertoli cell mass decreased, even if unilateral so low inhibin B, high FSH/LH; testosterone usually normal, unless bilateral cryptochordism

42
Q

Most common testicular tumor in boys under 3 yo

A

Yolk Sac

43
Q

Testicular tumor with high placental ALP (alk phos)

A

Seminoma

44
Q

Testicular tumor with high AFP

A

Yolk sac

45
Q

Testicular tumor with high beta-hCG

A

Choriocarcinoma

46
Q

18 yo M with unilateral painless testicular enlargement. Does not transilluminate. Afebrile with fatigue, tachycardia, heat intolerance. Diagnosis?

A

Choriocarcinoma (with hyperthyroidism as paraneoplastic syndrome due to high beta-hCG)

47
Q

T/F: Mature teratoma is benign.

A

False - benign in females and children, but can be malignant in males

48
Q

Most common testicular cancer in older men

A

Testicular lymphoma (aka lymphoma metastasis to testes)

49
Q

BPH: (hyperplasia/hypertrophy) of prostate can lead to (atrophy/hypertrophy/hyperplasia/dysplasia) of bladder.

A

Hyperplasia; hypertrophy

50
Q

Flutamide MOA

A

Competitive inhibitor at androgen receptors

51
Q

Flutamide used for:

A

Prostate carcinoma (improves side effects of initial increase in T with GnRH analogs)

52
Q

Ketoconazole MOA

A

Inhibits steroid synthesis (17,20 desmolase/17alpha-hydroxylase)

53
Q

Tamsulosin MOA

A

Alpha-1 antagonist, specific for 1A/D receptors on prostate (versus vascular 1B receptors); used to treat BPH

54
Q

Aside from erectile dysfunction, which other disease are PDE-5 inhibitors used to treat?

A

Pulm HT (decrease pulm vascular resistance)

STEP 1 (21 decks)

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