Clinical Integration VIII Flashcards

1
Q

75% of prostatic cancers are associated with elevated..?

A

serum PSA (prostate specific antigen)

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2
Q

What is PSA?

A

organ specific

not malignancy specfic

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3
Q

With what conditions is PSA high?

A
BPH
prostatitis
infarction
following ejaculation
DRE
exercise
biopsy
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4
Q

what measures should be used to diagnose prostate cancer?

A

DRE
PSA
biopsy

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5
Q

what is the problems with the cancerous lesions in the prostate gland?

A

they are not close to urethra (unlike the BPH), so you don’t get symptoms for a while…

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6
Q

what site is most BPH originate?

A

mucosal glands
submucosal glands

closer to urethra

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7
Q

where is most prostatic cancer found?

A

in the main prostate glands

far away from urethra

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8
Q

what happens to the columnar cells of the endocervix?

A

they undergo metaplastic changes to become more resilient cells of the ectocervix

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9
Q

what can happen to the endocervix metaplsia under persistent stress?

A

dysplasia and lead to cancer - HPV

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10
Q

what type of neoplasm is HPV?

A

cervical intraepithelial neoplasm (CIN)

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11
Q

what does HPV infect?

A

immature basal cells of squamous epithelium
or
metaplastic squamous cells at the squamocolumnar junction

HPV cannot infect mature cells!

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12
Q

characteristics of CIN?

A

asymptomatic

if dysplasia continues -> squamous cell carcinoma - because cancer is within epithelium

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13
Q

what are risk factors for cervical cancer?

A
  • number of lifetime partners
  • young age - age 20-24 ish
  • tobacco use - increase risk by 2x
  • BC pill more than 5 yrs.
  • weak immune system
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14
Q

what are chaacteristics of leiomyoma/fibroid

A

well circumscribed’
does not infiltrate surrounding tissue
histology looks normal

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15
Q

where are leiomyomas usually found?

A

uterine myometrium

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16
Q

how are leiomyomas classified?

A
  • subserosa - under serosa
  • intramural - within myometrium
  • subserosal - under endometrium
17
Q

what are symptoms of leiomyomas?

A
  • menorrhagia
  • metorrhagia
  • infertility
18
Q

what are characteristics of proliferative epithelium?

A

highly cellular

straight glands

19
Q

what are characteristics of secretory epithelium

A

coiled glands
glycogen stores
spiral arteries
progesterone

20
Q

what is endometriosis

A

occurence of endometrial tissue other than the lining of the uterine cavity

21
Q

what are some extra uterine locations for endometriosis?

A
ovary
fallopian tubes
parametrium
gut
serosa
umbilicus
pouch of Douglas
22
Q

what are some morphological structures of endometriosis?

A

endometrial glands
endometrial stroma
hemosiderin pigment

23
Q

what are clinical features of endometriosis?

A

dysmenorrhea
pelvic pain
dysparenunia
infertility

24
Q

what is polycycstic ovarian symdrome?

A
  • stein levanthal Syndrome
  • hormonal imblanace (LH:FSH 2:1)
  • affects women of repro age
25
Q

what are clinical symptoms of POS?

A
oligomenorrhea - infreq. menstration
anovulation
obesity
hirsutism - male pattern of body hair
virilism - male secondary sex characteristics dev.
26
Q

how do ovaries appear with POs?

A
  • extremely large
  • thick capsule with many unruptures follicles cysts which are lined by granulosa cells and hypertrophied theca intera cells
  • stroma is thick and hypertrophies
  • no corpus luteum

Thick tunica albuginea

  • follicles arrested in different stages fo development
  • cysts may contain clear gelatinous or serosangineous fluid
27
Q

what is breast cancer due to?

A

family history

-mutation in BRCA1, BRCA 2, P53

28
Q

describe the mammary glands?

A

modified sweat glands
15-25 lobes -compound tubuloalveolar glands
glandular elements - arranged in a radial fashion around the nipple into which ducts from secretory unit empty
-apocrine + merocrine gland!

29
Q

what is breast cancer in postmenopausal women due to?

A

estrogen

30
Q

where does the main souce of estogen come from?

A

aromatization of adrenal-produced androgen