Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Step 1 notes > Embryology - reproductive system > Flashcards

Embryology - reproductive system Flashcards

1
Q

Shh:

  1. produced at?
  2. function?
  3. mutation causes?
A
  1. produced at: base of limbs in zones of polarity
  2. function:
    1) patterning along A-P axis
    2) . CNS development
  3. mutation causes holoprosencephaly 前脑无裂畸形
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Wnt-7:

  1. produced at?
  2. function?
A
  1. produced at apical ectodermal ridge

2. function: dorsal-ventral axis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

FGF gene:

  1. produced at?
  2. function?
A
  1. produced at apical ectodermal ridge

2. function: stimulate mitosis of underlying mesoderm to length the limbs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Homeobox (Hox):

  1. function?
  2. mutation causes?
A
  1. function: segmental organization of embryo in craniocaudal directions
  2. mutation causes: appendages in wrong location
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

early fetal development:

day 0:

A

form zygote

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

early fetal development:

wk 1:

A

implantation of blastocyte, hCG secretion begins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

early fetal development:

wk 2:

A

2 = 2 layers

form bilaminar disc (epiblast 上胚层)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

early fetal development:

wk 3: 出现的重要结构？

A

3 = 3 layers

form trilaminar disc - gastrulation 原肠胚形成

出现的重要结构：

  1. primitive streak 原条
  2. notochord: 脊索
  3. mesoderm
  4. neural plate begins
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

which embroygenesis period is extremely susceptible to teratogens?

A

wks 3- 8

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

which embroygenesis period will neural tubes (胚层起源） be closed?

A

wk 4

胚层起源： ectoderm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

early fetal development:

wk 4 events?

A
  1. heart starts to beat
  2. neural tube closes
  3. upper and lower limb buds start to form
    (wk 4 = 4 limbs)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

early fetal development:

wk 6 events?

A

heart beat can be detected by transvaginal ultrasound

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

early fetal development:

wk 10 events?

A

genitalia have male/female characteristics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

gastrulation: define

A

form the 3 layers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

neural crest: give rise to?

A

3P + ABCM

  1. PNS (DRG, cranial N, celiac ganglion, Schwann cells, ANS)
  2. Pia + arachnoid
  3. Parafollicular (C) cells of thyroid 【secrete calcitonin】
  4. Aorticopulmonary septum 【separates the aorta and pulmonary arteries and fuses with the inter ventricular septum】
  5. Branchial arches (Bones of the skull - 其余的骨是mesoderm形成, cartilage, odontoblasts 成齿质细胞）
  6. Chromaffin cells of the adrenal medulla
  7. Malanocytes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Dx: brain mass filled with cholesterol + calcification

胚胎起源？和哪些结构起源相同？

A

Craniopharyngioma

胚胎起源： Rathke pouch (surface ectoderm)

和哪些结构起源相同：

  1. adenohypophysis 腺垂体
  2. glands: parotid, sweat and mammary glands
  3. lens of eye,
  4. epithelial lining of oral cavity
  5. sensory organs of ear and olfactory epithelium
  6. epidermis
  7. anal canal below the pectinate line
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

mesoderm: 包括哪些结构？defects 口诀？

A
  1. spleen （liver， kidney等等都是内胚层）
  2. adrenal cortex (肾上腺髓质是neural crest外胚层起源）
  3. serous lining of body cavities
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Notochord 脊索: function? postnatal derivative?

A

postnatal derivative: nucleus pulpous of the inter vertebrate disc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

endoderm: 包括哪些结构？

A
  1. anal canal above the pectinate line (齿状线以下是neural crest -ectoderm origin)
  2. thyroid follicular cells (note: Parafollicular (C) cells of thyroid 【secrete calcitonin】- neural crest -ectoderm origin)
  3. 大部分内脏
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Define: what type of error in organ morphogenesis is this:

absent organ due to absent primordial tissue

A

agenesis 缺如

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Define: what type of error in organ morphogenesis is this:

absent organ despite presence of primordial tissue

A

aplasia 发育不全

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Define: what type of error in organ morphogenesis is this:

incomplete organ , despite presence of primordial tissue

A

hypoplasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Define: what type of error in organ morphogenesis is this:

2° breakdown of a previously normal tissue or structure; example?

A

disruption

amniotic band syndrome 羊膜索综合征：
Amniotic band syndrome (ABS)：
-rare congenital disorder that results when the amnion is damaged. This produces bands, or fibers, to wrap around or trap parts of the fetus, decreasing blood flow to those areas.
- Hands and fingers are the most common body parts to be affected by ABS, but it also may damage the face, legs or toes.
- Effects can range from slight creases in the skin to severe limb deformity or amputation. ABS is one of the main causes of club foot. Since the bands are slender, ABS often is difficult to diagnose by prenatal ultrasound. Most cases are found at birth.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

amniotic band syndrome

A

Amniotic band syndrome (ABS)：

  • rare congenital disorder that results when the amnion is damaged. This produces bands, or fibers, to wrap around or trap parts of the fetus, decreasing blood flow to those areas.
  • Hands and fingers are the most common body parts to be affected by ABS, but it also may damage the face, legs or toes.
  • Effects can range from slight creases in the skin to severe limb deformity or amputation. ABS is one of the main causes of club foot. Since the bands are slender, ABS often is difficult to diagnose by prenatal ultrasound. Most cases are found at birth.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Define: what type of error in organ morphogenesis is this:

Extrinsic disruption, occurs after the embryonic period

vs

intrinsic disruption, occurs during the embryonic period (wks 3 -8 )?

A

Extrinsic disruption, occurs after the embryonic period: deformation

intrinsic disruption, occurs during the embryonic period (wks 3 -8 ): malformation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Define: what type of error in organ morphogenesis is this:

Abnormalities result from a single 1 ° embryological event ; 举例？

A

sequence

举例: Potter sequence vs. Potter syn

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

teratogens affect which period?

exposure before that? after that?

A

3 - 8 wks (“embryonic period - organogenesis)

before that: all or none

after that: growth and function affected

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

teratogens： cause ?

ACE I

A

renal damage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

teratogens： cause ?

alkylating agents

A

alkylating agents

  1. cyclophosphamide, ifosfamide;
  2. nitrosoureases [such as carmustine, lomustine, semustine, streptozocin],
  3. busulfan

act as tetatogens: absent digits, multiple anomalies

act on blood as carcinogen: leukemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

teratogens： cause ?

carbamazepine （other toxicity?)

A

DOC for complex partial seizures, generalized tonic-clonic seizures,

most severe side effects:
- agranulocytosis, aplastic anemia

as teratogen: neural tube defects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

teratogens： cause ?

aminoglycosides?

A

CN VIII toxicity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

teratogens： cause ?

diethylstibestrol （DES）

A

己烯雌酚 synthetic nonsteroidal estrogen

From about 1940 to 1971, DES was given to pregnant women in the mistaken belief it would reduce the risk of pregnancy complications and losses.

In 1971, DES was shown to cause a rare vaginal tumor in girls and women who had been exposed to this drug in utero. The United States Food and Drug Administration subsequently withdrew DES from use in pregnant women.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

teratogens： cause ?

folate antagonists：代表药物？机制？致畸作用？

A

代表药物 methotrexate and pemetrexed ( Alimta)；

机制： inhibit dihydrofolate reductase (DHFR)】

致畸作用：neural tube defects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

teratogens： cause ?

Lithium

A

Ebstein anomaly （atrialized RV)

rare heart defect in which parts of the tricuspid valve are abnormal： one or two of the leaflets are stuck to the wall of the heart and don’t move normally. Back flow from RV to RA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

teratogens： cause ?

methimazole

A

Me‘thimazole 甲巯基咪唑,他巴唑

甲亢药，inhibit peroxidase only (最严重的副作用是agranulocytosis

teratogens： aplasia cutis congenita 先天性皮肤发育不全

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

teratogens： cause ?

thalidomide

A

反应停

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

teratogens： cause ?

val‘proate

A

丙戊酸 (抗癫痫药) 致畸作用是抗叶酸

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

teratogens： cause ?

warfarin? 孕妇抗凝用什么药？

A

heparin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

fetal alcohol syn

A

one of the leading causes of congenital malformations in the US:

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

teratogens： cause ?

cocaine:

A
  1. abnormal fetal growth
  2. fetal addiction !
  3. placental abruption
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

teratogens： cause ?

smoking, CO?

A

leading cause for low birth weight;

associated with preterm labor, placental problems, IUGR, ADHD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

teratogens： cause ?

Iodine (lack or excess)

A

congenital goiter or hypothyrodism (cretinism)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

teratogens： cause ?

Maternal diabetes?

A

“Caudal regression syn”

  1. anal atresia 肛门闭锁 ， sirenomelia 人鱼腿 （并腿畸形）
  2. congenital heart defects
  3. neural tube defects
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

teratogens： cause ?

Vit A excess

A

abortion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

monozygotic twins:

胚胎形成的几个关键阶段？
如何决定是否share placenta, etc?

A

2-cell stage - morula (桑椹胚） - blastocyst (囊)胚泡 -

分开的顺序：placenta - chorion - amnion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

placenta组成, 各自功能？

A
  1. fetal component:

1) cytotrophoblast: 细胞滋养层 inner layer of chorionic villa
2) syncytiotrophoblast: 合胞体滋养层 - secrete hCG

  1. maternal component:

decidua basalis: 底蜕膜,基蜕膜

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

umbilical cord derived from ?

组成?

A

umbilical cord derived from allantois 尿囊 [ә’læntәuis]

2 umbilical arteries - returned deoxygenated blood from fetal internal iliac A to placenta

1 umbilical vein: drain into IVC via liver or ductus venous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

urachus:

derived from? at which developmental stage?

failure of urachus to obliterate results in?

A

urachus: 脐尿管 duct between fetal bladder and yolk sac

derived from：allantois 尿囊 [ә’læntәuis] （extends from the talk sac into the urogenital sinus)

at which developmental stage: wk 3

failure of urachus to obliterate results in:

  1. Patent urachus: urines discharge from umbilicus (脐尿管完全未闭：从脐带里漏尿）
  2. urachal cyst: (脐尿管部分未闭：cavity lined with uroepithelium, - can lead to infection, adenocarcinoma）
  3. vesicourachal diverticulum: 膀胱脐尿管憩室
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

vitelline duct:

connect what?

obliterate at which developmental stage?

failure of vitelline duct to close results in? Cx?

A

卵黄管

connect: yolk sac to miggut lumen

obliterate at which developmental stage: 7th wk

failure of vitelline duct to close results in:

  1. vitelline fistula - meconium 胎粪 discharge from umbilicus
  2. meckel diverticulum: true diverticulum; Cx: melena, periumbilical pain, and ulcers
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

meckel diverticulum:

rue or pseudo diverticulum? 各自定义？

define meckel diverticulum

Cx?

组织学特点

Dx:

A

true diverticulum: 包含肠壁的全部3层：mucosa, submucosa, mascularis;

pseudo diverticulum: 包含肠壁的2层：mucosa, submucosa only [e.g.: Zenker’s diverticulum]

Cx: melena, periumbilical pain, and ulcers (感染情况下很难和急性阑尾炎区别）

组织学特点： may contain ectopic gastric mucosa and/or pancreatic tissue

Dx: 99mmTc-pertechnetate scan in the right lower abdominal quadrant 【 99m锝扫描】

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

aortic A derivatives:

A

1st: 1st is maximal - part of maxillary artery 上颌动脉 [branch of external carotid]

2nd: Second = Stapedial
Stapedial A 镫骨A + hyoid A [‘haiɒid] 舌骨

3rd: C is the 3rd letter
- Common Carotid A and proximal part of internal carotid A

4th: (4 limbs = systemic)
- left: aortic arch
- right: proximal part of right subclavian A

6th: proximal part of pulmonary a and (left) DA (ductus arterioles)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

branchial apparatus:

又名？组成？胚层起源？

A

鳃器， 又名pharyngeal apparatus

组成: CAP
1. branchial Clefts: 鳃裂, [又名branchial grooves], derived from ectoderm

  1. branchial arches: 鳃弓
    derived from mesoderm (- muscles, arteries) and neural crest (- bones, cartilages)
  2. branchial pouches: 鳃囊
    derived from endoderm
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

branchial Clefts (鳃裂) derivatives

不闭锁导致？

A

1st cleft: - external auditory meatus 外耳道

2nd - 4th clefts: temporary cervical sinus, will obliterated by proliferation of the 2nd arch mesenchyme

if persistent cervical sinus - 导致branchial cleft cyst within lateral neck

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

branchial arch (鳃弓) derivatives:

1st arch:

  1. cartilage:
  2. Muscle
  3. Nerves:
  4. abnormalities
A

branchial arch (鳃弓) derivatives 总体口诀：

“At the restaurant of the golden arches, children first chew (1), smile (2) then swallow stylishly (3), or simply swallow (4) and then speak (6).

1st arch:
1. cartilage: Meckel cartilage (mandible 下颌骨, malleus 锤骨, incus 砧骨, spheno-mandibular ligament 蝶下颌韧带)

  1. Muscle:
    mastication: temporalis 颞肌, masseter 咬肌, pterygoid 翼状肌， mylohyoid 【mailou’hai,ouid] 下颌舌骨肌， anterior belly of digastric 二腹肌， tensor veli palatini 腭帆张肌， tensor tympani 鼓膜张肌
  2. Nerves: chew - CN V2 and V3
  3. abnormalities:
    “Teacher Collins Syn”: 1st-arch neural crest fails to migrate - madibular (下颌骨）hypoplasia, facial abnormalities
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

branchial arch (鳃弓) derivatives:

2nd arch:

  1. cartilage:
  2. Muscle
  3. Nerves:
  4. abnormalities
A

branchial arch (鳃弓) derivatives 总体口诀：

“At the restaurant of the golden arches, children first chew (1), smile (2) then swallow stylishly (3), or simply swallow (4) and then speak (6).

2nd arch:

  1. cartilage: Reichert cartilage 【stapes，镫骨； styloid process 茎突; lessor horn of hyoid 舌骨; stylohyoid ligament 茎突舌骨韧带】
  2. Muscle： muscles of facial expression [Stapedius, Stylohyoid, platySma （pla’tisma) 颈阔肌, belly of digastric 二腹肌
  3. Nerves: CN VII (facial expression - Smile)
  4. abnormalities:
    Congenital pharyngocutaneous fistula：
    persistence of cleft and pouch - fistula between tonsillar area and lateral neck
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

branchial arch (鳃弓) derivatives:

3rd arch:

  1. cartilage:
  2. Muscle
  3. Nerves:
  4. abnormalities
A

branchial arch (鳃弓) derivatives 总体口诀：

“At the restaurant of the golden arches, children first chew (1), smile (2) then swallow stylishly (3), or simply swallow (4) and then speak (6).

3rd arch:
1. cartilage: greater horn of hyoid 舌骨

  1. Muscle: stylopharyngeus 茎突咽肌 (innervated by glossopharyngeal n)
  2. Nerves: CN IX [stylopharyngeus - swallow stylishly]
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

branchial arch (鳃弓) derivatives:

4th - 6 th arch:

  1. cartilage:
  2. Muscle
  3. Nerves:
  4. abnormalities
A

branchial arch (鳃弓) derivatives 总体口诀：

“At the restaurant of the golden arches, children first chew (1), smile (2) then swallow stylishly (3), or simply swallow (4) and then speak (6).

4th - 6 th arch:

  1. cartilage: for thyroid, cricoid 环状软骨, arytenoid 杓状软骨, corniculate 小角软骨, cuneiform 楔骨
  2. Muscle:
    1) 4th: pharyngeal constrictors, cricothyroid 环甲肌, levator veli palatini 腭帆提肌
    2) 6th: all intrinsic muscles of larynx except cricothyroid
  3. Nerves:
    1) 4th: “simply swallow” - CN X (superior laryngeal branch)

2) 6th: “speak” - CN X (recurrent laryngeal branch)
4. abnormalities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

branchial pouch derivatives:

1st pouch:

A

“Ear, tonsil, bottom-to-top”

1st pouch: “ear”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

branchial pouch derivatives:

2nd pouch:

A

“Ear, tonsil, bottom-to-top”

2nd pouch: tonsil 扁桃体

epithelial lining of palatine tonsil 腭扁桃体

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

branchial pouch derivatives:

3rd pouch:

A

3rd pouch contributes to 3 structures:
thymus, left + right inferior parathyroids

3rd-pouch structures end up BELOW 4th-pouch structures (superior parathyroids)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

branchial pouch derivatives:

4th pouch:

A

“Ear, tonsil, bottom-to-top”

dorsal wings develop into uperior parathyroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

DiGeorge Syn:

Cause?
Cx?

A

aberrant development of 3rd and 4th pouches :

1) thymic aplasia - T-cell deficiency
2) failure of parathyroid development - hypocalcemia
3) conotruncal anomalies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

MEN 2A :

mutation?
Cx?

A

Multiple endocrine neoplasias (MEN) 2A

mutation of germ line RET (neural crest cells):

  1. adrenal medulla (pheochromocytoma)
  2. parathyroid tumor: 3rd/ 4th pharyngeal pouch
  3. parafollicular cells (medullary thyroid cancer): derived from neural crest cells, associated with the 4th/5th pharyngeal pouches
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

Cleft lip vs. cleft palate:

etiology:

A

Cleft lip: failure of fusion of the maxillary (上颌) and medial nasal processes - formation of 1° palate

cleft palate: failure of fusion of the 2 lateral palatine processes, - formation of 2° palate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

Genital development:

which gender is default?
sex organs derived from?

A

which gender is default: female

sex organs derived from: mesonephron (interact with urogenital sinus)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

female genital development:

哪种结构degenerate, 哪种develop (这种结构又名）？

A

female genital development:

哪种结构degenerate： mesonephric duct

哪种develop: paramesonephric duct develops
这种结构又名: Mullerian duct

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

male genital development:

重要的一个基因和2种细胞？分别分泌什么？功能？

A
  1. SRY gene on Y-chromosome:
    - produce testis-determining factor
    - testes development
  2. Sertoli cells
    - secrete Mullerian inhibitory factor (MIF) 否则米勒管就发育成女性生殖器官
    - suppress development of paramesonephric duct
    [记忆法：男性喜欢玩SM]
  3. Leydig cells
    - secrete androgens
    - stimulate the development of mesonephric ducts

[记忆法：LA是SM的天堂]

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

Mullerian duct: 又名？
develop into?
abnormalities result in?

A

Mullerian duct: 又名paramesonephric duct

develop into: female internal structures (fallopian tubes, uterus, upper portion of vagina [note: lower portion from urogenital sinus]

abnormalities result in: anatomical defects, may present as 1° amenorrhea in females with normal 2° sexual characteristics (indicting the functional ovaries)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

Wolffian duct: 又名？
develop into?
abnormalities result in?

A

Wolffian duct: 又名mesonephric duct

develop into male internal structures
[SEED: seminal vesicles 精囊，epididymis 附睾，ejaculatory duct 射精管，ductus deferens ]

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

complete failure of fusion of the paramesonephric ducts?

imcomplete failure of fusion of the paramesonephric ducts? - Can lead to?

A

complete failure of fusion of the paramesonephric ducts: double uterus and vagina

imcomplete failure of fusion of the paramesonephric ducts - bicornuate uterus 双角子宫
- Can lead to recurrent miscarriage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

5a-reductase: function? deficiency results in?

A

5a-reductase converts T to DHT:
T: Wolffican duct becomes male internal genitalia (expect prostate) 男性内生殖器
DHT: male external genitalia + prostate

deficiency results in: male internal genitalia, but ambiguous external genitalia until puberty

72
Q

Undiff. genitalis在男、女性中分别受什么激素影响，变成什么结构？

  1. genital tubercle
A

Undiff. genitalis在男、女性中分别受什么激素影响: DHT, E2

  1. genital tubercle:
    - male: glans penis 龟头, corpus cavernosum 海绵体 and spongiosum
  • female: glans clitoris 阴蒂头, vestibular bulbs
73
Q

Undiff. genitalis在男、女性中分别受什么激素影响，变成什么结构？

  1. urogenital sinus
A

Undiff. genitalis在男、女性中分别受什么激素影响，变成什么结构？

  1. urogenital sinus:
    - male: bulbourethral gland (of Cowper) 尿道球腺, prostate gland
    - female: greater vestibular glands (of Barthlin), urethral and paraurethral glands (of Skene) 尿道旁腺
74
Q

Undiff. genitalis在男、女性中分别受什么激素影响，变成什么结构？

  1. urogenital folds
A

urogenital folds:

  • male: ventral shaft of penis (penile urethra) 尿道海绵体部
  • female: labia minora
75
Q

Undiff. genitalis在男、女性中分别受什么激素影响，变成什么结构？

  1. labioscrotal swelling
A

labioscrotal swelling 阴唇阴囊突起

  • male: scrotum
  • female: labia majora
76
Q

hypospadias vs. epispadias: 定义？成因？各自associated with which disease?

A

hypospadias: 尿道下裂
abnormal opening of penile urethra on inferior side, due to failure of urethral folds to close
[more common, need to be fixed to prevent UTIs]

epispadias: 尿道上裂
abnormal opening of penile urethra on superior side, due to faulty positioning of genital tubercle 生殖结节
- associated with exstrophy of bladder

77
Q

descent of testes and ovaries:

  1. gubernaculum
  2. processus vaginalis
A
  1. gubernaculum: 引带
    - male: anchor testes in scrotum
    - female: ovarian ligament + round ligament of uterus
  2. processus vaginalis 鞘状突:
    - male: form tunica vaginalis 鞘膜 [hydrocele 睾丸鞘膜积液的部位】
    - female: obliterated
78
Q

Gonadal venous drainage:

left vs. right:

varicocele is more common on which side?

A

“Left gonadal v. takes the Longest way”

varicocele is more common on which side: left

79
Q

Gonadal lymphatic drainage:

left vs. right:

A

从内向外：

  1. ovaries/ testes: → para-aortic lymph nodes
  2. uterus, proximal vagina → obsturator (闭孔肌), external iliac and hypogastric nodes 下腹的
  3. distal vagina, vulva 女阴/ scrotum → superficial inguinal nodes
80
Q

盆腔韧带：

  1. infundibulopelvic ligament 漏斗骨盆韧带：

又名？
connect what?
里面的结构？
notes?

A

又名: suspensory lig. of the ovaries

connect: ovaries to lateral pelvic wall

里面的结构: ovarian vessels

notes:

  1. ligate vessels during oophorectomy 卵巢切除术 to avoid bleeding
  2. ureter courses retroperitoneally, close to gonadal vessels; at risk of injury during ligation of ovarian vessels
81
Q

盆腔韧带：

  1. cardinal ligament 漏斗骨盆韧带：

connect what?
里面的结构？
notes?

A

connect: cervix to side wall of pelvis

里面的结构: uterine vessels

notes: ureter at risk of injury during ligation of uterine vessels in hysterectomy 子宫切除术

82
Q

盆腔韧带：

  1. round ligament of the uterus

connect what?
notes?

A

connect: uterine fundus to labia majora
notes: derivative of guber’naculum 引带; travels through round inguinal canal, above the A. of Sampson

83
Q

盆腔韧带：

  1. broad ligament

connect what?
里面的结构？
notes?

A

connect uterus, fallopian tubes, and ovaries to pelvic side wall

里面的结构: ovaries, fallopian tubes, round lig. of uterus

notes: 含3个结构：mesosalpinx 输卵管系膜, mesometrium 子宫系膜, mesovarium 卵巢系膜

84
Q

盆腔韧带：

  1. ovarian ligament

connect what?
notes?

A

connect medial pole of ovary to lateral uterus

notes: derivative of guber’naculum 引带; “ovarian Lig. Latches to Lateral utereus”

85
Q

female reproductive epithelial histology:

从阴道 - 宫颈 - 子宫 - 输卵管 - 卵巢， 分别是什么上皮，有什么腺体？

MC site for cervical cancer?

A

female reproductive epithelial histology:

  1. 阴道 ， 宫颈 （ectocervix 外宫颈的): stratified squamous epithelium, non-keratinized
  2. transformation zone between ectocervix and endocervix: squamocolumaner junction (MC site for cervical cancer)
  3. endocervix: simple columnar epithelium
  4. uterus: simple columnar epithelium, with long tubular glands
  5. 输卵管 : simple columnar epithelium, many ciliated cells + a few secretory (peg) cells
  6. 卵巢: simple cuboidal 似立方形的epithelium (germinal epi covering ovary surface)
86
Q

female sexual response cycle?

mediated by?
其他症状？

A
  1. excitement (uterus elevates, vaginal lubrication)
  2. plateau (expansion of inner vagina)
  3. orgasm (contraction of uterus)
  4. resolution

mediated by ANS

其他症状： tachycardia, skin flushing

87
Q

pathway of sperm during ejaculation? 口诀？

A

“SEVEN UP”

seminiferous tubules 曲细精管
tunica albuginea: 白膜
prepuce: 包皮
glans: 龟头

88
Q

ANS control of the male sexual response:

  1. erection: 由什么N控制？ 哪些神经递质？
  2. emission?
  3. ejaculation?
A
  1. erection: 由什么N控制：pelvic N (para-symathetic, “Point and Shoot”)

哪些神经递质: NO and cGMP
[sildenafil: 昔多芬,一氧化氮样药物,商品名Viagra(伟哥);
vardenafil: 伐地那非, 治疗ED]

  1. emission: 遗精：Sympathetic N (hypogastric nerve 腹下神经)
  2. ejaculation: visceral and somatic N (pudendal N)
89
Q

spermatogonia:

function and location?

A

精原细胞

90
Q

Sertoli cells:
function and location?
sensitive to?

A

function:

  1. secrete inhibin - inhibit FSH
  2. produce MIF - inhibit development of Mullerian duct (paramesonephric duct)
  3. secrete androgen-binding protein - maintain local level of T: aromatase converts T and androstenedione to E2
  4. Support and nourish spermatozoa, regulate spermatogenesis
    “Sertoli cells Support Sperm Synthesis”
  5. tight junctions between adjacent Sertoli cells form Blood-testis barrier - isolate gametes from autoimmune attack

sensitive to temperature (in cryp’torchidism 隐睾, varicocele)

91
Q

Testosterone produced by?

If affected by temperature?

A

Testosterone produced by Leydig cells

If affected by temperature: No

92
Q

estrogens:

  1. source? 各产生什么雌激素？potency比较？
  2. function?
    which one indicates the fetal well-being during pregnancy?
A

which one indicates the fetal well-being during pregnancy: 1000-fold increase of E3

93
Q

P4:

effect on ERs? gonadotrophins? prolactin?

A
  1. P4 ↓ ER expression
  2. inhibit gonadotrophins (LH, FSH)
  3. fall in P4 level after delivery disinhibits prolactin - lactation
94
Q

menstrual cycle:

激素变化的顺序？
分哪2phase?
画出所有激素变化的曲线？

A

激素变化的顺序：
E2 ↑ - LH surge - ovulation - ↑ P4 - P4 fall - menstruation (apoptosis of endometrial cells)

分哪2phase: follicular phase, luteal phase

95
Q

Define:

  1. oligomenorrhea
  2. polymenorrhea
  3. metrorrhagia
  4. menorrhagia
  5. metromenorrhagia
A
  1. oligomenorrhea: > 35-d cycle
  2. polymenorrhea: < 21-d cycle
  3. metrorrhagia: intermenstral bleeding
  4. menorrhagia
  5. metromenorrhagia
96
Q

Oogenesis:

  1. meisosis I arrested at which phase? until?
  2. . meisosis II arrested at which phase? until?
A
  1. meisosis I arrested at prophase I, until Ovulation (to form 1° oocyte)
  2. . meisosis II arrested at metaphase II until fertilization (to form 2° oocyte)
97
Q

mittelschmerz:

define:
和什么鉴别？

A

经间痛

98
Q

Pregnancy期间4种最主要激素的变化？

implantation happens at when?
which cells make hCG?

A

implantation happens at 6 days after fertilization (子宫内膜最厚的时候）

which cells make hCG： syncytiotrophoblasts 滋养层细胞

99
Q

lactation: 激素变化？

A

↓ E2 and P4: disinhibit lactation

  • prolactin
  • oxytocin 催产素, 缩宫素
100
Q

hCG:

  1. source?
    2: function?
  2. structure?
  3. patho?
A
  1. source: syncytiotrophoblasts of placenta
    2: function: maintain the corpus luteum and thus P4 for the 1st trimester by acting like LH
  2. structure: alpha subunit structurally identical to alpha subunit of LH, FSH, and TSH
    beta subunit: unique (detected in pregnancy test)
  3. patho: ↑ in hydratidiform mole (葡萄胎), choriocarcinoma
101
Q

menopause:

hormone change?
症状的口诀？

A

hormone change:

↓ E2, P4
↑↑ FSH (specific for menopause, lose feedback),
↑ LH (No surge)
↑ GnRH

症状的口诀： “HAVOCS”

102
Q

spermatogenesis:

begin at when?
time to fully develop?
occur at location?

impaired sperm tail mobility seen in?

Ploidy, chromatids的变化图？

A

begin at when： puberty

time to fully develop: 2m

occur at location: seminiferous tubules

impaired sperm tail mobility seen in: ciliary dyskinesia / Kartagener syn

103
Q

Androgens: 哪几种？分别在什么地方产生？potency? function? 转化？

A

Androgens:
哪几种： T, DHT, androstenedione 雄甾烯二酮

分别在什么地方产生:
T, DHT: testis
AnDrostenedione: ADrenal

potency: DHT > T > androstenedione

转化: T is converted to DHT by 5a-reductase [this E. can be inhibited by finasteride （非那司提(治疗良性前列腺增生)

function?:
1. T: 男性内部器官的分化（除了前列腺）， closing of epiphyseal plates (骺板) via E2 converted from T;

  1. DHT: 男性外部器官的分化+前列腺； 前列腺增生，秃顶，皮脂腺
104
Q

Klinefelter syn: 基因型？表现型？ 激素变化？

A

male, XXY (多出来Barr body), 1: 850

瘦高体型，女性化乳房，阴毛为女性化分布。

激素变化:
↓ inhibin - ↑ FSH
↓ T - ↑ LH - ↑ E

105
Q

Turner syn: 基因型？有无barr body?

表现型？ 激素变化？

A

Turner syn: XO [mitotic or meiotic error], female, 无barr body

MCC for 1° amenorrhea

基因型: can be complete monosomy (45 XO) or mosaicsm (45 XO/46 XX)

表现型: female,

  1. 平胸，short,
  2. ovarian dysgenesis (streak ovary)
  3. 心脏：bicuspid aortic valve, preductal coarctation 上下肢血压差：brachial pulse > femoral + notched ribs)
  4. lympathic defects: webbed neck, cystic hygroma 水囊状淋巴管瘤； lymphedema in feet and hands

激素变化:
↓ E - ↑ LH and FSH

106
Q

True hermaphroditism: 基因型？表现型？

A

真两性同体

46 XX, or 47 XXY

ovotestis: 卵睾体, 两性生殖腺(卵巢睾丸并存)

107
Q

Dx:

↑ T, ↑ LH

A

defective AR

108
Q

Dx:

↑ T, ↓ LH

A

T-secreting tumor, exogenous steroids

109
Q

Dx:

↓ T, ↑ LH

A

1 ° hypogonadism

110
Q

female pseudohermaphrodite:
genotype? phenotype?
cause?

A

假两性体, 假半阴阳体

genotype: XX
phenotype: ovaries present, external genitalia ambiguous
cause: ↑ androgens during early gestation

111
Q

male pseudohermaphrodite:
genotype? phenotype?
cause?

A

假两性体, 假半阴阳体

genotype: XY
phenotype: testes present, external genitalia female or ambiguous
cause: androgens insensitivity syn

112
Q

Androgen insensitivity syn:

genotype?
Cx?
有无女性器官？有无男性器官？
Hormone变化？

A

genotype: 46 XY, 男性develop女性特征

Cx：female appearing,scant sexual hair

  • 有无女性器官: female external genitalia with rudimentary vagina + absent ovary and fallopian tubes; scant sexual hair
  • 有无男性器官: develop testis in labia major

Hormone变化: ↑ T, E, LH

113
Q

Kallmann syn:

Cause?
属于哪一大类疾病的一种？
Hormone变化？

A

Cause: defective migration of GnRH cells and formation of olfactory bulb; fail to complete puberty - ↓ synthesis of GnRH in the hypothalamus, anosmia 嗅觉缺失症

属于哪一大类疾病的一种:
hypogonadotropic hypogonadism

Hormone变化: ↓ GnRH, FSH, LH

in males： low sperm count

in females: amenorrhea

114
Q

Gestational HTN:

define:
Rx?

A

define:

  1. after 20 wks才出现 BP > 140/90, no pre-existing HTN
  2. no proteinuria or end-organ damage

Rx:

  1. 药物： HyLAN (Hydralazine, Labetalol, a-methyldopa, Nifedipine)
  2. deliver at 39 wks
115
Q

preeclampsia

  1. define:
  2. Cx: mild / severe
  3. Cause
  4. Incidence ↑ with which conditions?
  5. complications
  6. Rx
A

先兆子痫

  1. define:
    (mild) ：HTN > 140/90 + proteinuria (> 300 mg/24hr) between 20 wks gestation - 6 wks postpartum
    - [与单纯的gestational HTN区别：妊娠期高血压无蛋白尿]
    - if < 20 wks: suggest molar pregnancy 葡萄胎
  2. Cx:
    severe: BP > 160/110 with or without end-organ damage （e.g., headache, scotoma 盲点， oliguria, ↑ AST/ALT, thrombocytopenia
  3. Cause: abnormal placental spiral arteries - result in maternal endothelial dysfunction, vasoconstriction, or hyperreflexia
  4. Incidence ↑ with which conditions:
    pre-existing HTN, DM, chronic renal disease, autoimmune
  5. complications:
    placental abruption, coagulopathy, renal failure, uteroplacental insufficiency, or eclampisa
  6. Rx：
    1） anti-HTN (HyLAN: Hydralazine, Labetalol, a-methyldopa, Nifedipine)
    2) deliver at 34 wks (severe) or 37 wks (mild)
    3) IV Mg sulfate to prevent seizure
116
Q

Eclampsia:

Cx?
Cause of death?
Rx

A

Cx: preeclampsia + maternal seizure

Cause of death: stroke - intracranial hemorrhage or ARDS (Acute respiratory distress syndrome)

Rx:
1） anti-HTN (HyLAN: Hydralazine, Labetalol, a-methyldopa, Nifedipine)
2) deliver immediately
3) IV Mg sulfate to prevent seizure

117
Q

HELLP syn

Cx?
Rx?

A

Hemolysis, Elevated Liver enzymes, Low Platelets

118
Q

Placental abruption:

症状？

A

产科急症，life-threatening to both mother and fetus

症状: abrupt, painful bleeding in 3rd trimester

119
Q

placenta accreta/ increta / percreta:

  1. Cause?
  2. risk factor?
  3. Cx?
A

植入胎盘的不同程度：

placenta accreta: 植入胎盘 (attached to)
placenta increta (penetrate into)
placenta percreta: 穿透性 (penetrate through - perforates)

  1. Cause: defective de’cidual 蜕膜的 layer - abnormal attachment and separation after delivery
  2. risk factor: prior C-section, inflammation, placenta pre via (前置胎盘),
  3. Cx: no separation of placenta after delivery - massive bleeding; life threatening for mother
120
Q

ectopic pregnancy:

MC location?
Suspect in which population? diff?
how to confirm?
Rx?
Risk factors?
A

MC location: ampulla of fallopian tube

Suspect in which population: history with amenorrhea, low-than-expected rise in hCG, sudden lower abdominal pain with or without bleeding

diff: appendicitis

how to confirm: ultrasound

Rx: 甲氨喋呤

机制- folic acid analog that inhibits dihydrofolate reductase ⇒ ↓ dTMP ⇒ ↓ DNA (both purines and thymidine) and protein synthesis

用途: 2大临床应用：肿瘤及非肿瘤
1. cancers: leukemias, lymphomas, choriocarcinoma (绒毛膜癌), sarcomas

  1. non-neoplastic: abortion, ectopic pregnancy, autoimmune类

Risk factors:

  • history of infertility
  • salpingitis 输卵管炎, PID (Pelvic inflammatory disease)
  • ruptured appendix
  • prior tubal surgery
121
Q

polyhydramnios:

define?
associated with?

A

羊水过多

define: > 1.5 - 2 L of amniotic fluid

associated with:
1. fetal malformations: esophageal / duodenal atresia, etc

122
Q

oligohydramnios:

define?
associated with?
Profound one can cause?

A

羊水过少

123
Q

cervical patho: Dysplasia or carcinoma in situ (CIN):

  1. define
  2. location to begin?
  3. classification?
  4. associated with viruses? encode which genes?
  5. Cx? Pap smear见什么特征？
  6. prognosis?
  7. risk factors?
A
  1. define: disordered epithelial growth
  2. location to begin: basal layer of squamocolumnar junction (transition zone)
  3. classification: CIN 1, 2, 3
  4. associated with viruses? encode which genes?
    - HPV 16 and 18, producing both E6 gene product (inhibit p53) and E7 (inhibit RB suppressor)
  5. Cx: asymptomatic (detected by pap smear; can present as abnormal bleeding - often postcoital 性交后的

Pap smear见什么特征: koilocytes 中空细胞， wrinkled “raisinoid” nuclei

  1. prognosis: if untreated, can progress slowly to invasive carcinoma
  2. risk factors:
    - #1 !!! : multiple sexual partners
    - smoking
    - early sexual intercourse
    - HIV infection
124
Q

Cervical: invasive carcinoma:

patho 分型？
Pap smear can catch at which stage？
引起renal failure的原因？

A

patho 分型： squamous cell carcinoma

Pap smear can catch at which stage: cervical dysplasia (kilobytes)

引起renal failure的原因: lateral invasion

125
Q

endometritis [,endәumi’traitis]

  1. define: what inflammation cells infiltrate?
  2. cause?
  3. Rx?
A

子宫内膜炎

  1. define: what inflammation cells infiltrate: plasma cells and lymphocytes
  2. cause: retained with products of connection following delivery/miscarrage/ abortion/foreign bodies such as IUD
  3. Rx: gentamicin+ clindamycin, with or without Amp
126
Q

endometriosis:

  1. define: 良性恶性？
  2. cause?
  3. location?
  4. Cx? 子宫大小？
  5. Rx?
  6. diff?
A

子宫内膜异位

  1. define: non-neoplastic endometrial glands/storma outside of the endotmetrial cavity
  2. cause: retrograde flow, lymphatic transportation, metaplastic transformation of multipotent cells
  3. location: anywhere, MC site is the ovary (“chocolate cyst”) and peritoneum - 诊断上大便痛
  4. Cx： cyclic pelvic pain, bleeding, dysmenorrhea, dyspareunia [交媾困难】， dyschezia [pain with defecation 大便困难], infertility, 子宫大小正常
  5. Rx： NSAIDs, OCPs, progestins, GnRH agonists, surgery
  6. adenomyosis
127
Q

adenomyosis

  1. define/与什么鉴别？
  2. cause?
  3. Cx? 子宫大小？
  4. Rx?
A

子宫肌腺病 （过去，曾将其称为内在性子宫内膜异位症，而其他部位的内膜异位症则称之为外在性子宫内膜异位症； 现在2者要鉴别）

  1. define: extension of endometrial tissue into the uterine myometrium

与什么鉴别: endometriosis [non-neoplastic endometrial glands/storma outside of the endotmetrial cavity]

  1. cause: hyperplasia of the basalis layer of the endometrium
  2. Cx: 临床上主要表现为痛经、经量增多与子宫增大。dysmenorrhea, menorrhagia

子宫大小: uniformly enlarged, soft, globular uterus

  1. Rx: hysterectomy
128
Q

adenomyoma:

define:
contain what cells?
extend to?

A

腺肌瘤; 子宫内膜瘤

define: well-circumscribed collection of endometrial tissue within the uterine wall

contain what cells: SMCs

extend to endometrial cavity in the form of polyp

129
Q

endometrial hyperplasia:

  1. define:
  2. cause?
  3. ↑ risk for?
  4. Cx?
  5. risk factors?
A
  1. define: abnormal endometrial gland proliferation
  2. MC cause: excess E stimulation
  3. ↑ risk for: endometrial carcinoma
  4. Cx: postmenopausal vaginal bleeding
  5. risk factors: anovulatory cycles 无排卵周期, HRT, POS (polycystic ovarian syn), ganulosa cell tumor
130
Q

MC gynecologic malignancy?

  1. peak age:
  2. Cx
  3. risk factors?
  4. prognosis?
A

endometrial carcinoma:

  1. peak age: 55 -65
  2. Cx: vaginal bleeding, typically preceded by endometrial hyperplasia
  3. risk factors: prolonged use of E without progestins, obesity, DM, HTN, nulliparity 未经产, late menopause
  4. ↓ prognosis with ↑ myometrial invasion
131
Q

leiomyoma:

Cx?
# of tumors?
种族发病率？
对什么激素敏感？
does it progress to leiomyosarcoma?
A

平滑肌瘤

Cx: MC tumor in females (20 -40);

of tumors: multiple, discrete

种族发病率: ↑ in blacks

对什么激素敏感：E

does it progress to leiomyosarcoma - no (benign)

132
Q

Premature ovarian failure:

age?
hormonal change?

A

< 40

↓ E, ↑ LH, FSH

133
Q

PCOS (polycystic ovarian syn, Stein-Leventhal syn):

  1. cause?
  2. hormonal change
  3. Cx?
  4. ↑ risk for
  5. Rx
A

MCC for infertility in women

  1. cause:
    1) theca cells synthesize excess Androgens - hyperandrogenism
    2) hyperinsulinemia

insulin and T ↓ SHBG (steroid hormone binding protein) - 这个作用会被E拮抗： E ↑ SHBG, ultimately ↓ free T

  1. hormonal change:
    ↑ LH, ↑ FSH (3: 1), ↑ T, ↑ E (from aromatization)
  2. Cx: enlarged, bilateral cystic ovaries; amenorrhea/oligomenorrhea, hirsutism, acne, infertility
  3. ↑ risk for endometrial cancer
  4. Rx:
    1) hirsutism, acne: weight reduction, OCPs, anti androgens
    2) infertility: clomiphene citrate 克罗米酚柠檬酸盐 (blocks negative feedback of circulating E, ↓ FSH, LH
    3) metformin for insulin insensitivity
    4) cyclic P4 to protect endometrial
134
Q

ovarian neoplasm:

MC in age?
胚胎起源
MC type?
risk factors?
Cx
Dx
monitor
A

can be benign or malignant

MC in age: < 55

胚胎起源: > 95% epithelial

MC type: serous cystadenocarcinoma

risk factors: ↑ age, infertility endometriosis, PCOS, genetic (BRAC-1/2, HPNCC, family history)

Cx: adnexal 子宫附件mass, abdominal dissension, bowel obstruction, pleural effusion

Dx: surgically

monitor: CA-125

135
Q

Dx for ovarian neoplasm:

MC type;

A

serous cystadenoma

136
Q

Brenner tumor:

define
良恶性？
gross appearance?
H&E staining

A

rare ovarian tumor, most are benign but can be malignant

“looks like bladder”
solid tumor, pale yellow-tan in color + capsulated

“coffee bean” nuclei on H&E staining

137
Q

Meigs syndrome:

triad
histology

A

triad: ovarian fibromas + ascites + hydrothorax

138
Q

ovarian teratoma:

benign/mature contains
malignant/immature contains

A

ovarian teratoma:

benign/mature contains thyroid tissue

malignant/immature contains embryonic-like neural tissue

139
Q

granulosa cell tumor:

MC age
hormone change
Cx
histo

A

MC age: 50s

hormone change: E and/or P4

Cx: abnormal uterine bleeding, breast tenderness, sexual precocity 性早熟 if in pre-adolescents

histo: Call-Exner bodies [small eosinophilic fluid-filled spaces between granulosa cells. The granulosa cells are usually arranged haphazardly around the space.]

140
Q

MC malignant ovarian tumor?

单、双侧？
histo特征？

A

serous cystadenocarcinoma
浆液性囊腺癌

frequently bilateral

histo特征: Psammoma bodies

141
Q

mucinous cystadenocarcinoma

粘液性囊腺癌

A

pseudomyxoma [ˌpsju:dəumik`səumə]

假粘液瘤：腹膜上的胶样生长物，常继发于卵巢囊肿

142
Q

dysgerminoma:

MC in which age?
histo特征？
marker?

A

无性细胞瘤：一种恶性卵巢赘生物，来源于未分化胚胎性性腺原始生殖细胞，它是典型的睾丸精细胞瘤的复本(seminoma)，在肉眼和组织学上都与精细胞瘤相同

MC in which age: in adolescents

histo特征: “fried eggs”

marker: hCG, LDH

143
Q

choriocarcinoma:

什么细胞的肿瘤？
are chorionic villi present？
Cx?
扩散途径
Rx
A

绒毛膜癌

由胎盘上皮立方细胞及合体细胞异常增生而形成的滋养层细胞恶性上皮癌，但无绒毛产生。所有病例几乎均在子宫发生，可由葡萄胎发展而来(50％)，或在流产后(25％)或在正常妊娠中(22％)发生。其余发生于子宫外妊娠以及生殖器(卵巢及睾丸)和生殖器外畸胎瘤

144
Q

yolk sac tumor (endodermal sinus tumor)

age?
gender
histo
tumor marker

A

卵巢内胚层窦瘤,卵黄囊瘤

age: young children, MC tumor in male infants
gender: both
histo: hemorrhagic, solid mass; “Schiller-Duval bodies”

tumor marker: AFP

145
Q

Krukenberg tumor:

A

GI malignancy, blood metastasize to the ovaries, causing a mucin-secreting signet cell adenocarcinoma

146
Q

Gestational diabetes mellitus:

cause?

A

↑ insulin resistance

caused by:

1) hPL (human placental lactogen) 人胎盘催乳素
2) GH, E, P4, glucocorticoids

147
Q

Vaginal tumors:

  1. SCC: 病因？
  2. clear cell adenocarcinoma 病因？
  3. sarcoma botryoides: 人群？ tumor cell shape? marker?
A
  1. SCC: 2° to cervical SCC
  2. clear cell adenocarcinoma: exposed to DES in utero
  3. sarcoma botryoides 葡萄状肉瘤: 人群: < 4-yr girls,
    tumor cell shape: spindle-shaped,
    marker: desmin
148
Q

Fibroadenoma:

发生部位？
良恶性
characteristics
epidemiology
和激素相关？
is it a precursor to breast cancer?
A

发生部位: breast stroma

良恶性: benign

characteristics
epidemiology
和激素相关？
is it a precursor to breast cancer?

149
Q

intraductal papilloma:

发生部位？
良恶性
characteristics

risk for breast cancer?

A

发生部位: in lactiferous duct, typically beneath areola

良恶性: benign (注意：虽然有血性渗液，还是良性）

characteristics： serous or bloody nipple discharge

risk for breast cancer: slight increased risk for carcinoma

150
Q

Phyllodes tumor

发生部位？
良恶性
characteristics
epidemiology
risk for breast cancer?
A

叶状肿瘤

发生部位: breast stroma (small, vs Phyllodes tumor - large, 大的乳房基质肿瘤）

良恶性： benign (but may become malignant)

characteristics: large stroma tumor (vs. small fibroadenoma); “leaf-like” projections
epidemiology: > 60

risk for breast cancer: may

151
Q

Malignant breast tumors:

usually arise from?
triple negative?

the single most important prognostic factor?
ethnicity

A

usually arise from: terminal duct lobular unit

triple negative: ER-, PR, Her2/Neu -

the single most important prognostic factor: axillary lymph node metastasis

ethnicity: ↑ in AA

152
Q

define:

DCIS (ductal carcinoma in situ):

arise from
mammography见到征象？
pathology
有无basement mem penetration?

A

DCIS : noninvasive 乳腺癌，早期

arise from：ductal atypia 不典型囊性导管

mammography见到征象： early micro calcifications

pathology: tumor confined to the duct and blood vessels

有无basement mem penetration- no

153
Q

comedocarcinoma : define

发生部位？
病理特点？

A

粉刺性癌，noninvasive breast cancer, DCIS subtype

发生部位 - ductal

病理特点: caseous necrosis

154
Q

“large cells in epidermis with clear halo” - name these cells

If see on nipples, indicate
if see on vulva, indicate

A

“large cells in epidermis with clear halo” - Paget cells

If see on nipples, indicate: DCIS

if see on vulva, usually no underlying malignancy

155
Q

Invasive ductal breast cancer:

外观
细胞形态

classic infiltration?
prognosis

A

外观: firm, fibrous, “rock-hard” mass, sharp margins

细胞形态: small, glandular, duct-like cells

classic infiltration: “stellate” 星状的

prognosis: worst (but it’s the MC form)

156
Q

invasive lobular breast cancer:

patho characterisics

单，双侧？

A

patho characterisics： orderly row of cells (Indian file)

often bilateral with multiple lesions in the same location

157
Q

medullary breast cancer:

细胞浸润？
Px?

A

fleshy, cellular, lymphocytic infiltrate

good prognosis

158
Q

inflammatory breast cancer:

特点？
Px?

A

橘皮样变

159
Q

bicornuate uterus / uterus didelphys:

caused by which embryologic failure?
detected by?

A

双角子宫/双子宫

failure in fusion of the paramesonephric ducts

detected by hysterogram 子宫X线照相

160
Q

enterobiasis [ˌentərəu`baiəsis]

age
life cycle
Dx
Rx

A

蛲虫病：蛲虫属线虫感染，主要是蠕形住肠线虫，即蛲虫

age: 5- 10

life cycle: live in intestine, lay eggs in perianal area - perianal itching (pruritus ani)

Dx: “Scotch tape” test

Rx:
mebendazole [mi`bendəzəul]〕甲苯达唑
albendazole 丙硫咪唑,扑尔虫,抗蠕敏

161
Q

If elder pt presents high fever, skin flushing, low BP, tachycardia:

Dx?
MCC - which bacteria, from where？

A

Dx: septic shock

MCC: E.coli - UTI

162
Q

Proliferative breast disease:

Cx
if ↑ risk for cancer
histologic types/ MC age

A

Cx: MCC for “breast lumps” > 25 to menopause; premenstrual breast pain and multiple lesions, often bilateral; fluctuation in sizes;

if ↑ risk for cancer: depends

histologic types/ MC age :

1) fibrosis - hyperplasia of stroma
2) cystic - ductal dilation, fluid filled
3) sclerosing adenosis
4) epithelial hyperplasia

163
Q

acute mastitis:

MC bac
Rx

A

MC bac: S. aureus

Rx: dicloxacillin 双氯青霉素 + continued breast-feeding

164
Q

fat necrosis of breast

MCC
mammography见？
biopsy见

A

MCC： trauma

mammography见abnormal calcification

biopsy见 necrotic fat, giant cells

165
Q

gynecomastia:

causes, 口诀？

A

causes：

  1. hyperestrogenism: cirrhosis, testicular tumor, puberty, old age
  2. Klinefelter syn
  3. drugs: “Some Dope Drugs Easily Create Awkward Hairy DD Knockers”
166
Q

Prostatitis:

MC bac

A

Acute: E.coli
chronic: abacterial

167
Q

BPH (benign prostate hyperplasia)

age
patho
which lobes hyperplasia
marker
Rx
A

age: > 50
patho: hyperplasia, not hypertrophy! (看名字就知道了！）

which lobes hyperplasia： lateral + middle

marker: ↑ free PSA

Rx:
1) a1-antagonists to relax SMC (osin, 高血压药和BPH):
terazosin 特拉唑嗪,
tamsulosin 坦(索)洛新

2) finasteride : anti- 5a reductase 非那司提(治疗良性前列腺增生)

168
Q

prostate adenocarcinoma:

location
Dx
markers
metastasis , indicated by

A

location: posterior lobe

Dx: ↑ PSA + needle core biopsy

markers: ↑ PSA and PAP, with ↓ fraction of free PSA

metastasis - bone
indicated by: lower back pain, ↑ ALP, PSA

169
Q

crytorchidism:

change to:

T, inhibin, FSH, LH

A

T: normal in unilateral, ↓ in bilateral

↓ inhibin,

↑ FSH, LH

170
Q

testicular tumors: 分2大类（再分细类），各占多少比例？良恶性

A
  1. germ cell tumor > 95%： malignant if not transilluminate 透照
  2. non-germ cell tumor: 5%
171
Q

seminoma:

良恶性
age
patho, 与什么部位的肿瘤类似？

marker
特殊的激素变化？

Rx
Px

A

精原细胞瘤

良恶性: malig

age: ~ 30, nerv in infancy
patho: similar to germinoma in pineal gland region!
marker: ↑ placental ALP

特殊的激素变化： ↑ hCG，

Rx: radiosensitive

Px: great

172
Q

choriocarcinoma in testicular region:

良恶性
转移部位？

Cx
特殊的激素变化？

A

良恶性: mag, ↑ hCG

转移部位: brain + lung (may Cx as “hemorrhagic stroke”)

Cx: may gynecomastia + hyperthyroidism

特殊的激素变化: ↑ hCG - analog of LH and FSH

173
Q

teratoma in testis:

良恶性
特殊的激素变化？

A

良恶性 mag

特殊的激素变化: ↑ hCG and/or AFP

174
Q

embryonal carcinoma in testis:

良恶性
patho
Px

Cx
特殊的激素变化？

A

良恶性 mag

patho: often glandular/papillary

Px: worse than serminoma

Cx: painful, hemorrhagic mass with necrosis

特殊的激素变化: ↑ hCG, AFP depends

175
Q

tunica vaginalis lesions:

diff with testicular tumor?
分类

A

鞘膜

diff with testicular tumor - transilluminate 透照

分类：

  1. hydrocele 睾丸鞘膜积液
  2. spermatocele [`spə:mətəuˌsi:l] 精液囊肿,精子囊肿
176
Q

squamaous cell carcinoma of the penile:

地域分布
Precursor in situ lesion?
viral association?

A

地域分布: Asia, Africa, South America

Precursor in situ lesion: “Bowen disease”

viral association: HPV

Step 1 notes (22 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions