female reproductive

Question 1

what are the karyotypes possible in complete hydatidiform mole

Answer 1

46,XX

46, XY (not common)

Question 2

what are the karyotypes possible in a partial mole

Answer 2

69, XXX
69, XXY
69, XYY

Question 3

Letrozole MOA

Answer 3

inhibits aromatase to surpress ovarian estradiol production and induce ovulation

Question 4

Clomiphene MOA

Answer 4

depletes estrogen receptors in hypothalamus and pituitary thereby decreasing ability to detect negative feedback –> FSH and LH release to induce ovulation

Question 5

what cause of vaginal discharge is an anaerobic gram-variable rod

Answer 5

bacterial vaginosis

Question 6

Anatomic or functional ________is the almost always necessary for the development of acute pyelonephritis

Answer 6

anatomic or functional vesicoureturetal reflux

Question 7

Fusion of and involution of the ________ gives rise to the fallopian tubes, uterus, cervix, and upper vagina

Answer 7

paramesonephric ducts (mullerian ducts)

Question 8

what breast lesion produces bloody nipple discharge with histology of epithelial and myoepithelial cells lining fibrovascular cores

Answer 8

intraductal papilloma

Question 9

what hormone increases the most after ovulation

Answer 9

progesterone

Question 10

what are the common cardiovascular anomalies seen in Turner syndrome

Answer 10

bicuspid aortic valve
coarctation of the aorta
aortic root dilation

Question 11

what is the clinical presentation of mullerian agenesis

Answer 11

variable uterine development and no upper vagina –> inability to menstruate
ovaries and secondary sexual characteristics are normal

Question 12

what are clue cells which are seen in bacterial vaginosis

Answer 12

squamous epithelial cells with adherent bacteria

Question 13

Leuprolide MOA

Answer 13

GnRH agonist

Question 14

what is the purpose of estrogen stimulating the upregulation of connexin proteins immediately prior to delivery

Answer 14

connexins form gap junctions which form between myometiral smooth muscle cells which heightens myometrial excitability

Question 15

what ovarian mass appears grossly as an oily cystic mass and may produce symptoms of unintentional weight loss, hot flushes, irregular menses, and low TSH

Answer 15

struma ovarii (a germ cell tumor)

Question 16

what is the effect of an ovulatory cycle on estrogen and progesterone

Answer 16

ovarian follicle does not degenerate and become corpus luteum –> no progesterone –> estrogen remains persistantly high

Question 17

what is a disorder caused by an abnormal collection of endometrial glands and stroma within the uterine myometrium

Answer 17

adenomyosis

Question 18

What is the clinical presentation of adenomyosis

Answer 18

dysmenorrhea, heavy menses, and a uniformly enlarged uterus

Question 19

how do somatic mosaicism and germline mosaicism differ in presentation

Answer 19

somatic mosaicism causes disease manifestation to develop in the affected individual
germline mosaicism causes affected genes to be passed to the offspring but the affected individual will not have disease manifestation

Question 20

A 63 yo patient presenting with chronic constipation and a vaginal bulge likely has what diagnosis

Answer 20

pelvic organ prolapse

Question 21

pelvic organ prolapse occurs due to damage to what muscle

Answer 21

levator ani muscle complex

Question 22

The _____ contains the ovarian artery, vein, lymphatics, and nerves

Answer 22

suspensory ligament

Question 23

A midline episiotomy is a vertical incision from the posterior vaginal opening to the _______

Answer 23

perineal body

Question 24

A patient premenopausa, nulliparous patient presenting with constipation, uterine pressure, and an enlarged uterus with normal menses likely has what diagnosis

Answer 24

uterine leiomyoma

Question 25

What causes the classic skin findings of peau d'orange in inflammatory breast cancer?

Answer 25

cancer cells obstructing lymphatic drainage

Question 26

What is the cause of cervical intraepithelial neoplasia

Answer 26

HPV | CIN in situ --> squamous cell carcinoma

Question 27

what hormone surge causes the rupture of the dominant follicle

Answer 27

LH

Question 28

Menotropin, human menopausal gonadotrophin, therapy mimics ___ and has what effect when treating anovulation

Answer 28

FSH | formation of the dominant ovarian follicle

Question 29

after menotropin triggers formation and maturation of a dominant ovarian follicle, what is administered to mimic LH and therefore stimulate LH surge and induce ovulation

Answer 29

exogenous human chorionic gonadotropin (hCG)

Question 30

what is the best way to diagnose trichomonas vaginalis

Answer 30

wet mount microscopy of vaginal discharge

Question 31

what complication during a hysterectomy can lead to flank pain and fever

Answer 31

damage to the ureter (since unilateral, the patient can still pee fine)

Question 32

what is a Krunkenberg tumor?

Answer 32

primary gastric cancer that has metastasized to the ovary often presenting with bilateral ovarian lesion

Question 33

what are the histologic features of Krunkenberg tumor

Answer 33

nests of signet ring cells: cells with large amounts of mucin displacing the nucleus

Question 34

what serum tumor marker is elevated in epithelial ovarian cancer

Answer 34

CA-125

Question 35

during postpartum hemorrhage, what artery can be bilaterally ligated to stop the bleeding while still preserving fertility

Answer 35

``` internal iliac (all structures supplied by internal iliac receive collateral blood supply) ```

Question 36

The ovary is covered in _____ epithelial cells

Answer 36

simple cuboidal

Question 37

the fallopian tubes are lined with _____ epithelial cells

Answer 37

simple columnar (both ciliated and nonciliated)

Question 38

the endometrium is comprised of ____ epithelial cells

Answer 38

simple columnar

Question 39

the endocervix is lined with _____ epithelium and the ectocervix is lined with ____ epithelium

Answer 39

endo: simple columnar ecto: stratified squamous, non keratinized

Question 40

the vagina is lined by ____ epithelium

Answer 40

stratified suqamous, nonkeratinized

Question 41

oral contraceptive, multiparity, and breastfeeding are protective against epithelial ovarian cancer, how?

Answer 41

decreasing frequency of ovulation --> decreased frequency of trauma and repair of ovarian surface

Question 42

the ovary receives its blood supply through the vessels that transverse the ______ ligament

Answer 42

infundibulopelvic/suspensory

Question 43

a cystic hygroma, a posterior neck mass, on a newborn is concerning for what diagnosis

Answer 43

Turner syndrome

Question 44

Turner syndrome is characterized by a 45.X karyotype due to loss of _____

Answer 44

paternal chromosome X

Question 45

what is the primary lymph node drainage for the uterus

Answer 45

external iliac

Question 46

what is the primary lymph node drainage for cervix

Answer 46

internal iliac

Question 47

what is the primary lymph node drainage for the vagina

Answer 47

proximal: internal iliac distal: inguinofemoral

Question 48

what is the primary lymph node drainage for the vuvla

Answer 48

inguinofemoral

Question 49

what is the primary lymph node drainage for the ovaries

Answer 49

paraaortic

Question 50

what urinalysis finding is pathognomonic for acute pyelonephritis when accompanied by symptoms of acute UTI

Answer 50

white blood cell casts

Question 51

LH stimulates the _____ cells of the ovarian follicle to produce androgens

Answer 51

theca interna

Question 52

what is seen on wet mount microscopy of vulvovaginal candidiasis

Answer 52

pseudohyphae

Question 53

treatment of vulvovaginal candidiasis

Answer 53

fluconazole

Question 54

____ withdrawal causes endometrial cells to undergo apoptosis, resulting in menstrual bleeding

Answer 54

progesterone

Question 55

how does endometriosis cause infertility and/or retroverted uterus

Answer 55

inflammation --> adhesion formation which can interfere with ovulation and fallopian tube function

Question 56

Malignant infiltration of ______ of the breast can cause skin retractions in breast cancer

Answer 56

suspensory ligaments

Question 57

ovarian torsion clinical features:

Answer 57

sudden onset unilateral pelvic pain, nausea and vomiting, sometimes has a palpable adnexal mass

Question 58

in order to provide anesthesia to most of the perineum a ____ nerve block can be performed by injecting anesthetic intravaginally, medial to the ischial spine and through the sacrospinous ligament

Answer 58

pudendal

Question 59

what is the most common cause of Turner syndrome during gametogenesis resulting in loss of one X chromosome in all of the patients cells

Answer 59

meiotic nondisjunction

Question 60

What is the diagnosis of a uniformly enlarged, globular uterus with the abnormal presence of endometrial glands and stroma in the myometrium

Answer 60

adenomyosis

Question 61

Koilocytosis is a hallmark sign of ____ infection

Answer 61

HPV