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GU/GYN Flashcards

1
Q

R renal artery crosses anterior or posterior to IVC

A

Posterior!

Anterior to renal calyx

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2
Q

L renal v crosses anterior or posterior to aorta

A

Anterior

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3
Q

Which renal v can be ligated due to icnreased collaterals

A

Left renal v

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4
Q

Seminal vesicles are connected to

A

vas deferens

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5
Q

Spermatic cord structures

A

testicular artery, pampiniform plexus, vas deferens, cremasteric muscle, ilioinguinal nerve, genital branch of genitofemoral nerve

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6
Q

calcium oxalate stones are increased in pts whop have had what previous surgery

A

TI resection due to increased oxalate absorption in colon

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7
Q

Struvite stones occur with infections with what bacteria

A

Proteus mirabilis
Urease producing
Cause staghorn calculi

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8
Q

Uric acid stones are increased in pts with what 3 diseases

A

ileostomies
gout
myeloproliferative disorders
They are RADIOLUCENT

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9
Q

Which type of stone is radiopaque

A

Struvite

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10
Q

How to prevent cysteine stones

A

tiopronin

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11
Q

Stones greater than what size are unlikely to pass

A

6 mm

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12
Q

1 testicular tumor

A

seminoma

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13
Q

Seminoma - sensitivity to XRT?

A

Extremely sensitive

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14
Q

Seminoma with AFP elevation

A

Shouldn’t be! Treat like non seminomatous

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15
Q

tx for seminoma

A

orchiectomy and retroperitoneal XRT

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16
Q

Chemo in seminoma - what types and when

A

Reserved for mets or bulky retroperitoneal disesase

cisplatin, bleomycin, VP-16

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17
Q

90% of non seminomatous testicular CA have what markers

A

AFP and b-HCG

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18
Q

At what stage do non seminomatous testicular CA receive adjuvant chemo

A

Stage II or greater

Cisplatin, bleomycin, VP-16

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19
Q

MC site of prostate ca

A

posterior lobe

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20
Q

most common mets for prostate CA

A

bone

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21
Q

what are options if intracapsular prostate CA and no mets (T1 and T2)

A

XRT
OR
radical prostatectomy + pelvic LND (if life span >10 years)

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22
Q

Option for prostate CA with extracapsular invasion or metastatic disease

A

XRT + androgen ablation with leuoprolide, flutamide or bilateral orchiectomy

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23
Q

Leuprolide MOA

A

GnRH agonist

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24
Q

Flutamide MOA

A

testosterone receptor blocker

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25
Q

Stage IA prostate CA found with TURP - tx?

A

nothing

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26
Q

With prostatectomy, how long should it take for PSA to go to 0?

A

3 weeks

If it doesnt decrease get bone scan to check for mets

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27
Q

What should worry you in a pt with prostate CA with increased alk phos

A

mets or extracapsular disease

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28
Q

Most common location for RCC met

A

lung

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29
Q

Radical nephrectomy takes what organs along with the kidney

A

adrenal gland

Also fat, Gerotas fascia, and regional nodes

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30
Q

Partial nephrectomy is indicated in RCC if..

A

pt would require dialysis after nephrectomy (tumor <4 cm, cr > 2.5)

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31
Q

MC tumor in kidney

A

metastasis from breast CA

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32
Q

RCC paraneoplastic syndromes

A

renin, erythropoietin, PTHrp, ACTH, insulin

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33
Q

Tx for transitional cell CA of renal ppelvis

A

radical nephroureterectomy

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34
Q

multifocal and recurrent RCC, renal cysts, CNS tumors, pheochromocytoma

A

Von Hippel Lindau

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35
Q

T1 bladder CA

A

muscle wall not involved

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36
Q

Tx for T1 bladder CA

A

intravesical BCG or transuretheral resection

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37
Q

Tx for T2 or greater bladder CA

A

cystectomy with ileal conduit, chemo and XRT

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38
Q

Chemo for bladder CA

A

MVAC - methotrexate, vinblastine, adriamycin and cisplatin

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39
Q

Squamous cell CA of bladder is assoc with wha kind of infection

A

schistosomiasis

40
Q

What kind of suture for ureteral trauma repair

A

absorable (to avoid stone formation)

41
Q

Where does BPH arise from

A

transitional zone

42
Q

MOA of finasteride

A

5 alpha reductase inhibitors

inhibits conversion of testosterone to dihydrotestosterone which inhibits prostate hypertrophy

43
Q

What is post TURP syndrome

A

hyponatremia secondary to irrigation with water, can precipitate seizures from cerebral edema

44
Q

neurogenic bladder can be caused by a nerve injury above what level

45
Q

neurogenic obstructive uropathy (incomplete emptying) caused by nerve injury below what level

A

T12

Can also occur with APR

46
Q

Tx of uretropelvic obstruction

A

Pyeloplasty

47
Q

Tx of veiscoureteral reflux

A

prophylactic abx and see if child outgrows it

Surgical tx is reimplantation of ureter with long bladderp ortion

48
Q

Most common urinary tract abnormality

A

ureteral duplication

can sometimes see ectopic ureter

49
Q

MC reason for newborn boy not to urinate

A

posterior urethral valves

50
Q

Hypospadias is when urethral opens where

51
Q

Repair for hypospadias

A

At 6 months with penile skin - use foreskin so NOOO circumcision in these pts!

52
Q

Varicocele is worrisome for

A

Renal cell CA

left gonadal vein inserts into left renal vein – obstructure by renal tumor causes varicocele

53
Q

Sterile epidydimitis can occur secondary to

A

Increased abodominal straining

54
Q

Tx of failure of closure of urachus

A

Resection of sinus/cyst and closure of bladder, relieve lbladder outlet obstruction

55
Q

RBC casts seen in

A

glomerulonmephritis

56
Q

WBC casts are seen in

A

pyelonephritis or glomerulonephritis

57
Q

tx for priapism

A

aspiration of cprpus cavernosum with diliute epinephrine or phenylephrine

58
Q

SCC of penis tx

A

penectomy with 2 cm margin

59
Q

phimosis found at time of laparotomy tx

A

dorsal slit

60
Q

What ligament allows anteversion of uterus

A

round ligament

61
Q

what ligament contains uterine vessels

A

broad ligament

62
Q

infundibular ligament contains what

A

ovarian artery, nerve and vein

63
Q

Can see most pregnancies on US at what stage

64
Q

CT delivers how many rads

A

2.5 rad (0.025 Gy)

65
Q

Fetal pole usually seen with beta HCG at

66
Q

Gestational sac usually seen with beta HCG at

67
Q

MC site of ectopic pregnancy

A

ampullary portion of fallopian tubes

68
Q

MC site of endometriosis

69
Q

1 primary vaginal CA

A

squamous cell CA

70
Q

DES (diethylstilbestrol) can cause what CA?

A

clear cell CA of vagina

71
Q

Majority of vulvar CA are what type

A

squamous cell CA

72
Q

<2 cm vulvar cA: treatment?

A

WLE and ipsilateral inguinal node dissection, 2 cm margins

73
Q

Tx of >2 cm vulvar ca

A

Stage II or greater

Radical vulvectomy - bilateral labia with bilateral inguinal dissections, postop XRT if close margins <1 cm

74
Q

worst prognosis ovarian CA

A

clear cell

75
Q

ovarian CA stage III

A

spread throughout abdomen

76
Q

ovarian CA stage I

A

one or both ovaries only

77
Q

tx for ovarian CA

A 
TAH BSO for all stages PLUS 
plevic and paraaoritc LN dissection
omentectomy
4 quadrant washes 
chemo
78
Q

chemo for ovarian CA

A

cisplatin and paclitaxel

79
Q

what is a krukenberg tumor and what does path show

A

stomach CA that has metastasized to ovary

pathology classically shows signet ring cells

80
Q

what is Meiges syndrome

A

pelvic ovarian fibroma that causes ascites and hydrothorax

81
Q

MC malignant tumor in female genital tract

A

endometrial CA

82
Q

worst prognosis endometrial CA

A

clear cell

83
Q

what stages receieve mandatory XRT in endometrial CA

A

Stage III/IV

84
Q

Endometrial CA in cervix is what stage

85
Q

Tx of stage I or II endometrial CA

A

TAH + BSO or XRT

86
Q

Endometrial CA in vagina, peritoneum and ovary - what stage

87
Q

Cervical CA assoc with what HPV subtypes

88
Q

Where does cervical CA travel to (what nodes) first

89
Q

stage I and IIa cervical CA - what tx?

90
Q

stage IIb to IV cervical CA - what tx?

A

chemo - XRT

91
Q

Cervical CA in upper 2/3 of vagina, waht stage?

92
Q

Cervical CA in bladder and rectum, what stage?

93
Q

ovarian cysts in post menopausal patient - what characteristics mandate oophorectomy with intraoperative frozen sections

A 
septated
increased vascular flow on doppler
solid components
OR
papillary projections
94
Q

Tx of abnormal uterine bleeding if <40 years old

A

clomiphene citrate (anovulation) or GnRH agonists such as leuoprolide (leiomyoma)

95
Q

markers for granulosa cell tumor

96
Q

presence of AFP with ovarian neoplasm strongly suggests what kind of tumor

A

endodermal sinus tumor

97
Q

elevated LDH and ovarian tumor is likely

A

dysgerminoma

ABS (23 decks)

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