High Yield Topics-Reproductive Flashcards
an example of dysplasia and is a precursor to cervical cancer
CIN (Cervical intraepithelial neoplasia)
Gonadotropin Release Hormone (GnRH) is released at a steady rate but begins to be released in a pulses starting
puberty
LH work on what cell, what enzyme works there, and what product hormone is produced?
- theca cell
- desmolase
- androstenedione
FSH work on what cell, what enzyme works there, what hormone comes in, and what hormone leaves in that enzyme?
- granulosa cell
- aromatase
- androstenedione
- 17/B estradiol (estrogen)
Uterine cycle is divided into what three phases?
- Proliferative
- Secretory
- Menstrual
Ovarian cycle is divided into what two phases?
- Follicular Phase
2. Luteal Phase
The predominant hormone during follicular phase
estrogen
What does estrogen stimulate in the endometrium
proliferation
Ovulation occurs following a high level of estrogen causing ____ surge
LH
What is the remnant after primary oocyte is released on ovulation day (day 14)?
corpus luteum
What does granulosa cells in corpus luteum begin to secrete during luteal phase? what is it’s function?
- Inhibin
- inhibits FSH release from anterior pituitary
What does estrogen stimulate in the endometrium
proliferation
What phase of uterine cycle is most characterized by coiled/spiral uterine glands (secrete glycogen-rich mucus) and tortuous spiral arteries that extend from the deeper layers to the uterine lumen?
Secretory Phase
Corpus luteum is replaced by ______ if no implantation occurs, which doesn’t make any hormones
Corpus albicans
The predominant hormone during luteal phase
progesterone
Progesterone during luteal phase is mainly produced by
corpus luteum
What does progesterone do to gonadotropins?
decrease LH and FSH levels
What does progesterone do to body temp?
increase
What does progesterone do in the endometrium?
stimulate glandular secretions and spiral artery development to make implantation more possible
How does progesterone inhibit sperm entry to uterus
production of a thick cervical mucus
- progesterone favors implantation > conception
Withdrawal of what hormone causes endometrial cells to undergo apoptosis, resulting in collpasing of spiral arteries (menstrual bleeding)?
Progesterone
A disorder characterized by elevated LH levels –> excess androgen production by theca cells –> follicles are prevented from developing –> decreased progesterone production & excess androgen gets converted to estrone (adipose tissue) –> estrone inhibits GnRH release –> prevents ovulation
PCOS
What is hypothesized to increase LH:FSH ratio in PCOS leading to excess androgen synthesis?
Hyperinsulinemia and/or insulin resistance
Peripheral adipose tissue converts androstenedione to what form of estrogen?
Estrone
A disorder with clinical features that include obesity, acanthosis nigricans, menstrual irregularities, acne, hirsutism, and enlarged BILATERAL cystic ovaries
PCOS
PCOS patients are at risk for what uterine condition due to chronic estrogen (estrone) stimulation with low level of progesterone secretion?
Endometrial Hyperplasia or Endometrial carcinoma
First line of therapy for PCOS; why?
Weight Loss & diet to decrease peripheral estrone formation (more body fat means more estrone formation)
Second line of therapy for PCOS; prevents endometrial hyperplasia caused by unopposed estrogen
OCPs (has progesterone)
An estrogen receptor modulator that DECREASES negative feedback inhibition on the hypothalamus by circulating estrogen (estrone made by adipose tissue), thereby increasing gonadotropin production; tx for infertility in PCOS patients
Clomiphene
What CONFIRMS menopause diagnosis?
↑↑ FSH with low estrogen
Menopause is diagnosed after ___ months of amenorrhea
12
Average age of menopause
51
The source of estrogen after menopause
peripheral conversion of androgens
What is a concern of early menopause
Premature ovarian failure (POF)
Decreased estrogen, inc FSH, LH, signs of menopause after puberty but before 40
Premature ovarian failure (POF)
A disease characterized by a lack of secondary sex characteristics due to ↓ GnRH, FSH, LH, testosterone; can occur in both males and females; presents with anosmia (unable to detect smell) and infertility
Kallmann Syndrome
What causes ↓ synthesis of GnRH in the hypothalamus in Kallmann Syndrome?
Defective migration of neurons
What causes anosmia in Kallmann Syndrome?
Failure of olfactory bulb development
Androgens are converted into estrogens in what places/organs?
- Ovaries
- Testes
- Peripheral (adipose) tissues
- Placenta
Inability to synthesize estrogens from androgens leading to ↑ serum androgens during pregnancy, resulting in “ambiguous” external genitalia in female infants and maternal virilization (masculinization)
Aromatase deficiency
A disorder characterized with no upper vagina or short vagina; patients are 46,XX females w/ NORMAL ovaries, fully developed 2° sexual characteristics, and 1° amenorrhea (due to a lack of uterine development)
Müllerian aplasia/agenesis
aka. Mayer-Rokitansky-Küster-Hauser syndrome
In females, _________ fuse to form the fallopian tubes, uterus, cervix, and upper vagina; disruptions of this process can lead to a variety of Müllerian tract anomalies
paramesonephric ducts
aka. Müllerian ducts
Incomplete fusion of paramesonephric ducts (Müllerian ducts) can lead to what Mullerian tract anomalie characterized by an indentation in the center of the fundus?
Bicornuate uterus
What is responsible for the regression of the paramesonephric (Mullerian) ducts and suppresses female internal reproductive organ development?
Mullerian Inhibiting Factor (MIF)
The ______ gene on the Y chromosome codes for the testis determining factor (TDF), which stimulates tests development
SRY
Cells that produce Mullerian Inhibiting Factor
Sertoli cells
What stimulates the development of mesonephric ducts (Wolffian ducts) into INTERNAL male reproductive organs?
testosterone
What stimulates the development of the EXTERNAL male genitalia?
DHT
What cells produce testosterone necessary for the development of Wolffian ducts?
Leydig Cells
A disorder caused by a defect in androgen RECEPTOR, resulting in normal-appearing female (46,XY DSD); presents w/ female external genitalia and rudimentary (not connected to uterus/cervix) vagina but without axillary/pubic hair; uterus and fallopian tubes are absent due to persistence of anti-Müllerian hormone from testes (normal, functioning)
Androgen insensitivity syndrome
- 46, XY but appears like a normal female!!
Testosterone and estrogen levels in androgen insensitivity syndrome
- increased or decreased?
both are increased
- testosterone is produced normally by the testes, but there are no testosterone receptors
Inability to convert testosterone to DHT; AR inheritance; presents with ambiguous genitalia (due to low DHT) until puberty (when ↑ testosterone causes ↑ growth of external genitalia)
5α-reductase deficiency
Testosterone/estrogen levels are (increased/decreased/normal) in 5α-reductase deficiency
NORMAL
Internal genitalia is (normal/abnormal) in 5α-reductase deficiency
NORMAL
LH level is (increased/decreased/normal) in 5α-reductase deficiency
NORMAL
Developmental Milestones for 2 months
*STUDY AID: 2 = February (Valentine’s Day)
- Lift head up
- Social smile
- STUDY AID: “Lift you head up” for a kiss and “social smile”
Developmental Milestones for 4 months
*STUDY AID: 4 = April (April Fool’s)
- Rolling over
- Laughter
- STUDY AID: “Rolling over” in “laughter”
Developmental Milestones for 6 months
*STUDY AID: 6 = June (Summer Picnic)
- Sitting Up
- Stranger Anxiety
- STUDY AID: “sitting up” at a picnic and “stranger anxiety” at mom’s weird work friends
Developmental Milestones for 12 months
*STUDY AID: 12 = December (Christmas)
- Walking
- Separation Anxiety
- STUDY AID: “walking” over to Santa Claus, but getting “separation anxiety”
Cubes stacked can be estimated for each age using what formula?
Age (in yr) x 3
What age uses about 50-200 words?
age 2 yr
What age uses about 300+ words and understands 1000 words?
age 3 yr
What age uses complete sentences and prepositions?
age 4 yr
What age can tell detailed stories (legends)?
age 4 yr
What age cooperatively play and has imaginary friends?
age 4 yr
What age can start to roll?
4 months
What age can start to stand?
10 months
What age can start climbing stairs?
18 months
The presence of endometrial glands and stroma “outside” the uterus; present with dysmenorrhea, pelvic pain, back pain, bleeding, dyspareunia (painful sex), diarrhea/constipation, and/or infertility
Endometriosis
Endometriosis most commonly occurs in the
ovary (often bilateral)
- also common in fallopian tube, peritoneum
Endometriosis in ovary appears as ______ while endometriosis in peritoneum appears as _______
- “chocolate cysts” (blood-filled)
- “powder-burn” reddish black lesions
Endometrial tissue can end up outside the uterus via what two ways?
- Retroverted uterus –> retrograde flow of endometrial tissue
- Transportation via lymphatic system
The size of uterus is (increased/normal/decreased) in endometriosis
NORMAL
- uterus is not affected
There is an increased risk of _____ at the site of endometriosis
Carcinoma
Benign smooth muscle tumor that is estrogen sensitive, resulting in pelvic pressure, heavier menses, asymmetrically enlarged nodular uterus, and/or constipation; most common tumor in females
Leiomyoma (fibroid)
Heavy bleeding caused by uterine fibroid may lead to what type of anemia?
Iron deficiency
Peak age occurrence of uterine fibroid
20-40 (child bearing age)
Histological finding seen in leiomyoma
Whorled pattern of smooth muscle bundles with well demarcated borders
Adenomyosis is the “extension” of endometrial tissue (glandular) into uterine “myometrium” due to hyperplasia of the endometrium basal layer; presents with dysmenorrhea, abnormal uterine bleeding, and UNIFORMLY enlarged uterus
Adenomyosis
Appearance of biopsy of uterus with adenomyosis
Uniformly enlarged uterus w/ normal-appearing endometrial tissue
Adhesions (due to scarring) or fibrosis of the endometrium; presents with infertility, recurrent pregnancy loss, abnormal uterine bleeding, and pelvic pain
Asherman Syndrome
The most common cause of Asherman Syndrome
dilation and curettage of the intrauterine cavity
- iatrogenic
D & C (dilation and curettage) of the intrauterine cavity can cause secondary amenorrhea by
accidentally removing the stratum basalis (regenerative layer)
A mass that develops around the uterus (ovaries, fallopian tube, etc.)
Adnexal Mass
Presents with STREAK ovaries (ovarian dysgenesis), amenorrhea, and infertility; have short stature, webbed neck, shield chest (widely spaced nipples), and low posterior hairline
Turner Syndrome
The most common cardiac comorbidity of Turner syndrome; associated with aortic stenosis (not due to aging)
Bicuspid Aortic Valve (AV)
The second most common cardiac comorbidity of Turner syndrome; associated with femora < brachial pulse
Coarctation of Aorta
Turner Syndrome can have what different types of karyotype?
- 45, XO (complete monosomy)
- 45, X/46, XX (mosaicism)
Complete monosomy or 45, XO karyotype in Turner syndrome is caused by
meiotic nondisjunction
Mosaic karyotype or 45, X/46, XX in Turner syndrome is caused by
loss of sex chromosome in some but not all cells
Turner syndrome in neonate present with
- lymphedema
- cystic hygromas (swollen neck with a huge sac)
Also presents with lymphedema, horseshoe kidney, high-arched palate, shortened 4th metacarpals, and cystic hygromas
Turner syndrome
What is the best way for Turner Syndrome to get pregnant?
IVF
The most common type of ovarian malignancy linked to the frequency of trauma and repair at the ovarian surface
Epithelial ovarian cancer
- arises from the surface epithelium cells of the ovary
Epithelial tumors are typically _____ (lined by _____ epithelium natively found in fallopian tubes
OR
_______ (lined by ______ epithelium natively found in cervix
Serous; mucinous
What ovarian cancer has the histological finding of anaplasia of epithelial cells (poor cellular differentiation) with invasion into the stroma, along with papillary formations with cellular atypia?
Epithelial ovarian cancer
What can be used as a serum marker to monitor response to therapy/relapse of EPITHELIAL ovarian cancer?
CA-125 (not for screening)
OCPs, multiparity, and breastfeeding (↑ risk/↓ risk) for ovarian cancer
↓ risk
Advanced age, BRCA 1/2 mutations, nulliparity, endometriosis, early menarche/late menopause, and infertility (↑ risk/↓ risk) for ovarian cancer
↑ risk
A gastric tumor that has metastasized to the ovary and can present with unintentional weight loss, epigastric pain, and adnexal masses
Krukenberg tumor
What ovarian tumor has large amounts of mucin-filled cells with peripherally displaced nuclei, resulting in a signet (flat) ring appearance?
metastatic tumor (Krukenberg tumor)
What ligament of the ovary contains the ovarian artery, vein, lymphatics, and nerves?
suspensory ligament
aka. infundibulopelvic ligament
What artery is the major blood supply to the ovary and must be ligated during an oophorectomy to prevent heavy bleeding?
Ovarian artery
A sex-cord stromal tumor of the ovary that secrete ESTROGEN and INHIBIN B and can cause endometrial hyperplasia; grossly, the tumor appears yellow due to the lipid content in theca cells
Granulosa cell tumor
What sex-cord stromal tumor of the ovary histologically shows Call-Exner bodies (resemble primordial follicles)?
Granulosa cell tumor
A sex-cord stromal tumor of the ovary that secrete TESTOSTERONE and is usually large; presents with signs of virilization (masculinization)
Sertoli-Leydig cell tumor
What sex-cord stromal tumor of the ovary histologically shows tubular structures lined by round Sertoli cells and surrounded by a fibrous stroma?
Sertoli-Leydig cell tumor
The most common germ cell tumor of the ovary; divided into mature and immature types
Teratoma
Ovarian teratomas occur most frequently in females age 10-30.
10-30 (young females)
(Mature/Immature) teratoma commonly contains hair, teeth, skin, or thyroid tissue and involves all 3 germ layers; benign
Mature Cystic Teratoma
(Mature/Immature) teratoma commonly contains fetal tissue (neuroectoderm); Malignant and aggressive
Immature Teratoma
Most common cause of scrotal enlargement in males due to dilated pampiniform plexus veins caused by increased venous pressure; presents with “bag of worms” like sensation
Varicocele
Varicocele can cause infertility due to (increased/decreased) temperature caused by dilated pampiniform plexus veins
Increased
Varicocele occurs most often on the (right/left) side due to increased resistance to venous drainage from (R/L) gonadal vein into (R/L) renal vein
LEFT
Varicocele gets bigger by _____ maneuver
valsalva
Varicocele (does/does not) transilluminate
does not
Congenital hydrocele (scrotal swelling due to fluid accumulation) in infants is caused by an incomplete obliteration of the
processus vaginalis
Results when serous fluid accumulates within the tunica vaginalis; presents as a painless scrotal swelling in infant males
Congenital hydrocele
Congenital hydrocele in infants is caused by an incomplete obliteration of the
processus vaginalis
Hydrocele (does/does not) transilluminate
does
Unilateral, lower abdominal pain associated with ovulation; can mimic appendicitis
mittelschmerz
- means middle pain (midway pain)
What presents with lower quadrant pain, amenorrhea, vaginal bleeding, and positive B-hCG?
Ectopic pregnancy
What presents with a sudden-onset, severe, unilateral lower quadrant pain + nausea/vomiting and unilateral adnexal mass?
Ovarian Torsion
What presents with a sudden-onset, severe, unilateral lower quadrant pain immediately after sexual activity?
Ruptured Ovarian Cyst
What presents with fever/chills, vaginal discharge, and lower quadrant pain + cervical “motion” tenderness?
Pelvic Inflammatory Disease
Twisting of the infundibulopelvic ligament, often due to the weight of a large adnexal mass; occlusion of the blood and nerve supply to the ovary results in severe, acute pelvic pain and ovarian ischemia
Ovarian Torsion
PID is most frequently caused by
Neisseria gonorrhoeae and Chlamydia trachomatis
PID ↑ the risk of ____ by causing scarring of the fallopian tubes (salpingitis)
Ectopic pregnancy
Tx for PID must always be what two drugs?
Ceftriaxone (cephalosporin to cover both organisms) + doxycycline or azithromycin
Causes cutaneous and genital warts as well as benign and malignant cervical intraepithelial neoplasia
Human Papillomavirus (HPV)
A hallmark sign of HPV (both high & low risk types) infection; pyknotic, superficial squamous cells with a dense, irregularly staining cytoplasm and perinuclear halo-like clearing
Koilocytes
Atypical squamous cells and is classified as low grade “squamous” intraepithelial lesions or high-grade “squamous” intraepithelial lesions
Cervical Intraepithelial Neoplasia (CIN)
- Cervical dysplasia that can potentially become cervical cancer/carcinoma
CIN is considered _____ if extending <1/3 of the epithelium
Low grade
CIN is considered _____ if extending beyond >1/3 of the epithelium
High grade
What signifies invasive CIN?
Beyond basement membrane invasion
The strongest risk factor for development of cervical dysplasia and invasive cervical carcinoma
HPV 16, 18, 31, 33
- early onset of sexual activity or multiple partners introduce them!
Coinfection with _____ allows HPV infection to persist and enhances expression of HPV oncogenes, increasing the risk for cervical dysplasia/cancer
HIV
Human papillomavirus (HPV) oncogenicity relies on the viral proteins ___ and ____, which inhibit cell cycle regulatory proteins (tumor suppressors) p53 and Rb. This allows cells infected with HPV to undergo unchecked cellular proliferation and evasion of apoptosis
E6; E7
What kind of contraceptive is extremely important for preventing STIs, including HPV?
Barrier Contraceptives (ex. condom)
Pts infected with carcinogenic strains of HPV (16, 18, 31, 33) are at risk for what cancer?
SCC of the cervix
Competitive inhibitors of estrogen binding to ERs. They can have “agonist” or “antagonist” effects depending on the specific tissue.
Selective ER modulators
- Tamoxifen
- Raloxifene
What inhibits lactation during pregnancy despite increased prolactin secretion as pregnancy progresses?
Progesterone (secreted first by corpus luteum and later by the placenta)
A selective ER modulator that has an estrogenic effect on the uterus and can cause endometrial hyperplasia and cancer; it works as an antagonist in breast tissue
Tamoxifen
Typically presents as an irregularly shaped, adherent breast mass, most commonly in the upper outer quadrant
Invasive breast carcinoma
Malignant infiltration of ________ of the breast can cause skin retractions/skin dimpling
suspensory ligaments
A type of breast cancer characterized by ducts distended by pleomorphic cells with prominent central necrosis that DO NOT penetrate the basement membrane
Ductal carcinoma in situ
What is the “precursor” to invasive ductal carcinoma?
Ductal carcinoma in situ
Characterized histologically by a cellular or myxoid stroma that encircles and sometimes compresses epithelium lined glandular and cystic spaces; the most common BENIGN tumor of the breast
Fibroadenomas
A proliferation of papillary cells in a cyst wall or duct that may contain focal atypia. It is the most common cause of bloody nipple discharge and typically presents without breast masses or skin changes
Intraductal papilloma
A treatment for infertility that acts like FSH and triggers the formation of a dominant ovarian follicle
Menotropin (human menopausal gonadotropin)
______ infusion of GnRH induces FSH and LH release
Pulsatile
______ infusion of GnRH suppresses FSH and LH release and subsequently suppresses gonadal fxn
Nonpulsatile (constant)
All hormone-containing contraceptives prevent pregnancy through the actions of _______
progestins
The main mechanism of contraceptives with progestins is inhibiting ______ by decreasing FSH and LH synthesis in the anterior pituitary
ovulation
A protein that binds to and transports androgens and estrogen to tissues
Sex Hormone-Binding Globulin (SHBG)
The effect of hyperinsulinemia on Sex Hormone-Binding Globulin (SHBG) concentration
Decrease
- hyperinsulinemia inhibits the production of SHBG in the liver
Patient with a ruptured ovarian cyst will most likely accumulate fluid in what location?
Rectouterine pouch (space b/w rectum and uterus)
Rectouterine pouch is aka.
Pouch of Douglas
Spindle-shaped cells most likely correspond to what type of cell?
fibroblasts
What female pelvic ligament carries ovarian artery, vein, nerves, and lymphatics?
suspensory ligament
Suspensory ligament is aka.
Infundibulopelvic (IP) ligament
What ligament is affected during ovarian TORSION?
suspensory (Infundibulopelvic) ligament
Buccal mucosal cells with a single dark body attached to the nuclear membrane; absent in Turner syndrome with karyotype 45, XO
Barr body
Mosaicism seen in Turner Syndrome with karyotype 45, XO/46, XX is caused by what mutation?
Postzygotic Mitotic Nondisjunction
The failure of sister chromatids to separate during mitosis of an embryonic cell, which leads to monosomy in some but not all daughter cells
Postzygotic Mitotic Nondisjunction
What is almost always associated with vaginal bleeding AFTER menopause due to excessive cell growth and proliferation of endometrial glands?
Endometrial Carcinoma
- Not bleeding from endometrial shedding due to hormonal cycle!
The triad of ascites, pleural effusion, and an ovarian fibroma indicates
Meigs syndrome
Eosinophilic cytoplasmic inclusions found in Leydig cells
Reinke crystals
Patients with Turner syndrome are at increased risk for what MSK complication due to estrogen deficiency caused by ovarian dysgenesis?
Osteoporosis
Forms when a Graafian follicle fails to ovulate and continues to grow instead; benign and presents as a single fluid-filled; regresses spontaneously
Follicular cyst
Presents with a gray-white vaginal discharge with “fishy” odor
Bacterial Vaginosis
Bacterial Vaginosis is caused by an overgrowth of what anaerobic gram-variable rod?
Gardnerella vaginalis
Squamous epithelial cells covered with bacterial organisms that are seen on wet mount microscopy or cytology of Bacterial Vaginosis
Clue cells
Preferred Tx options for bacterial vaginosis (2)
Metronidazole
Clindamycin
Pelvic floor strengthening exercises (ex. Kegel) target what muscle to improve urinary incontinence by supporting around the urethra and bladder?
Levator Ani
A common symptom during pregnancy, which occurs due to ↑ intra abdominal pressure and ↓ urethral tone caused by pregnancy hormones
Stress urinary incontinence
Lymph from the (scrotum/testes) drains to the superficial inguinal lymph nodes
Scrotum
A PAINLESS, solid scrotal mass should be considered _________ until proven otherwise!
testicular cancer
Testicular tumors (do/do not) transilluminate
DO NOT
(nonseminoma/seminoma) germ cell testicular tumors are composed of partially differentiated germ cells (made up of more than one type of cell), which often retain the ability to secrete hCG and alpha-fetoprotein (AFP)
Nonseminoma
Presents with tall stature, gynecomastia, small and firm testes, and intellectual disability; AZOOSPERMIA
Klinefelter Syndrome (47, XXY)
The most common mechanism/mutation causing Klinefelter Syndrome (47, XXY)
Nondisjunction during meiosis
Testosterone, estrogen, and gonadotropin (FSH, LH) levels in patients with Klinefelter syndrome (47, XXY)
- answer as either high or low
Testosterone: Low
Estrogen: high (gynecomastia)
FSH: high
LH: high
Benign prostatic hyperplasia can be medically treated with what 2 types of drugs?
- a-adrenergic blockers
2. 5-a reductase inhibitors
A drug that block the conversion of testosterone to DHT in prostate; ↓ prostate volume in pts with BPH and relieve the fixed component of bladder outlet
5-a reductase inhibitors
- finasteride
- dutasteride
A nonsteroid anti-androgen that acts as a competitive inhibitor of testosterone receptors. It is used in combination w/ long-acting GnRH agonists for the Tx of prostate cancer
Flutamide
The most common site of prostate cancer metastases due to hematogenous seeding
Lumbosacral spine
Prostate cancer spreads to the lumbosacral spine via the _______ which communicates with vertebral venous plexus
prostatic venous plexus
An x-linked disorder that presents with a long, narrow face, a large jaw and ears, and prominent forehead, and LARGE testes; have developmental delay and intellectual disability findings that overlap w/ anxiety disorders, autism, and ADHD
Fragile X Syndrome (FXS)
- STUDY AID: looks like an elf!
Fragile X Syndrome (FXS) is caused by an unstable expansion of Trinucleotide repeats of _____ on _____ gene
CGG; FMR1
The major complication of prostatectomy or injury to the prostatic plexus
Erectile Dysfunction (ED)
Lymph from the (scrotum/testes) drains into the para-aortic nodes
testes
Caused by an infection with low-risk HPV strains 6 and 11; presents as vulvar and vaginal warts
Condylomata Acuminata
aka. anogenital warts
The most common location of CIN and cervical cancer; the transitional area between the ectocervix and endocervix
Squamocolumnar junction
- Ectocervix (non-keratinized stratified squamous epithelium)
- Endocervix (simple columnar epithelium with tubular glands)
Besides cervical SCC, HPV infection is risk factor for what other cervical cancer?
Cervical Adenocarcinoma
Skin-colored, scaly, cauliflower-like papules on the elbows, knees, fingers, and/or palms of children/adolescents
Verruca Vulgaris
aka. Common Warts
Verruca vulgaris is caused by what virus?
HPV (strains 1,2,4)
HPV is
- (enveloped/noneveloped)
- (ssRNA/dsDNA)
- (circular/linear genome)
- (helical/icosahedral capsid)
- Nonenveloped
- dsDNA
- circular genome
- icosahedral shaped capsid
