LC Exam 1 Week 2 Flashcards

1
Q

Phases of spermatogenesis

A
  1. Proliferative (self renewal as well)
  2. Meiotic
  3. Spermiogenic (maturation)
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2
Q

Progression of spermatogenesis

A

Spermatogonia (2N, 2C) -> 1˚ (2N, 4C) -> 2˚ (1N, 2C) -> Spermatid (1N, 1C) -> Mature spermatozoon

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3
Q

Types of spermatogonia

A

Adark (self renewing) -> Apale -> B
All 2N
Give rise to 1˚

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4
Q

Spermiogenesis phases

A
  1. Golgi phase (to head, acrosomal vesicles)
  2. Cap phase (vesicles will become cap)
  3. Acrosomal phase
  4. maturation phase (centrioles to tail, attract mito)
    extra cytoplasm cast off (may stimulate new round)
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5
Q

Spermiation

A

End of spermiogenesis

Released into lumen by sertoli cell

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6
Q

Epididymis function

A

Mature sperm
Head: concentrait
Body: maturation (mobility, fertilization capability)
Tail: storage

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7
Q

Disorders that decrease SHBG

A

Insulin resistance
Metabolic syndrome
Diabetes
Normal aging

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8
Q

Pituitary related hypogonadism: levels and examples

A
Low T and low FSH/LH
Prolactinoma
Tumor/mass effect
Hemachromatosis (classically: bronze skin)
Autoimmune hypophysitis
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9
Q

OSA effects on testosterone

A

Mildly decreased T levels
Erectile dysfxn (decreased NO, cGMP)
CPAP

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10
Q

Acquired hypertrophic hypogonadism

A
Traums/torsion
Mumps orchitis
Alcohol (direct toxin)
Diabetes
Radiation/chemo
Autoimmune testicular failure
Gonadotrope pituitary tumor (high FSH, +/- LH, low T)
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11
Q

Recommended for normal/low

A

Diet/lifestyle modification

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12
Q

Cardiac risk and testosterone therapy

A

Appears to be within the first 90 days

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13
Q

Low FSH/LH, testosterone

A

Genetic: Kallman
Acquired: narcotics, GC’s, hemochromatosis, tumor, XRT, stress, illness
Not real: OSA, get T assay (SHBG)

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14
Q

High FSH/LH, low testosterone

A

Primary testicular failure (XXY, trauma)

Gonadotrope pituitary tumor

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15
Q

Tunica vaginalis

A

Peritonem taken with descent

Injury can fill with fluid (hydrocele)

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16
Q

Tunica albugenia

A

Fibrosis, tough, capsule

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17
Q

Cryptorchidism

A

Most: superficial inguinal canal
Wrong temperature for sperm production
Usually unilateral, but bilateral atrophy w/out tx (infertility)
5x risk of seminoma
Orchiopexy by 2 years decreases risk to 2x

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18
Q

47XXY pathogenesis

A

Dysgenesis of seminiferous tubules: low inhibin, high FSH

Abnormal Leydig: low T, high LH, high E2 conversion

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19
Q

Varicocele

A

90% of the time left side (due to left renal artery)
Bag of worms appearance
Assoc. with left sided renal cell carcinoma

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20
Q

Testicular torsion

A

Venous before arterial
Blood pumps in, can’t pump out
Failure of testes to attach to inner lining of scrotum (via process vaginalis)

21
Q

Inflammatory dz leading to orchitis

A
  1. Chlamydia (D-K), gonorrhea (young)
  2. E. coli and pseudo (old)
  3. Mumps (1 wk post parotid, unilateral)
  4. Syphilis
  5. Gran/autoimmune (TB)
22
Q

Three general types of testicular tumors

A
  1. Germ cell tumors (malignant)
  2. Sex cord stromal tumors (benign or malignant)
  3. Lymphoma: diffuse large B-cell (>60 y/o)
23
Q

Germ cell tumors

A

Seminoma (good prognosis, large cells, clear cytoplasm, central nuclei)
Non-seminoma:
Embryonal carcinoma (primitive, glandular, necrosis, differentiation with chemo, AFP and/or ß-hCG)
Yolk sac (Schiller-Duval bodies, AFP)
Choriocarcinoma (ß-hCG, FLßT)
Teratoma (malignant in males, AFP and/or ß-hCG)
Mixed (most common)

24
Q

Sex cord stromal tumors

A

Usually benign
Leydig cell tumor: androgen secretion (precocious puberty, gynecomastia, Reinke crystals)
Sertoli cell: tubules, clinically silent

25
Q

Condyloma acuminatum

A

HPV 6, 11
Koilocytic change (raisin nucleus)
Benign warty growth

26
Q

Verrucous carcinoma

A

HPV associated
More destructive
Non-met

27
Q

In situ SCC of the penis

A
  1. Glans: erythroplasia of Queyrat (erythroplakia)

2. Shaft: Bowen disease (leukoplakia)

28
Q

Testis cancer serum markers

A

AFP
ß-hCG
Placental like alk phos
LDH

29
Q

Penile malignancies

A

Epithelial (95%): SCC, Basal cell, melanoma

Mesenchymal (5%): tissue sarcomas

30
Q

BPH

A

usually around transition zone (periurethral)
Age related change
Related to DHT stimulation on stromal and epithelial cells resulting in hyperplastic nodules

31
Q

BPH treatment

A

alpha-1 antagonist: terazosin

5alpha reductase inhibitors

32
Q

Prostate inflammation

A

Acute: lymphs, STI/UTI bugs
Chronic: mononuclear, granulo form, atrophy assoc.

33
Q

Prostatic atrophy

A
Increased cancer risk
concrete formation (associated with chronic inflammation)
34
Q

Prostatic carcinoma

A
Western/environment risk
Biopsies (blind, random) gold standard
Multifocality
Gleason grading: based soley on architecture
Mets to spine
20-30 years for natural history
35
Q

Menstrual cycles phases

A
  1. Follicular phase
  2. Ovulation
  3. Luteal phase
36
Q

Primordial follicles

A

Oogonia + somatic cells (pre-granulosa cells)

37
Q

Ovarian/pituitary hormones

A

LH stimulates theca cells to produce androgens

FSH stimulates granulosa cells to convert androgens to E2

38
Q

Oogenesis

A

1˚ oocyte begin meiosis I during fetal life and finish just prior to ovulation (prophase = pause)
Meiosis 1 results in 2˚ plus polar body

39
Q

Corpus luteum

A

Progesterone secretion
Small/large cells + capillaries
Some estrogen
Stablized by hCG from placenta

40
Q

Follice =

A

oocyte + granulosa cell

41
Q

FSH an LH functions in menstrual cycle

A

FSH: stimulates granulosa proliferation
LH: fosters granulosa lutenization

42
Q

Is atresia related to selection of the dominant follicle?

A

NO

43
Q

Lymph drainage of lady bits

A

Vulva + lower 1/3 vagina (UGS) = inguinal, para-aortic

Cervix + upper 2/3 vagina (parameso) = iliac

44
Q

Epithelial progression through female tract

A

Vulva: keratinizing squamous
Vagina: non-keratinizing squamous
Cervical, endocervical: glandular (singular)
Uterus: glandular (multi)

45
Q

Vulva condyloma

A

6, 11

Koilocytes, hyper parakartosis

46
Q

Vulva infection

A

Trichomonas -> strawberry cervix
Candida -> pH change, curdlike d/c, itch
Actinomyces -> sulfer granules, copper IUD

47
Q

VIN

A

Leukoplakia, 16, 18

  1. HPV associated SCC - BM invasion
  2. Non-HPV (Lichen sclerosis, thin parchment paper)
48
Q

Paget extramammilary dz

A
PAsKET'S dz
PAS+
KEraTin +
S100- (otherside of ')
Ery, puritic, ulcerated
49
Q

Melanoma of the vulva

A

PAS-
Keratin-
S100+