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Designated study period: daily cards > March 25 - Repro > Flashcards

March 25 - Repro Flashcards

1
Q

Endometrium in phases of menstrual cycle

A

Proliferative phase

  • estrogen driven
  • straight short endometrial glands with compact stroma
  • gland:stroma ratio less than 1

Secretory/luteal phase

  • progesterone driven
  • decidualization, preparing uterus for implantation
  • dilated, coiled glands with increased gland to stroma ratio
  • vascularized edematous stroma
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2
Q

Congenital rubella syndrome

A
  • microcephaly and mental retardation
  • cataracts, deafness (cataracts present as white pupils)
  • PDA, pulmonic stenosis
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3
Q

MMR vaccine

A

All three components are live attenuated

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4
Q

Hep A vaccine

A

killed virus

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5
Q

Rabies vaccine

A

killed virus

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6
Q

Porstatic plexus

A

Lies within the fascia surrounding the prostate. Originates from the inferior hypogastric plexus. Includes cavernous nerves which innervate the corpora cavernosa of the penis and urethra and parasympathetics resonsible for erection. Damage during prostatectomy can cause erectile dysfunction.

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7
Q

Epithelia of female genital tract

A

Ovary: simple cuboidal
Fallopian tube, uterus, and endocervix: simple columnar
Ectocervix and vagina: Stratified squamous, non-keratinizing

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8
Q

Endometriosis: pathology, etioloty, symptoms, treatment

A

Pathology: Endometrial cells implanted on various pelvic organs. Hemosiderin deposits, powder burn lesions (purple-brown spots)

Etiology: Two hypotheses: retrograde menstruation and metaplasia

Symptoms: pelvic pain, infertility, dysmenorrhea, dyspareunia

Treatment: NSAIDs, GnRH agonist, hysterectomy

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9
Q

Uretrhal injury due to trauma: presentation, and most common location

A

Inability to void, blood at urethral meatus, high riding boggy prostate due to hematoma formation behind th gland. Pelvic trauma most commonly causes damage to the bulbomembranous junction of the urethra where it curves.

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10
Q

Lymphatic drainage of male repro organs

A

Testis: para-aortic nodes
Glans penis: deep inguinal nodes
Scrotum: superficial inguinal nodes

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11
Q

Communicating hydrocele

A

Collection of peritoneal fluid in the tunica vaginalis. Due to failure of the connection between tunica vaginalis and peritoneum to obliterate. Common in newborns. Presents as painless scrotal swelling that transilluminates

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12
Q

Risk factors for testicular cancer

A

Klinefelter’s syndrome. History of cryptorchidism

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13
Q

Male urethra portions

A
  1. Prostatic urethra: widest portion, where other ducts dump in
  2. Membranous urethra: passes through perineal membrane and surrounded by perineal muscles. Narrowest part
  3. Penile urethra: longest part
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14
Q

Urethral rupture above vs below urogenital diaphragm

A

Urogenital diaphragm is the junction between the membranous and penile urethra.

Rupture below: urine goes to scrotum and perineum
Rupture above: urine goes to retropubic spaces

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15
Q

Cause of bicornuate uterus

A

Partial failure of fusion of Mullerian ducts

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16
Q

Uterine hypoplasia or agenesis

A

Caused by failure of the paramesonephric ducts to form; commonly associated with urinary tract anomalies

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17
Q

Unicornuate uterus

A

Failure of one of the paramesonephric ducts to form

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18
Q

Didelphus uterus

A

Both ducts develop but fail to fuse. Can have separate or shared cervix/vagina

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19
Q

Bicornuate uterus

A

Failed fusion at the top of the uterus; single cervix. Most common uterine anomaly

20
Q

Septate uterus

A

Normal external shape (doesn’t have two horns) but have two separate cavities inside

21
Q

Arcuate uterus

A

Small midline indentiation; failure of septum to completely dissolve

22
Q

DES uterus

A

Due to exposure to DES in utero. T shaped uterine cavity

23
Q

Ligaments of ovary: suspensory, cardinal/transferse cervical, round

A

Suspensory: house ovarian artery and vein
Cardinal/transferse cervical: house uterine arteries. Form base of broad ligament
Round ligament: no structures

24
Q

Embryologic structures that give rise to external genitalia

A

Genital tubercle: glans penis/clitoris
Urogenital folds: ventral shaft of penis/labia minora
Labioscrotal folds: scrotum/labia majora

25
Q

beta-hCG structure

A

shared subunit with TSH, LH, and FSH

26
Q

Organogenesis

A

Occurs during weeks 3-8. When exposure to teratogens is the most concerning

27
Q

Testicular seminoma

A

Large cells with clear cytplasm and central nuclei. Homogenous mass without hemorrhage or necrosis. Good prognosis

28
Q

Embryonal germ cell testicular tumor

A

Hemorrhagic and necrotic. Can form glands. Aggressive. May differentiate when give chemo

29
Q

Yolk sac testicular tumor

A

Seen in young kids. Schiller Duval bodies (glomeruloid like structure). Elevated AFP.

30
Q

Choriocarcinoma testicular tumor

A

Makes beta hCG. Synctiotrophoblasts and cytotrophoblasts but no villi. Spreads early via blood.

31
Q

Twinning - timing

A

Day 3 or earlier: di/di
Day 4-8: mono/di
Day 8+: mono/mono

32
Q

Epispadius vs hypospadius

A

Epispadius: urethral opening on dorsal penis. Caused by abnormal development of genital tubercle

Hypospadius: urethral opening on ventral penis. Caused by abnormal development of urogenital folds

33
Q

Development of prostate

A

Exception in that it doesn’t develop from Wolffian duct, develops from urogenital sinus along with prostatic urethra in response to testosterone

34
Q

Complete vs partial mole: uterine size, beta hCG, and immunohistochemistry

A

Complete: enlarged uterus inconsistent with dating, extremely high beta hCG, p57 negative

Partial mole: normal uterus, normal to high beta hCG, p57 positivw

35
Q

Cell cell connections during labor

A

Just prior to labor, estrogen stimluates upregulaton of gap unctions while increases myometrial excitability

36
Q

Krukenberg tumor

A

Primary gastric cancer metastasized to ovary. Pathology is signet ring cells producing mucin

37
Q

Uterine fibroids: pathology, locations, presentation

A

Pathology: Benign, monocloncal tumors of uterine smooth muscle. Express estrogen receptors and are estrogen responsive (can enlarge with increased estrogen and cna regress with menopause or leuprolide)

Locations: Subserosal most common, intramural (in uterine wall), or submucosal (below endometrium)

Presentation: pelvic pressure, menorrhagia, metrorrhagia, constipation if in the posterior uterus, obstructive urinary symptoms if displaces uterius upward

38
Q

High vs low grade CIN

A

HIgh grade: invades beyond lower 1/3 of cervical epithelium (to epithelial surface); associated with HPV 16 or 18 and often progress to cancer

Low grade: cells not invaded past lower 1/3, associated with HPV 6 and 11; usually regress

39
Q

Ureter injury during hysterectomy

A

Very common due to close proximity of ureter and uterine artery. Injury with suture causes flank pain due to urine obstruction. Transection causes urine leak and flank pain. Voiding can be normal as injur y is unilateral

40
Q

Congenital torticollis

A

Presents at 2-4 weeks. Caused by birth trauma or malposition of the head in utero. Damage to SCM muscel results in fibrosis and contraction. HEad is tilted toward affected side

41
Q

Infundibulopelvic ligament

A

Another name for suspensory ligament of the ovary. Houses ovarian vessels and ovarian nerve plexus

42
Q

Distinguishing causes of vaginal bleeding during pregnancy

A

Abruptio placentae: painful vaginal bleeding in 3rd trimester, prior to labor. May see initiation of contraction. Risk factors include HTN, smoking, cocaine

Uterine rupture: painful vaginal bleeding during labor, seen during vaginal delivery in women wtih prior C section

Placenta previa: placentation that covers cervical os; painless bright red vaginal bleeding

43
Q

PCOS diagnosis

A

Based on

  • clinical symptoms: hirsutism, insulin resistance, infertility, anovulatory bleeding, enlarged cystic ovaries
  • LH/FSH 3:1 (normal is 1.5:1)
44
Q

Paget disease of nipple: histology

A

large cells with clear halos

45
Q

Phenytoin side effect

A

horizontal nystagmus on vertical gaze

Designated study period: daily cards (32 decks)

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