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Step 1 Smart Book > Repro > Flashcards

Repro Flashcards

1
Q

What’s the most common breast mass in men under 25?

A

Gynecomastia

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2
Q

What gene is involved in the oncogenesis of cervical cancer?

A

p53 - HPV has E6 and E7 proteins which combine with and inactivate the tumor suppressor genes p53 and p105rB respectively

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3
Q

What is the HER2 receptor?

A

Tyrosine kinase receptor

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4
Q

What does the RET gene encode?

A

Receptor tyrosine kinase

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5
Q

What is the most likely complication of a bicuronate uterus?

A

Frequent abortions

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6
Q

Describe the developmental cycle of Chlamydia.

A

EB - elementary body that is infectious

RB - metabolically active form

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7
Q

What is Paget disease and how does it present?

A

Paget disease - adenocarcinoma cells within the squamous epithelium of the skin near the nipple

Presentation - nipple inflammation, pigmentation, eczematoid changes

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8
Q

What symptoms follows entry of amniotic fluid into circulation?

A

Respiratory depression

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9
Q

What type of teratoma can develop appearance of mature thyroid tissue?

A

Monodermal teratoma

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10
Q

What is the most common cause of septic arthritis in otherwise healthy, sexually active adults?

A

Neisseria gonorrhea

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11
Q

Why is there virtually no immunity to reinfection with neisseria?

A

May express over 1 million variants of pili

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12
Q

Masculinized female fetus suggests what disorder?

A

21-hydroxylase deficiency

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13
Q

What hormone is immediate elevated in 21-hydroxylase deficiency?

A

17-OH progesterone

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14
Q

What does vaginal pruritus and white discharge suggest?

A

Candidiasis

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15
Q

What serum hormone level might you expect in a patient with frequent early spontaneous abortions?

A

Decreased progesterone

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16
Q

Where does herpes lay dormant?

A

Sacral ganglia

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17
Q

What uterine tumor on biopsy exhibits well-demarcated borders and a whorled surface?

A

Leiomyoma

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18
Q

What is a tumor marker for leiomyoma?

A

Smooth muscle actin

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19
Q

What does fever, abdominal pain, tender cervix in a sexually young woman suggest?

A

PID - probably gonorrhea or chlamydia

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20
Q

Which vaginal infection produces a neutrophilic discharge with gram-negative cocci?

A

Neisseria gonorrhea

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21
Q

Oocyte surrounded by several layers of follicular cells within a small antrum - what type of follicle is this?

A

Secondary follicle

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22
Q

How does acyclovir work?

A
  1. Inhibits viral DNA polymerase

2. Also gets incorporated into viral DNA

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23
Q

What are 2 late sequelae of Group A streptococcal infection?

A
  1. Rheumatic fever

2. Acute post-streptococcal glomerulonephritis

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24
Q

How can you differentiate rheumatic fever vs. acute post-streptococcal glomerulonephritis just based on the preceding infection?

A

Post-streptococcal glomerulonephritis - can present after either skin infection or acute pharyngitis

Rheumatic fever - only follows acute pharyngitis; does NOT follow skin infection

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25
Q

What should you be suspicious of if amniocentesis at 18 weeks reveals LOW alpha fetal protein?

A

Down syndrome

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26
Q

Why are clavulanic acid, sulbactam, and tazobactam added to penicillin family medications?

A

They are beta lactamase inhibitors - they decrease the destruction of the antibiotic by beta lactamases

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27
Q

What is the Hawthorne effect?

A

Tendency of a study population to affect an outcome due to the knowledge of being studied

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28
Q

Is a triploid karyotype partial or complete mole?

A

Partial mole

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29
Q

What can help prevent calcium crystal precipitation?

A
  1. Increased citrate

2. High fluid intake

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30
Q

How have enterococci developed resistance to aminoglycosides?

A

Have modifying enzymes that transfer different chemical groups (acetyl, adenyl, or phosphate) to the aminoglycoside molecule and thereby impair antibiotic binding to ribosomal subunits

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31
Q

Breast biopsy: cellular, myxoid stroma that encircles and compresses epithelium-lined glandular and cystic spaces

A

Fibroadenoma

32
Q

What causes formation of a bicuronate uterus?

A

Failure of the paramesonephric ducts to fuse

33
Q

Where does the proximal 1/3 of the ureter receive its blood supply from?

A

Branches of the renal artery

34
Q

Contrast where lymph from the scrotum vs. the testes drain.

A

Scrotum - superficial inguinal lymph nodes

Testes - para-aortic nodes

35
Q

What are the 3 types of groin hernia and their relation to the inguinal ligament?

A

Above the inguinal ligament - direct and indirect

Below the inguinal ligament - femoral

36
Q

Describe the location of a femoral hernia.

A

Below inguinal ligament
Lateral to the pubic tubercle
Medial to the femoral vein

37
Q

What drugs can be used to treat postoperative urinary retention?

A

Muscarinic agonist (e.g. bethanechol) or alpha 1 blocker

38
Q

Why would we not use oxybutynin for postoperative urinary retention?

A

Oxybutynin is an antimuscarinic agent commonly used for urge incontinence - would worsen the condition

39
Q

What virulence factor in Group A strep prevents phagocytosis?

A

M protein

40
Q

What are the complications of PID?

A
  1. Infertility

2. Ectopic pregnancy

41
Q

What is the most common viral cause of hemorrhagic cystitis?

A

Adenovirus

42
Q

What are the effects of IL-2?

A
  1. Promotes the growth of lymphocytes (B and T cells)

3. Activates NK cells and macrophages

43
Q

What should you be careful to ligate when doing surgery on the ovary?

A

Suspensory ligament - carries most of the nerves and vessels to the ovary

44
Q

Contrast direct and indirect inguinal hernia relative to inferior epigastric vessels.

A

Direct hernia - medial to interior epigastric vessels

Indirect hernia - lateral to inferior epigastric vessels

45
Q

Contrast the causes of direct and indirect inguinal hernia.

A

Direct - weakness of transversalis fascia

Indirect - persistent processus vaginalis and failure of the internal inguinal ring to close

46
Q

Contrast the causes of direct and indirect inguinal hernia.

A

Direct - weakness of transversalis fascia

Indirect - persistent processus vaginalis and failure of the internal inguinal ring to close

47
Q

What findings make you suspicious of pyelonephritis?

A
  1. Systemic manifestations of febrile illness (or UTI)
  2. White blood cell casts
  3. Pain upon urination
48
Q

What are the two most common causes of urethritis in males?

A

Chlamydia and gonorrhea (can also co-infect)

49
Q

How do you treat chlamydia/gonorrhea?

A

Ceftriaxone - for gonorrhea

Doxycycline or azithromycin - for chlamydia

50
Q

Masculinization of a female fetus with virilization of the mother during gestation

Diagnosis?

A

Aromatase deficiency in the fetus

51
Q

Where is the prostate located on CT?

A

Pretty central - in between the pubic symphysis and the anal canal

52
Q

Describe the reaction that occurs with an acute hemolytic transfusion reaction.

A

Type II hypersensitivity - host antibody binds antigen on donor RBC and activates complement

53
Q

What pregnancy complication are SLE patients at increased risk for?

A

Repeated 2nd or 3rd trimester miscarriages due to antiphospholipid antibody syndrome

54
Q

Explain how eosinophils are involved in antibody-dependent cytotoxicity.

A

Eosinophils have Fc receptors on their surface that bind IgE-parasite antigen complexes. This stimulates the eosinophils to release major basic protein and other enzymes from their granules.

55
Q

What is cystinuria and how does it present?

A

Autosomal recessive defect in the transporter of cystine, ornithine, arginine and lysine - presents as cysteine stones

The defect impairs the transporter’s affinity in both the intestine and the kidney so you have decreased reabsorption once it is filtered at the glomerulus

56
Q

What does a “bunch of grapes” removed from the uterus suggest?

A

Hydatidiform mole

57
Q

What hormone level should be monitored in patients who have had a hydatidiform mole removed?

A

beta hCG

58
Q

How do you treat chlamydia/gonorrhea?

A

Gonorrhea - ceftriaxone

Chlamydia - doxycycline or azithromycin

59
Q

What should you be suspicious of in a patient who suffers both a renal infarct and a stroke?

A

Embolism from the left side of the heart - causes include atrial fibrillation, aortic aneurysm, infective endocarditis

60
Q

What are 4 things caused by Kartagener’s syndrome?

A
  1. Male infertility
  2. Situs inversus
  3. Recurrent sinusitis
  4. Bronchiectasis - destruction and widening of the larger airways
61
Q

What causes gram-negative sepsis?

A

LPS - specifically the lipid A component

62
Q

What are UAA, UAG, and UGA?

A

Stop codons

63
Q

What recognizes stop codons to terminate protein synthesis?

A

Releasing factors

64
Q

What is most important virulence factor in uropathogenic E coli?

A

P fimbriae

65
Q

How can you prevent recurrence of herpes?

A

Daily treatment with oral acyclovir, valacyclovir, or famciclovir

66
Q

What often happens to the ovaries in Turner syndrome?

A

Dysgensis (including complete absence)

67
Q

Describe what happens in cryptorchidism.

A

Undescended testes –> temperature is higher than it should be –> damage to semniferous tubules which have the Sertoli cells –> low sperm count, impaired inhibin synthesis, increased FSH (because of low inhibin levels)

68
Q

Describe the calcium levels in the blood and urine in patients with calcium stones.

A

Hypercalciuria but NORMOcalcemia

69
Q

What are PCOS patients at increased risk of developing?

A

Endometrial adenocarcinoma and type 2 diabetes

70
Q

Describe the path of the ureters.

A

They cross over the external/common iliac vessels and under the gonadal (and ovarian) vessels

As they enter the pelvis, they pass medial to the gonadal vessels and lateral to the internal iliac vessels

71
Q

What staphylococcus is responsible for almost half of all UTI’s in sexually active young women?

A

Saprophyticus

72
Q

What should you be suspicious of in an elderly man who is straining on urination?

A

Bladder outflow obstruction likely due to BPH

73
Q

What can happen to the kidneys in BPH?

A

Parenchymal pressure atrophy

74
Q

What is the mechanism of acyclovir?

A
  1. Nucleoside analog that gets incorporated into viral DNA and terminates DNA synthesis
  2. Also inhibits DNA polymerase
75
Q

What is the role of “tan fat-containing tissue”?

A

Brown adipose tissue - heat production

Step 1 Smart Book (13 decks)

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