Repro Flashcards
1
Q
Presentation of kallman
A
Decreased GnRH
- amenorrhea
- No 2 sex characteristics
- no smell
2
Q
presentation of androgen insensitivity
A
- Normal breast development (testosterone–>estriol)
- No pubic/axillary hair (estradiol/testosterone is the main driver)
- No wolffian/mullerian structures
3
Q
Complete mole causes vaginal bleeding in:
A
The first trimester of pregnancy
4
Q
theca lutein cysts
A
hydatidiform mole
5
Q
Describe the differentiation of a male
A
SRY chromosome on Y chromosome–>Testes differentiating factor–>Development of testes–>sertoli and leydig cells
Sertoli cells synthesize MIF–>involution of paramesonephric ducts
Leydig cells make testosterone–>Wolffian duct–>epididymis and vas deferens–>DHT–>external genitalia
6
Q
Causes of polyhydramnios
A
Decreased fetal swallowing (GI atresia)
Increased fetal urination (anemia, twin twin transfusion)
7
Q
Causes of oligohydramnios
A
renal agenesis
posterior urethral valve
8
Q
What is the problem with cryptorchidism?
A
Undescended testes atrophy, causing damage to sertoli cells. and infertility.
Low inhibitin, high FSH.
Normal LH and leydig cell function
9
Q
Where does inhibitin/testosterone provide negative feedback?
A
Inhibin feeds back to pituitary
Testosterone feedsback to hypothalamus AND pituitary
10
Q
Fusion of maxillary prominence with medial nasal prominence failure
A
cleft lip
11
Q
Cleft palate
A
failure of palatine shelves to fuse with primary palate or each other
12
Q
Ligation of uterine artery during hysterectomy can damage
A
The ureter
13
Q
ovary epithelium
A
simple cuboidal
14
Q
fallopian tube epithelium
A
simple columnar
15
Q
uterus epithelium
A
simple columnar
16
Q
cervix epithelium
A
simple columnar/stratified squamous
17
Q
vagina epithelium
A
squamous
18
Q
Which portion of the urethra in men is most likely to be injured
A
membranous segment.
Signs of urethral injury: blood at meatus, boggy prostate. Do NOT put in a foley catheter
19
Q
Pudendal nerve innervates
A
pelvic floor
20
Q
How do uterine fibroids present?
A
As menorrhagia
21
Q
Ductus arteriosus is derived from:
A
The sixth aortic arch
22
Q
Cause of pyelonephritis in a young healthy woman
A
vesicoureteral reflux causing retrograde urine. Normally if pt gets UTI, urine flow and bladder mucosa and urea prevent colonization
23
Q
Imperforate anus
A
Problem with anorectal structures (surface ectoderm, below pectinate line)
–inability to pass meconium may come out vagina/urethra if fistulated
24
Q
imperforate anus associated with
A
urogenital tract abnormalities most common (renal agenesis, bladder extrophy, spadias) -Vertebral defects -anal atresia cardiac/renal/limb anomalies tracheoesophageal fistula esophageal atresia
25
Urachus connects
bladder with yolk sac (vitteline duct)
26
Urachus derives from
allantois
27
The bladder derives form the
urogenital sinus
28
vesicourachal diverticulum
outputching of apex of the bladder. Caused by failure to close the urachus adjacent to the bladder
29
Failure to close the distal part of the urachus
urachal sinus. periumbilical tenderness and discharge from umbilicus
30
Failure of central portion of urachus to obliterate
urachal cyst, asymptomatic
31
estrogen secreting primary ovarian tumor
granulosa cell tumor
32
mucin secreting tumor
mucinous cystadenocarcinoma. Can cause pseudomyxoma peritonei, where peritoneum fills with mucin.
33
most common germ cell tumor
benign cystic teratoma (dermoid cyst)
34
Breast milk contains everything except
vitamin K and D
35
What vitamin deficiency are premie babies at risk for?
Right away, vitamin K. Vitamin D deficiency shows up at 6 months. newborns have hepatic immaturity and no GI tract necessary to synthesize vitamin K from gut flora. Also, they haven't been eating their leafy green veggies. No teeth!
36
most common fraternal twin presentation
ALWAYS dichorionic, diamniotic but sometimes chorions can fuse
37
most common identical twin presentation
monochorionic, diamniotic
38
early separation of identical twins (0-4 days)
2 amnions, 2 chorions, 2 placentas
39
late separation of identical twins (8-12 days)
1 amnion, 1 chorion.
40
late separation of identical twins (13 days)
monochorionic conjoined twins
41
Testosterone inhibit
BOTH gnRH AND LH
42
inhibin inhibits
ONLY FSH
43
The right ovarian artery drains into the
inferior vena cava
The left drains into the left renal vein
44
Common complication of surgeries of the female reproductive tract
ligation of the ureter
45
vessels supplying the ovary travel through
The suspensory ligament
46
sonic hedgehog protein produced in
zone of polarizing activity (base of limbs)
47
sonic hedghog use:
anterior/posterior axis
48
mutation in sonic hedgehog
holoporsencephaly (failure of two hemispheres to separate)
49
wnt-7 gene produced in
apical ectodermal ridge (at the distal end of limbs)
50
wnt-7 use:
dorsal ventral organization
51
FGF gene produce in
apical ectodermal ridge
52
FGF fxn
mitosis of mesoderm to lengthen limbs
53
homeobox (hox) genes
cranio-caudal organization.
54
mutation in hox
appendages in wrong locations
55
when does hCG secretion begin
1 week
56
when does implantation happen
1 week
57
bilaminar disc formation (epiblast, hypoblast)
2 weeks
58
trilaminar disc
3 weeks
59
notochord, primitive streak, mesoderm, and neural plate form
3 weeks
60
embryonic period
3-8 weeks susceptible to teratogens
61
neural tube closed by
week 4
62
heart begins beating
week 4
63
limbs form
week 4
64
fetal movement, fetus appears
week 8
65
genitalia (can sex the fetus)
weeek 10
66
agenesis
absent organ from absent primordial tissue
67
aplasia
absent organ with primordial tissue present
68
deformation
extrinsic disruption after embryonic period
69
malformation
intrinsic disruption: occurs during embryonic period
70
teratogen: renal damage
ACE inhibitors
71
teratogen: absent digits, other anomalies
alkylating agents
72
teratogen: Neural tube defects, fingernail hypoplasia, and developmental delay with facial defects
carbamazepine
73
teratogen:vaginal clear cell adenocarcinoma and congenital mullerian anomalies
Diethylstilbestrol
74
teratogen:neural tube defects
folate antagonist
carbamazepine
valproate
75
teratogen: Ebstein's anomaly (atrialized right ventricl)
lithium
76
teratogen: microcephaly, dysmorphic face, hypoplastic nails and distal phalances with cardiac defects
phenytoin (fetal hydantoin syndrome)
77
teratogen:flipper limbs
thalidomide
78
teratogen: bone deformities, hemorrhage, abortion
| opthalmologic abnormalities
warfarin
79
teratogen:placental abruption
cocaine
80
teratogen: preterm labor and placental problems, ADHD
smoking
81
which drugs can cause intrauterine growth retardation?
carbamazepine
phenytoin
smoking
82
maternal diabetes can cause
```
anal atresia (caudal regression)
congenital heart defects
neural tube defects
```
83
Vitamin A causes
spontaneous abortions and birth defects
84
X rays cause
microcephaly and mental retardation
85
mental retardation, microcephaly, holoprosencephaly, face abnormalities, limb dislocation, and heart/lung fistulas
fetal alcohol syndrome
86
dizygotic twins always are
dichorionic
| diamniotic
87
most monozygotic twins are
monochorionic
| diamniotic
88
cleavage: dichorionic diamniotic monozygotic twins
0-4 days
89
cleavage: monochorionic diamniotic twins
4-8 days
90
cleavage: monochorionic monoamniotic twins
8-12 days
91
cleavage: monochorionic monoamniotic onjoined twins
> 13 days
92
fxn cytotrophoblast
cells of inner layer of chorionic villi
93
fxn syncytiotrophoblast
secretes hCG.
| stimulates corpus luteum to make progesterone
94
umbilical arteries connect
fetal internal iliac arteries to placenta
95
umbilical arteries and veins derived from
allantois
96
umbilical vein connects
placenta to ductus venosus
97
contents of umbilical cord
2 arteries
1 vein
allantoic duct
wharton's jelly
98
urachal duct
connects bladder and yolksac (umbilical cord)
99
urachal duct comes from
allantois
100
outpouching of bladder
vesicourachal diverticulum. failure of urachus to close
101
urine discharge from umbilicus
patent urachus
102
when does the allantois form
3 week
103
vitelline (omphalomesenteric duct)
connects yolk sac to gut lumen
104
discharge of meconium from umbilicus
vitelline fistula
105
meckel's diverticulum: cause?
failure of vitelline duct to close
106
when does vitelline duct close
week 7
107
branchial cleft (grooves) vs arches vs pouches
cleft: ectoderm
arches: mesoderm and crest cells (bones, cartilage)
pouches: endoderm
108
1st branchial cleft
external auditory meatus
109
2nd-4th branchial clefts
temporary cervical sinuses
110
branchial left cyst in lateral neck caused by
persistent cervical sinus
111
pt with mandibular hypoplasia and facial abnormalities
failure of 1st arch neural crest cell migration (treacher collins)
112
persistence of fistula between tonsillar area and cleft in lateral neck caused by
3rd arch problem
| =congenital pharyngocutaneous fistula
113
DiGeorge sx
No thymus
| hypocalcemia (no parathyroids)
114
Men2A caused by mutation in
RET
115
RET codes
neural crest cells
116
parafollicular cells come from
neural crest cells
| 4th and 5th pharyngeal pouches
117
failure of fusion of maxillary and medial nasal processes
cleft lip
118
failure of fusion of lateral palatine processes, nasal septum, median palantine processes
cleft palate
119
paramesonephric duct
female system
120
mesonephric duct
male system
121
wolffian duct becomes
seminal vesicles
epididymis
ejaculatory duct
ductus deferens
122
paramesonephric duct becomes
fallopian tubes
uterus
upper portion of vagina
123
lower vagina from
urogenital sinus
124
fully developed 2ndary sex characteristics in a female indicates
functional ovaries
125
male development summary
1. SRY=testes development-->simulate sertoli and leydig cells to form
2. sertoli-MIF
3. MIF inhibits paramesonephric ducts
4. Leydig=androgen
5. androgen simulates mesonephric duct
126
Both male and female internal genitalia, and male external genitalia
no MIF
127
male internal genitalia, ambigious external genitalia until puberty
5a reductase
128
hypospadias caused by
failure of urethral folds to close
129
epispadias caused by
faulty positioning of genital tubercle
130
epispadias associated with
extrophy of the bladder
131
gubernaculum in male
anchors testes in scrotum
132
gubernaculum in female
ovarian and round ligament of uterus
133
processus vaginalis forms
tunica vaginalis
134
more likely to get a hydrocele on the left or the right?
On the left--gonadal vein drains to left renal vein
135
ovaries/testes drain to what nodes
paraaortic lymph node
136
distal 1/3 or vagina/vulva drains to what nodes
superficial inguinal nodes
137
scrotum drains to
superficial inguinal nodes
138
proximal 2/3 of vagina drain what nodes
external iliac/hypogastric nodes
139
uterus drains to what nodes
external iliac/hypogastric nodes
140
suspensory ligament connects
ovaries to lateral pelvic wall
141
cardinal ligament connects
cervix to pelvis side wall
142
round ligament of the uterus connects
uterine fundus to labia majora
143
broad ligament connects
uterus, fallopian tubes, and ovaries to pelvic wall
144
ligament of the ovary connects
medial pole of ovary to lateral uterus
145
structures in suspensory ligament
ovarian vessels
146
structures in cardinal ligament
uterine vessels
147
structure in round ligament
artery of sampson
148
mesosalpinx
upper portion of broad ligament
149
mesometrium
lower portion of broad ligament
150
mesovarium
portion of broad ligament over the ovary
151
endocervix hsitology
simple columnar
152
uterus histology
simple columnar
153
fallopian histology
simple columnar
154
ovary histology
simple cuboidal
155
erection mediated by what nerve
pelvic.
156
emission (sperm into posterior urethra) nerve
hypogastric
157
ejaculation nerve
pudendal nerve
158
pathophys of erection
BONER:
1. NO-->cGMP-->smooth muscle relaxation-->vasodilation
BONER KILLER:
2. NE-->Increase in calcium in=vasoconstriction
159
nervous systems for erection, emission, ejaculation:
1. Parasympathetic
2. Sympathetic
3. Somatic
160
sertoli cells secrete
1. inhibitn
2. androgen binding protein (increase local levels of testosterone)
3. MIF
161
what forms the blood testes barrier?
sertoli cells
162
full development of sperm take how long
2 months
163
what does a spermatid do to become a spermatozoa?
loss of cytoplasmic contents
| gain of acrosomal cap=mature spermatozoa
164
pirmary spermatocyte nuclear content
doubled chromosomes, 2N
165
secondary spermatocyte nuclear contents
double chromsomes, haploid
| 1N, 2C
166
spermatid nuclear contents
1N, 1C
| haploid, one copy of everything
167
inhibin inhibits what?
ONLY anterior pituitary
| Not hypothalamus
168
closure of epiphyseal plates
estrogen.
| ==In male, converted from testosterone by adipose tissue and leydig cells
169
DHT differentiates
penis, scrotum, prostate
170
Ovary produces what form of estrogen
17B-estradiol
171
placenta produces what form of estrogen
estriol
172
adipose estrogen
estrone
173
potency of different estrogens
estradiol>estrone>estriol
174
effect of estrogen on prolactin
Stimulates prolactin secretion but blocks prolactin action at the breast
175
estrogen receptors located where in the cell?
cystoplasm.
| After binding, translocates to the nucleus
176
LH stimulates what enzyme
desmolase
| --converts cholesterol to androstenedione
177
Effect of estrogen on transport proteins
increased SHBG
Increased HDL
decreased LDL
178
elevation in progesterone in a woman indicates
ovulation
179
effets of progesterone
```
decreases myometrial excitability
increases body temperature
inhibits FSH, LH
relaxes uterine smooth muscle
decreases estrogen receptors
```
180
Tanner stage: curly and dark pubic hair
III
181
Tanner stage: penis length and size increase
III
182
Tanner: Enlargement of breast beyond buds
III
183
Tanner: raised areolae
IV
184
which phase of your period is constant
luteal phase
185
normal cycle length
21-35 days
186
metrorrhagia
frequent but irregular menstruation
187
menometrorrhagia
heavy and irregular bleeding
188
what hormones peak at 14 days
FSH
LH
Estrogen
189
mittelschmerz
blood from ruptured follicle causes peritoneal irritation. looks like appendicitis
190
eggs are held in what state until ovulation
prophase I
191
eggs are held in what state until fertilization?
metaphase II
192
what hormones STEADILY increase throughout the pregnancy
prolactin
progesterone
estriol
193
after labor, what causes lactation?
removal of progesterone
194
elevated hCG in which pathological states?
hydatidiform moles and choriocarcinoma
195
menopause occurs earlier in what group?
smokers
196
best test to confirm meenopaus?
Increase in FSH
197
why do women become hirsuit after menopause?
increase in androgens (more LH) with peripheral conversion to estrone. (no negative feedback from estrogen)
198
menopause before age 40
think premature ovarian failure
199
hormonal levels in klinefelter's
decreased inhibin
increased FSH
Increased LH
Increased estrogen
200
barr body
klinefelter's
201
heart defects seen in turner's
bicuspid aortic valve
| preductal coractation
202
renal defect in turner's
horseshoe
203
hormone levesl in turner's
low estrogen
high FSH
high LH
204
very fall, sever, acne
antisocial behavior
normal fertility
XYY
205
high testosterone, high LH
defective androgen receptor
206
high testosterone, low LH
testosterone tumor or exogenous use
207
ovaries present, but external genitalia ambiguous
CAH
208
testes present, but external genitalia are ambiguous
androgen insensitivity
209
true hermaphroditism
Both ovary and testicular tissue present
210
normal appearing female with rudimentary vagina and no internal genitalia
- -testes in labia majora
- -very little hair
androgen insensitivity. remove testes to prevent malignancy!
211
labs in androgen insensitivity
high testosterone
high estrogen
high LH
212
labs in 5a reductase deficiency
testosterone and estrogen levels are hormal. LH is normal.
213
kallman syndrome cause
defective migration of GnRH
214
labs in kallman
low GnRH, FSH, LH
| low testosteron and sperm count
215
most common precursor of a choriocarcinoma
hydatidiform mole
216
snowstorm appearance on US
complete mole
217
tx of mole
dilation and curettage and methotrexate
218
follow up after mole removal
monitor b-hCG
219
complete vs partial mole hcG
hcG much higher in complete mole
220
which mole more likely to convert to choriocarcinoma?
complete mole
221
risk of malignant trophoblastic disease higher in which mole?
complete mole
222
cause of pre-eclampsia
impaired vasodilation of spiral arteries
| =increased vascular tone
223
sx of preeclampsia
hypertension, proteinuria and edema
224
sx of preeclampsia before 20 weeks
molar pregnancy
225
cause of death in preeclampsia
cerebral hemorrhage and ARDS
226
how to prevent seizures of eclampsia
IV magnesium sulfate
227
risk factors for abruptio placentae
Smoking, HTN, cocaine
228
cause: placenta accreta
defective decidual layer. placenta attaches to myometrium
229
risk factors for placenta accreta
C section
inflammation
placenta previa
230
risk factors: placenta previa
multiparity and prior C section
231
problems with retained placental tissue
postpartum hemorrhage
| infection
232
hCG lower than expected on dates
ectopic
233
risk factors for ectopic pregnancy
1. history of infertility
2. salpingitis
3. ruptured appendix
4. prior tubal surgery
234
polyhydramnios assoc'd with
esophageal/duodenal atresia
| anencephaly
235
oligohydramnios assoc'd with
bilateral renal agenesis
posterior urethral valves
placental insufficiency
236
potter's syndrome
1. pulmonary hypoplasia
2. clubbed feet
3. cranial abnormalities
4. bilateral renal agenesis
237
HPV 16 gene product
E6. Inhibits p53
238
HPV 18 gene product
E7. Inhibits RB suppresor gene
239
sequelae of invasive carcinoma if growing laterally
block ureters=renal failure
240
endometritis
inflammation of endometrium from retained products of conception
241
tx for endometritis
gentamycin
| clindamycin
242
endometriosis sx
menorrhagia, dysmenorrhea, pain with a normal sized nucleus
243
adenomyosis sx
menorrhagia, dysmenorrhea, pelvic pain with an enlarged uterus
244
tx: endometriosis
contraceptives, NSAIDS
| leuprolide, danazol
245
endometrium within the myometrium
adenomyosis
246
tx of adenomyosis
hysterectomy
247
granulosa tumor will show
abnormal endometrial gland proliferation
| --excess estrogen
248
risk factors of endometrial carcinoma
lots of estrogen
- obesity
- diabetes
- htn
- nulliparity
249
prognosis endometrial carcinoma
increased myometrial invasion=poorer prognosis
250
leiomyoma type of tumor
benign smooth muscle tumor
251
whorled pattern of smooth muscle bundles; tumor?
leimyoma
252
sx of leiomyoma
abnormal bleeding
| miscarriage
253
bulky irregular tumor with necrosis and hmorrhage that may protrude from cervix and bleed. aggressive.
leimyosarcoma
254
leiomyoma and leiomyosarcoma have an increased incidence in
blacks
255
incidence by tumor type
endometrial>ovarian>cervical (US)
256
worst prognosis by tumor type
ovarian>cervical>endometrial
257
how does cushing's cause anovulation?
high ACTH
| --increased androgen production
258
labs in PCOS
```
high LH
low FSH
high testosterone
high estrogen (peripheral. aromatization)
NO progesterone
```
259
PCOS pts at increased risk for what cancer
endometrial cancer.
260
tx PCOS
weight loss medroxyprogesterone, OCPs
261
follicular cyst contents
unruptured graafian follicle
262
corpus luteum cyst
hemorrhage into corpus luteum
263
cause: theca lutein cyst
gnRH stimulation. usually multiple
264
theca/lutein cyst associated with
choriocarcinoma and moles
265
hemorrhagic cyst cause
blood vessel rupture into cyst
266
endometriod cyst
chocolate cyst. varies with menstrual cycle
267
elevated hCG and LDH. sheets of uniform cells
dysgerminoma
268
dysgerminoma associated with
Turner's syndrome
269
choriocarcinoma biopsy shows
trophoblastic tissue with NO chorionic villi
270
schiller duval bodies
yolk sac tumor
271
choriocarcinoma assoc'd with
increased theca lutein cysts
272
choriocarcinoma spreads first to the
lungs
273
yellow friable solid mass= tumor?
yolk sac
274
where do yolk sac tumors present in adults? kids?
adults=ovaries and testes
| kids=sacrococcygeal
275
immature vs mature teratoma (dermoid cyst)
immature is aggressive.
276
struma ovarii
teratoma that contains functional thyroid tissue
277
90 percent of ovarian non germ cell tumors are
serous cystadenoma or serous cystadenocarcinoma
278
histology: serous cystadenoma
fallopian tube epithelium
279
histology serous cystadenocarcinoma
psamomma bodies
280
multilocular cyst lined by mucus secreting epithelium. Intestine-like.
mucinsous cystadenoma
281
mucinous cystadenocarcinoma associated with
pseudomyxoma peritonei
282
pseudomyxoma peritonei
intraperitoneal accumulation of mucinous material from ovarian tumor
283
pulling sensation in groin with ovarian fibroma, ascites, and hydrothorax
fibromas
284
histology fibromas
spindle shaped fibroblasts
285
call exner bodies
small follicles with eosinophilic secretions. associated with granulosa cell tumor
286
estrogen secreting tumor
granulosa tumor
287
GI malignancy that metastasizes to ovaries
krukenberg
288
mucin secreting signet cell tumor in ovaries
krukenberg
289
girls under four with spindle shaped tumor cells that are desmin positive
sarcoma botryoides
290
Clear cell adenocarcinoma
women exposed to DES in utero
291
diseases of the nipple
Paget's
| abscess
292
diseases of the lactiferous sinus
intraductal papilloma
| mastitis
293
diseases of the major duct
fibrocystic change
| ductal cancer
294
diseases of the terminal duct
tubular carcinoma
295
diseases of the lobules
sclerosing adenosis
| lobular carcinoma
296
diseases of the breast stroma
fibroadenoma
| phyllodes tumor
297
small mobile firm mass with sharp edges in the breast
fibroadenoma
298
small tumor that grows in lactiferous ducts. Below areola
intraductal papilloma
299
large bulky mass of CT and cysts in breast.
phyllodes
300
"leaf like" projections in the breast
phyllodes
301
phyllodes age group
60's
302
serous or bloody nipple discharge
intraductal papilloma
303
risk of carcinoma with fibroma, intraductal papilloma, and phyllodes?
fibroma=none
intraductal papilloma=1.5-2x risk
phyllodes can become malignantM
304
Most important prognostic factor with malignant breast tumors
axillary lymph node
305
ductal caseous necrosis
comedocarcinoma
306
rock hard mass with duct like cells
invasive ductal carcinoma
307
stellate morpholoby
invasive ductal carcinoma
308
indian file cells
invasive lobular carcinoma
309
histology of medullary invasive carcinoma
fleshy, cellular, lymphocytic infiltrate
310
peau d'orange skin with neoplastic cells blocking lymphatic ducts
inflammatory invasive breast cancer
311
eczematous patches on nipple
paget's disease
312
which is the worst breast cancer to get
invasive ductal
313
Which breast cancer has a good prognosis
medullary
314
which breast cancer is usually bilateral with multiple lesions?
invasive lobular
315
large cells in epidermis with clear halo in breast biopsy
paget cells
316
Four types of fibrocystic disease
1. fibrosis
2. cystic
3. sclerosing adenosis
4. epithelial hyperplasia
317
most common cause of acute mastitis
S aureus colonizing during breast feeding
318
hyperplasia of the breast stroma---fibrocystic dz
fibrosis
319
fluid filled blue dome with ductal dilation--fibrocystic dz
cystic
320
increased acini and intralobular fibrosis with calcifications--fibrocystic dz
sclerosing adenosis. often confused with cancer
321
Increased number of epithelial cell layers in terminal duct lobule--fibrocystic dz
epithelial hyperplasia
322
which fibrocystic disease is associated with an increased risk of carcinoma?
epithelial hyperplasia
323
benign lump from injury to breast tissue
fat necrosis
324
drugs causing gynecomastia
```
spironolactone
digitalis
cimetidine
alcohol
ketoconazole
```
325
dysuria, frequency, urgency, and low back pain in a male
prostatitis
326
cause of acute prostatitis
bacterial
327
cause of chronic prostatitis
usually no bacteria
328
BPH = enlargement of...
lateral and middle lobes
329
sx of BPH
increased frequency of urination
difficulty starting and stopping pee
pain on urination
330
Treatment of BPH
terazosin, tamsulosin (a 1antagonist)
| finasteride (5a reductase blocker)
331
prostate cancer arises from which area
posterior lobe, won't cause sx like BPH
332
tumor markers for prostate cancer
1. increased prostatic acid phosphatase
2. increased total PSA
3. decreased free PSA
333
how do you know if prostate cancer has metastasized to the bone?
serum alkaline phosphatase increase
334
cryptorchidism
undescended testes
335
cryptorchidism associated with increased risk of
increased risk of germ cell tumors
336
risk factor for cryptorchidism
prematurity
337
hormone levels in cryptorchidism
less inhibin, increased FSH and LH
- -testosterone decreased in bilateral cryptorchidism
- -testosterone normal in unilateral cryptorchidism
338
bag of worms
varicocele
339
tx of varicocele
surgery or embolization by radiologist
340
95 percent of testicular tumors are
germ cell tumors
341
homogeneous testicular enlargement. Watery cytoplasm and fried egg appearance: tumor?
seminoma
342
increase in PLAP
seminoma
343
seminoma age group
15-35
344
yellow, mucinous with schillar duval bodies: testicular tumor?
yolk sac
345
man with increased hCG
choriocarcinoma or teratoma or embryonal carcinoma
346
choriocarcinoma in a male metastsizes to
lungs
347
tumors producing gynecomastia
choriocarcinoma from hCG
348
mature teratoma in a adult male vs child prognosis
adult male=malignant
| child=benign
349
teratoma labs
increased hCG and/or AFP
350
glandular/papillary morphology with increased hCG
embryonal carcinoma. Often a mixed tumor with increased AFP
351
Reinke crystals
leydig cell tumor
352
most common testicular cancer in older men
lymphoma
353
sertoli cell tumor
androblastoma from sex cord stroma
354
sx of leydig cell tumor
gynecomastia in men, precocious puberty in boys
355
hydrocele cause
incomplete fusion of processus vaginalis
356
cause spermatocele
dilated epididymal duct
357
bent penis from acquired fibrous tissue formation
peyronie's disease
358
causes of priapism
```
trauma
sickle cell disease
medications
PDE5 inhibitors
antidepressants
alpha blockers
cocaine
```
