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Repro Flashcards

1
Q

Presentation of kallman

A

Decreased GnRH

  • amenorrhea
  • No 2 sex characteristics
  • no smell
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2
Q

presentation of androgen insensitivity

A
  1. Normal breast development (testosterone–>estriol)
  2. No pubic/axillary hair (estradiol/testosterone is the main driver)
  3. No wolffian/mullerian structures
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3
Q

Complete mole causes vaginal bleeding in:

A

The first trimester of pregnancy

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4
Q

theca lutein cysts

A

hydatidiform mole

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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

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6
Q

Causes of polyhydramnios

A

Decreased fetal swallowing (GI atresia)

Increased fetal urination (anemia, twin twin transfusion)

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7
Q

Causes of oligohydramnios

A

renal agenesis

posterior urethral valve

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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

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9
Q

Where does inhibitin/testosterone provide negative feedback?

A

Inhibin feeds back to pituitary

Testosterone feedsback to hypothalamus AND pituitary

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10
Q

Fusion of maxillary prominence with medial nasal prominence failure

A

cleft lip

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11
Q

Cleft palate

A

failure of palatine shelves to fuse with primary palate or each other

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12
Q

Ligation of uterine artery during hysterectomy can damage

A

The ureter

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13
Q

ovary epithelium

A

simple cuboidal

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14
Q

fallopian tube epithelium

A

simple columnar

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15
Q

uterus epithelium

A

simple columnar

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16
Q

cervix epithelium

A

simple columnar/stratified squamous

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17
Q

vagina epithelium

A

squamous

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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

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19
Q

Pudendal nerve innervates

A

pelvic floor

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20
Q

How do uterine fibroids present?

A

As menorrhagia

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21
Q

Ductus arteriosus is derived from:

A

The sixth aortic arch

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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

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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

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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
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25
Q

Urachus connects

A

bladder with yolk sac (vitteline duct)

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26
Q

Urachus derives from

A

allantois

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27
Q

The bladder derives form the

A

urogenital sinus

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28
Q

vesicourachal diverticulum

A

outputching of apex of the bladder. Caused by failure to close the urachus adjacent to the bladder

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29
Q

Failure to close the distal part of the urachus

A

urachal sinus. periumbilical tenderness and discharge from umbilicus

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30
Q

Failure of central portion of urachus to obliterate

A

urachal cyst, asymptomatic

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31
Q

estrogen secreting primary ovarian tumor

A

granulosa cell tumor

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32
Q

mucin secreting tumor

A

mucinous cystadenocarcinoma. Can cause pseudomyxoma peritonei, where peritoneum fills with mucin.

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33
Q

most common germ cell tumor

A

benign cystic teratoma (dermoid cyst)

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34
Q

Breast milk contains everything except

A

vitamin K and D

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35
Q

What vitamin deficiency are premie babies at risk for?

A

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!

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36
Q

most common fraternal twin presentation

A

ALWAYS dichorionic, diamniotic but sometimes chorions can fuse

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37
Q

most common identical twin presentation

A

monochorionic, diamniotic

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38
Q

early separation of identical twins (0-4 days)

A

2 amnions, 2 chorions, 2 placentas

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39
Q

late separation of identical twins (8-12 days)

A

1 amnion, 1 chorion.

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40
Q

late separation of identical twins (13 days)

A

monochorionic conjoined twins

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41
Q

Testosterone inhibit

A

BOTH gnRH AND LH

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42
Q

inhibin inhibits

A

ONLY FSH

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43
Q

The right ovarian artery drains into the

A

inferior vena cava

The left drains into the left renal vein

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44
Q

Common complication of surgeries of the female reproductive tract

A

ligation of the ureter

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45
Q

vessels supplying the ovary travel through

A

The suspensory ligament

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46
Q

sonic hedgehog protein produced in

A

zone of polarizing activity (base of limbs)

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47
Q

sonic hedghog use:

A

anterior/posterior axis

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48
Q

mutation in sonic hedgehog

A

holoporsencephaly (failure of two hemispheres to separate)

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49
Q

wnt-7 gene produced in

A

apical ectodermal ridge (at the distal end of limbs)

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50
Q

wnt-7 use:

A

dorsal ventral organization

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51
Q

FGF gene produce in

A

apical ectodermal ridge

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52
Q

FGF fxn

A

mitosis of mesoderm to lengthen limbs

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53
Q

homeobox (hox) genes

A

cranio-caudal organization.

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54
Q

mutation in hox

A

appendages in wrong locations

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55
Q

when does hCG secretion begin

A

1 week

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56
Q

when does implantation happen

A

1 week

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57
Q

bilaminar disc formation (epiblast, hypoblast)

A

2 weeks

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58
Q

trilaminar disc

A

3 weeks

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59
Q

notochord, primitive streak, mesoderm, and neural plate form

A

3 weeks

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60
Q

embryonic period

A

3-8 weeks susceptible to teratogens

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61
Q

neural tube closed by

A

week 4

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62
Q

heart begins beating

A

week 4

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63
Q

limbs form

A

week 4

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64
Q

fetal movement, fetus appears

A

week 8

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65
Q

genitalia (can sex the fetus)

A

weeek 10

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66
Q

agenesis

A

absent organ from absent primordial tissue

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67
Q

aplasia

A

absent organ with primordial tissue present

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68
Q

deformation

A

extrinsic disruption after embryonic period

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69
Q

malformation

A

intrinsic disruption: occurs during embryonic period

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70
Q

teratogen: renal damage

A

ACE inhibitors

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71
Q

teratogen: absent digits, other anomalies

A

alkylating agents

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72
Q

teratogen: Neural tube defects, fingernail hypoplasia, and developmental delay with facial defects

A

carbamazepine

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73
Q

teratogen:vaginal clear cell adenocarcinoma and congenital mullerian anomalies

A

Diethylstilbestrol

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74
Q

teratogen:neural tube defects

A

folate antagonist
carbamazepine
valproate

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75
Q

teratogen: Ebstein’s anomaly (atrialized right ventricl)

A

lithium

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76
Q

teratogen: microcephaly, dysmorphic face, hypoplastic nails and distal phalances with cardiac defects

A

phenytoin (fetal hydantoin syndrome)

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77
Q

teratogen:flipper limbs

A

thalidomide

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78
Q

teratogen: bone deformities, hemorrhage, abortion

opthalmologic abnormalities

A

warfarin

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79
Q

teratogen:placental abruption

A

cocaine

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80
Q

teratogen: preterm labor and placental problems, ADHD

A

smoking

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81
Q

which drugs can cause intrauterine growth retardation?

A

carbamazepine
phenytoin
smoking

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82
Q

maternal diabetes can cause

A 
anal atresia (caudal regression)
congenital heart defects
neural tube defects
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83
Q

Vitamin A causes

A

spontaneous abortions and birth defects

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84
Q

X rays cause

A

microcephaly and mental retardation

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85
Q

mental retardation, microcephaly, holoprosencephaly, face abnormalities, limb dislocation, and heart/lung fistulas

A

fetal alcohol syndrome

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86
Q

dizygotic twins always are

A

dichorionic

diamniotic

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87
Q

most monozygotic twins are

A

monochorionic

diamniotic

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88
Q

cleavage: dichorionic diamniotic monozygotic twins

A

0-4 days

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89
Q

cleavage: monochorionic diamniotic twins

A

4-8 days

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90
Q

cleavage: monochorionic monoamniotic twins

A

8-12 days

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91
Q

cleavage: monochorionic monoamniotic onjoined twins

A

> 13 days

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92
Q

fxn cytotrophoblast

A

cells of inner layer of chorionic villi

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93
Q

fxn syncytiotrophoblast

A

secretes hCG.

stimulates corpus luteum to make progesterone

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94
Q

umbilical arteries connect

A

fetal internal iliac arteries to placenta

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95
Q

umbilical arteries and veins derived from

A

allantois

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96
Q

umbilical vein connects

A

placenta to ductus venosus

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97
Q

contents of umbilical cord

A

2 arteries
1 vein
allantoic duct
wharton’s jelly

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98
Q

urachal duct

A

connects bladder and yolksac (umbilical cord)

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99
Q

urachal duct comes from

A

allantois

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100
Q

outpouching of bladder

A

vesicourachal diverticulum. failure of urachus to close

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101
Q

urine discharge from umbilicus

A

patent urachus

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102
Q

when does the allantois form

A

3 week

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103
Q

vitelline (omphalomesenteric duct)

A

connects yolk sac to gut lumen

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104
Q

discharge of meconium from umbilicus

A

vitelline fistula

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105
Q

meckel’s diverticulum: cause?

A

failure of vitelline duct to close

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106
Q

when does vitelline duct close

A

week 7

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107
Q

branchial cleft (grooves) vs arches vs pouches

A

cleft: ectoderm
arches: mesoderm and crest cells (bones, cartilage)
pouches: endoderm

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108
Q

1st branchial cleft

A

external auditory meatus

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109
Q

2nd-4th branchial clefts

A

temporary cervical sinuses

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110
Q

branchial left cyst in lateral neck caused by

A

persistent cervical sinus

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111
Q

pt with mandibular hypoplasia and facial abnormalities

A

failure of 1st arch neural crest cell migration (treacher collins)

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112
Q

persistence of fistula between tonsillar area and cleft in lateral neck caused by

A

3rd arch problem

=congenital pharyngocutaneous fistula

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113
Q

DiGeorge sx

A

No thymus

hypocalcemia (no parathyroids)

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114
Q

Men2A caused by mutation in

A

RET

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115
Q

RET codes

A

neural crest cells

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116
Q

parafollicular cells come from

A

neural crest cells

4th and 5th pharyngeal pouches

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117
Q

failure of fusion of maxillary and medial nasal processes

A

cleft lip

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118
Q

failure of fusion of lateral palatine processes, nasal septum, median palantine processes

A

cleft palate

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119
Q

paramesonephric duct

A

female system

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120
Q

mesonephric duct

A

male system

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121
Q

wolffian duct becomes

A

seminal vesicles
epididymis
ejaculatory duct
ductus deferens

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122
Q

paramesonephric duct becomes

A

fallopian tubes
uterus
upper portion of vagina

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123
Q

lower vagina from

A

urogenital sinus

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124
Q

fully developed 2ndary sex characteristics in a female indicates

A

functional ovaries

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125
Q

male development summary

A
  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
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126
Q

Both male and female internal genitalia, and male external genitalia

A

no MIF

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Perfectly
127
Q

male internal genitalia, ambigious external genitalia until puberty

A

5a reductase

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128
Q

hypospadias caused by

A

failure of urethral folds to close

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129
Q

epispadias caused by

A

faulty positioning of genital tubercle

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130
Q

epispadias associated with

A

extrophy of the bladder

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131
Q

gubernaculum in male

A

anchors testes in scrotum

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132
Q

gubernaculum in female

A

ovarian and round ligament of uterus

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133
Q

processus vaginalis forms

A

tunica vaginalis

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134
Q

more likely to get a hydrocele on the left or the right?

A

On the left–gonadal vein drains to left renal vein

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135
Q

ovaries/testes drain to what nodes

A

paraaortic lymph node

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136
Q

distal 1/3 or vagina/vulva drains to what nodes

A

superficial inguinal nodes

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137
Q

scrotum drains to

A

superficial inguinal nodes

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138
Q

proximal 2/3 of vagina drain what nodes

A

external iliac/hypogastric nodes

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139
Q

uterus drains to what nodes

A

external iliac/hypogastric nodes

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140
Q

suspensory ligament connects

A

ovaries to lateral pelvic wall

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141
Q

cardinal ligament connects

A

cervix to pelvis side wall

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142
Q

round ligament of the uterus connects

A

uterine fundus to labia majora

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143
Q

broad ligament connects

A

uterus, fallopian tubes, and ovaries to pelvic wall

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144
Q

ligament of the ovary connects

A

medial pole of ovary to lateral uterus

145
Q

structures in suspensory ligament

A

ovarian vessels

146
Q

structures in cardinal ligament

A

uterine vessels

147
Q

structure in round ligament

A

artery of sampson

148
Q

mesosalpinx

A

upper portion of broad ligament

149
Q

mesometrium

A

lower portion of broad ligament

150
Q

mesovarium

A

portion of broad ligament over the ovary

151
Q

endocervix hsitology

A

simple columnar

152
Q

uterus histology

A

simple columnar

153
Q

fallopian histology

A

simple columnar

154
Q

ovary histology

A

simple cuboidal

155
Q

erection mediated by what nerve

A

pelvic.

156
Q

emission (sperm into posterior urethra) nerve

A

hypogastric

157
Q

ejaculation nerve

A

pudendal nerve

158
Q

pathophys of erection

A

BONER:
1. NO–>cGMP–>smooth muscle relaxation–>vasodilation
BONER KILLER:
2. NE–>Increase in calcium in=vasoconstriction

159
Q

nervous systems for erection, emission, ejaculation:

A
  1. Parasympathetic
  2. Sympathetic
  3. Somatic
160
Q

sertoli cells secrete

A
  1. inhibitn
  2. androgen binding protein (increase local levels of testosterone)
  3. MIF
161
Q

what forms the blood testes barrier?

A

sertoli cells

162
Q

full development of sperm take how long

A

2 months

163
Q

what does a spermatid do to become a spermatozoa?

A

loss of cytoplasmic contents

gain of acrosomal cap=mature spermatozoa

164
Q

pirmary spermatocyte nuclear content

A

doubled chromosomes, 2N

165
Q

secondary spermatocyte nuclear contents

A

double chromsomes, haploid

1N, 2C

166
Q

spermatid nuclear contents

A

1N, 1C

haploid, one copy of everything

167
Q

inhibin inhibits what?

A

ONLY anterior pituitary

Not hypothalamus

168
Q

closure of epiphyseal plates

A

estrogen.

==In male, converted from testosterone by adipose tissue and leydig cells

169
Q

DHT differentiates

A

penis, scrotum, prostate

170
Q

Ovary produces what form of estrogen

A

17B-estradiol

171
Q

placenta produces what form of estrogen

A

estriol

172
Q

adipose estrogen

A

estrone

173
Q

potency of different estrogens

A

estradiol>estrone>estriol

174
Q

effect of estrogen on prolactin

A

Stimulates prolactin secretion but blocks prolactin action at the breast

175
Q

estrogen receptors located where in the cell?

A

cystoplasm.

After binding, translocates to the nucleus

176
Q

LH stimulates what enzyme

A

desmolase

–converts cholesterol to androstenedione

177
Q

Effect of estrogen on transport proteins

A

increased SHBG
Increased HDL
decreased LDL

178
Q

elevation in progesterone in a woman indicates

A

ovulation

179
Q

effets of progesterone

A 
decreases myometrial excitability
increases body temperature
inhibits FSH, LH
relaxes uterine smooth muscle
decreases estrogen receptors
180
Q

Tanner stage: curly and dark pubic hair

A

III

181
Q

Tanner stage: penis length and size increase

A

III

182
Q

Tanner: Enlargement of breast beyond buds

A

III

183
Q

Tanner: raised areolae

A

IV

184
Q

which phase of your period is constant

A

luteal phase

185
Q

normal cycle length

A

21-35 days

186
Q

metrorrhagia

A

frequent but irregular menstruation

187
Q

menometrorrhagia

A

heavy and irregular bleeding

188
Q

what hormones peak at 14 days

A

FSH
LH
Estrogen

189
Q

mittelschmerz

A

blood from ruptured follicle causes peritoneal irritation. looks like appendicitis

190
Q

eggs are held in what state until ovulation

A

prophase I

191
Q

eggs are held in what state until fertilization?

A

metaphase II

192
Q

what hormones STEADILY increase throughout the pregnancy

A

prolactin
progesterone
estriol

193
Q

after labor, what causes lactation?

A

removal of progesterone

194
Q

elevated hCG in which pathological states?

A

hydatidiform moles and choriocarcinoma

195
Q

menopause occurs earlier in what group?

A

smokers

196
Q

best test to confirm meenopaus?

A

Increase in FSH

197
Q

why do women become hirsuit after menopause?

A

increase in androgens (more LH) with peripheral conversion to estrone. (no negative feedback from estrogen)

198
Q

menopause before age 40

A

think premature ovarian failure

199
Q

hormonal levels in klinefelter’s

A

decreased inhibin
increased FSH
Increased LH
Increased estrogen

200
Q

barr body

A

klinefelter’s

201
Q

heart defects seen in turner’s

A

bicuspid aortic valve

preductal coractation

202
Q

renal defect in turner’s

A

horseshoe

203
Q

hormone levesl in turner’s

A

low estrogen
high FSH
high LH

204
Q

very fall, sever, acne
antisocial behavior
normal fertility

A

XYY

205
Q

high testosterone, high LH

A

defective androgen receptor

206
Q

high testosterone, low LH

A

testosterone tumor or exogenous use

207
Q

ovaries present, but external genitalia ambiguous

A

CAH

208
Q

testes present, but external genitalia are ambiguous

A

androgen insensitivity

209
Q

true hermaphroditism

A

Both ovary and testicular tissue present

210
Q

normal appearing female with rudimentary vagina and no internal genitalia

  • -testes in labia majora
  • -very little hair
A

androgen insensitivity. remove testes to prevent malignancy!

211
Q

labs in androgen insensitivity

A

high testosterone
high estrogen
high LH

212
Q

labs in 5a reductase deficiency

A

testosterone and estrogen levels are hormal. LH is normal.

213
Q

kallman syndrome cause

A

defective migration of GnRH

214
Q

labs in kallman

A

low GnRH, FSH, LH

low testosteron and sperm count

215
Q

most common precursor of a choriocarcinoma

A

hydatidiform mole

216
Q

snowstorm appearance on US

A

complete mole

217
Q

tx of mole

A

dilation and curettage and methotrexate

218
Q

follow up after mole removal

A

monitor b-hCG

219
Q

complete vs partial mole hcG

A

hcG much higher in complete mole

220
Q

which mole more likely to convert to choriocarcinoma?

A

complete mole

221
Q

risk of malignant trophoblastic disease higher in which mole?

A

complete mole

222
Q

cause of pre-eclampsia

A

impaired vasodilation of spiral arteries

=increased vascular tone

223
Q

sx of preeclampsia

A

hypertension, proteinuria and edema

224
Q

sx of preeclampsia before 20 weeks

A

molar pregnancy

225
Q

cause of death in preeclampsia

A

cerebral hemorrhage and ARDS

226
Q

how to prevent seizures of eclampsia

A

IV magnesium sulfate

227
Q

risk factors for abruptio placentae

A

Smoking, HTN, cocaine

228
Q

cause: placenta accreta

A

defective decidual layer. placenta attaches to myometrium

229
Q

risk factors for placenta accreta

A

C section
inflammation
placenta previa

230
Q

risk factors: placenta previa

A

multiparity and prior C section

231
Q

problems with retained placental tissue

A

postpartum hemorrhage

infection

232
Q

hCG lower than expected on dates

A

ectopic

233
Q

risk factors for ectopic pregnancy

A
  1. history of infertility
  2. salpingitis
  3. ruptured appendix
  4. prior tubal surgery
234
Q

polyhydramnios assoc’d with

A

esophageal/duodenal atresia

anencephaly

235
Q

oligohydramnios assoc’d with

A

bilateral renal agenesis
posterior urethral valves
placental insufficiency

236
Q

potter’s syndrome

A
  1. pulmonary hypoplasia
  2. clubbed feet
  3. cranial abnormalities
  4. bilateral renal agenesis
237
Q

HPV 16 gene product

A

E6. Inhibits p53

238
Q

HPV 18 gene product

A

E7. Inhibits RB suppresor gene

239
Q

sequelae of invasive carcinoma if growing laterally

A

block ureters=renal failure

240
Q

endometritis

A

inflammation of endometrium from retained products of conception

241
Q

tx for endometritis

A

gentamycin

clindamycin

242
Q

endometriosis sx

A

menorrhagia, dysmenorrhea, pain with a normal sized nucleus

243
Q

adenomyosis sx

A

menorrhagia, dysmenorrhea, pelvic pain with an enlarged uterus

244
Q

tx: endometriosis

A

contraceptives, NSAIDS

leuprolide, danazol

245
Q

endometrium within the myometrium

A

adenomyosis

246
Q

tx of adenomyosis

A

hysterectomy

247
Q

granulosa tumor will show

A

abnormal endometrial gland proliferation

–excess estrogen

248
Q

risk factors of endometrial carcinoma

A

lots of estrogen

  • obesity
  • diabetes
  • htn
  • nulliparity
249
Q

prognosis endometrial carcinoma

A

increased myometrial invasion=poorer prognosis

250
Q

leiomyoma type of tumor

A

benign smooth muscle tumor

251
Q

whorled pattern of smooth muscle bundles; tumor?

A

leimyoma

252
Q

sx of leiomyoma

A

abnormal bleeding

miscarriage

253
Q

bulky irregular tumor with necrosis and hmorrhage that may protrude from cervix and bleed. aggressive.

A

leimyosarcoma

254
Q

leiomyoma and leiomyosarcoma have an increased incidence in

A

blacks

255
Q

incidence by tumor type

A

endometrial>ovarian>cervical (US)

256
Q

worst prognosis by tumor type

A

ovarian>cervical>endometrial

257
Q

how does cushing’s cause anovulation?

A

high ACTH

–increased androgen production

258
Q

labs in PCOS

A 
high LH
low FSH
high testosterone
high estrogen (peripheral. aromatization)
NO progesterone
259
Q

PCOS pts at increased risk for what cancer

A

endometrial cancer.

260
Q

tx PCOS

A

weight loss medroxyprogesterone, OCPs

261
Q

follicular cyst contents

A

unruptured graafian follicle

262
Q

corpus luteum cyst

A

hemorrhage into corpus luteum

263
Q

cause: theca lutein cyst

A

gnRH stimulation. usually multiple

264
Q

theca/lutein cyst associated with

A

choriocarcinoma and moles

265
Q

hemorrhagic cyst cause

A

blood vessel rupture into cyst

266
Q

endometriod cyst

A

chocolate cyst. varies with menstrual cycle

267
Q

elevated hCG and LDH. sheets of uniform cells

A

dysgerminoma

268
Q

dysgerminoma associated with

A

Turner’s syndrome

269
Q

choriocarcinoma biopsy shows

A

trophoblastic tissue with NO chorionic villi

270
Q

schiller duval bodies

A

yolk sac tumor

271
Q

choriocarcinoma assoc’d with

A

increased theca lutein cysts

272
Q

choriocarcinoma spreads first to the

A

lungs

273
Q

yellow friable solid mass= tumor?

A

yolk sac

274
Q

where do yolk sac tumors present in adults? kids?

A

adults=ovaries and testes

kids=sacrococcygeal

275
Q

immature vs mature teratoma (dermoid cyst)

A

immature is aggressive.

276
Q

struma ovarii

A

teratoma that contains functional thyroid tissue

277
Q

90 percent of ovarian non germ cell tumors are

A

serous cystadenoma or serous cystadenocarcinoma

278
Q

histology: serous cystadenoma

A

fallopian tube epithelium

279
Q

histology serous cystadenocarcinoma

A

psamomma bodies

280
Q

multilocular cyst lined by mucus secreting epithelium. Intestine-like.

A

mucinsous cystadenoma

281
Q

mucinous cystadenocarcinoma associated with

A

pseudomyxoma peritonei

282
Q

pseudomyxoma peritonei

A

intraperitoneal accumulation of mucinous material from ovarian tumor

283
Q

pulling sensation in groin with ovarian fibroma, ascites, and hydrothorax

A

fibromas

284
Q

histology fibromas

A

spindle shaped fibroblasts

285
Q

call exner bodies

A

small follicles with eosinophilic secretions. associated with granulosa cell tumor

286
Q

estrogen secreting tumor

A

granulosa tumor

287
Q

GI malignancy that metastasizes to ovaries

A

krukenberg

288
Q

mucin secreting signet cell tumor in ovaries

A

krukenberg

289
Q

girls under four with spindle shaped tumor cells that are desmin positive

A

sarcoma botryoides

290
Q

Clear cell adenocarcinoma

A

women exposed to DES in utero

291
Q

diseases of the nipple

A

Paget’s

abscess

292
Q

diseases of the lactiferous sinus

A

intraductal papilloma

mastitis

293
Q

diseases of the major duct

A

fibrocystic change

ductal cancer

294
Q

diseases of the terminal duct

A

tubular carcinoma

295
Q

diseases of the lobules

A

sclerosing adenosis

lobular carcinoma

296
Q

diseases of the breast stroma

A

fibroadenoma

phyllodes tumor

297
Q

small mobile firm mass with sharp edges in the breast

A

fibroadenoma

298
Q

small tumor that grows in lactiferous ducts. Below areola

A

intraductal papilloma

299
Q

large bulky mass of CT and cysts in breast.

A

phyllodes

300
Q

“leaf like” projections in the breast

A

phyllodes

301
Q

phyllodes age group

A

60’s

302
Q

serous or bloody nipple discharge

A

intraductal papilloma

303
Q

risk of carcinoma with fibroma, intraductal papilloma, and phyllodes?

A

fibroma=none
intraductal papilloma=1.5-2x risk
phyllodes can become malignantM

304
Q

Most important prognostic factor with malignant breast tumors

A

axillary lymph node

305
Q

ductal caseous necrosis

A

comedocarcinoma

306
Q

rock hard mass with duct like cells

A

invasive ductal carcinoma

307
Q

stellate morpholoby

A

invasive ductal carcinoma

308
Q

indian file cells

A

invasive lobular carcinoma

309
Q

histology of medullary invasive carcinoma

A

fleshy, cellular, lymphocytic infiltrate

310
Q

peau d’orange skin with neoplastic cells blocking lymphatic ducts

A

inflammatory invasive breast cancer

311
Q

eczematous patches on nipple

A

paget’s disease

312
Q

which is the worst breast cancer to get

A

invasive ductal

313
Q

Which breast cancer has a good prognosis

A

medullary

314
Q

which breast cancer is usually bilateral with multiple lesions?

A

invasive lobular

315
Q

large cells in epidermis with clear halo in breast biopsy

A

paget cells

316
Q

Four types of fibrocystic disease

A
  1. fibrosis
  2. cystic
  3. sclerosing adenosis
  4. epithelial hyperplasia
317
Q

most common cause of acute mastitis

A

S aureus colonizing during breast feeding

318
Q

hyperplasia of the breast stroma—fibrocystic dz

A

fibrosis

319
Q

fluid filled blue dome with ductal dilation–fibrocystic dz

A

cystic

320
Q

increased acini and intralobular fibrosis with calcifications–fibrocystic dz

A

sclerosing adenosis. often confused with cancer

321
Q

Increased number of epithelial cell layers in terminal duct lobule–fibrocystic dz

A

epithelial hyperplasia

322
Q

which fibrocystic disease is associated with an increased risk of carcinoma?

A

epithelial hyperplasia

323
Q

benign lump from injury to breast tissue

A

fat necrosis

324
Q

drugs causing gynecomastia

A 
spironolactone
digitalis
cimetidine
alcohol
ketoconazole
325
Q

dysuria, frequency, urgency, and low back pain in a male

A

prostatitis

326
Q

cause of acute prostatitis

A

bacterial

327
Q

cause of chronic prostatitis

A

usually no bacteria

328
Q

BPH = enlargement of…

A

lateral and middle lobes

329
Q

sx of BPH

A

increased frequency of urination
difficulty starting and stopping pee
pain on urination

330
Q

Treatment of BPH

A

terazosin, tamsulosin (a 1antagonist)

finasteride (5a reductase blocker)

331
Q

prostate cancer arises from which area

A

posterior lobe, won’t cause sx like BPH

332
Q

tumor markers for prostate cancer

A
  1. increased prostatic acid phosphatase
  2. increased total PSA
  3. decreased free PSA
333
Q

how do you know if prostate cancer has metastasized to the bone?

A

serum alkaline phosphatase increase

334
Q

cryptorchidism

A

undescended testes

335
Q

cryptorchidism associated with increased risk of

A

increased risk of germ cell tumors

336
Q

risk factor for cryptorchidism

A

prematurity

337
Q

hormone levels in cryptorchidism

A

less inhibin, increased FSH and LH

  • -testosterone decreased in bilateral cryptorchidism
  • -testosterone normal in unilateral cryptorchidism
338
Q

bag of worms

A

varicocele

339
Q

tx of varicocele

A

surgery or embolization by radiologist

340
Q

95 percent of testicular tumors are

A

germ cell tumors

341
Q

homogeneous testicular enlargement. Watery cytoplasm and fried egg appearance: tumor?

A

seminoma

342
Q

increase in PLAP

A

seminoma

343
Q

seminoma age group

A

15-35

344
Q

yellow, mucinous with schillar duval bodies: testicular tumor?

A

yolk sac

345
Q

man with increased hCG

A

choriocarcinoma or teratoma or embryonal carcinoma

346
Q

choriocarcinoma in a male metastsizes to

A

lungs

347
Q

tumors producing gynecomastia

A

choriocarcinoma from hCG

348
Q

mature teratoma in a adult male vs child prognosis

A

adult male=malignant

child=benign

349
Q

teratoma labs

A

increased hCG and/or AFP

350
Q

glandular/papillary morphology with increased hCG

A

embryonal carcinoma. Often a mixed tumor with increased AFP

351
Q

Reinke crystals

A

leydig cell tumor

352
Q

most common testicular cancer in older men

A

lymphoma

353
Q

sertoli cell tumor

A

androblastoma from sex cord stroma

354
Q

sx of leydig cell tumor

A

gynecomastia in men, precocious puberty in boys

355
Q

hydrocele cause

A

incomplete fusion of processus vaginalis

356
Q

cause spermatocele

A

dilated epididymal duct

357
Q

bent penis from acquired fibrous tissue formation

A

peyronie’s disease

358
Q

causes of priapism

A 
trauma
sickle cell disease
medications
PDE5 inhibitors
antidepressants
alpha blockers
cocaine

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