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1
Q

ACE inhibitor teratogen

A

REnal damage

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2
Q

alkylating agens teratogen

A

absence of digits, multiple anomalies

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3
Q

Aminoglycosides teratogen

A

CN VIII

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4
Q

carbamazepine teratogen

A

NTDs, craniofacial defects, fingernail hypoplasia, developmental delay, IUGR

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5
Q

DES teratogen

A

persistence of glandular epithelium in upper 1/3 of vagina –> vaginal clear cell adenocarcinoma, congenital mullerian anomalies

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6
Q

folate antagonists teratogen

A

NTDs

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7
Q

Lithium teratogen

A

Ebstein’s (atrialized RV)

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8
Q

Phenytoin teratogen

A

Fetal hydantoin syndrome: microcephaly, dysmorphic craniofacial features, hypoplastic nails and distal phalanges, cardiac defects, IUGR, MR

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9
Q

Tetracyclines teratogen

A

discolored teeth

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10
Q

thalidomide teratogen

A

limb defects (“flipper”)

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11
Q

Valproate teratogen

A

inhibition of maternal folate absorption –> NTDs

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12
Q

Warfarin teratogen

A

bone deformities, fetal hemorrhage, abortion, ophthalmologic
heparin doesn’t cross placenta

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13
Q

maternal diabetse teratogen

A

caudal regression syndrome, congenital heart defects, NTDs

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14
Q

vitamin A excess teratogen

A

SABs, cleft palate, cardiac anomalies

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15
Q

XRT teratogen

A

microcephaly, MR

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16
Q

breast epithelium

A

two layers!
luminal cell (epithelium) – protect duct and make milk in lobules
myoepithelial – contractile

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17
Q

periductal mastitits

A

smokers –> relative vitamin A deficiency –> squamous metaplasia of lactiferous ducts –> inflammation behind blockage –> subareolar mass with granulation tissue –> nipple retraction

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18
Q

fat necrosis

A

trauma –> disruption –> saponification –> calcifications, giant cells.

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19
Q

fibrocystic change

A

hormone mediated, cystic change of lobules and terminal ducts.
hormone mediated.
“vague irregularity”
“blue dome cysts,” fibrosis, cysts, apocrine metaplasia–> No increased risk for Ca!
Ductal hyperplasia (excess layers of epithelium) and sclerosing adenosis (too many glands, can be calcified) –> 2X risk
Atypical hyperplasia (ductal or lobular) –> 5X
NB incr risk of Ca is bilateral!

20
Q

apocrine metaplasia

A

only metaplasia that doesn’t incr risk for Ca

21
Q

intraductal papilloma

A

small tumor that grows in lactiferous ducts, beneath areola
Serous or bloody d/c
slight inc in Ca risk
must distinguish from papillary carcinoma (will lose myoepithelial cells)

22
Q

fibroadenoma

A

small, mobile, firm mass with sharp edges
mot common tumor in pre-menopausal women
incr size and pain with incr estrogen
Not pre-malignant

23
Q

Phyllodes tissue

A

Large bulky mass of connective tissue and cysts with “leaf like projections” (similar to fibroadenoma, but overgrowth of fibrous component)
POST-menopausal women
CAN be malignant

24
Q

DCIS

A

Ductal hyperplasia –> DCIS. Fills ductal lumen
Early malignancy w/o BM penetration
Comedo type has high grade cells with caseous necrosis and dystrophic calcification at center of ducts (detected on mammo)

25
Q

Paget dz of nipple

A

excematous patches on nipple, ulceration.
Paget cells = large cells in epidermis with clear halo
Suggests underlying DCIS! (not true for Paget’s of vulva

26
Q

Invasive ductal Ca

A

most common type of invasive
p/w mass (“rock hard”), “stellate”
small, glandular, duct-like cells in desmoplastic stroma (connective tissue)
NB single cell type in epithelium = Ca

27
Q

Inflammatory carcinoma

A

subtype of ductal Ca
looks like mastitis that doesn’t resolve with Abx. peau d’orange
cancer present in dermal lymphatics –> blocks drainage
poor prognosis

28
Q

Medullary Ca

A

high grade malignant cells with inflammatory infiltrate
incr in BRCA1
good prognosis

29
Q

LCIS

A

malignant proliferation from lobule cells
no mass or calcifications (incidental finding)
lack of E-cadherin (CAM)
often multifocal and bilateral
Risk factor for carcinoma, moreso than true cancer
Tx: Tamoxifen and close follow up.

30
Q

invasive lobular Ca

A

single-file pattern of invasion due to loss of E-cadherin.

31
Q

staging of breast Ca

A

sentinel node Bx

32
Q

HER2/neu

A

cell surface growth factor R
(vs Estrogen and progesterone, which are nuclear)
Gene amplification –> excess
trastuzumab = blocker

33
Q

triple negative Ca

A

poor prognosis

afr am women

34
Q

triple negative Ca

A

poor prognosis

afr am women

35
Q

BRCA1

A

incr risk of medullary breast Ca

serous ovarian Ca (also fallopian tube)

36
Q

BRCA2

A

breast carcinoma in males

37
Q

epispadias

A

more rare than hypospadias
abnormal positioning of genital tubercle
associated with bladder exstrophy

38
Q

Management of testicular mass

A 
DONT biopsy (seeding of scrotum) 
Vast majority are germ cell and malignant
39
Q

seminoma

A

Germ cell tumor
large cells, clear cytoplasm, central nuclei “fried egg”
homogenous mass with no hemorrhage or necrosis
incr PLAP. radiosensitive, late mets = good prognosis

40
Q

embryonal carcinoma

A

malignant, painful. primitive “embryo-like” cells. hemorrhage, early hematogenous spread
incr AFP or bhCG
CTX can cause to mature

41
Q

yolk sac tumor

A

most common testicular tumor in children analogous to yolk sac ovarian tumor
“schiller-duval body” = glomeruloid.
elevated AFP

42
Q

choriocarcinoma

A

synctiotrophoblasts (hCG) and cytotrophoblasts.
hCG –> hyperthyroidism or gynecomastia
mets to lungs (tiny mass in testicle, massive mets)

43
Q

Teratoma

A

mature fetal tissue
2-3 embryonic layers
benign in females, malignant in males
AFP or hCG

44
Q

Sertoli cell tumor

A

sex cord stromal tumor
tubules
clinically silen

45
Q

leydig cell tumor

A

sex cord stromal tumor
androgen (precocious puberty or gynecomastia)
Reinke crystals

46
Q

testicular lymphoma

A

most common testicular mass in male >60, often b/l

often DLBCL

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