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Step 1 AB > Repro > Flashcards

Repro Flashcards

1
Q

Gene produced at base of limbs (In ZPA) that is important for patterning along anterior posterior axis

A

Sonic hedgehog gene

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2
Q

Gene produced at apical ectodermal ridge necessary for proper organization along dorsal-ventral axis

A

Wnt-7 gene

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3
Q

Gene produced at apical ectodermal ridge that stimulates mitosis of underlying mesoderm and provides lengthening of limbs

A

FGF gene

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4
Q

Gene involved in organization of embryo in craniocaudal direction

A

Homeobox (HOX) genes

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5
Q

Mutation that results in appendages in wrong locations

A

Hox gene mutations

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6
Q

When does hCG secretion begin?

A

1 week after fertilization; around the time of implantation of blastocyst which is day 6

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7
Q

a. When is the embryo 2 layers?

b. When is the embryo 3 layers?

A

a. Within week 2 of development

b. Within week 3 (primitive streak, notochord, mesoderm neural plate begin to form)

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8
Q

When does neural tube close?

A

By week 4

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9
Q

What happens during week 4 of embryogenesis?

A

Heart begins to beat

Upper and lower limb buds begin to form

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10
Q

When is fetal cardiac activity visible by transvaginal ultrasound?

A

By week 6

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11
Q

When do genitalia have male or female characteristics during fetal development?

A

By week 10

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12
Q

Surface ectoderm derivatives

A 
Epidermis
Adenohypophysis
Lens of eye
Epithelial linings of oral cavity
Sensory organs of ear
Olfactory epithelium
Anal canal below the pectinate line
Parotid, sweat, mammary glands
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13
Q

Extrinsic disruption; occurs after embryonic period

A

Deformation

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14
Q

Secondary breakdown of previously normal tissue or structure. Example?

A

Disruption; amniotic band syndrome

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15
Q

Intrinsic disruption; occurs during embryonic period

A

Malformation

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16
Q

Abnormality resulting from a single primary embryologic event

A

Sequence (Potter sequence)

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17
Q

Causes of increased AFP

A

neural tube defect
multiple gestation
incorrect dating
abdominal wall defect

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18
Q

Fetal component of placenta

A

Cytotrophoblast - inner layer; makes cells

Synctiotrophoblast - outer layer of chorionic villi - secretes hCG

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19
Q

Why is the Synctiotrophoblast not attacked by the maternal immune system?

A

It lacks MHC-I expression

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20
Q

Maternal component of placenta

A

Decidua basalis; derived from endometrium; maternal blood in the lacunae

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21
Q

What is the urachus?

Anomalies associated with urachus?

A

In the 3rd week the yolk sac forms the allantois that extends into the urogenital sinus. The allantois becomes the urachus = a duct between fetal bladder and yolk sac

  • Patent urachus: total failure of urachus to obliterate –> urine discharge from umbilicus
  • Urachul cyst: partial failure of urachus to obliterate; fluid filled cavity lined with uroepithelium between umbilicus and bladder
  • Vesicourachal diverticulum: slight failure of urachus to obliterate –> outpouching of bladder
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22
Q

Complications of urachul cyst

A

Adenocarcinoma, infection

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23
Q

What is the vitelline duct?

Associated anomalies?

A

Vitelline duct connects the yolk sac to the midgut lumen

  • Vitelline fistula: if vitelline duct fails to close–> meconium discharge from umbilicus
  • Meckel diverticulum: partial closure of vitelline duct with patent portion attached to ileum –> causes melon, hematochezia, abdominal pain
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24
Q

Female homologs of:

a. Glans penis
b. corpus cavernosum and spongiosum
c. bulbourethral glands
d. prostate gland
e. ventral shaft of penis
f. scrotum

A

a. glans clitoris
b. vestibular bulbs
c. greater vestibular glands of Bartholin
d. urethral and paraurethral glands of Skene
e. labia minora
f. labia majora

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25
Q

Failure of urethral folds to fuse

A

Hypospadias (abnormal opening on ventral surface)

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26
Q

Hypospadias associations

A

Cryptorchidism

Inguinal hernia

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27
Q

Epispadias associations

A

Exstrophy of bladder

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28
Q

Pathway of sperm ejaculation

A 
Seminiferous tubules
Epididymis
Vas deferens
Ejaculatory ducts
(nothing)
Urethra
Penis
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29
Q

Cause of urine leaking beneath deep fascia of Buck

A

Anterior penile urethra injury

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30
Q

Source of:

a. estradiol
b. estriol
c. estrone

A

a. ovary
b. placenta
c. adipose tissue

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31
Q

Functions of progesterone

A 
Maintenance of pregnancy
Decreased myometrial excitability 
Production of thick cervical mucus, which inhibits sperm entry into uterus
Increased body temp
Inhibition of gonadotropins
Uterine smooth muscle relaxation
Decreased estrogen receptor expression
Prevents endometrial hyperplasia
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32
Q

Which phase of menstrual cycle varies in length? And which is set?

A 
Follicular phase (proliferative) varies
Secretory phase (luteal) is always 14 days
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33
Q

What layers are shed during menstruation?

A

Stratum compactum and stratum spongiosum

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34
Q

What hormones have the same alpha subunit?

A

hCG, LH, FSH, TSH

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35
Q

hCG levels in fetal anomalies

A

hCG increased in multiple gestations, hydatidiform moles, choriocarcinomas, down syndrome
hCG decreased in ectopic/failing pregnancy, edward syndrome, patau syndrome

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36
Q

Source of estrogen after menopause

A

Peripheral conversion of androgens to estrone

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37
Q

Hormone to measure if you suspect menopause

A

FSH levels are drastically increased from loss of negative feedback due to decreased estrogen)

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38
Q

Where are androgens converted to estrogen and by which enzyme?

A

Adipose tissue and testis by P-450 aromatase

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39
Q

Hypogonadotropic hypogonadism

A

Kallmann syndrome –> from defective migration of GnRH cells and formation of olfactory bulb –> anosmia, decreased GnRH, FSH, LH, testosterone and infertility

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40
Q

Normal appearing female with rudimentary vagina; no uterus or fallopian tubes. (Structure felt in labia majora)

A

Androgen insensitivity syndrome (46 X, Y)

Breast development from testosterone converted to estradiol

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41
Q

Maternal virilization

A

Aromatase deficiency (fetal androgens cross placenta)

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42
Q

Masculinization of female infant with increased serum testosterone and androstenedione

A

Aromatase deficiency

43
Q

Hydatidiform mole with increase of malignancy

A

Higher risk with complete mole (15-20%)

44
Q

a. Karyotype of complete mole

b. Karyotype of partial mole

A

a. 46,XX or 46XY (enucleated egg + single sperm; sperm divides)
b. 69 XXX, 69 XXY, 69 XYY (2 sperm + 1 egg)

45
Q

Honeycombed uterus or clusters of grapes

A

Complete mole (46 XX or 46 XY)

46
Q

preventing seizures in pre-eclampsia

A

IV magnesium sulfate

47
Q

Decreased deep tendon reflexes
Pulmonary edema
Cardiac conduction defect
AMS

A

IV Mg toxicity

48
Q

Complication of HELLP syndrome

A

Hepatic subcapsular hematomas –> rupture –> severe hypotension

49
Q

Pregnant woman with anemia, RUQ pain, jaundice, bruising

A

HELLP

50
Q

Painless third trimester bleeding

A

Placenta previa

51
Q

Vaginal tumor + for desmin

A

Sarcoma botryoides (rhabdomyosarcoma variant)

52
Q

Clear, grape-like polypoid mass emerging from vagina

A

Sarcoma botryoides

53
Q

Ovarian tumor with mucus secreting epithelium (like intestine)

A

Mucinous cystadenoma

54
Q

What is a Dermoid cyst?

A

Mature cystic teratoma

55
Q

Ovarian tumor that looks like bladder; coffee bean nuclei

A

Brenner tumor

56
Q

Triad of ovarian fibroma, ascites and hydrothorax

A

Meigs syndrome

57
Q

Tissue most common in immature teratoma

A

Neuroectoderm/ neural tissue

58
Q

Call-Exner bodies

A

Granulosa cell tumor (resemble primordial follicles)

59
Q

Psammoma bodies and ovarian tumor

A

Serous cystadenocarcinoma

60
Q

Pseudomyxoma peritonei

A

Mucinous cystadenocarcinoma

61
Q

Uniform fried egg cells

hCG and LDH

A

Dysgerminoma

62
Q

Increased bhCG, shortness of breath, hemoptysis

A

Choriocarcinoma (hematogenous spread to lungs)

63
Q

Yellow, friable mass
Schiller-Duval bodies (resemble glomeruli)
AFP tumor marker

A

Yolk sac (endodermal sinus) tumor

64
Q

Mucin-secreting signet cell adenocarcinoma

A

Krukenberg tumor (GI malignancy that metastasizes to ovaries)

65
Q

Whorled pattern of smooth muscle bundles with well-demarcated borders

A

Leiomyoma (fibroid)

66
Q

Extension of endometrial tissue into uterine myometrium

A

Adenomyosis

67
Q

Tender, boggy, enlarged uterus; dyspareunia

A

Adenomyosis

68
Q

Cause of endometriosis

A

Retrograde flow
Metaplastic transformation of multipotent cells
Transportation of endometrial tissue via lymphatic system

69
Q

Dyschezia

A

Pain with defecation

70
Q

Danazol

A

Partial agonist at androgen receptors; used for endometriosis, hereditary angioedema (counteracts effects of estrogen)

71
Q

Treatment for endometritis

A

Gentamicin + Clindamycin (with or without ampicillin)

72
Q

Small, mobile firm mass with sharp edges in breast

Increases with estrogen

A

Fibroadenoma (most common in those

73
Q

Small breast tumor that grows in lactiferous ducts (beneath areola) - benign

A

Intraductal papilloma

74
Q

Benign tumor with serous or blood nipple discharge

A

Intraductal papilloma

75
Q

Large, bulky mass of connective tissue and cysts (leaf like projections) - benign breast tumor

A

Phyllodes tumor (5th decade)

76
Q

Inflammation of duct; green nipple discharge, in post menopausal women

A

Mamillary duct ectasia

77
Q

Increased acini and interlobular fibrosis of breast

Calcifications

A

Sclerosing adenosis - benign (increased risk of developing cancer)

78
Q

Ductal, central necrosis - noninvasive breast tumor

A

Comedocarcinoma

79
Q

Drugs that cause Gynecomastia (Some Drugs Create Awesome Knockers)

A 
Spironolactone
Digoxin
Cimetidine
Alcohol
Ketoconazole
80
Q

Invasive breast tumor with reactive, desmoplastic stroma surrounding invasive glands

A

Invasive ductal cancer

81
Q

Peau d’orange

A

Dermal lymphatic invasion by breast carcinoma (inflammatory)

82
Q

Indian file orderly row of cells (due to decreased E-cadherin expression)

A

Invasive lobular breast cancer

83
Q

Causes of Priapism

A

Trauma
Sickle cell disease
Medications (Sildenafil, Trazodone)

84
Q

Leukoplakia on penile shaft

A

Bowen disease (squamous cell carcinoma)

85
Q

Erythroplakia on penis

A

Etyrhoplasia of Queyrat (SCC); cancer of glans

86
Q

Reddish papules on penis

A

Bowenoid papulosis (carcinoma in situ)

87
Q

Cause of congenital hydrocele

A

Incomplete obliteration of processus vaginalis

88
Q

Most common testicular tumor in boys

A

Yolk sac (endodermal sinus) tumor; Increased AFP, Schiller duval bodies (look like glomeruli)

89
Q

Ovarian/testicular tumor with signs of hyperthyroidism

A

Choriocarcinoma; bhCG is structurally similar to LH, FSH, TSH

90
Q

Painful testicular tumor

A

Embryonal carcinoma; most often mixed

Increased hCG and normal AFP levels (or increased if mixed)

91
Q

Testicular tumor with Reinke crystals

A

Leydig cell tumor

92
Q

What cells have fried egg appearance?

A

Koilocytes of HPV
Oligodendrogliomas
Seminomas/Dysgerminomas

93
Q

Which parts of prostate does BPH affect?

A

Lateral and middle - the periurethral part

94
Q

Osteoblastic metastases in bone

A

Prostatic adenocarcinoma metastases

95
Q

Clomiphene mechanism

A

Antagonist at estrogen receptors in hypothalamus –> prevents normal feedback inhibition and increased release of LH/FSH

96
Q

Raloxifene mechanism and S/E

A

Antagonist at breast, uterus; agonist at bone

Increased risk of thromboembolic events but no increased risk of endometrial cancer

97
Q

Anastrazole/Exemestane

A

Aromatase inhibitors used in post menopausal women with ER + breast cancer (S/E = osteoporosis)

98
Q

Mifepristone mechanism

A

Competitive inhibitor of progestins at progesterone receptors used for termination of pregnancy in combo with misoprostol (PGE1)

99
Q

Terbutaline, Ritodrine

A

B2 agonists that relax the uterus

Used to decrease contraction frequency in women during labor

100
Q

Finasteride mechanism and use

A

5 alpha reductase inhibitor; used for BPH and male pattern baldness (decreases conversion of testosterone to DHT)

101
Q

Flutamide mechanism and use

A

Non-steroidal competitive inhibitor of androgen receptors

Used for prostate carcinoma

102
Q

Ketoconazole mechanism

A

Inhibits steroids synthesis (inhibits 17,20 desmolase)

103
Q

Minoxidil mechanism

A

Direct arteriolar vasodilator used for androgenetic alopecia and severe refractory hypertension

104
Q

Blood nipple discharge differential

A

Intraductal papilloma - benign

Invasive papillary carcinoma - malignant

Step 1 AB (29 decks)

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