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1
Q

Hormone closes epiphyseal plates

A

estrogen

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2
Q

Converts androsteinedione to estrogen

A

aromatase in sertoli or granulosa cell

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3
Q

LH –> ovary

A

desmolase in theca cell to convert cholesterol to androsteindione

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4
Q

FSH –> ovary

A

aromatase in granulosa cell to convert androsteindione to estrogen

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5
Q

Estrogen form high in pregnancy

A

estriol

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6
Q

Phase of constant 14d

A

Luteal

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7
Q

Oocyte phase until ovulation

A

Prophase I

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8
Q

Oocyte phase until fertilization

A

Metaphase II

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9
Q

Implantation day

A

6

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10
Q

What secretes hCG?

A

trophoblast

  • blood = 1wk
  • urine = 2wk

Syncytiotrophoblast –> maintains CL for 1st trimester

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11
Q

What causes lactation?

A

Dec in progesterone

Prolactin maintains
Oxytocin = let down

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12
Q

Best test to confirm menopause

A

INC FSH - loss of feedback from estrogen

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13
Q

Klinefelter

A

47 XXY

Abnormal sertoli/seminiferous = dec inhibin, high FSH
Abnormal Leydig = dec T, high LH, high estrogen

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14
Q

Turner

A

45 XO
Bicuspid aortic valve, webbing, horseshoe kidney
Low estrogen –> high LH, FSH

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15
Q

1 cause of amenorrhea

A

Turner

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16
Q

Inc T

Inc LH

A

Defective androgen receptor

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17
Q

Inc T

Dec LH

A

T secreting tumor, steroids

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18
Q

Dec T

Inc LH

A

primary hypogonadism

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19
Q

Dec T

Dec LH

A

Hypogonadotropic hypogonadism

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20
Q

Androgen insensitivity

A

Normal appearing female
Rudimentary vagina
Testes in labia
NO SEXUAL HAIR

Inc T, estrogen, LH

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21
Q

5 alpha reductase deficiency

A

Males w/ ambiguous genitalia UNTIL PUBERTY

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22
Q

Kallmann syndrome

A

Defective GnRH

Anomsia, lack of secondary sex

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23
Q

Cluster of grapes, honeycomb uterus, snowstorm US, hCG >100,000

A

Mole - swelling of chorionic villi

Most = complete
More = Asians, TAIWAN
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24
Q

Complete mole

A

> > > > > hCG
46 XX, XY
#1 –> choriocarcinoma/malignancy
2 sperm, EMPTY egg

Completely a mole = no fetal tissue
Completely edematous = all villi
Completely proliferated = diffuse trophoblast

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25
Q

Partial Mole

A

69 XXX, XXY, XYY
Little inc in uterine size, hCG
RARE malignancy or choriocarcinoma
2 sperm, 1 egg

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26
Q

HELLP syndrome & Pre-eclampsia

A

HTN, proteinuria, edema after 20wks
hemolysis
elevated LFTs
Low platelets

Tx = IV Mag sulfate or diazepam

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27
Q

Painful bleeding in 3rd trimester, painful contractions

A

Abruption

- DIC, smoking, HTN, cocaine use

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28
Q

Painless bright red bleeding in any trimester

A

Previa

- inc w/ multiparity, prior C-section

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29
Q

Polyhydramnios

A

Esophageal/duodenal atresia

Anencephaly

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30
Q

Oligohydramnios

A

B/L renal agenesis (Potter seqence)

Post urethral valves

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31
Q

HPV 16

A

E6 inhibits p53

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32
Q

HPV 18

A

E7 inhibits RB

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33
Q

Endometritis

A

Retained product of conception after delivery

Tx = Cefoxitin, ampicillin-sulbactam, ticarcillin-clavulanate

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34
Q

Cyclic bleeding, menorrhagia, dysmenorrhea, dysparenunia, infertility, chocolate cysts

A

Endometriosis
Glands/Stroma OUTSIDE UTERUS
Normal sized uterus (vs. adenomyosis)

Inc risk of carcinoma

Tx = Danazol

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35
Q

Menorrhagia, pelvic pain, dysmenorrhea, enlarged uterus

A

Adenomyosis - endometrium in myometrium
Uniformly enlarged uterus

Tx = hysterectomy

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36
Q

Endometrial hyperplasia

A

Post-menopausal bleeding

  • inc estrogen
  • risk of carcinoma
  • inc in glands:stroma
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37
Q

1 GYN malignancy

A

Endometrial carcinoma

  • abnormal uterine bleeding in post-menopausal
  • preceded by endometrial hyperplasia
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38
Q

Prolonged use of estrogen w/o progestin, nulliparity, early menarche, late menopause risk for?

A

Endometrial carcinoma (endometrioid)

  • unopposed estrogen –> carcinoma
  • 50s
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39
Q

1 tumor in females

A

Leiomyoma

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40
Q

Abnormal uterine bleeding, multiple miscarriages, iron deficiency, pre-menopasual women, multiple, well-defined, white, whorled masses

A

Leiomyoma

  • higher in blacks
  • inc in pregnancy, dec in menopasue
  • usually multiple, well- demarcaated
41
Q

Abnormal uterine bleeding in post-menopasual women, single mass with hemorrhage and necrosis

A

Leiomyosarcoma

- NOT from leiomyoma = arise DE NOVO

42
Q

Obese woman with infertility, amenorrhea, hirsutism, high LH, T, estrogen, low FSH

A

Polycystic ovarian syndrome

  • Inc LH –> inc androgens –> inc estrone in adipose –> dec FSH = follicle degeneration & ANOVULATION
  • B/L enlarged cystic ovaries

LH:FSH >3:1

Tx = weight reduction, OCPs, Clomiphene

43
Q

1 ovarian mass in young women

A

Follicular cyst

  • hyperestrogen
  • endometrial hyperplasia
  • degeneration of follicles
44
Q

Cyst assoc w/ teratoma

45
Q

Cyst assoc w/ choriocarcinoma and moles

A

Theca-lutein cyst

- high serum hCG –> development

46
Q

Amenorrhea and failure to have menarche in a girl with NORMAL secondary sexual characteristics, cyclic abdominal pain, vaginal or anterior rectal bulge

A

Either imperforate hymen OR Mullerian duct anomalies

47
Q

Granulosa-Theca Cell Tumor

A

Yellow (lipid)
Secretes ESTROGEN
- feminizing, precocious puberty

Sheets/cords of cuboidal cells
Call-Exner

48
Q

Unilateral painful cyst in vestibule

A

Bartholin cyst

49
Q

HPV 6, 11

A

Condyloma of vulva & penis

- KOILOCYTES

50
Q

Koilocytes

A

Condyloma of vulva & penis

- HPV 6, 11

51
Q

Parchment-like, white vulvar skin

A

Lichen sclerosis

  • thinning of epidermis
  • fibrosis of dermis
  • benign, auto-immune
  • INC risk –> SCC
52
Q

Thick leathery vulvar skin

A

Lichen simplex chronicus

  • scratching –> hyperplasia –> THICKENING
  • NO risk of SCC
53
Q

How do you distinguish vulvar leukoplakia?

A

BIOPSY

- Lichen sclerosis vs. vulvar carcinoma

54
Q

HPV vs. Non-HPV vulvar carcinoma

A

HPV = 40s, VIN, 16, 18

Non-HPV = 70s, lichen sclerosis

55
Q

Carcinoma vs. Melanoma

A

Carcinoma = Keratin (epithelium), PAS +

Melanoma = S100+

56
Q

Upper 1/3 vagina origin & LN

A

Mullerian

Iliac LNs

57
Q

Lower 2/3 vagina origin & LN

A

UG sinus

Inguinal

58
Q

Persistence of columnar epithelium in upper 1/3 of vagina

A

Adenosis

- DES in utero

59
Q

Feared complication of DES assoc adenosis

A

Clear cell adenocarcinoma

60
Q

Mass with cytoplasmic cross-striations and desmin+, myogenin +

A

Embryonal Rhabdomyosarcoma

- grape-like mass from vagina or penis <5 y/o

61
Q

Neoplasia vs. CIS

A 
CIN/neoplasia = regresses
Carcinoma = less likely to regress
62
Q

Complication of advanced cervical carcinoma

A

Hydronephrosis –> post-renal failure –> death

63
Q

Confirmatory test for abnormal pap smear?

A

Colposcopy

64
Q

Limitations of pap smear

A

False - if not at transformation zone

Limited for adenocarcinoma

65
Q

Asherman syndrome

A

Secondary amenorrhea d/t loss of basalis (stem cells) –> can’t regenerate functionalis

cause = over aggressive D&C

66
Q

Cause of anovulatory cycle

A

High estrogen w/o progesterone –> abnormal endometrial growth and shedding (irregular uterine bleeding)

67
Q

SE of tamoxifen use

A

Endometrial polyp - pro-estrogenic effect in endometrium (vs. breast)

68
Q

“Gun-powder” nodules

A

Endometriosis implants

69
Q

1 site of endometriosis

A

ovary (chocolate cysts)

70
Q

Most important predictor for progression to carcinoma

A

Presence of cellular ATYPIA

71
Q

Post-menopausal bleeding in 75 y/o, serous and papillary structures with psamomma bodies in endometrium

A

Serous/papillary endometrial cancer

  • p53
  • SPORADIC
72
Q

PPL with polycystic ovarian syndrome are at risk for?

A

Endometrial carcinoma d/t high estrogen

Type II DM

73
Q

Most common ovarian tumor

A

Surface epithelial

74
Q

Single cystic, surface tumor of the ovary in 30 y/o, tumor cells in peritoneum

A

BENIGN serous/mucinous cystadenoma

- from surface epithelium

75
Q

Complex cyst of ovary with shaggy lining in 65 y/o, tumor cells in peritoneum

A

MALIGNANT serous/mucinous cystadenocarcinoma

- from surface epithelium

76
Q

BRCA1 cancers

A

Breast
Serous ovarian*
Serous fallopian

77
Q

Most common germ cell tumor in women

A

Cystic teratoma

  • # 1 benign
  • immature tissue (NEURAL) = malignant potential
  • thyroid = struma ovarii
78
Q

Ovarian tumor in 15-30 y/o

A

Germ cell tumor

  • tertoma
  • dysgerminoma
  • endodermal sinus
79
Q

Most common malignant germ cell tumor

A

Dysgerminoma

  • large cells w/ clear cyto
  • high LDH
80
Q

Most common germ cell tumor in kids

A

Endodermal sinus tumor (yolk sac)

  • HIGH AFP
  • SCHILLER-DUVAL bodies
81
Q

Reinke crystals

A

Sertoli-Leydig cell tumor

Women –> hirsutism, virilization
Males –> precocious puberty, gynecomastia

82
Q

Pelvic mass, fluid wave and SOB

A

Meigs syndrome

  • Ovarian fibroma
  • Pleural effusions
  • Ascites
83
Q

B/L ovarian tumor assoc w/?

A

Krukenberg tumor from diffuse type (signet ring) GASTRIC carcinoma

84
Q

Massive amounts of mucous in peritoneum

A

Psuedomyxoma peritonei

- mucinous tumor of the APPENDIX

85
Q

Most common cause of spontaneous abortion

A

Chr abnormalities

86
Q

Fetal alcohol syndrome

A

1 MR, facial, microcephal

87
Q

Fetal cocaine

A

IUGR

Abruption

88
Q

Fetal thalidomide

89
Q

Fetal Isotretinoin

A

spontaneous abortion

hearing, visual

90
Q

Fetal smoking

91
Q

Fetal phenytoin

A

Digit hypoplasia

Cleft lip/palate

92
Q

Germ cell vs. mole/gestational choriocarcinoma

A

Mole = RESPONDS to radiotherapy

93
Q

Most impact in lowering the rate of cervical cancer

94
Q

Bleeding in 1st 20 wks, closed cervix, viable fetus on US

A

Threatened abortion –> bed rest

Fetus not viable = missed
Open cervix = inevitable

95
Q

Pelvic pain, abnormal bleeding and hyperthyroid signs, high free T4/3

A

struma ovarii

96
Q

1 cause of infertility in women

97
Q

OCPs dec risk of?

A

Ovarian cancer

98
Q

SE of OCPs

A

High TAGs, cholesterol, HTN, hypercoagulable,

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