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Pathology 1st aid > Repro Path > Flashcards

Repro Path Flashcards

1
Q 
Male
Testicular atrophy
Eunechoid body shape
Gynecomastia
Female Hair distribution
A

Klinefelter’s Syndrome

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2
Q

Klinefelter’s Syndrome Genotype

A

XXY

Barr body present

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3
Q

Hormonal effect of dysgenesis of seminiferous tubules in Klinefelter’s

A

Decreased inhibin –> decreased FSH

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4
Q

Hormonal effect of abnormal Leydig Cells in Klinefelter’s

A

increased LH –> increased Estrogen

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5
Q

Most common cause of 1º amenorrhea

A

Turner Syndrome

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6
Q

Turner Syndrome genotype

A

XO

No Barr Body

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7
Q 
Short stature
Ovarian dysgenesis
shield chest
defects in lymphatics --> webbed neck
Lymphedema in hands and feet
A

Turner Syndrome

XO

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8
Q

Congenital defects associated with Turner Syndrome

A

Preductal Coarctation of Aorta
Horseshoe Kidney
Dysgerminoma

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9
Q

Hormone levels seen in Turner syndrome

A

Decreased Estrogen –> increased LH/FSH

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10
Q

Defective androgen receptor hormone levels

A

Increased T & LH

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11
Q

Testosterone secreting tumor or exogenous steroids hormone levels

A

increased T

Decreased LH

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12
Q

1º Hypogonadism hormone levels

A

Decreased T

Increased LH

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13
Q

Hypogonadotropic hypogonadism hormone levels

A

Decreased T and LH

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14
Q

Disagreement between phenotypic (external genitalia) and gonadal (testes/ovaries) sex

A

Pseudo-Hermaphoroditism

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15
Q

Female Pseudo-Hermaphoroditism (46 XX)

A

Ovaries but virulized/ambiguous genitalia

Exposure to androgens in utero

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16
Q

Male Pseudo-Hermaphoroditism (46 XY)

A

Testes present but female/ambiguous genitalia

Androgen insensitivity–most common cause

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17
Q

True Hermaphoroditism (46 XX or 47 XXY)

A

Both ovary and Testes

ambiguous genitailia

Rare

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18
Q

Increased E, T, and LH
Defect in Androgen Receptor
Genotypically male but Phenotypically female
Rudimentary vagina and no internal sex organs
Testes present in Labia

A

Androgen Insensitivity Syndrome

46 XY

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19
Q

Why do testicles need to be removed from labia in androgen insensitivity syndrome?

A

Prevent Malignancy

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20
Q

Male with ambiguous genitalia until puberty
Inability to convert T –> DHT
Autosomal Recessive

A

5alpha-reductase deficiency

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21
Q

Anosmia
Decreased Synthesis of GnRH
Decreased FSH, LH, T, and sperm count

A

Kallmann Syndrome

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22
Q

What causes Kallmann syndrome

A

failure of migration of GnRH cell and formation of olfactory bulb

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23
Q

Female presents with uterine bleeding, increased hCG, honeycomb uterus, and no fetus.

A

Hydatidiform Mole

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24
Q

Hydatidiform Mole is most common precursor of

A

Choriocarcinoma

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25
Q

Complete Hydatidiform Mole

A 
VERY HIGH hCG
46 XX or XY
Increased Uterine size
Choriocarcinoma risk
2 sperm in empty egg
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26
Q

Partial Hydatiform Mole

A 
69 XXX, XXY, XYY
increased hCG (not as much as complete)
normal uterus size
2 sperm 1 egg
Composed of fetal parts
RARELY becomes choriocarcinoma
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27
Q

Triad of preeclampsia

A

Edema
HTN
Proteinuria

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28
Q

Eclampsia

A

edema
HTN
Proteinuria
SEIZURES

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29
Q

HELLP Syndrome

A

Hemolysis
Elevated LV enzymes
Low Plts.

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30
Q

COD of pre-eclampsia

A

cerebral hemorrhage

ARDS

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31
Q

What causes pre-eclampsia?

A

placental ischemia due to compressed spiral aa. –> increased vascular tone

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32
Q

Tx for pre-eclmapsia

A

Delivery ASAP

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33
Q

Seizure Tx/prophylaxis during pregnancy (eclampsia)

A

Mg Sulfate

Watch for hyporeflexia

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34
Q

Painful bleeding in 3rd trimester
smoking, coke head mom
Hx of HTN

A

Abruptio placentae

detachment of placenta

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35
Q

Placenta accreta

A

Defective decidual layer allows placenta to attach to myometrium

Massive bleeding AFTER delivery

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36
Q

Increased risk of placenta accreta

A

prior C-section
inflammation
placenta previa

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37
Q

PAINLESS bleeding anytime during pregnancy
Placenta attached in lower part of Uterus
Near or over Os

A

Placenta previa

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38
Q

Retained placental tissue problems

A

post partum hemorrhage

infxn

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39
Q

Female presents with amenorrhea, RLQ pain, elevated hCG.

Endometrial Bx shows decidual endometrium but no chorionic villi

A

Ectopic pregnancy

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40
Q

Test of choice to Dx ectopic preg

A

ultrasound

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41
Q

Most common site for ectopic preg

A

fallopian tubes

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42
Q

Virus and genes associated with cervical CA

A

HPV 16–E6 inh. p53

HPV 18–E7 inh RB suppressor gene

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43
Q

complcation of invasive cervical CA

A

renal failure due to blocked ureters

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44
Q

Invasive cervical CA is usually what type of cell?

A

Squamous Cell CA

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45
Q

Inflammation of endometrium due to retained products of conception or foreign body (IUD)

A

Endometritis

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46
Q

Endometritis Tx

A

Gentamyxin + clindamycin

w/ or w/o ampicillin

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47
Q 
Cyclic pelvic pain with menses--severe
cyclic bleeding
painful intercourse
infertility
Endometial tissue outside of uterus
A

Endometriosis

Non-neoplastic

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48
Q

Endometrium within myometrium

A

Adenomyosis

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49
Q

Endometrial CA precurser

A

Endometrial Hyperplasia

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50
Q

What causes endometrial hyperplasia?

A

excess estrogen stimulation

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51
Q

Most common gyn malignancy

A

Endometrial CA

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52
Q

Endometrial CA presentation

A

most menopausal bleeding

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53
Q

Most common tumor in females

A

Leiomyoma (fibroids)

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54
Q 
Benign smooth mm. tumor 
Whorled pattern
Age 20-40
Located in myometrium
Black woman with anemia/vag bleeding
A

Leiomyoma (fibroids)

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55
Q

Bulky irregularly shaped tumor with areas of necrosis and hemorrhage in the uterus

black middle aged female

A

Leiomyosarcoma

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56
Q

Leiomyosarcoma arise from

A

de novo!!!!

Not from leiomyoma

57
Q

Most common GYN tumor locations

A

endometrial > ovarian > cervical (US)

Cervical worldwide

58
Q

GYN tumor locations with worst prognosis

A

Ovarian > cervical > endometrial

59
Q

Menopause before 40
Low E,
High LH, FSH
atresia of ovarian follicles

A

Premature ovarian failure

60
Q 
Amenorrhea
infertility (anovulation)
obesity
hirsutism
Bilaterally enlarged ovaries
NO PROGESTERONE
High LH
A

Polycystic Ovarian Syndrome

61
Q

why is there anovulation with Polycystic Ovarian Syndrome?

A

Increased LH –> anovulation –> NO PROGESTERONE

62
Q

Why is there an increased risk of endometrial CA with Polycystic Ovarian Syndrome?

A

Incresaed E due to aromatization of T in FAT CELLS with NO PROGESTERONE opposition

63
Q

Polycystic Ovarian Syndrome Tx

A 
Weight loss
OCP
Spironolactone
clomiphene (pregnancy desire)
metformin
64
Q

Distention of unruptured graafian follicle

A

Follicular cyst

65
Q

Hemorrhage into persistent corpus luteum

A

Corpus luteum cyst

66
Q

Bilater and multiple cysts
Gonadotropin stimulated
associated with chorio-CA and moles

A

Theca-Lutein cyst

67
Q

Blood vessel rupture in cyst wall

Grows with blood retention

A

Hemorrhagic Cyst

68
Q

Mature Teratoma

fat, hair, teeth, cartilage, bone

A

Dermoid Cyst

69
Q

Endometriosis within ovary and cyst formation

blood accumulate–dark brown color

A

Endometrioid cyst

Chocolate Cyst

70
Q

Malignant tumor in females
Sheets of uniform cells
Turner Syndrome

hCG and LDH markers

A

Dysgerminoma

71
Q

Tumor that presents with hyperthyroidsim due to functional thyroid tissue in ovary

A

Struma ovarii

72
Q

Most common ovarian germ cell tumor

benign

A

Mature teratoma

2-3 germ layers

73
Q

Aggressively malignant ovarian germ cell tumor

A

Immature tertoma

74
Q

Schiller Duvall bodies
yellow, friable, solid mass on ovary (testes)

Elevated AFP

A

Yolk Sac tumor

endodermal sinus tumor

75
Q

Increased hCG
Malignant ovarian tumor of Trophoblastic tissue
No chorionic villi
Occurs during/after preg in mom or baby

A

Choriocarcinoma

76
Q

increased frequency of choriocarcinoma with

A

theca-lutein cysts

77
Q

How does choriocarcinoma spread?

A

Hematogenously to lungs

78
Q

These 2 tumors account for 90% of ovarian tumors

A 
Serous Cystadenoma (45%)
Serous Cystadenocarcinoma (45%)
79
Q

Bilateral benign ovarian tumor lined with fallopian tube-like epithelium

A

Serous Cystadenoma

80
Q

malignant bilateral ovarian tumor

Psammoma bodies

A

Serous cystadenocarcinoma

81
Q

Serous cystadenoma tumor marker for prognosis

A

CA-125

not for screening

82
Q

Serous cystadenocarcinoma

A

BRCA-1
BRCA-2
HNPCC

83
Q

Multilocular cyst line by mucus secreting epithelium

benign intestine like tissue on ovary

A

Mucinous Cystadenoma

84
Q

Malignant mucus secreting ovarian tumor

causes pseudomyxoma peritonei

A

Mucinous cystadenocarcinoma

85
Q

pseudomyxoma peritonei

A

intrapericoneal accumulatoin (acites) of thick mucinous material from ovarian or appendiceal tumors

mucinous adenocarcinoma

86
Q 
Ovarian tumor that is bladder like tissue
bilateral or unilateral
solid pale yellow tan color
encapsulated
Coffe bean nuclei
A

Brenner Tumor

B’s
Bean, bilateral, bladder

87
Q

Bundles of spindle shaped fibroblasts
Ovarian tumor
causes Meig’s Syndrome

A

Fibromas

88
Q

Meig’s Syndrome

A

ovarian fibroma
ascites
hydrothorax

caused by fibromas

89
Q

Call-Exner Bodies
Secretes E –> presents with precocious puberty
Abnormal uterine bleeding
Ovarian tumor
Causes endometrial hyperplasia or CA in adults

A

Granulosa cell Tumor

90
Q

GI Mets to ovaries (bilateral)

Mucin secreting signet cell adenocarcinoma

A

Krukenberg Tumor

91
Q

Girls < 4
Spindle shaped tumor cells that are desmin +
Vaginal tumor

A

Sarcoma botryoides

(rhabdomyosarcoma variant)

looks like grapes coming out of vagina

92
Q

Tumor associated with DES exposure in utero

A

Clear cell adenocarcinoma of the vagina

93
Q

squamous cell CA of the vagina usually comes from

A

cervical SCC

94
Q

Small mobile firm mass in breast–benign
Sharp edges
< 35 yrs

increase size and tenderness with E

A

Fibroadenoma

95
Q

Small benign tumor in lactiferous ducts
usually bellow the areola

Serous/Bloody discharge

A

Intraductal papilloma

slight inc. risk of CA

96
Q

Large bulky mass of CT and cysts in breast

Leaf like projections

6th decade

may become malignant

A

Phyllodes tumor

97
Q

Single most important prognostic risk factor for malignant breast cancer

A

axillary lymph node involvement

98
Q

Over expression of what 2 receptors is common in breast cancer?

A

Estrogen/Progesterone receptors

c-erbB2 (HER-2, EGF)

99
Q

Risk factors of malignant breast cancer

A 
Estrogen exposure
increased total # menstrual cycles
older age of 1st live birth
obestiy
BRCA 1 and 2
100
Q

Breast tumor due to ductal hyperplasia that fills duct lumen

early malignancy w/o basement membrane penetration

A

Ductal CA in situ (DCIS)

101
Q

Ductal and caseous necrosis
Subtype of DCIS
breast tumor

A

Comedocarcinoma

102
Q

Most common of all breast cancers

Stellate morphology

Firm fibrous rock hard mass with sharp margins and small glandular duct-like cell

A

Invasice Ductal

103
Q

Invasive breast cancer
Orderly row of cells
Bilateral with multiple lesions

A

Invasive lobular

104
Q

Invasive breast cancer
Fleshy, cellular, lymphocytic infiltrate
Good prognosis

A

Medullary

105
Q

Invasive breast cancer
Dermal lymphatic invasion by breast CA

blocked lymph drainage –> Peau d’orange

A

Inflammatory

106
Q

Eczematous patches on nipple

large cells in epidermis with clear halo

suggestive of underlying DCIS

A

Paget’s disease of the nipple

107
Q

Types of fibrocystic disease

A

Fibrosis
Cystic
Sclerosing Adenosis
Epithelial Hyperplasia

108
Q

fibrocystic disease with hyperplasia of breast stroma

A

fibrosis

109
Q

fibrocystic disease with increased # of epithelial cell layers in terminal duct lobule

inc. risk of CA

A

Epithelial Hyperplasia

110
Q

fibrocystic disease with increased acinin and intralobular fibrosis

calcifications

A

Sclerosing adenosis

111
Q

fibrocystic disease with fluid filled blue dome

ductal dilation

A

cystic

112
Q

Breast abscess due to infection from cracked nipple during breast feeding

A

Acute Mastitis

113
Q

Most common bug for acute mastitis

A

S. aureus

114
Q

Post breast injury

benign

painless lumps

A

Fat necrosis

may not report trauma (sports)

115
Q

Rx’s associated with Gynecomastia

A 
Spironolactone
Digitalis
Cimetidine
Alcohol
Ketoconazole

Some drugs cause awkward knockers

116
Q

Lobes in BPH

A

Lateral and middle

periurethral

117
Q

BPH Tx

A

Alpha-1 antagonists (terazosin, tamsulosin)

Finasteride

118
Q

BPH marker

A

PSA

119
Q

Lower back pain

Incresaed Alk. Phos and PSA

A

Osteoblastic mets in bone from prostatic adenocarcinoma

120
Q

Markers for Prostatic adenocarcinoma

A

PSA (inc. total, dec. free)

Prostatic Acid Phosphatase (PAP)

121
Q

Lobe most common for prostatic adenocarcinoma

A

posterior lobe

peripheral zone

122
Q

Varicocele Tx

A

Varicocelectomy

Empolization by interventional radiologist

123
Q

95% of all testicular tumors

A

Germ Cell Tumors

124
Q

Malignant, painless, homogenous testicular enlargment
Radiosensitive
15-35
Large cells in lobules with watery cytosol
FRIED EGG APPEARANCE

A

Seminoma

125
Q

Seminoma Labs

A

increased placental alkaline phosphatatse (PLAP)

126
Q

Yellow mucinous tumor of testicle
Increased AFP
SCHILLER DUVALL BODIES

A

Yolk Sac tumor

endodermal sinus

127
Q 
Malignant testicle tumor
inc. AFP
Disordered Syncytiotrophoblastci and cytotrophoblastic elements
Gynecomastia
Hematogentous spread
A

Choriocarcinoma

128
Q

How are mature teratomas different in men than women?

A

they are malignant

129
Q

Malignant, painful testicular mass

glandular/papillary morphology
Usually with another tumor type
Incresaed hCG and NORMAL AFP (pure)

A

Embryonal CA

AFP can be elevated if mixed (more common)

130
Q 
Reinke Crystals
Androgen producing 
Gynecomastia in men
Precocious puberty in boys
Golden brown color
A

Leydig Cell

131
Q

Androblastoma from sex cord stroma

A

Sertolli cell

132
Q

Old men
Lymphoma mets to testes
Agressive

A

Testicular lymphoma

133
Q

Hydrocele

A

increased fluid due ot incomplete fusion of processusu vaginalis

Illuminates

134
Q

Spermatocele

A

Dilated epididymal duct

135
Q

2 tunica vaginalis lesions

A

hydrocele

spermatocele

136
Q

Squamous cell CA of penis

A

HPV and lack circumcision assoc.

137
Q

Bent penis due to aqcuired fibrosis

A

Peyronie’s Disease

138
Q

Painful sustained erections not due to sex

A

priapism

139
Q

causes of priapism

A 
Sickle cell
boner Rx
cocaine
alpha blockers
trauma
Rx

Pathology 1st aid (11 decks)

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