Repro Path High Yield Flashcards by Erin Allmer

What are 4 signs of Klinefleter syndrome?

1- Testicular atrophy
2- Gynecomastia
3- Long Extremitie
4- Inactivated X chromosome (Barr Body)

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What are the levels of the following in Klinefelter syndrome:

Inhibin
FSH
Testosterone
LH
Estrogen

Inhibitin- decreased

FSH- increased

Testosterone- decreased

LH- increased

Estrogen- increased

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What cardiac defect is associated with turner syndrome?

Bicuspid aorta

Preductal coartication

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What renal abnormality is assoiated with Turner syndrome?

Horseshoe kidney

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What are the levels of the following hormones in Turner syndrome:

Estrogen
LH
FSH

Estrogen- decreased

LH- increased

FSH- increased

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How can someone with Turner’s get pregnant?

OOcyte donation and exogenous estradiol/ progesterone administration

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How can 47, XXY result?

Nondisjunction event in mapternal meiosis II)

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What causes female psuedohermaphroditism?

Excessive and inappropriate exposure to androgenic steroids during early gestatino

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What causes male psuedohermaphroditism?

Androgen insensitivity syndrome

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What deficiency results in maternal virilization during pregnancy?

Aromatase deficiency (excess testosterone because can’t convert to estrogen)

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“normal appearing female with scant sexual har, rudimentary vagina and NO Uterus or fallopian tubes”

Androgen insensitivity syndrome (46, XY)

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“inability to convert testosterone to DHT leading to ambiguous external genitalia until puberty”

5alpha- reductase defciency

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“defective migration of GnRH cells and formation of olfactory bulb”

Kallman Syndrome

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Give an example of hypogonadotropic hypogonadism

Kallman syndrome

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Partial or complete mole:

46, XX or 46, XY

complete

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Partial or complete mole:

Extremely high hCG

Complete

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Partial or complete mole:

2 sperm in 1 egg

Partial

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Partial or complete mole:

Enucleated egg + single sperm (that then duplicates)

Complete

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Partial or complete mole:

Increased risk of choriocarcinoma

Complete

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Partial or complete mole:

Fetal parts

Partial

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Partial or complete mole:

honeycombed uterus/ snowstorm on ultrasound

Complete

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What 4 drugs can treat gestational HTN?

1- alpha Methyldopa
2- Labetolol
3- Hydralazine
4- Nifedipine

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What causes preeclampsia?

Abnormal placental spiral arteries–> endothelial dysfunction, vasoconstriction, ishcemia

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What causes preeclampsia?

Abnormal placental spiral arteries–> endothelial dysfunction, vasoconstriction, ishcemia

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"new onset HTN with either proteinuria or end organ dyfunction"

Preeclampsia

What is eclampsia?

Preeclampsia + maternal seizures

What is HELLP?

Hemolysis, Elevated Liver enzymes, Low Platelets

What are 5 major risk factor for placental abruption?

``` Trauma Smoking Cocaine use HTN Preeclampsia ```

What layer of the placena is defective in placental accreta/ increta/ percreta?

Defctive decidual layer

"placenta prentrates into the myometrium"

Placenta increta

"placenta attaches to myometrium but does NOT penetrate it"

Placental accreta

"placenta penetrates through myometrium and INTO uterine serosa (invades uterine wall)"

Placenta percreta

What is placental previa?

Implantation of the placenta in a lower uterine segment

What is a symptom of placental previa?

Painless 3rd trimester bleeding

What is a vasa previa?

Fetal vessels run ver the cervical os leading to vessel rupture, exsaguniation, and fetal death

Painful third trimerster vaginal bleeding?

Placental abruption

Assoicated with Polyhydramnios or Oligohydramnios? maternal diabetes

Polyhydramnios

Assoicated with Polyhydramnios or Oligohydramnios? placental insufficiency

Polyhydramnios

Most common gynecological tumors in the US?

Endometrial> Ovarian> cervial

Worst prognosis of gynecological tumors in the US?

Ovarian> cervical> endometrial

What causes Vaginal SCC?

High risk HPV...but it is usually secondary to cervical SCC

What is a cell marker for Sarcoma botryoides?

Desmin (+)

What types of HPV are associated with cervical SCC?

HPV 16 and 18

Is cervcal SCC reversible?

Yes, if caught in the SIN stages (cervical carcinoma in situ)

What is the #1 risk factor for cervical SCC?

multiple sexual partners

Describe the ratio of LH: FSH in PCOS?

Increased

Why is there an increased risk of endometrial cancer in PCOS?

Due to unopposed estrogen from repeated anovulatory cycles

What is the most common ovaria mass in young women?

Follicular cysts

What is a cell marker for ovarian cancer?

CA 125

What is the most common ovarian neoplasm?

Serous cystadenoma

"mass containing all 3 germ layers"

Mature cystic teratoma (dermoid cyst)

"ovarian tumor that resembles transitional cells of the bladder"

Brenner tumor

"triad of ovarian fibroma, ascites, hydrothorax"

Meigs syndrome

What hormone can thecomas produce?

Estrogen

""aggressive malignant ovarian tumor contains fetal tissue, neuroectoderm"

immature teratoma

What is the most common malignant stromal tumor of the ovaries?

Granulosa cell tumor

What hormones do granulosa cell tumors produce?

Estrogen | Progesterone

Tumor markers of dysgerminoma?

hCG and LDH

Marker for Choriocarcinoma?

hCG

Marker for Yolk sac tumors?

AFP

Whhat is a common histological finding of yolk sac tumors?

Schiller- Duval Bodies (resemble glomeruli)

"mucus secreting SIGNET cell adenocarcinoma of the ovaries"

Krunkenberg tumor (GI met to the ovaries

What is an endometrial polyp?

well circumscribed collection of endometrial tisue withint he uterine wall that MAY contain smooth muscle cells

benign smooth muscle tumor of the endometrium

Leimyoma (fibroid)

Why do leimyomas in the uterus have waxing and waning symptoms?

Beause they are sensitive to estrogen

"extension of endometrial tissue (glandular) into uterine myometrium"

Adenomyosis

What preceeds endometrial carcinoma?

Endometiral hyperplasia

Most common breast tumor in pre-menopausal women?

Fibroadenoma

Where are breast fibroadenomas located?

Stroma of the breast

Where are intraductal papillomas located?

Lacterferous sinus (typically beneath the areola)

Which benign breast tumor has an increased risk of malignancy?

Intraductal papilloma and phyllodes tumor

Where are phyllodes tumors located?

Stroma

What drugs creat gynecomastia in men?

``` Spironolactone Digoxin Cimetidine Alcohol Ketoconazole ```

What quadrant of the breast are malignant tumors more commonly located?

Upper outer quadrant

Where in the breast is DCIS located?

Major duct

What is the subtype of DCIS with ductal, central necrosis?

Comedocarcinoma

Where is invasive ductal carcinoma most likely located?

in the major duct

Where is invasive ductal carcinoma most likely located?

in the major duct

"invasive carcinoma of the breast with orderly rows of cells"

invasive lobular

What causes the orderly row like appearahce of cells in invasive lobular carcinoma of the breast?

Decreased E- cadherin expression

What causes the inflammatory invasive breast cancer?

Dermal lympocytic invasion by breast carcinoma--> neoplastic cells block lymphatic drainage

What causes the inflammatory invasive breast cancer?

Dermal lympocytic invasion by breast carcinoma--> neoplastic cells block lymphatic drainage

"abnormal curvature of the penis due to fibrous plaque within tunica albuginea that can cause pain and anxiety"

Peyronie disease

"painful sustained erection lasting >4 hours"

Priapism

How is priapism treated?

corporal aspiration, intracavernosal phenylephrine, or surgical decompression

"cancer of glans that presents as erythroplakia"

Erythroplasia of Queyrat--> Penile SCC

"presents on penile shaft as leukoplakia"

Bowen disease--> SC of the penis

"carcinoma in situ of unclear malignant potential, presenting as reddish papules on the penis"

Bowenoid papulosis

Why is there impaired spermatogenesis in cryptochidism?

Because sperm develop best at temperatures

"dilated veins in pampiniform plexus due to increased venous pressure"

Varicocele

"dilated veins in pampiniform plexus due to increased venous pressure"

Varicocele

"scrotal swelling in infants, due to incomplete obliteration of processus vaginalis"

Congenital hydrcele

Are the majority of testicular cancers germ cell or non-germ cell?

Germ cell!!

What are 2 risk factors for testicular germ cell tumors?

1- cryptorchidism | 2- Klinefelter syndrome

When are seminomas seen?

After the thrid decade in life! NEVER in infancy

What is the cell marker for yolk sac tumors?

AFP

What age are yolk sac testicular tumors seen?

What are the cell markers for teratoma?

hCG and AFP

"malignant,hemorrhagic mass with necrosis in the testicle"

Embryomal carcinoma

What are the 3 types of non-germ cell tumors?

1- Leydig cell 2- Sertoli cell 3- Testicular Lymphoma

What is the most common non germ cell testicular cancer?

Testicular lymphoma

What zone has undergone hyperplasia in BHP?

Periurethral

What type of bone mets are seen in prostate cancer?

Osteoblastic metastases