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Step 1 > Repro Random facts > Flashcards

Repro Random facts Flashcards

1
Q

What causes a cleft palate?

A

Failure of fusion of the two lateral palatine processes or failure of fusion of lateral palatine processes with the nasal septum and/or median palatine process

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2
Q

What causes testes development?

A

SEY gene in Y chromosome produces testes determining factor

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3
Q

What secretes MIF?

A

Sertoli cells

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4
Q

Action of MIF

A

Suppresses development of paramesonephric ducts

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5
Q

What does the mesonephric duct become and what stimulates it to become this?

A

Seminal vesicles, epididymis, ejaculatory duct, ductus deferens. Stimulated by androgens from Leydig cells

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6
Q

Primary amenorrhea in a woman with fully developed secondary sexual characteristics

A

Mullerian agenesis

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7
Q

What causes development of the prostate?

A

DHT (so 5-alpha-reductase deficiency causes male internal genetalia, ambiguous external genetalia until puberty)

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8
Q

What does the genital tubercle become in men?

A

Glans penis and corpus cavernosum and spongiosum

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9
Q

What is the female homolog of the prostate gland?

A

Urethral and para urethral glands (of Skene)

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10
Q

What is the male homolog of the greater vestibular glands (of Bartholin)

A

Bulbourethral glands of Cowper

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11
Q

What is hypospadias associated with?

A

Inguinal hernia and cryptorchidism

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12
Q

Mehta causes epispadias?

A

Faulty positioning of genital tubercle

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13
Q

What do the urogenital folds become?

A

Ventral shaft of penis in men and labia minora in women

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14
Q

What causes a cleft lip?

A

Failure of fusion of the maxillary and medial nasal processes (formation of primary palate)

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15
Q

Lymph drainage of the proximal vagina/uterus

A

Obturator, external iliac, and hypogastric nodes

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16
Q

What is the other name for the suspensory ligament of the ovary?

A

Infundibulopelvic ligaments

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17
Q

What is the round ligament?

A

Connects the uterine funds to labia majora. Derivative of the gubernaculum. Travels through round inguinal canal; above artery of Sampson

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18
Q

Affects of temperature on Sertoli cells

A

Increased temperature causes decreased sperm production and decreased inhibin

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19
Q

Where are the Leydig cells?

A

In the interstitial between seminiferous tubules

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20
Q

What does androgen binding protein do and what secretes it?

A

Secreted by Sertoli cells, maintains local levels of testosterone (by binding and making it less lipophilic so it stays in the tubule)

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21
Q

What types of estrogen are made by the ovary, placenta, and adipose tissue and what is the potency?

A

Ovary: 17-beta-estradiol; placenta: estriol; adipose tissue: estrone via aromatization. Potency: Estradiol> estrone> estriol

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22
Q

Effect of SHBG on cholesterol

A

Increased transport proteins (SHBG) causes increased HDL and decreased LDL

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23
Q

Which cells in the female make androgens?

A

Theca interna cells

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24
Q

What enzyme is used to make androgens from cholesterol

A

Desmolase

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25
Q

Which cells make estrogens from androgens

A

Grnaulosa cells

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26
Q

Where are estrogen receptors located?

A

Cytoplasm (translate to the nucleus when bound by estrogen)

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27
Q

Regulation of prolactin by estrogen and progesterone

A

Estrogen stimulates prolactin secretion, fall in progesterone after delivery disinhibits prolactin

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28
Q

When is follicular growth the fastest?

A

During the 2nd week of the proliferative phase

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29
Q

Where is meiosis I arrested and until when?

A

Arrested in prophase I for years until ovulation

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30
Q

Where is meiosis II arrested and until when?

A

Metaphase II until fertilization

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31
Q

What secretes hCG?

A

Syncytiotrophoblasts.

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32
Q

When is hCG detectable?

A

Detectable in blood 1 weeks after conception and on home test in urine two weeks after conception

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33
Q

Why do double Y males and people taking exogenous testosterone have acne?

A

Androgens stimulate follicular epidermal hyperproliferation and excessive sebum production

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34
Q

What do you see in aromatase deficiency?

A

Masculinization of female infants, increased serum testosterone and androstenedione. Can present with maternal virilization during pregnancy (fetal androgens cross the placenta)

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35
Q

Inheritance of aromatase deficiency

A

Autosomal recessive

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36
Q

Inheritance of complete androgen insensitivity syndrome

A

X-linked

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37
Q

Inheritance of 5-alpha-reductase deficiency

A

Autosomal recessive

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38
Q

What is Kallmann syndrome?

A

Hypogonadotropic hypogonadism. Defective migration of GnRH cells and formation of olfactory bulb, decreased synthesis of GnRH in the hypothalamus; anosmia. Most common mutation in KAL-1 gene or fibroblast growth factor-1, which code for proteins required in this migration

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39
Q

Which antihypertensives do you use for gestational HTN?

A

Alpha-methyldopa, labetalol, hydralazine, nifedipine

40
Q

What may be the cause of preeclampsia?

A

Abnormal placental spiral arteries ->endothelial dysfunction, vasoconstriction, ischemia

41
Q

What might cause maternal death in eclampsia?

A

Storke, intracranial hemorrhage, or ARDS

42
Q

What does the blood smear show in HELLP syndrome?

A

Schistocytes

43
Q

Complication of HELLP syndrome?

A

Can lead to hepatic sub capsular hematomas-> rupture -> severe hypotension

44
Q

Histology of sarcoma botryoides

A

Spindle-shaped cells; desmin positive

45
Q

How does HPV lead to cancer?

A

E6 gene product (inhibits p53 suppressor gene); E7 gene product (inhibits RB suppressor gene)

46
Q

White atrophic macules with “cigarette paper” quality

A

Lichen sclerosis et atrophicus

47
Q

What is a follicular cyst

A

Distention of unruptured graafian follicle. May be associated with hyperestrogenism, endometrial hyperplasia

48
Q

What is a Thea-lutein cyst?

A

Due to gonadotropin stimulation. Associated with choriocarcinoma and hydatidiform moles

49
Q

Most common malignant ovarian tumor

A

Serous cystadenocarcinoma

50
Q

What is a Brenner tumor?

A

A benign ovarian neoplasm, looks like bladder. “Coffee bean” nuclei on H&E sain

51
Q

What is Meigs syndrome?

A

Triad of ovarian fibroma (benign, bundles of spindle-shaped fibroblasts), ascites, hydrothorax

52
Q

What is an immature teratoma?

A

Malignant (vs mature teratoma, which is benign). Made up of fetal tissue, neuroectoderm.

53
Q

Which type of ovarian tumor produces estrogen?

A

Granolas cell tumor

54
Q

Cells arranged haphazardly around collections of eosinophilic fluid

A

Call-Exner bodies in a granolas cell tumor

55
Q

What is pseudomyxoma peritonei and which type of tumor causes it?

A

Intraperitoneal accumulation of mutinous material from ovarian or appendiceal tumor, caused by a mucinous cystadenocarcinoma

56
Q

Ovarian tumor with sheets of “fried egg” cells

A

Dygerminoma

57
Q

What do you see in choriocarcinoma?

A

Malignancy of trophoblastic tissue (cytotrophoblasts, syncytiotrophoblasts); NO chorionic villi present

58
Q

Yellow, friable (hemorrhagic), solid mass in a child

A

Yolk sac (endodermal sinus) tumor

59
Q

Tumor with things resembling glomeruli

A

Yolk sac tumor (glomeruli: Schiller-Duval bodies)

60
Q

Whorled pattern of smooth muscle bundles with well-demarcated borders

A

Leiomyoma

61
Q

Treatment for endometritis

A

Gentamicin + clindamycin with or without ampicillin

62
Q

What are the two layers of epithelium lining lobules and ducts?

A

Luminal cells and myoepithelial cells

63
Q

Histology of a phyllodes tumor

A

Large, bulky mass of connective tissue and cysts. “Leaf-life” projections

64
Q

Green-brown nipple discharge

A

Mammillary duct ectasia. Characterized by ductal dilatation, inspissated breast secretions, and chronic granulomatous inflammation in the predicate and interstitial areas

65
Q

Does apocrine metaplasia increase the risk for breast cancer?

A

NO

66
Q

What is sclerosing adenosis?

A

Increased acini and interlobular fibrosis. Associated with calcifications.

67
Q

Tx for lactational mastitis

A

Dicloxacillin

68
Q

Most common pathogen for lactational mastitis

A

S. aureus

69
Q

Which drugs can cause gynecomastia?

A

Spironolactone, digoxin, cimetidine, alcohol, ketoconazole

70
Q

What are Paget cells?

A

Large cells in epidermis with clear halo

71
Q

“Stellate” infiltration

A

Invasive ductal carcinoma

72
Q

Breast cancer with orderly rows of cells

A

Invasive lobular, due to decreased E-cadherin expression

73
Q

What is a penile fracture?

A

Rupture of corpora cavernous due to forced bending

74
Q

Tx of priapism

A

Corporal aspiration, intracarvernosa phenylephrine, or surgical decompression

75
Q

Precursor lesions for penile squamous cell carcinoma

A

Bowen disease: in penile shaft, presents as leukoplakia; Erythroplasia of Queyrat: cancer of glans, presents as erythroplakia; Bowenoid papulosis: carcinoma in situ of unclear malignant potential, presenting as reddish papules

76
Q

What is penile SCC associated with

A

HPV, lack of circumcision

77
Q

Where do you see extragonadal germ cell tumors?

A

In adults- most commonly in retroperitoneum, mediastinum, pineal, and suprasellar regions. In infants and young children, sacrococcygeal teratomas are most common

78
Q

Do you biopsy testicular tumors?

A

NO because of risk of seeding the scrotum

79
Q

Testicular tumor with large cells in lobules with watery cytoplasm, no hemorrhage or necrosis. Increased placental ALP

A

Seminoma, with “fried egg” appearance cells

80
Q

Prognosis of seminoma

A

Excellent. Radiosensitive, late metastasis

81
Q

Most common testicular tumor in boys

A

Yolk sac (endodermal sinus) tumor. Has Schiller- Duval bodies

82
Q

What symptoms might you see of choriocarcinoma in males?

A

Gynecomastia, symptoms of hyperthyroidism. (Disordered syncytiotrophoblastic elements produces hCG, which is structurally similar to LH, FSH, and TSH)

83
Q

In males are mature teratomas benign or malignant?

A

Malignant in adult males, but benign in children

84
Q

Testicular tumor that is hemorrhagic and necrotic

A

Embyonal carcinoma. Often glandular/papillary morphology

85
Q

Reinke crystals (eosinophilic cytoplasmic inclusion)

A

Seen in Leydig cell tumors. These tumors usually produce androgens->gynecomastia in men, precocious puberty in boys. Golden brown color

86
Q

Treatment of BPH

A

alpha-1-antagonists (terazosin, tamsulosin) which cause relaxation of smooth muscle; 5-alpha-reductase inhibitors (e.g. finasteride); PDE-5 Inhibitors

87
Q

Which part of the prostate does adenocarcinoma usually arise from?

A

Posterior lobe (peripheral zone)

88
Q

What should you give before starting leuprolide for prostate cancer?

A

Flutamide for androgen receptor blockade

89
Q

MOA of clomiphene

A

Antagonist at estrogen receptors in hypothalamus. Prevents normal feedback inhibition and increases release of LH and FSH from pituitary, which stimulates ovulation

90
Q

What is anastrozole

A

An aromatase inhibitor

91
Q

MOA of mifepristone

A

Competitive inhibitor of progestins at progesterone receptors

92
Q

What are terbutaline, ritodrine?

A

Beta-2-agoists that relax the uterus; used to decrease contraction frequency in women during labor

93
Q

MOA of danazol

A

Synthetic androgen that acts as a partial agonist at androgen receptos

94
Q

Clinical use of danazol

A

Endometriosis, hereditary angioedema

95
Q

How is ketoconazole an anti androgen?

A

Inhibits steroid synthesis (inhibits 17,20-desmolase)

96
Q

MOA of minoxidil

A

Direct arteriolar vasodilator

97
Q

Clinical use of minoxidil

A

Androgenetic alopecia; severe refractory hypertension

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