Repro-Stuff Missed Flashcards
PCOS
characterized by obesity
oligomenorrhea
infertility
enlarged ovaries with multiple cysts
Infertility treatments for PCOS patients
Treat with clomiphene - estrogen receptor modulator that decreases negative feedback inhibition on hypothalamus by circulating estrogen thus increasing gonadotropin production
Treatment of hirsuitism in PCOS patients
Spironolactone - androgen receptor antagnoist
Major risk factor for cervical cancer
Multiple sex partners – means more exposure to high risk strains of HPV (16, 18, 31, 33)
Major risk factors for cervical cancer
Cigarrette smokeing
Lower socioeconomic statis
Early coitarche
Mullerian inhibiting factor
responsible for regression of paramesonephric ducts give rise to female internal genetalia
Testosterone in embryogenesis
mediates development of male INTERNAL genitalia
DHT during embryogenesis
mediates development of male EXTERNAL genitalia
Sx: Infant male has small phalus and hydrophalus. Testes in inguinal area and BP and testosterone is normal. What enzyme is deficient?
5-alpha reductase.
5-alpha reductase converts testosterone to DHT.
DHT is reponsible for EXTERNAL male genitalia
17-hydroxylase deficiency
results in decreased secretion of cortisol and sex steroids and increased level of mineralcorticoids (aldosterone)
– results in HYPERTENSION and undervirilization of male genitalia
Aromatase deficiency
Results in virilization of female infants. Male infants NOT affected.
Aromatase catalyzes conversion of androgens to estrogen
DCIS (Ductal Carcinomas In Siute)
precancerous breast lesion
- maligant clonal cell proliferation contained by surrounding ductal basement membrane
- myoepithelial layer of duct is preserved and uninvolved
Paget disease of breast
rare form of breast cancer
malignant cells spread from superficial DCIS into nipple skin without crossing BM
Sclerosing adenosis
characterized by central acinar compression and distortion (by surrounding fibrotic tissue and peripheral ductal dilation
Mammary duct ectasia
characterized by ductal dilation, thickened breast secretions, and chronic granulomatous inflammation in periductal and interstitial areas
Sx: HIV positive man (CD4: 280) complains of rectal bleeding, pain, and itching. Single ulcerative mass in anal canal. Likely diagnosis
Human Papilloma Virus
- increased risk of anal carcinoma
Hyaditaform moles
- appear as “bunch of grapes”
- result of trophoblastic proliferation
- presents as enlarged uterine, abnormal vaginal bleeding, abdominal comfort
- EXCESSIVE B-hCG
Complete mole
46, XX; 46XY
- increased B-hCG
- increased uterine size
- can convert to choriocarcinoma
- 2 sperms + empty egg
- can become malignant
Partial mole
- 69 XXX; 69XXY; 69 XYY
- moderate increase in B-hCG
- doesn’t convert to carcinoma
- fetal parts
- 2 sperm + 1 egg
- low risk of malignancy
Bicornate uterus
- due to failure of paramesonephric ducts to close
Paramesonephric ducts
fuse to form uterine tubes, uterus, cervix, and superior 1/3 of vagina
Conditions that promote renal calculi
Increased calcium, phosphate, and uric acid
Conditions that PREVENT calculi formation
Increased citrate and high fluid intake
Patent urachus
due to failure of urachus to obliterate by birth
- *urachus is a remnant of allantois that connects bladder with yolk sac
- condition presents with urine discharge from the umbilicus
Meckel’s diverticulum
- incomplete obliteration of vitteline duct (from yolk sac) which conects small intestine with skin
Omphacele
caused by incomplete closure of anterior abdominal wall during embryonic development and presents as ventral opening
- convered by peritoneum
Hypospadias
urethral opening located on ventral surface of penis but rarely in scrotum or perinuem
- due to failure of urethral folds to close
- associated with downward curvature of penis
-
Gastrochsis
due to inadequate enlargement of peritoneal cavity during life
Primary syphillis
painless ulceration (chancre)
- develops 1-3 weeks after contact
resoves in 3 - 6 weeks
Secondary syphillis
- bacteremic stage
- develops 5 -10 weeks following chancre
- presents as maculo rash on palms and soles
- condylomata lata (large gray like growth)
Tertiary syphillis
gummas (painless, induration)
Sx: positive VRDL test + pleocytosis (increase in WBC) in lumbar puncture
- Tertiary syphillis
Pleocytosis in spinal cord = neurosyphillis
Sx: young male with purulent yellow-green urethral discharge. Gram - diplococci
N. gonorrhoae
Treatment of N. gonorrhoae
Ceftriaxone (for gonoccal infection) +
Azithromycin to treat Chlamydae
Candida vulvuvaginitis
- discharge is thick, white & adherent to vaginal walls (“cottage chesse)
- vaginal inflammation
- pseudohyphase
- treatment: flucanazole
Bacterial vaginosis
- thin, off-white discharge with fishy order
- no vaginal inflammation
- pH > 4,5
- Clue cells + positive whiff test
Trichomoniasis
- malodorus, gray-green thin frothy vaginal discharge
- evidence of vaginal inflammation
- PH > 4.5
- MOTILE trichomonad on smear
Causes of Candida vulvugaginits
- antibiotic use
- corticosteroid use
- OCP use
- systemic corticosteroid use
HSV-2
infection of sacral sensory ganglia with double stranded DNA virus
-results in recurrent, painful genital rash (genital herpes)
Mucopurulent cervicitis with cervical motion tenderness is sign of what?
PID - caused by N. gonorrheae and C. trachomatis
- can lead to ectopic pregnancy or infertility due to salpingitis
