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USMLE Step 1 > Repro-Stuff Missed > Flashcards

Repro-Stuff Missed Flashcards

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USMLE® Step 1 flashcards
1
Q

PCOS

A

characterized by obesity
oligomenorrhea
infertility
enlarged ovaries with multiple cysts

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2
Q

Infertility treatments for PCOS patients

A

Treat with clomiphene - estrogen receptor modulator that decreases negative feedback inhibition on hypothalamus by circulating estrogen thus increasing gonadotropin production

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3
Q

Treatment of hirsuitism in PCOS patients

A

Spironolactone - androgen receptor antagnoist

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4
Q

Major risk factor for cervical cancer

A

Multiple sex partners – means more exposure to high risk strains of HPV (16, 18, 31, 33)

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5
Q

Major risk factors for cervical cancer

A

Cigarrette smokeing
Lower socioeconomic statis
Early coitarche

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6
Q

Mullerian inhibiting factor

A

responsible for regression of paramesonephric ducts give rise to female internal genetalia

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7
Q

Testosterone in embryogenesis

A

mediates development of male INTERNAL genitalia

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8
Q

DHT during embryogenesis

A

mediates development of male EXTERNAL genitalia

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9
Q

Sx: Infant male has small phalus and hydrophalus. Testes in inguinal area and BP and testosterone is normal. What enzyme is deficient?

A

5-alpha reductase.

5-alpha reductase converts testosterone to DHT.

DHT is reponsible for EXTERNAL male genitalia

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10
Q

17-hydroxylase deficiency

A

results in decreased secretion of cortisol and sex steroids and increased level of mineralcorticoids (aldosterone)
– results in HYPERTENSION and undervirilization of male genitalia

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11
Q

Aromatase deficiency

A

Results in virilization of female infants. Male infants NOT affected.

Aromatase catalyzes conversion of androgens to estrogen

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12
Q

DCIS (Ductal Carcinomas In Siute)

A

precancerous breast lesion

  • maligant clonal cell proliferation contained by surrounding ductal basement membrane
  • myoepithelial layer of duct is preserved and uninvolved
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13
Q

Paget disease of breast

A

rare form of breast cancer

malignant cells spread from superficial DCIS into nipple skin without crossing BM

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14
Q

Sclerosing adenosis

A

characterized by central acinar compression and distortion (by surrounding fibrotic tissue and peripheral ductal dilation

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15
Q

Mammary duct ectasia

A

characterized by ductal dilation, thickened breast secretions, and chronic granulomatous inflammation in periductal and interstitial areas

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16
Q

Sx: HIV positive man (CD4: 280) complains of rectal bleeding, pain, and itching. Single ulcerative mass in anal canal. Likely diagnosis

A

Human Papilloma Virus

- increased risk of anal carcinoma

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17
Q

Hyaditaform moles

A
  • appear as “bunch of grapes”
  • result of trophoblastic proliferation
  • presents as enlarged uterine, abnormal vaginal bleeding, abdominal comfort
  • EXCESSIVE B-hCG
18
Q

Complete mole

A

46, XX; 46XY

  • increased B-hCG
  • increased uterine size
  • can convert to choriocarcinoma
  • 2 sperms + empty egg
  • can become malignant
19
Q

Partial mole

A
  • 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
20
Q

Bicornate uterus

A
  • due to failure of paramesonephric ducts to close
21
Q

Paramesonephric ducts

A

fuse to form uterine tubes, uterus, cervix, and superior 1/3 of vagina

22
Q

Conditions that promote renal calculi

A

Increased calcium, phosphate, and uric acid

23
Q

Conditions that PREVENT calculi formation

A

Increased citrate and high fluid intake

24
Q

Patent urachus

A

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
25
Q

Meckel’s diverticulum

A
  • incomplete obliteration of vitteline duct (from yolk sac) which conects small intestine with skin
26
Q

Omphacele

A

caused by incomplete closure of anterior abdominal wall during embryonic development and presents as ventral opening
- convered by peritoneum

27
Q

Hypospadias

A

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
-

28
Q

Gastrochsis

A

due to inadequate enlargement of peritoneal cavity during life

29
Q

Primary syphillis

A

painless ulceration (chancre)
- develops 1-3 weeks after contact
resoves in 3 - 6 weeks

30
Q

Secondary syphillis

A
  • bacteremic stage
  • develops 5 -10 weeks following chancre
  • presents as maculo rash on palms and soles
  • condylomata lata (large gray like growth)
31
Q

Tertiary syphillis

A

gummas (painless, induration)

32
Q

Sx: positive VRDL test + pleocytosis (increase in WBC) in lumbar puncture

A
  • Tertiary syphillis

Pleocytosis in spinal cord = neurosyphillis

33
Q

Sx: young male with purulent yellow-green urethral discharge. Gram - diplococci

A

N. gonorrhoae

34
Q

Treatment of N. gonorrhoae

A

Ceftriaxone (for gonoccal infection) +

Azithromycin to treat Chlamydae

35
Q

Candida vulvuvaginitis

A
  • discharge is thick, white & adherent to vaginal walls (“cottage chesse)
  • vaginal inflammation
  • pseudohyphase
  • treatment: flucanazole
36
Q

Bacterial vaginosis

A
  • thin, off-white discharge with fishy order
  • no vaginal inflammation
  • pH > 4,5
  • Clue cells + positive whiff test
37
Q

Trichomoniasis

A
  • malodorus, gray-green thin frothy vaginal discharge
  • evidence of vaginal inflammation
  • PH > 4.5
  • MOTILE trichomonad on smear
38
Q

Causes of Candida vulvugaginits

A
  • antibiotic use
  • corticosteroid use
  • OCP use
  • systemic corticosteroid use
39
Q

HSV-2

A

infection of sacral sensory ganglia with double stranded DNA virus
-results in recurrent, painful genital rash (genital herpes)

40
Q

Mucopurulent cervicitis with cervical motion tenderness is sign of what?

A

PID - caused by N. gonorrheae and C. trachomatis

- can lead to ectopic pregnancy or infertility due to salpingitis

USMLE Step 1 (34 decks)

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