Reproduction Flashcards
connects cervix to pelvic side wall
cardinal ligament
connects the ovaries to the lateral pelvic wall
suspensory ligament
connects the uterus, fallopian tubes, and ovaries to the pelvic side wall
broad
contains the uterine vessels
cardinal ligament
contains the ovarian vessels
suspensory ligament
testicular cancer first mets to
peri-aortic lymph nodes
what develops from mesonephric ducts
male internal genitalia except prostate
male homologue to: vestibular bulbs labia minora bartholin glands urethral and paraurethral glands (of Skene)
corpus cavernosum and spongiosum
ventral shaft of penis
bulbourethral glands
prostate gland
what gene product comes from the SRY gene that underlies male genital development
testis determining factor
anchors testes to the scrotum
gubernaculum
pulsing schedule of GnRH affects gonadotropin release how
pulsatile: increase release
continuous: decrease/stop release
difference btw androgen insensitivity and 5-alpha-reductase deficiency
androgen insensitivity: female genitalia, but genetically male.
5-a-reductase: male genitalia that are hypodeveloped until puberty causes a large increase in testosterone
sertoli and leydig cells
LH -> leydig cells -> testosterone
FSH -> sertoli cells -> androgen binding protein (keeps testosterone in testicle)
testicular tumor composed of cytotrophoblasts and syncytiotrophoblasts
choriocarcinoma
may present initially with gynecomastia in males
leydig cell tumor
elavated AFP in males
yolk sac, teratoma
elevated BhCG in males
choriocarcinoma, embryonal and teratoma
most common testicular cancer
seminoma
most common testicular tumor in infants and children up to 3yrs of age
yolk sac
most common testicular tumor in men over age 60
testicular lymphoma
histologic appearance similar to koilocytes (cytoplasmic clearing)
seminoma
histologically may have alveolar or tubular appearance sometimes with papillary convolutions
embryonal carcinoma
composed of multiple tissue types
teratoma
histologic endodermal sinus structures (Schiller-Duval bodies) in males
yolk sac tumor
25% have cytoplasmic rod-shaped crystalloids of Reinke
leydig cell
androgen-producing and associated with precocious puberty (test cancer)
leydig cell, may be sertoli
what is the major side effect of sildenafil
life threatening hypotension when combined with nitrates
balanitis is caused by what bug
candida albicans
difference between finasteride and flutamide
finasteride is 5areductase inhibitor (BPH, male pattern baldness)
flutamide inhibits testosterone receptor (treat prostate cancer)
most common cancer in men
prostate cancer
most common cause of urinary obstruction in men
BPH
most common treatment for erectile dysfunction
phosphodiesterase inhibitor (sildenafil)
layers of endometrium
stratum compactum
stratum spongiosum
stratum basale
the compactum and spongiosum are shed monthly
two-cell theory of estradiol production
FSH -> granulosa cell -> aromatase (androstenedione) -> estrogen
LH -> theca cell -> makes androstenedione
30 year old woman presents with a low grade fever, a rash across her nose that gets worse when she is out in the sun, and widespread edema. What blood test would you order to confirm your clinical suspicion?
ANA to screen for lupus
appearance of HPV infection
koilocytic change: perinuclear halo
dysplastic cervical cells with enlarged, dark nuclei
koilocytes
Diethylstilbestrol (DES)
clear cell adenocarcinoma of vagina
what are the risk factors for endometrial carcinoma
HHONDA hyperplasia HTN obesity nulliparity diabetes anovulatory state
excess unopposed estrogen is the main risk factor
endometrial proliferation and cancer
menorrhagia with an enlarged uterus and no palpable pain
fibroid (leiomyoma)
pelvic pain that presents only during menstruation
endometriosis
diagnosed by endometrial biopsy in clinic
endometrial hyperplasia and cancer
definitive diagnosis and treatment is by laparoscopy
endometriosis
menstruating tissue within the myometrium
adenomyosis
malignant tumor of the uterine smooth muscle
leiomyosarcoma
most common tumor in women
leiomyoma
most common gynecologic malignancy in the US
endometrial carcinoma
most common gynecologic malignancy worldwide
cervical carcinoma
chocolate cyst of the ovary
endometriosis
what is the underlying cause of PCOS?
increased LH and decreased FSH -> lack of ovulation
a young woman is found to have short stature and shortened 4th and 5th metacarpals. What endocrine disorder is most likely responsible for these manifestations?
albright hereditary osteodystrophy
type1a pseudohypoparathyroidism
ovarian tumor produces AFP
yolk sac (endodermal)
estrogen secreting ovarian tumor leading to precocious puberty
granulosa cell
intraperitoneal accumulation of mucinous material
mucinous cystadenocarcinoma
testosterone secreting, leading to virilization
sertoli-leydig cell
psammoma bodies in ovary
serous cytadenocarcinoma
multiple different tissues in tumor
teratoma
ovarian tumor lined with fallopian tube-like epithelium
serous cystadenoma
ovarian tumor + ascites + hydrothorax
fibroma (Meig’s syndrome)
call-exner bodies in ovarian tumor
granulosa cell
resembles bladder epithelium ovarian tumor
brenner tumor
ovarian tumor with elevated BhCG
choricarcinoma and dysgerminoma
risk factors for ovarian tumors
uninterrupted ovulation, nulliparity, early menarche, late menopause, family hx (BRCA1/2, HNPCC (lynch syndrome))
persistantly wet umbilicus in infant
patent urachus
CO and plasma volume changes in pregnancy
CO increases 30-50%
plasma volume increases 50%
elevated AFP on maternal serum screen
neural tube defects, twins, abdominal wall defects
incorrect dating is largest cause of false test results
monozygotic twins are delivered. one is pale with a hematocrit of 15%, the other is flushed with hematocrit of 55%. what is the cause
twin-twin transfusion syndrome
causes of recurrent miscarriage
low progesterone chromosomal abnormalities uterine abnormalities infections poor mental health autoimmune/clotting disorders
16wks pregnant women presents with atypically large abdomen and HTN. what might be the cause and how would it appear on blood test
hydatidiform mole
increased hCG
placenta previa, abruptio, accreta
previa: placenta over os (painless bleeding)
abruptio: early separation of placenta (painful bleeding, motor vehicle accident most common cause)
accreta: no decidua, placenta goes straight to myometrium
previous c-section increases risk for
placenta previo and accreta
HTN drugs during pregnancy
hydralazine, methyldopa, labetalol
Db drugs during pregnancy
insulin is gold standard
Epilepsy drugs during pregnancy
whatever best controls seizures. more defects without meds then with except valproic acid
supplement with folic acid (up to 4 grams)
hyperthyroidism drugs in pregnancy
propylthiouracil (PTU) 1 trimester
methimazole (2 and 3 trimester)
anticoagulation in pregnancy
heparin or enoxaprim
do not use warfarin
tocolysis
prevent uterine contractions
indomethacin, nifedipine, terbutaline, magnesium sulfate
labor promotion
pitocin
prostaglandins (dinoprostone (PGE2) misoprostol (PGE1))
tox: tachysystole, uterine rupture, fever
pregnancy termination
dilation and curretage
mifepristone (RU-486): inhibitor of progesterone receptor + misoprostol to ensure complete abortion
methotrexate: inhibits folate production
evaluation of infertility, semen analysis is normal and she has a history of pelvic inflammatory disease. What is next step?
hysterosalpingogram to evaluate patency of fallopian tubes
prenatal US finding is clue to Down syndrome
nuchal translucency
most common genetic event that causes Down syndrome
meiotic nondisjunction
Fragile X syndrome gene defect
FMR1
clinical features of Fragile X syndrome
macrochordism, long face, long jaw, everted ears, mitral valve prolapse, autism
elfin facies, hypercalcemia, exreme friendliness, valvular defects
Wilson disease
22q11
CATCH Cleft lip/palate Abnormal facies Thymus/T cell deficiency Cardiac defects Hypocalcemia
Klinefelter v Turner
Klinefelter: 47 XXY testicular atrophy, gynecomastia, long arms, tall
Turner 46 XO short stature, webed neck, shield chest
most common genetic cause of intellectual disability
trisomy 21
second most common genetic cause of intellectual disability
Fragile X
horseshoe kidney, congenital heart defects, streak ovaries, and cystic hygroma
Turner syndrome
rocker-bottom feet, clenched hands, microcephaly with prominent occiput and small jaw
trisomy 18
cause of headache in pt using topical retinoic acid for acne
pseudotumor cerebri
genetic defect for achondroplasia
FGFR3
defect causes hereditary spherocytosis
spectrin or ankyrin protein defect
floppy mitral valve, dissecting aortic aneurysm, berry aneurysm
Marfan
mitral valve prolapse, liver disease, berry aneurysm
ADPKD
neural tumors and pigmented iris hamartomas
neurofibromatosis type I
association with colon cancer
Familial adenomatous polyposis
MI before age 20
familial hypercholesterolemia
hemangioblastoma of retina/cerebellum/medulla
von-Hippel Lindau disease
increased MCHC, hemolytic anemia
hereditary spherocytosis
bilateral acoustic neuromas
neurofibromatosis type II
facial lesions, seizure disorder, cancer risk
tuberous sclerosis
caudate atrophy, dementia
Huntington’s
cystic medial necrosis of the aorta
marfan
defect of fibroblast growth factor receptor 3
achondroplasia
trinucleatide repeat disorders
Fragile X: CGG
Friedrich: GAA
Huntington: CAG
Myotonic dystrophy: CTG
gene defect in cystic fibrosis
CFTR gene on chromosome 7
test used to diagnose cystic fibrosis
sweat Cl test
invasion of dermal lymphatics -> visible changes
inflammatory carcinoma
signs of Peau d’orange, dimpling of breast, nipple retraction (new)
causes of gynecomastia
drugs (STACKED), puberty, cirrhosis, testicular tumors, Klinefelter
acute mastitis
S. aureus
intraductal papilloma common complaint
straw colored nipple discharge that may be bloody
most common breast tumor in women under 25
fibroadenoma
most common breast mass in postmenopausal women
invasive ductal carcinoma
most common breast mass in premenopausal women
fibrocystic disease
most common form of breast cancer
invasive ductal carcinoma
small, mobile, firm mass with sharp edges in 24-year-old woman
fibroadenoma
histological “leaf-like projections”
phyllodes
signet ring cells
lobular carcinoma in situ
loss of e-cadherin cell adhesion gene on chromosome 16
invasive lobular carcinoma
always ER (+) and PR (+)
invasive lobular and LCIS
commonly presents with nipple discharge
intraductal papilloma
eczematous patches on nipple
Paget’s with DCIS
multiple bilateral fluid-filled lesions with diffuse breast pain
fibrocystic change
firm, fibrous mass in a 55-year-old woman
invasive ductal
most common cancer in women in the US
breast
most common benign breast tumor
fibroadenoma
most common malignant breast tumor
invasive ductal
blue dome cyst in the breast
fibrocystic change
treatment for ER(+) breast cancer
tamoxifen
red, itchy, swollen rash on the areola and nipple
Paget disease
