Reproduction Flashcards
1
Q
connects cervix to pelvic side wall
A
cardinal ligament
2
Q
connects the ovaries to the lateral pelvic wall
A
suspensory ligament
3
Q
connects the uterus, fallopian tubes, and ovaries to the pelvic side wall
A
broad
4
Q
contains the uterine vessels
A
cardinal ligament
5
Q
contains the ovarian vessels
A
suspensory ligament
6
Q
testicular cancer first mets to
A
peri-aortic lymph nodes
7
Q
what develops from mesonephric ducts
A
male internal genitalia except prostate
8
Q
male homologue to: vestibular bulbs labia minora bartholin glands urethral and paraurethral glands (of Skene)
A
corpus cavernosum and spongiosum
ventral shaft of penis
bulbourethral glands
prostate gland
9
Q
what gene product comes from the SRY gene that underlies male genital development
A
testis determining factor
10
Q
anchors testes to the scrotum
A
gubernaculum
11
Q
pulsing schedule of GnRH affects gonadotropin release how
A
pulsatile: increase release
continuous: decrease/stop release
12
Q
difference btw androgen insensitivity and 5-alpha-reductase deficiency
A
androgen insensitivity: female genitalia, but genetically male.
5-a-reductase: male genitalia that are hypodeveloped until puberty causes a large increase in testosterone
13
Q
sertoli and leydig cells
A
LH -> leydig cells -> testosterone
FSH -> sertoli cells -> androgen binding protein (keeps testosterone in testicle)
14
Q
testicular tumor composed of cytotrophoblasts and syncytiotrophoblasts
A
choriocarcinoma
15
Q
may present initially with gynecomastia in males
A
leydig cell tumor
16
Q
elavated AFP in males
A
yolk sac, teratoma
17
Q
elevated BhCG in males
A
choriocarcinoma, embryonal and teratoma
18
Q
most common testicular cancer
A
seminoma
19
Q
most common testicular tumor in infants and children up to 3yrs of age
A
yolk sac
20
Q
most common testicular tumor in men over age 60
A
testicular lymphoma
21
Q
histologic appearance similar to koilocytes (cytoplasmic clearing)
A
seminoma
22
Q
histologically may have alveolar or tubular appearance sometimes with papillary convolutions
A
embryonal carcinoma
23
Q
composed of multiple tissue types
A
teratoma
24
Q
histologic endodermal sinus structures (Schiller-Duval bodies) in males
A
yolk sac tumor
25
25% have cytoplasmic rod-shaped crystalloids of Reinke
leydig cell
26
androgen-producing and associated with precocious puberty (test cancer)
leydig cell, may be sertoli
27
what is the major side effect of sildenafil
life threatening hypotension when combined with nitrates
28
balanitis is caused by what bug
candida albicans
29
difference between finasteride and flutamide
finasteride is 5areductase inhibitor (BPH, male pattern baldness)
flutamide inhibits testosterone receptor (treat prostate cancer)
30
most common cancer in men
prostate cancer
31
most common cause of urinary obstruction in men
BPH
32
most common treatment for erectile dysfunction
phosphodiesterase inhibitor (sildenafil)
33
layers of endometrium
stratum compactum
stratum spongiosum
stratum basale
the compactum and spongiosum are shed monthly
34
two-cell theory of estradiol production
FSH -> granulosa cell -> aromatase (androstenedione) -> estrogen
LH -> theca cell -> makes androstenedione
35
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
36
appearance of HPV infection
koilocytic change: perinuclear halo
37
dysplastic cervical cells with enlarged, dark nuclei
koilocytes
38
Diethylstilbestrol (DES)
clear cell adenocarcinoma of vagina
39
what are the risk factors for endometrial carcinoma
```
HHONDA
hyperplasia
HTN
obesity
nulliparity
diabetes
anovulatory state
```
40
excess unopposed estrogen is the main risk factor
endometrial proliferation and cancer
41
menorrhagia with an enlarged uterus and no palpable pain
fibroid (leiomyoma)
42
pelvic pain that presents only during menstruation
endometriosis
43
diagnosed by endometrial biopsy in clinic
endometrial hyperplasia and cancer
44
definitive diagnosis and treatment is by laparoscopy
endometriosis
45
menstruating tissue within the myometrium
adenomyosis
46
malignant tumor of the uterine smooth muscle
leiomyosarcoma
47
most common tumor in women
leiomyoma
48
most common gynecologic malignancy in the US
endometrial carcinoma
49
most common gynecologic malignancy worldwide
cervical carcinoma
50
chocolate cyst of the ovary
endometriosis
51
what is the underlying cause of PCOS?
increased LH and decreased FSH -> lack of ovulation
52
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
53
ovarian tumor produces AFP
yolk sac (endodermal)
54
estrogen secreting ovarian tumor leading to precocious puberty
granulosa cell
55
intraperitoneal accumulation of mucinous material
mucinous cystadenocarcinoma
56
testosterone secreting, leading to virilization
sertoli-leydig cell
57
psammoma bodies in ovary
serous cytadenocarcinoma
58
multiple different tissues in tumor
teratoma
59
ovarian tumor lined with fallopian tube-like epithelium
serous cystadenoma
60
ovarian tumor + ascites + hydrothorax
fibroma (Meig's syndrome)
61
call-exner bodies in ovarian tumor
granulosa cell
62
resembles bladder epithelium ovarian tumor
brenner tumor
63
ovarian tumor with elevated BhCG
choricarcinoma and dysgerminoma
64
risk factors for ovarian tumors
uninterrupted ovulation, nulliparity, early menarche, late menopause, family hx (BRCA1/2, HNPCC (lynch syndrome))
65
persistantly wet umbilicus in infant
patent urachus
66
CO and plasma volume changes in pregnancy
CO increases 30-50%
| plasma volume increases 50%
67
elevated AFP on maternal serum screen
neural tube defects, twins, abdominal wall defects
| incorrect dating is largest cause of false test results
68
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
69
causes of recurrent miscarriage
```
low progesterone
chromosomal abnormalities
uterine abnormalities
infections
poor mental health
autoimmune/clotting disorders
```
70
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
71
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
72
previous c-section increases risk for
placenta previo and accreta
73
HTN drugs during pregnancy
hydralazine, methyldopa, labetalol
74
Db drugs during pregnancy
insulin is gold standard
75
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)
76
hyperthyroidism drugs in pregnancy
propylthiouracil (PTU) 1 trimester
| methimazole (2 and 3 trimester)
77
anticoagulation in pregnancy
heparin or enoxaprim
| do not use warfarin
78
tocolysis
prevent uterine contractions
| indomethacin, nifedipine, terbutaline, magnesium sulfate
79
labor promotion
pitocin
prostaglandins (dinoprostone (PGE2) misoprostol (PGE1))
tox: tachysystole, uterine rupture, fever
80
pregnancy termination
dilation and curretage
mifepristone (RU-486): inhibitor of progesterone receptor + misoprostol to ensure complete abortion
methotrexate: inhibits folate production
81
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
82
prenatal US finding is clue to Down syndrome
nuchal translucency
83
most common genetic event that causes Down syndrome
meiotic nondisjunction
84
Fragile X syndrome gene defect
FMR1
85
clinical features of Fragile X syndrome
macrochordism, long face, long jaw, everted ears, mitral valve prolapse, autism
86
elfin facies, hypercalcemia, exreme friendliness, valvular defects
Wilson disease
87
22q11
```
CATCH
Cleft lip/palate
Abnormal facies
Thymus/T cell deficiency
Cardiac defects
Hypocalcemia
```
88
Klinefelter v Turner
Klinefelter: 47 XXY testicular atrophy, gynecomastia, long arms, tall
Turner 46 XO short stature, webed neck, shield chest
89
most common genetic cause of intellectual disability
trisomy 21
90
second most common genetic cause of intellectual disability
Fragile X
91
horseshoe kidney, congenital heart defects, streak ovaries, and cystic hygroma
Turner syndrome
92
rocker-bottom feet, clenched hands, microcephaly with prominent occiput and small jaw
trisomy 18
93
cause of headache in pt using topical retinoic acid for acne
pseudotumor cerebri
94
genetic defect for achondroplasia
FGFR3
95
defect causes hereditary spherocytosis
spectrin or ankyrin protein defect
96
floppy mitral valve, dissecting aortic aneurysm, berry aneurysm
Marfan
97
mitral valve prolapse, liver disease, berry aneurysm
ADPKD
98
neural tumors and pigmented iris hamartomas
neurofibromatosis type I
99
association with colon cancer
Familial adenomatous polyposis
100
MI before age 20
familial hypercholesterolemia
101
hemangioblastoma of retina/cerebellum/medulla
von-Hippel Lindau disease
102
increased MCHC, hemolytic anemia
hereditary spherocytosis
103
bilateral acoustic neuromas
neurofibromatosis type II
104
facial lesions, seizure disorder, cancer risk
tuberous sclerosis
105
caudate atrophy, dementia
Huntington's
106
cystic medial necrosis of the aorta
marfan
107
defect of fibroblast growth factor receptor 3
achondroplasia
108
trinucleatide repeat disorders
Fragile X: CGG
Friedrich: GAA
Huntington: CAG
Myotonic dystrophy: CTG
109
gene defect in cystic fibrosis
CFTR gene on chromosome 7
110
test used to diagnose cystic fibrosis
sweat Cl test
111
invasion of dermal lymphatics -> visible changes
inflammatory carcinoma
| signs of Peau d'orange, dimpling of breast, nipple retraction (new)
112
causes of gynecomastia
drugs (STACKED), puberty, cirrhosis, testicular tumors, Klinefelter
113
acute mastitis
S. aureus
114
intraductal papilloma common complaint
straw colored nipple discharge that may be bloody
115
most common breast tumor in women under 25
fibroadenoma
116
most common breast mass in postmenopausal women
invasive ductal carcinoma
117
most common breast mass in premenopausal women
fibrocystic disease
118
most common form of breast cancer
invasive ductal carcinoma
119
small, mobile, firm mass with sharp edges in 24-year-old woman
fibroadenoma
120
histological "leaf-like projections"
phyllodes
121
signet ring cells
lobular carcinoma in situ
122
loss of e-cadherin cell adhesion gene on chromosome 16
invasive lobular carcinoma
123
always ER (+) and PR (+)
invasive lobular and LCIS
124
commonly presents with nipple discharge
intraductal papilloma
125
eczematous patches on nipple
Paget's with DCIS
126
multiple bilateral fluid-filled lesions with diffuse breast pain
fibrocystic change
127
firm, fibrous mass in a 55-year-old woman
invasive ductal
128
most common cancer in women in the US
breast
129
most common benign breast tumor
fibroadenoma
130
most common malignant breast tumor
invasive ductal
131
blue dome cyst in the breast
fibrocystic change
132
treatment for ER(+) breast cancer
tamoxifen
133
red, itchy, swollen rash on the areola and nipple
Paget disease
