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Tim's Cards > Reproduction Final > Flashcards

Reproduction Final Flashcards

1
Q

Name the 2 risk factors for cancer among the benign lesions of the Breast.

A

Atypical Epithelial Hyperplasia

Multiple Intraductal Papillomas

(underneath nipple in dilated lactiferous sinuses)

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2
Q

Who is more likely to get a Fibrocystic Change in the breast?

A

Older women

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3
Q

The pathogenesis of Fibrocystic Change in the breast is related to what?

A

Sex Hormones

*why improvement after menopause

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4
Q

Are Fibrocystic Changes to the breast generally bilateral or unilateral?

A

Bilateral

*symmetrical, usually affecting both breasts

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5
Q

Fibrocystic Changes of the breast are seen between what ages?

A

Onset of puberty to menopause

*Sex hormone related

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6
Q

How does the progesterone/estrogen imbalances that cause the pathogenesis in Fibrocystic breast changes affect the tissue?

What 3 areas are affected?

A

Stimulates proliferation of cells

Excretory ducts, Lobules, and Intralobular stroma

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7
Q

What is the only risk factor that occurs in Fibrocystic breast change that leads to cancer?

A

Atypical Epithelial Hyperplasia

*more atypical, greater risk

**Atypical = multilayered

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8
Q

T/F

The most constant feature of fibrocystic change in the breast is Fibrosis

A

True

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9
Q

T/F

10-15% women between 20-50 have fibrocystic change

A

True

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10
Q

What are the presenting clinical features of Fibrocystic changes to the breast?

(5 things)

A

Blue-Domed Cysts

Both breasts

Pain, nodularity, palpation sensitivity

Easily palpated

Calcification (difficult to distinguish from cancer)

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11
Q

What is the most common presenting feature of Intraductal Papillomas?

A

Bloody/Serous nipple discharge

*secondarily sub-areolar mass

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12
Q

Non-pregnant woman with Bloody or Serous discharge from the nipple…

A

Intraductal Papilloma

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13
Q

Multiple papillomas are associated with an increased risk of ________. ______ are benign.

A

Papillary carcinomas

Solitary

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14
Q

What is the most common benign tumor of the breast?

A

Fibroadenoma

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15
Q

A fibroadenoma is made up of what two components?

A

Fibrous stroma

Glandular epithelium

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16
Q

T/F

Fibroadenomas are well-encapsulated, spherical, and freely moveable (which distinguishes them from cancers).

A

True

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17
Q

Fibroadenoma is most often seen in what demographic?

A

Young women

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18
Q

Fibroadenoma is most often in what location?

this is also the most common location for breast cancer

A

Upper Outer quadrant

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19
Q

Fibrosis and Blue-Domed cysts are seen in _______, NOT ______.

A

Fibrocystic disease

Fibroadenoma

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20
Q

What is the most common etiology behind fat necrosis of the Breast?

A

Trauma

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21
Q

What is the term for male breast cancer?

A

Gynecomastia

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22
Q

Gynecomastia is a ductile cancer because what is absent?

A

Lobules

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23
Q

What is Gynecomastia associated with?

2 things

A

Hormonal changes/puberty

Excess Estrogen (tumors/cirrhosis)

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24
Q

How does Gynecomastia present?

A

Fibrous cap under areola

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25
Q

T/F

Sex, Age, and Race are all risk factors for Breast Cancer

A

True

*peaks at 60

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26
Q

What ethnic bias does Breast cancer have?

A

Uncommon Japanese and Chinese, most common Caucasians and Jews

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27
Q

Other than Sex, Age, and Race, what are 5 risk factors for Breast Cancer?

A

Genetics (5-10 fold)

Hormonal (Estrogen - Tamaxaphen)

Other cancers (ovarian/endometrial)

Atypical Epithelial Hyperplasia/Multiple Intraductal Papillomas

Obesity, high fat diet, moderate EtOH consumption

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28
Q

What is the most common location for breast cancer?

A

Upper Outer quadrant (45%)

25% central, under areola

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29
Q

2/3 of Breast Cancers are of what type?

A

Invasive Ductal Carcinomas

*Desmoplastic rxn host response

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30
Q

What defines the difference between an In Situ lesion and and Invasive/Infiltrating lesion?

A

Breaching of Basement Membrane

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31
Q

T/F

90% of breast cancers metastasize via the lymphatics

A

True

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32
Q

Where does Breast cancer generally drain?

A

Axillary lymphatics

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33
Q

Distant breast metastases are common in what 5 areas?

A

Lungs

Liver

Bone

Brain

Adrenals

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34
Q

Lumpectomy is limited to resection of the tumor and what?

Mastectomy removes the entire breast and what?

A

Surrounding fat tissue

Axillary lymph node resection

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35
Q

In a Mammography, aside from looking for a Mass, what else are we looking for?

A

Calcification around the mass

*Spicules

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36
Q

Where are the primordial germ cells?

A

In the wall of yolk sac near the allantois

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37
Q

After the primordial germ cells leave the yolk sac and migrate to the gonadal ridges and penetrate into the primitive gonad, what do they become?

A

Cells that create spermatagonia, and eventually, sperm cells.

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38
Q

The epithelium of the genital ridge proliferates and penetrates the underlying mesenchyme to form what?

A

Primitive Sex cords

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39
Q

In the presence of the SRY gene, the primitive sex cords differentiate into what?

A

Medullary cords

Testicular seminiferous tubules

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40
Q

The medullary cords created from the Primitive Sex Cords further differentiate into what 4 structures?

A

Testicular seminiferous tubules

Rete testis

Efferent ducts

Vas deferens

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41
Q

What fibrous connective tissue separates the testes cords from the epithelium?

A

Tunica Albuginea

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42
Q

What is the function and location of Sertoli cells?

Leydig cells?

A

Support, nutrition - between germ cells

Testosterone secretion - between seminiferous tubules

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43
Q

Mesonepheric Ducts aka…

Paramesonephric Ducts aka…

A

Wolffian

Mullerian

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44
Q

What type of epithelium histologically allows for the propulsion of sperm from the Efferent ducts > Epididymis > Vas Deferens?

A

Ciliated Pseudostratified Columnar Epithelium

*surrounded by smooth muscle

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45
Q

What is the term for the congenital malpositioning of the testes outside normal scrotal location?

(most important congenital abnormality relating to testes)

A

Crytorchidism

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46
Q

T/F

Descent of testes may stop at any point and 4% newborns have condition

A

True

*also unilateral common, 1/4 bilateral

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47
Q

In Cryptorchidism, what % arrest in the High Scrotal Sac?

% inguinal canal?

% abdominal cavity?

A

60%

25%

15%

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48
Q

T/F

Most crytorchid children have testes descend within the 1st year, and condition in adults is less than 0.4%.

A

True

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49
Q

T/F
The decreased diameter of seminiferous tubules along with the decrease in germ cells can lead to Infertility in Cryptochidism

A

True

50
Q

What 2 types of tumors are increased 10-35 times in untreated cryptorchidism?

A

Seminoma

Embryonal Cercinoma

(Germ Cell Tumors)

51
Q

What are the 2 most feared complications of Cryptorchidism?

A

Infertility

Germ Cell Tumors

52
Q

Most testicular tumors are ______, and a small % are ______.

A

Seminomas

Embryonal Carcinomas

53
Q

Malignant transformation into Seminomas or Embryonal Carcinomas can happen in what 2 cases/states of Cryptochidism?

A

Non-descended testis

Delayed normally descended testis

54
Q

What is defined by male hypogonadism?

A

Klinefelter Syndrome

55
Q

Klinefelter’s Syndrome occurs when there is what pairing of chromosomes?

A

2 or more X

1 or more Y

**XXY most common

56
Q

T/F

Klinefelter’s is rarely diagnosed before puberty

A

True

57
Q

Gynocemastia, lack of beard/body hair, female hips, long arms, testicular/penile atrophy, long legs, and lack of pubic hair all are physical characteristics of what?

A

Klinefelter’s Syndrome

*lack all secondary sex characteristics

**mean IQ somewhat lower, retardation uncommon

58
Q

T/F

plasma FSH is increased and testosterone is decreased in Klinefelter’s

A

True

59
Q

What is the reproductive status of Klinefelters?

A

Infertile

*testicular tubules totally atrophied with hyaline

60
Q

What is the classic Karyotype of Klinefelter?

Results from paternal or maternal nondisjunction?

A

47 XXY

50/50 split maternal/paternal

61
Q

Hydrocele, Spermatocele, and Hematocele are different flavors of what?

A

Cystic Scrotal Masses

62
Q

A Hydrocele is a clear serous accumulation between what 2 layers?

(spontaneous)

A

Tunica Vaginalis

Testis or Epididymis

63
Q

Spermatocele is a cystic accumulation of semen in what 2 possible places?

A

Dilated efferent ductules

Ducts of rete testis

64
Q

A Hematocele accumulates blood where?

What causes?

A

Between Tunica Vaginalis layers

Trauma

65
Q

Histologically, what is the Spermatocele cyst lined with?

A

Cuboidal epithelium

*contains spermatozoa in various developmental stages

66
Q

What can result from testicular torsion, tumors, or infections?

A

Hematocele

67
Q

Phimosis =

A

Strangulation

68
Q

T/F

Hydrocele can be either congenital or acquired, and the compression can lead to atrophy

A

True

69
Q

If torsion of the Testes is severe enough, what can it cause?

A

Infarction (obstruction) of testicular Germ Cells

70
Q

How doe testicular Torsion present?

A

Severe pain, usually a few hours after vigorous exercise

Then swelling

*once Tunica Albuginea black - amputation

71
Q

Dysplastic lesions (Bowen Disease) on the glans and prepuce are known as what?

This occurs only in ______.

A

Erythroplasia of Queyrat

Uncircumcised

72
Q

What is a major risk factor in penile cancer?

A

Smegma

HPV 16 and 18

73
Q

Since penile cancer is an extension of the skin, it is…

A

Squamous Cell Carcinoma

*presents as ulcerated hemorrhagic mass on glans/prepuce

**most well-differentiated

74
Q

Buzzwords:
Herpes:

Chancre:

Koilocytosis

A

Vescicles

Syphylis

HPV

75
Q

What is the Etiology of Peyronie Disease?

A

Unknown

  • focal, asymmetric, penile curvature
  • collagen slowly replaces muscle

**question mark

76
Q

What far advanced disease results in General Paresis (brain spirochetes), Gummas (granulomas), and Tabes Dorsalis (spirochetal damage to sensory nerves)

A

Tertiary Syphilis

77
Q

What are the 2 most common organisms that cause PID?

A

Gonococcus

Chlamydia

78
Q

What are the 2 most common complications of PID?

A

Sterility and Ectopic Pregnancy

79
Q

Chondylomata Lata:

Maculopapular Rash:

A

Secondary Syphylis

Secondary Syphyllis

80
Q

Why do many women get PID?

A

GC and Chlamydia are asymptomatic in women

81
Q

What agar would one use to plate a GC swab?

A

Chocolate/Thayer-Martin

82
Q

T/F

Trichimonas vaginalis is only seen in a trophozoite form

A

True

**no cyst form

83
Q

What type of organism is Trichomonas vaginalis?

A

Protozoan

84
Q

Describe Trichomonas vaginalis

A

Pear shaped protozoan, anterior flagella

85
Q

Who is most likely to get Trichomonas vaginalis?

Least likely?

A

Sexually active women

Postmenopausal women

86
Q

Herpes symplex I or II has what 2 characteristics?

A

Latency

Cytopathic effect (inclusion bodies)

87
Q

Herpes simplex type I or II stains what color?

CMV stains what color?

A

Pink acidophilic nuclear inclusions

Basophilic/blue inclusion bodies

88
Q

What is the homologue to Seminoma?

What is the homologue to the Yolk sac tumor?

A

Dysgerminoma

Endodermal Sinus Tumor

89
Q

Lobular Carcinoma In-Situ is a marker for what?

A

Invasive Ductal or Lobular carcinoma

90
Q

What is the tumor marker for the Prostate?

A

PSA

91
Q

What is the serologic marker for Seminoma?

A

None

92
Q

Over 90% of testicular tumors are of what origin?

Is it the same in the ovary?

A

Germ Cell

No - surface epithelial most common (75%)

93
Q

4 Risk factors for Germ cell Tumors of the testes

A

Cryptorchidism

Klinefelters

Family History

Testicular Tumor on the opposite testis

94
Q

When considering a Teratoma, what factor is most important in predicting whether it will be malignant or benign?

A

Age

95
Q

What is another name for Leydig Cell Tumors?

A

Interstitial Cell Tumors

96
Q

What is the only Germ Cell Tumor that doesn’t metastasize via the lymphatics?

How does it metastasize?

A

Choriocarcinoma

Hematogenous routes

***this is if originate in either testes/ovaries

97
Q

What is the most common tumor of the Urinary Tract?

A

Urinary Bladder tumors

98
Q

What is the parasite that lays eggs in the Bladder?

What type of cancer does this cause?

A

Schistosoma haemotobium

Squamous Cell Carcinoma

99
Q

What marker in used for both diagnosis and monitoring of Yolk Sac Tumors?

A

AFP

100
Q

What is the most important risk factor (increases 4 fold) for Bladder Cancer?

What are some secondary risk factors?
(3 things)

A

Smoking

Azo dyes, Drugs, Radiation to area

*Cyclophosphamide

101
Q

What does PSA stand for?

What is it?

How is it used as a tumor marker?

A

Prostate Specific Antigen

Antigen that is only released into blood by Tumor Cells (but made always)

If detectable after radical prostatectomy, metastasis persists

102
Q

Explain Bone Alkaline Phosphate’s relationship to Prostate Cancer

A

Marker that Prostate Cancer has metastasized to bone

*proliferation of osteoblasts increases Alk Phos in blood

103
Q

T/F

Prostatic Cells produce Alkaline Phosphatase

A

False

*only osteoblasts produce

104
Q

T/F

Prostate normally secretes PSA, but the tumor puts it in the bloodstream

A

True

105
Q

T/F

BPH leads to Prostate Cancer

A

False

106
Q

BPH doesn’t lead to Prostate Cancer, but they are both under the influence of what hormone?

A

Testosterone

107
Q

What does TURP stand for?

What is the surgical procedure?

A

Trans Urethral Resection of Prostate

Stent, Prostatic Chips

108
Q

What does BPH stand for?

A

Benign Prostatic Hyperplasia

109
Q

What ethnic group has the highest incidence of BPH in the US?

In what region of the world is it most common?

Least common?

A

Blacks

Western Europe/US

Asia (the orient?)

110
Q

T/F

1/3 males over 65 have some degree of BPH, and 75% over 80 years have some degree of it.

A

True

111
Q

Which cells are present in Acute Prostatitis?

Which are present in Chronic Prostatitis

A

E. coli with acute inflammatory infiltrate (PMN’s, etc)

Lymphocytes, Plasma cells, Macrophage

112
Q

How can Acute and Chronic Prostatitis be diagnosed?

A

Recovery organism on Urine Culture

113
Q

What 2 organisms can cause granulomatous Prostatitis?

A

Mycobacterium tuberculosis

Histoplasma capsulatum

114
Q

What % of the semen is secreted by the prostate?

A

13-33%

115
Q

T/F

30-50 tubuloalveolar glands are in the prostate and they each secrete into the urethra through its own duct

A

True

116
Q

What histologically makes up the Prostate Gland?

2 things

A

Pseudostratified Columnar Cells

Glandular Cells

117
Q

What is the classification of Prostate Cancers based on 5 histologic patterns of tumor gland formation and infiltration?

A

Gleason score

118
Q

Each Gleason score is given a ______ pattern score and _____ pattern score.

A

Majority

Minority

119
Q

What is the best Gleason Score?

What is the histologic state?

A

2 (1 for each)

Well differentiated

120
Q

What is the worst Gleason Score?

What is the histologic state?

A

10 (5 majority, 5 minority)

Undifferentiated

121
Q

T/F
The Gleason score is strictly for the Grading and done by the Pathologist. The Oncologist will use that to stage the pt. with prostate cancer.

A

True

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