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KAPLAN FLASH CARDS > Reproductive > Flashcards

Reproductive Flashcards

1
Q

What develops from the Mesonephric (Wolffian) duct?

A

SEED

  • Seminal vesicles
  • Ejaculatory duct
  • Epididymis
  • Ductus deferens
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2
Q

What is the female remnant of the mesonephric duct?

A

Gartner duct

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3
Q

What are the structures that develop from the Mullerian duct?

A
  • Fallopian tubes
  • Uterus
  • Upper 1/3 of vagina
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4
Q

What is the male remnant of the Mullerian duct?

A

Appendix testis

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5
Q

Where embryologically does the prostate originate from?

A

Urogenital sinus

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6
Q

What does the urogenital sinus differentiate into in males?

A

Bladder
Prostate
Urethra
Bulbourethral glands

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7
Q

Patient has a small mass on the anterior midline of her neck that can elevate when she protrudes her tongue. What is this mass likely a remnant of embryologically?

A

Thyroglossal duct

*Distal end forms the thyroid gland, proximally the duct degenerates

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8
Q

Patient presents with a lateral neck mass anterior to the sternocleidomasteroid muscle that does NOT move with swallowing. What is this?

A

Pharyngeal cleft cyst due to a persistent cervical sinus embryologically

*Contrast with thyroglossal duct cyst where the mass DOES move with swallowing and is in the midline

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9
Q

What is the first major site of hematopoiesis? When does hematopoiesis begin?

A

Yolk sac is the first major site

Begins after 3 weeks of development

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10
Q

Give the correct sequence of hematopoiesis embryologically with time of occurrence

A

1) Yolk sac - 3rd week
2) Liver - 1 month
3) Spleen & lymphatic organs - 2-4 months
4) Bone marrow - after 7.5 months

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11
Q

Cause of hypospadias

A

Failure of the urethral folds to fuse

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12
Q

Cause of epispadias

A

Faulty positioning of the genital tubercle

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13
Q

Fetal male sex is determined by what hormone?

A

DHT

*Determines the development of male EXTERNAL genitalia from the genital tubercle, urogenital sinus, and labioscrotal swelling

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14
Q

When is sex of an embryo determined?

A

At fertilization

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15
Q

Role of testosterone in male differentiation of embryo

A

Stimulates development of SEED

  • Seminal vesicles
  • Ejaculatory duct
  • Epididymis
  • Ductus deferens
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16
Q

What is used as a sex indicator during ultrasound examination in a pregnant woman?

A

Genital tubercle

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17
Q

What week do gonads become structurally male or female? What about external genitalia?

A

Gonads: Week 7

External genitalia: Week 12

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18
Q

What specifically is the MIF (Mullerian inhibiting factor) suppressing development of?

A

Paramesonephric duct to prevent female INTERNAL sex organs from developing

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19
Q

What hormone is primarily responsible for endometrial changes in the menstrual cycle?

A

Progesterone

  • Proliferative & secretory phases
  • *Estrogen is only for the proliferative phase
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20
Q

What does FSH promote in females?

A

Folliculogenesis

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21
Q

What does LH stimulate in females?

A

Ovulation

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22
Q

At low doses of estrogen, what hormone does it inhibit?

A

LH

*High doses stimulate LH for ovulation

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23
Q

What hormone does hCG resemble and why?

A

It’s alpha glycoprotein subunit is identical to LH!

*hCG targets the ovary and rescues the corpus luteum, preventing its degeneration and allowing it to continue secreting progesterone and estrogen until placenta fully develops

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24
Q

In pregnancy, what placental hormone is the equivalent of growth hormone?

A

Human placental lactogen (hPL)

*Concentration is proportional to fetal mass, ensures adequate delivery of nutrients to the fetus

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25
Q

Which hormone sharply increases around week 28 of gestation and why?

A

CRH (corticotropin releasing hormone)

*Initiating role in labor and stimulating fetal cortisol production needed for fetal lung maturation

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26
Q

Which week does pre-eclampsia occur typically?

A

~20th week of gestation, to even 6 weeks postpartum

*HTN together with proteinuria, edema, or end-organ dysfunction

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27
Q

Reason for pre-eclampsia

A

Impaired remodeling of maternal spiral arteries during placentation, causing placental hypoperfusion

*Incomplete invasion of cytotrophoblasts

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28
Q

During menopause, what happens to the levels of estrogen, LH, FSH, and GnRH? Why?

A

Estrogen: DECREAESE

LH, FSH, GnRH: INCREASE

*Estrogen can no longer provide negative feedback on hormones

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29
Q

Function of Inhibin hormones?

A

Negative feedback inhibition on FSH release from the pituitary

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30
Q

If a patient has a 35 day cycle, what exact day will they ovulate on?

A

Day 21

*35-14 = 21

**Ovulation (beginning of luteal phase) is always 14 days before menstruation

***Luteal phase is constant (always 14 days), follicular phase can be variable

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31
Q

Why is the luteal phase so consistent in time whereas the follicular phase can be quite variable?

A

Due to the lifespan of the corpus luteum

*Luteal phase is always 14 days

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32
Q

For most of a woman’s life, her oocytes are arrested in what cell division cycle?

A

Prophase I

  • first meiotic division
  • *Second meiotic division only after fertilization by sperm
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33
Q

What phase is an ovulated oocyte in?

A

Metaphase II (meiosis 2)

*During a monthly cycle, a primary oocyte becomes unattested from prophase I and completes meiosis I to form a secondary oocyte and polar body

**Secondary oocyte is formed this way and is ovulated

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34
Q

What week does hCG peak?

A

10 weeks gestation

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35
Q

What produces hCG (2 answers)?

A

Blastocyst and later the placental syncytiotrophoblast

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36
Q

What scenario would show increased FSH, decreased LH, and decreased GnRH?

A

Treatment for infertility

*Give GnRH analogues to prevent spontaneous LH surges and delay ovulation to increase the yield of mature oocytes

**Analogues suppress GnRH production

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37
Q

Where are most ectopic pregnancies located?

A

Ampulla of fallopian tube

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38
Q

List 3 causes of ectopic pregnancy

A

1) PID (multiple sexual partners)
2) Prior ectopic pregnancies
3) Smoking

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39
Q

History of a 1st degree relative with breast cancer is associated with increased risk of what other cancer?

A

Epithelial ovarian cancer

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40
Q

Erythema (eczematous changes) around the nipple could indicate what?

A

Pagets disease of the nipple

*Underlying adenocarcinoma within the squamous epithelium of the skin in the nipple and areola

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41
Q

Histology stains that demonstrate Pagets disease of the nipple

A

PAS +

Cytokeratin +

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42
Q

What would be the diagnosis in a young patient with a small, mobile, firm nodule within the breast which fluctuates in size due to estrogen?

A

Fibroadenoma

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43
Q

Which tumor presents with skin changes of the nipple - lymphedema (peau d’orange)

A

Inflammatory carcinoma

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44
Q

What is inflammatory carcinoma frequently confused with and why?

A

Mastitis due to the lymphedema from the tumor cells invading lymph channels in the dermis

*Patients get prescribed antibiotics that do nothing

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45
Q

Major systemic complication of ovarian carcinoma

A

Ascites

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46
Q

Low & high risk HPV strains for cervical carcinoma development

A

6 & 11 = low risk

16, 18, 31 = high risk

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47
Q

Which nerve can be damaged due to stretching in childbirth? What does is normally innervate?

A

Pudendal nerve

  • Sensory: Perineum
  • Motor: External urethra & anal sphincters
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48
Q

_____ nerve is blocked with a local anesthetic during childbirth using the __________ as a landmark for injection

A

Pudendal nerve

ischial spine

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49
Q

Anatomical name for Douglas pouch in women

A

Rectouterine space

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50
Q

Lab finding in PCOS

A

2x amount of LH

Lowered FSH

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51
Q

What produces Inhibin B in females? What’s Inhibin B’s role?

A

Granulosa cells

Inhibits FSH release from pituitary gonadotrophs

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52
Q

Karyotype of Klinefelter syndrome

A

47, XXY

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53
Q

Signs of Klinefelter syndrome (5)

A
  • Gynecomastia**
  • Small testes
  • Infertility (absence of spermatozoa)
  • Long arms & legs
  • High pitched voice
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54
Q

List 1 key characteristic of the following:

  • Down syndrome
  • Patau syndrome
  • Edwards syndrome
  • Turner syndrome
A
  • Down syndrome: Epicanthal folds
  • Patau syndrome: Microcephaly
  • Edwards syndrome: Rocker-bottom feet
  • Turner syndrome: Webbed neck
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55
Q

What is the predominant vaginal microbiota in healthy women?

A

Lactobacillus

  • Gram + anaerobic rods
  • *Breaks down glycogen to lactic acid
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56
Q

Normal pH range of vagina

A

3.5-4.7

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57
Q

HER2 + has what kind of receptor? What protein would show to have high activity?

A

Tyrosine kinase receptor

Elevates RAS & MAPK

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58
Q

What does HELLP stand for?

A

Hemolytic anemia
Elevated Liver enzymes
Low Platelets

*Subset of severe pre-eclampsia

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59
Q

What is the difference between gestational hypertension & pre-eclampsia?

A

Gestational hypertension does NOT have proteinuria

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60
Q

Torsion of the spermatic cord causes strangulation of what vessels?

A

Gonadal arteries, which originate directly off of the aorta

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61
Q

How can secondary syphillus present?

A

Bronze colored diffuse maculopapular rash involving entire body, including palms and soles & mouth

*Diagnose with RPR (rapid plasma reagent)

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62
Q

Microscopic appearance of invasive ductal carcinoma

A

Desmoplastic stromal response surrounding invasive glandular structures

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63
Q

Microscopic appearance of colloid (mucinous) carcinoma

A

Abundant mucin secretion

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64
Q

Microscopic appearance of invasive lobular carcinoma

A

Single file distribution of invasive cells

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65
Q

Microscopic appearance of medullary carcinoma

A

Sheets of large, anaplastic tumor cells surrounded by lymphocytes & plasma cells

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66
Q

Common presentation of invasive ductal carcinoma

A

Palpable, fixed mass

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67
Q

What mutation is typically seen in medullary carcinoma?

A

BRCA1

*Usually triple negative (ER-, PR-, HER2-)

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68
Q

Physical examination reveals a cystic structure in the scrotum, which transilluminates the entire scrotum. What is the etiology of the finding?

A

Hydrocele

*Due to incomplete fusion of the process vaginalis

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69
Q

In males, what is the process vaginalis?

A

Evagination of the parietal peritoneum, descending through the inguinal canal before descent of the testis

**Normally, distal end remains patent as the tunica vaginalis

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70
Q

Predisposing risk factors for vulvovaginitis? What causes it?

A

Candida infection

  • Diabetes
  • Antibiotics
  • Increased estrogen (from pregnancy, BC, estrogen)
  • Immunosuppression
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71
Q

What hormone is significantly elevated in a hydatidform mole?

A

Beta-hCG
Thyroxine

*because of the same alpha subunit, TSH is significantly elevated, increasing thyroxine (signs are anxiety, diaphoresis, palpitations)

72
Q

What is a complete hydatidiform mole?

A

Fusion of 2 spermatozoa with a single oocyte lacking a nucleus (20%)

OR

Empty ovum fertilized by single sperm with duplicate chromosome (80%)

*Cystic swellings of chorionic villi

73
Q

Signs & labs of Androgen Insensitivity Syndrome

A
  • 46, XY genotype
  • Testosterone & LH increased
  • Female external genitalia
  • Testes present but fail to descend
  • No male or female internal genitalia
  • Bilateral masses in the labia majora (these are the undescended tests)
74
Q

Another name for androgen insensitivity syndrome

A

Testicular feminization

75
Q

Explain pathophysiology of androgen insensitivity syndrome

A
  • Testosterone produced normally by Leydig cells in testes
  • Defect in the androgen receptor
  • Wolffian duct maturation needs those androgens, and thus absence of stimulation results in small or non-existent male INTERNAL genitalia (SEED)
  • Female INTERNAL genitalia not present due to normal production of AMH (anti-mullerian hormone) by testes
  • EXTERNAL genitalia primarily female due to inadequate DHT
76
Q

What is seen on histology of chronic endometriosis? Is there a risk of endometrial adenocarcinoma?

A
  • Plasma cells on biopsy

- No risk of adenocarcinoma formation

77
Q

Simple hyperplasia of the endometrium versus complex

A

SIMPLE: No atypia, benign

COMPLEX: Atypia, highly irregular glands, branching, high malignant potential

78
Q

How does an amniotic fluid embolism occur?

A

When amniotic fluid enters the maternal VENOUS (not arterial!!) system and reaches pulmonary circulation, inducing ARDS

79
Q

Causes of amniotic fluid embolism

A
  • Abdominal trauma
  • Placental abruption or previa
  • Amniocentesis
  • Cesarean section
  • Uterine rupture
  • Instrumental vaginal delivery
80
Q

Why does amniotic fluid embolism cause ARDS

A

Amniotic fluid contains high amounts of prostaglandins, inducing:

  • Pulmonary artery vasospasm with pulmonary hypertension**
  • Hypoxia
  • Left heart failure
  • ARDS**
  • DIC
81
Q

Karyotype of Turner syndrome

A

45, X0

82
Q

Physiologic features of Turner syndrome (3)

A
  • Gonadal dysgenesis with atrophic streak ovaries
  • Primary amenorrhea [ie: 16 year old girl has not yet had her period]
  • Infertility
83
Q

Physical features of Turner syndrome (8)

LW-CH(3)

A
  • Webbing of neck
  • Hypothyroidism
  • Lymphedema
  • Horseshoe kidney
  • High arched palate
  • Shortened 4th metacarpal
  • Hydrops fetalis
  • Congenital heart disease (preductal coarctation of aorta; bicuspid aortic valve)
84
Q

Describe a patient with Turner syndrome’s possibility of future fertility

A

Moderate probability with donor ovum

85
Q

Why is the second X chromosome necessary in Turner syndrome?

A

Necessary for oogenesis and normal ovary development

*Uterus is normal so they can carry pregnancy from donor ovum

86
Q

Most common breast mass in males under 25

A

Gynecomastia

*benign proliferation of ductal and stromal elements of breast due to hormonal changes (increased estrogen)

87
Q

Presentation of intraductal papilloma. Benign or malignant potential?

A

Benign

-Serous or bloody nipple discharge

88
Q

What lymph nodes do the testes drain into?

A

Para-aortic

89
Q

Lab findings of Klinefelter Syndrome

A
  • Low testosterone
  • Decreased inhibin
  • High FSH & LH, estrogen
90
Q

Physical findings of 5-alpha reductase

A

Normal internal genitalia & testicles

Feminized external genitalia

*Male can be raised as a female and not noticed until puberty

91
Q

Preeclampsia develops secondary to what?

A

Placental ischemia

92
Q

Pregnant woman with new-onset hypertension without proteinuria, what would be diagnostic signs of pre-eclampsia? (5)

A
  • Decreased platelets
  • Pulmonary edema
  • Increased creatinine
  • Increased liver transaminases
  • Cerebral/visual disturbances
93
Q

Important cause of spontaneous abortion in 2nd or 3rd trimester

A

Chorioamnionitis

*infection of chorioamniotic membrane due to microbial pathogen

94
Q

Which artery is responsible for postpartum hemorrhage?

A

Internal iliac artery

*Uterine arteries more specifically, also called hypogastric artery

95
Q

What is Kallmann syndrome?

A

Idiopathic hypogonadotropic hypogonadism caused by defective migration of GnRH releasing neurons

96
Q

Labs of Kallmann syndrome

A

-Decreased FSH, LH, testosterone, estrogen, progesterone

97
Q

What fails to develop in Kallmann syndrome

A

Olfactory bulbs, causing anosmia

98
Q

Male presentation of Kallmann syndrome

A
  • Small testes
  • Failure of voice to deepen
  • Lack of increased muscle bulk
  • No body/facial hair
99
Q

Female presentation of Kallmann syndrome

A
  • Primary amenorrhea

- Absence of breast development

100
Q

Congenital abnormalities associated with Kallmann syndrome (3)

A
  • Midline cleft palate
  • Unilateral renal agenesis
  • Hearing deficit
101
Q

Granuloma cell tumors secrete what? What are signs

A

Estrogen

  • Abnormal bleeding
  • Endometrial hyperplasia
  • Breast enlargement
  • Precocious puberty in kids
102
Q

Pregnant patient presents with nystagmus, disorientation, vomiting for 3 days. What is the diagnosis and cause of her symptoms?

A

Wernicke encephalopathy

*Thiamine deficiency, which inhibits brain metabolism and causes neuronal injury

**Common in chronic alcoholics because of malabsorption

***This patient had hyperemesis granidarum, severe form of nausea and vomiting due to pregnancy

103
Q

Does sclerosing adenosis have malignant potential?

A

Yes –> invasive carcinoma

104
Q

Classic histology of sclerosing adenosis?

A

Whorled pattern

105
Q

Proliferation of both fibrous and glandular components with no atypia is consistent with what?

A

Fibroadenoma

106
Q

Dense fibrous breast tissue with focal lymphocytic infiltrate is characteristic of what and why?

A

Diabetic mastopathy

*Benign and only in DM1 patients because of glycosylation of connective tissue in breast

107
Q

Strongest risk factor for developing breast cancer

A

Family history

108
Q

Biggest risk factor for endometrial hyperplasia?

A

Obesity

*Allows chronically increased levels of endogenous estrogen due to aromatization of androgens to estrogens

109
Q

Most common cause of nipple discharge

A

Intraductal papilloma

  • benign
  • *premenopausal women
110
Q

What cancers can metastasize to bone?

A

“BLT with a Kosher Pickle”

  • Breast
  • Lung
  • Thyroid
  • Kidney
  • Prostate
111
Q

Patient has both lytic and plastic bone lesions. How can we tell what the origin of metastasis was from?

A

A chest xray would be negative if breast cancer, or positive if lung cancer

*We don’t see breast cancers on chest xray, but obviously we do for lung

112
Q

What condition is associated with a mass that changes in size with cycling estrogen levels?

A

Fibrocystic changes

*Benign

113
Q

Common cause of fat necrosis in breast

A

Trauma

114
Q

Presentation of fat necrosis of the breast

A

Irregular mobile non tender breast lump

115
Q

What is a partial mole

A

Triploid karyotype
69, XXY

*Fertilization of an ovum with one or two sperm

116
Q

Main two differences between complete and partial mole

A

COMPLETE:

  • No fetal parts
  • 2% risk of choriocarcinoma
  • p57 negative
  • hCG VERY increased
  • 46, XX

PARTIAL:

  • Fetal parts
  • No risk for choriocarcinoma
  • p57 positive
  • hCG slightly increased
  • 69, XXY
117
Q

Clinic signs of mole formation (4)

A

1) Uterus large for gestational age
2) Snowstorm pattern on US
3) Swollen villi
4) Early preeclampsia (before 20 weeks)

118
Q

Most common benign tumor of female reproductive tract

A

Leiomyoma (fibroids)

119
Q

Histology of leiomyoma

A

Whorls of benign, spindle shaped smooth muscle cells

120
Q

Macroscopic appearance of leiomyoma

A

Well-circumscribed, rubbery, white-tan masses

121
Q

Tumor marker for epithelial-derived ovarian carcinomas (ie: serious & mutinous cystadenocarcinoma)

A

CA-125

122
Q

Inflammatory carcinoma involves what specifically within the breast tissue?

A

Dermal lymphatic channels

*Reason for high stage at diagnosis

123
Q

Atypical intraductal epithelial cell proliferation with comedo necrosis indicates what?

A

Ductal carcinoma in situ

*Does NOT present with skin changes or induration

124
Q

Grossly, how do Granulosa cell tumors present

A

Solid, yellow ovarian masses

*producing estrogens

125
Q

Histologically, how do Granulosa cell tumors present

A

Call-Exner bodies (follicle-like structures)

+ for inhibin

126
Q

What two diseases present with “fried egg” appearance on histology

A

Dysgerminoma

*Seminoma is the equivalent in males

127
Q

Bilateral ovarian cancer is metatastatic from where? What’s the name of the cancer?

A

Gastric carcinoma (diffuse type)

Krukenberg tumor

128
Q

Cause of functional hypothalamic amenorrhea

A

Intense & sustained exercise regimen with chronic dieting, which surpasses the hypothalamic secretion of GnRH

129
Q

Lab findings of functional hypothalamic amenorrhea

A

LOW GnRH and estrogen

130
Q

Frequent cause of endometrial carcinoma

A

Prolonged estrogen exposure in the absence of sufficient progesterone opposition

131
Q

Tumor marker for testicular germ cell tumors

A

AFP

beta-hCG

132
Q

Function of BRCA1 & 2

A

DNA repair protein

133
Q

Pregnancy & postpartum period are associated with an increased risk of thromboembolic disease in part due to changes in what?

A
  • Increased factors 1, 2, 5, 7, 8, 10, 12
  • Decrease in free protein S
  • Increase in resistance to activated protein C
134
Q

Low levels of what hormone can cause early pregnancy loss

A

Progesterone

135
Q

Cause of abnormal uterine bleeding (AUB)

A

Anovulatory cycles

*Endometrium undergoes unopposed estrogenic stimulation

136
Q

What does the phrase “disordered proliferative endometrium” refer to

A

Anovulatory cycles

*Endometrium undergoes unopposed estrogenic stimulation

137
Q

If a young woman presents with anovulatory cycles, endometrial hyperplasia, or cancer, what could be the cause?

A

Unopposed estrogen such as:

  • Medication use
  • Ovarian granuloma cell tumor
  • PCOS
138
Q

What histological differentiates acute from chronic endometritis?

A

Acute: neutrophils

Chronic: plasma cells

139
Q

Chronic endometritis is due to what?

A

IUD or STD (chlamydia)

140
Q

What hormone would be given to treat endometrial hyperplasia?

A

Progesterone administration

*Arrests glandular proliferation and decreases mitotic activity causing secretly changes in the glands and stromal decidualization

141
Q

What tumor marker would be seen in a Kruckenberg tumor?

A

CEA

142
Q

Tumor marker of ovarian epithelial tumors (cystadenocarcinoma)

A

CA-125

143
Q

Cause of Meigs syndrome & 3 characteristics of it

A

*Ovarian fibroma

  • Hydrothorax (right sided)
  • Ascites
  • Ovarian fibroma
144
Q

What is another name for uterine fibroid?

A

Uterine leiomyoma

*Benign smooth muscle tumor

145
Q

Histology of endometriosis

A
  • Hyperchromatic epithelium on H&E
  • Hyperchromatic spindle shaped cells
  • Hemosiderin-laden macrophages
146
Q

Most common sites of endometriosis

A
  • Ovaries
  • Douglas Pouch
  • Uterus
  • Colon
147
Q

Classic signs of pelvic congestion syndrome

A

1) Chronic pelvic pain
2) Increases with standing
3) Painful intercourse

148
Q

Cause of pelvic congestion syndrome

A

Dilated veins within the pelvis from incompetent veins or proximal obstruction

*CT would demonstrate findings

149
Q

CASE STUDY:

16 year old girl has not begun menstruating. Tanner stage 1 breasts & genitalia. Severely increased LH, FSH, and decreased T3 & T4. What is the most likely explanation of the abnormal sexual development in this patient?

A

Ovarian dysgenesis

*This is a classic presentation of Turner Syndrome

**Ovarian dysgensis leads to decreased sex steroid levels, causing compensatory increase in LH & FSH

150
Q

List 5 causes of abnormal uterine bleeding

A

1) Endometrial polyps
2) Hyperplasia
3) Carcinoma
4) Endometritis
5) Leiomyoma

151
Q

Name a benign neoplasm that grows rapidly during pregnancy and regresses after menopause (estrogen dependency)

A

Leiomyoma

152
Q

Cystically dilated endometrial glands describes what pathologically?

A

Endometrial polyps

*Reddish-brown in color

153
Q

Nests of benign endometrial glands within the myometrium describes what pathologically?

A

Adenomyosis

154
Q

Blood gas of a pregnant woman

A

Compensated respiratory alkalosis

155
Q

Describe progesterones role in respiration of the mother in pregnancy

A

Increases central chemoreceptor sensitivity to CO2, increasing ventilation and thus, decreasing arterial PCO2

  • Causes respiratory alkalosis
  • *Low bicarbonate levels in kidney to compensate alkalosis
156
Q

Function of hPL (human placental lactogen)

A

Growth hormone equivalent

-Increase maternal lipolysis & ketogenesis

-Decrease maternal glucose utilization (anti-insulin)
^Cause of gestational diabetes

157
Q

Presentation of a Sertoli-Leydig cell tumor

A

Ovarian neoplasm of sex cord-stomal cells secreting testosterone and causing virilization of female patients

158
Q

How are FSH & LH affected in Sertoli-Leydig cell tumors?

A

Both decrease because of feedback inhibition of the high testosterone levels

159
Q

3 key features in patients presenting with Serotli-leydig tumor

A

1) Rapid onset acne
2) Hirsutism
3) Amenorrhea

160
Q

3 causes for increased levels of LH

A

1) Primary ovarian insufficiency
2) Pituitary disorder
3) PCOS

161
Q

In males or females are all teratomas considered to have malignant potential post-puberty?

A

Males

*Solid mature teratoma

162
Q

Another name for dermoid cyst

A

Mature cystic teratoma

163
Q

Erectile physiology

A

1) Cavernous nerve releases ACh & NO
2) NO activates guanylate cyclase, increasing cGMP and causing smooth muscle relaxation
3) ACh increases PLC & NO
4) Vasodilation engorges the corpora cavernosa

164
Q

Tumor marker of yolk sac tumor

A

AFP

165
Q

3 main characteristics of yolk sac tumor

A

“SAC”

  • Schiller-Duvall bodies (endodermal sinuses that resemble primitive glomeruli)
  • AFP increased
  • Occurs in children
166
Q

Gross examination of a yolk sac tumor would demonstrate what?

A

Solid tan-grey or yellow-tan tumor with hemorrhage, necrosis, and gelatinous features (reflects presence of germ cell components)

167
Q

A patient is diagnosed with ovarian torsion and a mass is discovered that is firm, tan, lobulated, and secretes lactate dehydrogenase (LDH). What is the tumor?

A

Dysgerminoma

*Malignant germ cell tumor

168
Q

Histologically, describe dysgerminoma

A

Sheets of large polygonal cells with central nuclei

169
Q

What histologically is diagnostic for a Leydig cell tumor?

A

Rod shaped crystals (Reinke crystals)

170
Q

Possible precursors of invasive squamous cell carcinoma of the penis and their physical presentation

A
  • Bowen Disease [grey-white plaque]
  • Bowenoid papulosis [Multiple reddish-brown papular lesions]
  • Erythroplasia of Queyrat [Soft red plaque]
  • Condyloma acuminatum
  • Giant condyloma
171
Q

Characteristics of chronic endometritis histologically & main cause

A

Infiltration of lymphocytes, plasma cells, and histiocytes into the endometrium

*Chlamydia infection, IUD, and recent pregnancy can cause

172
Q

Cause of acute endometritis

A

S. aureus

  • presents with fever & foul smelling
  • *Presence of micro abscesses
173
Q

Clinical presentation of seminoma

A

History of cryptochidism

174
Q

Histological presentation of seminoma

A
  • Large cells with clear cytoplasm

- Arranged in nests, mixed with lymphocytic stroma

175
Q

What can HPV cause?

A

1) Condyloma accuminata

2) Squamous dysplasia [koilocytosis]

176
Q

What clinical presentation would suggest adenomyosis?

A
  • Severe perimenstrual pain
  • Thickening of myometrium

**unknown why it occurs

177
Q

Cryptorchidism is associated strongly with what?

A

INCREASED RISK OF TESTICULAR CANCER

*Both descended and non-descended at risk

KAPLAN FLASH CARDS (10 decks)

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