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PAS 753 (Molecular Pathophysiology) > Reproductive > Flashcards

Reproductive Flashcards

1
Q

when does obstetrical dating start

A

the first day of the LMP

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2
Q

what is the average length of pregnancy

A

266 days from conception

280 days from LMP

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3
Q

what percept of prenancies are ectopic

what percent of those are in the fallopian tube

A

0.5%

95% in the fallopian tube

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4
Q

risks for ectopic pregnancy

A

salpingitis

prior ectopic pregnancy

prior tubal surgery

cigerette smoking

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5
Q

what percent of people with ecoptic pregnancy will have at least one risk factor

A

50%

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6
Q

what is the presentation of ectopic pregnancy

A

vaginal bleeding

pelvic pain

usually starts in the firs ttrimester

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7
Q

describe pelvic pain associated with ectopic pregnancy

A

usually mild, starts at 6-8 weeks in

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8
Q

describe pelvic pain associatd with ectopic pregnancy

A

usually starts at weeks 7-9

can vary from cramping to sharp pain

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9
Q

what is necessary for the evaluation of first trimester pain and bleeding

A

ultrasound is mandatory to catch ectopic pregnancy brefore rupture

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10
Q

US findings of ectopic pregnancy

A

No IUP “empty uterus”

adnexal mass

free fluid in the cul de sac

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11
Q

IUP

A

intrauterine pregnancy

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12
Q

what is the risk of a ruptured ectopic pregnancy

A

death

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13
Q

what is the presentation of ruptured ectopic pregnancy

A

massive intrabdominal blood loss

severe pain

syncope

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14
Q

what is the treatment of an ectopic pregnancy

A

removal of affected tube

blood transfusion

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15
Q

treatment of unruptured ectopics

A

methotrexate with follow up

laproscopy with preservation (little) or removal (big) of the tube

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16
Q

endometriosis

A

endometrial glands and stroma outside the uterus

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17
Q

what demographic is more likley yo hae endometriosis

A

infertile women 25-35%

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18
Q

symptoms of endometriosis

A

dysmenorrhea

dysparenunia

constant deep seated pelvic or rectal pain

infertility

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19
Q

dyspareunia

A

painful intercourse

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20
Q

what are the diagnostic considerations for endometriosis

A

laparoscopy

open surgery

US

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21
Q

two variants of endometriosis

A

benign and aggressive

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22
Q

benign variant endometriosis characteristics

A

later onset

superficial lesions

slow progression

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23
Q

aggressive variant endometriosis characteristics

A

early onset

invasive lesions

rapid progression

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24
Q

causes of endometriosis

A

retrograde mensturation that allows viable endometrial cells to implant on pelvis structures or travel in lymph that the immune system fails to elimante

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25
Q

5 common locations of distant endometriosis

A

umbilicus

intestine

upper abdomen

lung

brain

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26
Q

treatment for endometriosis

A

NSAIDs for dysmenorrhea

ovarian suppresssion

surgery

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27
Q

three ways to use hormone suppression to treat endometriosis

A

contraceptives

Pituitary down regulation

mild androgens

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28
Q

what is the definitive surgical treatment for endometriosis

A

hysterectomy and oophorectomy

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29
Q

three areas of cancer of the reproductive system

A

breast cancer

ovarian

uterine

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30
Q

four facts regardings breast cancer and age

increasing risk

rare before…

mean age

diagnosis time

A

risk increases with age

rare before 40

mean age of diagnosis 60-61

time from origin to diagnosis 2-8 years

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31
Q

how long does it take for a breast cancer tumor to double in size

A

20-100 days

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32
Q

what is the risk of breast cancer in females without estrogen

what about men with estrogen

A

male level risk

increased risk because of estrogen

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33
Q

what is the risk factor for breast cancer associated with familial linkage

but…

A

risk is increased 3-4x if a mother or sister has breast cancer

75% of patients have no history

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34
Q

two breast cancer mutations that increase risk

what type of genes are mutated

what is the life time risk with the mutation

A

BRCA 1 and 2

tumor suppressor mutations

50-85%

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35
Q

what other cancers are associated with BRCA 1 and 2

A

ovarian

pancreatic

fallopian

prostate

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36
Q

in what countries are breast cancers most commonly found

why

A

developed countries

related to fat content

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37
Q

what is the connection between ethanol and breast cancer

A

slight increase in ris

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38
Q

what is the usual presentation of breast cancer

A

a painless lump found by the patient

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39
Q

what are three less common presentations of breast cancer

A

nipple erosion or discharge

skin dimpling

inflammatory breast carcinoma

40
Q

four types of breast cancer screenings

A

monthly self exam

annual breast exam

mammography

blood test for tumor markers

41
Q

at what age does mammography have a proven value

A

between ages 50-70, no value under age 40

42
Q

five ways to treat breast cancer

A

surgery

radiation

chemo

anti estrogen driugs

antibodies against growth factors

43
Q

what are the three primary surgical treatments of breast cancer

A

lumpectomy

mastectomy

axillary node dissection

44
Q

what factors decrease risk for ovarian cancer

A

pregnancy

oral contraceptive use

tubal ligation

45
Q

three orgin sites for ovarian cancer

which is the most common

A

epithelial

germ cell

stromal/sex cord

epithelial

46
Q

serous and mucinous cystadenocarcinoma are examples of what type of ovarian cancer origin

A

epthelial

47
Q

does removing or blocking fallopian tubes increase to decrease risk of ovarian cancer

A

decrease

48
Q

how does early diagnosis effect prognosis of ovarian cancer

but…

A

early detection increases prognosis

but only 20% of cases are detected earyl

49
Q

what is common when ovarian cancer starts to spread in the abdomen

A

obstruction, malabsorption

50
Q

three sites of distant metastases in ovarian cancer

A

liver

lung

bone

51
Q

two treatment options for ovarian cancer

A

surgery

chemo

52
Q

when pursuing surgical treatment of ovarian cancer, what needs to be removed

A

uterus, ovaries, fallopian tubes, omentum

53
Q

three types of uterine cancer

A

cervical cancer

endometrial cancer

leiomyosarcoma

54
Q

what is the main cause of cervical cancer

what are two synergistic factors

A

HPV

smoking, immunosuppression

55
Q

what types of HPV are associted with warts

what are associated with cervical cancer

A

6, 11, 42, 43

16, 18, 33, 35, 45

56
Q

how effective is gardasil against cervical cancer

what about genital warts

A

prevents 70-90% of cervical cancer

only some protection

57
Q

what are the conventional screens for HPV

A

pap smear

liquid based medium

58
Q

three treatments of cervical cancer

A

radial hysterectomy and lymph node dissection

radiation

chemo

59
Q

three factors that increase risk for endometrial cancer

two factors that decrease risk

A

estrogen exposure, insufficient progesteron, genetics

oral contraceptives, progestin use

60
Q

what is the effect of birth control on the risk for the following cancers

breast

ovarian

cervical

endometrial

A

possible increased risk

decreased risk

no impact

decreased

61
Q

how is endometrial cancer diagnosed

A

post menopausal bleeding

endometrial biopsy/d & c

ultrasound

MRI for staging

62
Q

treatment for endometrial cancer

A

radiation

surgery

hormones

chemo

63
Q

psoriasis

A

chronic, relapsing skin disorder that causes itching, joint inflammation, and depression

64
Q

how common is psoriasis

what is the typical age of onset

what is the gender bias

A

very common (1-3%)

15-25 yrs

none

65
Q

describe the incidence of psoriasis from the follow ethnicities

caucasians

african americans

native americans

A

most common

uncommon

very rare

66
Q

psoriasis is associated with increased risk for what diseases

A

inflammatory bowel disease

skin cancer

upper GI cancer

lung cancer

67
Q

what is the etiology of psoriasis

A

it is a T cell mediated immune disease which also involves TNF and interleukins

68
Q

what is the familial genetic influence with psoriasis

A

1/3 of people will have a positive FHx

70% chance that twins will have this together

69
Q

what is the pathophysiology of psoriasis

A

excessively rapid turnover of the epidermis (3-5 days instead of 21-30 days)

70
Q

what is the goal of psoriasis treatment

A

slow the turnover rate of the epidermis

71
Q

what are the treatments for psoriasis ranked by toxicity

what is the relationship between toxicity and effectiveness

A

topical, photo, systemic

increasingly effective treatment is increasingly toxic

72
Q

three examples of topical psoriasis treatment

A

corticosteroids

anthralin

coal tar

73
Q

two photo treatments of psoriaisis

A

UVB, PUVA

74
Q

three systemic treatments of psoriaisis

A

cyclosprin

methotrextate

retinoids

75
Q

hypertrophic scars

A

raised or expanded scars that often form in reaction to suboptimal healing

76
Q

keloid scars

A

idiopathic benign neoplastic extension of scars

77
Q

what is the relationship between keloids and skin pigmentation

A

increasing pigmentation increases risk

78
Q

what is the most common age group to form keloids

A

10-20

79
Q

five treatment options for keloids

A

corticosteroid injections

cryotherapy

radiation

surgical excision

laser reduction

80
Q

two benign forms of skin cancer

one maglignant type

A

basal cell and squamous cell carcinoma

melanoma

81
Q

what is the most common form of skin cancer

what is the common cause

what is the risk if left untreated

A

basal cell carcinoma

UV light

local destruction, rarely metastasis

82
Q

what is the common cause of squamous cell carcinoma

when would it be considered deadly

A

UV light

when it is in the oral cavities or mucus membranes

83
Q

two treatment options for basal or squamous cell carcinoma

A

outpatient excision or thermal ablation

84
Q

what is the main risk factor for melanoma

why is the incidence increasing but the mortality decreasing

A

sun exposure

sun worship - early detection, better treatment

85
Q

diagnosis of melaoma

A

biopsy

ABCDE

ugly duckling

86
Q

ABCDE for melanoma

A

assymetry

border

color

diameter

evolution

87
Q

treatment for melanoma

A

excision

chemo

immunotherapy

88
Q

two considerations to account for with surgical excision of melanoma

A

wide surgical margins with lymph node sampling

89
Q

three forms of immunotherapy against melanoma

A

interferon

tumor vaccines

lymphocyte training

90
Q

dermatological manifestation of heart failure

A

pitting edema

91
Q

dermatological manifestation of insufficient oxygenation

A

clubbing and cyanosis

92
Q

dermatological manifestation of vascular insufficiency

A

venous stasis ulcers

93
Q

three types of coagulopathies

A

low platelet counts

clotting factor deficiencies

excessive anticoagulation

94
Q

three signs of clotting abnormalities in the skin

A

petechiae

purpura

easy bruising

95
Q

two types of lupus

A

systemic

discoid (only skin)

96
Q

three causes of contact dermatitis

A

allergic reaction similar to poison ivy/oak/sumac

PAS 753 (Molecular Pathophysiology) (17 decks)

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