Reproductive Flashcards
What is a communicating hydrocele?
Accumulation of serous fluid within the tunica vaginalis in the setting of a patent processus vaginalis
Process that results in a bicornuate uterus
Incomplete lateral fusion of the paramesonephric ducts
Menotropin
Treatment option for infertility that acts like FSH and triggers the formation of a dominant ovarian follicle
The use of hCG therapy mimics which physiologic event?
LH surge - induces ovulation
Mechanism of ovarian torsion
Typically involves twisting of the infundibulopelvic ligament (suspensory ligament of the ovary), often due to the weight of a large adnexal mass
Which hormone prevents lactation during pregnancy?
Progesterone
Clomiphene
An estrogen receptor modulator that decreases negative feedback inhibition on the hypotahalamus by circulating estrogen, thereby increasing gonadotropin production
Most common cause of bloody nipple discharge
Intraductal papilloma - proliferation of papillary cells in a cyst wall or duct that may contain focal atypia
Unilateral painful cystic lesion in the lower vestibule adjacent to the vagina. Typically in a woman of reproductive age.
Bartholin cyst and abscess
Low risk HPV subtypes
6 and 11
High risk HPV subtypes
16
18
31
33
Microscopic finding associated with HPV
Koilocytes
Pocelain-white plaques with a red or violet border. Typically seen in postmenopausal women.
Lichen sclerosus
Lichen sclerosus increases risk for?
SCC
Leathery, thick vulvar skin
Lichen simplex chronicus
Pruritus, erythema, crusting, ulcers of the vulva
Extramammary Paget disease
Differential diagnosis for extramammary Paget disease
Melanoma
How do you distinguish between extramammary Paget disease and melanoma of the vulva?
Paget cells: PAS+, keratin +, S100-
Melanoma: PAS-, keratin -, S100+
There is an increased incidence of adenosis in what population of patients?
Females exposed to DES in utero
Clear cell adenocarcinoma
Affects women who had exposure to DES in utero
Biopsy findings that show cytoplasmic cross striations and positive IHC staining for desmin and myoglobin
Rhabdomyoblast - cells of embryonal rhabdomyosarcoma
LN spread from a tumor in the lower 2/3 of the vagina
Inguinal nodes
LN spread from a tumor in the upper 1/3 of the vagina
Regional iliac nodes
Exocervix is lined by?
Squamous epithelium
Endocervix is lined by?
Columnar epithelium
HPV
DNA virus
What occurs with high risk HPV subtypes?
They produce E6 and E7 which cause destruction of p53 and Rb
Classic presentation of cervical carcinoma?
Vaginal bleeding in a middle aged woman
Risk factors for cervical carcinoma?
High risk HPV (16/18), smoking, immunodeficiency
What is the characteristic cell of chronic endometritis?
Plasma cell
Multiple, well defined white whirled masses
Leiomyoma (fibroid)
What stimulates the theca cells?
LH
What stimulates the granulosa cells?
FSH
LH:FSH>2
PCOS
What kind of cancer are pts with PCOS at increased risk for?
Endometrial carcinoma - due to high circulating levels of estrone
What kind of ovarian tumor is commonly seen in pts with BRCA1 mutation?
serous carcinoma of ovary and fallopian tube
CA-125
Serum marker for surface epithelial ovarian tumors
What causes hypospadias?
Failure of urethral folds to close
What causes epispadias?
Abnormal positioning of the genital tubercle. Associated with bladder exstrophy
What causes Lymphogranuloma venereum?
Chlamydia trachomatis L1-L3
Name the precursor lesions of squamous cell carcinoma of the penis
Bowen disease (shaft), erythroplasia of queyrat (glans), bowenoid papulosis
Complications of cryptoorchidism
Testicular atrophy with infertility and increased risk of seminoma
Cause of a varicocele
Dilation of spermatic veins due to impaired drainage
Varicocele is associated with?
Left sided renal cell carcinoma
Cellular description of seminoma
Large cells with clear cytoplasm and central nuclei
Gross description of seminoma
Homogenous mass with no hemorrhage or necrosis
What is the most common testicular tumor in children?
Yolk sac tumor
What is elevated with yolk sac tumors?
AFP
Malignant tumor of synctiotrophoblasts and cytotrophoblasts
Choriocarcinoma
How does choriocarcinoma spread?
Rapidly via the blood
Characteristic histology of leydig cell tumor
Reinke crystals
Most common cause of testicular mass in males > 60 years
Lymphoma, usually bilateral and diffuse large B-cell type
What location of the prostate does BPH occur?
In the periurethral zone
Possible treatments for BPH
- alpha 1 antagonist (terazosin) to relax smooth muscle
- selective alpha 1a antagonists (tamsulosin) in normotensive pt
- 5alpha reductase inhibitor
Malignant proliferation of prostatic glands
Prostate adenocarcinoma
Risk factors of prostatic adenocarcinoma
Age, race, diet high in saturated fats
Where is the most common location for prostate adenocarcinoma?
Posterior periphery of the prostate
Where does prostate cancer commonly spread?
Lumbar spine - osteoblastic metastases
What mediations can be used to treat prostate cancer?
Continuous GnRH analongs (Leuprolide)
Androgen receptor inhibitor (Flutamide)