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Reproductive: 4/21-4/29 > Reproductive- FA > Flashcards

Reproductive- FA Flashcards

1
Q

HER-2 has worse prognosis than Estrogen receptor positive in breast cancer. What molecule is HER-2? function?

A

tyrosine kinase receptor
=> promotes cell growth and proliferation

trastuzumab is antibody that targets HER-2, inhibiting cell growth
: antibody mediated cytotoxicity

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2
Q

Difference between partial vs. complete abruptio placentae?

A

complete: concealed hemorrhage
partial: apparent hemorrhage

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3
Q

Danazol

  • MOA
  • indications
  • side effects
A
  • androgen partial agonist
  • endometriosis (reducing dysmenorrhea by negative feedback to FSH/LH-> inhibiting mestural cycle), hereditary angiodema
  • heptatoxicity, hirsutism, masculization, also pseudomotor cerebri (so random)
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4
Q

Most effective emergency contraceptive?

A

copper IUD: local inflammation toxic to sperm and ova

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5
Q

Gubernaculum consists of which two ligaments in female? what is its function in male?

A

female- ovarian ligament and round ligament
*ligaments in upper region of uterus

male- holds testes within scrotum

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6
Q

Above which artery does the round ligament travel?

A

artery of Sampson

: tiny vessels that form anastomosis of uterine and ovarian artery

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7
Q

Leydig cell tumor

  • histologic finding
  • phenotypes- kid vs. adult
A
  • Reinke crystals: eosinophilic cytoplasmic inclusions
  • adult: gyenocomastia (estrogen from testosterone via aromatase)
  • kid: precocious puberty (testosterone)
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8
Q

What is treatment for seizure prevention in preeclampsia? what is definitive treatment?

A

seizure prevention- 1st line: IV MgSO4, 2nd line: BDZ

definitive treatment: immediate delivery

*In fact, definitive treatment for all hypertensive complications of pregnancy (pre/eclampsia, HELLP) is immediate delivery of fetus

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9
Q

Disorders of Sex Development (DSD): explain each

  • 46 XX DSD
  • 46 XY DSD
A
  • 46 XX DSD- ovary present, ambiguous external, virilization, excess androgen
  • 46 XY DSD- testes present, ambiguous external (or female). Androgen insensitivity
  • Bottomline: GONAD INTACT, EXTERNAL GENITALIA MESSED UP. It is matter of ANDROGEN (female- too much, male- too less)
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10
Q

Common theme of Klinefelter and Turner?

A

Hypergonotrophic hypogonadism

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11
Q

Klinerfelter: level of

  • FSH
  • LH
  • estrogen
  • testosteron
A
  • FSH: high
  • LH: high
  • hypergonatrophic
  • testosteron: low (Leydig not functioning)
  • estrogen: high -> gynecomastia
  • this is bit complicated. But bottomline is that
    Dysgenesis of semiferous tubules
    -> decreased inhibin -> high FSH -> more AROMATASE synthesis by FSH -> relative increase of estrogen by PERIPHERAL TISSUE
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12
Q

What estrogen form is predominant in ovary? What about adipose tissue?

A

17-beta estradiol (highest potency)

vs. adipose tissue: where estrone is predominant (2nd potency)

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13
Q

prolactin vs. oxytocin: which one induces milk letdown?

A

oxytocin

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14
Q

Clomiphene

  • MOA
  • indication
  • side effects
A
  • SERM, estrogen antagonist in HYPOTHALAMUS
  • > reduced negative feedback -> increased FSH/LH
  • > ovulation
  • indicated for PCOS (anovulation)
  • side effects: visual disturbance, hot flashes
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15
Q

Why tamsulosin is helpful in treating BPH without causing systemic vasoconstriction?

A

selective alpha agonist for alpha1-A/D

alpha1-B receptor is in vasculature: so no vasoconstriction

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16
Q

phenotype of 5alpha-reductase deficiency in male?

  • internal genitalia
  • external genitalia
A

internal genitalia intact
ambiguous external genitalia UNTIL PUBERTY

After puberty, testosterone can promotes masculinization

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17
Q

Role of DHT during

  • early development
  • late development (after puberty)
A
  • early development
    : external genitalia development, prostate DEVELOPMENT
  • late development (after puberty)
    : balding, SEBACEOUS GLAND ACITIVTY, prostate GROWTH
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18
Q

Blood smear finding in HELLP syndrome?

A

Schistocyte

Low platelet => platelet used up for thrombi
-> shistocyte -> hemolysis

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19
Q

Describe gross features of fetal alcohol syndrome. These defects are due to defect in what embryological step?

A
  • smooth philtrum
  • thin vermilon border (upper lip)
  • microcephaly (holoprosencephaly for severe form)
  • small palpebral fissures (small eye opening)

due to cell migration defect

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20
Q

hCG level in ectopic pregnancy?

A

lower than expected rise in hCG

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21
Q

blood at urethral meatus. diagnosis?

A

urethral injury

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22
Q

Two different mechanisms that may cause

  • anterior urethra damage
  • posterior urethra damage
A
  • anterior urethra damage: perineal straddle injury
    : falling onto bicycle bar
    -> bicycle bar press urethra against pubic symphysis
    -> damage ANTERIOR side of urethra by pubic symphysis
  • posterior urethra damage: pelvic fracture
    pelvic bone on posterior side can damage urethra from back
    (there is good figure in picture folder)
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23
Q

histology

  • ovary
  • ectocervix
  • endocervix
  • transformation zone
A
  • ovary: simple cuboidal
  • ectocervix: squamous
  • endocervix: columnar
  • transformation zone: squamocolumnar, most common area for cervical cancer. Pap smear should have this cell type to be valid
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24
Q

Different mechanisms for contraception by using

  • progestin
  • antiprogestin
A
  • progestin: thick cervical mucus, preventing sperm entrance => contraception before fertilization
  • antiprogestin: inhibition of maintaining thick uterus wall => contraception after fertilization (termination of pregnancy)
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25
Q

Name of antiprogestrin for emergency contraception?

A

ulipristal

*Uli= sounds like URgenet

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26
Q

Ploidy and chromatids for

  • spermatogonium
  • spermatozoon
A
  • spermatogonium: 2N,2C (diploid)
  • GONIum= GOINg to be sperm. so before meiosis
  • spermatozoon: 1N,1C (haploid)
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27
Q

What type of epithelium lines the uterus in the proliferative phase? In the secretory phase?

A

proliferative phase: columnar

secretory phase: coiled glands

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28
Q

prostate is derived from what embryological structure?

A

urogenital sinus

  • gland= sinus
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29
Q

What is the gene responsible for proper organization along the dorsal-ventral axis?

A

Wnt-7

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30
Q

What is the gene responsible for lengthening of limbs?

A

FGF, through stimulating mitosis of mesoderm

FGF= fibroblast GROWTH factor -> limb GROWTH

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31
Q

Chorionic villi: name and location of two parts? role of each?

A
  • cytotrophoblast: highly mitotic, cells division, inner layer
    Cytotrophoblast, Cells
  • syncytiotrophoblast: beta-hCG, outer layer
    SYNcytiotrophoblast, SYNthesizes hormone
  • hormone outside, cells inside
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32
Q

Phenotypes of endometriosis

A
  • dyschezia: pain with defecation
  • dysmenorrhea
  • dyspareunia: pain with sex
  • retroverted uterus: adhesion
  • PAINFUL things in endometriosis
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33
Q

most common site of endometrial tissue growth in endometriosis?

A

ovary

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34
Q

What is amniotic band syndrome? what type of error in organ morphogenesis?

A

entrapment of fetal parts (hands, feet) in fibrotic amniotic bands

this is example of disruption: secondary breakdown of PREVIOUSLY NORMAL structure

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35
Q

notochord arises from which embryological layer?

A

mesoderm

  • way to remember: notochord stimulates differentiation of overlying ectoderm into neural plate. So it is gotta be one layer below= mesoderm
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36
Q

What is Peyronie disease ?

A

abnormal penile curvature caused by a tunica albuginea fibrous plaque => erectile dysfunction

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37
Q

clear cell carcinoma of the vagina: due to exposure to what teratogen in utero?

A

Diethylstilbestrol

*also causes congenital Müllerian anomalies

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38
Q

what is Metrorrhagia ?

A

frequent or irregular mesnturation

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39
Q

What GI maliganancy is associated with ovarian cancer?

A

Lynch syndrome

  • also associated with endometrial and skin cancer
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40
Q

Twinning: define when it occurs

  • Dichorionic/ Diamnionic
  • Monochrionic/ Diamnionic
  • mono/mono
  • mono/mono, conjoined
A
  • Dichorionic/ Diamnionic
    1. 2 eggs/ 2 sperms
    2. before morula (day4)
  • Monochrionic/ Diamnionic
    : between morula and blastocyst (4-8 days)
  • mono/mono
    :after blstocyst (8-12 days)
  • mono/mono, conjoined
    : too late: embryonic disc is formed, >13 days
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41
Q

During the third week of fetal development, what structure forms the allantois? Into which part of the fetus does it then extend? what does it become eventually?

A

yolk sac -> allantois -> it extends to urogenital sinus

  • > allantois becomes urachus, , duct between bladder and umbilicus
  • FA p. 572
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42
Q

During which week of development can the first male/female characteristics be distinguished?

A

10 wks, when genitalia shows to have characteristics

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43
Q

A woman receives antibiotics for mastitis but does not improve. Why are you worried?

A

Inflammatory breast cancer is often mistaken for mastitis (or Paget disease), so you should do an urgent workup for this diagnosis

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44
Q

What is triad of Meigs syndrome? what sensation pts complain?

A

triad

  • ovarian fibroma
  • ascites
  • pleural effusion

patients complain pulling sensation in groin

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45
Q

Which part of 3rd and 4th brachial pouch give rise to inferior and superior parathyroid respectively?

A

dorsal wings

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46
Q

Pregnant mom is exposed to a teratogen that lead shielding could have blocked. What birth defects could occur?

A

Microcephaly and intellectual disability

: this teratogen is X-ray

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47
Q

urethra is derived from what embryological layer?

A

endoderm

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48
Q

What hormone is produced by thecoma? What is a common presentation?

A
  • estrogen (it is like benign version of granulosa cell tumor)
  • Although thecoma sounds like theca interna cell neoplasm, it is actually granulosa like
  • pts commonly present with postmenopausal uterine bleeding
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49
Q

From which branchial arch subset is the cricothyroid muscle derived?

A

4th

  • all intrinsic muscles of larynx EXCEPT CRICOTHYROID is derived from 6th
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50
Q

What germ layer gives rise to the adrenal cortex?

A

mesoderm

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51
Q

mandibular hypoplasia and facial anomalies: diagnosis? what defect in embryology?

A

Treacher Collins syndrome

: due to failure of first brachial arch migration

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52
Q

micrognathia, glossoptosis, cleft palate, and airway obstruction: diagnosis? what defect in embryology?

A

Pierre Robinson sequence
: due to failure of first brachial arch function

  • similar defect with Treacher Collins, yet completely different phenotypes
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53
Q

How may varicocele result in infertility?

A

limited blood drainage

  • > increased scrotum temperature (blood is warm!)
  • > decreased spermatogenesis
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54
Q

What is common site of metastasis in choriocarcinoma? how does it spread (lymph? or blood?)

A

lung -> may cause hemoptysis

spread hemtogenously

  • one of 4 exceptions of carcinoma
  • RCC
  • HCC
  • Choriocarcinoma
  • follicular cell carcinoma of thyroid
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55
Q

Both complete hydatidifrom mole and choriocarcinoma can result in high hCG in lab. How to differentiate these two?

A

complete hydatidifrom: cystic swelling of chorionic villi

choriocarcinoma: no chorionic villi
* think like this: in choriocarcinoma, neoplasm is pretty advanced and chorionic villi is gone

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56
Q

Barr body

  • what is it
  • describe histologic finding
  • what disease?
A
  • inactivated X chromosome
  • dumbbell shaped extension nucleus
    : looks like tiny spot is coming out from nucleus, localizing in the edge (google it)
  • Klinefelter
  • No Barr body in Turner. just one X is missing
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57
Q

Which nerve mediates erection, emission, ejacuation

A

erection: Parasympathetic, Pelvic
emission: Sympathetic, Hypogastric
ejacuation: Somatic, Pudendal

Point SHoot, SPoon

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58
Q

Two types of ovarian cyst? Each is associated with what other conditions?

A
  • follicular: associated with hyperestrogen (so endometrial hyperplasia)
  • many follicles are making cyst. Remember estrogen is required to mature follicles and induce ovulation. So hyperestrogen leads to make more follicles
  • theca-lutein cyst: Due to gonadotropin stimulation. associated with choriocarcinoma or hydatidiform moles
  • Luteinized follicles are making cyst. Remember choriocarcinoma or hydatidiform moles are associated with trophoblast, which exists only when fertilization occur, thus leuteinized follicles
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59
Q

What is the most common benign ovarian tumor in female age of 10-30?

A

MATURE cystic teratoma

60
Q

Why OCP can be helpful in endometriosis

A

OCP -> negative feedback to FSH/LH

  • > inhibit ovulation/ menstural cycle
  • > reduce pain in dysmenorhhea
61
Q

What is the most common testicular cancer among older men? Is it aggressive or indolent?

A

Testicular lymphoma (it is NOT a primary tumor but arises when lymphoma metastasizes to the testes)

aggressive

62
Q

High testosterone. What lab test helps distinguish a defect in the androgen receptor from a testosterone-secreting tumor?

A

LH test

  • defective androgen receptor: no negative feedback, high LH
  • testosterone secreting tumor: negative feedback still intact, low LH
63
Q

How to treat androgen insensitivity syndrome, 46XY?

A

testes are often present in labia majora

surgical removal to prevent malignancy

64
Q

What is thought to be the etiology of preeclampsia?

A

Abnormal placental spiral arteries leading to maternal endothelial dysfunction, vasoconstriction, and ischemia
-> HTN, proteinuria (ischemic renal damage), end organ dysfunction

65
Q

cryptorchidism: level of
- inhibin
- testosterone
- LH
- FSH

A
  • inhibin: sertoli cells not functioning due to high temperature, also aspermatogenesis
  • testosterone: can be normal (leydig cell is not affected by high temperature)
    can be decreased in bilateral cryptochidism
  • LH: high
  • FSH: high
66
Q

clear cell adenocarcinoma of vaginal tumor is associated with in utero exposure of what chemical?

A

DES (diethylstilbestrol)

67
Q

maternal diabetes: oligo or polyhydramnios? why?

A

polyhydramnios
: maternal diabetes -> neural tube defect (anancephaly)
-> defect in swallowing center

68
Q

Effect of testosterone therapy on serum lipid- LDL and HDL?

A

high LDL, low HDL => premature CAD
: opposite with estrogen!
(estrogen is beneficial in terms of lipid)

69
Q

From which fetal structure are the umbilical arteries and veins derived?

A

allantois

70
Q

What is the most common risk factor for cervical cancer?

A

multiple sexual partners

lack of barrier contraceptive (condom) is next

71
Q

What germ layer gives rise to the upper vagina? The lower vagina?

A

upper: mesoderm ( mullarian duct)
lower: endoderm (derived from urogenital sinus)

72
Q

Explain how pregnancy can result in transient hyperthyroidism

A

beta-hCG has alpha subunit equivalent to TSH

73
Q

best serum test to confirm that menopause

A

FSH: decreased estrogen reduces negative feedback on FSH

74
Q

Differentiate Tanner stage 4 and 5 in female

A

stage 4:

  • pubic hair growth, but spares medial thigh
  • raised areola, mound on mound

stage 5:

  • pubic hair extends to medial thigh
  • flattened areola
75
Q

Cardinal ligament connects which two parts?

A

CERVIX to lateral side wall of pelvis

76
Q

Define Menorrhagia

A

Heavy menses with greater than 80 mL blood loss or menses that last for more than 7 days.

REGULAR mens cycle
(vs. menometrorrhagia, irregular heavy menses)

77
Q

Major source of beta-hCG during 8-10 wks? After 10 wks?

A

8-10wks: when beta-hCG peaks, synthesized from Corpus Luteum

After 10wks: placenta takes it over.

78
Q

Most common age group for dysgerminoma?

A

adolescents

79
Q

Most common age group for yolk sac tumor?

A

<3 yrs old

  • everything is YOUNG in YOlk sac
  • alpha-fetoprotein (feto=young)
  • young age group
80
Q

What happens in 4 wks of embryology

A

upper/lower limb buds formation
heart beating

4 limbs and 4 chambers of heart during 4 weeks

81
Q

Explain how anemia develops during pregnancy

A

relative dilution effect
plasma level increases (by 50%) more than RBC (by 30%)

  • this makes sense: it is easier to get volume overloaded than making new cells
82
Q

During which part of the menstrual cycle is follicular growth fastest?

A

2nd week of follicular phase

  • It is not first week. follicular maturation peaks before ovulation, thus 2nd week
83
Q

Embryological origin

  • upper 1/3 vagina
  • lower vagina
A
  • upper 1/3 vagina: Mullerian duct, mesoderm
  • Mullerian, Mesoderm
  • lower vagina: urogenital sinus ,endoderm
  • urogEnital sinus, Endoderm
84
Q

What is full score of APGAR? what is cut off for further evaluation? What is cut off for pulse between score 2 and score 1?

A
  • 10 points total
  • score <7 requires further evaluation
  • pulse >100: score 2, pulse <100, score 1, score 0 is for no pulse
85
Q

Which form of estrogen has the greatest increase during pregnancy?

A

estriol: x1000 folds, compared to other forms, estradiol or estrone, which typically show x50 folds increase

86
Q

What form of estrogen is indicator for fetus well being?

A

estriol

* estriol is mostly in placenta, healthy placenta, healthy baby, more estriol

87
Q

genotypes of Turner?

A

45 XO

45 XO/46 XX : mosaicism due to mitotic error

88
Q

Embryological layer origin

  • follicular cells of thyroid
  • parafollicular cells of thyroid
A
  • follicular cells of thyroid: endoderm

- parafollicular cells of thyroid: neural crest (P in MOTELPASS)

89
Q

Which internal organs (5) are derived from mesoderm?

A

spleen, kidney, adrenal cortex (vs. medulla- neural crest), ovaries, testes

90
Q

Embryological later origin

  • epidermis
  • dermis
A
  • epidermis: ectoderm

- dermis: mesoderm

91
Q

how to calculate gestational and embryonic ages?

A
  • gestational age: since last mens

- embryonic age: since conception (gestational age- 2wks)

92
Q

Explain mechanism of development of hypotension in HELLP syndrome

A

hepatic subcapsular hematoma

-> rupture -> hypotension

93
Q

Name three hormones that share same alpha subunit of beta-hCG

A

FSH, LH, TSH (can cause transient gestational hyperthyroidism)

94
Q

Phenotypes of 47XYY? (5)

A

very tall

normal fertility, learning disability, acne, autism
vs. Klinefelter

95
Q

woman who has not had her period for 8 weeks presents with severe LLQ pain without vaginal bleeding. Diagnosis?

A

Ectopic pregnancy

  • not always accompanied by vaginal bleeding; the key is pain (with or without bleeding) and amenorrhea
96
Q

From which branchial arch subset is the lesser horn of the hyoid derived? what about greater horn of hyoid?

A

lesser- 2nd arch
greater- 3rd arch

lesser- less number than greater, so 2nd for lesser and 3rd for greater

97
Q

Is multiparity or nulliparity cause of endometrial cancer? why?

A

nulliparity

  • It is true that estrogen is higher during pregnancy, but RELATIVELY higher PROGESTERONE is opposing action of estrogen (progesterone INHIBITS ENDOMETRIAL HYPERPLASIA).
98
Q

two methods are used to diagnose cervical dysplasia?

A

Colposcopy and biopsy

Biopsy first, followed by colposcopy

99
Q

Define terms: malformation vs. deformation

A
  • malformation: intrinsic failure of development during embryonic period (3-8wks)
  • deformation: extrinsic failure after embryonic period
100
Q

Placenta accreta/increta/percreta is associated with what endocrine disorder?

A

Placenta accreta/increta/percreta

  • > no separation of placenta after delivery
  • > postpartum bleeding
  • > Sheehan syndrome
101
Q

When is embryonic period? what is happening during this period?

A

3-8 weeks
oraganogenesis

*this is the time when organ development is mostly affected by teratogens

102
Q

umbilical arteries shunt deoxygenated blood to the placenta out of which arteries in the fetus?

A

Fetal internal iliac arteries

103
Q

3-year-old girl presents with a clear grape-like polypoid mass emerging from her vagina. Diagnosis?

A 
sarcoma botryoids
(embryonal rhabdomyosarcoma variant)
104
Q

sarcoma botryoids: what is histologic marker?

A

desmin

  • desmin is transcription factor only found in immature muscle cells
105
Q

palpitations, sweating, weight loss, and a low level of thyroid-stimulating hormone. What ovarian pathology may be responsible?

A

struma ovarii: mature teratoma with FUNCTIONAL thyroid tissue

106
Q

Level of FSH in PCOS?

A

FSH is also increased with lesser extent than LH

=> it is RATIO of LH:FSH that matters. Due to high LH, even with elevated FSH, ovulation does not occur in PCOS

107
Q

What two phenotypes may be seen in most severe form of fetal alcohol syndrome?

A
  • lung-heart fistula

- holoprosencephaly

108
Q

history of cervical carcinoma now has oliguria and a creatinine of 4.0 mg/dL (high). What is the likely cause?

A

LATERAL invasion of cervical carcinoma

-> blocking ureters -> hydronephrosis and postrenal renal failure

109
Q

Pilots, especially those flying at night, are not allowed to take PDE-5 inhibitors before or during the flight. Why might this be?

A

PDE-5 inhibitors can cause blue-green vision impairment. This is called cyanopia

110
Q

How would intelligence test look like in Klinefelter?

A

impaired. It may be normal too.
So it is both.
But always keep in mind that intellectual disability is possible in Klinefelter

111
Q

How is progesterone drop after delivery associated with lactation?

A

progesterone inhibits prolactin

drop in progesteron -> disinhibition of prolactin
-> lactation

*conversely, estrogen stimulates prolactin

112
Q

What germ layer gives rise to the endocardial cushions?

A

ectoderm

113
Q

Histologic finding for granulosa cell tumor

A

microfollicular pattern surrounded by eosinophilic fluid.

: Call-Exner bodies

114
Q

mesonephric duct gives rise to what structures?

A

SEED and trigone of bladder

S- seminal vesicles
E- ejaculatory tract
E- epidymis
D- ductus deferans
Trigone of BLAADER
  • prostate is completely independent structure. It arises from urogenital sinus with DHT
115
Q

Risk of which breast cancer genotype is increased with African American background?

A

triple negative (negative for ER, HER2, PR-progesterone receptor)

  • African, breast cancer, but cleanest one
  • triple negative is MORE AGGRESSIVE than other positives
116
Q

Why increased risk for DVT/PE during pregnancy

A

hypercoagulability due to stasis

physiologically it minimizes blood loss during delivery

117
Q

How to treat lactational mastitis?

A

antibiotics and KEEP BREASTFEEDING

  • Continuing breastfeeding helps clearing out infection, while not harming baby
118
Q

From which branchial arch subset is the posterior belly of the digastric muscle derived? what about anterior bell of digastric muscle?

A

anterior bell of digastric muscle: 1st

posterior bell of digastric muscle: 2nd

119
Q

Ectoderm gives rise to what big three embryological origins?

A

surface ectoderm
neuroectoderm
neural crest

120
Q

Leiomyoma (fibroid) is tumor of what type of cell in endometrium?

A

smooth muscle

121
Q

vasa previa

  • what is it
  • etiology
  • classic triad
A
  • fetal vessels runs over cervical os
  • umbilical cord inserted to chorioamniotic membrane, not placenta
  • classic triad
    1. fetal bradycardia
    2. PAINLESS vaginal bleeding (it is fetal blood, not mom’s)
    3. membrane rupture
122
Q

Epithelial histology of fallopian tube?

A

CILIATED simple columnar epithelium

  • think fimbriae of fellopian tube. Ciliated.
123
Q

Normal appearing woman, scant sexual hair, no ovaries/ no uterus, rudimentary vagina, mass in labia majora
- What disorder is this? what genotype? explain each phenotype

A

46 XY, androgen insensitivity syndrome

- AMH => no ovaries, no uterus
rudimentary vagina (upper 1/3 is from Mullerian duct, so it is messed up, while lower 2/3 is intact)
  • insensitivity to androgen receptor
    => scant sexual hair
    => no male external genitalia
    => mass in labia majora: testes in labia majora, which is equivalent to scrotum in male.
  • Looks like Female, but has nothing inside and XY chromosome.
124
Q

Gyenocology tumors: order worst to best prognosis, what about incidence? (US. vs. worldwide)

  • cervical cancer
  • ovarian cancer
  • endometrial cancer
A

prognosis (worst -> best)
- ovarian > endometrial > cervical

incidence (most common -> least common)
- U.S.
endometrial > ovarian > cervical

  • Worldwide: lack of HPV vaccination/screening
    cervical > endometrial> ovarian
125
Q

hemoptysis is associated with what gynecologic cancer? why?

A

choriocarcinoma, often spread to lung hematgenously

126
Q

A pregnant woman has evidence of virilization during her pregnancy. Fetal androgens are detected in her blood. What is the likely diagnosis?

A

Placental aromatase deficiency in her fetus (fetal androgens can cross the placenta and cause maternal virilization)

127
Q

Female: embryological origin of Bartholin glands and Gartner duct?

A

Bartholin glands: urogenital sinus

Gartner duct: remnant of mesonephric duct

128
Q

What germ layer gives rise to the aorticopulmonary septum?

A

ectoderm

129
Q

A woman has low human chorionic gonadotropin levels for gestation. Name three scenarios that could result in this observation.

A
  • ectopic/failing pregnancy
  • Edwards syndrome
  • Patau syndrome
130
Q

What structure do the urogenital folds develop into in male? female?

A
  • male: ventral shaft of penis
  • hypospadias is result of failure closure of urogenital folds
  • female: labia minora
131
Q

A woman has vaginal bleeding, enlarged uterus, pelvic pressure/pain, theca-lutein cysts, hyperthyroidism, and hyperemesis. Diagnosis?

A

hydatidiform mole

all phenotypes are result of high beta-hCG

132
Q

Embryology: when does heart start to beat? when is cardiac activity visible by transvaginal ultrasound

A
  • week 4: heart starts beating
  • week 4, 4 chambers
  • week 6: cardiac activity visible by transvaginal ultrasound
133
Q

fully developed secondary sex characteristics with primary amenorrhea. ovaries are functional. diagnosis?

A

Mayer-Rokitansky-Küster-Hauser syndrome
: Müllerian agenesis

  • mullerian agensis
    => no uterus -> primary amenorhhea
    => ovaries are still intact (ovaries are derived from mesoderm) -> fully developed secondary sex characteristics
134
Q

What germ layer gives rise to the parotid glands?

A

ectoderm

135
Q

immature teratoma is derived from what embryologic layer?

A

neuroectoderm

136
Q

teratoma: male vs. female- what is big difference?

A

female- mature teratoma is benign, immature teratoma is malignant

male- even mature teratoma is malignant

137
Q

Two cancers originated from neuroectoderm?

A
  • ewing sarcoma

- immature teratoma (female ovarian cancer)

138
Q

histologic finding of leydig cell tumor?

A

Reinke crystals: eosinophilic cysoplasmic inclusions

139
Q

Most common testicular cancer in older man?

A

metastatic lymphoma

: usually diffuse large B cell lymphoma

140
Q

Which hormone is responsible for growth spurt and closure of epiphyseal plate (thus short stature in precocious puberty)?

A

estrogen

  • NOT testosterone. testosterone is indirectly causing it as it gets converted to estrogen. but it is ESTROGEN that is directly associated with it.
141
Q

difference between fibroadenoma and fibrocystic change?

A

fibrocystic change is often bilateral, while fibroadenoma is focal, solitary lump

  • they both present as mass with increased tenderness with high estrogen
142
Q

Does adenomyosis present as painful mens?

A

yes.
Along with endometriosis, adenomyosis also give dysmenorrhea. But not dyspareunia (painful intercourse) as adenomyosis is limited to myometrium

143
Q

when is onset of pre-eclampsia?

A

after 20 weeks of gestation

144
Q

most common condition for bloody discharge from nipple?

A

intraductual papilloma

145
Q

marker for seminoma

A

placental ALP

146
Q

Which structure is remnant of Mullerian duct in male?

A

appendix testis

  • little tiny thing coming out from testis (like ductus arteriosus) google it.

Reproductive: 4/21-4/29 (5 decks)

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