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Disease Processes > Reproductive Pathology > Flashcards

Reproductive Pathology Flashcards

1
Q

Which cell determines the sex of the embryo?

A

The father’s X chromosome and Y chromosome (sperm cell)

Mother will only give X chromosome
Indifferent until ~week 7
SRY protein encoded on Y chromosome (becoming male)

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2
Q

What are the possible complications of cryptorchidism?

A
  • Sterility/infertility
    • Increased risk of Trauma
  • Increased risk of Neoplasms
  • Testicles may not be functioning
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3
Q

What is the purpose of the Pap smear

A

dysplasia detection
Decreased rates of cervical cancer

Guidelines vary
Age
Frequency
Vaccination

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4
Q

What are the causes of dysplasia in the cervix

A

Smoking, reduced immune function, HPV
Can effect younger woman
90% SCC

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5
Q

What is the cell of origin in prostate cancer?

A

Adenocarcinomas from

Prostatic epithelial cell

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6
Q

Main tumours of the female reproductive system and its cell of origin

A

Vagina- stratified squamous cell
Ectocervix - stratified squamous cell

Endocervix - Glandular (adeno)
Uterus proper - endometrium (adeno)

Smooth muscle (myometrium)- leiomyoma, glandular epithelium, germ cells

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7
Q

What is the fate of most embryos & what is the most critical time of development?

A

Critical time - 1st trimester

Spontaneous abortion is common

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8
Q

main causes of Pelvic inflammatory disease

A
  • Gonorrhoea
    • Chlamydia
  • Ascending infection, strep, coliform and clostridium perfringens - scarring occurs due to granualtion tissue formation and leads to infertility
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9
Q

Consequences of PID

A

Most common cause of female infertility 30-40%

Accounts for 40-50% of ectopic pregnancies

Sepsis - infection gets into blood

Peritonitis - infection in peritoneal cavity

Intestinal obstruction

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10
Q

Syphillis stages

A

Primary stage
- No symptoms

Secondary stage

- Systemic spread of spirochetes (spiral bacteria) 
- 2 months to 2 years later
- Symptoms may or may not be visible

Latent stage
- no symptoms, blood test picks it up

Tertiary stage
- CNS and cardiovascular lesions, damages sensory nerves for gate and movement. Personality changes. Can lead to blindness
- Dramatic changes to bone structures
2 to 20 years later

Forms aneurysms - predispose to heart failure

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11
Q

Testicular dysgenesis syndrome symptoms

A
  • Cryptorchidism: hidden testis. Risk factors of cancer. (doubled in incidence)
    • Hypospadias: malformation of urethral orifice. It is anywhere within the penis or scrotum
      Poor sperm quality
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12
Q

Rule of 90s

A

90% occur in 25-45 year olds

90% Germ cell origin: 5% Leydig & Sertoli cells. 5% Metastases.

90% Malignant- All treated as such

90% Curable- Catch prior to metastasis  surgery combined with radio- or chemotherapy

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13
Q

Two categories of testicular tumours

A

Germ cell
Sex-cord

Does not increase in incidence with age
Metastasis to bone - causes pain, prone to fracture

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14
Q

Testicular torsions

A

Twisting of the spermatic cord
Any age but 12-18 yr olds most common
Most common cause of testicular loss in adolescents
Bell clapper

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15
Q

Testicular torsions symptoms

A

Extreme pain
Swelling
Nausea, vomiting

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16
Q

What does atrophy of the male reproductive system lead to

A 
Atherosclerosis
End-stage inflammatory disease
Cryptorchidism
Hypopituitarism
Exhaustive atrophy (Xs FSH)
Malnutrition
Cachexia
Irradiation
Prolonged treatment of anti-androgens
17
Q

Prostatitis

A

Acute bacterial
UTI, STI
Fever, chills dysuria

Chronic bacterial
History of repeated infections
Hard to treat
Asymptomatic or dysuria, perineal, suprapubic & lower back pain
As above but without history of infection

18
Q

Hormonally induced lesions causes in females

A 
Anovulatory cycle (female does not ovulate)
- Excessive exercise (female athlete)
- Anorexia nervosa
- Physical/psychological stress
- Obesity
- Start of menarche
Menopause
19
Q

Symptoms of endometriosis

A 
Chronic pelvic pain [NB2]
Dysmenorrhoea (painful periods)
Dyspareunia (painful intercourse)
Dyschesia (difficult defecation)
Dysuria (painful urination)
Cyclical haematuria
Premenstrual spotting
Heavy menstrual bleeding
Period-related (catamenial) gastrointestinal symptoms (eg diarrhoea, occasionally painful abdominal bloating)
Infertility
20
Q

Categories of male tumours

A

Adenocarcinoma of prostate - increase in incidence with age
Squamous cell carcinoma of penis and the vulva
Testies - teratoma( Germ cell)
Does not increase in incidence with age
Metastasis to bone - causes pain, prone to fracture

21
Q

Endometrial hyperplasia

A

unopposed estrogen stimulation
Can cause abnormal bleeding

Happens during:
Obesity (peripheral conversion of androgens to oestrogens)
Menopause
PCOS (polycystic ovarian syndrome)
Prolonged use of oestrogen RT
Oestrogen secreting tumours
22
Q

Ovarian tumours

A

Common
80% benign (20-45 yrs)
Benign, borderline, malignant (45-65 yrs)
Tumors of the surface epithelial
Tumors of germ cells
Tumors of the ovarian stroma & sex cord stromal cells
Metastases from tumor of other organs

23
Q

Germ cell tumour of the ovary

A

Most common = Ovarian Teratoma or dermoid cyst
Young women often <25 yrs
96% benign
Malignant tumors (teratocarcinomas) may secrete AFP and hCG.
Can proliferate further to create malignancy
Germ cell that proliferates without stimulation and is able to differentiate into any tissue type

24
Q

Choriocarcinoma

A

Choriocarcinoma: formed from placental tissue
In 50%, develops from hydatidiform mole
In 25%, develops from placental cells after abortion
In 25%, develops from normal placenta

25
Q

Breast cancer risk factors

A 
99% Female - hyperplasia in breasts due to cycle
5-10% germline mutations (BRCA 1&2)
15-20% 1st degree relative
Race/ethnicity
Age 30+ peaks @70-80 yrs
Age @ menarche 20% increase if before 11
Late menopause
Age @ 1st full-term pregnancy <20 reduces risk by half compared to nulliparous & mothers over 35
Long term oestrogen therapy
Increased breast density 4-6 fold increase
Moderate-heavy R-OH
Obesity after menopause
Radiation
26
Q

What is endometriosis and its consequences

A

Endometrial glands/stroma in abnormal locations outside uterus
Ovaries, uterine ligaments, rectovaginal septum, pelvic peritoneum,
Rarely: umbilicus, vagina, vulva, appendix

Spontaneously haemorrhage but body walls off and capsulate it as it cannot exit the body easily.
Causes pain.
If it causes scarring, can cause ectopic pregnancy.

27
Q

Risks of endometriosis

A

3-10 X increased risk if 1st degree relative affected

Early menarche
Shorter cycles
~30% identified due to infertility

28
Q

Risk of multiple pregnancies

A

Twin to Twin Transfusion Syndrome (TTTS) 15%
- Twins share a placenta (afterbirth) and blood vessels required in the womb

2 times risk of defects
2 times risk of preeclampsia
Multiple placentas increases the risk of gestational diabetes

29
Q

Teratogens

A 
Irradiation
Alcohol
Drugs
- Thalidomide
- Folic acid antagonists
- Anticonvulsants
- Warfarin
- Testosterone & synthetic progestogens
Infections: Rubella, Syphilis, Zika

Disease Processes (13 decks)

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