Reproductive System Flashcards
Answer: Breast
Answer: Foetal ACTH
Answer: Regional iliac nodes
Answer: HPV 6 and 11
Answer: Bacterial vaginosis
Answer: Bartholin cyst
Answer: Pudendal nerve
Answer: Straight arterioles, stratum basalis, stratum functionalis
Answer: Tunica vaginalis
Answer: Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium
Answer: Seminoma
The vast majority of testicular cancers are germ cell tumours; of those seminomas are the most common. Only 1% of testicular tumours are benign. Metastases occurs via the para-aortic lymph nodes.
Answer: Squamous cell hyperplasia
Answer: Peripheral zone
Answer: The sacrotuberous ligament
Answer: Lichen sclerosus
Answer: Late menopause, early onset of periods, not having children
Answer: Embryonal rhabdomyosarcoma
Answer: Condyloma acuminatum
Answer: Polycystic ovarian syndrome
Answer: 16, 18, 31, 33
Answer: Doxycycline, erythromycin, or clarithromycin
Answer: Bacterial vaginosis
Answer: Cervical ectropion
Cervical ectropion (34% of post-coital bleeding) is the presence of columnar epithelium on the ectocervix and is commonly found in postpubertal adolescents, pregnant individuals, and those using estrogen-containing contraceptives (eg, oral estrogen-progestin pills, vaginal ring, or transdermal patch).
Answer: Corkscrew-shaped
Treponema pallidum is a spirochaete bacterium with subspecies that cause syphilis.
Answer: Adenocarcinoma
Answer: Ampulla of the fallopian tube
Answer: Secondary amenorrhea
Secondary amenorrhea is defined as the cessation of regular menses for three months or the cessation of irregular menses for six months. You need to first check the hCG and make sure the patient is not pregnant. Most cases of secondary amenorrhea can be attributed to polycystic ovary syndrome, hypothalamic amenorrhea, hyperprolactinemia, or primary ovarian insufficiency.
Answer: Chlamydia infection
Answer: a painless chancre
Answer: Pubococcygeus, puborectalis, iliococcygeus, coccygeus
Answer: Iliococcygeus
Answer: Asherman’s syndrome
Asherman Syndrome describes secondary amenorrhea due to the loss of the basalis and scarring as a result of overaggressive dilation and curettage.
Answer: Anti-Mullerian hormone
Answer: Seminoma
Answer: Chlamydia trachomatis
Answer: By increasing testicular temperature
Varicoceles can result in the pampiniform plexus being unable to cool arterial blood; higher intratesticular temperatures affect sperm production and quality.
Answer: Gonorrhoea
Answer: Mullerian duct
Answer: the superficial inguinal lymph nodes
Lymphatic drainage of the scrotum goes to the superficial inguinal lymph nodes.
Testes go to the para-aortic lymph nodes
Answer: Androstenedione
Answer: Mumps virus
Answer: phimosis
Answer: Tunica vaginalis
Answer: paraphimosis
Answer: Prolactin
Hyperprolactinemia inhibits the pulsatile secretion of the gonadotrophin-releasing hormone, which causes decreased pulsatile release of follicle stimulating hormone, luteinizing hormone, and testosterone.
Answer: The sacrospinous ligament
Answer: Endometrial carcinoma
Post-menopausal bleeding=endometrial carcinoma until proven otherwise.
Answer: HPV 16 and 18
The Human Papillomavirus (HPV) strains 16 and 18 are the two most common HPV strains that lead to cases of genital cancer.
Answer: Para-aortic nodes
Answer: pampiniform venous plexus, left
Answer: Chlamidya trachomatis
Answer: Leiomyoma
Answer: Ovarian ligament
Answer: Leiomyoma
The most common neoplasm of the uterus is a leiomyoma. They can be multiple, can slowly enlarge, and can lead to abnormal bleeding.
Answer: The inguinal ligament
Answer: Trichomonas vaginalis
Answer: leiomyomas
Answer: surface epithelia
Answer: Candidiasis
Answer: Dysgerminoma
Dysgerminomas are the most common malignant germ cell tumour.
Answer: Puborectalis
Answer: Endometrial polyp
Answer: As soon as possible regardless of CD4 count
Consider starting ART at the time of diagnosis or as soon as possible following diagnosis, regardless of CD4+ T-cell count.
Answer: As soon as possible regardless of CD4 count
Consider starting ART at the time of diagnosis or as soon as possible following diagnosis, regardless of CD4+ T-cell count.
Answer: Epididymo-orchitis is a complication in males
Answer: Pituitary tumour
Answer: Investigations for chlamydia, gonorrhoea, syphilis and HIV may be performed
Answer: Inhibin
Answer: Coccygeus
Pin B is coccygeus.
Origin Sacrospinous ligament and ischial spine
Insertion Lateral margin of coccyx and related border of sacrum
Answer: The patient has hypothalamic amenorrhea
Answer: Pubococcygeus
Answer: hyperinsulinemia
An alteration in insulin secretion and insulin action results in hyperinsulinemia and insulin resistance
Answer: upper outer quadrant, invasive ductal carcinoma
Answer: E6 and E7; p53 and Rb
Answer: Ovulation
Endometriosis is the presence of endometrial tissue in extrauterine sites that results in cyclic bleeding in response to oestrogen and progesterone. First-line treatments include hormonal contraceptives and NSAIDs.
Answer: Escherichia coli
Answer: There is an increased rate of testicular malignant change in cryptorchidism.
The prevalence of cryptorchidism in Klinefelter Syndrome is very low.
Answer: Tubal infertility is the main complication
Complications of PID include:
- Infertility
- Ectopic pregnancy
- Tubo-ovarian abscess
- Hydrosalpinx
- Bowel obstruction
- Fritz-Hugh-Curtis syndrome
- Septic arthritis (if gonorrhoea infection)
Answer: Stimulation and development of the indifferent gonad is initiated by the sex-determining region of the Y chromosome (SRY) gene
Answer: Gonorrhoea
Answer: endometriosis, ovary
Answer: Endometrial cancer
Answer: Uterosacral ligament
Answer: Stratified squamous epithelium
Answer: Thyroid
Struma ovarii is a rare ovarian tumour that was first described in 1899. It is defined by the presence of thyroid tissue comprising more than 50% of the overall mass. It most commonly occurs as part of a teratoma, but may occasionally be encountered with serous or mucinous cystadenomas. Strumae ovarii comprise 1% of all ovarian tumours and 2-5% of ovarian teratomas.
Answer: Human papillomavirus
Answer: Abdominal aorta
Answer: The Bartholin gland
Answer: Posterolateral
The epididymis is located posterolaterally, and hence this site will be maximally tender in the setting of epididymitis.
Answer: Double stranded DNA, non-enveloped
Answer: Clear cell adenocarcinoma
Answer: Lichen sclerosis
Lichen sclerosis is of unknown aetiology, but may involve autoimmunity. It is characterised by thinning of the epidermis and fibrosis of the dermis. It most commonly occurs in post-menopausal women.
Answer: Müllerian inhibiting factor
Anti-Müllerian hormone (AMH) is a growth factor produced solely by small, growing follicles in the ovary. As serum levels of this hormone correlate strongly with the number of growing follicles, AMH is a good indicator of the size of the primordial ovarian pool.
In addition, AMH could potentially help assess the progression of ovarian senescence, as serum AMH levels are independent of hypothalamic–pituitary–gonadal axis function and decrease to undetectable levels at menopause.
Answer: phimosis
Answer: Mumps
Answer: The iliolumbar ligament
Answer: Serous cystadenocarcinoma
Answer: scabies
Scabies is caused by a mite, Sarcoptes scabiei, which burrows into the skin and deposits eggs. It causes a pimple-like rash with severe itchiness.
Answer: Endometriosis
Endometriosis involves the presence of endometrial glands and stroma outside of the endometrial lining. Sites of involvement include the ovary (where the formation of ‘chocolate cysts’ occur’, the uterine ligaments, the pouch of Douglas, the bladder wall, bowel serosa, and fallopian tube mucosa.
Answer: Peyronie’s disease
Answer: Yolk sac tumour
Schiller-Duval bodies are glomerulus-like structures seen on histology.
Answer: Simple columnar epithelium
Answer: Endometrial stroma
Pain is a key feature of endometriosis. The foci of endometriosis are most often found on serosal surfaces in the pelvis, but can be found in other locations such as the surface of the bowel. Endometrial glands, stroma, and hemorrhage are microscopic features.
Answer: Koilocytes from HPV infection
A koilocyte is a squamous epithelial cell that has undergone a number of structural changes, which occur as a result of infection of the cell by human papillomavirus.
Answer: priapism
Answer: T11/12-L2/3
Answer: Clear cell adenocarcinoma
Answer: Ectopic pregnancy
Answer: Functional hypothalamic amenorrhea
Answer: Sertoli-Leydig cell tumor
Answer: Prostate
The most common source of sclerotic or blastic bone metastases is a primary malignancy of the prostate.
Answer: No menses by age 13 in absence of secondary sexual characteristics, or no menses by age 15 with secondary sexual characteristics, or no menses two years after thelarche.
Answer: Used to classify the many different appearances of prostatic adenocarcinoma
Gleason grading is a system used to classify the many different appearances of prostatic adenocarcinoma into behaviourally prognostic groups based on a complex scoring system of 1 to 5.
Used to calculate a score. A higher score is associated with a worse prognosis. It contributes to the T component (tumour grade) of the TNM staging system.
Answer: Superficial inguinal lymph nodes
Answer: Inguinal nodes
Squamous epithelium of the lower 1/3 of the vagina is embyrologically derived from the urogenital sinus; cancer speads to the inguinal nodes. The upper 2/3 of the vagina is comprised of columnar epithelium derived from the Mullerian ducts; cancer speads via the regional iliac nodes. Vaginal carcinoma is usually associated with high-risk HPV (types 16, 18, 31, and 33).
Answer: Increased tidal volume
Progesterone causes an increased depth of breathing by relaxing the intercostal muscles and diaphragm.
Answer: Cremaster muscle
Answer: The follicular phase
The luteal phase is fixed at 14 days in the majority of women, so the differences in the length of the follicular phase account for cycle length differences.
Answer: MRI of brain to exclude pituitary adenoma
Prolactinoma is the most common functioning pituitary adenoma and therefore the patient needs imaging.
Prolactinomas may disrupt the hypothalamic-pituitary-gonadal axis as prolactin tends to suppress the secretion of GnRH from the hypothalamus and in turn decreases the secretion of FSH and LH.
Which muscle is this?
piriformis
Answer: The anterior longitudinal ligament
Answer: Uniformly smooth prostatic enlargement
A normal prostate should feel firm with a smooth surface to the examiner’s gloved finger.
Digital rectal examination (DRE): symmetrically enlarged, smooth (no nodules), firm, nontender prostate with rubbery or elastic texture
The patient’s history indicates a bladder outlet obstruction, commonly caused by benign prostatic hypertrophy (BPH).
Answer: The anterior sacroiliac ligament
Answer: Transitional zone
Answer: Yolk sac tumour
Answer: Neisseria gonorrhoeae
Neisseria gonorrhoeae is a gram-negative diplococcus.
Answer: Tunica vaginalis
The tunica vaginalis is a pouch of serous membrane and as such a potential space for fluid accumulation. It derives embryologically from the peritoneum and thus has visceral and parietal surfaces. Hydroceles are associated with incomplete closure of the processus vaginalis leading to communication with the peritoneal cavity (in infants) or blockage of lymphatic drainage (in adults). It presents as a scrotal mass that can be transilluminated.
Answer: CA-125
Answer: Reduced secretion of GnRH
Which muscle is this?
Pubococcygeus
Answer: Human papillomavirus
Answer: Androgen insensitivity
Androgen insensitivity syndrome, also known as testicular feminization syndrome, is where patients are genetically and gonadally male, but phenotypically female. Testes are present and functional, producing testosterone, but due to the absence of androgen receptors, tissues do not respond to testosterone androgen effects.
Which muscle is this?
Cocyggeus
Answer: Varicocele
- Varicocele is one of the most common causes of scrotal swelling. It typically presents as scrotal swelling with a “bag of worms” appearance.
- Varicoceles are usually left-sided due to an important anatomical variation: the right testicular vein drains directly into the inferior vena cava, whereas the left firstly drains into the left renal vein.
- The left testicular vein drains into the left renal vein at a right angle; this can disturb flow and cause back pressure into the pampiniform plexus
- The left testicular vein also travels between two arteries, making it vulnerable to compression
- The left vein itself is longer, meaning it is more susceptible to changes in pressure compared with the shorter right vein
Answer: Scrotum → dartos muscle → external spermatic fascia → cremaster muscle → internal spermatic fascia → tunica vaginalis → tunica albuginea
Answer: A=anteflexed, B=anteverted, C=retroverted, D=retroflexed
Which muscle is this?
Ileococcygeus
Answer: the puborectalis, pubococcygeus and iliococcygeus muscles
Answer: Choriocarcinoma
The alpha-subunit of hCG is similar to that of FSH, LH, and TSH
Answer: Choriocarcinoma
Choriocarcinomas are small, haemorrhagic malignant tumours that spread hematogenously. They mimic placental tissue and are made up of cytotrophoblasts and syncytiotrophoblasts. A high beta-HcG is characteristic on investigation.
Answer: Choriocarcinoma
Answer: Lymphoma
Answer: External spermatic fascia
Answer: Seminoma
“Seminomas are the most common type of testicular tumour. They are comprised of large cells with clear cytoplasm and central nuclei that form a homogenous mass with no haemorrhage or necrosis.” (Pathoma, 2018)
Answer: Sertoli cells
The Y chromosome is necessary and sufficient for the production of testes, and the testis-determining gene product is called SRY (standing for sex-determining region of the Y chromosome). SRY is a DNA-binding regulatory protein. It bends the DNA and acts as a transcription factor that initiates transcription of a cascade of genes necessary for testicular differentiation, including the gene for Mullerian-inhibiting substance.” Ganong’s Review of Medical Physiology (25th edition)
Answer: Ectopic pregnancy
Answer: Chlamydia trachomatis
C. trachomatitis, the leading cause of non-gonococcal urethritis, is the most frequent form of prostatitis in young adult men. There is typically no history of chronic urinary tract infection, and it is difficult to culture.
Answer: The tunica vaginalis
Answer: Androgens
Polycystic ovarian disease results in multiple ovarian follicular cysts. It is characterised by increased LH and low FSH. The increased levels of LH induce excess androgen production from theca cells. Androgen is also converted to estrone in adipose tissue, which decreases FSH release and results in cystic degeneration of follicles. Typically, the clinical presentation fo PCOS is an obese young woman with infertility, oligomenorrhea, and hirsutism.” (Pathoma, 2018)
Answer: Epididymo-orchitis
Positive Prehn’s sign: Lifting the affected testicle results in a reduction of symptoms/pain.
A positive Prehn’s sign is indicative of epididymo-orchitis; a differential for testicular torsion. However, a negative Prehn’s sign does not rule out the possibility of epididymo-orchitis (i.e. this test has low specificity).
Answer: Clue cells, which are a medical sign of bacterial vaginosis, commonly caused by Gardnerella vaginalis
Answer: Progesterone
Answer: Neisseria gonorrheae
Answer: Varicocele
The increased warmth from the increased vascularity reduces sperm production. Spermatogenesis can only occur at temperature lesser than body temperature; this is reason for male genitalia to be externalised.
Answer: Leydig cell tumor
Answer: Suspensory ligament
Answer: Posterolaterally
Answer: Hypospadias
Hypospadias are the most common penis abnormality (1 in 300) and result from a failure of male urogenital folds to fuse in various regions. The dorsal and ventral sides of the penis are shown in this image:
Late one evening, a 19 year old university student experiences sudden-onset strong discomfort in his scrotum. No position is comfortable for him to sit or lie down in. Aspirin and beer have had no effect. He has a friend drive him to the emergency room. On physical examination his vital signs include temperature 37degrees, RR=22bpm, PR=80bpm, BP = 100/65mmHg. His left testis is slightly enlarge and extremely tender. There is no inguinal adenopathy. A Doppler ultrasound scan is shown below:
Answer: Torsion
Answer: Epispadias
Epispadias are a rare abnormality, seen in 1 / 300’000 newborns. This abnormality can be traced back to a disorder of the mesoderm cell migration during the 4th developmental week.
In boys with epispadias, the urethra generally opens on the top or side of the penis rather than the tip. From the meatal opening to the tip of the penis, the penis is split and is opened, forming a gutter. The penis also usually has some degree of curvature or chordee. In girls, the opening of the urethra is usually between the clitoris and the labia, but may be in the belly area.
The dorsal and ventral sides of the penis are shown in the image below.
Answer: Androgen insensitivity
Answer: The dartos muscle
Answer: Lichen simplex chronicus
This lesion appears in conjunction with human papillomavirus infection.
