RSL - Repro Flashcards

1
Q

Scrotum lymphatics

A

Superficial inguinal (basically everything from below umbilicus; except: Testes, glans penis, and cutaneous portion of posterior calf)

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2
Q

Glans penis

A

Deep inguinal (also receive from superficial inguinal)

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3
Q

Müllerian agenesis

A

Presents as primary amenorrhea, lack of uterine development, with fully developed secondary sexual characteristics (functional ovaries)

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4
Q

Prostate origins

A

Urogenital sinus (Female paraurethral glands of skene)

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5
Q

Lymph drainage: proximal vagina/uterus

A

Opturator, external iliac, hypogastric nodes

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6
Q

Infundibulopelvic ligament

A

Ovaries to lateral pelvic wall; contains ovarian vessels

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7
Q

Cardinal ligament

A

Cervix to side of pelvis; uterine vessels

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8
Q

Ovarian ligament

A

Ovary to side of lateral uterus

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9
Q

Female orgasm: Excitement

A

Uterus elevates, vaginal lubrication

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10
Q

Female orgasm: Plateau

A

Expansion of inner vagina

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11
Q

Path of sperm

A
(SEVEN UP)
Seminiferous tubules
Epididymous
Vas def
Ejaculatory duct
Urethra
Penis
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12
Q

Erection nerve

A

PSNS: pelvic nerve

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13
Q

Emission nerve

A

SNS: Hypogastric nerve

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14
Q

Ejaculation nerve

A

Visceral and somatic nerves: pudendal nerve

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15
Q

Spermatogonia

A

Germ cells –> Spermatocyte –> Spermatids –> spermatozoon

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16
Q

Sertoli cells: Secretions

A

Inhibin, ABP, MIF, Aromatase

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17
Q

Sertoli cells: Location / homolog

A

line seminiferous tubules, Homolog of granulosa cell

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18
Q

Sertoli cells: Heat sensitive?

A

yes

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19
Q

Leydig cells: secretions

A

Testosterone

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20
Q

Leydig cells: location homolog

A

Interstitium / homolog of theca interna cells

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21
Q

Leydig cells: heat sensitive?

A

no

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22
Q

Estrogen from Ovary;

A

17beta-estradiol

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23
Q

Estrogen from placenta:

A

Estriol

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24
Q

Estrogen from fat

A

Estrone

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25
Q

Potencies of estrogen?

A

Estradiol>Estrone>Estriol

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26
Q

Estrogen & prolactin

A

Estrogen –> Prolactin

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27
Q

Estrogen & lipids

A

Increase HDL, Decrease LDL

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28
Q

Myometrial excitability: Progesterone / Estrogen

A

Estrogen increases

Progesterone decreases,

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29
Q

Oligomenorrhea

A

> 35-Day cycle

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30
Q

Polymenorrhea

A
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31
Q

Metrorrhagia

A

Abnormal cycle (irregular)

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32
Q

Menorrhagia

A

Heavey menstration

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33
Q

Dysmenorrhea

A

Pain with menses

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34
Q

Meiosis 1 happens;

A

During fetal life, arrested in prophase until ovulation, then just prior to ovulation meiosis 1 is completed

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35
Q

Meiosis 2 happens:

A

Arrested in metaphase 2 until fertilization

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36
Q

Mittelschmerz

A

Transient midcycle ovulatory pain; peritoneal irritation

Can mimic appendicitis

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37
Q

menopause Hormonal changes:

A

Decreased Estrogen, Increased FSH, Increased LH, Increased GnRH

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38
Q

DHT and testosterone origin

A

Testes

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39
Q

Androsteinedione origin

A

Adrenal

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40
Q

Klinefelter syndrome: Hormones

A

Dysgenesis of seminiferous tubules –> low inhibin –> increased FSH
Abnormal Leydig cell function –>low testosterone –> High estrogen

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41
Q

Kallman syndrome

A

Hypogonadotrophic hypogonadism: Low GnRH, FSH, LH, Testosterone. –> Infertiility, Low sperm count in men; Amenorrhea in women. Also have anosmia.

Defective migration of GnRH cells and formation of olfactory bulb

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42
Q

Gestational HTN: (+ treatment)

A

BP>140/90 with no pre-existing hypertension. Treat with antihypertensives (Hydralazine, methyldopa, nifedipine, labetalol)

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43
Q

Preeclampsia: (+ treatment)

A

HTN + Proteinuria + Edema (treat with antiHTN + IV MgS for seizure prevention)

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44
Q

Eclampsia: (+treatment)

A

Pre-eclampsia + Seizures (Treat: Anti-HTN, IV MgS, Delivery of baby)

45
Q

HELLP syndrome

A

Hemolysis (thrombi–> shistocytes), Elevated liver enzymes (liver ischemia), Low platelets (thrombi)

46
Q

HELLP complication:

A

Hepatic subcapsular hematomas –> rupture –> severe hypotension

47
Q

Placental abruption (abruptio placentae)

A

Premature separation of placenta from uterine wall

48
Q

Abruptio placentae risk factors

A

Trauma, Smoking, Pre-eclamsia, cocaine

49
Q

Abruptio placentae symptoms

A

Painful bleeding in third trimester, Maternal shock, DIC

50
Q

Placenta accreta

A

attached to myometrium

51
Q

Placenta increta

A

Inserted into the myometrium

52
Q

Placenta pancreta

A

Perforates through myometrium

53
Q

Placenta accreta/increta/pancreta presentation

A

No separation of placenta after delivery –> bleeding –> sheehan syndrome

54
Q

Placenta previa (complete and partial)

A

Complete covers cervical internal os completely

55
Q

Vasa Previa: pathophys

A

Fetal vessels run over cervical OS

56
Q

Vasa Previa: Triad

A

Painless bleeding, Fetal Bradycardia, membrane rupture

57
Q

Vasa previa: Associations

A

velamentous umbilical cord insertion (Cord inserts into chorioamniotic membrane rather than placenta

58
Q

Gynecological tumor incidence (Cervical, endo, ovarian)

A

Endo>Ovarian>Cervical

59
Q

Gynecological tumor prognosis (Cervical, endo, ovarian)

A

Worst: Ovarian >Cervical >Endometiral

60
Q

vaginal Squamous cell CA: MCC

A

Cervical SCCa

61
Q

Vaginal clear cell adenocarcinoma

A

Adenosis–> CC adenocarcinoma (DES exposure)

62
Q

Sarcoma botryoides (rhabdomyosarcoma variant)

A

Girls, spindle shapped cells, Desmin +

Grape-like mass emerging from vagina

63
Q

HPV 16/18 pathogenesis

A

produce E6 –> inhibition of p53 tumor suppressor,

Produce E7 –> inhibition of Rb tumor supressor

64
Q

Invasice cervical carcinoma: lateral growth comp.

A

Blockage of ureters

65
Q

Extramammory pagets of vulva

A

malignant epidermis (no underlying cancer). Carcinoma in situ; PAS +, Keratin +, S100 - (rules out melanoma)

66
Q

Squamous cell carcinoma of vulva (two types)

A
HPV related (>40 yrs old, Vulvar intraepithelial dysplasia)
HPV unrelated: Long standing lichen sclerosis (>70)
67
Q

Follicular cyst

A

high estrogen –> no LH surge –> Unruptured graffian follicules

68
Q

Theca-Lutein cyst

A

High beta-hCG –> Maintenance of ruptured cyst –> sealed off

69
Q

Ovarian tumors: Serous cystadenoma: histology

A

Fallopian tube-like epithelium

70
Q

Ovarian tumors: Mucinous cystadenoma: histology

A

Endocervix epithelium (columnar W goblet cells)

71
Q

Ovarian tumors: Brenner tumor histology

A

Urothelium with coffee bean nuclei

72
Q

Ovarian tumors: Serous cystadenocarcinoma: histology

A

Fallopian tube-like epithelium + psammoma bodies

73
Q

Ovarian tumors: Mucinous cystadenocarcinoma: comp.

A

Pseudomyxoma peritonei

74
Q

Ovarian tumors: Struma ovarii

A

Teratoma containing functional thyroid tissue

75
Q

Ovarian tumors: Immature vs. mature teratoma

A
Immature = Fetal tissue, neuro-ectoderm
Mature = adult tissue, thyroid tissue
76
Q

Ovarian tumors: Endodermal sinus (yolk sac tumor)

A

MCC child tumor; Yellow, friable (hemorrhagic), solid mass. 50% show schiller duval bodies. AFP = tumor marker

77
Q

Ovarian tumors: Dysgerminoma

A

Fried egg appearance. hCG, LDH = tumor markers

78
Q

Ovarian tumors: Gestational (germ cell) Choriocarcinoma: treatment

A

Poor response to chemotherapy

79
Q

Ovarian tumors: Granulosa cell tumor: histology

A

Call-Exner bodies (granulosa cells, arranged haphazardly around eosinophilic material resembling primordial follicle)

80
Q

Ovarian tumors: Thecoma

A

Sex chord stromal tumor (benign)

81
Q

Ovarian tumors: Fibroma triad

A

Meigs: Ovarian fibroma, ascites, hydrothorax

82
Q

Adenomyosis

A

Extension of endometrial glands into the myometrium

83
Q

Endometritis: treatment

A

Gentamicin + clindamycin

84
Q

Proliferative breast disease: Cystic

A

Fluid filled, blue dome. duct dilation

85
Q

Proliferative breast disease: Sclerosing adenosis

A

Increase acini and intralobular fibrosis. Associated with calcifications. increased risk for cancer

86
Q

Lactational mastitis: organism

A

S. aureus

87
Q

Gynecomastia: drugs

A

Spironolactone, digoxin, cimetidine, alcohol, ketoconazole (some drugs create awesome knockers)

88
Q

Asherman syndrome

A

Secondary amenorrhea; dt/ stratum basale loss (ie. DNC)

89
Q

Breast Cancer: Paget cells

A

Large cells in epidermis with clear halo

90
Q

Breast Cancer: Comedocarcinoma

A

Subtype of DCIS; Central necrosis +/- calcifications

91
Q

Breast Cancer: Pagets disease

A

Underlying DCIS –> fills lumen –> moves down tube to nipple –> eczematous patches on nipple

92
Q

Breast Cancer: DCIS

A

Tumor of tubule cells –> filling lumen

93
Q

Breast Cancer: LCIS

A

Acini cells tumor

94
Q

Breast Cancer: Invasive ductal

A

Firm, fibrous, rock hard mass, stellate cells

95
Q

Breast Cancer: invasive ductal: Medullary

A

Lymphocytic infiltrate, fried egg cells (similar to dysgerminoma, seminoma, oligodendroglioma, multiple myeloma)

96
Q

Breast Cancer: Invasive ductal: inflammatory

A

Lymphatics infiltration –> peu d’orange

97
Q

Breast Cancer: Invasive lobular

A

Loss of E-Cadherin, India file

98
Q

Peryonie disease

A

abnormal curvature of the penis due to fibrous plaque within tunica albuginea. Associated with ED

99
Q

Penile pathology: reddish papules

A

Bowenoid papulosis: carcinomoa in situ

100
Q

Penile pathology: erythroplakia

A

Erythroplasia of Queyrat: cancer of glans penis

101
Q

Penile pathology: Leukoplakia

A

Bowen disease: penile shaft

102
Q

Testosterone and cryptorchidism

A

normal: unilateral
low: bilateral

103
Q

Spermatocele

A

Dilated epididymal duct or rete testes

104
Q

Mature teratoma in men: malignant?

A

yes (children no)

105
Q

Male testes: Embryonal Carcinoma

A

Malignant, hemorrhagic mass with necrosis, increased hCG

106
Q

Leydig cell tumor

A

Secretes estrogens / androgens. Histo: reinke crystals

107
Q

Prostatic adenocarcinoma markers

A

high PSA, low fraction of free PSA

108
Q

Uterus didelphys

A

Complete failure of fusion –> double uterus, vagina, cervix

109
Q

Lichen sclerosis vs lichen symplus chronicus

A

LS: leukoplakia w/ parchment paper skin (squamous CCa risk)
LSC: leukoplakia w/ thick leathery skin (no cancer risk)