Rx_1.26 (Reproductive) Flashcards
Ringworm (tinea corpis) tx + MOA + SE
- ketoconazole
- MOA = blocks formation of fungal membrane sterols
- SE = endocrine effects
- blocks CYP450scc/desmolase = necc. for testerone and cortisol from cholesterol
- decreased cortisol ==> decreased inhibition of POMC ==> increased synth of ACTH, melanocyte-stimulating hormone, endorphins ==> skin darkening
Penile venous outflow abnormalities ==>
- erectile dysfxn
- normal = blood flow accelerates into corpus cavernosum ==> blockage of venous outflow ==> erection
- abnormalities usually due to insufficient relation of smooth m. from excess adrenergic tone or damaged parasympathetic
- leak from dorsal vein ==> saphenous vein ==> inability to maintain erection
Normal vaginal pH
3.8-4.5
Vaginitis w/vulvar pruritis + discharge + [image] ==> Dx?
vulvovaginal candidiasis
Common vaginal infections and impact on vaginal pH
- candida = normal pH (<4.5)
- bacterial vaginosis ==> 5.0 - 6.0
- trichomonas ==> 5.0-7.0
- vaginal pH = 8.0 ==> suspicious for contamination w/cervical mucus or sperm
Neonate w/hepatosplenomegaly, ascites, peripheral edema, purpura ==> dx?
- hydrops fetalis = consequence of severe hemolytic disease of the newborn
- mechanism:
- Rh-negative mother w/previous Rh-positive child ==> sensitization
- if next child = Rh-positive ==> maternal IgG crosses placenta attacks fetal RBCs
Characteristics of seminoma
- most common testicular neoplasm
- common @ 15-35yo
- painless presenation
- radiosensitive
- pathology =
- large cells in lobules w/watery cytoplasm
- “fried egg” appearance
testicular mass w/glandular/papillary morphological pattern ==> dx?
- embryonal carcinoma
- [usually painful]
cowdry type A nuclear inclusions ==> dx?
CMV infection
testicular mass w/Reinke’s crystals ==> dx?
- Leydig’s cell tumors
- usually produce androgens ==> gynecomastia in men or precocious puberty in boys
- non-germ cell tumor
testicular mass w/structures resembling primitive glomeruli ==> dx?
- yolk sac tumors
- “schiller-duval bodies” = structures resembling primitive glomeruli
Structure of cilia + common defect
- central pair of microtubules w/ nin surrounding pairs w/dynein arms that create “sweeping motion”
- dynein defect ==> Kartagener’s syndrome
- poor mucous clearance ==> chronic sinus infections
- infertility
- assoc. w/situs inversus
Normal vaginal flora + fxn
- lactobacilli = gram-positive facultative anaerobes
- help maintain acidic vaginal pH (3.5-4.2)
- loss of bacteria (e.g. during a course of antibiotic tx) ==> slight increase in vaginal pH ==> growth of candida (yeast infection)
Pharm tx for HER2 (human epidermal growth factor) breast cancer cells
- Trastuzumab = monoclonal antibody agains HER2
Tamoxifen use
- chemotherapeutic agent @ estrogen receptor-positive breast cancer
- selective antagonist ==> inhibition of production of estrogen-responsive genes
Common lymphatic spread of testicular tumors
==> paraaortic chain of lymph nodes
Components of male urethra
- prostatic urethra (runs through prostate)
- membranous urethra (runs through urogeneital diaphragm)
- penile urethra (runs through penis)
consequences of rupture of urethra below the urogenital diaphragm (males)
- rupture @ jxn of membranous and penile urethra ==> urine into scrotum and perineal region
- “straddle injury”
Characteristics of fibroadenomas
- most common breast mass in young women
- histologic appearance
- fibrosing interlobular stroma around normal duct and gland architecture
Large cells w/clear “halos” on breast biopsy ==> dx?
Paget disease = eczematous skin findings around nipple associated w/underlying ductal carcinomas
Branching fibrovascular core extending from a dilated duct on breast biopsy ==> dx?
- intraductal papilloma = benign solitary lesions that line lactiferous ducts
- ==> serosanguinous (serous fluid or blood) and unilateral nipple discharge
Parallel arrays of small, monomorphic cells w/scant cytoplams on breast biopsy ==> dx?
- infiltrating lobular carcinoma
- irregular mass on palpation
- common @ postmenopausal women
Sheets of pleomorphic cells infiltrating adjacent stroma on breast biopsy ==> dx?
- invasive ductal carcinoma = most common mass in older women
- ==> overlying skin changes; e.g. pigmented dimpling or unilateral bloody nipple discharge
- palpation = firm, irregular, fixed masses
- mammography = multiple small calcifications
Presentation of congenital adrenal hyperplasia
- 21-hydroxylase deficiency ==>
- inability to convert steroid precursors to aldosterone or cortisol
- excess substrate ==> androgen production ==>
- ambigous (virilized) genitals
- low aldosterone/cortisol ==>
- renal salt wasting (hyponatremia)
- hypotension
- hyperkalemia
Substrate of 21-hydroxylase
- 17-hydroxyprogesterone <== will build up in 21-hydroxylase deficiency
Ovarian biopsy ==> Dx?
- Brenner’s tumor = benign ovarian tumor composed of cells resembling bladder transitional epithelium
Edward’s syndrome (Trisomy 18): AFP, B-HCG, estriol, inhibin A
- AFP = low
- B-HCG = low
- estriol = low
- inhibin A = normal
Patau syndrome (Trisomy 13): AFP, B-HCG, estriol, inhibin A
- AFP = normal
- B-HCG = normal
- estriol = normal
- inhibin A = normal
