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AAW - Endo/Repro > Test 2 > Flashcards

Test 2 Flashcards

1
Q

what forms the acrosome in a sperm cell

A

golgi

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2
Q

what gland has a lot of stroma and concretions

A

prostate gland

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3
Q

blood moving into what arteries causes the penis to become erect

A

helicine arteries

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4
Q

epithelium found in the:

prostatic urethra
membranous urethra
penie urethra

A

prostatic: transitional to stratified columnar
membranous: stratified columnar
penile: stratified columnar to stratified squamous non-keratinizing distally

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5
Q

what tubules produce spermatozoa

A

seminiferous

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6
Q

where are the cells of leydig

A

in the interstitial connective tissue that surrounds the seminiferous tubules

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7
Q

name of the cells that contain 1n DNA

A

spermatids

they are the product of meiosis II

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8
Q

what cells give rise to primary spermatocytes

list the types of cells from there all the way to spermatids

A

spermatogonia –> spermatocytes –> secondary spermatocytes (hard to find) –> spermatids

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9
Q

if you see short cell tall cell short cell tall cell where are you

what are the functions of the tall cells

A

efferent ductules - moves sperm from the testis into the epididymis

the tall cells are ciliated and the beat of the cilia helps move the sperm towards the epididymis

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10
Q

epithelium of the ductus deferens

A

pseudostratified columnar with stereocilia

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11
Q

superficial perineal fascia (in the female) and dartos fascia (in the male) is an extension of what fascia of the abdominal wall

A

camper and scarpa fascia

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12
Q

colles’ fascia

A

superficial perineal fascia that branches off of the dartos fascia and goes above the testis

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13
Q

internal pudendal artery branches off of what

leaves through what foramen

A

internal iliac

leaves pelvis through the greater sciatic foramen, goes back in through the lesser sciatic foramen

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14
Q

bartholin gland cysts spread to which lymph nodes

A

superficial inguinal lymph nodes

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15
Q

what cells respond to FSH

A

sertoli cells

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16
Q

testosterone inhibits the release of what other hormones

A

GnRH (acts through IP3)

FSH (indirectly, via inhibition of GnRH), and LH (both act through cAMP)

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17
Q

volume of dist. for testosterone

A

1L/kg

because it is fat soluble (fat soluble things have a high volume of distribution)

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18
Q

what cells secrete mullerian inhibiting factor (MIF) and what does it do

A

sertoli cells

causes the primordial female duct system to regress, giving rise to male genitalia

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19
Q

gonadorelin and leuprolide

A

not in FA - not used often

GnRH analogs (agonists)

(gonadorelin is synthetic human GnRH)

stimulates FSH and LH

*if given in pulses, they increase FSH, LH and GnRH

if given continuously, they wear out the receptors - used to suppress testosterone synth in prostate cancer

leuprolide can be used in LIEU of GnRH

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20
Q

where is the androgen receptor in the cell

A

in the cytoplasm

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21
Q

oxandrolone

A

DHT derivative

orally active, anabolic steroid that promotes muscle growth

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22
Q

flutamide, bicalutamide

A

non steroidal (“pure”) androgen receptor antagonists used in prostate carcinoma

use initially with GnRH agonists to stop the initial stimulating effect

SE: gynecomastia, hepatotox

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23
Q

the GnRH antagonists

A

Degarelix - male chemical castration

Ganirelix, Cetrorelix - blocks premature LH surge in females

more expensive, less commonly used

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24
Q

of the following what does testosterone inhibit directly? indirectly?

GnRH, LH, FSH

A

directly: GnRH, LH

indirectly (by inhibiting GnRH): FSH

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25
Q

testis are drained by what lymph nodes

A

periaortic and retroperitoneal

inginals drain the penis, scrotum, and legs, but NOT the testis

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26
Q

what general types of testicular tumors are very uncommon and almost always benign

A

Sex cord stromal tumors:

sertoli cell tumor
leydig cell tumor
granulosa cell tumor
mixed

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27
Q

most common testicular germ cell tumor

A

seminoma

Malignant; painless, homogenous testicular enlargement; most common testicular tumor. Does
not occur in infancy. Large cells in lobules with watery cytoplasm and “fried egg” appearance.
 placental ALP. Radiosensitive. Late metastasis, excellent prognosis.

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28
Q

what cells that are naturally in placentas also show up in seminomas and choriocarcinoma

A

syncytiotrophoblasts - produce hCG, which can be used as a tumor marker

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29
Q

why do some vietnam war vets have a higher incidence of prostate cancer

A

exposure to dioxin (agent orange)

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30
Q

PSA velocity numbers that are worrying

A

psa velocity rise of greater than .75ng/ml in one year

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31
Q

usefulness of a free PSA test

A

useful in determining need for biopsy when total psa level is between 4 and 10

cancer is unlikely if it is greater than 25% free PSA

low percent of free PSA is bad

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32
Q

how do you know that you have a secondary follicle in follicular development

A

if it has a disjointed antrum (liquid space)

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33
Q

function of the theca interna

A

produces androgens that can be converted into estrogens by granulosa cells

highly vascular, epithelioid

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34
Q

what is on the inside layer of the granulosa cells in a primary follicle

A

zona pellucida

eosinophilic

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35
Q

corpus luteum

A

temporary glandular structure that is derived from remnants of ruptured follicle following ovulation

granulosa cells in there enlarge and transform into granulosa lutein cells, produce progesterone and estrogen

theca interna cells enlarge and transform into theca lutein cells, which also produce progesterone and estrogen

if embryo does not develop, it involutes and forms a corpora albicans (white scar)

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36
Q

relaxin

A

inhibits contraction of myometrium during pregnancy

promotes dilation of cervix

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37
Q

peg cells

A

in the fallopian tube

make secretions

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38
Q

what layer of the endometrium gets shed during menses

A

functional layer

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39
Q

during the proliferative phase of the menstrual cycle, what glads and increasing in number and length?

what are they accumulating?

A

straight tubular glands in the functional layer of the endometrium

they accumulate glycogen

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40
Q

what stimulates the first meiotic division of an oocyte? second?

A

LH surge in responsive follicles stimulates the first division

fertilization stimulates the second

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41
Q

during ovulation, why do you see a surge of LH and not FSH

A

inhibin is suppressing FSH selectively

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42
Q

corpus luteum

A

hormone secreting (hCG) structure that develops in an ovary after an ovum has been discharged but degenerates after a few days unless pregnancy has begun

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43
Q

you inject a pregnant womans urine into a rabbit

what happens

A

the hCG in the urine mimicts LH by binding to the LH receptor, causes a corpus luteum to be formed in the rabbits ovary

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44
Q

why is oxytocin only effective in the third trimester

A

because in the first and second trimester, progesterone levels inhibit the oxytocin receptor, but in the third trimester there is more estrogen, which ramps up the oxytocin receptors

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45
Q

what is the function of going from progesterone dominance in the first 2 trimesters to estrogen dominance in the 3rd

A

increases oxytocin receptors

promotes uterine contractility (oxytocin and prostaglandins)

cervical ripening (you can smear prostaglandins on the cervix to cause it to ripen)

increases local prostaglandin release from the placenta which causes myometrial contraction

46
Q

why do you get no milk secretion if the placenta is retained

A

because it is a source of progesterone, which inhibits lactation

47
Q

what hormone stimulates the theca and what does it produce after stimulation

A

LH stimulates the theca, which produces androgen precursors to estradiol

48
Q

what hormone stimulates the granulosa and which does it produce after stimulation

A

FSH

estradiol (suppresses GnRH and LH) and inhibin (suppresses FSH)

49
Q

what is weird about estradiol during ovulation

tracht fact

A

estradiol augments (instead of inhibits) GnRH and LH, also FSH (but FSH in inhibited by inhibin)

50
Q

graafian follicle

A

mature follicle of the ovary

antrum is at its largest

51
Q

where is the corona radiata

A

it is the granulosa cells that remain attached to the zona pellucida of the oocyte when it is in the secondary and graafian follicle forms

52
Q

large, lighter cells in the corpus luteum?

smaller, darker cells?

which produce progesterone and estrogens

A

granulosa lutein cells - larger, light, bulk of the corpus luteum

theca lutein cells are small and dark - come from the theca interna

corpus luteum produce progesterone and estrogens

53
Q

what cells are not ciliated in the oviduct epithelium

A

peg cells

54
Q

most common cause of abnormal vaginal bleeding

A

95% endometrial in origin - dysfunctional uterine bleeding = disorders of ovulatory cycle (anovulation) either idiopathic, perimenarchal, perimenopausal

or due to polycystic ovarian syndrome

55
Q

post menopausal vaginal bleeding is what

A

Cancer until proven otherwise

but also endometrial atrophy (actually this is more common)

56
Q

worst cancer of the ovary

A

serous epithelial cancer

57
Q

commonest tumor in women in their 20s

A

germ cell: dermoid cyst (AKA mature cystic teratoma)

58
Q

accreta

A

when the placenta has grown into the myometrium

59
Q

mastitis is almost always caused by

A

S. aureus (but witraks kid had group B strep)

60
Q

what bugs can cause perihepatitis, when the liver binds to the peritoneum and forms violin string adhesions

A

chlamydia trachomatis

neisseria gonorrhoeae
chlamydia trachomatis

called fitz-hugh-curtis syndrome

comes on after pelvic inflammatory disease

61
Q

abnormal maturation of squamous cells with vacuolization and hyperchromasia (low grade dysplasia)

A

HPV condyloma

62
Q

most common type of cancer of the vulva

A

squamous carcinoma (precursor is vulvar intraepithelial neoplasia)

63
Q

plaque or thickness in the vulva is what until proven otherwise

A

cancer - can even look like a condyloma

64
Q

why is the cervix more vulnerable to HPV infection than any other genital tract site

A

it contains immature metaplastic squamous epithelium at the transitional zone

65
Q

how do you diagnose a testicular torsion

A

doppler imaging showing decreased ar absent blood flow to affected testicle

66
Q

why do women in their 20s get endometrial cancer

A

polycystic ovarian syndrome

diabetes

causes continual estrogen phases

67
Q

what happens to the endometrium if you have anovulation

A

it proliferates too much and puts you at risk for endometrial cancer

68
Q

multiple lung mets years after a historectomy

A

endometrial stromal sarcoma

69
Q

surgical wound from c section gets a growth with rubbery white tissue with hemosiderin brown spots

A

endometriosis

70
Q

catamenial pneumothorax

A

endometriosis on the pleural surface in lung that causes monthly pneumothoraces

71
Q

“2 ways that GI pathology can present as acute abdominal pain in a woman without rebound tenderness”

A

enlarged, infarcted leiomyoma (outgrows its blood supply)

adnexal torsion (sometimes assc with tumor, but not always)

but I would think ectopic pregnancy as well?

72
Q

genetics assc with peritubal carcinoma (fallopian tubes)

A

BRCA 1&2

73
Q

most common ovarian benign cyst

A

follicle or corpus luteal cysts

follicular cyst - may be assc with hyperestrogenism, endometrial hyperplasia

74
Q

commonest tumor in women 10-30

A

dermoid cyst

AKA mature cystic teratoma

75
Q

largest tumors in humans

A

ovarian mucinous neoplasms

76
Q

what types of tumors are almost always malignant in the testis but almost always benign in the ovary

A

germ cell tumors

specifically immature teratoma,

category also includes yolk sac, choriocarcinoma, embryonal carcinoma, dysgerminoma

77
Q

calcium in a cystic lesion in a woman in the pelvis

A

dermoid cyst (teeth or jaw bone)

78
Q

see orange or yellow in vesicles that is not necrosis

A

it is producing steroids (granulosa cell tumor for example) - think Call-exner bodies (granulosa cells arranged haphazardly around collections of eosinophilic fluid)

79
Q

hCG in ectopic pregnancy?

molar gestation?

A

it doesn’t double as fast in ectopic

it doubles faster in molar

80
Q

risk of infection during delivery due to what commonly

A

rupture of membranes and then like 12 hr until they deliver

81
Q

asian presents with new onset seizure in pregnancy

A

metastatic molar neoplasia until proven otherwise…

moles and choriocarcinoma prevalent in southeast asia

get super high hCG

82
Q

what can be used after pregnancy to stop bleeding

A

ergots - contract the uterus and constricts veins

they cause smooth muscle contraction

ergonovine, ergotamine

83
Q

whats a tocolytic

name 2

A

a thing used to stop uterine contractions

terbutaline is the classic

also magnesium sulfate (competes with calcium)

84
Q

what type of prostaglandin can be smeared on the cervix to make it relax

A

PGE2

85
Q

atosiban

A

oxytocin receptor antagonist

only one approved for clinical use but its not used much

causes increased fetal fatality

86
Q

how can you tell if someone with amenorrhea is ovulating or not

A

progestin challenge

give progesterone every day

if they bleed in 2-7 days of it then they are not ovulating

IF normal or low FSH, LH: View sella turcica - may be hypothalamic amenorrhea

High FSH, LH - ovarian failure

87
Q

what birth control would one of the lecturers use for a lactating patient

A

progesterone only

estrogen may inhibit lactation or it may not

88
Q

IUD that may make periods larger?

IUD that will make them less heavy, but more irregular

A

heavy - copper IUD (paragard)

levonorgestrel-releasing intrauterine system (LNG-IUS) - has progesterone and may reduce heaviness but you may spot

89
Q

essure

A

put a stick in the fallopian tube and it makes a scar

90
Q

what tightens the internal urethral sphincter

what relaxes the bladder dome

A

alpha-1 receptors being bound

(sympathetics are involved in storage)

beta 2 relaxes the dome

91
Q

inhibiting contraction in the bladder can do what to the mouth

what receptor

A

cause dry mouth

M3 receptor (M2 receptors are also bound during bladder contraction)

92
Q

pessaries

A

inserts into the vagina and has a ball to hold stuff in place

93
Q

oxybutynin

A

nonselective anticholinergic used for urinary incontinence

94
Q

tolterodine

A

nonselective anticholinergic used for urinary incontinence

detrol

95
Q

darfenacin, solifenacin

A

M2 selective anticholinergic used for urinary incontinence

less dry mouth than the nonselectives

enablex and VESIcare

96
Q

mirabegron

A

B2 adrenergic receptor antagonist

relaxes the bladder to treat incontinence

97
Q

clomiphene

A

estrogen receptor antagonist in the hypothalamus, prevents normal feedback inhibition and causes an increase in LH and FSH

SE: hot flashes, ovarian enlargement, multiple simultaneous pregnancies, visual disturbances

98
Q

menotropin, urofolitropin

A

FSH and LH urine extract

99
Q

follitropin

A

just FSH

100
Q

fulvestrant

A

“selective estrogen receptor disruptor”

antagonist of estrogent in all areas, breast, uterine, and bone

bone antagonist = not used much

101
Q

anastrozole, letrazole, exemestane

A

aromatase inhibitor

used in breast cancer in postmenopausal women

anasty odor stanes

102
Q

medroxyprogesterone, norethindrone, levonorgesterol

A

progesterone receptor agonist

103
Q

mifepristone

A

progesterone receptor antagonist - used for termination of pregnancy with misoprostol, or emergency contraception

104
Q

gosetrelin

A

GnRH receptor agonist

used in breast and prostate cancer to suppress FSH and LH by burning out the receptors

105
Q

abiraterone

A

17 alpha hydroxylase inhibitor

stops conversion of pregnenolone and progesterone to their 17-hydroxy counterparts

106
Q 
tamoxifen
vs
toremifene
vs
raloxifene
vs
fulvestrant
A

all answers are referring to estrogen

tamoxifen - antagonist in breast, agonist in uterus (bad), agonist in bone
vs
NOT IF FA - toremifene - antagonist in breast, unknown in uterus, no effect on bone (it is unknown just like its spelling (trachte spelled it wrong twice)
vs
raloxifene - ALL of the GOOD effects (the RAL course does good everywhere)
vs
fulvestrant - antagonist everywhere (good everywhere except bone)

107
Q

anthracyclines used in breast cancer

A

5-FU (stops thymidylate synthase)

doxorubicin (intercalates into DNA and damages it)

cyclophosphamide (alkylating agent)

108
Q

what unwinds the HPV viral genome and recruits host cell DNA polymerase to duplicate it?

A

E1

E2 is the loader of E1. It helps E1 get onto the viral genome

109
Q

E6 and E7

what do they do

A

Viral E6 binds to the host E6AP and P53 to form trimeric complex

P53 gets ubiquitinated (P53 normally is a DNA damage checkpoint - interacts with the RB gene too)

Viral E7 binds RB (16 and 18 HPV have a very strong binding to RB) - RB cannot then bind to E2F and sequester it (E2F not bound to RB transcribes replication enzymes)

110
Q

purulent penile discharge

what is it

virulence
Tx

media?

A

N. gonorrhea

gram neg intracellular diplococci

IgA protease
Capsule (SHiNE)
endotoxin

Tx - ceftriaxone (+ doxy for probably concurrent chlamydia)

difference from meningitidis - it only oxidises glucose, meningitidis oxidises maltose too

thayer-martin media - vanco, colistin, nystatin, SXT - sheep’s blood, beef, starch

111
Q

mech of acyclovir

A

guanosine analogs that terminate DNA synth

monophosphorylated by HSV/VZV thymidine kinase

112
Q

pseudohyphae

whiteish discharge

itching

A

candida yeast infection

AAW - Endo/Repro (3 decks)

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