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term 4 > sessh > Flashcards

sessh Flashcards

1
Q

enzymes for iodide uptake

other important enzymes

A

NIS(na I, brings into thymocyte)

pendrin(chloride iodide exchanger, transports across the cell) to arrive in the follicular lumen

this is the first step of making iodide hormone

once in the lumen TPO-thyroidal peroxidase turns iodide to iodine via oxidization…. once in this form iodide can ionize tyrosine molecule (organifying them) making MIT and DIT. MIT and Dit couple up which is catalyzed by TPO

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2
Q

megalin

A

member of the LDL family that helps endocytize the iodine rich colloid. proteolysis is the final enzyme to make T4

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3
Q

5′ deiodinase

A

turns t4 to t3
then t3 can enter the nucleus to bind to thyroid receptor

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4
Q

Radioiodine uptake is usually markedly elevated

A

hyperthyroidism

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5
Q

inhibiting the peroxidase, thus blocking iodine organification, and coupling of the iodotyrosines.also blocks peripheral deiodination

A

thiamines

-does not block the uptake of iodide into the gland just stops the production. causes delayed effect because the thyroid will use up all its stores first.

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6
Q

DOC for Graves’ disease.

A

methimazole

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7
Q

_______preferred in severe hyperthyroid states or thyroid storm because_______

A

Propylthiouracil PTU

because blocks t4 to t3

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8
Q

pregnancy considerations with hyperthyroidism

A

1st trimester give PTU after give Methimazole

never give radioactive iodide

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9
Q

thiamin AE

A

pruritic rash, agranulocytosis, severe hepatitis*

PTU spa associated with liver failure

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10
Q

used prior to surgery to decrease vascularity of the thyroid gland and used in….

A

iodide
also used in a cytokine storm of cytotoxicosis

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11
Q

iodide AE

A

swelling of the neck and mouth, metallic taste in mouth, mouth ulcers

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12
Q

therapeutic effect is due to emission of β rays

A

radioactive iodine

contraindicated in pregnancy

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13
Q

amiodarone therapy can induce

A

either hyper or hypothyroidism

hypo esp in pts with AI thyroiditis(can add levothyroxine if meds cant be stopped)

hyper1. iodine in the amiodarone causes inc production of hormone esp if preexisting goiter(thioamine)

hyper2. destructive thyroid in previously normal pt causes inc in hormone release(glucocorticoids)

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14
Q

the obvious and not obvious side effects of glucocorticoids

A

metabolic effect(fat deposition), immunosupressive, anti-inflammatory

behavioural(insomnia, depression), pseudotumor cerebri(inc intracranial pressure), development of peptic ulcers(provokes H pylori and inc, stimulated fetal surfactant production, inc platelets and RBC

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15
Q

Weakness, fatigue, weight loss, hypotension, hyperpigmentation and
inability to maintain the blood glucose level during fasting.

tx

A

chronic adrenal insufficiency, Addisons

Daily hydrocortisone (with higher doses during periods of stress)
* Must be supplemented with fludrocortisone

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16
Q

antagonist at glucocorticoid & progesterone receptors

use?

A

MIFEPRISTONE

-Inoperable patients with Cushing’s syndrome due to ectopic ACTH production or adrenal carcinoma who failed to respond to other therapeutic manipulations

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17
Q

competes with aldosterone for its receptor

use?

A

spironolactone

Aldosteronism (diagnosis & treatment), hirsutism in women (acts as androgen antagonist), K+ sparing diuretic

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18
Q

spironolactone AE

A

Hyperkalemia, cardiac arrhythmia, impotence, menstrual abnormalities, gynecomastia,

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19
Q

potent & non-selective inhibitor of adrenal & gonadal steroid synthesis

use?

A

KETOCONAZOLE

-cushings syndrom
-prostate cancer

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20
Q

KETOCONAZOLE AE

A

hepatotoxicity
irregular menses, decreased libido, impotence, gynecomastia

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21
Q

blocks conversion of cholesterol to pregnenolone which leads to reduced synthesis of all hormonally active steroids

use?

AE?

A

AMINOGLUTETHIMIDE

Cushing syndrome due to adrenal cancer

lethargy, skin rash

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22
Q

relatively selective inhibitor of steroid 11-hydroxylation (interferes with cortisol & corticosterone synthesis)

use?

A

METYRAPONE

to test adrenal function
Tx for pregnant women with Cushing syndrome

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23
Q

METYRAPONE AE

A

hirsutism, salt and water retention

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24
Q

DKA management

A

replace fluid loss with saline, Insulin IV, possassium support, bicarb supp

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25
Q

advanced glycosylation end products

A

causes sone of the diabetic complications

-this and non enzymatic glycosylation, and inc TGFb will be caused from hyperglycemia and lead to diabetic glomerulosclerosis

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26
Q

diabetic glomerulosclerosis becuase of

A

non enzymatic glycosylation, inc TGFb, and advanced glycosalation end products appear from hyperglycemia and will cause:
-inc mesangial matrix formation
-inc type 4 collagen fibronectin
-glomerular hypertroph

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27
Q

parathyroid adenoma mutation

A

MEN1 mutation(MEN 1 and 2) and Cyclin D1 gene rearrangement

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28
Q

Preventing addition of iodine to tyrosine residues on thyroglobulin

A

organification

thioamines

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29
Q

prostatic carcinoma metastisis

A

hematogenous to axial selection
-osteoBLASTIC lesions which can present as low back ache

if spread to lymph will spread obturator and para-aortic lymph nodes

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30
Q

mϋllerian-inhibiting hormone`

A

stimulates the descent of the testes from the abdomen, the rest of the descent is due to androgen

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31
Q

cryptorchidism risks

A

infertility and germ cell neoplasm in the normal testicle

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32
Q

mutations for testicular germ cell tumors

A

Mutations involving genes encoding for the ligand for tyrosine kinase KIT and BAK.

  • Reduplication of short arm of chromosome 12 (isochromosome 12p) is strongly associated

other associations are cryptorchidism, hydrospias, adrenal insufficiency

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33
Q

On a cut section they appear as homogenous, gray-white and lobulated masses, with minimal hemorrhage or necrosis.
* Histologically they are composed of uniform cells divided into lobules by fibrous septa, interspersed with lymphocytic infiltrate.
* The tumor cells are large round cells with a glycogen-rich (clear or watery appearing) cytoplasm, a round nuclei and prominent nucleoli.

A

seminoma

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34
Q

may secrete β-hCG and its levels may be elevated and used as a tumor marker.

A

seminoma, choriocarcinoma

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35
Q

On a cut section they have a variegated appearance due to presence of hemorrhage and necrosis.
* Histologically they are composed of sheets of large tumor cells with a basophilic cytoplasm, large nuclei and prominent nucleoli.
* The cells may be poorly differentiated (anaplastic) or forming tubular or papillary patterns.

A

embryonal carcinoma

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36
Q

endodermal sinus tumors

A

yolk sac

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37
Q

Histologically they are composed of lace-like or reticular network of cuboidal epithelial cells.
* The cells may be arranged in papillary structures or solid cords.
* Some tumor cells are arranged to have a mesodermal core with a
blood vessel along with surrounding parietal and visceral layers of
cells, like primitive glomeruli, known as

A

yolk sac tumor

known as Schiller-Duval bodies

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38
Q

tumor cells also have eosinophilic globules that have α1- antitrypsin and α feto protein (AFP)

A

yolk sac tumor

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39
Q

The tumors where the pluripotent germ cells differentiate into cells resembling placental trophoblastic tissue.
* It is a highly malignant and aggressive tumor with a poor prognosis.

A

choriocarcinoma
-this is in men and women

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40
Q

Histologically they are composed of neoplastic syncytiotrophoblasts and cytotrophoblasts.

what are features of each cell

A

choriocarcinoma

-Syncytiotrophoblasts are large multinucleated cells with eosinophilic cytoplasm containing hCG,
-Cytotrophoblasts are mononuclear polygonal cells with clear cytoplasm.

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41
Q

These tumors arise when the totipotent germ cells differentiate into various cellular components representing more than one germ cell layer.

A

teratoma

good prognosis, esp the mature ones with all three germ types there (immature has worse prognosis)

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42
Q

testicular germ cell tumor metastisis and non germ cell tumors

A

lymphatics for germ cell -retroperitoneal para-aortic lymph nodes → mediastinal →supraclavicular nodes.

non germ cell: hematogenously to the lungs

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43
Q

LDH is elevated in what tumor

A

large testicular germ cell tumors

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44
Q

Abnormal urethral opening on the ventral surface, anywhere along the shaft of the penis vs dorsal

A

ventral: hypospadias

dorsal: epispadias

both lead to many complications.

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45
Q

Is a condition where the orifice of the prepuce is too small to permit normal retraction. This could be due to developmental anomalies or infection with scarring of the preputial ring.

A

Phimosis

-clinically present as painful, urethral constrictions and recurrent urinary tract infections. Circumcision is curative.

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46
Q

Occurs when a phimotic prepuce is forcibly retracted over the glans penis, causing marked constriction & swelling.

A

Paraphimosis

-clinically present as painful, urethral constrictions and recurrent urinary tract infections. Circumcision is curative.

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47
Q

warty benign condition of penis shaft

caused by
progression?

A

CONDYLOMA ACUMINATUM

caused by HPV 6 and 11
-DOES NOT cause cancer
(other HPV infections the penis will cause caner)

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48
Q

Histologically they are composed of papillary infoldings of squamous epithelium which show
koilocytic changes (vacuolization of keratinocytes and nuclear abnormalities) that are characteristic
of

A

viral benign lesion

CONDYLOMA ACUMINATUM

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49
Q

risk factors for developing invasive squamous cell carcinoma of penis

A

cig smoking and Bowen disease

circumcision is protective

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50
Q

The lesions are papillary or flat and progress to large infiltrating masses involving the entire shaft of penis.
* Histologically they show squamous differentiation of tumor cells, keratin pearls and inter-cellular bridges may be seen. They may also have areas of necrosis and hemorrhage.
➢ Clinically they are painless growths until there is ulceration and secondary infection. They usually
spread to the inguinal lymph nodes early in the disease, however, widespread metastasis is rare and
until the lesion is very advanced.

A

invasive squamous cell carcinoma of penis

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51
Q

persistence of epidermal thickenings along the milk line, which extends from the axilla to the perineum

A

Polythelia, extra nipples

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51
Q

Dilated ducts
* Filled with inspissated secretions
* Numerous lipid-laden macrophages
Granulomas may form around cholesterol deposits and secretions
* Subsequent fibrosis produces an irregular mass with skin and nipple retraction

A

duct ectasia

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52
Q

Acute lesions: hemorrhagic and necrotic with neutrophils and few macrophages.
Later over the next few days→ proliferating fibroblasts and chronic inflammatory
cells
* Subsequently→ giant cells, calcifications, and hemosiderin
* Eventually→ focus replaced by scar tissue or is encircled and walled off by fibrous
tissue
* Grossly: ill-defined, firm, gray white nodules containing small chalky-white foci of
calcification

A

fat necrosis

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53
Q

Frequently multiple and bilateral, mobile masses
* Epithelial component is hormonally responsive

A

fibroadenoma of the breast

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54
Q

rubbery, grayish whiteish nodule (1) that
bulges above the surrounding tissue (2) and often contain slit like spaces

A

fibroadenoma of the breast

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55
Q

leaf like

A

phyllodes

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56
Q

phyllodes metastisis

A

hematogenously

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57
Q

“lumpy bumpy” breas

A

fibrocystic change,
benign
blue dome cyst

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58
Q

apocrine metaplasia

A

benign in fibrocystic change
can also be seen in intraductal papilloma

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59
Q

increase in the number of acini per
lobule seen in

A

adenosis

seen in pregnancy and fibrocystic change

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60
Q

what breast lesion mimics carcinoma

A

sclerosing adenosis(slinically and histologically)

intraductal papilloma(bloody discharge)

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61
Q

Components of sclerosing adenosis, papillomas, and epithelial hyperplasia- also called complex sclerosing lesions

A

radial scar

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62
Q

breast cancer metastisis

A

bone(see hypercalcemia) , brain, lungs, liver

63
Q

Clonal proliferation of epithelial cells limited to ducts and lobules by the basement membrane
* Myoepithelial cells preserved in involved ducts/lobules

A

ductal carcinoma in situ

64
Q

toothpaste out the nipple

A

comeo ductal carcinoma in situ

65
Q

Mucin-positive signet ring cells are commonly present
* Loss of________________

A

lobular carcinoma in situ

loss of E cadherin

66
Q

Usually ER-negative and overexpress HER2

A

pagets disease, DCIS with bad prognosis

67
Q

lobular carcinoma mutation

A

double loss of CDH1 (E cadherin)
will also be at risk for signet cell carcinoma of the GI

68
Q

lobular carcinoma metastisis

A

peritoneum and retroperitoneum, the
leptomeninges (carcinomatous meningitis), the gastrointestinal tract, and the
ovaries and uterus

specific

69
Q

medullary carcinoma of breast mutation

A

BRCA1

70
Q

Presents as breast erythema, swelling, and skin thickening (resembling acute
mastitis/abcess)
* Characteristic gross appearance caused by extensive plugging of the
lymphovascular spaces of the dermis with carcinoma cells
* Edematous skin tethered to the breast by Cooper ligaments and mimics the
surface of an orange peel : peau d’orange appearance`

A

inflammatory carcinoma of the breast

-clinically appears inflamed but is not! the underlying carcinoma is diffusely infiltrative with no palpable mass

71
Q

Consist of normal looking endometrial
glands + stroma + RBC + hemosiderin

Induce fibrosis, adhesions, pain

usually associated with infertility

A

Endometriotic cyst in ovary
= chocolate cyst

72
Q

LH are increased, FSH decreased, and androgens increased.

effects?

A

PCOS

-inc in FSH: LH ratio
inc estrogen= endometrial hyperplasia(then to carcinoma), stimulate adipose tissues
inc androgen= hirtuism, virilization(male features)

73
Q

PCOS diagnostic criteris

A

2 out of 3
1. hyperandogenism
2. menstral irregularities
3. ultrasound string of pearls appearence

74
Q

thick, smooth capsule and absence of corpora lutea and corpora albicans

Cysts lined by granulosa cells and hypertrophied theca interna cells

A

PCOS

75
Q

investigations of ovarian tumors

A

CA 125
Ascitic fluid tap
FNAC

76
Q

type 1 ovarian tumor mutations

A

this one progresses from benign to Bassline to type 1

KRAS, BRAF = low grade
all kinds of epithelial tumors

77
Q

type 2 ovarian tumor

A

starts with cyst from fallopian tube, high grade, most commonly serous

78
Q

areas of marked epithelial atypia in fallopian tube epithelium: observed in fallopian tubes of women

A

STIC: Serous tubal intraepithelial carcinoma/ type 2

79
Q

Serous tubal intraepithelial carcinoma mutation

A

p53, Rb, BRCA1/2

80
Q

Psammoma bodies

A

calcified papillae in serous ovarian tumor

81
Q

mutation for mutinous carcinoma of ovart

A

KRAS

82
Q

ENDOMETRIOID TUMORS
mutations

A

PTEN, microsatellite instability (MSI due to mismatch repair
genes), KRAS

83
Q

clear cell tumor mutations

A

KRAS, PTEN, p53

84
Q

sheets of large epithelial cells with abundant clear cytoplasm
-polygonal shape
* Very aggressive and poor outcom

A

clear cell carcinoma of ovary

-associated with clear cell adenocarcinoma and endometriosis

-glycogen containing cytoplasm

85
Q

Contain neoplastic epithelial cells resembling urothelium

A

transitional cell tumors-brenner tumors

-most benign

86
Q

Dysgerminoma genes and serum tumro markers

A

c-kit

LDH and hCG

87
Q

large uniform vesicular cells in sheets with clear cytoplasm, well defined cellboundaries, and centrally placed regular nuclei; fibrous stroma diving into lobules and rich in
infiltrating lymphocytes and can see a granulomatous reaction
* Very responsive to chemotherapy

A

dysgerminoma

88
Q

cervical ripening agents(induce labor

A

prostaglandins misoprostol (PGE1), and dinoprostone (PGE2).

and stimulate contractions

89
Q

prostaglandin AE

A

tachysystole, fever, N, V, D

90
Q

the preferred pharmacologic agent for inducing labor when the cervix is favorable or ripe

A

oxytocin

91
Q

oxytocin receptor type and effect

A

Gq-PLC
inc Ca with IP3 and inc PKC with DAG

Ca activate MLCK resulting in myometrial contraction

also activated MAPK cascade to activate PLA2, to stimulate more prostaglandins and more contractions (positive feedback loop)

92
Q

oxytocin AE

A

excessive uterine contraction(fetal distress, uterine rupture, placental rupture)

*activation of the vasopressin receptor(fluid retention, hyponateremia, HF, Seizure, death)

93
Q

management of post partum hemorage

A

uterine message,
oxytocins(oxytocin-IV, DOC, ergot alkaloids-methylergonovine, prostaglandins)

94
Q

partial agonist at α-adrenergic receptors and some serotonin receptors

A

methylergonovine -ergot alkaloid

acts on the smooth muscle of the uterus and increases the tone, rate, and amplitude of rhythmic contractions(used for hemorage and can induce labor)

95
Q

contraindications for postpartum hemorage agents

A

most heart or vascular problems- HTN, MI, angina, stroke

-long term use of methylergonovine is contraindicated because it can lead to ergot posioning/gangrene in the feeding infant through the milk

96
Q

synthetic analogue of PGF2α

A

Carboprost tromethamine

97
Q

management of preterm birth

A

uterine relaxants- tocolytics, Glucocorticoids, and rest

-used in labor that begins before 34 weeks. 37 is considered preterm

98
Q

tocolytic agents

A

magnesium sulfate (MgSO4), indomethacin, and nifedipine.

99
Q

uncouples excitation–contraction in myometrial cells through inhibition of cellular action potentials.

AE

A

magnesium sulfate

-flushing , N, V, blurred vision. high levels rep depress, cardiac arrest and can cross the placenta= resp and motor depress

100
Q

NSAID used to slow preterm labor

AE

A

indomethican

-crosses the placenta and can cause oligohydramnios from dec renal blood flow
-not recommended after 32 weeks bc it will close the ductus arterioles in the kid

101
Q

The calcium channel blocking agent _____________acts by impairing the entry of Ca2+ into myometrial cells via voltage-dependent Ca2+ channels, and thereby inhibiting contractility.

A

nifedipine

-most safe

102
Q

Peptide analog of oxytocin. Competitive antagonist at oxytocin receptors.

A

Atosiban

-not available in US

103
Q

Activation of ____________ on myometrial cell membranes activates adenylyl cyclase. This causes a rise in cAMP which in turn activates protein kinase A. Protein kinase A phosphorylates smooth-muscle myosin light chain kinase (SmMLCK). Phosphorylation of SmMLCK results in a lower affinity of SmMLCK for the Ca2+-calmodulin complex. As a result, SmMLCK does not phosphorylate myosin, and the myometrial smooth muscle relaxes, delays birth for several hours

A

B2 adrenoreceptor agents- Terbutaline

104
Q

abortion drugs

A

for less than 8 weeks gestation

mifepristone (antiprogestin), misoprostol (prostaglandin analog) and methotrexate (folic acid antagonist).

105
Q

steroidal estrogens most commonly used clinically

A

Ethinyl estradiol and mestranol

106
Q

estrogen side effects

A

-dec bone resorbtion
-inc HDL and dec LD
-inc production of platelet factors and inc risk for thromboembolism
-inc hepaticc production of proteins
-inc production NO
-water retention

107
Q
  • Oral Contraceptives
  • Endometrial Cancer
  • Abnormal Uterine Bleeding
  • Hormone Replacement Therapy
  • Infertility
  • Diagnostic Test of Estrogen Secretion
A

use of progestins

108
Q

vaginal malodor
thin off white/grey discharge
no vaginal inflammation

causes?

A

bacterial vaginosis

bacterial overgrowth
from antibiotics, contraception, sex

109
Q

Candida virulence factors

A

-dimorphic
-adhesion on the surface of pseudohyphae = Als3
-hydrolyase: lipase, hydrolipase, protease
-candidalysin (invade and evade)

110
Q

Ciliate
Free-floating trophozoite
aquired through sexs

A

Trichomonas vaginalis -parasite

111
Q

Trichomonas vaginalis MOA

A

sex, convert to ameba to adhesive to epithelium. digest lactobacilli, erythrocytes . produces cell detaching factor to slough off the epithelial discharge. **degrades iGg and igA

112
Q

thin green/yellow odorous vaginal discharge, vaginitis

A

Trichomoniasis

113
Q

clahmydia virulence factors

A

ER can bind to receptors on the mucosa anywhere inside the vaginal area.

then turns into RB to multiply(can damage cells during replication and a pro inflammatory cytokine release)

114
Q

New or increased discharge
* Purulent, cloudy or bloody
* Intermenstrual bleeding * Pain during intercourse

A

clahmydia

115
Q

New or increased discharge
* Purulent, cloudy or bloody
* Intermenstrual bleeding * Pain during intercourse
-fever
-N
-low ab pain

A

Pelvic Inflammatory disease induced by clahmydia

116
Q

Urethritis
* Urethral discharge: clear or cloudy with mucus strands

A

clahmydia

117
Q

lacks a cell wall
Triple layer external membrane contains sterol
* Serum or cholesterol must be added to growth media

A

mycobacterium genitalium

consider if have been treated many times for a STI

118
Q

mycobacterium genitalium virulence factor

A

MgTa tip adhesions which can cause evasion, H2O2 cell damage, inflammation

119
Q
  • Gram negative, facultatively
    intracellular flattened diplococci
  • obligate aerobes
  • catalase +, oxidase+
  • Lipooligosaccharide (LOS) instead of LPS
  • dissemin
A

neisseria gonnerhea

120
Q
  • disseminated infection (DGI) * “septic arthritis”
A

neisseria gonnerhea

121
Q
  • Highly antigenically variable pili (>1 million different types!)
  • No protective immunity post- infection
A

neisseria gonnerhea

122
Q

neisseria gonnerhea virulence factors

A

On the surface: LOS(endotoxin), Type 4 pilli(very variable), porins

-porins helps with iron aquisistions
-DNA detoxer
-regulatory networks

-antibiotic resistance bc of efflux pump, mutations in antibiotic target, DNA gyros

123
Q

twitching motility

A

neisseria gonnerhea

124
Q
  • Humans are only host
  • Enters via microtrauma
  • Does not Gram stain; visualize with?
    motility?
    -painless lesions
A

Treponema pallidum (syphilis)

dark field microscopy
corkscrew motility

endoflagellum seen as actin filaments

125
Q

Treponema pallidum MOA

A

-inflammation at sight on innoculation
-rapidly in the lymph and blood
-produces metalloprotinase1 in dermal cells to go deeper causing inflammation from the epithelial cells

126
Q

surface is antigenic ally inert

A

Treponema pallidum
-they are very sneaky with the immune system, keep low numbers, go to immune underserved areas, slow growth, doesnt need iron sequestration

127
Q

nonspecific cardiolipin-
cholesterol-lecithin antigen
(“beef heart cardiolipin”)

A

non-treponemal
-used in nonspecific syphillis test

the specific test will use the actual antibody

128
Q

Gram –ve, encapsulated
* oxidase +, catalase -, facultative anaerobe.
* Pleomorphic, “railroad tracks” or “school of fish” arrangement

A

Haemophilus ducreyi

129
Q

Haemophilus ducreyi virulence factors

A

LOS & Fimbria-Like-Protein (Adherence to epithelial cells and fibroblasts)

required factor X for growth

tissue, cell damage with Cytolethal distending toxin (CDT) and Cytotoxin hemolysin

130
Q
  • Gram-negative pleomorphic * “safety-pin appearance”
  • Characterized by intracellular inclusions in macrophages, called?
  • Encapsulated.
  • Highly fastidious
A

Klebsiella granulomatis

inclusions are called Donavan bodies

lesions are painless

131
Q

icosahedral, non-enveloped, circular dsDNA viruses

A

HPV
-human epithelial cells are effected
-group1

132
Q

HPV moa

A

gains entry through micro wound and goes to the basal cell of the epithelium. E6and E7 promote host cell proliferation and prevents apoptosis, viral genome incoperates itself into host genome which will upregulat E6,7 causing more instability and risk for aneuploidy, dysplasia, carcinoma`

133
Q

HPV vaccine based on

A

capsid

134
Q

The placenta implants in the lower uterine segment or cervix, often leading to serious third trimester bleeding

A

placental previa

Patients with placenta previa can present with painless vaginal bleeding or postcoital spotting at or more than 30 weeks’ gestation. Ultrasound is diagnostic and should be performed prior to vaginal examination in any third trimester bleed to avoid tearing the placenta and causing hemorrhage.

135
Q

abnormally implanted, invasive, or adhered placenta.

A

PLACENTA ACCRETA

villi grow into the myometrium

The condition can cause severe post-partum hemorrhage because of failure of placental separation. A hysterectomy might be required to stop the bleeding.

136
Q

Premature and abrupt separation of placenta from the uterus due to hemorrhage between the placenta and the uterine wall

risk factors:

A

ABRUPTIO PLACENTA

risk: Increasing maternal age, multiparty, hypertension, preeclampsia, trauma, smoking and cocaine use.

-will present with painful bleeding, DIC, fetal distress

137
Q

characterized by widespread maternal endothelial dysfunction that presents after 20 weeks’ gestation with hypertension, edema, and proteinuria.

A

pre-eclampsia

sx dissapead after taking out the placent. due to placental ischemia which will cause the endothelial dysfunction potentially bc of failure to revacularize the placenta
risk: hydatidiform mole

-htn presents as headache

138
Q

preeclampsia conplication

A

HELLP Syndrome (Hemolysis(micrangiopathic with schistocytes), Elevated Liver enzymes, and Low Platelets).

hyper coagulability, acute renal failure, DIC, pulmonary edema

139
Q

gun powder

A

describes endometriosis

140
Q

what drug can cause endometrial polyps

A

tamoxifen
-proestrogen in the uterus

141
Q

what stimulates a endometrial polyp and what is a complication

A

stimulated by estrogen and not by progesterone.

can lead to adenocarcinoma

the excess estrogen will also stimulate the endometrium cells to hyperplasia(PTEN gene has both these pathologies in common)

142
Q

what condition is closely associated with type 1 endometrial carcinoma

A

Lynch syndrome

143
Q

red degeneration,what induces this

A

necrosis of fibroids when they grow quickly in pregnancy(or with proliferative phase of cycle)

coagulative necrosis seen in leiyomyosarcoma

144
Q

Retention (Nabothian) cysts may be seen in what condidiotn

A

chronic cervicitis

145
Q

Wolffian (mesonephric) duct rests

A

seen in Gartner duct cyst on the lateral wall of the vaignal

-fluid filled

146
Q

Diethyl stilbesterol (DES) causes what

which has what complication

A

vaginal adensosis

-red patches in the vaginal made of mutinous columnar epithelium that has failed to turn into squamous epic

clear cell carcinoma complication

147
Q

cambium layer

A

fibromyxomatous stroma where will see immature rhabdomyoblasts seen in SARCOMA BOTYROIDES

seen as bunch of grapes

147
Q

Bartholinitis caused by what orgs

A

strep, staph, gonococci, e coli

147
Q

lichen simplex chronicus

A

squamous cell hyperplasia
clinically looks like leukoplakia

147
Q

Auotimmune condition of white plaques or macules that in time may enlarge and coalesce, producing a surface that resembles porcelain or parchment.

A

lichen sclerosis

may lead to SCC

148
Q

cells positive for Periodic acid Schiff stain, cytokeratin 7 (negative in its differential diagnosis- melanoma).

A

Paget

148
Q

resulting from rubbing or scratching the skin to relieve pruritus.

A

squamous cell hyperplasia

not premalignent

149
Q

small, distinctive, glandlike structures filled with an acidophilic
material recall immature follicles

A

Call-Exner bodies in granulosa cell tumors

150
Q

granulosa cell tumors serum marker

A

inhibin

151
Q

two types of monodermal teratoma and what do they secrete

A
  1. Struma Ovarii = thyroxine
  2. carcinoid = 5HT

term 4 (13 decks)

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