GU Flashcards
Hernias!!! Which population are they common in..Describe the types of hernias
They are more common in men! (25% vs 2% female)..There are
1. Direct Hernias (Protrusion through hesselbach triangle with lower border IL, medial border Rectus AM,lateral IE vessels)
2. Indirect Hernias (Protrusion through deep inguinal ring with lower border IL and medial border IE vessels, Posteriorly is transversalis fascia)
3. Femoral hernias (medial is inguinal ligament, and hesselbachs triangle, lateral is femoral vessels, COOPERS or pectineal ligament posteriorly)
NB inferior epigastrics join fermoral vessels at the inguinal ligament, midway between the ASIS and pubic symphisis
Which side do we tend to see indirect hernias
Direct Hernias?
On the right side…Usually occur due to failure of processus vaginalis to obliterate hence abdominal contents seep through deep ring…They follow the path of the inguinal canal and can even exit through the external ring into scrotum..Use tip of finger with deep palpation of the external ring
Direct Hernias seep through weak spots of the anterior abdomen. Less prone to incarceration and no direct path to scrotum for descent…Use pulp of finger with deep palpation
Female genital structures cell types and associated epithelial tumors
Vagina (stratified squamous but no keratin): squamous cell
Ectocervix (stratified squamous)
Endocervix (simple columnar):- no mucous during ovulation. Squamous cell ca/adenocarcinoma/condyloma acuminatus
Uterus (pseudostratified simple columnar):- endometrial Ca
Fallopian tube made of ciliated cells for embryo transport and peg cells for nutrients(simple columnar)- rare cancer
Ovary (simple cuboidal becomes peritoneum at broad ligament)- serous, mucinous, clear, endometrioid, brenner/urothelial
Mifepristone aka RU 486
Used up to 49 days post conception. ANTI PROGESTIN with about 5x affinity for progesterone receptor than natural progesterone (this is needed for implantation and maintenance). ANTIGLUCO, ANTI MINERALO
ALSO releases endogenous prostaglandins to senstize myometrium to its effect, hence cramps, nausea and bleeding…success rate is higher than typical 80% if misoprostol, prostaglandin E1 analog is useed
Methotrexate in abortion
Inhibits trophoblast division, decreasing survival and encouraging expulsion..combine with misoprostol..Used for ectopic pregnancy
Kallmans Syndrome
Delayed puberty and anosmia..GNRH secreing nuerones do not migrate from olfactory placode to hypothalamus due to mutation of KAL-1 gene or FGF R1 gene….
Can sometimes see midline defects like cleft lip or palate in addition to central hypogonadism and anosmia
