3/17 repro Flashcards

(122 cards)

1
Q

renal cell carcinoma

-most common location of metastasis?

A

lungs

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2
Q

Where do primary brain neoplasms often metastasize to?

A

inside the CNS

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3
Q

link btwn hypothyroidism & amenorrhea/galactorrhea

A

inc. TRH can stimulate PRL prod.

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4
Q

Most common cause of spont. nipple discharge?

A

intraductal papilloma

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5
Q

polythelia

-what is it?

A

accessory nipple

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6
Q

ephelide

-what is it?

A

freckle

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7
Q

ANP & BNP

-which messenger system do they use?

A

inc. cGMP.

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8
Q

vitamin D

-wheres its receptor?

A

cytoplasm

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9
Q

AFP:

  • what normally produces it?
  • marker for which tumors?
A
  • fetal liver & yolk sac = normal

- HCC, nonseminomatous testicular carcinomas, ovarian carcinomas.

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10
Q

CA-125

-marker for what?

A

ovarian cancer

  • not good for screening: highly nonspecific.
  • use it to monitor progression.
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11
Q

Gross hematuria in a sickle cell pt/DM pt/tylenol abuser

  • which disease?
  • dont confuse w/what?
A

renal papillary necrosis

-dont confuse w/acute tubular necrosis which presents in a severely ill hospitalized pt w/oliguria.

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12
Q

choriocarcinoma

-most common distant metastasis?

A

lungs

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13
Q

choriocarcinoma

  • cancer of which cells?
  • villi? cytotropho? syncytiotropho?
A
  • neoplasm of trophoblast = which includes both cyto & syncytio.
  • NOT of villi.
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14
Q

klinefelters:

-abnormal hormone levels?

A
  • dec. testosterone
  • inc. FSH (bc dec inhibin)
  • inc. LH => inc. estrogen

*i dont understand why estrogen is inc.

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15
Q

CEA

-marker for what?

A

-colorectal & pancreatic cancer

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16
Q

Where do most ovarian malignancies arise from?

A

90% = surface epithelium derived

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17
Q

Case control study

-odds ratio or relative risk?

A

-odds ratio

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18
Q

Cohort study

-odds ratio or relative risk?

A

-relative risk

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19
Q

Most important chemical mediator of sepsis?

A

TNF-alpha

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20
Q

Suckling increases which hormone production?

A

oxytocin & PRL

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21
Q

Risks for child thats not breast-fed:

A

-Asthma, allergies, diabetes mellitus, and obesity.

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22
Q

hPL

-inc or dec. in hypoglycemia?

A
  • elevated to shunt what little glucose there is to the fetus.
  • inc. the moms resistance to insulin.
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23
Q

Which is a better diagnostic test for menopause, LH or FSH?

A

FSH.

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24
Q

Why do post menopausal woman have inc. risk of CAD?

A

bc estrogen inc. HDL and dec. LDL.

-and now you have way less estrogen!

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25
spermiogenesis
- loss of cytoplasmic contents, gain of acrosomal cap = forms mature spermatozoon. * dont confuse w/spermatogenesis.
26
Which hormone responsible for growth of penis?
Testosterone
27
Which hormone responsible for differentiation of penis?
DHT
28
Klinefelter vs Turner | -which one has a barr body, which one doesn't?
- Klinefelter (47 XXY) has a barr body | - Turner (45 XO) does NOT.
29
Genetics of Turners syndrome:
-Can be complete monosomy (45,XO) or mosaicism (e.g., 45,XO/46,XX).
30
Double Y males [male] (XYY) | -Sxs:
Phenotypically normal - very tall, severe acne. - antisocial behavior. - Normal fertility. - Small % diagnosed with autism spectrum disorders.
31
True hermaphroditism - genetics? - aka?
- 46,XX or 47,XXY - ovotesticular disorder - both ovary and testicular tissue present.
32
Female pseudo-hermaphrodite - genetics? - what is it?
- XX - Ovaries present, but external genitalia are virilized or ambiguous. - Due to excessive and inappropriate exposure to androgenic steroids during early gestation (e.g., CAH or exogenous admin. of androgens during pregnancy)
33
Male pseudo-hermaphrodite - genetics? - what is it?
- XY - Testes present, but external genitalia are female or ambiguous. - Most common form is androgen insensitivity syndrome (testicular feminization).
34
Maternal virilization during pregnancy | -possible cause?
-Aromatase deficiency: fetal androgens cross placenta.
35
Androgen insensitivity syndrome - genetics? - presentation?
- 46,XY | - testes present, female external genitalia.
36
Androgen insensitivity syndrome (46,XY) | -hormone levels?
- inc. test. - inc. estrogen - inc. LH
37
5α-reductase deficiency - inheritance pattern? - who gets this disease?
- Autosomal recessive (like most enzyme deficiencies). | - genetic males 46 XY
38
5α-reductase deficiency | -Sxs:
ambiguous genitalia until puberty, then male.
39
"penis at 12" phenomenon | -aka?
5α-reductase deficiency
40
5α-reductase deficiency | -testosterone levels?
normal - you may think increased bc you're not converting any to DHT, but thats not the case. - that is the case if you use 5α-reductase inhibitors.
41
hydatidiform mole - swelling of what? - proliferation of what?
-Cystic swelling of chorionic villi and proliferation of chorionic epithelium (only trophoblast).
42
hydatidiform mole - Tx: - monitor levels of what?
- D&C and methotrexate | - b-HCG
43
Is uterine size inc. in partial mole?
no
44
Genetic components of a complete mole.
- Enucleated egg + single sperm (subsequently duplicates paternal DNA) - empty egg + 2 sperm is rare
45
Genetic components of a partial mole.
2 sperm + 1 egg
46
Sxs of complete mole?
- vaginal bleeding - enlarged uterus - hyperemesis - pre-eclampsia - hyperthyroidism
47
Sxs of preeclampsia before 20 wks gestation =
Molar pregnancy! | -most likely complete mole.
48
Mittelschmerz
- transient mid-cycle ovulatory pain - classically associated with peritoneal irritation (e.g., follicular swelling/rupture, fallopian tube contraction). - Can mimic appendicitis.
49
potential cause of pre-eclampsia
placental ischemia
50
Time frame for pre-eclampsia
20 wks gestation => 6 weeks post-partum
51
Elevated liver enzymes and thrombocytopenia during pregnancy?
These are potential Sxs of pre-eclampsia.
52
Eclampsia | -maternal death usually due to:
-stroke (intracranial hemorrhage) or ARDS.
53
Eclampsia | -Tx:
-antihypertensives, IV magnesium sulfate, immediate delivery.
54
Anti-HTN meds for pregnancy
α-methyldopa, labetalol, hydralazine, nifedipine
55
Pre-eclampsia | -Tx:
- antihypertensives - deliver at 34 weeks (severe) or 37 weeks (mild) - IV magnesium sulfate to prevent seizure.
56
HELLP syndrome - what is it? - Tx:
Hemolysis, Elevated Liver enzymes, Low Platelets. - A manifestation of severe preeclampsia, although may occur without hypertension. -thrombotic microangiopathy in liver -RBCs get sheared as they pass by these micro-clots in the liver -> schistocytes. -some liver tissue will infarct -platelets being used up to form all these little thrombi. -Tx: delivery immediately.
57
Thrombotic microangiopathy in liver during pregnancy?
HELLP syndrome
58
Placental abruption - painful? - causes:
- yes - trauma, smoking, HTN, preeclampsia, cocaine. *life threatening for mother & fetus.
59
Placenta previa | -painful?
no
60
Placental abruption | -will mother have bleeding?
depends if bleeding is concealed or not.
61
Placenta accreta
- placenta attaches to myometrium without penetrating it | - most common type.
62
Placenta increta
-placenta penetrates into myometrium.
63
Placenta percreta
- placenta penetrates (“perforates”) through the myometrium and into uterine serosa (invades entire uterine wall) - can result in placental attachment to rectum or bladder.
64
decidua =
Endometrium under the effects of progesterone. | -aka during a pregnancy
65
Placenta accreta/increta/percreta - due to defective what? - is it serious?
- decidual layer (endometrium during pregnancy) | - life threatening for mother. no separation of placenta following birth => massive bleeding.
66
Placenta accreta/increta/percreta | -risk factors:
prior C-section, inflammation, placenta previa.
67
Placenta previa - risk factors? - Sxs:
- prior C-section, multiparity. - may cause painless bleeding. - will require C-section to deliver.
68
Ectopic pregnancy | -b-HCG levels:
lower than expected rise in b-HCG | -should be doubling every 2 days up until 7th week.
69
Polyhydramnios | -associated w/what common disease the mother could have?
DM
70
What types of cell does HPV infect?
Squamous cells | -thats why it only causes SCC.
71
HPV 16 & 18 | -E6 gene product: inhibits what?
p53
72
HPV 16 & 18 | -E7 gene product: inhibits what?
RB
73
Invasive cervical SCC | -can it affect kidneys?
-Lateral invasion can block ureters, causing renal failure. -may present as hydronephrosis. -post-renal failure is one of most common causes of death in pt. w/invasive cervical carcinoma.
74
HPV infected cell histology
koilocytic change | -nucleus looks like a raisin.
75
What age does cervical SCC present?
Takes about 20-25 years from HPV infection until cervical carcinoma. So carcinoma usually presents around 40-50 yr old females.
76
Does pap smear detect adenocarcinoma well?
no
77
HPV vaccine protects against which strains of HPV?
HPV 6, 11, 16, 18 (not 31 or 33) | -thats why u still need to get pap smear.
78
Endometritis | -Tx:
gentamicin + clindamycin with or without ampicillin.
79
How does endometriosis happen? How does it spread?
-Can be due to retrograde flow, metaplastic | transformation of multipotent cells, or transportation of endometrial tissue via the lymphatic system.
80
endoemetriosis vs adenomyosis | -size of uterus?
``` endometriosis = normal size uterus adenomyosis = uniformly enlarged uterus ```
81
Asherman Syndrome
- Loss of basalis leading to secondary amennorhea. | - Caused by over aggressive D&C.
82
Adenomyosis | -Tx:
hysterectomy
83
Most common gynecologic malignancy?
endometrial carcinoma
84
endometrial carcinoma | -what age does it present?
-55-65, postmenopausal.
85
most common tumor in females? | -what race gets them the most?
leiomyoma | -blacks
86
leiomyoma - hormone sensitive? - usually singular or multiple?
- yes, estrogen sensitive | - multiple
87
leiomyoma | -histology?
Whorled pattern of smooth muscle bundles w/well-demarcated borders.
88
leiomyoma | -what age?
20-40, pre-menopausal.
89
Between cervical, endometrial, and ovarian cancer: | -incidence rate?
- endometrial > ovarian > cervical * USA - cervical is most common worldwide.
90
Between cervical, endometrial, and ovarian cancer: | -worst prognosis?
Worst prognosis—ovarian > cervical > endometrial.
91
Dermoid cyst | -what is it?
mature teratoma
92
Endometrioid cyst - where? - aka?
- endometriosis w/in ovary w/cyst formation. | - chocolate cyst (when filled w/blood)
93
sex cord stroma =
-Granulosa cells + theca cells + fibroblasts
94
tubal ligation | -inc or dec chances of ovarian cancer?
- dec. | - if it increased ur chances then no one would get it.
95
Ovarian neoplasms - how can they present? - how do you Dx?
- presents with adnexal mass, abdominal distension, bowel obstruction, pleural effusion. - diagnose surgically
96
Ovarian neoplasms | -whats one reason why they have a poor prognosis?
They present late.
97
Serous cystadenoma | -unilateral or bilateral?
often bilateral
98
most common ovarian tumor in women 20–30 years old.
mature cystic teratoma | -aka dermoid cyst
99
Mature cystic teratoma (dermoid cyst) | -whats it called if it has functional thyroid tissue?
struma ovarii
100
Ovarian cyst + hyperthyroidism
struma ovarii | -type of mature cystic teratoma (aka dermoid cyst).
101
Brenner tumor - whats it look like? - whats its nuclei look like?
- Looks like bladder, looks like transitional epi. | - "coffee bean" nuclei
102
Meigs syndrome
Triad of ovarian fibroma, ascites, and | hydrothorax. Pulling sensation in groin.
103
ovarian fibroma, ascites, and hydrothorax. Pulling sensation in groin.
Meigs syndrome
104
Age 15-30: | -what is the ovarian mass?
germ cell tumor
105
Age 35-40 | -what is the ovarian mass?
benign surface epithelial tumor
106
Age 60-70 | -what is the ovarian mass?
malignant surface epi tumor.
107
Thecoma | -may produce what hormone?
Estrogen | -My guess would be androgens, but answer is estrogen.
108
BRCA-1: most common ovarian/fallopian tube neoplasm =
serous cystadenocarcinoma
109
gene mutation leading to primary pulm. HTN.
- BMPR2 mutation (normally inhibits vascular smooth muscle prolif.) - auto dom, variable penetrance
110
Osteoporosis | -serum chemistry?
NORMAL serum chemistry!
111
Osteoporosis - affects which type of bone? - example?
Trabecular | -distal radius, vertebral bodies, neck of femur.
112
Mosaic pattern of lamellar and woven bone. | -which disease?
Paget's disease of bone.
113
Spongiosa filling medullary canals | -which bone disease?
Osteopetrosis
114
What exits the jugular foramen?
CN 9, 10, 11 & jugular vein.
115
Negative charges in basement membrane of glomerulus provides by what?
heparan sulfate
116
acanthosis | -what is it?
- inc. thickness of stratum spinosum | - psoriasis has this.
117
Duchenne muscular dystrophy | -what kind of mutation?
frameshift
118
Becker muscular dystrophy | -what kind of mutation?
point | -x-linked
119
Rapid relief for RA - give what?
corticosteroids
120
Vimentin - found where? - marker to Dx what?
- Int. filament found in cells of mesenchymal origin. | - used ti Dx sarcomas
121
Where do brain metastases usually occur?
Junction btwn white and grey matter.
122
most commonly injured nerve in leg? | -location?
``` common peroneal (fibular) -due to its superficial location around the neck of the fibula. ```