3/17 repro Flashcards
(122 cards)
1
Q
renal cell carcinoma
-most common location of metastasis?
A
lungs
2
Q
Where do primary brain neoplasms often metastasize to?
A
inside the CNS
3
Q
link btwn hypothyroidism & amenorrhea/galactorrhea
A
inc. TRH can stimulate PRL prod.
4
Q
Most common cause of spont. nipple discharge?
A
intraductal papilloma
5
Q
polythelia
-what is it?
A
accessory nipple
6
Q
ephelide
-what is it?
A
freckle
7
Q
ANP & BNP
-which messenger system do they use?
A
inc. cGMP.
8
Q
vitamin D
-wheres its receptor?
A
cytoplasm
9
Q
AFP:
- what normally produces it?
- marker for which tumors?
A
- fetal liver & yolk sac = normal
- HCC, nonseminomatous testicular carcinomas, ovarian carcinomas.
10
Q
CA-125
-marker for what?
A
ovarian cancer
- not good for screening: highly nonspecific.
- use it to monitor progression.
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.
12
Q
choriocarcinoma
-most common distant metastasis?
A
lungs
13
Q
choriocarcinoma
- cancer of which cells?
- villi? cytotropho? syncytiotropho?
A
- neoplasm of trophoblast = which includes both cyto & syncytio.
- NOT of villi.
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.
15
Q
CEA
-marker for what?
A
-colorectal & pancreatic cancer
16
Q
Where do most ovarian malignancies arise from?
A
90% = surface epithelium derived
17
Q
Case control study
-odds ratio or relative risk?
A
-odds ratio
18
Q
Cohort study
-odds ratio or relative risk?
A
-relative risk
19
Q
Most important chemical mediator of sepsis?
A
TNF-alpha
20
Q
Suckling increases which hormone production?
A
oxytocin & PRL
21
Q
Risks for child thats not breast-fed:
A
-Asthma, allergies, diabetes mellitus, and obesity.
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.
23
Q
Which is a better diagnostic test for menopause, LH or FSH?
A
FSH.
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!
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.
```
