1
Q
PAINFUL BLEEDING, FIRM UTERUS, FETAL DISTRESS
A
PLACENTAL ABRUPTION
2
Q
PAINLESS BLEEDING, NO CONTRACTIONS, LATE PREGNANCY
A
PLACENTA PREVIA
3
Q
NO BLEEDING, RETAINED PLACENTA, HEMORRHAGE AT DELIVERY
A
PLACENTA ACCRETA
4
Q
Chronic Villi attach to myometrium
A
Placenta Accreta
5
Q
Chronic Villi penetrate into myometrium
A
Placenta increta
6
Q
Chronic villi penetrate through myometrium to uterine serosa or adjacent organs
A
Placenta pancreta
7
Q
Tx for gonorrhea/chlmydia
A
ceftriaxone/doxyclycine
8
Q
Which nodes drain the testicles?
A
Para-aortic
9
Q
Which nodes drain the penis?
A
deep inguinal
10
Q
Which nodes drain the scrotum
A
superficial inguinal
11
Q
What drug treats bacterial vaginosis? MOA?
A
Metronidazole.
forms free radicals that damage DNA and inhibit nucleic acid synthesis
12
Q
what kind of virus is HPV?
A
nonenveloped, naked, dsDNA
13
Q
what kind of virus is HSV?
A
enveloped, dsDNA
14
Q
How to screen for HSV?
A
PCR, tzank smear (multinucleated giant cells)
15
Q
TX HSV?
A
acyclovir, vancyclovir
16
Q
What type of cells do you see on pap smear with HPV?
A
koilocytes
17
Q
Complete Mole karyotype
A
46 XX or 46 XY. Empty ovum
18
Q
Partial mole karyotype?
A
69 XXY or 69XXX
19
Q
in what molar preganancy is fetal tissue absent
A
complete mole - snowstorm appearance
20
Q
in what molar pregnancy is fetal tissue present
A
partial mole
21
Q
Which molar pregnancy? High BetaHCG, no fetus, high cancer risk (choriocarcinoma), may present with hyperthyroidism (hcg mimics TSH)
A
complete mole
22
Q
What is pathognomonic for molar pregnancy?
A
preeclampsia before 20 weeks
23
Q
Beta hcg increase slower than normal, US shows no intrauterine pregnancy, amenorrhea, abdominal pain and vaginal bleeding.
TX?
A
Ectopic pregnancy
Methotrexate
24
Q
Most common cause of secondary amenorrhea
A
Pregnancy
Hypothalamic –> stress, weight loss
Pit –> prolactinoma
ovarian –> PCOS
Uterine –> Ashermans
25
Most common cause of primary amenorrhea which is no menses by age 15
Turner's --> high FSH, short, streak ovaries
Mullerian agenesis: normal hormones, absent uterus/vagina
26
Tx endometriosis
Chocolate cysts
NSAIDS, OCPS, GnRH agonists
27
Most common malignant ovarian tumor
serous cystadenocarcinoma. Bilateral
28
which tumor has shiller duval bodies and increased AFP
Yolk salf
29
Which tumor has increased estrogen and call exner bodies
granulosa tumor
30
Which tumor is associated with molar preganncy and increased beta hcg
Theca lutein cyst
31
What OCP do you give breastfeeding women?
Progestin only
32
Combined OCP's suppress ___
LH/FSH
33
Ovulation is the
LH surge (estrogen positive feedback)
34
Follicular phase is the
FSH --> follicle growth --> estrogen rises
35
What does the corpus luteum secrete in the luteal phase
Progesterone
36
Clear or mucopurulent discharge, dysuria, asymptomatic usually, cervicitis, PID
Chlamydia
37
TX for chlamydia
Doxycycline or Azithromycin
38
What STD? Obligate, intracellular, no peptidoglycan
Chlamydia
39
Thick, purulent yellow/green discharge. Dysuria, PID.
Neisseria gonorrhoeae
40
What STD?
Gram negative dipoloccoi, intracellular in PMNs
Neisseria gonorrhoeae
41
TX for gonorrhea
Ceftriaxone / doxy
42
Primary: Painless chancre
Secondary: Rash on palms/soles, condylomata lata
Tertiary: Neurosyphilis, tabes dorsalis, aortitis, Argyll Robertson pupil
Treponema pallidum (syphilis)
43
How to TX syphillis?
Penicillin
44
How to screen and confirm syphillis?
RPR/VDRL, confrim with FTA-ABS
45
"school of fish" on gram stain
haemophilus ducreyi (chancroid)
46
How to TX haemophilus ducreyi (chancroid)
Azithromycin or ceftriaxone
47
where does HSV lay latent?
sacral ganglia
48
Koilocytes, epithelial hyperplasia
HPV
49
How to TX HPV?
Topical imiquimod, cryotherpahy
Garadasil vaccine
50
Frothy, yellow green discharge
Trich vaginalis
51
Strawberry cervix
Trich vaginalis
52
Motile protozoa on wet mount
Trich vaginalis
53
How to tx trich vaginalis
metronidazole.. both partners
54
Thin, gray white discharge with fishy odor
Garderella vaginalis (BV)
55
How to TX BV
metronidazole
56
Clue cells, epithelial cells coated with bacteria, positive whiff test
Gardnerella vaginalis (BV)
57
Thick white cottage cheese discharge, pseudohyphae on KOH prep..
TX?
Candida albicans (yeast infection)
Fluconazole
58
Groove sign + protocolitis
Small painless ulcer--> days later it is painful
Lymphogranulma venereum LGV
59
If postmenopausal + ascites + adnexal mass --> suspect malignancy
Papillary projections, postmenopausal women
Psammoma bodies, CA 125 increased
Serous carcinoma
60
estrogen producing, endometrial hyperplasia
Comlex tip: postmenopausal bleeding + ovarian mass + thickened endometrium
Granulosa cell tumor
61
Oligomenorrhea, deep voice, clitormegaly, solid ovarian mass
Sex cord stromal tumor --> Sertoli Leydig cell tumor
62
thickened endometrial stripe
Endometrial carcinoma
63
whorled smooth muscle bundles
Leiomyoma (fibroid)
64
fried egg cells, LDH increased.
Dysgerminoma
65
Reinke crystals are found in what tumor
sertoli leydig
66
placental issue..
Postpartum hemorrhage.
Prior C section/ashermans
Placenta accreta/increta/percreta
67
In a threatened spontaneous abortion..
Cervical OS:
Products of Conception:
US finding:
Closed
Present
Fetal cardiac activity
68
In an inevitable spontaneous abortion..
Cervical OS:
Products of Conception:
US finding:
Open
Present
No fetal activity
69
In an Incomplete spontaneous abortion
Cervical OS:
Products of Conception:
US finding:
Open
Some expelled
Retained tissue
70
Complete spontaneous abortion..
Cervical OS:
Products of Conception:
US Finding
Closed
All expelled
empty uterus
71
TX of HELLP syndrome
immediate delivery, manage platelets if needed
72
Microangiopathic hemolysis (shcistocytes) + low platelets + Increased LFTs (AST/ALTs)
HELLP
73
Seizure + HTN + proteinuria in pregnant patient
Eclampsia
74
Headache, RUQ pain, edema, blurry vision in 3rd trimester
Preeclampsia
75
Pathophysiology of gestational DM?
placental hormones (hPL which is human placental lactogen) increases insulin resistance
76
Magnesium toxicity early features
Flushing and warmth, N/V, hypotension, loss of deep tendon reflexes, bradycardia, muscle weakness
77
metastatic mucinous tumor that invovles both ovaries, most commonly due to metastatic gastric carcinoma. bilateral!
Krukenburg tumor - muciin producing signet ring cells
78
benign tumor , bundle of spindle shaped fibroblasts
fibroma
79
triad of ovarian fibroma, ascities, pleural effusion. Pulling sensation in groin
Fibroma
think fiBROma. Bros drink beer --> beer belly --> looks like ascites
80
reinke crystals on imaging think
sertoli leydig cell tumor
leyDIG for crystals
81
what cells do you associate with granulosa cell tumors?
Call Exner bodies
call granny exner
82
anything with the bladder syptoms, think what tumor?
brenner
83
psammoma bodies tumor think
serous carcinoma
84
increase in hcg and LDH, what tumor?
dysgermanoma --> think dysGERMANoma.. three colors in the flag..
Think HCG and LDH increased bc they start with three
85
chronic crusting, eczema like reaction, and ulcers around the nipple
Paget disease of the breast and highly associated with invasive ductal carcinoma
86
orange peel, peau d'orange is mostly associated with what breast pathology.
Inflammatory breast carcinoma
87
clear/watery cytoplasm with central nuclei, fried egg appearance, fibrous septae,
most common testiuclar tumor, PLACENTAL ALP increased
Seminoma
Seminoma = seminole = fried egg
or Seminoma = semen omo eggs in semen
88
Premature cells that may look glandular or papillary, hemorrhagic or necrotic, painful, increased levels of AFP/or Beta HCG.
Embryonal Carcinoma
Ember = fiery, dark (necrotic, hemorrhage)
89
comprised of various germinal layers tumor
Teratoma
teeth etc
90
Synctiotrophoblasts, cytotroohoblasts, multinucelated giant cells, gynecomastia, increased HCG (looks like TSH --->), hyperthyroidism
Male tumor
choriocarcinoma
CHORiocarcinoma
gyneCHORmastia
hypCHORAthyroidism
91
Schiller duval bodies, yellow, mucinous, increased AFP, children
Yolk sac
92
most common testicular tumor in older men
Diffuse large B cell subtype
Bilateral
Lymphoma
93
unilateral painful testicle
Prehn sign --> elevation of scrotum, if that improves pain (push it up), and relieve pain, Positive
Cremaster --> Q tip and stroke medial portion of thigh, testicle will move up into scrotum --> positive
Epididymitis
94
Prehn and cremaster negative
testicular torsion
95
Fever, dysuria, urinary frequency, urethral discharge, prehn and cremaster are positive, <35 sexually active, chlamydia/gonorrhea, but MCC overall is Ecoli
Epididmytitis
96
High riding teste, painless scrotal mass in neonates, N/V, prehn and cremaster reflex negative
testicular torsion
97
If you lift the scrotum up and the pain improves (positive prehn), you have the MITIS touch
epididmytitis
98
painless, enlarged testicle, transilluminates, fluid accumulation (tunica vaginalis).
Communicating: yes affected by valsalva and increases in size , failed process vaginalis
Non communicating: size not affected by valsalva, tunica vaginalis.
Hydrocele
99
painless, enlarged testicle, doesn't transilluminate, pampiniform plexus, left testicle most common, bag of worms
Varicocele
100
Left testicle most common in varicocele why?
left sperm vein inserts at left renal vein @ 90 degree angle so more obstructed
101
slow onset, painless mass, may be right sided testicle, ipsilateral lower limb swelling due to venous or lymphatic obstruction, serum tumor markers (AFP)
testicular tumor
102
inflammation of breast parenchyma, most commonly due to S aeureus entry into fissures during breast feeding, can be caused by insufficient milk drainage causing milk stasis
Mastitis, have mom continue to breast feed
103
subareolar periductal inflammation with dilated mammary ducts
green brown nipple discharge
inverted nipple possible
mammary duct ectasia
Oregon duck - green and orange
104
nonviable adipose tissue being replaced by scar tissue
multinucleated giant cells with calcifications
most commonly associated with mechanical trauma or recent breast surgery
fat necrosis of the breast
105
blood nipple discharge in pre menopausal women, fibrovascular projection lined by epithelial cells
if myoepithelium --> intraducutal papilloma
if no underlying myoepithelium --> papillary carcinoma
Intraductal papilloma
papillary = myoepitheliam popped (not there)
intradcutal - myo included
106
estrogen sensitive, refers to a marble like rubbery mobile, stromal glandular benign tumor
15-35 woman
Fibroadenoma
fibROadeomas - estROgen sensitive
107
refers to a proliferation within ducts but has not yet invaded the basement membrane
presence of calcifications in various arrangements
Ductal carcinoma in situ
DCS has Dem CalcificationS
108
duct like structures in a desmoplastic stroma
Invasive Ductal carcinoma
109
two types of invasive ductal carcinoma are
Inflammatory
- dermal lymphatic invasion by tumor cells, worst prognosis, peau d orange
Medullary breast carcinoma
- syncytial, sheet like growth with lymphocytic infiltrate
110
refers to proliferation of lobular cells but not yet invaded basement membrane
lacks E cadherin
Lobular carcinoma in situ
LC Lacks Cadherin
111
lack e cadherin
noncohesive cells organized in a single file pattern
invasive lobular carcinoma
ILC = individual line carcinoma
112
Paget disease of breast associated with
invasive ductal carcinoma
113
infant noted to have bulge in scrotal region and no illumination to light
indirect inguinal hernia
internal inguinal ring --> into scrotum
lateral to inferior epigastric vessels --> LIE
114
adult who has abdominal bulge worse with coughing. On exam it's reducible.
Direct inguinal hernia
External inguinal ring --> directly into abdomen
Medial to inferior epigastric vessels
MD (medial - direct hernias)
115
female with mass in groin region. Excruciating pain. Mass not compressible
femoral hernia --> below inguinal ligament
116
Hypertension that first appears with pregnancy and has NO ASSOCIATED PROTEINURIA
GESTATIONAL HTN
117
Med given to reduce urinary symptoms by relaxing bladder smooth muscle in BPH
tamsulosin
a1 antagonist
118
Med that shrinks prostate
Finasteride
5a-reductase inhibitor
119
prevents prostate cancer growth
flutamide
120
what does APGAR stand for?
Appearance (skin color)
Pulse (HR)
Grimace (reflex irritability like crying)
Activity (muscle tone)
Respiration
121
diethylstilbestrol exposure in utero can lead to
development of clear cell adenocarcinoma
122
pt has sudden hypotension + dyspnea followed by a seizure during active labor --> think
Pulmonary embolism and can lead to DIC
123
female phenotype
primary amenorrhea
low estradiol
tall stature
LH and FSH increased
46 XY
streak gonads
mullerian organs
Swyer syndrome
124
46 XY
female phenotype
testes
no mullerian organs
normal estradiol
metabolic disorder (elevated blood glucose)
Androgen Insensitivity
125
enlarged globular, tender symmetrically enlarged uterus with no adnexal masses
Adenomyosis - glandular tissue in myometrium
126
has no uterus, fallopian tubes, no ovaries, could have testes in labia majora
46 XY androgen insensitivity
127
tanner stage 5, complete development shortened vaginal canal, absent uterus, absent fallopian tubes, normal ovaries
46 XX, mullerian agenesis
MISSED
flashcards
Decks in class (20)
# Cards
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MISSED MSK35
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MISSED HEME48
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MISSED MICRO66
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MISSED NEURO/EYE132
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MISSED ANATOMY66
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MISSED REPRO127
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MISSED RESP39
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MISSED IMMUNO31
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MISSED GI102
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MISSED PHARM48
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MISSED OPP114
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MISSED CARDIO68
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MISSED ENDO41
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MISSED BIOSTATS20
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RAPID REVIEW42
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missed DERM6
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