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Flashcards in Pathology - repro Deck (34):
1

Klinefelter syndrome (47, XXY)

hypogonadism! testicular atrophy, gynecomastia

abnormal seminiferous tubules and abnormal Leydig cell function (low inhibin, low testosterone), leads to increased FSH/LH, incr. estrogen

Barr body present

2

Turner syndrome (45, XO)

female, short stature w. primary amenorrhea (most common)

no Barr body

menopause before menarche, decr. estrogen leads to incr. FSH/LH

pregnancy is possible w/ oocyte donation and exogenous estradiol/progesterone

3

Aromatase deficiency

No estrogen synthesis

Masculinization of female infants, incr. serum testosterone, incr. serum androstenedione

Can present with maternal virilization during pregnancy

4

Androgen insensitivity syndrome (46, XY)

Defect in androgen receptor

Normal-appearing female with female external genitalia, no uterus/fallopian tubes

testes are surgically removed to prevent malignancy

incr. testosterone, estrogen and LH

5

5a reductase deficiency

no testosterone --> DHT

ambiguous genitalia until puberty, incr. testosterone causes masculinization

normal internal genitalia (testosterone intact)

6

Kallmann syndrome

defective migration of GnRH cells and defective development of olfactory bulb

decr. synthesis of GnRH in the hypothalamus, decr. FSH/LH/testosterone

infertility in males and females

7

Complete mole

46, very high hCG, enucleated egg + single sperm (duplicated paternal sperm), elevated risk of malignant disease, lots of maternal symptoms

honeycombed uterus (clusters of grapes)

8

Partial mole

69 chromosomes, fetal parts present, 2 sperm + 1 egg, low risk of malignancy

9

Treatment for gestational hypertension

alpha-methyldopa, labetalol, hydralazine, nifedipine

10

Cause of pre-eclampsia

Abnormal placental spiral arteries, leads to endothelial dysfunction, vasoconstriction, ischemia

Look for proteinuria or end-organ dysfunction after 20th week of pregnancy

11

Complications of pre-eclampsia

Placental abruption
Coagulopathy
Renal failure
Uteroplacental insufficiency
Eclampsia

12

Causes of death in eclampsia

stroke, intracranial hemorrhage, ARDS

13

HELLP syndrome

Hemolysis, elevated liver enzymes, low platelets

Look for schistocytes

Rupture of subcapsular liver hematomas can lead to severe hypotension

14

Placenta accreta vs. increta vs. percreta

accreta - attachment to myometrium (no penetration)

increta - placenta penetrates into myometrium

percreta - placenta perforates through myometrium and into serosa

15

Vasa previa triad

Membrane rupture, painless vaginal bleeding, fetal bradycardia

16

HPV and cervical cancer

subtypes 16 and 18

produce E6 (flags p53 for ubiquitin degradation) and E7 (competitively inhibits RB)

lateral invasion of tumor can block ureters

17

PCOS pathophysiology

hyperinsulinism/insulin resistance

incr. LH:FSH ratio

incr. androgens from theca interna cells

decr. follicular maturation

18

ovarian cysts

follicular cyst - unruptured graffian cyst, most common ovarian mass

theca-lutein cyst - bilateral/multiple, due to gonadotropin stimulation, associated with choriocarcinoma/hydatidform moles

19

mitigating risk factors for ovarian cancer

previous pregnancies, breastfeeding, OCPs, tubal ligation

20

benign neoplasms

serous cystadenoma: lined with fallopian tube-like epithelium

mucinous cystadenoma: lined by mucus-secreting epithelium

endometrioma, mature teratoma (can present as hyperthyroidism), Brenner tumor (looks like bladder, coffee bean appearance), fibroma, thecoma

21

Meigs syndrome

ovarian fibroma, ascites, hydrothorax

22

dysgerminoma

most common ovarian tumor in adolescents

23

Krukenberg tumor

GI tumor that metastasizes to ovaries (mucin-secreting signet cell adenocarcinoma)

24

treatment of endometritis

gentamicin + clindamycin w/ or w/o ampillin

25

breast pathology by location

nipple: Paget dz, breast abscess
lactiferous sinus: intraductal papilloma, mastitis
major duct: fibrocystic change, DCIS, invasive ductal carcinoma
terminal duct: tubular carcinoma
lobules: lobular carcinoma
stroma: fibroadenoma, Phyllodes

26

phyllodes tumor

leaf-like projections, large bulky mass of connective tissue and cysts

may become malignant

27

Drugs that cause gynecomastia

Spironolactone
Digoxin
Cimetidine
Alcohol
Ketoconazole

28

Most important prognostic factor for breast cancer

Axillary node involvement

29

Paget disease histology

large cells in epidermis with clear halo

30

Invasive ductal vs. lobular

ductal - rock-hard with sharp margins, stellate infiltration

lobular - orderly row of cells, decr. E-cadherin

31

Effects of cryptorchidism

Impaired spermatogenesis w/ normal testosterone levels (unilateral) or low T (bilateral)

incr. risk of germ cell tumors (hCG)

loss of inhibin = incr. in FSH

32

Spermatocele

Cyst due to dilated epididymal duct or rete testis

33

BPH location

periurethral (lateral and middle) lobes, compresses urethra into a vertical slit

hyperplasia not hypertrophy

34

Prostate cancer location

posterior lobe (peripheral zone)

look for signs of bone mets