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Flashcards in Repro Deck (75):
1

What's the most common breast mass in men under 25?

Gynecomastia

2

What gene is involved in the oncogenesis of cervical cancer?

p53 - HPV has E6 and E7 proteins which combine with and inactivate the tumor suppressor genes p53 and p105rB respectively

3

What is the HER2 receptor?

Tyrosine kinase receptor

4

What does the RET gene encode?

Receptor tyrosine kinase

5

What is the most likely complication of a bicuronate uterus?

Frequent abortions

6

Describe the developmental cycle of Chlamydia.

EB - elementary body that is infectious
RB - metabolically active form

7

What is Paget disease and how does it present?

Paget disease - adenocarcinoma cells within the squamous epithelium of the skin near the nipple

Presentation - nipple inflammation, pigmentation, eczematoid changes

8

What symptoms follows entry of amniotic fluid into circulation?

Respiratory depression

9

What type of teratoma can develop appearance of mature thyroid tissue?

Monodermal teratoma

10

What is the most common cause of septic arthritis in otherwise healthy, sexually active adults?

Neisseria gonorrhea

11

Why is there virtually no immunity to reinfection with neisseria?

May express over 1 million variants of pili

12

Masculinized female fetus suggests what disorder?

21-hydroxylase deficiency

13

What hormone is immediate elevated in 21-hydroxylase deficiency?

17-OH progesterone

14

What does vaginal pruritus and white discharge suggest?

Candidiasis

15

What serum hormone level might you expect in a patient with frequent early spontaneous abortions?

Decreased progesterone

16

Where does herpes lay dormant?

Sacral ganglia

17

What uterine tumor on biopsy exhibits well-demarcated borders and a whorled surface?

Leiomyoma

18

What is a tumor marker for leiomyoma?

Smooth muscle actin

19

What does fever, abdominal pain, tender cervix in a sexually young woman suggest?

PID - probably gonorrhea or chlamydia

20

Which vaginal infection produces a neutrophilic discharge with gram-negative cocci?

Neisseria gonorrhea

21

Oocyte surrounded by several layers of follicular cells within a small antrum - what type of follicle is this?

Secondary follicle

22

How does acyclovir work?

1. Inhibits viral DNA polymerase
2. Also gets incorporated into viral DNA

23

What are 2 late sequelae of Group A streptococcal infection?

1. Rheumatic fever
2. Acute post-streptococcal glomerulonephritis

24

How can you differentiate rheumatic fever vs. acute post-streptococcal glomerulonephritis just based on the preceding infection?

Post-streptococcal glomerulonephritis - can present after either skin infection or acute pharyngitis

Rheumatic fever - only follows acute pharyngitis; does NOT follow skin infection

25

What should you be suspicious of if amniocentesis at 18 weeks reveals LOW alpha fetal protein?

Down syndrome

26

Why are clavulanic acid, sulbactam, and tazobactam added to penicillin family medications?

They are beta lactamase inhibitors - they decrease the destruction of the antibiotic by beta lactamases

27

What is the Hawthorne effect?

Tendency of a study population to affect an outcome due to the knowledge of being studied

28

Is a triploid karyotype partial or complete mole?

Partial mole

29

What can help prevent calcium crystal precipitation?

1. Increased citrate
2. High fluid intake

30

How have enterococci developed resistance to aminoglycosides?

Have modifying enzymes that transfer different chemical groups (acetyl, adenyl, or phosphate) to the aminoglycoside molecule and thereby impair antibiotic binding to ribosomal subunits

31

Breast biopsy: cellular, myxoid stroma that encircles and compresses epithelium-lined glandular and cystic spaces

Fibroadenoma

32

What causes formation of a bicuronate uterus?

Failure of the paramesonephric ducts to fuse

33

Where does the proximal 1/3 of the ureter receive its blood supply from?

Branches of the renal artery

34

Contrast where lymph from the scrotum vs. the testes drain.

Scrotum - superficial inguinal lymph nodes

Testes - para-aortic nodes

35

What are the 3 types of groin hernia and their relation to the inguinal ligament?

Above the inguinal ligament - direct and indirect

Below the inguinal ligament - femoral

36

Describe the location of a femoral hernia.

Below inguinal ligament
Lateral to the pubic tubercle
Medial to the femoral vein

37

What drugs can be used to treat postoperative urinary retention?

Muscarinic agonist (e.g. bethanechol) or alpha 1 blocker

38

Why would we not use oxybutynin for postoperative urinary retention?

Oxybutynin is an antimuscarinic agent commonly used for urge incontinence - would worsen the condition

39

What virulence factor in Group A strep prevents phagocytosis?

M protein

40

What are the complications of PID?

1. Infertility
2. Ectopic pregnancy

41

What is the most common viral cause of hemorrhagic cystitis?

Adenovirus

42

What are the effects of IL-2?

1. Promotes the growth of lymphocytes (B and T cells)
3. Activates NK cells and macrophages

43

What should you be careful to ligate when doing surgery on the ovary?

Suspensory ligament - carries most of the nerves and vessels to the ovary

44

Contrast direct and indirect inguinal hernia relative to inferior epigastric vessels.

Direct hernia - medial to interior epigastric vessels

Indirect hernia - lateral to inferior epigastric vessels

45

Contrast the causes of direct and indirect inguinal hernia.

Direct - weakness of transversalis fascia

Indirect - persistent processus vaginalis and failure of the internal inguinal ring to close

46

Contrast the causes of direct and indirect inguinal hernia.

Direct - weakness of transversalis fascia

Indirect - persistent processus vaginalis and failure of the internal inguinal ring to close

47

What findings make you suspicious of pyelonephritis?

1. Systemic manifestations of febrile illness (or UTI)
2. White blood cell casts
3. Pain upon urination

48

What are the two most common causes of urethritis in males?

Chlamydia and gonorrhea (can also co-infect)

49

How do you treat chlamydia/gonorrhea?

Ceftriaxone - for gonorrhea
Doxycycline or azithromycin - for chlamydia

50

Masculinization of a female fetus with virilization of the mother during gestation

Diagnosis?

Aromatase deficiency in the fetus

51

Where is the prostate located on CT?

Pretty central - in between the pubic symphysis and the anal canal

52

Describe the reaction that occurs with an acute hemolytic transfusion reaction.

Type II hypersensitivity - host antibody binds antigen on donor RBC and activates complement

53

What pregnancy complication are SLE patients at increased risk for?

Repeated 2nd or 3rd trimester miscarriages due to antiphospholipid antibody syndrome

54

Explain how eosinophils are involved in antibody-dependent cytotoxicity.

Eosinophils have Fc receptors on their surface that bind IgE-parasite antigen complexes. This stimulates the eosinophils to release major basic protein and other enzymes from their granules.

55

What is cystinuria and how does it present?

Autosomal recessive defect in the transporter of cystine, ornithine, arginine and lysine - presents as cysteine stones

The defect impairs the transporter's affinity in both the intestine and the kidney so you have decreased reabsorption once it is filtered at the glomerulus

56

What does a "bunch of grapes" removed from the uterus suggest?

Hydatidiform mole

57

What hormone level should be monitored in patients who have had a hydatidiform mole removed?

beta hCG

58

How do you treat chlamydia/gonorrhea?

Gonorrhea - ceftriaxone
Chlamydia - doxycycline or azithromycin

59

What should you be suspicious of in a patient who suffers both a renal infarct and a stroke?

Embolism from the left side of the heart - causes include atrial fibrillation, aortic aneurysm, infective endocarditis

60

What are 4 things caused by Kartagener's syndrome?

1. Male infertility
2. Situs inversus
3. Recurrent sinusitis
4. Bronchiectasis - destruction and widening of the larger airways

61

What causes gram-negative sepsis?

LPS - specifically the lipid A component

62

What are UAA, UAG, and UGA?

Stop codons

63

What recognizes stop codons to terminate protein synthesis?

Releasing factors

64

What is most important virulence factor in uropathogenic E coli?

P fimbriae

65

How can you prevent recurrence of herpes?

Daily treatment with oral acyclovir, valacyclovir, or famciclovir

66

What often happens to the ovaries in Turner syndrome?

Dysgensis (including complete absence)

67

Describe what happens in cryptorchidism.

Undescended testes --> temperature is higher than it should be --> damage to semniferous tubules which have the Sertoli cells --> low sperm count, impaired inhibin synthesis, increased FSH (because of low inhibin levels)

68

Describe the calcium levels in the blood and urine in patients with calcium stones.

Hypercalciuria but NORMOcalcemia

69

What are PCOS patients at increased risk of developing?

Endometrial adenocarcinoma and type 2 diabetes

70

Describe the path of the ureters.

They cross over the external/common iliac vessels and under the gonadal (and ovarian) vessels

As they enter the pelvis, they pass medial to the gonadal vessels and lateral to the internal iliac vessels

71

What staphylococcus is responsible for almost half of all UTI's in sexually active young women?

Saprophyticus

72

What should you be suspicious of in an elderly man who is straining on urination?

Bladder outflow obstruction likely due to BPH

73

What can happen to the kidneys in BPH?

Parenchymal pressure atrophy

74

What is the mechanism of acyclovir?

1. Nucleoside analog that gets incorporated into viral DNA and terminates DNA synthesis
2. Also inhibits DNA polymerase

75

What is the role of "tan fat-containing tissue"?

Brown adipose tissue - heat production