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Flashcards in Repro Deck (199):
1

24 y/o male develops testicular cancer. Metastatic spread occurs by what route

para-aortic lymph nodes (recall descent of testes during development)

2

woman with previous cesarean section has a scar in her lower uterus close to the opening of the os. What is she at increased risk for?

placenta previa

3

obese woman presents with hirsuitisma nd increase levels of serum testosterone. What is the dx?

Polycystic ovarian syndrome

4

pregnat woman at 16 weeks of gestation presents with an atypically large abdomen. what is the dx?

high hCG; hydatidiform mole

5

55 y/o postmenopausal woman is on tamoxifen therapy. What is she at increase risk of aquiring

endometrial carcinoma

6

what is the drainage of the left ovary/testes

left gonadal vv -> left renal vv -> IVC

7

what is the drainage of the right ovary/testes

right ovary/testis -> right gonadal vein -> IVC

8

suspensory ligament of ovaries contains these vessels

ovarian vessels

9

transverse cervical (cardinal) ligament contains these vessels

uterine vessels

10

round ligament of uterus contains

no important sx

11

broad ligament contains

round ligaments of the uterus and ovaries and the uterine tubules and vessels

12

erection is mediated by the _______ nervous system

parasympathetic

13

emission is mediated by the _______ nervous system

sympathetic

14

ejaculation is mediated by _____ and _____ nerves

visceral and somatic neves

15

acrosome of the sperm is derived from this

golgi apparatus

16

flagellum (tail) is derived from these

centrioles

17

middle piece (neck) has this

mitochondria

18

sperm food supply

fructose

19

spermatogenesis begins with _______(type A and B). Full development takes 2 mo

spermatogonia

20

spermatogenesis occurs here

seminiferous tubules.

21

type A forms these types of spermatogonia

type A & B

22

spermatogonium is ____, __N

dipoloid, 2N

23

spermatocyte is ____, __N

diploid, 4N

24

primary spermatocyte is ____, __N

diploid, 4N

25

secondary spermatocyte is ____, __N

haploid, 2N

26

spermatid is ____, __N

haploid, N

27

In male spermatogenesis, androgen-binding protein (ABP) functions to

ensure that tesetosterone in seminiferous tubule is high

28

In male spermatogenesis, inhibin functions to

inhibits FSH

29

testosterone functions to

differentiate male genitalia, has anabolic effects on protein metabolism, maintains gametogenesis, maintains libido, inhibits GnRH, and fuses epiphyseal plates in bone

30

FSH stimulates these cells to produce sperm

Sertoli cells

31

LH stimulates these cells to produce testosterone

Leydig cells

32

give some examples of androgens

testosterone, dihydrotestosterone (DHT, androstenendione

33

what is the source of DHT and testosterone

testes

34

what is the source of androstenedione

adrenal

35

rate testosterone, DHT and androstenedione in terms of potency

DHT>testosterone>androstenedione

36

name some targets of androgens

skin, prostate, seminal vesicles, epidydymis, liver, muscle, brain

37

testosterone is converted to DHT by this enzyme

5 alpha reductase

38

testosterone is converted to DHT by 5 alpha reductase which is inhibited by _______

finasteride

39

androgens functions to differentiate the wolffian duct system into these

internal gonadal structures

40

androgens functions to produce these changes in puberty

produce secondary sexual characteristics and growth spurt

41

androgens are required for normal spermatogenis. T or F

T

42

androgens functions for anabolic effects. E.g.,

increased mm size, increased RBC production

43

androgens increase this

libido

44

testosterone and androstenedione are converted to estrogen in adipose tissue by this enzyme

aromatase

45

ovaries produce this version of estrogen

estradiol

46

placenta produces this version of estrogen

estriol

47

list estrone, estradiol, and estriol in terms of potency

estradiol > estrone > estriol

48

give some fxs of estrogen

1) growth of follicle
2) endometrial proliferation, myometrial exitability
3) development of genitalia
4) stromal development of breast
5) female fat distribution
6) hepatic synthesis of transport protiens
7) feedback inhibition of FSH
8) LH surge (estrogen feedback on LH secretion switches to positive from negative just before LH surge)
9) increase myometrial exitability
10) incrase HDL, decreae LDL

49

estrogen hormone replacement therapy after menopause has these effects

decreased hot flashes and decreased postmenopauseal bone loss

50

unopposed estrogen therapy increases the risk of this CA

endometrial CA

51

using this with estrogen therapy can reduce the risk of CA

progesterone

52

what is the source of progesterone

corpus luteum, placenta, adrenal cortex, testes

53

progesterone functions to stimulate this?

endometrial glandular secretions and spiral artery development

54

progesterone functions to maintaine this?

pregnancy

55

progesterone functions to decrease exitability of this?

myometrial

56

progesterone produces thick cervical mucus, which functions to do this?

inhibits sperm entry into the uterus

57

progesterone functions to do this to body temperature?

increase

58

progesterone functions to do this to gonadotropins(LH,FSH)?

inhibit

59

progesterone functions to do this to uterine smooth mm?

relax it

60

follicular growth is fastest during this week of the proliferative phase

2nd week

61

this hormone stimulates proliferation of endometrium

estrogen

62

this hormone maintains endometrium to support implantation

progesterone

63

decreased amounts of this hormone can lead to decreased fertility

progesterone

64

there is a surge of this hormone the day before ovulation

estrogen

65

ovulation has this effect on LH, and this effect on FSH

stimulates LH
inhibits FSH

66

LH surge causes this

ovulation (rupture of follicle)

67

ovulation results in an increase in temperature which is induced by this hormone

progesterone

68

ovulation has this effect on the cervical mucosa

ferning

69

oral contraceptives prevent the surge of this hormone, LH surge -> ovulation does not occur

estrogen

70

this word refers to when blood from a ruptured follicule causes peritoneal irritation that can mimic appendicitis

Mittelschmerz

71

primary oocytes begin this during fetal life and complete it just prior to ovulation

meiosis I

72

Meiosis I is arrested in this phase for years until Ovulation

prOphase

73

Meiosis is arrested in this phase until fertilization

METaphase

mneu: an egg MET a sperm

74

source of hCG

syncytiotrophoblast of placenta

75

hCG functions to maintain this ________ for the 1st trimester by acting like LH.

corpus luteum

76

In the 2nd and 3rd trimester, this synthesizes its own estrogen and progesterone and the corpus luteum degenerates

placenta

77

this hormone is used to detect pregnancy because it appears in the urine 8 days after successful fertilization (blood and urine tests available)

hCG

78

elevated hCG can be seen in woman with these 2 neoplasms

hydatiform moles
choriocarcinoma

79

this is the cessation of estrogen production with age-linked decline in number of ovarian follicles

menopause

80

what is the average age of onset of menopause

51 years

81

menopause tends to be earlier in this group of people

smokers

82

what hormonal changes occur in menopause?
estrogen
FSH
LH
GnRH

estrogen:↓
FSH:↑↑
LH:↑
GnRH:↑

83

what are some symptoms of menopause

mneu: HAVOC
Hot flashes
Atrophy of the vagina
Osteoporosis
Coronary artery dz

84

bicornuate uturus results from incomplete fusion of thse ducts

paramesonephric ducts

85

bicornate uterus is associated with these abnormalities

urinary tract abnormalities and infertality

86

this is abnormal opening of penile urethra on inferior (ventral) side of penis due to failure of urethral folds to close

hypospadias

87

this is an abnormal opening of penile urethra on superior (dorsal) side of penis due to faulty positioning of genital tubercle

epispadias

88

what is more common hypospadias or epispadias

hypospadias

89

why should you fix hypospadias.

prevent UTI

90

exstrophy of the bladder is associated with this

epispadias

91

pt presens for infertility workup with testicular atrophy, eunuchoid body shape, tall, long extemities, gynomastia, female hair distribution.

kleinfelter's syndrome

92

kleinfelter's syndrome karyotype

XXY presence of inactivated X chromosome (Barr body)

93

frequency of kleinfelter's syndrome

1:850

94

pt presents for primary amenorrhea with short stature, ovarian dysgenesis (streak ovary) webbing of neck, coarctation of the aorta.

turners syndrome

95

Turner's syndrome karyotype

XO (no barr body)

96

man in penal institution looks normal but is very tall and has severe acne

double Y males

97

frequency of double Y male

1:1000

98

this is a disagreement between the phenotypic (external genitalia) and gonadal (testes vs. ovaries) sex

pseudohermaphroditism

99

In this form of pseudohermaphroditism ovaries are present but external genitalia are virilized or ambiguous

female pseudohermaphroditism (XX)

100

what are some causes of female pseudohermaphroditism (XX)

excessiva and inappropriate exposure to androgenic steroids during early gestration (i.e., congenital adrenal hyperplasia or exogenous administration of androgens during pregnancy)

101

testes are present, but external genitalia are female or ambiguous.

male pseudo-hermaphrodite (XY)

102

what is the most common form of male pseudo-hermaphrodite (XY)

androgen insensitivity syndrome (testicular feminization)

103

what is a true hermaphrodite (46 XX, 47 XXY

both ovary and testicular tissue present; ambigous genetalia. Very rare.

104

this results when a defect in androgen receptor results in a normal-appearing female. Female external genitalia are present with rudimentary vagina. Uterus and uterine tubes are generally absent.

androgen insensitivity syndrome (46 XY)

105

what do you do with the testes in a pt with androgen insensitivity syndrome

remove them to prevent malignancy

106

what will the levels of testosterone, estrogen and LH look like in androgen insensitivity syndrome

all will be high

107

unable to convert testosterone to DHT. Ambiguous genitalia until puberty, when increased testosterone causes masculinization of genitalia. Testosterone/estrogen levels are normal; LH is normal or increased

5alpha reductase deficiency

108

this is common in men >50 y/o. often presents with increased frequency of urination, nocturia, difficulty starting and stopping the stream of urine and dysuria

benign prostatic hyperplasia

109

complications of BPH (is it precancerous)

may lead to distension and hypertrophy of the bladder, hydronephrosis and UTIs. Not considered a premalignant lesion.

110

BPH is characterized by a nodular enlargement of these lobes of the prostate gland, compressing the urethra into a verticle slit

periurethral (lateral and middle) lobes

111

possible etiology of BPH

age related increase in estradiodl with possible sensation of the prostate to growth promoting effects of DHT

112

prostatic adenocarcinoma is common in men >50 y/o. It arises most often from this lobe of prostate gland.

posterior lobe (peripheral zone.

113

how is prostatic adenocarcinoma frequently diagnosed

hard nodule on digital rectal exam and prostate bx.

114

what are two tumor markers for prostatic adenocarcinoma

prostatic acid phosphatase and prostate specific antigen (PSA)

115

increase in serum alkaline phosphorus and PSA in pt with prostatic adenocarcinoma may indicate what

osteoblastic metastases

116

this is a pathologic ovum ("empty egg"--ovum with no DNA) resulting in cystic swelling of chorionic villi and proliferation of choorionic epithelium (trophoblast). "honeycomed uterus" and clluster of grapes appearance

hydatiform mole

117

hydatiform mole produces high levels of this

B-hCG

118

what is the genotype of a complete mole? Is it maternal or paternal in origin?is there a fetus?

46, XX-completely paternal-no fetus

119

this type of mole is made up of 3 or more parts (triploid or tetraploid; It may contain fetal parts.

a partial mole

120

this triad in pregnancy is hypertension, proteinuria, and edema.

preeclampsia (pregnancy induced hypertension)

121

the preeclampsia triad + seizures =

eclampsia

122

preeclapsia/eclampsia affects what percentage of pregnant women form 20 weeks' gestation to 6 weeks postpartum

7%

123

what are some conditions that predispose a woman to preeclampsia

hypertension, dbts, chronic renal dz, autimmune disorders

124

etiology of preeclampsia includes placental ______

ischemia

125

preeclampsia can be associated with HELLP syndrome. What does this stand for

Hemolysis, Elevted LFTs, Low Platelets

126

What are some of the clinical features of preeclampsia

headache, blurred vision, abdominal pain, edema of face and extremities, altered mentation, hyperreflexia

127

lab findings of preeclampsia may inculde

thrombocytopenia, hyperuricemia

128

what is the tx of preeclampsia

deliver the fetus as soon as viable. Until then bed rest, salt restriction and monitoring and tx of HTN

129

what is the tx of eclapsia

medical emergency, IV magnesium sulfate and diazepam

130

this pregnancy complication describes a premature separation of the placenta. It presents with PAINFUL uterine bleeding (usually during 3rd trimester). Fetal death occurs. It may be associated with DIC. there is increased risk in mothers who have HTN, smoke, or use cocaine

abruptio placenta

131

this pregnancy complication describes when a defective decidual layer allows the placenta to attach ddirectly to the myometrium. Prior C-section or inflammation predisposes a woman to it. There may be a massive hemorrhage after delivery

placenta accreta

132

this pregnancy complication describes the attachment to the placenta to the lower uterine segment. It may occlude the cervical os. PAINLESS bleeding may occur in any trimester

placenta previa

133

this pregnancy complication occurs most often in the fallopian tubes. It is predisposed by salpingitis (PID). Suspect it with increased hCG and sudden lower abdominal pain. Confirm with an ultra sound

ectopic pregnancies

134

>1.5-2L of amniotic fluid; associated with esophogeal/duodenal atresa, cauasing inability to swallow amniotic fluid, and with anencephaly

polyhydramnos

135

<0.5L of amniotic fluid. Associated with bilateral renal agenesis or posterior urethral valves (in males) and resultant inability to excrete urine

oligohydramnios

136

disordered epithelial growth. begins at basal layer and extens outward. classified as I-III depending on extent of disordere.

dysplasia and carcinoma in situ

137

carcinoma in situ is associated with what virus

HPV 16,18

138

is carcinoma in situ premalignant

yes it may progress slowly to invasive carcinoma

139

invasive carcinoma is often this type

squamous cell carcinoma

140

papsmear can catch this sign of cervical dysplsia before it progresses to invasive carcinoma

koilocytes

141

lateral invasion of invasivve carcinoma can block ureters, causing this

renal failure

142

this uterine pathology is characterized by non-neoplastic endometrial glands/ stroma in abnormal location outside the uterus. It is characterized by cylcic bleeding (menstral type) from ectopic endometrial tissue resulting in blood filled "chocolate cysts." In ovary or peritoneum. It manifests clinically as severe menstrual related pain. It often results in infertility

endometriosis

143

this is endometriosis within the myometrium

adenomyois

144

this abnormal endometrial gland proliferation is usually caused by excess estrogen stimulation. It most commonly presents clinically as vaginal bleeding. Pts with this are at increased risk for endometrial carcinoma

endometrial hyperplasia

145

this is the most common gynecologic malignancy. Peak age is 55-65 y/o. Clinically presetns with vaginal bleeding and is typically preceded by endometrial hyperplasia. Risk factors include prolonged estrogen use, obesity, dbts, and hypertension.

endometrial carcinoma

146

this is the most common of all tumors in females. It often presents with multiple tumors. there is an increase incidence in blacks. These tumors are estrogen sensitive and tumor size increases with pregnancy and decreases with menopause. malignant transformation is rare.

leiomyoma

147

this is a bulky tumor with areas of necrosis and hemorrhage, dypically arising de novo (not from leiomyoma0. There is an increased incidence in blacks. THis is a highly aggressive tumor with tendency to recur. May protrude from cervix and bleed

Leiomyosarcoma

148

increased LH production leads to anovulaiton, hyperandrogenism due to deranged steroid synthesis. It manifests itself clinically by amenorrha, infertility, obesity, and hirsutism. Tx with weight loss, OCPs, gonadotropin analogs, or surgery

polycystic ovarian syndrome

149

this ovarian cyst is a distension of unruptured graafian follicle. It may be associated with hyperestrinism and endometrial hyperplasia

follicular cyst

150

this ovarian cyst is a results from hemorrhage into persistant corpus luteum. It cfan cause menstral irregularity

corpus luteum cyst

151

this ovarian cyst is often bilateral/multiple. It is due to gonadotropin stimulation. It is associated with choriocarcinoma and moles

theca-lutein cyst

152

this ovarian cyst is a blood containing cyst from ovarian endometriosis. It varies with the menstral cycle

chocolate cyst

153

this is the most common germ cell tumor of the ovaries and testse. It produces incresed hCG and sheets of uniform cells

germinomas

154

germinoma of the ovary is called

dysgerminoma

155

germinoma of the testes is called

seminoma

156

how does seminoma often present

with painless testicular enlargment

157

what puts pts at increased risk for seminoma

cryptochidism

158

this is an aggressive malignancy in the ovaries, testes, sacrococcygeal are of young children.

yolk sac (endodermal sinus) tumor

159

______ bodies and primitive glomeruli are seen in yolk sac (endodermal sinus) tumors

Schiller-Duval bodies

160

this lab value is increased with yolk sac (endodermal sinus) tumor

AFP

161

this is a rare but malignant germ cell tumor that can develop during pregnancy in mother or baby. Tumor shows large hyperchromatic syncytrotrophoblastic cells

choriocarcinoma

162

what lab value is increased in choriocarcinoma

hCG

163

this is the 2nd most common testicular germ cell tumor. It presents as a painful mass. Microscopically the tumor is glandular w/ papillary convolutions

embryonal carcinoma

164

this constitutes 90% of ovarian germ cell tumor. It contains cells from 3 germ layers.

teratoma

165

in woman matuure teratoma ("dermoid cyst") is _______

immature teratoma is _______

benign

malignant

166

In Men, Mature teratomas can present with gynecomastia, they are painful and __________

Malignant

167

this form of teratoma contains functional thyroid tissue

struma ovarii

168

This ovarian non-germ cell tumor consists of 20% of ovarian tumors. It is frequently bilateral, and lined with fallopian tubbe-like epithelium. It is benign

serous cystadenoma

169

This ovarian non-germ cell tumor consists of 50% of ovarian tumors. These are malignant and frequently bilateral

serous cystadenocarcinoma

170

This ovarian non-germ cell tumor is benign. It is a multilocular cyst lined by mucus-secreting epithelium

mucinous cystadenoma

171

This ovarian non-germ cell tumor is malignant. It can be associated with pseudomyxoma peritonei-intraperitoneal accumulaiton of mucinous material from ovarian or eppendiceal tumor

mucinous cystadenocarcinoma

172

This ovarian non-germ cell tumor is a benign tumor that resembles Bladdr epithelium.

Brenner tumor

173

This ovarian non-germ cell tumor consists of bundles of spindle-shaped fibroblasts

ovarian fibroma

174

what is Meigs syndrome

triad of ovarian fibroma, ascites, and hydrothorax

175

This ovarian non-germ cell tumor secretes estrogen which leads to precocious puberty (kids). It can cause endometrial hyperplasia or carcinoma in adults.

granulosa cell tumor

176

these "bodies" consisting of small follicles filled with eosinophilic secretions are characteristic of granulosa cell tumors

CAll-Exner bodies

177

this testicular non-germ cell tumor is benign. It contains Reinke crystals. It is androgen producing leading to gynecomastia in men and precocious puberty in boys.

Leydid cell tumor

178

this testicular non-germ cell tumor is benign. It is an androblastoma from sex cordd stroma.

Sertoli cell tumor

179

this testicular non-germ cell tumor is the most common testicular cancer in older men

testicular lymphoma

180

this breast dz presents with diffuse breast pain and multiple lesions, often bilateral. Bx shows fibrocystic elements. Usually does not indicate increased risk of carcinoma

fibrocystic breast dz

181

this histologic type of fibrocystic breast dz, manifests itself in hyperplasia of the breast stroma

fibrosis fibrocystic breast dz

182

this histologic type of fibrocystic breast dz, manifests itself in fluid filled cysts

cystic fibrocystic breast dz

183

this histologic type of fibrocystic breast dz, manifests itself in increased acini and intralobular fibrosis

sclerosing fibrocystic breast dz

184

this histologic type of fibrocystic breast dz, manifests itself in increased numbers of epithelial cell layers in terminal duct lobule. There is increased risk of carcinoma with atypical cells. it usually occurs in women over 30 y/o

epithelial hyperplasia fibrocystic breast dz

185

this benign tumor is the most common tumor of young women under 25 y/o. It is characterized by a small, mobile, firm mass with sharp edges. It may increase size and tenderness with pregnancy. It is not a precursor to breast cancer

fibroadenoma

186

this benign tumor is a large, bulky mass of connective tissue and cysts. Tumor may have "leaflike" projections

cystosarcoma phyllodes

187

this benign tumor is a tumor of the lactiferous ducts and presents with nipple discharge

intraductal papilloma

188

when do malignant tumors of the breast (carcinomas) usually occur in a womans life

postmenopausally

189

breast carcinomas can arise from either of these 2 tissues

mammary duct epithelium or lobula rglands

190

breast carcinomas may show an overexpression of these receptors which affect therapy and prognosis

estrogen/progesterone receptors or
erb-B2 (HER-2, an EGF receptor)

191

this histologic type of breast carcinoma refers to early malignancy without basement membrane penetration

ductal carcinoma in situ (DCIS)

192

this histologic type of breast carcinoma is very common. It presents as a firm, fibrous mass

invasive ductal, no specific type

193

this histologic type of breast carcinoma is ductal, with a cheesy consistency due to central necrosis

comedocarcinoma

194

this histologic type of breast carcinoma has lmphatic involvement and a poor prognosis

inflammatory

195

this histologic type of breast carcinoma is often multiple and bilateral

invasive lobular

196

this histologic type of breast carcinoma is fleshy, cellular, with lymphocytic infiltrates. It carries a good prognosis

medullary

197

this histologic type of breast carcinoma presents with eczematous patches on the nipple. On biopsy there are large cells with a clear halo. This type of malignancy is also seen on the vulva

paget's dz of the breast

198

what are some risk factors for breast carcinoma

gender, age, early 1st menarchy (30y/o), late menopause (>50y/o), family hx of 1st degree relative w/ breast cancer at a young age.

199

T or F. Fisk of breast carcinoma is not increased by fibroadenomas or nonhyperplastic cysts

T