repro Flashcards Preview

Step 1 > repro > Flashcards

Flashcards in repro Deck (46):
1

ACE inhibitor teratogen

REnal damage

2

alkylating agens teratogen

absence of digits, multiple anomalies

3

Aminoglycosides teratogen

CN VIII

4

carbamazepine teratogen

NTDs, craniofacial defects, fingernail hypoplasia, developmental delay, IUGR

5

DES teratogen

persistence of glandular epithelium in upper 1/3 of vagina --> vaginal clear cell adenocarcinoma, congenital mullerian anomalies

6

folate antagonists teratogen

NTDs

7

Lithium teratogen

Ebstein's (atrialized RV)

8

Phenytoin teratogen

Fetal hydantoin syndrome: microcephaly, dysmorphic craniofacial features, hypoplastic nails and distal phalanges, cardiac defects, IUGR, MR

9

Tetracyclines teratogen

discolored teeth

10

thalidomide teratogen

limb defects ("flipper")

11

Valproate teratogen

inhibition of maternal folate absorption --> NTDs

12

Warfarin teratogen

bone deformities, fetal hemorrhage, abortion, ophthalmologic
heparin doesn't cross placenta

13

maternal diabetse teratogen

caudal regression syndrome, congenital heart defects, NTDs

14

vitamin A excess teratogen

SABs, cleft palate, cardiac anomalies

15

XRT teratogen

microcephaly, MR

16

breast epithelium

two layers!
luminal cell (epithelium) -- protect duct and make milk in lobules
myoepithelial -- contractile

17

periductal mastitits

smokers --> relative vitamin A deficiency --> squamous metaplasia of lactiferous ducts --> inflammation behind blockage --> subareolar mass with granulation tissue --> nipple retraction

18

fat necrosis

trauma --> disruption --> saponification --> calcifications, giant cells.

19

fibrocystic change

hormone mediated, cystic change of lobules and terminal ducts.
hormone mediated.
"vague irregularity"
"blue dome cysts," fibrosis, cysts, apocrine metaplasia--> No increased risk for Ca!
Ductal hyperplasia (excess layers of epithelium) and sclerosing adenosis (too many glands, can be calcified) --> 2X risk
Atypical hyperplasia (ductal or lobular) --> 5X
NB incr risk of Ca is bilateral!

20

apocrine metaplasia

only metaplasia that doesn't incr risk for Ca

21

intraductal papilloma

small tumor that grows in lactiferous ducts, beneath areola
Serous or bloody d/c
slight inc in Ca risk
must distinguish from papillary carcinoma (will lose myoepithelial cells)

22

fibroadenoma

small, mobile, firm mass with sharp edges
mot common tumor in pre-menopausal women
incr size and pain with incr estrogen
Not pre-malignant

23

Phyllodes tissue

Large bulky mass of connective tissue and cysts with "leaf like projections" (similar to fibroadenoma, but overgrowth of fibrous component)
POST-menopausal women
CAN be malignant

24

DCIS

Ductal hyperplasia --> DCIS. Fills ductal lumen
Early malignancy w/o BM penetration
Comedo type has high grade cells with caseous necrosis and dystrophic calcification at center of ducts (detected on mammo)

25

Paget dz of nipple

excematous patches on nipple, ulceration.
Paget cells = large cells in epidermis with clear halo
Suggests underlying DCIS! (not true for Paget's of vulva

26

Invasive ductal Ca

most common type of invasive
p/w mass ("rock hard"), "stellate"
small, glandular, duct-like cells in desmoplastic stroma (connective tissue)
NB single cell type in epithelium = Ca

27

Inflammatory carcinoma

subtype of ductal Ca
looks like mastitis that doesn't resolve with Abx. peau d'orange
cancer present in dermal lymphatics --> blocks drainage
poor prognosis

28

Medullary Ca

high grade malignant cells with inflammatory infiltrate
incr in BRCA1
good prognosis

29

LCIS

malignant proliferation from lobule cells
no mass or calcifications (incidental finding)
lack of E-cadherin (CAM)
often multifocal and bilateral
Risk factor for carcinoma, moreso than true cancer
Tx: Tamoxifen and close follow up.

30

invasive lobular Ca

single-file pattern of invasion due to loss of E-cadherin.

31

staging of breast Ca

sentinel node Bx

32

HER2/neu

cell surface growth factor R
(vs Estrogen and progesterone, which are nuclear)
Gene amplification --> excess
trastuzumab = blocker

33

triple negative Ca

poor prognosis
afr am women

34

triple negative Ca

poor prognosis
afr am women

35

BRCA1

incr risk of medullary breast Ca
serous ovarian Ca (also fallopian tube)

36

BRCA2

breast carcinoma in males

37

epispadias

more rare than hypospadias
abnormal positioning of genital tubercle
associated with bladder exstrophy

38

Management of testicular mass

DONT biopsy (seeding of scrotum)
Vast majority are germ cell and malignant

39

seminoma

Germ cell tumor
large cells, clear cytoplasm, central nuclei "fried egg"
homogenous mass with no hemorrhage or necrosis
incr PLAP. radiosensitive, late mets = good prognosis

40

embryonal carcinoma

malignant, painful. primitive "embryo-like" cells. hemorrhage, early hematogenous spread
incr AFP or bhCG
CTX can cause to mature

41

yolk sac tumor

most common testicular tumor in children analogous to yolk sac ovarian tumor
"schiller-duval body" = glomeruloid.
elevated AFP

42

choriocarcinoma

synctiotrophoblasts (hCG) and cytotrophoblasts.
hCG --> hyperthyroidism or gynecomastia
mets to lungs (tiny mass in testicle, massive mets)

43

Teratoma

mature fetal tissue
2-3 embryonic layers
benign in females, malignant in males
AFP or hCG

44

Sertoli cell tumor

sex cord stromal tumor
tubules
clinically silen

45

leydig cell tumor

sex cord stromal tumor
androgen (precocious puberty or gynecomastia)
Reinke crystals

46

testicular lymphoma

most common testicular mass in male >60, often b/l
often DLBCL