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Flashcards in Repro Deck (96):
1

Sonic hedgehog gene

- Produced at base of limbs
- Anteroposterior axis and CNS development
- Mutation --> holoprosencephaly

2

Wnt-7 gene

- Produced at apical ectodermal ridge (distal limb)
- Dorsal-ventral exis

3

FGF gene

- Produced at apical ectodermal ridge
- Lengthening of limbs

4

Homeobox genes

- Code for TF
- Mutation --> appendages in wrong locations

5

ACEi during pregnancy

Renal damage

6

Alkylating agent during pregnancy

Absence of digits, multiple probs

7

Aminoglycosides

Ototoxicity

8

Antiepileptic drugs (Valproate, carbamazepine, phenytoin, phenobarbital)

Neural tube defects (high dose folate supplementation), cardiac defects, cleft palate, skeletal abnormalities

9

DES

Vaginal clear cell adenocarcinoma, congenital Mullerian anomalies

10

Folate antagonists (trimethoprim, methotrexate, antiepileptics)

Neural tube defects

11

Isotretinoin

Multiple severe birth defects
Conception mandatory

12

Lithium

EBSTEIN ANOMALY - apical displacement of tricuspid valve (decreased volume of RV, atrialization of RV)

13

Methimazole

Aplasia cutis congenita

14

Tetracyclines

Discolored teeth, inhibited bone growth

15

Thalidomide

Limb defects ("flipper" limbs)

16

Warfarin

Bone deformities, fetal hemorrahge, abortion, ophthalmologic abnormalities
- USE HEPARIN IN PREGNANCY

17

Alcohol in pregnancy

FAS - intellectual disability, pre- and postnatal development retardation, microcephaly, smooth philtrum, thin upper lip, small palepbral fissures, limb dislocation, heart defects, heart-lung fistulas, holoprosencephaly
- Failure of cell migration

18

Cocaine in pregnancy

Low birth weight, preterm birth, IUGR, placental abruption
- Causes vasoconstriction

19

Smoking in pregnancy

Low birth weight, preterm labor, placental problem, IUGR, SIDS
- Nicotine --> vasoconstriction
- CO --> impaired O2 delivery

20

Iodine (lack or excess) in pregnancy

Congenital goiter/hypothyroidism (cretinism)

21

Maternal Diabetes

- Caudal regression syndrome (anal atresia, sirenomelia), congenital heart defects, neural tube defects, macrosomia

22

Methylmercury (from swordfish, shark, tilefish, king mackerel) in pregnancy

Neurotoxicity

23

Vitamin A excess in pregnancy

Spontaneous abortions, birth defects (cleft palate, cardiac probs)

24

X-rays in pregnancy

Microcephaly, intellectual disability

25

Urachus

- Fetal bladder --> umbilicus
- Patent urachus --> urine discharge from umbilicus
- Urachal cyst, vesicourachal diverticulum

26

Vitelline Duct

Yolk sac --> midgut lumen
Vitelline fistula --> meconium discharge from umbilicus
- Meckel diverticulum

27

Cleft Lip

Failure of fusion of maxillary and medial nasal processes

28

Cleft Palate

Failure of fusion of two lateral palatine shelves or failure of fusion of lateral palatine shelves with nasal septum and/or medial palatine shelf

29

Mullerian Agenesis (Mayer-Rokitansky-Kuster-Hauser Syndrome)

Primary amenorrhea (lack of uterine development) in females with fully developed secondary sexual characteristics (functional ovaries)
- Paramesonephric duct prob

30

Gartner Duct

Remnant of mesonephric duct in females

31

Male remnant of paramesonephric duct

appendix testis

32

No sertoli cells or lack of mullerian inhibitory factor

Testes + no MIF
- Develop both male and female internal genitalia
- Develop male external genitalia

33

5-alpha reductase deficiency

Inability to convert testosterone to DHT
- Male internal genitalia, ambiguous external genitalia until puberty (increased testosterone causes masculinization)
- Testosterone/estrogen levels normal
- LH is normal or increased
- Internal genitalia normal

34

Hypospadias

Failure of URETHRAL FOLDS to fuse
- Assoc. w/ inguinal hernia and cryptorchidism

35

Epispadias

Faulty position of GENITAL TUBERCLE
- Assoc. w/ exstrophy of the bladder

36

Gubernaculum

Male: anchors testes
Female: ovarian ligament + round ligament of uterus

37

Processus vaginalus

Forms tunica vaginalis in male

38

What drains to para-aortic lymph nodes?

Ovaries/testes

39

What drains to external iliac nodes?

Body of uterus
Cervix
Superior bladder

40

What drains to internal iliac nodes?

Prostate
Cervix
Corpus cavernosum
Proximal vagina

41

What drains to superficial inguinal nodes?

Distal vagina
Vulva
Scrotum
Distal anus

42

What drains to deep inguinal nodes?

Glans penis

43

Infundibulopelvic Ligament (Suspensory Ligament of the Ovary)

Ovary --> lateral pelvic wall
- OVARIAN VESSELS
- Ligate during oophorectomy
- Ureter courses retroperitoneally (close to gonadal vessel) --> can injure during ligation

44

Cardinal Ligament

Cervix --> side wall of pelvis
- UTERINE VESSELS
- Ureter at risk of injury during ligation in hysterectomy

45

Round ligament of uterus

Uterine fundus --> labia majora
- GUBERNACULUM
- travels through round inguinal canal

46

Broad ligament

Uterus/fallopian tubes/ovaries --> pelvic side wall
- OVARIES, FALLOPIAN TUBES, ROUND LIGAMENT OF UTERUS
- Mesosalpinx, mesometrium, mesovariu

47

Ovarian ligament

Medial pole of ovary --> lateral uterus
- GUBERNACULUM

48

Posterior Urethral Injury

- Pelvic fracture
- Membranous urethra
- Urine --> retropubic space

49

Anterior Urethral Injury

- Perineal straddle injury
- Bulbar/penile urethra
- Urine --> deep fascia of Buck --> if torn, superficial perineal space

50

Placental Aromatase Deficiency
- 46 XX infant with ambiguous genitalia

Inability to synthesize estrogens from androgens
- Increased testosterone and androstenedione
- Can present with maternal virlization during pregnancy (fetal androgens cross placenta)

51

Kallmann Syndrome
- Failure to complete puberty
- Anosmia
- Infertiliry

- Hypogonadotropic hypogonadism
- Defective migration of GnRH cells and formation of olfacotry bulb
- Decreased GnRH synthesis in hypothalamus
- Decreased GnRH, FSH, LH, testosterone

52

Presentation of Choriocarcinoma

- Abnormally high beta-hCG, SoB, hemoptysis
- Malignancy of trophoblastic tissue, NO chorionic villi
- Increased frequency of bilateral/multiple theca-lutein cysts

53

Bartholin Cyst

Vulva
- Unilateral lesion in lower vestibule, painful, adjacent to vaginal canal
- Women of reproductive age

54

Lichen Sclerosis

- Thinning of epidermis and fibrosis of dermis
- BENIGN - slightly increased risk of SCC
- Leukoplakia w/ parchment-like vulvar skin
- POST-menopausal women

55

Lichen Simplex Chronicus

- Hyperplasia of vulvar squamous epithelium
- BENIGN - NO increased risk of SCC
- Leukoplakia w/ thick, leathery vulvar rash
- From chronic irritation and scratching

56

Vulvar Carcinoma

- HPV related (16, 18) - VIN (dysplasia), 40-50 yo
- Non-HPV related = long-standing lichen sclerosis - older > 70
- Presents as leukoplakia (need bx to distinguish)

57

Vaginal SCC

- Secondary to cervcial SCC (high risk HPV)

58

Vaginal clear cell adenocarcinoma

DES in utero
- Clear cytoplasm

59

Sarcoma botryoides (embryonal rhabdomyosarcoma variant)

- Girls

60

CIN Stages for Cervical Carcinoma

- CIN: koilocytic change, nuclear atypia, increased mitotic activity (dysplasia)
- CIN1: first 1/3
- CIN2: middle 2/3
- CIN3: most of epi
- CIS: entire epi (NOT reversible)

61

RF for Cervical Carcinoma

Multiple sexual partners!!! smoking, intercourse at young age, HIV, immunodeficiency

62

Premature Ovarian Failure

- Premature atresia of ovarian follicles in women of reproductive age
- Signs of menopause after puberty but before age 40
- Decreased estrogen, increased LH & FSH

63

Follicular Cyst
- Most common ovarian mass in young women

- Distention of unruptured graafian follicle
- Assoc. w/ hyperestrogenism, endometrial hyperplasia

64

Theca-Lutein Cyst

- Due to gonadotropin stimulation
- Assoc. w/ choriocarcinoma and hyatidiform moles

65

CA-125

Ovarian neoplasm

66

Most common ovarian neoplasm

Serous cystadenoma

67

Most common ovarian tumor in females 10-30

Mature cystic teratoma (dermoid cyst)

68

Struma ovarii

Monodermal teratoma with thyroid tissue --> hyperthyroidism

69

Meigs Syndrome

Ovarian fibroma + ascites + hydrothorax

70

Most common malignant stromal tumor

Granulosa cell tumor
- CALL EXNER BODIES

71

Most common malignant ovarian neoplasm

Serous cystadenocarcinoma
- PSAMMOMA BODIES

72

Pseudomyxoma peritonei

Intraperitoneal accumulation of mucinous material from ovarian or appendiceal tumor

73

Dysgerminoma tumor markers

hCG, LDH
"Fried egg" cells

74

Yolk Sac (endodermal sinus) tumor markers

AFP
Schiller-duval bodies
Kids

75

Krukenberg tumor

GI mets to ovaries --> mucin-secreting signet cell adenocarcinoma

76

Asherman Syndrome

Secondary amenorrhea due to loss of basalis (regenerative layer) and scarring
- Result of overaggressive D & C

77

Most common tumor in females

Endometrial leiomyoma (fibroid)
- Whorled pattern

78

Greatest RF in endometrial hyperplasia

Nuclear atypia

79

Most common gynecologic malignancy

Endometrial carcinoma

80

Fibrocystic changes --> risk for invasive carcinoma

NO RISK: fibrosis, cysts, apocrine metaplasia
2x RISK: ductal hyperplasia, sclerosing adenosis (calcified)
5x RISK: atypical hyperplasia

81

Intraductal Papilloma

- BLOODY discharge
- Small papillary tumor within lactiferous ducts
- Slight increased risk for cancer
- Pre-menopausal

82

Phyllodes Tumor

Large mass of CT and cysts with "leaf-like" lobulations
- Most common in fifth decade
- Some may become malignant

83

Periductal Mastitis

- Inflammation of subareolar ducts
- SMOKERS - Vit A deficiency --> keratin plugs tube
- Subareolar mass with nipple retraction

84

Mammary Duct Ectasia

- GREEN/BROWN NIPPLE DISCHARGE
- Plasma cells
- Inflammation with dilation of subareolar ducts
- Multiparous postmenopausal women

85

Peyronie Disease

Abnormal curvature of penis due to fibrous plaque within tunica albuginea
- ED, pain, anxiety

86

Bowen DZ

SCC in penile shaft --> presents as leukoplakia

87

Erythroplasia of Queyrat

SCC in glans --> presents as erythroplakia

88

Bowenoid papulosis

CIS of unclear malignant potential --> presents as reddish papules

89

Seminoma Marker

Placental ALP

90

Yolk Sac Tumor Marker

AFP
Schiller Duval Bodies

91

Most common testicular tumor in boys

Yolk sac tumor

92

Leydig Cell Tumor

Reinke crystals

93

Most common testicular cancer in old men

Lymphoma

94

Most common site of BPH

Periurethral zone (lateral and middle lobes)

95

Causes of orchitis/prostatits

Young/sexually active: Chlamydia, GC
Old/UTI: E. coli, psuedomonas

96

Most common site of prostatic adenocarcinoma

Posterior lobe (peripheral zone)
- PAP and PSA tumor markers
- Increased serum ALP and PSA