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Endocrinology > Repro pathology > Flashcards

Repro pathology Flashcards

1
Q

Double Y male (XYY)

A
  • phenotypically nl
  • tall, severe acne, antisocial behavior
  • Normal fertility
  • Small percentage diagnosed w autism spectrum disorders
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2
Q

Female pseudoheramphrodite (XX)

A

Ovaries present, external genitalia are virilized or ambiguous
-Due to excessive/inappropriate exposure to androgenic steroids during early gestation (momma weight-lifter or BL Adrenal Hyperplasia)

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3
Q

Androgen insensitivity syndrome (46 XY)

A
  • Defect in androgen receptors
  • -> look like girls w rudimentary vagina but have testes, uterus/fallopian tubes absent
  • Incr T, Estrogen, LH (they’re all trying, and don’t have T receptors to neg. feedback on LH)
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4
Q

5alpha reductase deficiency

A
  • can’t make DHT - which is needed at the beginning for external genitalia (have ambigous genitalia)
  • At puberty, T is the main player, so see masculinization and incr growth of external genitalia
  • T and E levels are nl
  • LH is nl or incr
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5
Q

Complete hydatiform mole

A
  • 46 XX or 46 XY
  • enucleate egg + sperm that duplicates –> 2N
  • very high hCG, risk of choriocarcinoma
  • no fetal parts
  • path: cystic swelling of chorionic villi, proliferation of chorionic epithelium, “honeycombed” uterus or “cluster of grapes”. moles have “snowstorm apparance” on US.
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6
Q

Partial hydatiform mole

A

69 XXX, 69 XXY, 69 XYY

  • Partial fetal pars
  • 2 sperm + 1 egg
  • low risk of malignancy
  • path: cystic swelling of chorionic villi, proliferation of chorionic epithelium, “honeycombed” uterus or “cluster of grapes”. moles have “snowstorm apparance” on US
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7
Q

preclampsia

A

HTN, proteinura, edema
>20 wks gestation
-incr incidence in pts w preexisting HTN, diabetes, chronic renal ds, AI ds
-due to placental ischemia, impaired vasodilation of spiral arteries
-mortality due to cerebral hemorrhage and ARDS
-Hyperreflexia*

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8
Q

HELLP syndrome

A

Hemolysis
Elevated LFTs
Low Platelets

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9
Q

Abruptio placenta

A
  • premature detachment of placenta
  • assoc w DIC
  • incr risk w smoking, cocaine use, HTN
  • -> painful bleeding 3rd trimester
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10
Q

Placenta accreta

A
  • Defective decidual layer –> placenta attaches to myometrium
  • won’t detach when deliver –> massive bleeding after delivery
  • incr risk w prior C section, inflammation, placenta previa

“accreta sounds like concrete”

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11
Q

Placenta previa

A
  • placenta attached to lower uterus (can cover cervical os)
  • incr risk w multiparity, prior C section
  • -> painless bleeding, any trimester
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12
Q

Retained placental tissue

A

–> DIC, postpartum hemorrhage, incr risk of infxn

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13
Q

Risk factors for Cervical HPV cancer

A
  • # 1 multiple sexual partners
  • smoking
  • early first sex
  • HIV infxn
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14
Q

Endometrial c.

A

55-65 yrs of age

  • present w vaginal bleeding
  • RF: prolonged estrogen use, obesity, diabetes, HTN, nullparity, lage menopause
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15
Q

Follicular cyst

A
  • Most common ovarian mass in young women
  • Distention of unruptured graffian follicle
  • assoc w hyperestrinism, endometrial hyperplasia
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16
Q

Corpus luteum cyst

A

Hemorrhage into persistent corpus luteum

-typically regress spontaneously

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17
Q

Theca-lutein cyst

A

often BL, multiple

  • due to gonadotropin stimulation
  • Assoc w choriocarcinoma and moles
18
Q

Dermoid cyst - women

A

mature teratoma in ovary - benign

immature are malignant

19
Q

Dysgerminoma

germ cell tumor

A

-Ovarian tumor
-tumor markers: hCG, LDH
-Malignant
~male seminoma
-sheets of “fried egg” cells
-assoc w Turners

20
Q

Choriocarcinoma - WOMEN

germ cell tumor

A
  • malignancy of trophoblastic tissue; chorionic villi are not present
  • Incr frequency of theca-lutein cysts
  • Malignant
  • can develop during or after pregnancy in mother or baby
  • Early hematogenous spread to lungs
  • tumor marker: hCG
21
Q

Yolk sac (endodermal sinus) tumor
germ cell tumor
women!

A
  • aggressive malignancy of ovary (or testes-men, Sacrococygeal area-young children)
  • Yellow, friable, solid
  • Schiller-duval bodies (look like glomeruli)
  • tumor marker : AFP
22
Q

Brenner tumor

A
  • ovary
  • Looks like bladder
  • pale, yellow-tan
  • appears encapsulated
  • “coffee bean” nuclei
23
Q

Meig’s syndrome

A

-triad: ovarian fibroma, ascites, hydrothorax

24
Q

Sarcoma botryoides of vagina

A

girls <4yrs of age
-spindle shaped tumors
Desmin positive (Intermed filaments of muscle)

25
Q

Intraductual papilloma (benign)

A
  • small tumor, grows in lactiferous ducts
  • typically beneath areola
  • -> serous or bloddy nipple discharge
26
Q

Phyllodes tumor (benign)

A
  • Large bulky mass of CT and cysts
  • “Leaf like” projections
  • 60 yr old
  • may become malignant
27
Q

Comedocarcinoma (malignant)

A

subtype of Ductal Carcinoma In Situ (DCIS)

-ductal, caseous necrosis

28
Q

Invasive ductal breast ca.

A

-firm, fibrous “rock-hard” mass
-sharp margins
-small,glandular, duct-like cells
-“Stellate” morphology
worst and most invasive, most common

29
Q

Invasive lobular breast ca.

A

Orderly row of cells** “indian file”

-often BL, multiple lesions in same location

30
Q

medullary breast ca.

A

fleshy, cellular lymphocytic infiltrate

good prognosis

31
Q

Inflammatory breast ca.

A

Dermal lymphatic invasion

  • Peau d’orange
  • Neoplastic cells block lymphatic drainage
32
Q

Pagets ds of breast

A

Eczematous patches on nipples

  • Pagets cells: large cells in epidermis, clear halo
  • suggests underlying DCIS
  • can be seen on vulva
33
Q

Drugs that cause Gynecomastia

A

Some Drugs Create Awkward Knockers

Spironolactone
Digitalis
Cimetidine
Alcohol (by cirrhosis)
Ketoconazole
34
Q

Cryptochoridism

A
  • undescended testes
  • incr risk of germ cell tumors
  • assoc w premies
  • low inhibin, incr FSH and LH
  • BL: Testosterone decr / Unilteral: T nl
35
Q

Seminoma (malignant germ cell)

A
  • Painless, homogenous testicular enlargement
  • Most common
  • men 15-35 yrs
  • “fried egg”
  • Incr Placental Alk Phos (PLAP)
36
Q

Yolk sac (endodermal sinus) tumor MEN

A
  • yellow, mucinous
  • Schillder duval
  • tumor marker: AFP
37
Q

Choriocarcinoma - MEN

A
  • incr hCG – may cause gynecomastia in men (hcG as LH analog)
  • Hematogenous metastases to lungs
  • disordered syncytiotrophoblastic and cytotrophoblstic elements
38
Q

Teratoma in men

A

Mature teratoma more malignant (vs. in women) - benign in children
-Incr hCG and/or AFP

39
Q

Embryonal carcinoma of testes

A
  • malignant, painful (poor prognosis)
  • glandular/papillary morphology
  • “pure”: rare, incr hCG and nl AFP
  • usually mixed w other tumor types: incr AFP
40
Q

Leydig cell tumor

A
  • Contains Reinke crystals
  • androgen producing –> gynecomastia, precocious puberty in boys
  • golden brown color
41
Q

Testicular lymphoma

A
  • most common ca. in older men
  • a metastases from somewhere else
  • aggressve
42
Q

Spermatocele

A

Dilated epididymal duct

-presents as testicular mass, can be transilluminated

Endocrinology (4 decks)

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