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Flashcards in Repro Random facts Deck (97):
1

What causes a cleft palate?

Failure of fusion of the two lateral palatine processes or failure of fusion of lateral palatine processes with the nasal septum and/or median palatine process

2

What causes testes development?

SEY gene in Y chromosome produces testes determining factor

3

What secretes MIF?

Sertoli cells

4

Action of MIF

Suppresses development of paramesonephric ducts

5

What does the mesonephric duct become and what stimulates it to become this?

Seminal vesicles, epididymis, ejaculatory duct, ductus deferens. Stimulated by androgens from Leydig cells

6

Primary amenorrhea in a woman with fully developed secondary sexual characteristics

Mullerian agenesis

7

What causes development of the prostate?

DHT (so 5-alpha-reductase deficiency causes male internal genetalia, ambiguous external genetalia until puberty)

8

What does the genital tubercle become in men?

Glans penis and corpus cavernosum and spongiosum

9

What is the female homolog of the prostate gland?

Urethral and para urethral glands (of Skene)

10

What is the male homolog of the greater vestibular glands (of Bartholin)

Bulbourethral glands of Cowper

11

What is hypospadias associated with?

Inguinal hernia and cryptorchidism

12

Mehta causes epispadias?

Faulty positioning of genital tubercle

13

What do the urogenital folds become?

Ventral shaft of penis in men and labia minora in women

14

What causes a cleft lip?

Failure of fusion of the maxillary and medial nasal processes (formation of primary palate)

15

Lymph drainage of the proximal vagina/uterus

Obturator, external iliac, and hypogastric nodes

16

What is the other name for the suspensory ligament of the ovary?

Infundibulopelvic ligaments

17

What is the round ligament?

Connects the uterine funds to labia majora. Derivative of the gubernaculum. Travels through round inguinal canal; above artery of Sampson

18

Affects of temperature on Sertoli cells

Increased temperature causes decreased sperm production and decreased inhibin

19

Where are the Leydig cells?

In the interstitial between seminiferous tubules

20

What does androgen binding protein do and what secretes it?

Secreted by Sertoli cells, maintains local levels of testosterone (by binding and making it less lipophilic so it stays in the tubule)

21

What types of estrogen are made by the ovary, placenta, and adipose tissue and what is the potency?

Ovary: 17-beta-estradiol; placenta: estriol; adipose tissue: estrone via aromatization. Potency: Estradiol> estrone> estriol

22

Effect of SHBG on cholesterol

Increased transport proteins (SHBG) causes increased HDL and decreased LDL

23

Which cells in the female make androgens?

Theca interna cells

24

What enzyme is used to make androgens from cholesterol

Desmolase

25

Which cells make estrogens from androgens

Grnaulosa cells

26

Where are estrogen receptors located?

Cytoplasm (translate to the nucleus when bound by estrogen)

27

Regulation of prolactin by estrogen and progesterone

Estrogen stimulates prolactin secretion, fall in progesterone after delivery disinhibits prolactin

28

When is follicular growth the fastest?

During the 2nd week of the proliferative phase

29

Where is meiosis I arrested and until when?

Arrested in prophase I for years until ovulation

30

Where is meiosis II arrested and until when?

Metaphase II until fertilization

31

What secretes hCG?

Syncytiotrophoblasts.

32

When is hCG detectable?

Detectable in blood 1 weeks after conception and on home test in urine two weeks after conception

33

Why do double Y males and people taking exogenous testosterone have acne?

Androgens stimulate follicular epidermal hyperproliferation and excessive sebum production

34

What do you see in aromatase deficiency?

Masculinization of female infants, increased serum testosterone and androstenedione. Can present with maternal virilization during pregnancy (fetal androgens cross the placenta)

35

Inheritance of aromatase deficiency

Autosomal recessive

36

Inheritance of complete androgen insensitivity syndrome

X-linked

37

Inheritance of 5-alpha-reductase deficiency

Autosomal recessive

38

What is Kallmann syndrome?

Hypogonadotropic hypogonadism. Defective migration of GnRH cells and formation of olfactory bulb, decreased synthesis of GnRH in the hypothalamus; anosmia. Most common mutation in KAL-1 gene or fibroblast growth factor-1, which code for proteins required in this migration

39

Which antihypertensives do you use for gestational HTN?

Alpha-methyldopa, labetalol, hydralazine, nifedipine

40

What may be the cause of preeclampsia?

Abnormal placental spiral arteries ->endothelial dysfunction, vasoconstriction, ischemia

41

What might cause maternal death in eclampsia?

Storke, intracranial hemorrhage, or ARDS

42

What does the blood smear show in HELLP syndrome?

Schistocytes

43

Complication of HELLP syndrome?

Can lead to hepatic sub capsular hematomas-> rupture -> severe hypotension

44

Histology of sarcoma botryoides

Spindle-shaped cells; desmin positive

45

How does HPV lead to cancer?

E6 gene product (inhibits p53 suppressor gene); E7 gene product (inhibits RB suppressor gene)

46

White atrophic macules with "cigarette paper" quality

Lichen sclerosis et atrophicus

47

What is a follicular cyst

Distention of unruptured graafian follicle. May be associated with hyperestrogenism, endometrial hyperplasia

48

What is a Thea-lutein cyst?

Due to gonadotropin stimulation. Associated with choriocarcinoma and hydatidiform moles

49

Most common malignant ovarian tumor

Serous cystadenocarcinoma

50

What is a Brenner tumor?

A benign ovarian neoplasm, looks like bladder. "Coffee bean" nuclei on H&E sain

51

What is Meigs syndrome?

Triad of ovarian fibroma (benign, bundles of spindle-shaped fibroblasts), ascites, hydrothorax

52

What is an immature teratoma?

Malignant (vs mature teratoma, which is benign). Made up of fetal tissue, neuroectoderm.

53

Which type of ovarian tumor produces estrogen?

Granolas cell tumor

54

Cells arranged haphazardly around collections of eosinophilic fluid

Call-Exner bodies in a granolas cell tumor

55

What is pseudomyxoma peritonei and which type of tumor causes it?

Intraperitoneal accumulation of mutinous material from ovarian or appendiceal tumor, caused by a mucinous cystadenocarcinoma

56

Ovarian tumor with sheets of "fried egg" cells

Dygerminoma

57

What do you see in choriocarcinoma?

Malignancy of trophoblastic tissue (cytotrophoblasts, syncytiotrophoblasts); NO chorionic villi present

58

Yellow, friable (hemorrhagic), solid mass in a child

Yolk sac (endodermal sinus) tumor

59

Tumor with things resembling glomeruli

Yolk sac tumor (glomeruli: Schiller-Duval bodies)

60

Whorled pattern of smooth muscle bundles with well-demarcated borders

Leiomyoma

61

Treatment for endometritis

Gentamicin + clindamycin with or without ampicillin

62

What are the two layers of epithelium lining lobules and ducts?

Luminal cells and myoepithelial cells

63

Histology of a phyllodes tumor

Large, bulky mass of connective tissue and cysts. "Leaf-life" projections

64

Green-brown nipple discharge

Mammillary duct ectasia. Characterized by ductal dilatation, inspissated breast secretions, and chronic granulomatous inflammation in the predicate and interstitial areas

65

Does apocrine metaplasia increase the risk for breast cancer?

NO

66

What is sclerosing adenosis?

Increased acini and interlobular fibrosis. Associated with calcifications.

67

Tx for lactational mastitis

Dicloxacillin

68

Most common pathogen for lactational mastitis

S. aureus

69

Which drugs can cause gynecomastia?

Spironolactone, digoxin, cimetidine, alcohol, ketoconazole

70

What are Paget cells?

Large cells in epidermis with clear halo

71

"Stellate" infiltration

Invasive ductal carcinoma

72

Breast cancer with orderly rows of cells

Invasive lobular, due to decreased E-cadherin expression

73

What is a penile fracture?

Rupture of corpora cavernous due to forced bending

74

Tx of priapism

Corporal aspiration, intracarvernosa phenylephrine, or surgical decompression

75

Precursor lesions for penile squamous cell carcinoma

Bowen disease: in penile shaft, presents as leukoplakia; Erythroplasia of Queyrat: cancer of glans, presents as erythroplakia; Bowenoid papulosis: carcinoma in situ of unclear malignant potential, presenting as reddish papules

76

What is penile SCC associated with

HPV, lack of circumcision

77

Where do you see extragonadal germ cell tumors?

In adults- most commonly in retroperitoneum, mediastinum, pineal, and suprasellar regions. In infants and young children, sacrococcygeal teratomas are most common

78

Do you biopsy testicular tumors?

NO because of risk of seeding the scrotum

79

Testicular tumor with large cells in lobules with watery cytoplasm, no hemorrhage or necrosis. Increased placental ALP

Seminoma, with "fried egg" appearance cells

80

Prognosis of seminoma

Excellent. Radiosensitive, late metastasis

81

Most common testicular tumor in boys

Yolk sac (endodermal sinus) tumor. Has Schiller- Duval bodies

82

What symptoms might you see of choriocarcinoma in males?

Gynecomastia, symptoms of hyperthyroidism. (Disordered syncytiotrophoblastic elements produces hCG, which is structurally similar to LH, FSH, and TSH)

83

In males are mature teratomas benign or malignant?

Malignant in adult males, but benign in children

84

Testicular tumor that is hemorrhagic and necrotic

Embyonal carcinoma. Often glandular/papillary morphology

85

Reinke crystals (eosinophilic cytoplasmic inclusion)

Seen in Leydig cell tumors. These tumors usually produce androgens->gynecomastia in men, precocious puberty in boys. Golden brown color

86

Treatment of BPH

alpha-1-antagonists (terazosin, tamsulosin) which cause relaxation of smooth muscle; 5-alpha-reductase inhibitors (e.g. finasteride); PDE-5 Inhibitors

87

Which part of the prostate does adenocarcinoma usually arise from?

Posterior lobe (peripheral zone)

88

What should you give before starting leuprolide for prostate cancer?

Flutamide for androgen receptor blockade

89

MOA of clomiphene

Antagonist at estrogen receptors in hypothalamus. Prevents normal feedback inhibition and increases release of LH and FSH from pituitary, which stimulates ovulation

90

What is anastrozole

An aromatase inhibitor

91

MOA of mifepristone

Competitive inhibitor of progestins at progesterone receptors

92

What are terbutaline, ritodrine?

Beta-2-agoists that relax the uterus; used to decrease contraction frequency in women during labor

93

MOA of danazol

Synthetic androgen that acts as a partial agonist at androgen receptos

94

Clinical use of danazol

Endometriosis, hereditary angioedema

95

How is ketoconazole an anti androgen?

Inhibits steroid synthesis (inhibits 17,20-desmolase)

96

MOA of minoxidil

Direct arteriolar vasodilator

97

Clinical use of minoxidil

Androgenetic alopecia; severe refractory hypertension