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Flashcards in Reproduction Deck (133):
1

connects cervix to pelvic side wall

cardinal ligament

2

connects the ovaries to the lateral pelvic wall

suspensory ligament

3

connects the uterus, fallopian tubes, and ovaries to the pelvic side wall

broad

4

contains the uterine vessels

cardinal ligament

5

contains the ovarian vessels

suspensory ligament

6

testicular cancer first mets to

peri-aortic lymph nodes

7

what develops from mesonephric ducts

male internal genitalia except prostate

8

male homologue to:
vestibular bulbs
labia minora
bartholin glands
urethral and paraurethral glands (of Skene)

corpus cavernosum and spongiosum
ventral shaft of penis
bulbourethral glands
prostate gland

9

what gene product comes from the SRY gene that underlies male genital development

testis determining factor

10

anchors testes to the scrotum

gubernaculum

11

pulsing schedule of GnRH affects gonadotropin release how

pulsatile: increase release
continuous: decrease/stop release

12

difference btw androgen insensitivity and 5-alpha-reductase deficiency

androgen insensitivity: female genitalia, but genetically male.
5-a-reductase: male genitalia that are hypodeveloped until puberty causes a large increase in testosterone

13

sertoli and leydig cells

LH -> leydig cells -> testosterone
FSH -> sertoli cells -> androgen binding protein (keeps testosterone in testicle)

14

testicular tumor composed of cytotrophoblasts and syncytiotrophoblasts

choriocarcinoma

15

may present initially with gynecomastia in males

leydig cell tumor

16

elavated AFP in males

yolk sac, teratoma

17

elevated BhCG in males

choriocarcinoma, embryonal and teratoma

18

most common testicular cancer

seminoma

19

most common testicular tumor in infants and children up to 3yrs of age

yolk sac

20

most common testicular tumor in men over age 60

testicular lymphoma

21

histologic appearance similar to koilocytes (cytoplasmic clearing)

seminoma

22

histologically may have alveolar or tubular appearance sometimes with papillary convolutions

embryonal carcinoma

23

composed of multiple tissue types

teratoma

24

histologic endodermal sinus structures (Schiller-Duval bodies) in males

yolk sac tumor

25

25% have cytoplasmic rod-shaped crystalloids of Reinke

leydig cell

26

androgen-producing and associated with precocious puberty (test cancer)

leydig cell, may be sertoli

27

what is the major side effect of sildenafil

life threatening hypotension when combined with nitrates

28

balanitis is caused by what bug

candida albicans

29

difference between finasteride and flutamide

finasteride is 5areductase inhibitor (BPH, male pattern baldness)
flutamide inhibits testosterone receptor (treat prostate cancer)

30

most common cancer in men

prostate cancer

31

most common cause of urinary obstruction in men

BPH

32

most common treatment for erectile dysfunction

phosphodiesterase inhibitor (sildenafil)

33

layers of endometrium

stratum compactum
stratum spongiosum
stratum basale
the compactum and spongiosum are shed monthly

34

two-cell theory of estradiol production

FSH -> granulosa cell -> aromatase (androstenedione) -> estrogen
LH -> theca cell -> makes androstenedione

35

30 year old woman presents with a low grade fever, a rash across her nose that gets worse when she is out in the sun, and widespread edema. What blood test would you order to confirm your clinical suspicion?

ANA to screen for lupus

36

appearance of HPV infection

koilocytic change: perinuclear halo

37

dysplastic cervical cells with enlarged, dark nuclei

koilocytes

38

Diethylstilbestrol (DES)

clear cell adenocarcinoma of vagina

39

what are the risk factors for endometrial carcinoma

HHONDA
hyperplasia
HTN
obesity
nulliparity
diabetes
anovulatory state

40

excess unopposed estrogen is the main risk factor

endometrial proliferation and cancer

41

menorrhagia with an enlarged uterus and no palpable pain

fibroid (leiomyoma)

42

pelvic pain that presents only during menstruation

endometriosis

43

diagnosed by endometrial biopsy in clinic

endometrial hyperplasia and cancer

44

definitive diagnosis and treatment is by laparoscopy

endometriosis

45

menstruating tissue within the myometrium

adenomyosis

46

malignant tumor of the uterine smooth muscle

leiomyosarcoma

47

most common tumor in women

leiomyoma

48

most common gynecologic malignancy in the US

endometrial carcinoma

49

most common gynecologic malignancy worldwide

cervical carcinoma

50

chocolate cyst of the ovary

endometriosis

51

what is the underlying cause of PCOS?

increased LH and decreased FSH -> lack of ovulation

52

a young woman is found to have short stature and shortened 4th and 5th metacarpals. What endocrine disorder is most likely responsible for these manifestations?

albright hereditary osteodystrophy
(type1a pseudohypoparathyroidism)

53

ovarian tumor produces AFP

yolk sac (endodermal)

54

estrogen secreting ovarian tumor leading to precocious puberty

granulosa cell

55

intraperitoneal accumulation of mucinous material

mucinous cystadenocarcinoma

56

testosterone secreting, leading to virilization

sertoli-leydig cell

57

psammoma bodies in ovary

serous cytadenocarcinoma

58

multiple different tissues in tumor

teratoma

59

ovarian tumor lined with fallopian tube-like epithelium

serous cystadenoma

60

ovarian tumor + ascites + hydrothorax

fibroma (Meig's syndrome)

61

call-exner bodies in ovarian tumor

granulosa cell

62

resembles bladder epithelium ovarian tumor

brenner tumor

63

ovarian tumor with elevated BhCG

choricarcinoma and dysgerminoma

64

risk factors for ovarian tumors

uninterrupted ovulation, nulliparity, early menarche, late menopause, family hx (BRCA1/2, HNPCC (lynch syndrome))

65

persistantly wet umbilicus in infant

patent urachus

66

CO and plasma volume changes in pregnancy

CO increases 30-50%
plasma volume increases 50%

67

elevated AFP on maternal serum screen

neural tube defects, twins, abdominal wall defects
incorrect dating is largest cause of false test results

68

monozygotic twins are delivered. one is pale with a hematocrit of 15%, the other is flushed with hematocrit of 55%. what is the cause

twin-twin transfusion syndrome

69

causes of recurrent miscarriage

low progesterone
chromosomal abnormalities
uterine abnormalities
infections
poor mental health
autoimmune/clotting disorders

70

16wks pregnant women presents with atypically large abdomen and HTN. what might be the cause and how would it appear on blood test

hydatidiform mole
increased hCG

71

placenta previa, abruptio, accreta

previa: placenta over os (painless bleeding)
abruptio: early separation of placenta (painful bleeding, motor vehicle accident most common cause)
accreta: no decidua, placenta goes straight to myometrium

72

previous c-section increases risk for

placenta previo and accreta

73

HTN drugs during pregnancy

hydralazine, methyldopa, labetalol

74

Db drugs during pregnancy

insulin is gold standard

75

Epilepsy drugs during pregnancy

whatever best controls seizures. more defects without meds then with except valproic acid
supplement with folic acid (up to 4 grams)

76

hyperthyroidism drugs in pregnancy

propylthiouracil (PTU) 1 trimester
methimazole (2 and 3 trimester)

77

anticoagulation in pregnancy

heparin or enoxaprim
do not use warfarin

78

tocolysis

prevent uterine contractions
indomethacin, nifedipine, terbutaline, magnesium sulfate

79

labor promotion

pitocin
prostaglandins (dinoprostone (PGE2) misoprostol (PGE1))
tox: tachysystole, uterine rupture, fever

80

pregnancy termination

dilation and curretage
mifepristone (RU-486): inhibitor of progesterone receptor + misoprostol to ensure complete abortion
methotrexate: inhibits folate production

81

evaluation of infertility, semen analysis is normal and she has a history of pelvic inflammatory disease. What is next step?

hysterosalpingogram to evaluate patency of fallopian tubes

82

prenatal US finding is clue to Down syndrome

nuchal translucency

83

most common genetic event that causes Down syndrome

meiotic nondisjunction

84

Fragile X syndrome gene defect

FMR1

85

clinical features of Fragile X syndrome

macrochordism, long face, long jaw, everted ears, mitral valve prolapse, autism

86

elfin facies, hypercalcemia, exreme friendliness, valvular defects

Wilson disease

87

22q11

CATCH
Cleft lip/palate
Abnormal facies
Thymus/T cell deficiency
Cardiac defects
Hypocalcemia

88

Klinefelter v Turner

Klinefelter: 47 XXY testicular atrophy, gynecomastia, long arms, tall
Turner 46 XO short stature, webed neck, shield chest

89

most common genetic cause of intellectual disability

trisomy 21

90

second most common genetic cause of intellectual disability

Fragile X

91

horseshoe kidney, congenital heart defects, streak ovaries, and cystic hygroma

Turner syndrome

92

rocker-bottom feet, clenched hands, microcephaly with prominent occiput and small jaw

trisomy 18

93

cause of headache in pt using topical retinoic acid for acne

pseudotumor cerebri

94

genetic defect for achondroplasia

FGFR3

95

defect causes hereditary spherocytosis

spectrin or ankyrin protein defect

96

floppy mitral valve, dissecting aortic aneurysm, berry aneurysm

Marfan

97

mitral valve prolapse, liver disease, berry aneurysm

ADPKD

98

neural tumors and pigmented iris hamartomas

neurofibromatosis type I

99

association with colon cancer

Familial adenomatous polyposis

100

MI before age 20

familial hypercholesterolemia

101

hemangioblastoma of retina/cerebellum/medulla

von-Hippel Lindau disease

102

increased MCHC, hemolytic anemia

hereditary spherocytosis

103

bilateral acoustic neuromas

neurofibromatosis type II

104

facial lesions, seizure disorder, cancer risk

tuberous sclerosis

105

caudate atrophy, dementia

Huntington's

106

cystic medial necrosis of the aorta

marfan

107

defect of fibroblast growth factor receptor 3

achondroplasia

108

trinucleatide repeat disorders

Fragile X: CGG
Friedrich: GAA
Huntington: CAG
Myotonic dystrophy: CTG

109

gene defect in cystic fibrosis

CFTR gene on chromosome 7

110

test used to diagnose cystic fibrosis

sweat Cl test

111

invasion of dermal lymphatics -> visible changes

inflammatory carcinoma
signs of Peau d'orange, dimpling of breast, nipple retraction (new)

112

causes of gynecomastia

drugs (STACKED), puberty, cirrhosis, testicular tumors, Klinefelter

113

acute mastitis

S. aureus

114

intraductal papilloma common complaint

straw colored nipple discharge that may be bloody

115

most common breast tumor in women under 25

fibroadenoma

116

most common breast mass in postmenopausal women

invasive ductal carcinoma

117

most common breast mass in premenopausal women

fibrocystic disease

118

most common form of breast cancer

invasive ductal carcinoma

119

small, mobile, firm mass with sharp edges in 24-year-old woman

fibroadenoma

120

histological "leaf-like projections"

phyllodes

121

signet ring cells

lobular carcinoma in situ

122

loss of e-cadherin cell adhesion gene on chromosome 16

invasive lobular carcinoma

123

always ER (+) and PR (+)

invasive lobular and LCIS

124

commonly presents with nipple discharge

intraductal papilloma

125

eczematous patches on nipple

Paget's with DCIS

126

multiple bilateral fluid-filled lesions with diffuse breast pain

fibrocystic change

127

firm, fibrous mass in a 55-year-old woman

invasive ductal

128

most common cancer in women in the US

breast

129

most common benign breast tumor

fibroadenoma

130

most common malignant breast tumor

invasive ductal

131

blue dome cyst in the breast

fibrocystic change

132

treatment for ER(+) breast cancer

tamoxifen

133

red, itchy, swollen rash on the areola and nipple

Paget disease