Reproduction Final Flashcards Preview

Tim's Cards > Reproduction Final > Flashcards

Flashcards in Reproduction Final Deck (121):
1

Name the 2 risk factors for cancer among the benign lesions of the Breast.

Atypical Epithelial Hyperplasia

Multiple Intraductal Papillomas

(underneath nipple in dilated lactiferous sinuses)

2

Who is more likely to get a Fibrocystic Change in the breast?

Older women

3

The pathogenesis of Fibrocystic Change in the breast is related to what?

Sex Hormones

*why improvement after menopause

4

Are Fibrocystic Changes to the breast generally bilateral or unilateral?

Bilateral

*symmetrical, usually affecting both breasts

5

Fibrocystic Changes of the breast are seen between what ages?

Onset of puberty to menopause

*Sex hormone related

6

How does the progesterone/estrogen imbalances that cause the pathogenesis in Fibrocystic breast changes affect the tissue?

What 3 areas are affected?

Stimulates proliferation of cells

Excretory ducts, Lobules, and Intralobular stroma

7

What is the only risk factor that occurs in Fibrocystic breast change that leads to cancer?

Atypical Epithelial Hyperplasia

*more atypical, greater risk

**Atypical = multilayered

8

T/F
The most constant feature of fibrocystic change in the breast is Fibrosis

True

9

T/F
10-15% women between 20-50 have fibrocystic change

True

10

What are the presenting clinical features of Fibrocystic changes to the breast?

(5 things)

Blue-Domed Cysts

Both breasts

Pain, nodularity, palpation sensitivity

Easily palpated

Calcification (difficult to distinguish from cancer)

11

What is the most common presenting feature of Intraductal Papillomas?

Bloody/Serous nipple discharge

*secondarily sub-areolar mass

12

Non-pregnant woman with Bloody or Serous discharge from the nipple...

Intraductal Papilloma

13

Multiple papillomas are associated with an increased risk of ________. ______ are benign.

Papillary carcinomas

Solitary

14

What is the most common benign tumor of the breast?

Fibroadenoma

15

A fibroadenoma is made up of what two components?

Fibrous stroma

Glandular epithelium

16

T/F
Fibroadenomas are well-encapsulated, spherical, and freely moveable (which distinguishes them from cancers).

True

17

Fibroadenoma is most often seen in what demographic?

Young women

18

Fibroadenoma is most often in what location?

(this is also the most common location for breast cancer)

Upper Outer quadrant

19

Fibrosis and Blue-Domed cysts are seen in _______, NOT ______.

Fibrocystic disease

Fibroadenoma

20

What is the most common etiology behind fat necrosis of the Breast?

Trauma

21

What is the term for male breast cancer?

Gynecomastia

22

Gynecomastia is a ductile cancer because what is absent?

Lobules

23

What is Gynecomastia associated with?
(2 things)

Hormonal changes/puberty

Excess Estrogen (tumors/cirrhosis)

24

How does Gynecomastia present?

Fibrous cap under areola

25

T/F
Sex, Age, and Race are all risk factors for Breast Cancer

True

*peaks at 60

26

What ethnic bias does Breast cancer have?

Uncommon Japanese and Chinese, most common Caucasians and Jews

27

Other than Sex, Age, and Race, what are 5 risk factors for Breast Cancer?

Genetics (5-10 fold)

Hormonal (Estrogen - Tamaxaphen)

Other cancers (ovarian/endometrial)

Atypical Epithelial Hyperplasia/Multiple Intraductal Papillomas

Obesity, high fat diet, moderate EtOH consumption

28

What is the most common location for breast cancer?

Upper Outer quadrant (45%)

(25% central, under areola)

29

2/3 of Breast Cancers are of what type?

Invasive Ductal Carcinomas

*Desmoplastic rxn host response

30

What defines the difference between an In Situ lesion and and Invasive/Infiltrating lesion?

Breaching of Basement Membrane

31

T/F
90% of breast cancers metastasize via the lymphatics

True

32

Where does Breast cancer generally drain?

Axillary lymphatics

33

Distant breast metastases are common in what 5 areas?

Lungs

Liver

Bone

Brain

Adrenals

34

Lumpectomy is limited to resection of the tumor and what?

Mastectomy removes the entire breast and what?

Surrounding fat tissue

Axillary lymph node resection

35

In a Mammography, aside from looking for a Mass, what else are we looking for?

Calcification around the mass

*Spicules

36

Where are the primordial germ cells?

In the wall of yolk sac near the allantois

37

After the primordial germ cells leave the yolk sac and migrate to the gonadal ridges and penetrate into the primitive gonad, what do they become?

Cells that create spermatagonia, and eventually, sperm cells.

38

The epithelium of the genital ridge proliferates and penetrates the underlying mesenchyme to form what?

Primitive Sex cords

39

In the presence of the SRY gene, the primitive sex cords differentiate into what?

Medullary cords

Testicular seminiferous tubules

40

The medullary cords created from the Primitive Sex Cords further differentiate into what 4 structures?

Testicular seminiferous tubules

Rete testis

Efferent ducts

Vas deferens

41

What fibrous connective tissue separates the testes cords from the epithelium?

Tunica Albuginea

42

What is the function and location of Sertoli cells?

Leydig cells?

Support, nutrition - between germ cells

Testosterone secretion - between seminiferous tubules

43

Mesonepheric Ducts aka...

Paramesonephric Ducts aka...

Wolffian

Mullerian

44

What type of epithelium histologically allows for the propulsion of sperm from the Efferent ducts > Epididymis > Vas Deferens?

Ciliated Pseudostratified Columnar Epithelium

*surrounded by smooth muscle

45

What is the term for the congenital malpositioning of the testes outside normal scrotal location?

(most important congenital abnormality relating to testes)

Crytorchidism

46

T/F
Descent of testes may stop at any point and 4% newborns have condition

True

*also unilateral common, 1/4 bilateral

47

In Cryptorchidism, what % arrest in the High Scrotal Sac?

% inguinal canal?

% abdominal cavity?

60%

25%

15%

48

T/F
Most crytorchid children have testes descend within the 1st year, and condition in adults is less than 0.4%.

True

49

T/F
The decreased diameter of seminiferous tubules along with the decrease in germ cells can lead to Infertility in Cryptochidism

True

50

What 2 types of tumors are increased 10-35 times in untreated cryptorchidism?

Seminoma

Embryonal Cercinoma

(Germ Cell Tumors)

51

What are the 2 most feared complications of Cryptorchidism?

Infertility

Germ Cell Tumors

52

Most testicular tumors are ______, and a small % are ______.

Seminomas

Embryonal Carcinomas

53

Malignant transformation into Seminomas or Embryonal Carcinomas can happen in what 2 cases/states of Cryptochidism?

Non-descended testis

Delayed normally descended testis

54

What is defined by male hypogonadism?

Klinefelter Syndrome

55

Klinefelter's Syndrome occurs when there is what pairing of chromosomes?

2 or more X

1 or more Y

**XXY most common

56

T/F
Klinefelter's is rarely diagnosed before puberty

True

57

Gynocemastia, lack of beard/body hair, female hips, long arms, testicular/penile atrophy, long legs, and lack of pubic hair all are physical characteristics of what?

Klinefelter's Syndrome

*lack all secondary sex characteristics

**mean IQ somewhat lower, retardation uncommon

58

T/F
plasma FSH is increased and testosterone is decreased in Klinefelter's

True

59

What is the reproductive status of Klinefelters?

Infertile

*testicular tubules totally atrophied with hyaline

60

What is the classic Karyotype of Klinefelter?

Results from paternal or maternal nondisjunction?

47 XXY

50/50 split maternal/paternal

61

Hydrocele, Spermatocele, and Hematocele are different flavors of what?

Cystic Scrotal Masses

62

A Hydrocele is a clear serous accumulation between what 2 layers?

(spontaneous)

Tunica Vaginalis

Testis or Epididymis

63

Spermatocele is a cystic accumulation of semen in what 2 possible places?

Dilated efferent ductules

Ducts of rete testis

64

A Hematocele accumulates blood where?

What causes?

Between Tunica Vaginalis layers

Trauma

65

Histologically, what is the Spermatocele cyst lined with?

Cuboidal epithelium

*contains spermatozoa in various developmental stages

66

What can result from testicular torsion, tumors, or infections?

Hematocele

67

Phimosis =

Strangulation

68

T/F
Hydrocele can be either congenital or acquired, and the compression can lead to atrophy

True

69

If torsion of the Testes is severe enough, what can it cause?

Infarction (obstruction) of testicular Germ Cells

70

How doe testicular Torsion present?

Severe pain, usually a few hours after vigorous exercise

Then swelling

*once Tunica Albuginea black - amputation

71

Dysplastic lesions (Bowen Disease) on the glans and prepuce are known as what?

This occurs only in ______.

Erythroplasia of Queyrat

Uncircumcised

72

What is a major risk factor in penile cancer?

Smegma

HPV 16 and 18

73

Since penile cancer is an extension of the skin, it is...

Squamous Cell Carcinoma

*presents as ulcerated hemorrhagic mass on glans/prepuce

**most well-differentiated

74

Buzzwords:
Herpes:

Chancre:

Koilocytosis

Vescicles

Syphylis

HPV

75

What is the Etiology of Peyronie Disease?

Unknown

*focal, asymmetric, penile curvature

*collagen slowly replaces muscle

**question mark

76

What far advanced disease results in General Paresis (brain spirochetes), Gummas (granulomas), and Tabes Dorsalis (spirochetal damage to sensory nerves)

Tertiary Syphilis

77

What are the 2 most common organisms that cause PID?

Gonococcus

Chlamydia

78

What are the 2 most common complications of PID?

Sterility and Ectopic Pregnancy

79

Chondylomata Lata:

Maculopapular Rash:

Secondary Syphylis

Secondary Syphyllis

80

Why do many women get PID?

GC and Chlamydia are asymptomatic in women

81

What agar would one use to plate a GC swab?

Chocolate/Thayer-Martin

82

T/F
Trichimonas vaginalis is only seen in a trophozoite form

True

**no cyst form

83

What type of organism is Trichomonas vaginalis?

Protozoan

84

Describe Trichomonas vaginalis

Pear shaped protozoan, anterior flagella

85

Who is most likely to get Trichomonas vaginalis?

Least likely?

Sexually active women

Postmenopausal women

86

Herpes symplex I or II has what 2 characteristics?

Latency

Cytopathic effect (inclusion bodies)

87

Herpes simplex type I or II stains what color?

CMV stains what color?

Pink acidophilic nuclear inclusions

Basophilic/blue inclusion bodies

88

What is the homologue to Seminoma?

What is the homologue to the Yolk sac tumor?

Dysgerminoma

Endodermal Sinus Tumor

89

Lobular Carcinoma In-Situ is a marker for what?

Invasive Ductal or Lobular carcinoma

90

What is the tumor marker for the Prostate?

PSA

91

What is the serologic marker for Seminoma?

None

92

Over 90% of testicular tumors are of what origin?

Is it the same in the ovary?

Germ Cell

No - surface epithelial most common (75%)

93

4 Risk factors for Germ cell Tumors of the testes

Cryptorchidism

Klinefelters

Family History

Testicular Tumor on the opposite testis

94

When considering a Teratoma, what factor is most important in predicting whether it will be malignant or benign?

Age

95

What is another name for Leydig Cell Tumors?

Interstitial Cell Tumors

96

What is the only Germ Cell Tumor that doesn't metastasize via the lymphatics?

How does it metastasize?

Choriocarcinoma

Hematogenous routes

***this is if originate in either testes/ovaries

97

What is the most common tumor of the Urinary Tract?

Urinary Bladder tumors

98

What is the parasite that lays eggs in the Bladder?

What type of cancer does this cause?

Schistosoma haemotobium

Squamous Cell Carcinoma

99

What marker in used for both diagnosis and monitoring of Yolk Sac Tumors?

AFP

100

What is the most important risk factor (increases 4 fold) for Bladder Cancer?

What are some secondary risk factors?
(3 things)

Smoking

Azo dyes, Drugs, Radiation to area

*Cyclophosphamide

101

What does PSA stand for?

What is it?

How is it used as a tumor marker?

Prostate Specific Antigen

Antigen that is only released into blood by Tumor Cells (but made always)

If detectable after radical prostatectomy, metastasis persists

102

Explain Bone Alkaline Phosphate's relationship to Prostate Cancer

Marker that Prostate Cancer has metastasized to bone

*proliferation of osteoblasts increases Alk Phos in blood

103

T/F
Prostatic Cells produce Alkaline Phosphatase

False

*only osteoblasts produce

104

T/F
Prostate normally secretes PSA, but the tumor puts it in the bloodstream

True

105

T/F
BPH leads to Prostate Cancer

False

106

BPH doesn't lead to Prostate Cancer, but they are both under the influence of what hormone?

Testosterone

107

What does TURP stand for?

What is the surgical procedure?

Trans Urethral Resection of Prostate

Stent, Prostatic Chips

108

What does BPH stand for?

Benign Prostatic Hyperplasia

109

What ethnic group has the highest incidence of BPH in the US?

In what region of the world is it most common?

Least common?

Blacks

Western Europe/US

Asia (the orient?)

110

T/F
1/3 males over 65 have some degree of BPH, and 75% over 80 years have some degree of it.

True

111

Which cells are present in Acute Prostatitis?

Which are present in Chronic Prostatitis

E. coli with acute inflammatory infiltrate (PMN's, etc)

Lymphocytes, Plasma cells, Macrophage

112

How can Acute and Chronic Prostatitis be diagnosed?

Recovery organism on Urine Culture

113

What 2 organisms can cause granulomatous Prostatitis?

Mycobacterium tuberculosis

Histoplasma capsulatum

114

What % of the semen is secreted by the prostate?

13-33%

115

T/F
30-50 tubuloalveolar glands are in the prostate and they each secrete into the urethra through its own duct

True

116

What histologically makes up the Prostate Gland?

(2 things)

Pseudostratified Columnar Cells

Glandular Cells

117

What is the classification of Prostate Cancers based on 5 histologic patterns of tumor gland formation and infiltration?

Gleason score

118

Each Gleason score is given a ______ pattern score and _____ pattern score.

Majority

Minority

119

What is the best Gleason Score?

What is the histologic state?

2 (1 for each)

Well differentiated

120

What is the worst Gleason Score?

What is the histologic state?

10 (5 majority, 5 minority)

Undifferentiated

121

T/F
The Gleason score is strictly for the Grading and done by the Pathologist. The Oncologist will use that to stage the pt. with prostate cancer.

True

Decks in Tim's Cards Class (140):