reproductive Flashcards
(245 cards)
0
Q
Wnt-7 gene
A
production at apical ectodermal ridge,
thickened ectoderm at distal end of each developing limb
necessary for proper organization along dorsal-central axis
1
Q
Sonic hedgehog gene
A
proced at the base of linbs in zone of polarization
involved in patterning along anterior posterior axis
involved in CNS development
mutation can cause holoprosencephaly
2
Q
FGF gene
A
production at apical ectodermal ridge
stimulation mitosis of underlying mesoderm
providing for lengthening of limbs
3
Q
Homeobox, HOX genes
A
Involved in segmented organization of embryo in a craniocaudal direction.
HOX mutation–>appendages in wrong location
4
Q
hCG secretion happens in?
A
week 1
detected by urine in 2weeks
5
Q
bilaminar disc develop in
A
week2
6
Q
trilaminar disc develop in?
A
week 3
7
Q
gastrulation happens in
A
wk 3
8
Q
what appears in wk 3?
A
primitive streak, notochord, mesoderm and it’s organization, neural plate begin to form
9
Q
organogenesis happens in?
A
3-8WK
10
Q
neural tube closes in
A
3-8wk
11
Q
heart begin to beat
A
wk 4
12
Q
upper and lower limb begin to bud
A
wk 4
13
Q
fetal movement begin?
A
wk8
14
Q
genitalial development
A
wk10
15
Q
gastrulation
A
process that forms the trilaminar embryonic disc
establishs the ectoderm, mesoderm and endoderm germ layers
starts with epiblast invagination to form primitive streak
16
Q
absent organ due to absent primordial tissue
A
agenesis
17
Q
absent of tissue despite present primordial tissue
A
aplasia
18
Q
extrinsic disruption, occurs after embryonic period
A
deformation
19
Q
incomplete organ develoment
primordial tissue present
A
hpoplasia
20
Q
intrinsic disruption, occurs during the embryonic period
wk 3-8
A
malformation
21
Q
ACE inhibitor
A
renal damage
22
Q
Alkylating agents
A
absence of digits
multiple anomalies
23
Q
aminoglycoside
A
CN VIII toxicity
24
carbamazepine
craniofacial defects,developmental delay
neural tube defect
fingernail hypoplasia
IUGR
25
Diethylstilbestrol
vaginal clear cell adenocarcinoma
| congenital mullerian anomalies
26
folate antagonists
neural tube defects
27
lithium
ebstein's anomaly
28
phenytoin
```
fetal hydantoin syndrome
microcephaly, dysmorphic,craniofacial features, mental retardation
cardiac defect
hypoplastic nails and distal phalanges
IUGR
```
29
tetracyclines
discoloration of teeth
30
thanlidomide
limb defects
31
valproate
lnhibition of maternal folate absorption-->neural tube
32
warfarin
bone deformities,
fetal hemorrhage,
abortion
ophthalmologic abnormalitis
33
alcohol
leading cause of birth defects and mental retardation
| fetal alcohol syndrome
34
Cocaine
abnormal fetal development and fetal addicition
| placental abruption
35
smoking
preterm labor
placenta problem
IUGR
36
iodide
congenital goiter or hypothyroidism
37
maternal DM
caudal regression syndrome
congenital heart defects,
neural tube defects
38
Vit A
extremely high risk for spontaneous abortion and birth defects
facial abnormally:cleft lip and palate,
cardiac abnormalities
39
XR
microcephaly
| mental retardation
40
dichorionic
diamniotic
twins
0-4days in monozygotic twin
| 2 sperm and 2 egg
41
monochorionic
| diamniotic
4-8days cleavage
| from motula to blastocyst
42
monochorionic
| monoamniotic
cleavage after a week
43
cleavage after 13 days will likely to result in?
conjoined twins
44
fetal compartment of placent
cytotrophoblast: inner layer of chorionic villi
syncytiotrophoblast: outer layer of chorionic villi secretes hCG
45
maternal compartment of placenta
derived from the endometrium
| maternal blood in lacunae
46
umbilical arteries and vein are derived from?
allantosis
| also give raise to urachus-median umbilical ligament
47
patenet urachus
urine discharge from umbilicus
| failure of urachus to obliterate, urachus is a duct between bladder and yolk sace
48
vesicourachal diverticulum
outpouching bladder
| failure of urachus to obliterate,urachus is a duct between bladder and yolk sac
49
Vitellin fistula
meconium discharge from umbilicus
| failure of closure vitellin duct-connects yolk sac and midgut lumen
50
meckel's diverticulum
partial closure of vitellin duct-connects yolk sac and midgut lumen
with patent portion attachment to ileum
may have ectopic gastric mucosa
melena, periumbilical pain and ulcer
51
when do vitelline dust close?
wk7
52
when is allantosis formed?
week 3
53
1st arch of aorta develops into?
part of maxillary artery
| external carotid
54
2nd arch of aorta develops into?
stapedial artery and hyoid artery
55
3rd arch of aorta develops into?
common carotid artery
| proximal part of internal carotid artery
56
4th arch of aorta develops into?
on left, aortic arch
| onright, proximal part of right subclacian artery
57
6th arch of aorta develops into?
proximal part of pulmonary arteries and ductus arteriosus
58
branchial apparatus arise from?
cleft-ectoderm
arch-mesoderm
pouch-endoderm
59
1st cleft ?
external auditory meatus
60
2nd cleft
temporary cervical sinuses
obliterated by proliferation of 2nd arch mesenchyme
persistent cervical sinus-branchial cleft with in lateral neck
DD:thyroglossal duct cyst
61
1st arch cartilage
```
meckel's cartilage:
malleus
incus
sphenoMandibular ligament
mandible
```
62
2nd arch cartilage
```
Reichert's cartilage:
Stapes
Styoid process
stylohyoid ligament
lesser horn of hyoid
```
63
3rd arch cartilage
greater horn of hyoid
64
4th-6th arch cartilage
```
thyroid
cricoid
arytnoid
corniculate
cuneiform
```
65
1st arch muscles
```
muscle of mastication(temporalis, masseter, lateral and medial pterygoids)
mylohyoid
anterior belly of diagastric
tensor tympani
tensor veli palatini
CNV2 and V3, chew
```
66
2nd arch muscle
```
facial expression
stapeidus
stylohyoid
posterior belly of digastric
CNII- smile
```
67
3rd arch muscles
stylophargngeus
| CN IX, swallow with style
68
4th arch muscle
pharyngeal constrictors,
cricothyroid
levator veli palatini
CNX superior laryngeal branch, simple swallow
69
6th arch muscle
all intrinsic muscle of larynx except cricothyroid
| CN X recurrent laryngeal branch
70
Treacher collins syndrome
1st arch neural crest fails to migrate->mandibular hypoplasia, facial abnormalities
71
congenital pharyngocutaneous fistula
persistence of cleft and pouch-->fistula between tonsillar area, cleft in the lateral neck
72
posterior 1/3 of tongue is formed by?
arch 3 and 4
73
pierre robin syndrome
mandibular hypoplasia
glossoptosis
may obstruct airway
74
DeGeorge
```
Cardio: truncus arteriosus, tetralogy of fallot
Abnormal faces
Thymic hyperplasia
Cleft palate
Hypocalcemia
22 chrom
```
75
1st pouch
develops into middle ear cavity, Eustachian tube, mastoid air cells
endoderm-lined structures of ear
76
2nd pouch
develops into epithelial lining of palatine tonsil
77
2nd pouch
develops into epithelial lining of palatine tonsil
78
3rd pouch
dorsal wings-develops into inferior parathyroids
| ventral wings-develops into thymus
79
4th ouch
dorsal wings-develop into superior parathyroid
80
MEN2A
mutation of germline RET, neural crest celss
adrenal medulla , pheochromocytoma
parathyroid, tumor, 3rd and 4th pharyngeal pouch
parafollicular cells, medullary thyroid cancer, neural crest cells, 4th ad 5th pouches
81
failure of fusion of maxillary and media nasal process, formation of primary palate
cleft lip
82
failure of fusion of lateral palatine process, the nasal sptum and /or median palatine process
2ndary palate
cleft palate
83
mesonephric duct develop into?
| Müllerian duct
male internal structures except prostate-seminal vesicles, epididymis, ejaculatory duct, ductus deferens
stimulated by androgens that is secreted by leydig cells
84
paramesonephric duct develops into
| Wolffian duct
female, default development
if nothing happens in 12 wk, then the fetus become a female
Fallopian tube
uterus
upper portion of vagina, lower from urogenital sinus
85
male is determine by?
SRY gene on Y chrom-->
produces testis determining factor (TDF)
Sertoli cell secrete Mullerian inhibitory factor (MIF) that - parameso
leydig cell secrete androgen that stimulate Mesonephric
86
failure of suppression of the other duct result in?
Male: appendix of tests
female: duct of gartner
87
cephalic end remnant
male: appendix of epididymis
female: appendix of vesiculosa
88
incomplete fusion of paramesonephric ducts
bicornuate uterus
| mischarges and UT abnormalitis
89
Imperforate hymen
mother estrogen stimulateion at birth---->mucocolpos
accumulation of mucus-->bulging in
if it is not diagnosed then, puberty will show no M but pain in abdomin
90
genital tubercle develops into?
Glans clitors
Glans penis
Vestibular bulb
Corpus cavernosum and spongiosum
91
Urogenial sinus
Greater vestibular gland, Bartholin
Bulbourethral glands of cowper
urethral and paraurethral glands of skene,
prostate gland
92
urogenital folds
Labia minora
| ventral shaft of penis, penile urethra
93
Labioscrotal swelling
labia majora
| scrotum
94
caudal genital ligament
round ligament
| spermatic cord
95
gonadal artery
suspensory ligament ovary
| testicular artery
96
hypospadias
abnormal opening of penile urethra on inferior(ventral) side of penis due to failure of urethral folds to close
97
epispadias
abnormal opening of penile urethra on superior, dorsal side of penis due to penis due to faulty positioning of genital tubercle
98
gubernaculum: band of fibrous tissue
Male: anchors tests within scrotum
Female: Ovarian ligament+ round ligament of uterus
99
Processus vaginalis
| evagination of peritoneum
Male: forms tunica vaginalis
female: obliterated
100
Vein drainage
Left ovary/testis-->left gonadal vein-->left renal vein-->IVC
right ovary/testis-->right gonadal vein-->IVC
101
Lymphatic drainage
ovary and testis-->para-aortic LN
Distal1/3 of vagina/vulva/scrotum-->superficial inguinal nodes
proximal 2/3 of vagina/uters->obturator, extenal iliac and hypogastric nodes
102
suspensory ligament of the ovaries
ovaries to lateral pelvic wall
ovarian vessels
ureter at risk of injury during ligation of ovarian vessels in oophorectomy
103
cardinal ligament
cervix to side wall of pelvis
uterine vessels
ureter at risk of injury during ligation of uterine vessels in hysterectomy
104
Round ligament of the uterus
uterine fundus to labia
artery of sampson(Simpsons are very round,lol)
derivation of gubernaculum, travels through round inguinal canal
105
Broad ligament of the uterus
uterus fallopiantubes
ovaries to pelvic side wall
ovaries Fallopian tubes and round ligaments of uterus
mesosalpinx, mesometrium and mesovarium are components of the broad ligament
106
ligament of the ovary
medial pol of ovary to lateral uterus
none,
ligament of the ovary latches ovary to lateral uterus, derivative of gubernaculum
107
epi of female reproductive system
| vagina, ectocervix, endocervix, uterus, fallopian tube, ovary.
```
stratified squamous epithelium,
stratified squamous epithelium
simple columnar epi
simple columnar epi, pseudostratified tubular
simple ciliated columnar, ciliated
simple cuboidal
```
108
erection is innvervated by?
PANS
NO-->increase cGMP-->smooth muscle relaxation-->vasodilation-->proerectile
NE-->increase Ca in-->smooth muscle contraction-->vasoconstriction-->antierectile
109
Emission is controlled by?
SANS
| hypogastric nerve
110
ejaculation innervated by?
visceral and somatic nerve, pudendal nerve
111
trauma in the perineal region result in?
injury to the bulb of the penis-->extravasation of urine into the perineal space
112
what creat the blood testis barrier?
Sertoli cells and the thigh junctions
| isolate gametes from autoimmune
113
function of Sertoli cells
secrete Müllerian inhibitory factor
secrete inhibin
secrete androgen binding protein-->maintain local testosterone level
temp sensitive-->decrease sperm count and decrease inhibin,ex. varicele, Cryptorchidism
line the semiferous tubules
114
Leydig cell function?
secrete testoserone
| unaffected by temp located in intersitium
115
from basal lamina to lumen, germ cell type?
spermatobonium-->primary spermatocyte-->secondary spermatocyte-->spermatids-->sperm
116
spermatogensis begin?
| full development?
bigins at puberty, takes 2 months
| produce spermatid that under goes spermiogenesis(loss of cytoplasm and gain of acrosoaml cap)
117
androgen bind to ABP because
prevent renal filatration,
118
what happen with ppl with only one testis
decrease leydig cell
decrease Sertoli cell
decrease inhibin
increase FSH
119
prostate growth and balding is due to?
DHT
also sebaceous gland activity
Teastosterone-->DHT(5-alpha-reductase),(-)by finasteride
120
exogenous testosterone result in?
inhibtion of hypothalamic-pituitary-gonadal axis-->decrease intratesticular testosterone-->testicular size-->azoospermia
121
potency of estrogen?
estradiol>estrone>estriol
122
Estrogen and cardial effect?
decrease the probability of AS
| postm-->increase risk for AS
123
LH surge stimulates
prolactin secretion , but blocks its action at breast
124
estrogen and progestrone secretion function on uterus
E: growth of follicles, "stimulates "endometrial proliferation, increase excitability of myometrial
P: +glandular secretion and spiral artery development,decrease excitability("maintain" pregnancy)
125
follicular phase and luteal phase length
follicular varies
| luteal is within 14 days
126
oigomenorrhea
>35dys cycle
127
polymenorrhea
<21-days
128
metrorrhagia
frequent but irregular
129
menometrorrhagia
heavy, irregular menstruation
130
surges in menstruation cycle
ovulation surge: LH, E, FSH
after ovulation surge: progesterone, E
2 surge: E
131
menstrual cycle
4-7: endometrial gland straight&short, compact stroma, no edema,little mitotic
6-10:long, little stroma, edema, many mitosis
11-14: gland wavy&tortous, subnuclear vacuole with glycogen appear
14: subnuclear vacuolization 50%
22:stromal edema max,predecidualization,eosinophlic
26-27, necrosis begin, vacuole are prominent7abundant glands
132
mittelschmerz
blood from ruptured follicle or follicular enlargement causes pertoneal irritation that can mimic appendicitis
133
asynchronous secretory endometrium
mismatch 2 or more days between glands and stroma
infertility/oral contracetives
due to in adequate luteal phase
134
anovulation bleeding
proliferative endometrium with stromal breakdown
| dysfunctional uterine bleeding
135
oocyte begin meiosis at? complete at?
begin at meiosis I during fetal life and complete prior to ovulation
complete meiosis I before ovulation
Meiosis I arrest at prophase until ovulation
meiosis II arrest at metaphase until fertilization
136
ovulation follicles
primordial follicle: inactive reserved follicles:1 oocytes+follicular cell
primary follicle:oocyte+cubiodal follicular cell
secondary follicle: spaces infollicle fuse into atrum
graafian follicle: mature form, bulges out at ovarian surface,corona radiation of granulosa, zona pellucidal
corpus luteum:after release ovum, follicle theca interna cell secrete E
corpus albicantia: fibrotic remnant of corpus lutea
137
fertilization occurs?
ampulla, within 1 day
138
implantation within the wall of the uterus occurs?
6 days after fertilization
139
hCG secreted by?
syncytiotrophoblast of placenta
140
function of hCG
maintain corpus lutem(like LH)-->progesterone for the 1st trimester,
placenta secretes progesterone for the 2nd and 3rd stimulated by LH? (hCG decrease after 10th week)
141
lactation
progesterone inhibits lactation be fore pregnancy
after pregnancy progesterone decreases
suckling is require for maintain milk production by increasing prolactin (increase lactation and decrease reproductive functions) and oxytocin (appears to help with milk let down and uterine contraction)
142
best test to confirm menopause
increase FSH
| other changes include: decrease E, increase LH, increase GnRH
143
premature ovarian failure
before 40
premature atresia of ovarian follicles in women of reproductive age
patients presents present with signs of menopause after puberty
decrease E, increase LH FSH
144
DM inpregnancy?
hPL: increase insulin tolenrant
DM in 1st trimester:
mom decrease Glu uptake and the baby take more
145
if AFP/hCG/E level measure at 16-18wk increased
common cause is wrong dating
146
klinefelter's syndrome
XXY(Barr body), hyaline semiferous tubule->absence of sperm
eunuchoid body shape: tall long extremities
gynecomastia, female hair distrubution
testicular atropy, hypogonadism:
dysgenesis of semiferous tubules-->inhibin decrease-->increase FSH
abnormal leydig cell-->decrease testosterone-->increase LH&E
147
Turner syndrome
XO,ovarian dysgenesis, streaky ovary
short, shield chest, hypothyroidism, horseshoe kidney,
bicuspid aortic valve, preductal coarctation of the aorta
defect in lymphatics->webbing of neck(cystic hygroma) &lymphedema in feet and hands
decrease E, increase LH FSH
148
double Y males
| XYY
phenotypically normal, very tall, severe acne,
antisocial behavior
norma fertility
autism spectrum disorder
149
increase testosterone
| increase LH
androgen receptor defect
150
increase test
| decrease LH
test-secreting tumor,
| exogenous steroid
151
decrease test
| increase LH
primary hypogonadism
152
decrease test
| decrease LH
hypogonadotropic hypogonadism
153
female peudohermaphrodite
| XX
ovary present
external genital are ambigous
due to excessive exposure to androgenic steroid of mom in early gestation
154
male pseudohermaphrodite
tests present, but external genitalia are female or ambigous
| most common form of insensitivity of androgen
155
Congenital Lipoid adrenal hyperplasia
defect transport of chol into mitochondria of the cell of adrenal cortex
defect the conversion of chol to pregnenolone->the 1st step in the synthesis of steroid hormones
mineralocorticoid deficiency and under virilized
adrenal is filled with lipoid and large
156
True hermaphroditism
both ovary and testicular tissue present(ovotestis)
| ambiguous genitalia
157
androgen insensitivity
defect in receptor
normal appearing femalewith rudimentary vagina
develops tests, found in labia majora, surgically removed
increased T and E and LH
158
5-alpha reductase deficiency
AR,inability to convert T to DHT, mom expose to finasteride
sex limited to genetic males
ambiguous genitalia until puberty internal normal
increase testosterone causes maculinization/increase growth of external genitalia
normal T, LH can be increased
159
Kallmann syndrome
migration of GnRH cell and formation of olfactory bulb
decrease synthesis of GnRH to hpothalamus
anosmia
lack of secondary sexual characteristics
decrease GnRH, FSH, LH,T, sperm
160
Complete mole
```
46XX, 46XY, increase hCG, increase BP
unterine size increase
convert to choriocarcinoma 2%,
15-20% malignant trophoblstic disease
no fetal parts
2 sperm+empty
```
161
Partial mole
```
69XXX, 69XXY, 69XYY, 2sperm+1egg
increase hCG
convert rare
fetal part
low risk of malignancy,bleedin gin the 1st trimester
```
162
preclampsia
HTN, proteinuria, edema
20wk-6wk after birth
placental ischemia due to impaired vasodilation of spiral artery, resulting in increase vascular tone
Hemolysis Elevated Liver enzyme Low Platelets
163
Eclampsia
preeclampsia+seizure
164
abruptio placentae
premature deatchment of placenta from implantation site
may be associated with DIC
increase risk with smoking, HTN, cocaine use
painful bleeding he 3rd trimester
may be life threatening
165
placenta accreta
defective decidual layer allows placenta to attach to myometrium
no separation of placenta after birth
increase risk with prior C-section, inflammation and placenta previa
massive bleeding after delivery
166
placenta previa
attachment of placenta to lower uterine segment.
lies near or extends over internal cerrvical
increase risk with multiparity and prior C-sectionPainless bleeding in any trimester
167
retained placenta tissue
may cause postpartum hemorrage
| increase risk of infection
168
ectopic pregnancy
most often in Fallopian tubes
amenotthea, increase hCG based on dates and sudden lower abdominal pain
confirm with ultrasound
often clinically mistaken for appendicities
decidualized endometrium but no chorionic villi
169
polyhydramnios
>1.5-2 L amniotic fluid
esophageal/duodenal atresia, inability to swallow amniotic fluid
with anencephaly
170
oligohydramnios
s syndrome
171
miscarriages in the 1st trimester
chrom problems
| low progestrone
172
miscarriages in the 2nd trimester
bicornuate uterus, Y shape uterine cavity
| Leiomyomas
173
bacteria that can cause miscarriages
Milk and Cheese-->Listeria monocytogenes
174
dysplasia and carcinoma in situ
disordered epi growth
begins at basal layer of squamo-columnar junction and extends outward-->progress slowly to invasive CA
associatedwith HPV16 (E6 gene product inhibits p53 suppressor)and hpv18(E7 gene product inhibits RB suppressor gene), vaccine
Risk: multiple sexual partner #1, smoking, early sexual intercourse
175
invasive carcinoma
```
often squamous CA
Pap smear (koilocytes: wrinkled, "raisinoid" nuclei, some of which have clearing or a perinuclear halo)
```
176
endometritis
inflammation of the endometrium associated with retained products of conception following deliveryabortion/foreign body such as IUD
retained material in uterus promotes infection by bacterial flora from vagina or intestinal tract
gentamycin + clindamycin
177
endometriosis
non-neoplastic endometrial glands/stroma in abnormal locations outside the uterus
characterized by cyclic bleeding(menstrual type) from ectopic endometrial tissue-> severe pain
blood-filled chocolate cysts
treatment: oral contraceptive,NSAID, leuprolide, danazol
178
adenomyosis
endometrium within the myometrium
treat with hysterectomy
menorrhagia, dysmenorrhea, pelvic pain, uterus is enlarged
179
endometral hyperplasia
abnormal endometrial gland proliferation usually caused by excess estrogen stimulation.
increase risk for endometrial carcinoma
clinically manifests as postmenopause vaginal bleeding
risk factor include anovulatory cycles, hormone replacement therapy, PCOS and granulosa cell tumor
180
endometrial carcinoma
most common gynecologic malignancy, peak occurrence at 55-65 yrs
presents with vaginal bleeding
typically precceded by endometrial hyperplasia
risk factor: E without progestins, obesity, diabetes, HTN, null parity and late menopause
increase myometrial invasion-->decrease prognosis
181
Leiomyoma
most common of all tumors in females,increase incidence in blacks
often presents with multiple tumors with well-demarcated borders
benign smooth muscle tumor, whorled pattern
Estrogen sensitive-tumor size increase with pregnancy and decrease with menopause
uterine bleeding-->miscarriage/iron dificiency
182
Leiomyosarcoma
```
bulky,irregularly shaped tumor with areas of necrosis and hemorrhage
arising de novo
increase incidence in blacks
highly aggressive, tendency to recur
may protrude from cervix and bleed
most commonly seen in middle-aged women
```
183
gynecologic tumor epidemiology
incidence-endometrial>ovrian>cervical
| worst prognosis-ovarian>cervical>endometrial
184
most common causes of anovulation
pregnancy, PCOS, obesity
HPO axis abnormalities, premature ovarian failure, hyperprolactinemia, thyroid disorder, eating disorder, eating disorders, Cushing syndrome, adrenal insufficiency
185
PCOS
increase LH-->anovulation-->no progesterone
hyperandrogenism due to deranged steroid synthesis by theca cells
Enlarged bilateral cystic ovaries, amenorrhea, infertility, obesity, obesity and hirsutism, insulin resistance
increase E from aromatization of T in fat cells without Progesterone-->increase risk for endometrial cancer
186
follicular cyst
distention of unruptured Graafian follicle
may be associated with hyperestrinism and endometrial hyperplasia
most common ovarian mass in young women
187
corpuslutem cyst
hemorrhage into persistent corpus luteum
| commonly regress spontaneously
188
theca-lutein cyst
often bilateral/multiple
due to gonadotropin stimulateion
associated with choriocarcinoma and mole
189
hemorrhagic cyst
blood vessel rupture in cyst wall
cyst growth with increase blood retention
usually self-resolves
190
dermoid cyst
mature teratoma
| cystic growths filled with various types of tissue such as fat, hair, teeth, bits of bone and cartilage
191
endometrioid cyst
endometriosis within ovary with cyst formation
varies with mentrual cycle
when filled with dark reddish-brown blood it is called a chocolate cyst
192
dysgerminoma
malignant,equivalent to male seminoma but rarer1% of germ cell tumor in femalrs vs 30% in males)
sheets of uniform cell, associated with Turner syndrome
tumor marker: hCG, LDH
193
choriocarcinoma
rare but malignant, can develop during/after pregnancy in mom/baby
malignant or trophoblastic tissue, chorionic villi are not present
increase freq of theca-lutein cysts
along with mole, spectrum of gestational trophoblastic neoplasia
early hematogenous spread to the lung
marker: hCG is an LH analog
194
Yolk-sac tumor
aggressive malignancy in ovaries(testis in boys) and sactococcygeal area of young children
Yellow friable solid masses (mucinous)
50% have Schiller-Duval bodies, resenble glomeruli
marker: AFP increase
195
Teratoma
90% of ovarian germ cell tumor, contain cells from2 or 3 layers
1. mature teratoma(dermoid cyst)-most common ovarian germ cell tumor, mostly benign
2. immature teratoma-aggressively malignant (male)
3. struma ovarii-contains functional thyroid tissue, hyperthyroidism
increase hCG, increase T3 and T4(bind TSH receptor)
196
serous cystadenoma
45% of ovarian tumor
frequently bilateral lined with Fallopian tube- like epi
Benign
increase CA-125 is general ovarian cancer marker (good for monitor progression, not for screening)
197
serous cystadenocarcinoma
45% of ovarian tumors, malignant and freq bilateral
psammoma bodies seen on histology
risk factor-BRCA-1, BRCA-2, HNPCC
significant genetic predisposition makes family history the most important risk factor
198
mucinous cystadenoma
multilocular cyst lined by mucus-secreting epi.
benign
intestine-like tissue
199
mucinous cystadenocarcinoma
malignant
pseudomyxoma peritonei
intraperitoneal accumulation of mucinous material from ovarian or appendiceal tumor
200
Brenner tumor
benign and unilateral
looks like bladder
solid tumor that is pale yellow-tan in color and appears encapsulated
coffee bean nuclei on H&E staining
201
fibromas
bundles of spindle shaped fibroblasts
| pulling sensation in groin.
202
Meigs' syndrome
triad of ovarian fibroma, ascites, and hydrothroax
203
granulosa cell tumor
secretes estrogen-->precocious puberty (kid)
can cause endometrial hyperplasia or carcinoma in adult
Call-Exner bodies- small follicles filled with eosinophilic secretions
abnormal uterine bleeding
soild yellow mass
204
krukenberg tumor
GI malignancy that metastasizes to ovaries
| causing a mucin-secreting signet cell adenocarcinoma
205
squamous cell carcinoma
usually 2ndary to cervical SCC;
| primary vaginal carcinoma
206
Clear cell adenocarcinoma
affects women who had exposure to DES in utero
207
Sarcoma botryoides
rhabdomysarcoma variant--
affects girls<4yrs of age
spindle-shaped tumor cells that are desmin positive
208
Bartholin's gland cyst
blockage of bartholin's duct
sequela to previous infection
lined by transitional epi/metaplastic squamous epi
treat by excision or marsupialization
209
vestibular adenitis
exquisitely tender posterior introitus with focal ulceration
210
Pseudomyxoma peritoneal
produced when malignant or benign(mucus producing tumor, mucinous cystadenoma or mucinous cystadenocarcinoma)
ovary/appendix origin
hard to treat/ remove
211
fibroadenoma
small, mobile, firm mass with sharpe edges
common in those<35yrs
increase size and tenderness with increase estrogen (pregnancy, menstruation)
not a precursor to breast cancer
212
intraductal papilloma
small tumor that grows in lactiferous duct
typically beneath areola
serous or bloody nipple discharge
slight (1.5-2X) increase risk for carcinoma
213
Phyllodes tumor
large bulky mass of connective tissue and cysts
Leaf-like projection
most common in 6th decade
some may become malignant
214
malignant breast tumor
common postmenopause
usually arise from terminal duct lobular unit
overexpression of estrogen/progesterone receptor or c-erbB2 (HER-2, EGF receptor)
prognosis factor: axillary LN
risk factor: increase estrogen, total number of menstrual cycle
215
ductal carcinoma in situ(DCIS)
fills ductal lumen
arises from ductal hyperplasia
early malignancy without basement membrane penetration
216
comedocarcinoma
ductal, central caseous necrosis
| subtype of DCIS
217
invasive ductal carcinoma of breast
```
firm fibrous "rock hard" mass with sharp margins
small, glandular, duct-like cells
classic stellate morphology
worst and most invasive
most common of all breast cancer
```
218
invasive lobular breast cancer
orderly row of cells
indian file
often bilateral with multiple lesions in the same location
219
Medullary breast cancer
Fleshy,
cellular, lymphocyticinfiltration
good prognosis
220
inflammatory breast cancer
dermal lymphatic invasion by breast carcinoma
Peau d'orange (breast skin resembles orange peel)
neoplastic cells block lymphatic drainage
221
Paget's disease
eczematous patches on nipple
paget cells=large cells in epidermis with clear halo
suggests underlying DCIS
also seen on vulva
222
fibrocytic disease of breast
most common cause of breast lumps from age 25 to menopause
presents with premenstrual breast pain and multiple lesions, bilateral
fluctuation in size of mass
usually does not indicate increase risk of carcinoma.
223
histology type of fibrocystic breast disease
fibrosis-hyperplasia of breast stroma
cystic-fluid filled, blue dome, ductal dilation
sclerosing adenosis-increase acini and intralobular fibrosis, calcification. confused with cancer
epithelial hyperplasia-increase in number of epi cell layer in terminal duct lobule, increase risk for CA with atypical cells
224
acute mastitis
breast abcess
during breast-feeding
increase risk of bacterial infection throught cracks in the nipple
S.aureus is the most common pathogen
treatment: antibiotics + drain, can still breast beed
225
Fat necrosis
a benign, usually painless lump
forms as a result of injury to breast tissue
up to 50% of patients may not report trauma
multinucleated giant cells originate from histiocytes
226
Gynecomastia
occurs in males
result from hyperestrogenism (cirrhosis, testicular tumor, puberty, old age), Klinefelter's syndrome, or drugs (estrogen, matijuana, heroin, psychoactive drugs, spironolactone, Digitalis, Cimetidine, Alcohol, Ketoconazole)
some drugs cause awkward kases
227
benign prostatic hyperplasia
| BPH
```
>50yrs
nodular enlargement of the periurethral
premalignant lesion
lead to distention and hypertrophy of the bladder, hydronephrosis and UTI
increase PSA
```
228
prostatic adenocarcinoma
common in men>50yrs
arises most often from the posterior lobe, peripheral lobe
diagnosis: increase PSA and subsequent needle core biopsies
increase total PSA, decrease fraction of free PSA
metastases in bone may develop in late stage, as indicated by lower back pain and increase serum alkaline phophatase and PSA
229
cryptorchidism
undescended testis (one or both)
impaired spermatogenesis(sperm develop best at temp<37)
normal testosterone if on one side(Leydig cells are unaffected by temp)
associated with increase risk of germ cell tumors
prematurity increase the risk of cryptochidism
decrease inhibin, increase FSH, LH
230
seminoma=dysgerminoma
malignant, painless, homogenous testicular enlargement
most common testicular tumor, mostly affecting males age 15-35
Large cells in lobules with watery cytoplasm & fried egg appearance
increase placental alkaline phosphatase(PLAP)
radiosensitive
late metastasis, excellent prognosis
231
embryonal carcinoma
malignant, painful, worse prognosis than seminoma
glandular/papillary morphology
Pure embryonal carcinoma is rare
most commonly mixed with other tumor types.
may be associated with increase hCG and normal AFP levels when pure (increase AFP when mixed)
232
leydig cell tumor
contains Reinke crystals (pale staining rod-shaped inclusions)
usually androgen producing, gynecomastia in men
precocious puberty in boys
Golden brown color
increase T, decrease gonadotropin
233
Sertoli cell tumor
androblastoma from sex cord stroma
microscopically cord like resembling seminiferous tubules
gray-white to yellow
234
testicular lymphoma
most common testicular cancer in older men
not a primary cancer, arises from lymphoma metastases to testes
aggressive
235
tunica vaginalis lesions
lesion in the serous covering of testis presents as testicular masses that can be transilluminated (testicular tumors)
236
hydrocele
increase fluid secondary to incomplete fusion of processus vaginalis
237
Spermatocele
dilated epididymal duct
238
complete failure to fuse
congenital inguinal hernias
239
Squamous cell carcinoma of penile
more common in Asia Africa and South America
| commonly associated with HPV, lack of circumcision
240
Peyronie's disease
Bent penis due to acquired fibrous tissue formation
241
Priapism
painful sustained erection not associated with sexual stimulation or desire
Associated with trauma, sickle cell disease (sickle RBC get trapped in vascular channels), medications (anticoagulants, PDE5I, antidepressants, alpha-blocker, cocaine)
242
testicular torsion
violent movement or physical trauma to the testes
| occlusion of both testicular artery & vein (artery come directly from aorta)(left vein->renal, right->IVC)
243
In situ penile carcinoma
bowenoid papulosis
multiple reddish- brown papular lesion
erythroplasia of quegrat
soft red plaque
244
hair loss
1. male pattern baldness: inherited (androgenetic alopecia)-->treat with 5-alpha-reductase
2. Tinea capitis: ring worm-->Terbinafine
3. Telogen effuvium
4. Alopecia areata: Autoimmune-->patchy hair loss
