Flashcards in Reproductive Deck (21):
34 yr old with bleeding from right nipple. whats the finding?
intraductal papilloma is the most common cause of bloody nipple charge. Caused by proliferation of papillary cells in duct or cyst wall with fibrovascular core
22 yo pregnant female with maculopapular rash that spreads from face to trunk + postauricular lymphadenopathy. Whats the mother and infant at risk for?
Pt has measles. Mother will get polyangitis and fetus will develop sensorineural deafness, cataracts and PDA.
Medication for female with PCOS and want to get pregnant?
SERM: clomiphene, prevent negative feedback inhibition of hypothalamus and pituitary by circulating estrogen
Mechanism of action of mifepristone
progesterone antagonist, causing necrosis of uterine decidua and prevents development of first trimester pregnancy
screening during pregnancy: low AFP, low estriol, high beta hcg, high inhibin. What's the diagnosis?
Down syndrome: typically see decrease AFP and unconjugated estriol due to suboptimal fetal tissue function. Increased beta hcg and inhibin A are secreted in compensation
Malignant infiltration is which structure of the breast causes dimpling?
when is b HCG first be detectable in the serum?
8 days after fertilization
52yo women with leakage of urine with coughing and sneezing. Diagnosis and treatment?
Stress incontinence, and Kegels will target levator ani muscles that hold the bladder and urethra in appropriate anatomic position
15 yo patient with impaired writing and reading skills, misbehaviors, mild intellectual disability. Karyotype is 47. Diagnosis and other findings?
Klinefilters/ tall stature, gynecomastia, azoospermia (primary testicular failure) ** remember that macroorchidism is a result of fragile x
eval for amenorrhea --> oral medroxyprogesterone is administered. A few days after, pt has heavy bleeding and cramping. Why?
due to progesterone withdrawal --> increase in prostaglandin production that leads to vasoconstriction of spiral arteries and acause apoptosis of endometrial epithelium
After radical prostatectomy, nerves within fascia surrounding the gland are injured, which one?
prostatic plexus that can lead to erectile dysfunction
testicular mass is discovered. Which lymph node if malignant will it spread to first?
1. superficial inguinal lymph nodes
2. deep inguinal nodes
3. external iliac
4. common iliac
5. inferior mesenteric
1.cutaneous inferior to umbilicus, external genitalia anus up to pectiate line
2. glans penis and clitoris
3. superficial and deep inguinal nodes
4. internal and external nodes
5. descending colon, upper part of rectum
female with irregular menses has decreased alpha fetoprotein level during second trimester. what do you suspect?
Dating error: AFP levels increase with gestational age --> need an ultrasound to determine gestational age. normally, increased AFP= neural tube defect, ventral wall defect, multiple gestation. decrease = down
no blood flow to the ovary? with structure is involved
suspensory ligament (aka infundibulopelvic ligament)
23 yo female with R lower ab pain with bloody vaginal bleeding. Tachy and ill appearing with positive urine B HCG , prior history of infection. Diagnosis?
Suspect ectopic pregnancy. Common risk factors are PID --> usually from untreated gonorrhea or chlamydia infection.
40yo women with vaginal bleeding, midline pelvic pain, severe nausea, vomiting --> super high B HCG, US with no fetus and uterine cavity with multiple small cysts. What is it? and karyotype?
complete hydatidiform mole. Usually these are 46 XX
16yo girl with vaginal bleeding. Path shows fetal tissue, focal trophoblastic hyperplasia, enlarged villi. Diagnosis?
Path characteristics of ectopic pregnancy?
dilated coiled endometrail glands and edematous stroma
mammography reveals microcalcifications. histology shows pleomorphic cells with prominent central necrosis. What type of lesions? origin?
ductal carcinoma in situ --> arises from the ducts