Reproductive

Question 1

What is a communicating hydrocele?

Answer 1

Accumulation of serous fluid within the tunica vaginalis in the setting of a patent processus vaginalis

Question 2

Process that results in a bicornuate uterus

Answer 2

Incomplete lateral fusion of the paramesonephric ducts

Question 3

Menotropin

Answer 3

Treatment option for infertility that acts like FSH and triggers the formation of a dominant ovarian follicle

Question 4

The use of hCG therapy mimics which physiologic event?

Answer 4

LH surge - induces ovulation

Question 5

Mechanism of ovarian torsion

Answer 5

Typically involves twisting of the infundibulopelvic ligament (suspensory ligament of the ovary), often due to the weight of a large adnexal mass

Question 6

Which hormone prevents lactation during pregnancy?

Answer 6

Progesterone

Question 7

Clomiphene

Answer 7

An estrogen receptor modulator that decreases negative feedback inhibition on the hypotahalamus by circulating estrogen, thereby increasing gonadotropin production

Question 8

Most common cause of bloody nipple discharge

Answer 8

Intraductal papilloma - proliferation of papillary cells in a cyst wall or duct that may contain focal atypia

Question 9

Unilateral painful cystic lesion in the lower vestibule adjacent to the vagina. Typically in a woman of reproductive age.

Answer 9

Bartholin cyst and abscess

Question 10

Low risk HPV subtypes

Answer 10

6 and 11

Question 11

High risk HPV subtypes

Answer 11

16
18
31
33

Question 12

Microscopic finding associated with HPV

Answer 12

Koilocytes

Question 13

Pocelain-white plaques with a red or violet border. Typically seen in postmenopausal women.

Answer 13

Lichen sclerosus

Question 14

Lichen sclerosus increases risk for?

Answer 14

SCC

Question 15

Leathery, thick vulvar skin

Answer 15

Lichen simplex chronicus

Question 16

Pruritus, erythema, crusting, ulcers of the vulva

Answer 16

Extramammary Paget disease

Question 17

Differential diagnosis for extramammary Paget disease

Answer 17

Melanoma

Question 18

How do you distinguish between extramammary Paget disease and melanoma of the vulva?

Answer 18

Paget cells: PAS+, keratin +, S100-

Melanoma: PAS-, keratin -, S100+

Question 19

There is an increased incidence of adenosis in what population of patients?

Answer 19

Females exposed to DES in utero

Question 20

Clear cell adenocarcinoma

Answer 20

Affects women who had exposure to DES in utero

Question 21

Biopsy findings that show cytoplasmic cross striations and positive IHC staining for desmin and myoglobin

Answer 21

Rhabdomyoblast - cells of embryonal rhabdomyosarcoma

Question 22

LN spread from a tumor in the lower 2/3 of the vagina

Answer 22

Inguinal nodes

Question 23

LN spread from a tumor in the upper 1/3 of the vagina

Answer 23

Regional iliac nodes

Question 24

Exocervix is lined by?

Answer 24

Squamous epithelium

Question 25

Endocervix is lined by?

Answer 25

Columnar epithelium

Question 26

HPV

Answer 26

DNA virus

Question 27

What occurs with high risk HPV subtypes?

Answer 27

They produce E6 and E7 which cause destruction of p53 and Rb

Question 28

Classic presentation of cervical carcinoma?

Answer 28

Vaginal bleeding in a middle aged woman

Question 29

Risk factors for cervical carcinoma?

Answer 29

High risk HPV (16/18), smoking, immunodeficiency

Question 30

What is the characteristic cell of chronic endometritis?

Answer 30

Plasma cell

Question 31

Multiple, well defined white whirled masses

Answer 31

Leiomyoma (fibroid)

Question 32

What stimulates the theca cells?

Answer 32

LH

Question 33

What stimulates the granulosa cells?

Answer 33

FSH

Question 34

LH:FSH>2

Answer 34

PCOS

Question 35

What kind of cancer are pts with PCOS at increased risk for?

Answer 35

Endometrial carcinoma - due to high circulating levels of estrone

Question 36

What kind of ovarian tumor is commonly seen in pts with BRCA1 mutation?

Answer 36

serous carcinoma of ovary and fallopian tube

Question 37

CA-125

Answer 37

Serum marker for surface epithelial ovarian tumors

Question 38

What causes hypospadias?

Answer 38

Failure of urethral folds to close

Question 39

What causes epispadias?

Answer 39

Abnormal positioning of the genital tubercle. Associated with bladder exstrophy

Question 40

What causes Lymphogranuloma venereum?

Answer 40

Chlamydia trachomatis L1-L3

Question 41

Name the precursor lesions of squamous cell carcinoma of the penis

Answer 41

Bowen disease (shaft), erythroplasia of queyrat (glans), bowenoid papulosis

Question 42

Complications of cryptoorchidism

Answer 42

Testicular atrophy with infertility and increased risk of seminoma

Question 43

Cause of a varicocele

Answer 43

Dilation of spermatic veins due to impaired drainage

Question 44

Varicocele is associated with?

Answer 44

Left sided renal cell carcinoma

Question 45

Cellular description of seminoma

Answer 45

Large cells with clear cytoplasm and central nuclei

Question 46

Gross description of seminoma

Answer 46

Homogenous mass with no hemorrhage or necrosis

Question 47

What is the most common testicular tumor in children?

Answer 47

Yolk sac tumor

Question 48

What is elevated with yolk sac tumors?

Answer 48

AFP

Question 49

Malignant tumor of synctiotrophoblasts and cytotrophoblasts

Answer 49

Choriocarcinoma

Question 50

How does choriocarcinoma spread?

Answer 50

Rapidly via the blood

Question 51

Characteristic histology of leydig cell tumor

Answer 51

Reinke crystals

Question 52

Most common cause of testicular mass in males > 60 years

Answer 52

Lymphoma, usually bilateral and diffuse large B-cell type

Question 53

What location of the prostate does BPH occur?

Answer 53

In the periurethral zone

Question 54

Possible treatments for BPH

Answer 54

1. alpha 1 antagonist (terazosin) to relax smooth muscle 2. selective alpha 1a antagonists (tamsulosin) in normotensive pt 3. 5alpha reductase inhibitor

Question 55

Malignant proliferation of prostatic glands

Answer 55

Prostate adenocarcinoma

Question 56

Risk factors of prostatic adenocarcinoma

Answer 56

Age, race, diet high in saturated fats

Question 57

Where is the most common location for prostate adenocarcinoma?

Answer 57

Posterior periphery of the prostate

Question 58

Where does prostate cancer commonly spread?

Answer 58

Lumbar spine - osteoblastic metastases

Question 59

What mediations can be used to treat prostate cancer?

Answer 59

Continuous GnRH analongs (Leuprolide) | Androgen receptor inhibitor (Flutamide)