Reproductive System Flashcards
(163 cards)
1
Q
A
Answer: Breast
2
Q
A
Answer: Foetal ACTH
3
Q
A
Answer: Regional iliac nodes
4
Q
A
Answer: HPV 6 and 11
5
Q
A
Answer: Bacterial vaginosis
6
Q
A
Answer: Bartholin cyst
7
Q
A
Answer: Pudendal nerve
8
Q
A
Answer: Straight arterioles, stratum basalis, stratum functionalis
9
Q
A
Answer: Tunica vaginalis
10
Q
A
Answer: Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium
11
Q
A
Answer: Seminoma
The vast majority of testicular cancers are germ cell tumours; of those seminomas are the most common. Only 1% of testicular tumours are benign. Metastases occurs via the para-aortic lymph nodes.
12
Q
A
Answer: Squamous cell hyperplasia
13
Q
A
Answer: Peripheral zone
14
Q
A
Answer: The sacrotuberous ligament
15
Q
A
Answer: Lichen sclerosus
16
Q
A
Answer: Late menopause, early onset of periods, not having children
17
Q
A
Answer: Embryonal rhabdomyosarcoma
18
Q
A
Answer: Condyloma acuminatum
19
Q
A
Answer: Polycystic ovarian syndrome
20
Q
A
Answer: 16, 18, 31, 33
21
Q
A
Answer: Doxycycline, erythromycin, or clarithromycin
22
Q
A
Answer: Bacterial vaginosis
23
Q
A
Answer: Cervical ectropion
Cervical ectropion (34% of post-coital bleeding) is the presence of columnar epithelium on the ectocervix and is commonly found in postpubertal adolescents, pregnant individuals, and those using estrogen-containing contraceptives (eg, oral estrogen-progestin pills, vaginal ring, or transdermal patch).
24
Q
A
Answer: Corkscrew-shaped
Treponema pallidum is a spirochaete bacterium with subspecies that cause syphilis.
25
**Answer: Adenocarcinoma**
26
**Answer: Ampulla of the fallopian tube**
27
**Answer: Secondary amenorrhea**
## Footnote
Secondary amenorrhea is defined as the cessation of regular menses for three months or the cessation of irregular menses for six months. You need to first check the hCG and make sure the patient is not pregnant. Most cases of secondary amenorrhea can be attributed to polycystic ovary syndrome, hypothalamic amenorrhea, hyperprolactinemia, or primary ovarian insufficiency.
28
**Answer: Chlamydia infection**
29
**Answer: a painless chancre**
30
**Answer: Pubococcygeus, puborectalis, iliococcygeus, coccygeus**
31
**Answer: Iliococcygeus**
32
**Answer: Asherman’s syndrome**
## Footnote
Asherman Syndrome describes secondary amenorrhea due to the loss of the basalis and scarring as a result of overaggressive dilation and curettage.
33
**Answer: Anti-Mullerian hormone**
34
**Answer: Seminoma**
35
**Answer: Chlamydia trachomatis**
36
**Answer: By increasing testicular temperature**
## Footnote
Varicoceles can result in the pampiniform plexus being unable to cool arterial blood; higher intratesticular temperatures affect sperm production and quality.
37
**Answer: Gonorrhoea**
38
**Answer: Mullerian duct**
39
**Answer: the superficial inguinal lymph nodes**
## Footnote
Lymphatic drainage of the scrotum goes to the superficial inguinal lymph nodes.
Testes go to the para-aortic lymph nodes
40
**Answer: Androstenedione**
41
**Answer: Mumps virus**
42
**Answer: phimosis**
43
**Answer: Tunica vaginalis**
44
**Answer: paraphimosis**
45
**Answer: Prolactin**
## Footnote
Hyperprolactinemia inhibits the pulsatile secretion of the gonadotrophin-releasing hormone, which causes decreased pulsatile release of follicle stimulating hormone, luteinizing hormone, and testosterone.
46
**Answer: The sacrospinous ligament**
47
**Answer: Endometrial carcinoma**
## Footnote
Post-menopausal bleeding=endometrial carcinoma until proven otherwise.
48
**Answer: HPV 16 and 18**
## Footnote
The Human Papillomavirus (HPV) strains 16 and 18 are the two most common HPV strains that lead to cases of genital cancer.
49
**Answer: Para-aortic nodes**
50
**Answer: pampiniform venous plexus, left**
51
**Answer: Chlamidya trachomatis**
52
**Answer: Leiomyoma**
53
**Answer: Ovarian ligament**
54
**Answer: Leiomyoma**
## Footnote
The most common neoplasm of the uterus is a leiomyoma. They can be multiple, can slowly enlarge, and can lead to abnormal bleeding.
55
**Answer: The inguinal ligament**
56
**Answer: Trichomonas vaginalis**
57
**Answer: leiomyomas**
58
**Answer: surface epithelia**
59
**Answer: Candidiasis**
60
**Answer: Dysgerminoma**
## Footnote
Dysgerminomas are the most common malignant germ cell tumour.
61
**Answer: Puborectalis**
62
**Answer: Endometrial polyp**
63
**Answer: As soon as possible regardless of CD4 count**
## Footnote
Consider starting ART at the time of diagnosis or as soon as possible following diagnosis, regardless of CD4+ T-cell count.
64
**Answer: As soon as possible regardless of CD4 count**
## Footnote
Consider starting ART at the time of diagnosis or as soon as possible following diagnosis, regardless of CD4+ T-cell count.
65
**Answer: Epididymo-orchitis is a complication in males**
66
**Answer: Pituitary tumour**
67
**Answer: Investigations for chlamydia, gonorrhoea, syphilis and HIV may be performed**
68
**Answer: Inhibin**
69
**Answer: Coccygeus**
## Footnote
Pin B is coccygeus.
Origin Sacrospinous ligament and ischial spine
Insertion Lateral margin of coccyx and related border of sacrum
70
**Answer: The patient has hypothalamic amenorrhea**
71
**Answer: Pubococcygeus**
72
**Answer: hyperinsulinemia**
## Footnote
An alteration in insulin secretion and insulin action results in hyperinsulinemia and insulin resistance
73
**Answer: upper outer quadrant, invasive ductal carcinoma**
74
**Answer: E6 and E7; p53 and Rb**
75
**Answer: Ovulation**
## Footnote
Endometriosis is the presence of endometrial tissue in extrauterine sites that results in cyclic bleeding in response to oestrogen and progesterone. First-line treatments include hormonal contraceptives and NSAIDs.
76
**Answer: Escherichia coli**
77
**Answer: There is an increased rate of testicular malignant change in cryptorchidism.**
## Footnote
The prevalence of cryptorchidism in Klinefelter Syndrome is very low.
78
**Answer: Tubal infertility is the main complication**
Complications of PID include:
1. Infertility
2. Ectopic pregnancy
3. Tubo-ovarian abscess
4. Hydrosalpinx
5. Bowel obstruction
6. Fritz-Hugh-Curtis syndrome
7. Septic arthritis (if gonorrhoea infection)
79
**Answer: Stimulation and development of the indifferent gonad is initiated by the sex-determining region of the Y chromosome (SRY) gene**
80
**Answer: Gonorrhoea**
81
**Answer: endometriosis, ovary**
82
**Answer: Endometrial cancer**
83
**Answer: Uterosacral ligament**
84
**Answer: Stratified squamous epithelium**
85
**Answer: Thyroid**
## Footnote
Struma ovarii is a rare ovarian tumour that was first described in 1899. It is defined by the presence of thyroid tissue comprising more than 50% of the overall mass. It most commonly occurs as part of a teratoma, but may occasionally be encountered with serous or mucinous cystadenomas. Strumae ovarii comprise 1% of all ovarian tumours and 2-5% of ovarian teratomas.
86
**Answer: Human papillomavirus**
87
**Answer: Abdominal aorta**
88
**Answer: The Bartholin gland**
89
**Answer: Posterolateral**
## Footnote
The epididymis is located posterolaterally, and hence this site will be maximally tender in the setting of epididymitis.
90
**Answer: Double stranded DNA, non-enveloped**
91
**Answer: Clear cell adenocarcinoma**
92
**Answer: Lichen sclerosis**
## Footnote
Lichen sclerosis is of unknown aetiology, but may involve autoimmunity. It is characterised by thinning of the epidermis and fibrosis of the dermis. It most commonly occurs in post-menopausal women.
93
**Answer: Müllerian inhibiting factor**
## Footnote
Anti-Müllerian hormone (AMH) is a growth factor produced solely by small, growing follicles in the ovary. As serum levels of this hormone correlate strongly with the number of growing follicles, AMH is a good indicator of the size of the primordial ovarian pool.
In addition, AMH could potentially help assess the progression of ovarian senescence, as serum AMH levels are independent of hypothalamic–pituitary–gonadal axis function and decrease to undetectable levels at menopause.
94
**Answer: phimosis**
95
**Answer: Mumps**
96
**Answer: The iliolumbar ligament**
97
**Answer: Serous cystadenocarcinoma**
98
**Answer: scabies**
## Footnote
Scabies is caused by a mite, Sarcoptes scabiei, which burrows into the skin and deposits eggs. It causes a pimple-like rash with severe itchiness.
99
**Answer: Endometriosis**
## Footnote
Endometriosis involves the presence of endometrial glands and stroma outside of the endometrial lining. Sites of involvement include the ovary (where the formation of 'chocolate cysts' occur', the uterine ligaments, the pouch of Douglas, the bladder wall, bowel serosa, and fallopian tube mucosa.
100
**Answer: Peyronie's disease**
101
**Answer: Yolk sac tumour**
## Footnote
Schiller-Duval bodies are glomerulus-like structures seen on histology.
102
**Answer: Simple columnar epithelium**
103
**Answer: Endometrial stroma**
Pain is a key feature of endometriosis. The foci of endometriosis are most often found on serosal surfaces in the pelvis, but can be found in other locations such as the surface of the bowel. Endometrial glands, stroma, and hemorrhage are microscopic features.
104
**Answer: Koilocytes from HPV infection**
## Footnote
A koilocyte is a squamous epithelial cell that has undergone a number of structural changes, which occur as a result of infection of the cell by human papillomavirus.
105
**Answer: priapism**
106
**Answer: T11/12-L2/3**
107
**Answer: Clear cell adenocarcinoma**
108
**Answer: Ectopic pregnancy**
109
**Answer: Functional hypothalamic amenorrhea**
110
**Answer: Sertoli-Leydig cell tumor**
111
**Answer: Prostate**
## Footnote
The most common source of **sclerotic** or blastic bone metastases is a primary malignancy of the prostate.
112
**Answer: No menses by age 13 in absence of secondary sexual characteristics, or no menses by age 15 with secondary sexual characteristics, or no menses two years after thelarche.**
113
**Answer: Used to classify the many different appearances of prostatic adenocarcinoma**
## Footnote
Gleason grading is a system used to classify the many different appearances of prostatic adenocarcinoma into behaviourally prognostic groups based on a complex scoring system of 1 to 5.
Used to calculate a score. A higher score is associated with a worse prognosis. It contributes to the T component (tumour grade) of the TNM staging system.
114
**Answer: Superficial inguinal lymph nodes**
115
**Answer: Inguinal nodes**
## Footnote
**Squamous epithelium** of the **lower 1/3** of the vagina is embyrologically derived from the urogenital sinus; cancer speads to the **inguinal nodes**. The **upper 2/3** of the vagina is comprised of **columnar epithelium** derived from the Mullerian ducts; cancer speads via the **regional iliac nodes**. Vaginal carcinoma is usually associated with high-risk HPV (types 16, 18, 31, and 33).
116
**Answer: Increased tidal volume**
## Footnote
Progesterone causes an increased depth of breathing by relaxing the intercostal muscles and diaphragm.
117
**Answer: Cremaster muscle**
118
**Answer: The follicular phase**
## Footnote
The luteal phase is fixed at 14 days in the majority of women, so the differences in the length of the follicular phase account for cycle length differences.
119
**Answer: MRI of brain to exclude pituitary adenoma**
## Footnote
Prolactinoma is the most common functioning pituitary adenoma and therefore the patient needs imaging.
Prolactinomas may disrupt the hypothalamic-pituitary-gonadal axis as prolactin tends to suppress the secretion of GnRH from the hypothalamus and in turn decreases the secretion of FSH and LH.
120
Which muscle is this?
piriformis
121
**Answer: The anterior longitudinal ligament**
122
**Answer: Uniformly smooth prostatic enlargement**
## Footnote
A normal prostate should feel firm with a smooth surface to the examiner’s gloved finger.
Digital rectal examination (DRE): symmetrically enlarged, smooth (no nodules), firm, nontender prostate with rubbery or elastic texture
The patient's history indicates a bladder outlet obstruction, commonly caused by benign prostatic hypertrophy (BPH).
123
**Answer: The anterior sacroiliac ligament**
124
**Answer: Transitional zone**
125
**Answer: Yolk sac tumour**
126
**Answer: Neisseria gonorrhoeae**
## Footnote
Neisseria gonorrhoeae is a gram-negative diplococcus.
127
**Answer: Tunica vaginalis**
## Footnote
The tunica vaginalis is a pouch of serous membrane and as such a potential space for fluid accumulation. It derives embryologically from the peritoneum and thus has visceral and parietal surfaces. Hydroceles are associated with incomplete closure of the processus vaginalis leading to communication with the peritoneal cavity (in infants) or blockage of lymphatic drainage (in adults). It presents as a scrotal mass that can be transilluminated.
128
**Answer: CA-125**
129
**Answer: Reduced secretion of GnRH**
130
Which muscle is this?
Pubococcygeus
131
**Answer: Human papillomavirus**
132
**Answer: Androgen insensitivity**
## Footnote
Androgen insensitivity syndrome, also known as testicular feminization syndrome, is where patients are genetically and gonadally male, but phenotypically female. Testes are present and functional, producing testosterone, but due to the absence of androgen receptors, tissues do not respond to testosterone androgen effects.
133
Which muscle is this?
Cocyggeus
134
**Answer: Varicocele**
* Varicocele is one of the most common causes of scrotal swelling. It typically presents as scrotal swelling with a "bag of worms" appearance.
* Varicoceles are usually left-sided due to an important anatomical variation: the right testicular vein drains directly into the inferior vena cava, whereas the left firstly drains into the left renal vein.
* The left testicular vein drains into the left renal vein at a right angle; this can disturb flow and cause back pressure into the pampiniform plexus
* The left testicular vein also travels between two arteries, making it vulnerable to compression
* The left vein itself is longer, meaning it is more susceptible to changes in pressure compared with the shorter right vein
135
**Answer: Scrotum → dartos muscle → external spermatic fascia → cremaster muscle → internal spermatic fascia → tunica vaginalis → tunica albuginea**
136
**Answer: A=anteflexed, B=anteverted, C=retroverted, D=retroflexed**
137
Which muscle is this?
Ileococcygeus
138
**Answer: the puborectalis, pubococcygeus and iliococcygeus muscles**
139
**Answer: Choriocarcinoma**
## Footnote
The alpha-subunit of hCG is similar to that of FSH, LH, and TSH
140
**Answer: Choriocarcinoma**
## Footnote
Choriocarcinomas are small, haemorrhagic malignant tumours that spread hematogenously. They mimic placental tissue and are made up of cytotrophoblasts and syncytiotrophoblasts. A high beta-HcG is characteristic on investigation.
141
**Answer: Choriocarcinoma**
142
**Answer: Lymphoma**
143
**Answer: External spermatic fascia**
144
**Answer: Seminoma**
## Footnote
"Seminomas are the most common type of testicular tumour. They are comprised of large cells with clear cytoplasm and central nuclei that form a homogenous mass with no haemorrhage or necrosis." (Pathoma, 2018)
145
**Answer: Sertoli cells**
## Footnote
The Y chromosome is necessary and sufficient for the production of testes, and the testis-determining gene product is called SRY (standing for sex-determining region of the Y chromosome). SRY is a DNA-binding regulatory protein. It bends the DNA and acts as a transcription factor that initiates transcription of a cascade of genes necessary for testicular differentiation, including the gene for Mullerian-inhibiting substance." Ganong's Review of Medical Physiology (25th edition)
146
**Answer: Ectopic pregnancy**
147
**Answer: Chlamydia trachomatis**
## Footnote
C. trachomatitis, the leading cause of non-gonococcal urethritis, is the most frequent form of prostatitis in young adult men. There is typically no history of chronic urinary tract infection, and it is difficult to culture.
148
**Answer: The tunica vaginalis**
149
**Answer: Androgens**
## Footnote
Polycystic ovarian disease results in multiple ovarian follicular cysts. It is characterised by increased LH and low FSH. The increased levels of LH induce excess androgen production from theca cells. Androgen is also converted to estrone in adipose tissue, which decreases FSH release and results in cystic degeneration of follicles. Typically, the clinical presentation fo PCOS is an obese young woman with infertility, oligomenorrhea, and hirsutism." (Pathoma, 2018)
150
**Answer: Epididymo-orchitis**
## Footnote
Positive Prehn's sign: Lifting the affected testicle results in a reduction of symptoms/pain.
A positive Prehn's sign is indicative of epididymo-orchitis; a differential for testicular torsion. However, a negative Prehn's sign does not rule out the possibility of epididymo-orchitis (i.e. this test has low specificity).
151
**Answer: Clue cells, which are a medical sign of bacterial vaginosis, commonly caused by Gardnerella vaginalis**
152
**Answer: Progesterone**
153
**Answer: Neisseria gonorrheae**
154
**Answer: Varicocele**
## Footnote
The increased warmth from the increased vascularity reduces sperm production. Spermatogenesis can only occur at temperature lesser than body temperature; this is reason for male genitalia to be externalised.
155
**Answer: Leydig cell tumor**
156
**Answer: Suspensory ligament**
157
**Answer: Posterolaterally**
158
**Answer: Hypospadias**
## Footnote
Hypospadias are the most common penis abnormality (1 in 300) and result from a failure of male urogenital folds to fuse in various regions. The dorsal and ventral sides of the penis are shown in this image:
159
Late one evening, a 19 year old university student experiences sudden-onset strong discomfort in his scrotum. No position is comfortable for him to sit or lie down in. Aspirin and beer have had no effect. He has a friend drive him to the emergency room. On physical examination his vital signs include temperature 37degrees, RR=22bpm, PR=80bpm, BP = 100/65mmHg. His left testis is slightly enlarge and extremely tender. There is no inguinal adenopathy. A Doppler ultrasound scan is shown below:
**Answer: Torsion**
160
**Answer: Epispadias**
## Footnote
Epispadias are a rare abnormality, seen in 1 / 300'000 newborns. This abnormality can be traced back to a disorder of the mesoderm cell migration during the 4th developmental week.
In boys with epispadias, the urethra generally opens on the top or side of the penis rather than the tip. From the meatal opening to the tip of the penis, the penis is split and is opened, forming a gutter. The penis also usually has some degree of curvature or chordee. In girls, the opening of the urethra is usually between the clitoris and the labia, but may be in the belly area.
The dorsal and ventral sides of the penis are shown in the image below.
161
**Answer: Androgen insensitivity**
162
**Answer: The dartos muscle**
163
**Answer: Lichen simplex chronicus**
## Footnote
This lesion appears in conjunction with human papillomavirus infection.
