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Flashcards in SAS/Review Deck (144)
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1

Which antibiotic is associated with pumonary fibrosis?

Nitrofurantoin

2

What is the treatment for endometrial hyperplasia?

Progesterone therapy or hysterectomy

 

(Sometimes do progesterone now, plan hysterectomy for later if pt wants to have more children)

3

B - rule out other sources of hyperandrogenism

 

Most likely PCOS, but cannot say definitively until other causes (tumor, CAH, Cushing) are ruled out

 

4

List the estrogenic (4) and anti-estrogenic (2) effects of tamoxifen

  • Estrogenic
    • Venous thrombosis :(
    • Endometrium: polyps, hyperplasia, risk of cancer :(
    • Maintains bone density :) 
    • Maintains vaginal mucosa :)
       
  • Anti-estrogenic
    • Breast :) - fights cancer!
    • Hot flashes :(

 

5

List 2 nerves that innervate levator ani

Pudendal nerve (inferior rectal branch)

Nerve to the levator ani

 

Nerve to the levator ani is also from the anterior branches of S2, S3, S4, but not the same as the pudendal

 

6

Which kidney stones are diamond-shaped?

Calcium oxalate

7

What is the most malignant tumor involving the spermatic cord?

Liposarcoma

8

Describe the management of placenta previa

  • Pelvic rest 
  • Expectant management
    • Give antenatal steroids if <34 weeks
  • Planned C-section at 37 weeks

 

9

What is the function of prostate-specific antigen?

Liquifies semen

 

(And also used as a marker for prostate cancer)

10

In a patient with functional hypothalamic amenorrhea, what would you expect the results to be from:

  • Prostestin challenge:
  • Estrogen + progestin challenge:

  • Prostestin challenge: No bleeding (negative)
    • Implies either outflow obstruction OR low estrogen
  • Estrogen + progestin challenge: Bleeding (positive)
    • Implies low estrogen; cause of amenorrhea is central

 

Functional hypothalamic amenorreha = suppresed GnRH -> no LH/FSH -> no estrogen or progesterone 

NOTE: GnRH levels cannot be measured in the blood

11

Which nerve is responsible for emission?

Which one is responsible for ejaculation (aka expulsion)?

 

(How are these two entities different?

Emission: Lumbar sympathetic nerves 

Ejaculation (expulsion): Pudendal nerve (somatic)

 

 

Emission gets semen to the posterior urethra

Ejaculation gets it out into the world

12

What kind of renal cancer is associated with hereditary leiomyomatosis renal cell cancer?

What is the causative gene?

Papillary RCC type 2 or collecting duct carcinoma

FH

13

List 3 features of koliocytes

  • Large cells
  • Large, crinkled, possibly binucleated nuclei (raisin-like)
  • Perinuclear clear halo

 

14

Which of the following is a contraindication to medical abortion?

  1. Inadequate cervical cancer screening
  2. Long term OCP use
  3. IUD in place
  4. Liver disease

c. IUD in place

 

 

15

Which imaging study is most useful for diagnosing hydronephrosis?

Ultrasound

 

CT is pretty good, but, not the best for imaging things with a large cavity in the middle

16

A patient on a combined OCP is experiencing nausea and breast tenderness.

Which hormone is most likely responsible for these effects?

How would you modify her OCP to mitigate these effects?

Estrogen

Switch to a combined OCP with a lower dose of estrogen

17

What is the usual natural history of mild cervical dysplasia due to HPV infection?

Usually, the dysplasia will regress and resolve

  • Can progress - slow growing
  • More likely to progress in immunocompromised individuals

 

18

Which hormone can be measured (and when) to predict ovulatioN?

Serum progesterone on day 21 and 27

 

More reliable than temperature charting

19

MOA: Finasteride

5-alpha-reductase inhibitor

Acts as an anti-androgen by preventing the conversion of testosterone to the more potent DHT

Anti-androgen therapy helpful in the treatment of BPH

20

6 weeks after surgical removal of a cancerous prostate lesion, a patient's PSA is elevated (>0.1 ng/mL)

What is the best adjuvant approach?

Combined androgen ablation + radiation

21

What is the female homolog of the male prostate?

Where is it located?

Skene gland

Around the opening of the urethra

(In the vestibule, anterior to the opening of the vagina)

22

Where would a Gartner's duct cyst be located?

What cause this cyst?

Anterolateral aspect of the proxmal vagina

Wolffian duct remnant

23

Which GI complaint is most common in the first trimester of pregnancy?

Why?

Nausea + vomiting

Caused by high hCG

24

What are the histologic features of a mixed germ cell tumor (embryonal carcinoma) of the testes?

Solid, glandular, and papillary patterns

25

What is the primary arterial blood supply to the prostate?

Inferior vesical artery

26

What is the half life of PSA?

2-3 days

27

What is the differece between mild, moderate, and severe cervical dysplasia?

  • Mild = lower 1/3 of epithelum only
  • Moderate = Involves middle 1/3 and lower 1/3 of the epithelium
  • Severe = Involves the hwol epithelium

 

28

What is the most serious and likely side effect estrogen-only hormone replacement therapy?

Endometrial cancer

 

DVT also possible, but less common?

29

What is the histologic hallmark of a yok sac tumor?

Schiller-duvall body

 

30

If a patient's testicular tumor markers do not normalize after orchiectomy, what is the next step in their managment?

Start chemotherapy

 

If tumor markers don't normalize, implies metastatic disease

Do chemotherapy; if tumor markers normalize, can do post-chemotherapy surgical resection (PC-RPLND)