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Flashcards in Shit - Repro Deck (108):
1

FAS mutations

limb dislocation, heart defects (PDA, VSD, ASD), Tetrallogy, heart-lung fistulas, holoprosencephaly.

2

syncitiotrophoblast role

Secrete bHCG which looks like LH, so corpus luteum is stimulated to keep making progesterone and not regress (sustains pregnancy). Eventually the placenta will take over progesterone (and estrogen) production role.

3

Syncytiotroph cell marker

NO MHC-I - prevents attack by maternal system

4

umbilical artery vs vein: carry, #, derived from, problems

Umbilical arteries (2) = deO2 from baby's internal iliac
Umbilical vein (1) = O2 blood from placenta to baby liver/ductus venosus.

Derived from allantoid (form yolk sac)

1 artery (2-vessel cord) = congenital/chromosomal abnormalities

5

Urachus

from yolk sac from allantois
connects urogenital sinus to yolk sac
Fail to fust: fistula (bellybutton pee), cyst, vesicourachal diverticulum

6

vitelline duct

= omphalomesenteric duct
connects midgut to yolk sac
Fail to fuse = fistula (bellybutton poo), cyst, or meckel's diverticulum

7

MEckel's sequale

infection.
heterotopic gastritis (choristoma)
heterotopic pancreatic (choristoma)

8

Digeorge =

missing 3rd and 4th pouches
3 = thymus + inferior parathyroids
4 = C-cells + superior parathyroids

Parathyroids always from the dorsal wings; other = ventral

9

Cleft lip = failure of:

1' palate
maxillary and medial NASAL processes

10

Cleft palate = failure of:

2' palate
2 lateral PALATNE processes; or lateral PALATINE process with nasal SEPTUM or medial PALATINE process

11

congenital torticolis: s/s

neck, dip dysplasia, matatarsal adductus, talipes equinovarus

12

SRY

makes TDF --> grow testes

13

MIF

from sertoli cells, inhibit mullein (paramesonephric) duct system

14

Testosterone (embyo)

From leydig, makes internal male genetalia (except prostate)

15

Missing MIF or sertoli

Male from leydig side, but no regression of internal female genetalia

16

Missing 5-a-reductase

can't turn testosterone to DHT, so internal male, external ambicuous until puberty, puberty = massive testosterone spike which promotes 2' male sex characteristics

17

Uterus malformations: order of severity

septate, bicorunate, didelphys (double everything)

18

Mullerian agenesis (Maybe-Rokitansky-Kuster-Hauser)

Mullerian duct does not develop.
Ovaries and short blind vagina present.
1' amenorrhea, no uterus/tubes

19

genital tubercle

glans (both), shaft, vestibular bulbs

Malposition = epispadias

20

urogenital sinus

Senke and bartholin
bulbourethral (cowpers) and prostate

21

urogenital folds

labia minora and ventral penis

Fait to fuse urethral fods = hypospadias

22

associations with hypospadias

cryptorchidism and inguinal hernia

23

associations with epispadias

bladder exstrophy

24

use of misoprostol (PGE1 analog) with mifepristone

sensitizes myometrium to mifepristone; also causes abdominal cramping/pain

25

gland penis and clitoris lymph drainage

deep inguinal

26

broad ligament

connects everything to pelvic SIDE wall

27

Nerves of boners

Erection = S2-S4 pelvic splanchnics (PSNS to hindgut)
Emission = SNS hypogastrics
Ejaculation = visceral and somatic nerves (pudendal)

28

Male cell affected by temperature

Stroll ONLY (so T fine)

29

enzymes in granulosa vs theca cells

granulosa = aromatase
theca = desmolase

* after ovulation, granolas get LH-R; bring in cholesterol to make PROGESTINS

30

Estrogens from where?

Estradiol = ovary
Estrone = fat
Estriol = placenta *test of fetal well-being; placenta makes it from fetal adrenal DHEA to liver A/T

31

Estrogen levels in pregnancy

Estradiol and estrone increase 50x
Estriol increases 1000x

32

Hormone that increases body temperature

progesterone

33

Hormones on gonadotropins

Estrogen inhibits LH
Inhibin inhibits FSH
Progesterone inhibits both LH and FSH

34

Progesterone on estrogen

down regulated estrogen receptors (prevents unopposed estrogen and thus endometrial hyperplasia/CA)

35

Basic preeclampsia s/s

HTN, proteinuria, edema

36

Vaginal agenesis aka mullerian aplasia

mullein failure with short vagina and no or rudimentary uterus and tubes; no uterus = 1' amenorrhea. Ovaries present, so full female 2' sexual characteristics.

37

AIS

look female, but male internal structures. So internal testes, and minimal pubic/axillary hair because insensitive to androgens

38

Kartageners vs CF infertility

Kartgeners = immotile cilia
CF = congenital absence of vas def

39

Turner via:

Loss of paternal X

40

Poli vs oligo - menorrhagia

oligo = few bleeds .: LONG cycle >35d
poly = many bleeds .: SHORT cycle

41

stage of oocyte and chromosome contents

birth to ovulation = MIPI = 2N4C
ovulation to fertilization = MIIMII = 1N2C
post-fertilization = complete MII = 1N1C

42

Estrogen positive feedback mechanism

Estrogen induces GnRH receptors on the AP

43

Mittelschmerz

mid-cycle pain from peritoneal irritation (i.e. follicle swelling, tubal contraction); ddx = appendicitis

44

post-ovulatoin dates: fertilization (conception), implantation, bHCG detectoin

1d = fertilization (24h viable; sperm = 72)
6d = implant
d7 = blood bHCG
d14 = urine bHCG

45

What hormone(s) inhibit lactation during pregnancy

Progesterone AND estrogen

46

why don't you get pregnant while breastfeeding?

prolactin inhibits GnRH release (only if baby feeds on demand)

47

what is in breast milk, and what diseases does it prevent

IgA, Macro, Lympho.
Baby: asthma, allergies, DM, obesity
Mom: breast and ovarian CA

48

where doe sP come from throughout pregnancy:

pre-conception = CL via LH
conception - week 8/10 = CL via syncitiotrophoblasts acting like LH; identical alpha units on LH, FSH, hCG, and TSH (.: preg test looks for beta subunit of hCG (b-hCG))
week 8/10- end = placenta (makes P and E)

49

high vs low hCG and what it means:

high = twins, h. mole, chorioCA, downs
low = patau, edwards, failing/ectopic pregnancy

50

hPL job and outcome

inhibits maternal glucose uptake (give glucose to baby) and induces lipolysis (to feed mother with KB and FFA).

Increased by maternal hypoglycaemia, and can cause gestational DM

51

best marker of menopause

high FSH (no estrogen to feedback)

52

chromosome numbers in sperm development

gonium = 2N2C
1'cyte = 2N4C
2'cyte = 1N2C
tid = 1N1C

53

late DHT effects

prostate growth, balding, sebaceous gland activity

54

where is aromatase found in males:

adipose and testes (sertoli)

55

Hormone levels in XXY

High LH and FSH
Low T and Inhibin (destruction and hyalinization of seminiferous tubules)
High E

56

Turners: what is missing, hormone levels

Missing: ovaries (streaky), period (via hormones), barr body
Hormones: low E, high LH and FSH

57

how to get XYY male + s/s

non-disfunction at dad M-II
s/s = tall, acne, LD, autism-spectrum

58

M-I vs M-II nonductionction; terminology

M-I = homologous chromosomes fail to separate = different
M-II = sister chromatids fail to separate = identical

59

Maternal virilizatoin during pregnancy

fetus has aromatase deficiency; testosterone crosses the placenta

60

Kallmans genes and s/s

LOF of Kal-I, FGFR-1, GPR-54, GnRH-Rs
Anosmia, infertile, midline defects, long armspan, unlit. renal agenesis, syndactyly

61

complete mole:

XX or YY (empty egg + usually 1 sperm that then duplicates).
Dad controls placenta, so only see trophoblasts.
S/s = 1st trimester bleeding, very high hCG, enlarged uterus, hyperemesis, pre-eclampsia, hyperthyroidism, theca-lutein cysts, honeycomb/grapes/US snowstorm

62

partial mole =

69 so maternal also so both placental and fetal parts.
bleeding + abd pain

63

Gestational HTN =

>140/90 after week 20; NO other s/s

64

Pre-eclampsia s/s + mechanism

Gestational HTN + proteinuria or end-organ dysfunction.
Via abnormal placental spiral arteries

65

pre-eclampsia drugs =

antiHTN (a-methyldopa, hydralazine, labetalol, nifedipine).
IV Mg-sulfate to prevent seizures (eclampsia)

66

HELLP: s/s + rx

pre-eclampsia + Hemolysis, Elevated Liver enz, Low Platelets. Can cause hepatic sub-capsular hematomas
Rx = delivery

67

Eclampsia s/s + rx

pre-exlampsia + seizures
Die from stroke, intracranial bleed, ARDS
Rx = IV Mg-sulfate + delivery

68

Painful vs painless 3rd trimester vaginal bleeding in pregnancy

painless = placenta previa
painful = placenta abruptio

69

vasa previa: mechaism, s/s

usually via velamentous cord (into amino-chorio then to placenta rather than straight into placenta)
PainLESS bleeding, membrane rupture, fetal bradycardia (

70

Random cases of poly and oligohydramnios:

Poly = maternal DM, fetal anemia
Oligo = placental insufficiency

71

Incidence of tumours vs mortality

Incidence (USA) = endometrial > ovarian > cervical
Mortality = ovarian > cervical > endometrial

72

Vagina tumours (3)

SqCC - 2' from cervical from HPV
Clear cell AdenoCA - from adenosis from columnar remnants, via DES
Sarcoma botryoides -

73

E6 and E7

E6 - degrades p53
E7 - displaces TFs on Rb

74

Lichen sclerosis vs lichen simplex chronicus

Sclerosis = thin epi, fibrosed derm, parchment, risk SqCCA
simplex chronicus = leathery from itching

75

PCOS treatment

weight loss, spironolactone, ketoconazole, OCP, clomiphene citrate (blocks E-R @ hypo to increase LH and FSH to induce ovulation)

76

Follicular vs theca-lutein cyst associations

follicular = high estrogen, endometrial hyperplasia
theca-lutein = chorio-CA and H mole

77

Random RF and preventative factor for ovarian tumours

RF = HNPCC (also for endometrial CA)
Protective = tubal ligation

78

Benign ovarian neoplasms with buzzwords

Serous cystadenoma - columnar
Mucinous cystadenoma - multiloculated
Endometrioma - chocolate cyst
Dermoid - 3 layers; can be struma ovarii
Brenner - urothelium, coffee bean nuclei, encapsulated tumour
Fibroma -spindle; Meigs = fibroma, ascites, hydrothorax
Thecoma - estrogen

79

Malignant ovarian neoplasms with buzzwords

Immature teratoma - neuroectoderm
Granulosa - Estrogen/Progesterone; Call-exner bodies
Serous cystadenocarcinoma - psammoma bodies
Mucinous cystadenocarcinoma - pseudomyxomaperitonei (can also be from appendix)
Dysgerminoma - hCG and LDH
ChorioCA - hCG, early lung mets (SOB, hemoptysis)
Yolk sac - Schiller-Duvall (like glomeruli), AFP, ovaries/testies or sacrococcygeal
Krukenberg - mets, signet ring

80

Leiomyoma vs adenomyosis

Leio = irregularly enlarged; whorled
Adeno = uniformly enlarged; SM hypertrophy and hyperplasia around hyperplaised endometrial basal layer

81

Asherman's syndrome

2' amenorhhea via stratum basale loss (i.e. D+C)

82

Intraductal papilloma: where, s/s

lactiferous duct .: serous/bloody nipple discharge (but benign)

83

FCC with sclerosing adenosis

calcifications

84

Lactation mastitis: bug and Rx

s. aureus; dicloxacillin

85

gynecomastic drugs:

Spironolactone, Digoxin, Cimetidine, Alcohol, Ketoconazole

86

Triple negative breast cancer

Black, more aggressive

87

Most important prognostic factor

axillary LN mets

88

Comedocarcinoma

Type of DCIS with central necrosis

89

rock hard breast mass with sharp margins, small glandular cells, stellate infiltration

invasive ductal CA. Most invasive, worst, MC

90

Indian file

Invasive stromal

91

Subtypes of invasive ductal:

Tubular
Mucinous
Inflammatory: peau d'orange, blocked dermal lymph drainage
Medullary: lymphocytic infiltrate

92

Peyronie

fibrous plaque in tunica albuguinea (surrounds cavernosae)

93

causes and rx of priapism

cause = sildenafil, trazodone
rx = phenylepherine direct, manual, aspirate

94

SqCell penis:

Bowens = leukoplakia
Queyrat = erythroplakia (cancer of gland)
Bowenoid = CIS

95

Wxtragonadal germcell tumours: location in adults and kids

Adults = retroperitoneum, mediastinum, pineal gland, suprasellar

Kids = sacrococcygeal teratoma

96

LGV via

Chlamydia L1-L3
necrotizing granulomas

97

fluctuant scrotal cyst

spermatocele

98

Seminoma: who, marker

men in 30s (MC tumor).
ALP
Dysgerminoma = hCG and LDH]

99

yolk sac: who, marker, histo

boys

100

chorio in men s/s

gynecomastic and hyperthyroidism

101

teratoma in men

mature may malignant, hCG, AFP

102

embryonal CA

malignant, hemorhagic, necrosis, PAINFUL, usually mixed

103

Lydig cell tumours

reinke crystals, golden brown, androgens or estrogens

104

BPH lobes and zone

Lateral and middle LOBES
Periurethral ZONE
HyperPLASIA

105

Acute vs chronic prostatitis

Acute = bacterial (e. coli)
chronic = bacterial or abacterial (MC)

106

Prostate Ca lobe and zone

Posterior LOBE
Peripheral ZONE

107

Prostate CA markers and grading

PPAP and PSA (increase total, decrease free fraction)
Grading via Gleason = architechture (not atypia)

108

Prostate CA bone mets =

Osteoblastic .: sclerotic lesions