Test 2 Flashcards
(112 cards)
1
Q
what forms the acrosome in a sperm cell
A
golgi
2
Q
what gland has a lot of stroma and concretions
A
prostate gland
3
Q
blood moving into what arteries causes the penis to become erect
A
helicine arteries
4
Q
epithelium found in the:
prostatic urethra
membranous urethra
penie urethra
A
prostatic: transitional to stratified columnar
membranous: stratified columnar
penile: stratified columnar to stratified squamous non-keratinizing distally
5
Q
what tubules produce spermatozoa
A
seminiferous
6
Q
where are the cells of leydig
A
in the interstitial connective tissue that surrounds the seminiferous tubules
7
Q
name of the cells that contain 1n DNA
A
spermatids
they are the product of meiosis II
8
Q
what cells give rise to primary spermatocytes
list the types of cells from there all the way to spermatids
A
spermatogonia –> spermatocytes –> secondary spermatocytes (hard to find) –> spermatids
9
Q
if you see short cell tall cell short cell tall cell where are you
what are the functions of the tall cells
A
efferent ductules - moves sperm from the testis into the epididymis
the tall cells are ciliated and the beat of the cilia helps move the sperm towards the epididymis
10
Q
epithelium of the ductus deferens
A
pseudostratified columnar with stereocilia
11
Q
superficial perineal fascia (in the female) and dartos fascia (in the male) is an extension of what fascia of the abdominal wall
A
camper and scarpa fascia
12
Q
colles’ fascia
A
superficial perineal fascia that branches off of the dartos fascia and goes above the testis
13
Q
internal pudendal artery branches off of what
leaves through what foramen
A
internal iliac
leaves pelvis through the greater sciatic foramen, goes back in through the lesser sciatic foramen
14
Q
bartholin gland cysts spread to which lymph nodes
A
superficial inguinal lymph nodes
15
Q
what cells respond to FSH
A
sertoli cells
16
Q
testosterone inhibits the release of what other hormones
A
GnRH (acts through IP3)
FSH (indirectly, via inhibition of GnRH), and LH (both act through cAMP)
17
Q
volume of dist. for testosterone
A
1L/kg
because it is fat soluble (fat soluble things have a high volume of distribution)
18
Q
what cells secrete mullerian inhibiting factor (MIF) and what does it do
A
sertoli cells
causes the primordial female duct system to regress, giving rise to male genitalia
19
Q
gonadorelin and leuprolide
A
not in FA - not used often
GnRH analogs (agonists)
(gonadorelin is synthetic human GnRH)
stimulates FSH and LH
*if given in pulses, they increase FSH, LH and GnRH
if given continuously, they wear out the receptors - used to suppress testosterone synth in prostate cancer
leuprolide can be used in LIEU of GnRH
20
Q
where is the androgen receptor in the cell
A
in the cytoplasm
21
Q
oxandrolone
A
DHT derivative
orally active, anabolic steroid that promotes muscle growth
22
Q
flutamide, bicalutamide
A
non steroidal (“pure”) androgen receptor antagonists used in prostate carcinoma
use initially with GnRH agonists to stop the initial stimulating effect
SE: gynecomastia, hepatotox
23
Q
the GnRH antagonists
A
Degarelix - male chemical castration
Ganirelix, Cetrorelix - blocks premature LH surge in females
more expensive, less commonly used
24
Q
of the following what does testosterone inhibit directly? indirectly?
GnRH, LH, FSH
A
directly: GnRH, LH
indirectly (by inhibiting GnRH): FSH
25
testis are drained by what lymph nodes
periaortic and retroperitoneal
inginals drain the penis, scrotum, and legs, but NOT the testis
26
what general types of testicular tumors are very uncommon and almost always benign
Sex cord stromal tumors:
sertoli cell tumor
leydig cell tumor
granulosa cell tumor
mixed
27
most common testicular germ cell tumor
seminoma
Malignant; painless, homogenous testicular enlargement; most common testicular tumor. Does
not occur in infancy. Large cells in lobules with watery cytoplasm and “fried egg” appearance.
placental ALP. Radiosensitive. Late metastasis, excellent prognosis.
28
what cells that are naturally in placentas also show up in seminomas and choriocarcinoma
syncytiotrophoblasts - produce hCG, which can be used as a tumor marker
29
why do some vietnam war vets have a higher incidence of prostate cancer
exposure to dioxin (agent orange)
30
PSA velocity numbers that are worrying
psa velocity rise of greater than .75ng/ml in one year
31
usefulness of a free PSA test
useful in determining need for biopsy when total psa level is between 4 and 10
cancer is unlikely if it is greater than 25% free PSA
low percent of free PSA is bad
32
how do you know that you have a secondary follicle in follicular development
if it has a disjointed antrum (liquid space)
33
function of the theca interna
produces androgens that can be converted into estrogens by granulosa cells
highly vascular, epithelioid
34
what is on the inside layer of the granulosa cells in a primary follicle
zona pellucida
| eosinophilic
35
corpus luteum
temporary glandular structure that is derived from remnants of ruptured follicle following ovulation
granulosa cells in there enlarge and transform into granulosa lutein cells, produce progesterone and estrogen
theca interna cells enlarge and transform into theca lutein cells, which also produce progesterone and estrogen
if embryo does not develop, it involutes and forms a corpora albicans (white scar)
36
relaxin
inhibits contraction of myometrium during pregnancy
promotes dilation of cervix
37
peg cells
in the fallopian tube
make secretions
38
what layer of the endometrium gets shed during menses
functional layer
39
during the proliferative phase of the menstrual cycle, what glads and increasing in number and length?
what are they accumulating?
straight tubular glands in the functional layer of the endometrium
they accumulate glycogen
40
what stimulates the first meiotic division of an oocyte? second?
LH surge in responsive follicles stimulates the first division
fertilization stimulates the second
41
during ovulation, why do you see a surge of LH and not FSH
inhibin is suppressing FSH selectively
42
corpus luteum
hormone secreting (hCG) structure that develops in an ovary after an ovum has been discharged but degenerates after a few days unless pregnancy has begun
43
you inject a pregnant womans urine into a rabbit
what happens
the hCG in the urine mimicts LH by binding to the LH receptor, causes a corpus luteum to be formed in the rabbits ovary
44
why is oxytocin only effective in the third trimester
because in the first and second trimester, progesterone levels inhibit the oxytocin receptor, but in the third trimester there is more estrogen, which ramps up the oxytocin receptors
45
what is the function of going from progesterone dominance in the first 2 trimesters to estrogen dominance in the 3rd
increases oxytocin receptors
promotes uterine contractility (oxytocin and prostaglandins)
cervical ripening (you can smear prostaglandins on the cervix to cause it to ripen)
increases local prostaglandin release from the placenta which causes myometrial contraction
46
why do you get no milk secretion if the placenta is retained
because it is a source of progesterone, which inhibits lactation
47
what hormone stimulates the theca and what does it produce after stimulation
LH stimulates the theca, which produces androgen precursors to estradiol
48
what hormone stimulates the granulosa and which does it produce after stimulation
FSH
estradiol (suppresses GnRH and LH) and inhibin (suppresses FSH)
49
what is weird about estradiol during ovulation
tracht fact
estradiol augments (instead of inhibits) GnRH and LH, also FSH (but FSH in inhibited by inhibin)
50
graafian follicle
mature follicle of the ovary
antrum is at its largest
51
where is the corona radiata
it is the granulosa cells that remain attached to the zona pellucida of the oocyte when it is in the secondary and graafian follicle forms
52
large, lighter cells in the corpus luteum?
smaller, darker cells?
which produce progesterone and estrogens
granulosa lutein cells - larger, light, bulk of the corpus luteum
theca lutein cells are small and dark - come from the theca interna
corpus luteum produce progesterone and estrogens
53
what cells are not ciliated in the oviduct epithelium
peg cells
54
most common cause of abnormal vaginal bleeding
95% endometrial in origin - dysfunctional uterine bleeding = disorders of ovulatory cycle (anovulation) either idiopathic, perimenarchal, perimenopausal
or due to polycystic ovarian syndrome
55
post menopausal vaginal bleeding is what
Cancer until proven otherwise
but also endometrial atrophy (actually this is more common)
56
worst cancer of the ovary
serous epithelial cancer
57
commonest tumor in women in their 20s
germ cell: dermoid cyst (AKA mature cystic teratoma)
58
accreta
when the placenta has grown into the myometrium
59
mastitis is almost always caused by
S. aureus (but witraks kid had group B strep)
60
what bugs can cause perihepatitis, when the liver binds to the peritoneum and forms violin string adhesions
chlamydia trachomatis
neisseria gonorrhoeae
chlamydia trachomatis
called fitz-hugh-curtis syndrome
comes on after pelvic inflammatory disease
61
abnormal maturation of squamous cells with vacuolization and hyperchromasia (low grade dysplasia)
HPV condyloma
62
most common type of cancer of the vulva
squamous carcinoma (precursor is vulvar intraepithelial neoplasia)
63
plaque or thickness in the vulva is what until proven otherwise
cancer - can even look like a condyloma
64
why is the cervix more vulnerable to HPV infection than any other genital tract site
it contains immature metaplastic squamous epithelium at the transitional zone
65
how do you diagnose a testicular torsion
doppler imaging showing decreased ar absent blood flow to affected testicle
66
why do women in their 20s get endometrial cancer
polycystic ovarian syndrome
diabetes
causes continual estrogen phases
67
what happens to the endometrium if you have anovulation
it proliferates too much and puts you at risk for endometrial cancer
68
multiple lung mets years after a historectomy
endometrial stromal sarcoma
69
surgical wound from c section gets a growth with rubbery white tissue with hemosiderin brown spots
endometriosis
70
catamenial pneumothorax
endometriosis on the pleural surface in lung that causes monthly pneumothoraces
71
"2 ways that GI pathology can present as acute abdominal pain in a woman without rebound tenderness"
enlarged, infarcted leiomyoma (outgrows its blood supply)
adnexal torsion (sometimes assc with tumor, but not always)
but I would think ectopic pregnancy as well?
72
genetics assc with peritubal carcinoma (fallopian tubes)
BRCA 1&2
73
most common ovarian benign cyst
follicle or corpus luteal cysts
follicular cyst - may be assc with hyperestrogenism, endometrial hyperplasia
74
commonest tumor in women 10-30
dermoid cyst
AKA mature cystic teratoma
75
largest tumors in humans
ovarian mucinous neoplasms
76
what types of tumors are almost always malignant in the testis but almost always benign in the ovary
germ cell tumors
specifically immature teratoma,
category also includes yolk sac, choriocarcinoma, embryonal carcinoma, dysgerminoma
77
calcium in a cystic lesion in a woman in the pelvis
dermoid cyst (teeth or jaw bone)
78
see orange or yellow in vesicles that is not necrosis
it is producing steroids (granulosa cell tumor for example) - think Call-exner bodies (granulosa cells arranged haphazardly around collections of eosinophilic fluid)
79
hCG in ectopic pregnancy?
molar gestation?
it doesn't double as fast in ectopic
it doubles faster in molar
80
risk of infection during delivery due to what commonly
rupture of membranes and then like 12 hr until they deliver
81
asian presents with new onset seizure in pregnancy
metastatic molar neoplasia until proven otherwise...
moles and choriocarcinoma prevalent in southeast asia
get super high hCG
82
what can be used after pregnancy to stop bleeding
ergots - contract the uterus and constricts veins
they cause smooth muscle contraction
ergonovine, ergotamine
83
whats a tocolytic
name 2
a thing used to stop uterine contractions
terbutaline is the classic
also magnesium sulfate (competes with calcium)
84
what type of prostaglandin can be smeared on the cervix to make it relax
PGE2
85
atosiban
oxytocin receptor antagonist
only one approved for clinical use but its not used much
causes increased fetal fatality
86
how can you tell if someone with amenorrhea is ovulating or not
progestin challenge
give progesterone every day
if they bleed in 2-7 days of it then they are not ovulating
IF normal or low FSH, LH: View sella turcica - may be hypothalamic amenorrhea
High FSH, LH - ovarian failure
87
what birth control would one of the lecturers use for a lactating patient
progesterone only
estrogen may inhibit lactation or it may not
88
IUD that may make periods larger?
IUD that will make them less heavy, but more irregular
heavy - copper IUD (paragard)
levonorgestrel-releasing intrauterine system (LNG-IUS) - has progesterone and may reduce heaviness but you may spot
89
essure
put a stick in the fallopian tube and it makes a scar
90
what tightens the internal urethral sphincter
what relaxes the bladder dome
alpha-1 receptors being bound
(sympathetics are involved in storage)
beta 2 relaxes the dome
91
inhibiting contraction in the bladder can do what to the mouth
what receptor
cause dry mouth
M3 receptor (M2 receptors are also bound during bladder contraction)
92
pessaries
inserts into the vagina and has a ball to hold stuff in place
93
oxybutynin
nonselective anticholinergic used for urinary incontinence
94
tolterodine
nonselective anticholinergic used for urinary incontinence
| detrol
95
darfenacin, solifenacin
M2 selective anticholinergic used for urinary incontinence
less dry mouth than the nonselectives
enablex and VESIcare
96
mirabegron
B2 adrenergic receptor antagonist
relaxes the bladder to treat incontinence
97
clomiphene
estrogen receptor antagonist in the hypothalamus, prevents normal feedback inhibition and causes an increase in LH and FSH
SE: hot flashes, ovarian enlargement, multiple simultaneous pregnancies, visual disturbances
98
menotropin, urofolitropin
FSH and LH urine extract
99
follitropin
just FSH
100
fulvestrant
"selective estrogen receptor disruptor"
antagonist of estrogent in all areas, breast, uterine, and bone
bone antagonist = not used much
101
anastrozole, letrazole, exemestane
aromatase inhibitor
used in breast cancer in postmenopausal women
anasty odor stanes
102
medroxyprogesterone, norethindrone, levonorgesterol
progesterone receptor agonist
103
mifepristone
progesterone receptor antagonist - used for termination of pregnancy with misoprostol, or emergency contraception
104
gosetrelin
GnRH receptor agonist
used in breast and prostate cancer to suppress FSH and LH by burning out the receptors
105
abiraterone
17 alpha hydroxylase inhibitor
| stops conversion of pregnenolone and progesterone to their 17-hydroxy counterparts
106
```
tamoxifen
vs
toremifene
vs
raloxifene
vs
fulvestrant
```
all answers are referring to estrogen
tamoxifen - antagonist in breast, agonist in uterus (bad), agonist in bone
vs
NOT IF FA - toremifene - antagonist in breast, unknown in uterus, no effect on bone (it is unknown just like its spelling (trachte spelled it wrong twice)
vs
raloxifene - ALL of the GOOD effects (the RAL course does good everywhere)
vs
fulvestrant - antagonist everywhere (good everywhere except bone)
107
anthracyclines used in breast cancer
5-FU (stops thymidylate synthase)
doxorubicin (intercalates into DNA and damages it)
cyclophosphamide (alkylating agent)
108
what unwinds the HPV viral genome and recruits host cell DNA polymerase to duplicate it?
E1
E2 is the loader of E1. It helps E1 get onto the viral genome
109
E6 and E7
what do they do
Viral E6 binds to the host E6AP and P53 to form trimeric complex
P53 gets ubiquitinated (P53 normally is a DNA damage checkpoint - interacts with the RB gene too)
Viral E7 binds RB (16 and 18 HPV have a very strong binding to RB) - RB cannot then bind to E2F and sequester it (E2F not bound to RB transcribes replication enzymes)
110
purulent penile discharge
what is it
virulence
Tx
media?
N. gonorrhea
gram neg intracellular diplococci
IgA protease
Capsule (SHiNE)
endotoxin
Tx - ceftriaxone (+ doxy for probably concurrent chlamydia)
difference from meningitidis - it only oxidises glucose, meningitidis oxidises maltose too
thayer-martin media - vanco, colistin, nystatin, SXT - sheep's blood, beef, starch
111
mech of acyclovir
guanosine analogs that terminate DNA synth
monophosphorylated by HSV/VZV thymidine kinase
112
pseudohyphae
whiteish discharge
itching
candida yeast infection
