Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
78 Cards in this Set
- Front
- Back
|
What are some risk factors for endometrial hyperplasia?
|
PCOS, > 40 years old, estrogen treatment, increased exposure (early menarche, granulosa theca cell, late menopause), nulliparity, obesity, DM (type 2), hypertension
|
|
|
What does estrogen stimulate?
|
endometrial lining and hyperplasia
|
|
|
What are the causes of cervicitis?
|
gardnella vaginalis, trichomonas vaginalis, candida albicans, and chlamydia trichomatis
|
|
|
What is associated with HPV?
|
inhibition of tumor suppressor genes p53 and RB
|
|
|
What is the treatment for low grade CIN (CIN 1)?
|
mild dysplasia. cryotherapy, laser, loop electric excision procedure
|
|
|
What is the treatment for high grade CIN (CIN 2 and CIN 3)?
|
cone biopsy
|
|
|
What are the stages of invasive cervical carcinoma?
|
stage 0 = CIS
stage 1 = invasive carcinoma (cervix) stage 2 = cervix + upper vagina stage 3 = pelvic wall stage 4 = pelvic wall + bladder |
|
|
What are the benign uterine disorders?
|
endometrial polyps, PCOS (polycystic ovarian syndrome), endometriosis, uterine leiomyoma,
|
|
|
What is the cause of polycystic ovarian syndrome?
|
EXCESS LH
-->stimulates ovarian theca cells (produce androgen) -->androgen causes acne and hirtuism & estrogen -->estrogen inhibits ant pituitary ( decreased FSH) |
|
|
What are some causes of anovulatory periods?
|
pregnancy and polycystic ovarian syndrome
|
|
|
Patient presents w/ infertility, amenorrhea, oligomenorrhea, acne, and hirstuism, obesity, and diabetes. What does the patient have?
|
polycystic ovarian syndrome
|
|
|
Patient has dysmenorrhea, dyschezia (difficulty in defecating), and dyspareunia. What does the patient have?
|
endometriosis (chocolate cysts may also be present)
|
|
|
Black patient has a biopsy and shows "whorled pattern of smooth muscle bundles" and abnormal menstrual bleeding. What is the cause?
|
uterine leiomyoma ie fibroma (benign, estrogen sensitive masses). In reproductive females
|
|
|
What are some side effects of having uterine leiomyoma?
|
urinary frequency, impaired infertility, increased risk of spontaneous abortion, postpartum hemorrage
|
|
|
What is the genetic component for a "complete mole"?
|
completely paternal
2 "X" chromosome, containing sperm that have fertilized one ENUCLATE ovum **higher risk for malignancy than incomplete mole (immature) |
|
|
What is the genetic components of an incomplete mole?
|
ovum with 2 or more sperm. paternal and maternal genetic material. Yielding-->triploidy, tetraploidy
**lower risk for malignancy (than complete mole) |
|
|
Patient has cystic swelling of villi (grape like cysts) with trophoblastic proliferation with VERY high levels of beta-HcG. What is the dz?
|
hydatidiform mole
|
|
|
What is choriocarcinoma?
|
malignant neoplasm of trophoblastic cells (placenta) in ovary or testes
|
|
|
What are some causes of choriocarcinoma?
|
retained gestational trophoblast, retained placenta from deliver or placenta, spontaneous
|
|
|
What are the 3 benign breast cancers
|
fibroadenoma (most common)
phyloiddes tumor (+ 60 yo) intraductal papilloma (nipple discharge) |
|
|
What are the most common malignant breast cancers?
|
ductal carcinoma, lobular carcinoma, paget's dz of the nipple
|
|
|
What are the 5 types of ductal carcinoma in situ?
|
comedocarcinoma (solid sheets of malignant cells)
solid cribriform (nests) papillary micropapillary |
|
|
Patient has "scirrhous" (hard) mass that is fixed. The skin is peau d'orange with nipple retraction, dimpling. What is the dz?
|
invasive ductal carcinoma
|
|
|
Patient has bilateral masses in the breast with signet ring cells.
|
Lobular Carcinoma
|
|
|
What breast cancer is associated with BRCA 1 mutation?
|
medullary carcinoma
|
|
|
What breast cancer has a gelatinous consistency?
|
colloid (mucinous) carcinoma
|
|
|
What is the MC mass in the breast associated with calcifications?
|
ductal carcinoma in situ
|
|
|
What are the oncogenes associated with breast cancer?
|
c-erb-B2 (HER-2/neu)
|
|
|
What are the tumor suppressor genes associated with breast cancer?
|
BRCA-1, BRCA-2, p53
|
|
|
Glossitis
|
B2 or B12 deficiency
|
|
|
Cheilosis
|
drying and scaling of the lips
B2 deficiency |
|
|
Smooth beefy red tongue
|
B12 deficiency
|
|
|
Strawberry tongue--white coated tongue with bumps
|
scarlet fever (due to strep pyogenes),
|
|
|
What are the three locations of esophageal diverticula?
|
above UES--ZENKER
midpoint--TRACTION above LES--EPIPHRENIC |
|
|
Where does chronic gastritis type A due to autommune response and glandular atrophy normally occur?
|
fundus (top part of the stomach),
|
|
|
Where does chronic gastritis type B due to H pylori normally occur?
|
antrum (bottom)
|
|
|
What disorders are associated with chronic gastritis A?
|
autoimmune-->hashimotos disease, addisons, vitiligo
|
|
|
What are the major types of intestinal polyps?
|
hyperplastic
hamartomatous inflammatory lymphoid adenomatous (malignant) |
|
|
What type of polyps form with hamartomaous polyps (overgrowth in natural area)?
|
Peutz Jeghers syndrome (autosomal dominant)
|
|
|
What are the three types adenomatous polyps (neoplastic)?
|
tubular
villous (worst) tubulovillous |
|
|
Hyperpigmentation of lips, palms and soles. Polyps with risk of colon cancer.
|
Peutz Jeghers Syndrome
|
|
|
What is the cause of familial polyposis syndrome of the colon (autosomal dominant)?
|
loss of tumor suppressor gene, APC
|
|
|
classic familial polyposis syndrome colon polyps + benign mandible and skull tumors + epidermal cysts + high risk abnormal dentition
|
Gardner's Syndrome (autosomal dominant)
|
|
|
classic FAP colon polyps + malignant brain tumors
|
Turcot's syndrome (autosomal dominant)
|
|
|
colon malignancies in multiple sites, NO polyps, no association with adenomas
|
hereditary non-polyposis colorectal cancer syndrome (defective DNA mismatch repair)
|
|
|
What are the two molecular mechanisms in which colon cancer develops?
|
1. APC/Beta-catenin pathway
-->APC becomes inactivated 2. k-RAS (oncogene) -->k-RAS mutated and p53 is inactivated |
|
|
What medications are colon cancer protective?
|
NSAIDS and aspirin
|
|
|
What are some S/S of right colonic cancer?
|
INCREASED bleeding
hemorrage, hemoccult stool, iron-deficiency anemia |
|
|
>50 yo with iron deficiency anemia
|
colon cancer (MUST do the work up)
|
|
|
What are the S/S of left colon cancer?
|
crampy, discomfort, tenesmus (spasm, feels like they need to use the restroom)
|
|
|
MC mets from the colon
|
liver and lungs
|
|
|
What is the MC site for diverticulums (outpouchings)?
|
sigmoid colon
-due to high pressure |
|
|
Painless + hemooccult stool
|
diverticulosis
|
|
|
How do you diagnose a diverticulosis?
|
barium enema, xray or colonscopy
|
|
|
LLQ pain, (-) hemoocult stool, inflammation present
|
Diverticulitis
|
|
|
What is the dx and trmnt of diverticulitis?
|
Dx-CT
Trmnt-ciprofloxacin, metronidazole |
|
|
What do we use fluorquinolones for?
|
G+/G- bacteria, cancer
|
|
|
recurrent, unpredictable bowel habits (diarrhea an/or constipation), plus abdominal cramping, worse with stress
|
irritable bowel syndrome
|
|
|
What is the treatment for Crohn's dz?
|
anti-inflamm-->sulfsalazine, 5-ASA
vit B12 metroniadazole plus corticosteroids |
|
|
What is the treatment for ulcerative colitis?
|
anti-inflamm-->sulfsalazine or 5-ASA +/- immunsuppresives (6-MP, methotrexate, azathioprine)
bowel rest |
|
|
Patient has transmural skip lesions (rectum spared) with granulomas (non-caseating), ulcers, strictures/fistulas/fissurs
+ string sign. Painful. |
Crohn's dz
|
|
|
Patient has mucosa/submucosal continous lesions with pseudopolyps. Lead pipe colon (xray). Bleeding.
|
Ulcerative Colitis
|
|
|
What is the gold standard stool test?
|
stool fat analysis (qualitative)
|
|
|
What does the schilling test show us?
|
patient has vit B12 deficiency (no B12 in urine)
improves with instrinsic factor-->pernicous anemia (B12 in urine) doesn't improve (B12 in urine)-->pancreatitis, bacteria, dz of ileum |
|
|
chronic diarrhea, steatorrhea, and weight loss in tropical population
|
tropical sprue
|
|
|
anti-gliadin lab with dermatitis herpetiformis. What cancer is the patient is at risk for?
|
MALT mucosa-associated lymphoid tissue lymphoma (celiac dz)
|
|
|
Steatorrhea, arthralgia, fever, PAS +macrophages.
|
Whipple's Dz
|
|
|
What is the trmnt for Whipple's Dz?
|
any antibiotic therapy (TMP-SMZ or penicillin) for at least 4-6 months
|
|
|
What is the most common type of galllstone?
|
cholesterol
|
|
|
What are the risk factors for cholesterol gallstones?
|
female, fertile, fat, fourty
|
|
|
What is a lab that is elevated with biliary disorders?
|
alkaline phosphatase (bile duct injury)
|
|
|
porcelain gallbaldder, asymptomatic
|
cholelithiasis
|
|
|
fever, RUQ pain, murphy's sign
|
cholecystitis
|
|
|
RUQ pain, jaundice, clay-colored stool, tea-colored urine, elevated alk phos, conjugated bilirubin
|
choledo-cholithiasis (common bile duct blockage)
-->choledo: common bile duct |
|
|
RUQ pain + jaundice + fever
|
charcot's triad, ascending cholangitis
|
|
|
High levels of unconjugated bilirubin + brain damage in an infant.
|
Crigler Najjar: inherited non-hemolytic jaundice, affects metabolism of bilirubin
|
|
|
Pruiritis + RUQ pain, jaundice, cirrhosis. Labs-elevated conjugated bilirubin and alk phosphatase.
|
Primary Sclerosing Cholangitis (intra and extrahepatic ducts affected)
|
|
|
Pruiritis, jaundice, steatorrhea, xanthelasmas, anti-mitochondrial antibody
|
Primary Biliary Cirrhosis (autoimmune destruction intrahepatic ducts)
|
