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70 Cards in this Set
- Front
- Back
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What are some risk factors for premalignant endometrial hyperplasia?
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high estrogen, low progesterone
Ex: PCOS >40 yo estrogen tx (w/o progesterone) early menarche late meno (average is 51-52) nulliparity- pregnancy is an "estrogen holiday" DM II HTN Obesity |
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What is the number 1 invasive cancer of female tract?
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endometrial ca
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What is CIN?
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cervical intraepithelial neoplasia
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Difference between carcinoma in situ and invasive carcinoma?
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CIS- has NOT invaded BM
IC- HAS invaded BM |
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What is thought to cause PCOS?
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excess LH production by anterior pituitary, which stimulate theca cells to produce androstenedione (androgen) --> acne, hirsuitism.
Androgen is converted to estrone in aromatase in adipose (worse in obese) Estrone neg feedback inhibits FSH, no follicle develops, no ovum ready to be release--> anovulation |
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What disease do you see chocolate cysts in?
Why are they called that? |
Endometriosis- endometrial tissue developing outside the ovary
#1 site is ovary Collection of old blood in cyst makes it look chocolatey |
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What is the #1 overall tumor in women?
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Fibroids!
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What do fibroids look like histologically?
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"whorled pattern" of smooth muscle bundles
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Woman has grape like cysts and a very high beta hCG. Uterus is larger than expected for gestational age. What does she most likely have?
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Hydatidiform mole, molar pregnancy
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These are risk factors for what?
retained placenta hydatidiform mole |
Choriocarcinoma
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This is a single, sharply circumscribed, mobile and marbled shaped and sized mass of the breast
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fibroadenoma
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Which benign mass of the breast becomes log shaped?
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phylloides tumor
- stromal tumore >60 |
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Whats the difference b/t fibrocystic change and fibroadenoma
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fibrocystic change is multiple bilateral nodules forming a "lumpy bumpy breast". They fluctuate in size and tenderness with menstrual cycle
Fibroadenoma is actually a benign tumor. Usually a single, sharply circumscribed mobile marble shaped and sized nodule |
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most common breast cancer is?
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Invasive ductal carcinoma
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A woman presents with a fissured, ulcerated, oozing, hyperemic, edematous nipple. What does this sound like?
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Paget's disease of the nipple
- a form of DCIS that extends from the nipple ducts into the contiguous nipple skin and areola |
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True or False: Young women are more difficult to diagnose mammographically than other women
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True
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Do estrogen and prog receptor (+) breast cancer yield better or worse prognosis?
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slightly better
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What is the first sign of measles?
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Koplik spots- ulceration on buccal mucosa
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Smoothy beefy red tongue is sign of _____ deficiency
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B12
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What is cheliosis?
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drying and scaling of lips with fissuring at corners of mouth.
A/w Vit B2 deficiency |
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What is the hallmark of Chronic type A gastritis?
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autoimmune- Abs against gastric glands, parietal cells, and IF
--> pernicious anemia and achlorhydria due to parietal cell loss Usually a/w other AI diseases (Hashimotos |
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What pathogen is involved in Chronic type B gastritis?
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H. pylori causes chronic irritation
affects antrum |
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What happens in Addison's disease?
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autoimmune destruction of adrenal gland --> cant make aldosterone--> hyperkal and hyponat
Also see body-wide hyperpigmentation due to excess POMC --> excess melanin |
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What causes vitiligo?
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Autoimm destruction of melanocytes
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Which type of colonic polyps are neoplastic?
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Adenomatous polyps- they are pre-malignant, acting as a precursor lesion for invasive colorectal carcinoma
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What are the 3 types of adenomatous polyps?
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Tubular adenoma
Villous adenoma Tubovillous adenoma |
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What is Peutz-Jeghers syndrome?
inheritance? |
"Polyps and Pigmentation"
Auto dominant Hamartomatous polyps + spotted melanin hyperpig of lips, palms and soles Polyps have very low cancer potential themselves but patients with PH have higher risk of colon ca |
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This disease is caused by loss of tumor suppressor gene, APC
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FAP
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Once polyps develop in FAP, there is ____% chance of colon ca development
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100
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Inheritance of FAP?
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AD
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What are Gardners and Turcots syndrome?
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2 forms of classic FAP that are both AD with high risk of polyps becoming colon ca
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Lynch syndrome is also known as:
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Hereditary Nonpolyposis Colorectal Cancer (HNPCC)
- AD - not from polyps |
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Why is a low fiber diet a risk factor for colon cancer?
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Because that increases the transit time in the GI tract
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Iron def anemia, fatigue, weakness, (+) hemoccult stool, no stool changes noted
This is a Right or Left colon cancer? |
Right
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(+) hemoccult stool, change in bowel habits, crampy left lower quad pain or tenesmus, pencil stools may be produced.
Right or Left colon ca? |
Left
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Where is the most common place for diverticula to form?
Why? |
Sigmoid colon- highest pressures and greatest likelihood for bowel wall weakening
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Why is diverticulosis heme+ but diverticulitis is heme-?
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diverticulosis- blood vessels are now more exposed
diverticulitis- blood vessels are blocked off when objects lodge into outpouching |
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Treatment for diverticulitis?
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metronidazole and cipro
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Which IBD has skip lesions, granulomas (non-caseating), (+) string sign, strictures, transmural inflammation, and is more common in whites and Jews
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Crohn's
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What are some features of UC?
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continuous lesions, (+) lead pipe sign, non-granulomatous lesions, mucosa/submucosa only
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What is the drug sulfasalazine used for?
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Crohns and UC
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How long does ABX therapy need to be given for Whipples disease?
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AT LEAST 4-6 months, but preferably for 1 year
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What are the 4 F's of cholesterol GB stones?
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Fat
Forty Female Fertile |
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What is the most common type of GB stone worldwide?
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Mixed (combo of cholesterol and bilirubin precipitant)
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This biliary disorder has normal labs and is usually asymptomatic...
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cholelithiasis
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Charcot's triad for ascending cholangitis?
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RUQ pain, jaundice, fever
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This anti-inflammatory drug works to prevent further damage by suppressing macrophages and other phagocytes, depressing their lysosomal activity. Slows the progression of bone and joint destruction
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GOLD
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How do steroids decrease inflammation?
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by inhibiting phospholipase A2, preventing arachidonic acid production, preventing prostaglanding production
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Diff b/t infliximab and adalimumab?
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infliximab = chimeric monoclonal AB
adalimumab = fully human |
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this drug is a recombinant TNF receptor...
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etanercept- binds up TNF in the bloodstream
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How are thalidomide and pentoxyfilline similar?
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both decrease secretion of TNF
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What is technically the DOC for acute attacks of gout?
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colchicine, but NSAIDs are usually tried first
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MOA of colchicine?
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binds tubulin- stops mitosis, cells cant migrate to affected area
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What enzyme does allopurinol inhibit?
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xanthine oxidase
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What is the DOC for chronic gout?
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allopurinol
or probenecid- uricosuric agent |
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Which major enzyme is part of the purine salvage pathway? Hint, deficient in Lesch-Nyhan syndrome...
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HGPRT- recycles purines
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What does uricosuric mean?
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probenecid is uricosuric, meaning it blocks tubular reabsorption of uric acid
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What is tumor lysis syndrome?
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Cancer tx can cause gout bc of the excess nucleic acid from dying malignant cells
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Which sacral ligament divides the greater and lesser sciatic foramen?
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Sacrospinous
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Which ligaments are usually the first to become tender when lumbosacral dysfxn occurs?
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Iliolumbar
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A little over 10% of the population has this wrong with them regarding their piriformis...
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Their sciatic nerve runs directly through their piriformis which can cause sciatic nerve related pain radiating down leg.
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These nerves contribute to the lumbar plexus...
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T12 to L4
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These nerves contribute to the sacral plexus...
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L4-5, S1-3, portion of S4
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These nerves contribute to the sciatic nerve...
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L4 to S3
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Sacral flexion is also more officially known as...
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nutation of sacrum
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In inspiration the sacrum ___
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counternutates
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When the torso flexes, the sacrum ____
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counternutates
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When you walk and step on your right leg, a _____ axis is established
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Right oblique axis
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If L5 is rotated Right, then the sacrum is rotated ______
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Left
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If L5 is SB Right, then the sacrum has a ____ axis
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Right oblique
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