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97 Cards in this Set
- Front
- Back
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where does the lymph from the ovaries/testes drain to
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para aortic LNs
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what does the suspensory ligament of the ovary connect and what structures are contained in it
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ovalies to lateral pelvic wall, contains ovarian vessles
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what does the transverse cervical (cardinal) ligament connect and what structures are contained in it
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cervix to side wall of pelvis, uterine vessels
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what does the Broad ligament connect and what structures are contained in it
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uterus, fallopian tubes and ovaries to the pelvic side wall; contains the ovaries, fallopian tubes and round ligments
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what does the round ligament connect
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uterus to labia majora
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which branches of nerves are responsible for erection, emission and ejaculation
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erection is PNS (pelvic nerve), emission is SNS (hypogastric nerve), ejaculation is visceral and somatic nerves (pudendal)
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spermiogenesis
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final part of spermatogenesis, spermatid becomes a spermatozoa and develops structures
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which structure are the acrosome and flagellum derived from
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acrosome is from Golgi, flagellum is from centriole
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which molecules control the testes descent
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MIF causes descent to superficial ring, androgens cause their further descent into scrotum
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hormones involved in spermatogenesis
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FSH stimulation of sertoli cells is required to initiate spermatogenesis but LH induced testosterone synthesis is required for maintenence of spermatogenesis
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potentcy of estrogens
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estradiol>estrone>estriol
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what are the products and stimulatory molecules of the theca and granulosa cells
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theca: stimulaed by LH, converts cholesterol into androsteinedione; granulosa: stimulated by FSH, convert andrasteindione into estrogen
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what causes anovulation
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most common cause of dysfunctional bleeding; due to excessive and prolonged E effect with out post-ovulation prog effect
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which hormone maintains the endometrium for pregnancy
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progesterone
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which phase of menstruation is always 14 days
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secretory/luteal phase, this is because this is the length of the CL
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when does implantation occur
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6 days after fertilization (day 21 of cycle)
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which cells produce hCG and what does it do
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syncytiotrophoblast; it maintains the corpus luteum (and thus P) for 1st semester by acting like LH
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hormonal levels in post-menopause
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decr estrogen, large incr in FSH, incr in LH and GnRH
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karotype of complete and partial moles
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complete are usually 46XX (sometimes 46XY), partial are 69XXY
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common cause of miscarriage in 1st week, 1st trimester and 2nd trimester
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1st week is low progesterone, 1st trimester is chromosomal abnormalities, 2nd trimester is bicornuate uterus
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preeclamsia before 20 weeks
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suggests molar pregnancy
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which layer does dysplasia of the cervix begin at
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basal layer
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which HPVs are associated with CA
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16 and 18
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most common location for endometriosis
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ovary
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order of gyn cancers for incidence and prognosis
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incidence: endomet>ovarian>cervical; worst prognosis: ovarian>cervical>endometrial
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blacks have incr risk of which gyn abnormal
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leiyomyomas and maiomyosarcomas
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hormone levels in polycystic ovary dz
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incr LH, decr FSH, incr test, incr estrogens
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most common cause of ovarian mass
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follicular cyst, is distension of an unruptured grafian follicle, can be associated with hyperestrogen
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who has incr risk of ovarian CA, which type and what is the tumor marker
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Turners have incr risk of Dysgerminoma which has incr hCG
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theca-lutein cysts are asscoiated with what
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choriocarcinoma and moles; are often multiple/bilateral, are due to gonadotropin stimulation
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stuma ovarii
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teratoma containing functional thyroid tissue, can present as hyperthyroid
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ovarian tumors that are frequently bilaral
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serous cystedenoma/CA
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histo findings of serous cystadeno/CA
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adenoma: cyst lined with fallopian-tube like epithelium; adenoCA: papillary structures with invasion, psammoma body
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pseudomyxoma peritonei
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can occur in mucinous cystadenoCA, is intraperitoneal accumulation of mucinous material
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Meig's syndrome
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triad of ovarian fibroma, ascites and R-sided pleural effusion
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female with pulling sensation in groin
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fibroma of ovary
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call-exner bodies
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granulosa cell tumor of ovary
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vaginal CA of young girl
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sarcoma botryoides, rhabdomyosarcoma varient
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most common breast tumor in someone less than 25
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fibroadenoma, small/mobile, stroma proliferation compresses ducts, incr size/tenderness with estrogen
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phyllodes tumor
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large bulky mass of CT and cysts in breast, most common in 6th decade, small malignancy risk
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most important prognostic factor in breast CA
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axillary LN involvement
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most significant risk for breast CA
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fam hx
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breast CA that is often bilateral
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invasive lobular; orderly rows of cells
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Peau d'orange
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occurs in inflammatory breast CA, poor prognosis, due to lymphatic invasion, often also have pitting edema
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which 2 breast lesions are most likely to have calcifications
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ductal CA in situ, sclerosing adenosis (incr acini and intralobular fibrosis, often looks invasive)
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most common cause of breast lumps from age 25 to menopause
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fibrocystic change
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which lobes are involved in BPH and which in CA
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BPH involves lateral and middle lobes, CA involves posterior lobe
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what kind of bone abnormalities in prostate mets
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osteoblastic mets, can incr alk phos
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fried egg appearence of testicular CA
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seminoma, malignant, most common, radiosensitive, incr placental alk phos
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yolk sac tumor of testes
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contain schiller duval bodies, have primitive glomeruli, incr AFP, occur in young children
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Reinke crystals
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Leydig cell tumor of testis, benign, androgen producing, can produce gynecomastia or precoscious puberty
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most common testicular CA of older males
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lymphomas, represent mets
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most common complication of BPH
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obstructive uropathy
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which race has incr risk of BPH and prostate CA
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blacks
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most common cause of impotence in young vs. old men
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young is psychogenic, old is vascular insufficiency
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common age for endometrial, cervical and ovarian CA
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cervical is 45, endometrial is 55, ovarian is 65
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most common cause of sponatenous abortion
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trisomy 16
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Meig's syndrome
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triad of ovarian fibroma, ascites and R sided pleural effusion
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pseufomyoma peritonei
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intraperitoneal accumulation of mucinous material from ovarian (like mucinous cystadenocarcinoma) or appendiceal tumor
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Schiller Duval bodies
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Yolk Sac tumor in testicles
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Reinke crystals
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Leydig cell tumor in testicles
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Call-Exner bodies
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granulosa cell tumor of ovaries
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copus cavernosum vs. spongiosum
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cavernosum: 2, located on top; spongiosum: 1, located on bottom, contains urethra
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what does inhibin do
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is secreted by sertoli cells in response to FSH stimulation, feedback inhibits to prevent further FSH
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location of Leydig cells
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in the interstitium between seminiferous tubules
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progression of cells in spermatogenesis
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spermatogonium → 1 spermatocyte → 2 spermatocyte → spermatid (N) → undergoes spermiogenesis → spermatozoan
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roles of DHT (4)
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differentiation of penis, scotum, prostate; balding; incr sebaceous gland activity; incr prostate growth. rest of androgen function is by testosterone
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maturation of follicle
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primordial (ovum and 1 layer of cells) → 1 follicle (ovum and several layers) → 2 follicle (ovum, several layers, plus beg of antrum fluid) → Graffian (mature, large antrum)
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zona pellucida and corona radiata
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zona: directly around ovum, polysaccaride; corona: follicular cells outside zona
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hGH
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produced by the placenta, replaces maternal GH during pregnancy, simulates IGF secretion which allows the fetus to get incr gluc and AA's; if you had elevated levels, it would incr gluc levels in mom but have no effect on fetus
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where does fertilization usually occur
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ampulla of fallopian tube, then travels down towards uterus to imlant by day 6
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primary amenorrhea in pt with fully formed secondary sex characteristics
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think imperforate hymen or mullerian duct abnormality
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levels of test, estrogen and LH in androgen insensitivity
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are all high
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HELLP syndrome
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can be present in preeclamsia: hemolysis, elevated LFTs, low platelets
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endometritis
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can occur postpartum with fever, uterus tenderness, foul smelling discharge, leukocytosis; bacteriodes common but often mixed flora
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corpus luteum cyst
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hemorrhage into persitent CL, menstrual irregularity, often occur during pregnancy
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90% of ovarian germ cell tumors are what
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teratomas! yolk sac, dysgerminoma and chorioCA are all rare
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significance of erb-b2 +
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poor prognosis, associated with agressive tumors
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most common locations for breast CA
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outer quadrants, then areola
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invasive ductal CA
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firm, fibrous mass (desmoplasia), duct like cells, stellate shaped gray/white tumor; worst and most invasive, most common
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medullary breast CA
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fleshy, cellular, lymph infiltrate, BRCA1, good prognosis
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modified radical masectomy
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remove breast and nipple, leave pec major, remove axillary LNs, take pec minor; complications include winged scapula (cut long thorasic nerve), lymphedema (incr risk of lymphangiosarcoma)
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most common causes (3) of prostatitis
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E. Coli, P. auerginosa, K. pneumo; contain pilli for attachement
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flutamide
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adjunct therapy for prostate CA, competitive antagonist at androgen receptors
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leuprolide
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GnRH agonist used in prostate CA, when given continuously it acts as an antagonist and decr LH/FSH and testosterone
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embryonal CA of testes
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malignant, painful, worse prognosis, glandular/papullary morphology with sheets of undiferentiated cells
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Bowen's dz
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gray solitary crusty plaque, on shaft of penis or scrotum, rarely progresses to SCC
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Erythroplasia of Queyat
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red velvety plaques involving the glans, form of Bowdens
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Bowenoid papulosis
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mult papule lesions, affects younger age group, usually not invasive
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clomiphene
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partial agonist at E receptors in ant pit, prevents normal feedbac inhibition and leads to incr Lh/FSH release which stimulates ovulation; used in infertility and PCOS
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ketoconazole and spironolactone effects in repro
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keto: inhibits steroid biosynthesis by inhibiting p450; spiron: inhibits steroid binding; both can be used in polycystic ovarian to prevent hirsutism
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sildenafil
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inhibit cGMP phosphodiesterase, incr cGMP and incr SM relaxation in CC. contraindicated with nitrates b/c it can cause life threatening hypotension
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dinoprostone
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PGE2 analog causing cervical dilation and uterine contraction, inducing labor
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ritodrine/terbutaline
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B2-agonists that relax the uterus, reduce premature labor
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anastrozole
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aromatase inhibitor used in post-menopausal women with breast CA
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exemestane
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aromatase inhibitor used in post-menopausal women with breast CA
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raloxifene
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estrogen agonist on bone, used in osteoporosis
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