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85 Cards in this Set

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which is more common--hypospadias or epispadias?
subcutaneous fibrosis on dorsum of penis
Peyronie dz (unknown etiology, older age gp) (trying to have sex at half mast puts you at risk for this)
Bowen dz
carcinoma in situ of penis; single erythematous plaque on shaft or scotum; assoc'd with inc'd risk of VISCERAL MALIGNANCY
erythroplasia of Queyrat
single erythematous plaque on glans penis or prepuce; 10%--> sq cc; NOT assoc'd with visceral malignancies
How is Bowenoid papulosis different from erythroplasia of Queyrat and Bowen dz?
histological similar but grossly appears wart=like, younger age grp, not kown to progress to invasive though still considered premalignant
carcinoma of schlong usually asso'd with?
(usually squamous cell); uncircumcisioned, HPV 16 18 31 33
cryptorchidism assoc'd with increased risk of?
germ cell tumors--seminoma, embryonal
bilateral orchitis may lead to?
sterility due to atrophy of seminiferous tubules. testosterone goes down but FSH/LH increased
4 bugs that most commonly cause epididymitis
N.gonorrheae, Chlamydia, e.coli, mycobacterium tuberculosis
most common testicular tumor?
seminoma (malignant; peak incidence in 30s, PAINLESS enlg'ment of testis, very radiosensitive)
2nd most common male germ cell tumor?
embryonal carcinoma (presents with PAIN or mets, worse prognosis than seminoma)
name the tumor: peak incidence in infancy/early childhood, increased alphaFP
yolk sac tumor
how is testicular mature teratoma different from ovarian matura teratoma?
testicular--malignant; ovarian--usually benign (dermoid cyst)
histologic characterization of choriocarcinoma?
cells resembling syncytiotrophoblasts and ctotrophoblasts
prognosis of mixed germ cell tumor determined by?
least mature element
intracytoplasmic Reinke cystals
seen in Leydig cell tumor (usually benign)
Leydig cell tumor causes what?
kids: precocious puberty; adults: gynecomastia; (b/c androgen producing)
paucity of endocrine manifestations characterizes what kind of male tumor?
sertoli cell tumor
what PSA profile suggests prostatic adenocarcinoma > BPH
increased total PSA, decreased fraction of free PSA
what causes toxic shock syndrome?
staph aureus exotoxin
lymphogranuloma venereum
C. trachomatis L1, L2, L3; small papule/ulcer--> superficial ulcers and enlg'ment of regional lymph nodes which become matted; (mostly tropical dz)
STD caused by Haemophilus ducreyi (tropics!); soft, PAINFUL ulcerated lesion (vs syphilis chancre--firm, painless)
Donovan bodies
multiple organisms filling lg histiocytes; characteristic of infection by Calymmatobacterium (donovani) granulomatis--Granuloma inguinale
papillary hidradenoma
most common benign tumor of vulva, from apocrine sweat gls (tx: simple excision)
can there be malignant melanoma in vulva?
yes. ~10% of malignant vulvar tumors are melanoma
HPV viral proteins
E6 binds p53; E7 binds Rb
most common site of endometriosis?
ovary (get chocolate cysts)
T/F: leiomyosarcomas usually arise from leiomyoma?
False; usually de novo
follicular cysts
due to distension o f unruptured graafian follicle; sometimes assoc'd with hyperestrinism and endometrial hyperplasia
corpus luteum cyst
resuls from hemorrhage into a persistent mature corpus luteum; get menstrual irregularities and sometimes intraperitoneal hemorrhage
theca-lutein cyst
results from gonadotropin stimulation; usually multiple, bilateral; can be assoc'd with choriocarcinoma, hydatidiform mole
3 morphologic characteristics of PCOS
1. markedly thickened ovarian capsule; 2. multiple small follicular cysts; 3. cortical stromal fibrosis
WHO categories of ovarian tumors
epithelial origin (serous, mucinous, endometroid, clear cell, Brenner); germ cell origin (dysgerminoma, yolk sac, teratoma); sex cord-stromal (thecoma-fibroma, granulosa); mets to overy (Krukenberg)
serous ovarian tumors
serous cystadenoma--benign, lined w/cells similar to fallopian tube epi; serous cystadenocarcinoma--50% of ovarian carcinomas!
mucinous ovarian tumors
mucinous cystadenoma--multilocular cysts; mucinous cystadenocarcinoma--can rupture or mets--> pseudomyxoma peritonei
Brenner tumor
rare benign ovarian tumor or epithelial origin; characterized by small islands of epi cells (look like transitional epi) interspersed wtihin fibrous stroma
most frequent benign ovarian tumor?
dermoid cyst (teratoma)
monodermal teratoma
contains only single tissue element (instead of elements derived for 2-3 embryonic layers); ex: struma ovarii (thyroid tissue!)
struma ovarii
monodermal teratoma, consists entirely of thyroid tissue, can be hyperfxn'l--> hyperthyroidism
Meigs syndrome triad:
ovarian fibroma, ascites, hydrothorax
Call-Exner bodies + precocious puberty?
granulosa cell tumor
placenta accreta
attachment of placenta directly to myometrium (decidual layer defective)
what predisposes one to placenta accreta?
endometrial inflammation; old scars (c-section)
sudden peripartal respiratory difficulty--> ?
amniotic fluid embolism
karyotype of complete hydatidiform mole
46, XX (paternal)
chromosomal abnomality in partial hydatidiform mole?
triploidy, 69 csomes (2 dad, 1 mom) due to fertilization of ovum by 2+ spermies
blue dome cyst
type of fibrocystic change of breast; cysts filled with fluid which may appear blue
most common breast tumor in <25y/o?
fibroadenoma (benign, rubbery)
Phyllodes tumor
lg bulky boob mass of variable malignancy with ulceration of overlying skin
severe febrile illness + GI dysfunction + diffuse macular rash in pubescent female?
think toxic shock syndrome
most common pituitary tumor
prolactinoma (chromophobic)
2nd most common pituitary tumor
somatotropic adenoma (GH, acidophilic)
which pituitary tumor stains a)acidophilic; b)chromophobic; c) basophilic
a)somatotropic adenoma (GH); b)prolactinoma; c) corticotropic adenoma (ACTH)
Simmonds dz
pituitary cachexia; generalized panhypopituitarism
pituitary cachexia (Simmond's dz) most frequently caused by (2)?
pituitary macroadenomas; Sheehan syndrome
what other etiologies must exclude before making dx of prolactinoma? (8)
1. nonfunctioning pituitary macroadenoma (stalk compresson); 2. infiltrative dz (sarcoid); 3. primary hypoparathyroidism (inc'd TRH stimulates PRL); 4. kidney dz (can't excrete); 5. liver dz (can't metaboliz); 6. drugs (DA antags); 7. preggers; 8. stress
GH deficiency in adults-->
increased insulin sensitivity with hypoglycemia, dec'd mm strength, anemia
benign childhood tumor derived from remnants of Rathke pouch; nests and cords of squamous or columnar cells in loose stroma
craniopharyngioma similar to what other tumor?
ameloblastoma of jaw--also get nests and cords of squamous of columnar cells in loose stroma; resembles appearance of embryonic tooth bud enamel organ
HLA types assoc'd with Graves dz?
HLA-DR3, HLA-B8 (vs HLA-DR5, HLA-B5 in Hashimoto)
Plummer dz
hyperthyroidism and nodular goiter without exophthalmos
Hurthle cells + massive infiltrate of lymphocytes with germinal center formation =
Hashimoto thyroiditis
HLA types assoc'd with Hashimoto thyroiditis
HLA-DR5, HLA-B5 (vs HLA-DR3, HLA-B8 in Graves)
de Quervain thyroiditis
flu-like illness, pain and tenderness of thyroid (self-limited); get focal destruction of thyroid tissue and granulomatous inflammation
Riedel thyroiditis--characterized by? mimics?
thyroid replacement by fibrous tissue (systemic dz); can mimic carcinoma
Orphan Annie nuclei + psammoma bodies seen in?
papillary thyroid carcinoma (most common type); good prognosis, prior RT to neck? spread via lymph
which thyroid tumors assoc'd with RET oncogene mutation?
papillary carcinoma, medullary carcinoma
osteitis fibrosa cystica
cystic changes in bone due to osteoclastic activity. seen in hyperparathyroidism
why might get peptic ulcer in hyperparathyroidism?
hypercalcemia predisposes to peptic duodenal ulcer
most common cause of secondary hyperparathyroidism?
hypocalcemia of chronic renal dz
renal end-orgen resistance to PTH, shortened 4th and 5th metacarpals/tarsals, short stature
how differentiate pituitary vs ectopic Cushings?
high dose dexamethasone--suppresses pituitary not ectopic; petrosal sinus sampling--high ACTH is pituitary
primary vs secondary hyperaldosteronism
primary (Conn)--low sr renin; secondary (renal ischemia, etc)-- high sr renin (which activates aldosterone synthase via ang II)
21 hydroyxlase deficiency vs 11 hyrdoxylase deficiency?
both adrenogenital syndromes; 21--salt loss, hyPOtension, virilization; 11--salt RETENTION, HTN, virilization
most common cause of primary adrenocortical insufficiency?
autoimmune (autoimmune lymphocytic adrenalitis)
highly malignant catecholamine producing tumor of early childhood =
neuroblastoma (--> HTN; N-myc amplification and double minutes)
Tx for pheochromocytoma
alpha blocker (phenoxybenzamine) for >2weeks prior to surgery; once BP controlled but still tachycardic, add beta blockers
maturity onset DM of the young; AD, mild hypoglycemia and hyposecretion of insulin w/o loss of beta cells
Armanni-Ebstein lesion
tubular deposition of glycogen; uncommon result of prolonged untreated hyperglycemia
Whipple triad=
episodic hyperinsulinemia, hypoglycemia; CNS dysfxn (related to hypogly); dramatic reversal of CNS dysfxn with glucose; (seen in insulinoma)
secondary DM + necrolytic migratory erythema seen in?
rare tumor that seceretes VIP and causes pancreatic cholera (watery diarrhea, hypokalemia, achlorhdria)
Wermer syndrome
MEN type I (3 p's): pituitary, parathyroid, pancreatic islet cell tumor/hyperplasia
Sipple syndrome
MEN IIa--pheochromocytoma, medullary thyroid carcinoma, hyperparathyroidism; ret oncogene mut
MEN IIb--pheochromocytoma, medullary thyroid cancer, neuromas/gangliomas; ret oncogene mut