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140 Cards in this Set
- Front
- Back
Hypospadias
(a) describe (b) associations (c) complications |
(a) urethra opens onto ventral surface of penis
(b) poorly developed penis that curves ventrally (chordee) (c) infertility; increase risk of UTI's |
|
Epispadias
(a) describe (b) associations (c) complications |
(a) urethra opens onto dorsal surface
(b) extrophy of bladder (c) infertility |
|
Phimosis
(a) describe (b) complications (c) treatment |
(a) prepuce orifice too small to be retracted normally
(b) hygiene interference; predispose to infx; if foreskin retracted over glans may lead to urethral constriction (paraphimosis) (c) circumcision |
|
Bowen's disease
(a) description (b) epidemiology (c) gross (d) microscopic (e) outcome |
(a) penile carcinoma in situ
(b) mend>35; can be assoc w/visceral malignancy (c) thick, ulcerated plaque usually on shaft or scrotum (d) SCC in situ (e) <10% progress to invasive SCC |
|
Squamous Cell carcinoma of penis
(a) epidemiology (b) clinical presentation (c) risk factors (d) gross (e) outcomes |
(a) 1% of cancer in men; 40-70YO; rare in circumsized men
(b) slow growing; not painful (c) HYPV 16,18 (d) plaque progressing to ulcerated papule or fungating growth (e) mets can go to local LN |
|
Erythroplasia of Queyrat; appearance
|
Red velvety plaques usually involving glans; otherwise similar to Bowen's
|
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Bowenoid papulosis; appearance, epidemiology, outcome
|
Multiple papular lesions; younger age group; usually not invade
|
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Peyronie's Disease
|
Bent penis due to acquired fibrous tissue formation
|
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Prostate adenocarcinoma
(a) epidemiology (b)clinical presentation/lobe of prostate involved? (c) diagnosis (d) metastasis (e) treatment |
(a) >50YO; AA>caucasians
(b) urinary problems ; assoc w/posterior lobe enlargement (c) PSA (incr total PSA, w/ decr fraction of free PSA); DRE (d) mets via lymphatic or hematogenous route (bone w/osteoblastic mets indicated by back pain and incr alkP) (e) surgery, rad, hormonal modalities |
|
Benign prostatic hyperplasia
(a) epidemiology (b) possible etiology/lobe of prostate involved? (c) clinical presentation (d) complications (e) diagnosis |
(a) common in M>50
(b) hyperplasia; possible due to DHT; middle and lateral lobes hyperplasia (c) may narrow urethral canal; incr urinary frequency, nocturia, difficulty starting and stopping stream (d) distention and hypertrophy of bladder, hydronephrosis and UTI's (e) incr free PSA |
|
Acute prostatitis
(a) most common pathogens (b) spread via? |
(a) same as UTI (E coli most common)
(b) direct extension or lymphatic/hematogenous |
|
Chronic prostatitis
(a) common causes (b) presentation |
(a) bacterial and nonbacterial
(b) asymptomatic or present with lower back pain and urinary sx |
|
Cryporchidism
(a) cause (b) most common location (c) complications |
(a) failure of normal testes descent
(b) inguinal canal (more often on right); can be bilateral (c) bilateral (infertility); incr incidence of testicular cancer |
|
Torsion
(a) clinical presentation (b) complications |
(a) sudden onset testicular pain, and loss of cremasteric reflex
(b) compromise arterial/venous drainage (infarction) |
|
Testicular hydrocoele
(a) description (b) precipitating events |
(a) patency of processus vaginalis remains
(b) inflammatory causes (epididymitis) |
|
Testicular varicocoele
(a) cause (b) clinical presentation (c) complications |
(a) dilatations of tributaries of testicular vein and pampiniform plexus "bag of worms"
(b) varicosities seen when standing but disappear when sitting down (c) can cause infertility |
|
Spermatocoele
|
Dilated epididymal duct
|
|
Seminoma
(a) epidemiology (b) histology (c) prognosis (d) treatment |
(a) 15-35YO M (most common testicular tumor)
(b) large cells in lobules w/"fried egg appearance" (c) excellent (late mets) (d) radiosensitive |
|
Embryonal carcinoma of testes
(a) clinical presentation (b) histology (c) outcome (d) diagnosis |
(a) pain
(b) often glandular/papillary; can differentiate to other tumor (c) malignant; high mortality; less radiosensitive (may require orchiectomy) (d) incr serum AFP |
|
Choriocarcinoma
(a) epidemiology (b) clinical presentation (c) markers (d) outcome (e) treatment |
(a) 15-25YO
(b) gynecomastia' testicular enlargement (c) elevated hCG (d) disseminates hematogenously (lungs, liver, brain) (e) orchiectomy or chemo |
|
Yolk sac (endodermal sinus) tumor
(a) epidemiology (b) serum markers (c) histology |
(a) rare; most common in children and infants
(b) high alpha fetoprotein (AFP) (c) Schiller-Duval bodies, primitive glomeruli |
|
Testicular teratoma
(a) epidemiology (b) clinical presentation (c) histology (d) prognosis (e) treatment |
(a) any age but mostly infants/children
(b) testicular mass (c) variety of tissues (d) mature teratoma often malignant (e) orchiectomy followed by chemo and rad |
|
Leydig cell tumor
(a) clinical presentation (b) unilateral/bilateral (c) treatment/prognosis |
(a) testicular enlargement; often androgen producing (gynecomastia in men precocious puberty in boys)
(b) unilateral (c) usually curative w/surgery |
|
Sertoli cell tumor
(a) clinical presentation (b) unilatera/bilateral (c) outcome |
(a) testicular enlargement
(b) unilateral (c) usually benign |
|
Testicular lymphoma
(a) epidemiology |
Most common testicular cancer in elderly men
|
|
Klinefelter's Syndrome
(a) genetics (b) pathophys (c) clinical presentation |
(a) XXY; inactivated X chromosome (barr body)
(b) dysgenesis of seminiferous tubules, decr inhibin, incr FSH. Abnormal leydig cell fct; decr testosteron, incr LH and estrogen (c) hypogonadism, eunuchoid body shape, tall long extremities, gynecomastia, female hair distribution |
|
Turner's Syndrome
(a) genetics (b) clinical presentation (c) pathophys |
(a) XO
(b) short stature; ovarian dysgenesis (streaks); webbed neck; preductal coarctation of aorta; most common cause of primary amenorrhea (c) decr estrogen leads to incr LH and FSH |
|
Double Y males clinical presentation
|
Phenotypically normal; tall; severe acne; antisocial behavior in 1-2% of men; normal fertility
|
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Female pseudohermaphrodite
(a) Genetics (b) pathophys/cause (c) internal/external genitalia/presentation |
(a) XX
(b) excessive/inappropriate androgens during early gestation (congenital adrenal hyperplasia, exogenous) (c) ovaries but virilized/ambiguous external genitalia |
|
Male pseudohermaphrodite
(a) Genetics (b) pathophys/cause (c) internal/external genitalia/presentation |
(a) XY
(b) most common form is androgen insensitivity syndrome (c) testes but female external genitalia (or ambiguous) |
|
True hermaphrodite
(a) genetics (b) internal/external genitalia |
(a) either 46XX or 46XY
(b) both ovaries and testes; ambiguous genitalia |
|
Androgen insensitivity syndrome
(a) genetics (b) cause/pathophys (c) internal/external genitalia/clinical presentation (d) sex hormone levels |
(a) 46XY
(b) defective androgen receptor (c) normal appearing female; female external genitalia w/blunt vagina; uterus and uterine tubes absent; testes (d) levels of testosterone, estrogen, and LH high |
|
5alpha reductase deficiciency
(a) defect (b) clinical presentation (c) sex hormone levels |
(a) unable to convert testosterone to DHT
(b) ambiguous genitalia until puberty when incr testosterone causes masculinization (c) testosterone/estrogen levels normal; LH is normal or high |
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Common cause of recurrent miscarriages: 1st weeks
|
Low progesterone level (no response to beta hCG)
|
|
Common cause of recurrent miscarriage: 1st trimester
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Chromosomal abnormalities (robertsonian translocation)
|
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Common cause of recurrent miscarriage: 2nd trimester
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Bicornate uterus
|
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Preeclampsia triad
|
HTN, proteinuria, edema after 20wk gestation
|
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Eclampsia
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HTN, proteinuria, edema, seizures
|
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Etiology of preclampsia
|
Placental ischemia (lack of trophoblast invasion of spiral arteries in myometrium) causing elaboration of factors leading to altered maternal endothelial fct (incr vascular tone, incr vascular permeability, coagulopathy)
|
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Complications of preeclampsia
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Hemolysis, Elevated LFT's, Low platelets
|
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Clinical features of preeclampsia
|
HA, blurred vision, abd pain, edema, altered mentation, hyperreflexia
|
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Lab values in preeclampsia
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Thrombocytopenia, hyperuricemia
|
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Treatment of preeclampsia
|
Delivery of fetus as soon as viable; bed rest, salt restriction, monitor/treat HTN
IV mgsulfate and diazepam to prevent and treat seizures |
|
Abruptio placenta
(a) description (b) presentation (c) complications (d) risk factors |
(a) premature detachment of placenta from implantation site
(b) painful bleeding in 3rd trimester (c) fetal death; DIC (d) incr risk w/smoking, HTN, cocaine |
|
Placenta accreta
(a) description (b) presentation (c) complications (d) risk factors |
(a) defective decidual layer; placenta attached to myometrium
(b) massive bleeding after delivery (c) see above (d) prior C section, PID |
|
Placenta previa
(a) description (b) presentation (c) complications (d) risk factors |
(a) attachment of placenta to lower uterine segment
(b) painless bleeding in any trimester (c) may occlude internal os (d) prior C section |
|
Ectopic pregnancy
(a) clinical presentation/lab findings (b) most common site (c) risk factors |
(a) pain without bleeding; incr hCG; presents like appendicitis
(b) fallopian tubes (c) PID |
|
Polyhydramnios
(a) define (b) associations/cause |
(a) >1,5-2L of amniotic fluid
(b) esophageal/duodenal atresia (inability to swallow fluid); anencephaly |
|
Oligohydramnios
(a) define (b) cause (c) result |
(a) <0.5L amniotic fluid
(b) bilateral renal agenesis or posterior urethral valves; inability to secrete urine (c) Potter's syndrome |
|
Condyloma acuminatum
(a) presentation (b) histology (c) distribution (d) etiology (e) complications |
(a) warts
(b) koilocytes, acanthosis, hyperkeratosis, parakeratosis (c) vulva, perineum, vagina,cervix (d) HPV 6,11 association (e) incr risk ofcervical carcinoma |
|
Papillary hidradenoma
(a) description (b) distribution |
(a) benign tumor similar to intraductal papilloma of breast
(b) occur along milk line |
|
Extramammary Paget disease of vulva
(a) presentation (b) histology (c) distribution (d) assoc w/underlying tumor? |
(a) erythematous, crusted rash
(b) intraepidermal malignant cells w/pagetoid spread (c) labia majora (d) not assoc w/underlying tumor |
|
Candida vulvovaginitis
(a) description (b) distribution (c) risk factors |
(a) erythema, thick white discharge
(b) vulva and vagina (c) common; esp in diabetics and after antibiotic use |
|
Embryonal Rhabdomyosarcoma
(a) epidemiology (b) gross description (c) histology |
(a) rare; affect female infants and young children
(b) grapelike, soft tissue mass protruding from vagina (c) spindle cell tumor; + desmin (skeletal muscle origin) |
|
Clinical presentation of cervical carcinoma
|
Postcoital bleeding, dyspareunia, discharge
May be asymptomatic |
|
Endometriosis
(a) description (b) pathology (c) clinical presentation (d) complications |
(a) endometrial glands outside uterus
(b) red brown nodules (powder burns); ovarian "chocolate cysts" (c) severe menstrual related pain; rectal pain and constipation (d) may result in infertility |
|
Endometritis
(a) description (b) pathology (c) clinical |
(a) ascending infection of cervix
(b) ureaplasma, peptostrep, gardnerella, Bacteriodes, GBS, chlamydia (c) assoc w/pregnancy or abortions; assoc w/PID and IUD's |
|
Adenomyosis
|
Presence of endometrium within myometrium
|
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Leiomyoma
(a) description (b) pathology (c) clinical (d) complications |
(a) benign smooth muscle tumor; grows in resp to estrogen; most common of all tumors
(b) well circumscribed; "whorled" white tan mass (c) menorrhagia; abdominal mass; pelvic/back pain or suprapubic discomfort (d) infertility; iron deficiency anemia (bleeding) |
|
Leimyosarcoma
(a) description (b) epidemiology (c) clinical presentation |
(a) highly aggressive bulky irregular shaped tumor w/necrosis and hemorrhage
(b) incr incidence in blacks (c) may protrude from cervix and bleed |
|
Gynecological tumor incidence and prognosis(endo, ovar, cerv)
|
Incidence: endo>ovar>cerv
Worst prognosis: ovarian>cervical>endometrial |
|
Sex hormone levels in premature ovarian failure
|
Decr estrogen
Incr LH and FSH |
|
Endometrial hyperplasia
(a) describe (b) etiology (c) clinical presentation (d) risk factors |
(a) abnormal endometrial gland prolif
(b) usually excess estrogen (c) postmenopausal vaginal bleeding (d) anovulatory cycles, HRT, PCOS, granulosa cell tumor |
|
Endometrial carcinoma
(a) epidemiology (b) clinical presentation (c) gross path (d) micro (e) risk factors (f) most important prognostic factor |
(a) most common gynecological malignancy; peak at 55-65
(b) vaginal bleeding; typically preceded by endometrial hyperplasia (c) tan polypoid mass (d) endometriod adenocarcinoma (e) unopposed estrogen; obesity; diabetes; HTN; nulliparity; late menopause (f) myometrial invasion (stage) |
|
Polycystic ovary disease
(a) presentation (b) lab/path (c) etiology (d) treatment |
(a) young, obese, hirsute females of reproductive age; oligomemnnorhea
(b) bilaterally enlarged, cystic ovaries Elevated LH, low FSH, high testosterone (c) incr LH stimulation leads to incr androgen synth (d) wt loss, OCP's, gonadotropin analogs, clomiphene or surgery |
|
Cystadenoma
(a) description (b) pathology |
(a) most common benign ovarian tumor
(b) unilocular cyst w/simple serous or mucinous lining |
|
Follicular cyst
(a) desciption (b) associations |
Distention of unruptured graafian follicle
(b) hyperestrinism and endometrial hyperplasia |
|
Corpus luteum cyst complications
|
Hemorrhage into persistant corpus luteum; menstrual irregularity
|
|
Theca lutein cyst
(a) presentation (b) etiology (c) associations |
(a) often bilateral/multiple cysts
(b) gonadotropin stimulation (c) choriocarcinoma and moles |
|
"chocolate cyst"
|
Ovarian endometriosis
|
|
Teratoma
(a) epidemiology (b) lab/path (c) treatment |
(a) 90% of all germ cell tumors; immature teratoma aggressivel malignant; mature benign
(b) contain 2-3 germ layers; immature contains primitive cells (c) treatment |
|
Dysgerminoma
(a) epidemiology (b) lab/pathology (c) risk factors (d) treatment (e) tumor marker |
(a) mainly adults
(b) sheets of uniform cells (same as male seminoma) (c) Turner's, pseudohermaphrotidism (d) radiosensitive, so good prognosis (e) hCG? |
|
Choriocarcinoma
(a) clinical presentation (b) tumor marker (c) histology (d) associations (e) treatment |
(a) malignant
(b) beta hCG (c) large, hyperchromatic syncitiotrophoblastic cells (d) incr frequency of theca-lutein cysts (e) responsive to chemo |
|
Yolk sac tumor: tumor marker
|
AFP
|
|
Granulosa cell tumor
(a) clinical presentation (b) microscopic (c) complications |
(a) produces estrogen and can produce precocious puberty, irregular menses, or dysfunctional uterine bleeding
(b) polygonal tumor cells w/follicle like structures (Call Exner bodies-small follicles filled w/eosinophilic secretions) (c) endometrial hyperplasia/cancer |
|
Sertoli Leydig cell tumor
(a) clinical presentation |
(a) androgen producing tumor; presents w/virilization in females
|
|
Hydatidiform mole
(a) clinical presentation (b) serum markers (c) treatment |
(a) "size greater than date"; vaginal bleeding; passive of edematous grape like tissue
(b) beta hCG (c) curettage follow bHCG levels |
|
Partial hydatidiform mole
(a) Karyotype (b) hCG (c) uterine sz (d) convert to choriocarcinoma (e) fetal parts |
(a) 69XXY (2 sperm +1egg)
(b) incr (c) nc (d) rare conversion (e) yes |
|
Complete Hydatidiform mole
(a) Karyotype (b) hCG (c) uterine sz (d) convert to choriocarcinoma (e) fetal parts |
(a) 46XX(or XY) both paternal
(b) highly elevated (c) incr (d) 2% (e) no |
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Struma ovarii
|
Teratoma w/functional thyroid tissue (can present as hyperthyroidism)
|
|
Clear cell adenocarinoma (vagina) risk factor
|
Affect women who had exposure to diethylstilbestrol
|
|
Serous cystadenoma
(a) epidemiology (b) presentation (c) micro |
(a) 20% of ovarian tumors
(b) frequently bilateral, (c) lined w/fallopian tube like epithelium |
|
General ovarian cancer tumor marker
|
CA-125
|
|
Genetic risk factors for ovarian cancer
|
BRCA1, HNPCC
|
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Serous cystadenocarcinoma
(a) epidemiology (b) presentation (c) histology |
(a) 50% of all ovarian tumors
(b) frequently bilateral (c) psammoma bodies |
|
Mucinous cystadenocarcinoma
(a) possible serious consequence (b) route of spread |
(a) pseudomyxoma peritonei-intraperitoneal accumulation of nmucinous material from ovarian tumor
(b) direct pelvic cavity seeding (like serous) |
|
Brennar tumor
|
Benign ovarian tumor (bladder histology)
|
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Ovarian fibroma
(a) histo (b) Meig's syndrome |
(a) bundles of spindle shaped fibroblasts
(b) Triad of ovarian fibroma, ascities, hydrothorax; pulling sensation in groin |
|
Krukenberg tumor
|
GI malignancy that mets to ovaries causing mucin secreting sigment cell adenocarcinoma
|
|
Fibroadenoma of breast
(a) characteristics (b) epidemiology (c) gross histo (d) micro histo (e) risk for malignancy? |
(a) small, mobile, firm w/sharp borders; incr sz and tenderness w/estrogen
(b) most common tumor in <25YO (c) round/encapsulated (d) glandular epithelial lined spaces w/fibroblastic stroma (e) no |
|
Intraductal papilloma
(a) characteristics (b) epidemiology (c) gross histo (d) micro histo (e) risk for malignancy? |
(a) small tumor in lactiferous ducts; typically beneath areola; serous or bloody nipple discharge
(b) 20-50YO (c) small, usually close to nipple (d) multiple papillae (e) slight incr |
|
Phyllodes tumor
(a) characteristics (b) epidemiology (c) gross histo (d) micro histo (e) risk for malignancy? |
(a) Large, bulky mass of CT and cysts leaflike" projections
(b) 6th decade (c) irregular mass; often fungating or ulcerated (d) myxoid stroma w/anaplasia (e) some may become malignant |
|
Risk factors for carcinoma of breast
|
Incr age
Nulliparity Family hx Early menarche Late menopause Fibrocystic disease Previous hx Obesity High fat diet |
|
What is the most important prognostic factor for breast cancer?
|
Axillary lymph node involvement
|
|
BRCA1
|
100% lifetime risk for breast cancer
Incr risk for ovarian CA (men at incr risk for prostate) |
|
BRCA2
|
Incr incidence of breast CA only
|
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Ductal carcinoma in situ
|
Fills ductal lumen
|
|
Invasive ductal carcinoma in situ
(a) characteristics (b) epidemiology (c) prognosis |
(a) firm, fibrous mass; small glandular, duct like cells; foci of necrosis and calcification common
(b) most common breast CA (c) worst and most invasive |
|
Protein/receptor changes associ w/breast cancer
|
Overexpression of estrogen/progesterone rec
Overexpression of erb-2/Her-2( EGF receptor) |
|
Invasive lobular carcinoma of the breast
(a) presentation (b) gross (c) histology (d) tumor markers? |
(a) often multiple/bilateral
(b) rubbery and ill defined (c) small cells may be arranged in rows/rings; arise from terminal ductules (d) assoc w/incr estrogen receptors |
|
Medullary carcinoma of the breast
(a) gross (b) micro (c) prognosis |
(a) fleshy mass
(b) large, pleomorphic cells jw/lyphocytic infiltrate (c) good |
|
Comedocarcinoma
(a) gross (b) micro |
(a) gocus of increased consistency in breast tissue
(b) typical duct epithelial cells proliferate and fill ducts;caseous necrosis (may discharge from nipple) |
|
Paget disease of breast
(a) epidemiology/prognosis (b) gross (c) histo |
(a) older women; poor prognosis
(b) skin of nipple and areola ulcerated/oozing (c) ductal carcinoma (involving areolar skin) and large, hyperchromatic "paget cells" |
|
P'eau D'orange
|
Dermal lymphatic invasion by breast cancer
|
|
Colloid (mucinous) carcinoma
(a) epidemiology (b) prognosis (c) gross (c) histo |
(a) older women
(b) slow growing better prognosis than ductal (c) soft, large, gelatinous (d) islands of tumor cells w/mucin |
|
Fibrocystic disease
(a) description/epidemiology (b) clinical presentation (c) risk to carcinoma |
(a) most common cause of breast lumps from age 25 to menopause
(b) premenstrual brast pain and multiple lesions (c) usually not (except with epithelial hyperplasia histo type) |
|
4 histologic types of fibrocystic disease
|
(1) fibrosis-hyperplasia of breast stroma
(2) cystic-fluid filled, blue dome (3) sclerosing adenosis-incr acini and intralobular fibrosis (4) epithelial hyperplasia-incr number of epithelial cell layers in terminal duct lobule (incr risk of carcinoma w/atypical cells) |
|
Acute mastitis
(a) describe (b) usually pathogens (c) treatment |
(a) fissures in nipples during nursing predispose to infx; breast abscess
(b) S aureus and strep (c) Abs and surgical drainage |
|
Fat necrosis of breast
(a) presentation (b) cause |
(a) benign, painless lump
(b) result from injury to breast tissue |
|
Mammary duct ectasia (plasma cell mastitis)
(a) epidemiology (b) clinical presentation |
(a) 5th decade in multiparous women
(b) pain, redness, induration around areola w/thick secretion; usually unilateral Skin fixation, nipple retraction, axillary lymphadenopathy can occur (distinguish from malignancy) |
|
Gynecomastia causes
|
(a) hyperestrogenism (cirrhosis, testicular tumor, puberty, old age)
(b) Klinefelter's (c) drugs (estrogen, mairjuana, heroin, psycoactive drugs, spironolactone, digitalis, cimetidine, alcohol, ketoconazole) |
|
Selective phosphodiesterase (PDE) 5 inhibitors
(a) example(s) (b) mechanism (c) indication (d) toxicities/contraindications |
(a) sildenafil, vardenafil, tadalafil
(b) inhibits phosphodiesterase (which inactivates cGMP) leading to incr cGMP, incr vasodilation (c) erectile dysfct (d) addition of nitrates which also incr cGMP can cause severe hypotension |
|
Alprostadil
(a) drug class (b) mechanism (c) indication (d) toxicity/contraindication |
(a) synthetic prostaglandin E1 agents
(b) incr cAMP via adenylate cyclase leading to smooth muscle relaxation (c) erectile dysfct (d) intercourse w/pregnant women (can stimulate uterine contraction); conditions that predispose to priapism (sickle cell, multiple myeloma, leukemia) |
|
Flutamide
(a) mechanism (b) clinical use |
(a) androgen receptor antagonist
(b) prostate cancer |
|
Spironolactone
(a) mechanism (b) clinical use |
(a) androgen receptor antagonist (also apotassium sparing diuretic)
(b) hirsutism |
|
Leuprolide
(a) mechanism (b) clinical use (c) toxicity |
(a) GnRH analogue
(b) depot form used for prostate cancer (c) antiandrogen, nausea, vomiting |
|
Finasteride
(a) mechanism (b) clinical use |
(a) 5 alpha reductase inhibitor; prevents converstion of testosterone to DHT
(b) BPH, male pattern baldness |
|
Ketoconazole
(a) mechanism (b) clinical use |
(a) antifungal gent which also inhibits synth of steroids
(b) androgen receptor positive prostate cancer |
|
Tamoxifen
(a) mechanism (b) clinical use (c) benefits (d) negatives |
(a) SERM; estrogen antagonist in breast; agonist in endometrium/bone
(b) hormone responsive breast CA (c) reduce risk of breast CA in high risk women; prevent osteoporosis in women using for breast CA (d) increase risk of endometrial CA; hot flashes; incr risk of venous thrombosis |
|
Raloxifene
(a) mechanism (b) clinical use (c) benefits (d) negatives |
(a) partial estrogen agonist in bone; estrogen antagonist in breast/uterus
(b) estrogen replacement therapy in postmenopausal women (c) prevents osteoperosis; reduces risk of breast CA in high risk women; no incr risk of endometrial CA (d) hot flashes; incr risk of venous thrombosis |
|
Clomiphene
(a) mechanism (b) clinical use (c) side effects |
(a) partial agonist at estrogen receptors in hypothalamus (reduces negative feedback mechanism by reducing receptor recycling); incr FSH and LH to stimulat eovulation
(b) PCOS and infertility treatment (c) hot flashes, ovarian enlargement, multiple simultaneous pregnancies, visual disturbances |
|
Danazol
(a) mechanism (b) clinicla use |
(a) inhibits ovarian steroid synthesis
(b) endometriosis and fibrocystic breast disease |
|
Anastrozole
(a) mechanism (b) clinical use |
(a) aromatase inhibitor
(b) postmenopausal women with breast CA |
|
Mifepristone (RU 486)
(a) mechanism (b) clinical use (c) toxicity |
(a) progesterone and glucocorticoid antagonist
(b) termination of pregnancy; administered w/misoprostol (PGE1) (c) heavy bleeding, GI effect (N/V/anorexia); abd pain |
|
Dinoprostone
|
PGE2 analog causing cervical dilation and uterine contraction inducing labor
|
|
Ritodrine/terbutaline
|
Beta 2 agonists that relax the uterus; reduce premature uterine contractions
|
|
Testosterone (methyltestosterone)
(a) clinical use (b) toxicity |
(a) hypogonadism
Promote development of secondary sex char Stimulate anabolism after burn/injury Treat ER positive breast cancer (exemestane) (b) masculinization (females); reduces testosterone in males by inhibiting Leydig cells (gonadal atrophy) Premature closure of epiphyseal plates Incr LDL, decr HDL |
|
Ethyinyl estradiol, DES, mestranol
(a) mechanism (b) clinical use (c) toxicity (d) contraindications |
(a) bind estrogen receptors
(b) hypogonadis or ovarian failure Menstrual abnormalities HRT in postmenopausal women Androgen dependent prostate cancer (c) incr risk of endometrial cancer Bleeding in post menopausal women Clear cell adenocarcinoma of vagina in women exposed to DES in utero Incr risk of thrombi (d) Er positive breast cancer |
|
Gonorrhea pathogensis
|
Pili (adherence, antigenic cariation)
Antiphagocytic IgA protease |
|
Gonorrhea treatment
|
Ceftriaxone
|
|
Urethritis: culture negative, inclusion bodies
|
Chlamydia
|
|
Treatment for chlamydia
|
Tetracyclines
Erythromycin |
|
Urethritis: urease+
|
Ureaplasma yurealyticum (no cell wall)
|
|
Treatment of ureaplasma
|
Tetracyclin, erythromycin
|
|
Urethritis: flagellated protozoan
|
Trichomonas
|
|
Treatment of trichomonas
|
Metronidazole
|
|
Adherent yellowish discharge, high pH, fishy amine odor, clue cells
|
Garnderella vaginalis
|
|
Treatment of bacterial vaginosis
|
Gardnerella infection
Metronidazole |
|
Volvovaginitis, pruritis, erythema, discharge w/consistency of cottage cheese (MCC, treatment)
|
Candida, nystatin
|
|
"strawberry cervix", foamy purulent discharge (treatment)
|
Trichomonas (metronidazole)
|