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;
72 Cards in this Set
- Front
- Back
|
fibroadenoma vs. phyllodes tumor
|
both mixed stroma and epithelial but phyllodes has more cellular/atypical stroma and may be malignant (esp stromal part)
|
|
|
most common site for initial presentation of breast cancer?
|
upper outer quadrant
|
|
|
of the 2 sets of genital ducts, which plays significant role in female embryo
|
paramesonephric (not mesoneprhic)
|
|
|
Gartner duct cysts
|
cysts of persistent parts of mesonephric ducts, presents as discrete nontender nodule on anterolateral vag wall
|
|
|
"keyhole" pattern
|
assoc'd with classic presentation of lichen sclerosis
|
|
|
normal pH of vaginal secretioin
|
3.8-4.2
|
|
|
4 cardinal questions of preggers?
|
1. are you bleeding? 2.do you have any leaking fluid? 3. contractions? 4. is the baby moving well?
|
|
|
midcycle surge of FSH/LH a)caused by? B) Causes?
|
a) estradiol switching to pos feedback on pituitary (not hypothal); b)rupture of dominant follicle, primary steroid becomes progesterone
|
|
|
what rescues corpus luteum from nl regression?
|
if conception, trophoblast cells would secrete chorionic gonadotropin
|
|
|
primary site of GnRH secretion?
|
arcuate nucleus of hypothalamus
|
|
|
midcycle surge of FSH/LH comes from?
|
releasable pool (vs reserve pool)
|
|
|
what kind of R on a) theca cells, b)granulosa cells?
|
a) LH R (produce androstenedione, testosterone), b) FSH R (produce estradiol, estrone
|
|
|
how get estrone/estradiol from androstenedione/testosterone?
|
aromatization with P450arom
|
|
|
histology of lichen sclerosus
|
hyperkeratosis of vulvar skin, loss of rete ridges, acellular homogeneous zone in superficial dermis
|
|
|
most common malignancy arising in vulva?
|
squamous cell carcinoma
|
|
|
verrucous carcinoma assoc'd with infection by what?
|
HPV, types 6 or 11
|
|
|
how is vulvar Paget dz different from nipple Paget?
|
vulvar is only rarely assoc'd with underlying adenocarcinoma
|
|
|
most common malignancy of vagina?
|
squamous cell carcinoma
|
|
|
cambium layer
|
dense band of tumor cells beneath vag epithelium in sarcoma botryoides
|
|
|
when get microglandular hyperplasia?
|
during pregnancy, post-partum or with OCP (from progestin stim)
|
|
|
unique metastatic pattern of infiltrating lobular carcinoma
|
CNS, ovarian, uterine mets
|
|
|
most common sites of breast cancer mets?
|
skin, lymph, bone, liver
|
|
|
megastrol
|
anti-progestin
|
|
|
which endometrial adenocarcinomas are non-estrogen dependent?
|
papillary serous and clear cell variants
|
|
|
Aria-stella reaction
|
refers to thickened and hypersecretory endometrium that occurs during pregnancy, due to HCG stimulation (get hobnail cells)
|
|
|
endometrial polyps result of what?
|
focal hypersensitivity of endometrial glands to estrogen (or unresponsive to progesterone)
|
|
|
most important prognostic factor for endometrial hyperplasia?
|
nuclear atypia
|
|
|
endothelial intraepithelial neoplasia often asso'cd with what mutation?
|
loss of function of PTEN (tumor suppressor)
|
|
|
most common variant of endometrial adenocarcinoma?
|
endometroid variant (60%)
|
|
|
most common gyn cancers in US?
|
#1 endometrial #2 ovarian #3 cervical
|
|
|
US gyn cancer that cuases the most deaths?
|
ovarian
|
|
|
DDx for menorrhagia?
|
fibroids (submucosal), adenomyosis, blood dyscrasias (PLT d/o)
|
|
|
when is tissue bx indicated for vaginal bleeding?
|
1) >40y/o 2) unresponsive to med tx 3) high risk group (obese, HTN, diabetic)
|
|
|
lab definition of menopause
|
FSH>30mlU/ml
|
|
|
"premature" menopause =
|
<35 y/o
|
|
|
contraindications to estrogen replacement therapy
|
1. current breast/endometrial cancer 2. past breas/endometrial cancer 3. unexplained vag bleeding 4. preggers 5. liver dz 6. active VTE
|
|
|
nonhormonal treatment of vasomotor sxs of menopause
|
clonidine (antiHTN), SSRIs, vit E (herbal estrogen)
|
|
|
underlying abnormality in PCOS?
|
increased ovarian production of androgens secondary to abnl regulation of 17alpha hydroxylase
|
|
|
Krukenberg tumor
|
gastric carcinoma that mets to ovary; mucin producing signet ring cells
|
|
|
Schiller-Duval bodies seen in what gyn tumor?
|
yolk sac tumors (highly malignant, in <30y/o!)
|
|
|
Meigs syndrome
|
assoc'n of ovarian fibroma with ascites and sometimes pleural effusions
|
|
|
how make diagnosis of preeclampsia?
|
BP>140.90 (after 20wks gestation), 300mg protein in 24hr collection
|
|
|
effect of smoking on preeclampsia?
|
decreases risk
|
|
|
preeclampsia prior to 20wks gestation is highly suggestive of what?
|
molar pregnancy
|
|
|
prostanoid changes in preeclampsia
|
TXA>PGI (more vasoconstriction)
|
|
|
most common hematologic abnl in preeclampsia?
|
thrombocytopenia
|
|
|
severe preeclampsia defined by
|
BP=160/110, proteinuria=5g/24hr
|
|
|
HELLP
|
hemoslyis, elevated liver enzymes, low plt; variant, probably severe preeclampsia but may present with little or no HTN/proteinuria
|
|
|
when is childhood masturbation "abnormal"
|
if deliverately done in public after 5-6 years
|
|
|
ductal boob growth stimulated by?
|
estrogen
|
|
|
boob alveolar hypertrophy stimulated by?
|
progesterone
|
|
|
what happens to PTH during pregnancy? (and why?)
|
levels increase progressively (maintains serum calcium levles and allows for transfer to fetus)
|
|
|
effect of estrogen on thryoid?
|
increase in TBG (hence, check free T4/T3)
|
|
|
effect of estrogen on coagulation?
|
decreases AT3, increases plasminogen, II, VII, IX, X
|
|
|
what kind of estrogen R more active in reproductive system?
|
alpha
|
|
|
what kind of estrogen R increase in breast tumors?
|
alpha
|
|
|
indications for tamoxifen?
|
metastatic breast cancer, prophylaxis (only SERM for premenopausals!)
|
|
|
how is raloxifene different from tamoxifen?
|
has estrogen antagonist activity centrally (hot flashes) but also on uterus and breat tissue
|
|
|
indications for raloxifen
|
postmenopausal osteoporosis (b/c estrogen ag on bone..and lipids and coag)
|
|
|
indications for fulvestrant
|
treatment of ER + met breast cancer in postmenopausal women
|
|
|
fecundability vs fecundity
|
fecundability-probability of preggers w/I 1 mentstrual cycle; fecundity--ability to achieve LIVE birth in 1 menstrual cycle
|
|
|
5 tests to check for ovulatory d/o, progesterone
|
1.regular menses esp w/moliminal sxs; 2. basal body T (midcycle spike). 3. endometrial bx; 4. sr progesterone (day18-22, 15-15ng/ml); 5. urinary LH
|
|
|
MOA of clomiphene
|
easy to use SERM--ER antag on hypothal. Low estrogen causes increase GnRH pulse amplitude and frequency (but must have intact axis!)
|
|
|
effect of hcG in tx of ovulatory d/o
|
like natural LH surge, causes dominant follicle to release egg and corpus luteum to produce progesterone
|
|
|
hMG
|
very potent ovulation drug that stimulates follicular growth and maturation but need also hcg to induce ovulation
|
|
|
why use GnRH antag for tx of ovulatory d/o??
|
exposes pituitary gl to constant>pulsatile GnRH and somehow this enables better response to hMG
|
|
|
estrogenic component of combo OCP does what?
|
suprresses FSH (prevents emergence of dominant follicle), stabilizes endometrium
|
|
|
progestational part of combo OCP does what?
|
suppresses LH (prevents midcycle LH surge), stabilizes endometrium, affects cervical mucous and tubal motility
|
|
|
absolute contraindications to OCP (9)
|
DVT hx, vascular dz, hyperlipidemia, significant cardiac dz, estrogen-dep cancer, preggers, active liver dz/tumor, unexplained uterine bleeding, uncontrolled HTN
|
|
|
MOA of emergency contraception
|
delay/inhibt ovulation and alter endometrium to prevent implantation
|
|
|
medical tx of ectopic pregnancy?
|
MTX
|
|
|
placental abuption vs. previa?
|
abrptio is PAINFUL; previa is PAINLESS
|
