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193 Cards in this Set
- Front
- Back
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what is a cast?
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mold of whatever is going in your nephron, tammhorsefal protein surrounds the problem in the tubule and makes a mold that is passed in the urine
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what is the gold standard in the initial workup of any renal disease
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UA
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GLomerulonephritis what type of casts do you see?
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you have inflammation of the glom by definition so you damage the capillaries and make a RBC casts...because thats what is being spilled into the urine
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renal tubular necrosis, what type of casts do you see
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tubules are sloughing off from the BM and form renal tubular casts
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acut pyelonephritis, what type of casts do you see?
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neutrophils infiltrate the intersitium so you form casts of neutrophils (WBC casts)...casts surround whats going on.
cast of neutrophils |
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Nephrotic syndrome
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spilling libid into the urine so you make casts of them (make a casts of the lipid)
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VHY***
First thing that disapears when you have renal failure |
inability to concentrate urine (specific gravity)
>1.023 that means that the kidneys, that means the kidneys are ok IF less than that start thinking renal failure |
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Most benign of all casts, dosn't usually mean anything
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hyaline casts - cast of protein, unless w/ proteinuria
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what do you have to have to from uric acid crystals or stones? what could you give person to help w/ this?
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Patiet probably has gout (inc. purine metabolism: meats, alcohol) have to have acidic urine to form uric acid crstals
carbonic anhydrase inhibitor (acetacolamide) - causes HCO3 to inc. in kidney preventing stone formation |
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VHY***
street person comes in a stupor state, they have a high anion gap and you see calcium oxalate crystals in the urine, DX has high, ethylene glycol, has a |
Ethylene glycol ingestion causes calcium oxalate crystals (looks like an X-box)MC stone to form
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VHY***
what is the most common type of kidney stone? |
calcium oxalate
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patient has a horshoe kidney, what is restricting it?
when do you see this? |
inferior mesenteric artery, go over it and trap it...it is seen in turners syndrome
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patient has a potter faces, they cannot create urine in utero so they have oligohydraminos, dx?
what is the inheritance |
AR - infantile polycystic kidney disease, cysts are also in the liver and pancreas...incompatible w/
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what is the inheritance of adult polycystic kidney disease...do they have cysts on the kidney at birth?
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AD - adult polycystic kidney disease (cysts not present at birth)
variable penatrance |
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incomplete penatrance
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example is Marfans
have the abnormality in the genetics but no physical manifestation...but you can pass it on. |
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patient presents w/ HTN, have cysts on the kidney on ultrasound and come to see you because they are experiencing the worst headache of their life, DX
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PCKD
HTN gives increased risk of berry aneurysm - when that rupture you have blood in teh subarachnoid space (worst headache ever is the most common symptom |
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HTN abnormality of on renal ultrasound and had a click murmur, what was the patient kidney disease?
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ADULT POLYCYSTIC KIDNEY DISEASE
high assocaition w/ mitral valve prolapse |
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patient presents w/ HTN, abnormalities on the renal ultrasound and had a sudden loss of 600ml (hematachezia) of blood from the but all the sudden?
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APKD
most common cause of hematachezia (massive blood loss) is diverticulosis |
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3 common complications of APKD
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Berry aneurysm form HTN
mitral valve prolapse Diverticulosis |
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Glomerulonephritis, what is the hyepersensitivity?
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type III HTN (if it ends in itis it has type III hypersensitivity)
examples: IGA glomeerulonephritis diffuse membranous glomerulonephritis |
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diffuse VS focal
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every single glomerulus has something wrong w/ it
focal - some glomeruli are involved (not all) |
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DEFINE
segmental VS proliferative |
only a part of the glomerulus is involved
=lots cells involved...more than 100 nuclei |
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example:
don't see a lot of neuclei (Cells) but you see a thick membrane, DX? |
membranous disease
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incresed membarne and number of cells (nuclei)?
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membranoproliferative disease
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describe the anatomy of the glomerulus starting from the blood to the lining of the urinary space.
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endothelial cells (fenesterated)...BM...visceral epithelial cell (make the BM)..contian the foot like processes(spaces between, called slit pores)...urniary space...parietal epithelial cells(lining cells of bowmens capsule)
the mesangial cells are on the other side of the endothelial cells and support the gomerular capillaries |
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what primarily prevents proteins from getting into in the nephron?
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strong negative charge of BM (heparan sulfat specifically, strong negative charge)
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what determines the protein filtration through the glomerulo basement membrane?
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Size and charge of the protein
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If we damage the visceral epithelial cells what else are we then damaging?
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basement membrane...could result in nephrotic syndrome
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what does immmunoflouresence?
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TWO TYPES: linear or lumpy bumpy granular
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Linear pattern on flourescent tag, DX?
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MCC is Goodpastuers disease...because the BM is throughout the whole thing
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Granular ("lumpy-bumpy")pattern indicates?
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Immunocomplex deposition(type III)... they have different solubilities, charges and sizes...so won't be nice and linear
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SLE vs poststreptococcal glomerulonephritis?
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subepithelial deposit (complexes are more souluble so they dissolve further)
subendothelial deposit (to big and get stuck) |
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VHY***
only glomerulonephritis that can be diagnosed by immunofluorescence is? |
IgA glomerulonephritis - because you have to prove it is IgA and nothing else (IgG)
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Anti-basement membranes antibodies (IgG) directed against the BM are what type of hypersensitivity?
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TYPE II
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Two types of glomerulonephritis
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Nephritic or Nephrotic
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Hematuria, RBC casts, mild proteinuria and oligouria are all consistant w/ what type of kidney disease?
why do see each of the physical findings |
Nephritic disease- unique casts (RBC casts...inflammation (i.e. swollen capillaries) leads to less filtration (oligouria and Na retention (causes HTN)) and causes a little protien to be spilled as well as blood
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Fatty cast, greater than 3 1/2 gm of protien in the urine, pitting edema is consistent w/ what type of kidney disease?
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Nephrotic syndrome
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Patient rheumatic fever a few weeks ago, has hematuria, HTN and little periorbital puffiness, on biopsy there are to many nuclei, and all of the glomeruli look like this, DX?
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diffuse proliferative posterptococcal glomerulonephritis (MC type of post-infectious GN)
caused by immune complex deposition, subepithelial deposits. tx-costicosteroids |
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women 35, has positive serum ANA w/ rim pattern (anti double stranded ANA) and develops hematuria, on biopsy there are to many nuclei, and all of the glomeruli look like this, DX?
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Diffuse proliferative glomerulonephritis
subendothelial deposits |
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VHY***
What disease classicaly produces a cresentric GN? |
goodpasteures disease...poor prognosis (will get renal failure), it is called rapidly progressive glomerulonephritis
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VHY***
fatty casts w/ Maltese crosses and oval fat bodies are a key finding to? |
Nephrotic syndrome (you see the maltese cross under polarized light and they are due to cholesterol)
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with what syndrome do you rund the risk of spontaneous peritonitis? what organsims cause it in kids and adults?
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nephrotic syndrome
kids - cause is strep penumoniae adults - E. coli |
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Pateint had an upper respiratory tract infection 1 week ago, has pitting edema, and hypercholesterolemia, DX?
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Fusion of podocytes is seen in any cause of nephrotic syndrome...they have lipoid nephrosis (minimal change disease)
hae loss negative charge of BM so albumin can get through...albumin is what they have in their urine tx-coritocsteroids (usually get 100% remission) |
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MCC of nephrotic sydnrome in kids
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minimal change diseease
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VHY***
Guy has AIDS, HTN and pitting edema, has normal EM and Immuno, but see on H&E that some of the glomeruli in certain spots look all messed up, DX? |
focal segmental glomerulosclerosis (MC glomerular lesion in AIDS and IV drug abuser)
next worst glomerular disease compared to cresentric. |
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FUSION OF THE PODOCYTES IS SEEN IN ALL __________syndromes?
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NEPHROTIC SYNDROME
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VHY***
Adult had pitting edema, fatty casts...on biopsy you see a very thick BM, DX? what else might you see on biopsy? what can cause this? |
diffuse membranous glomerulonephritis
epimembranous spikes*** ("spike and dome appearnce"), these are the immune complexes and they can be seem w silver stain... NSAIDS, Hepatitis B, captapril, infections, syphilis, cancer... |
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most common GN of adults is?
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diffuse membranous glomerulonephrosis
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what kidney problem is associated w/ NSAIDS?
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diffuse membranous glomerulonephritis
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This is this drug of choice for Diabetic nephropathy and heartfaliure?
what is the kidney problem it can cuase |
captopril - diffuse membranous glomerulonephritis
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This nephrotic syndrome is associated w/ hepatitis B and you have subendothelial deposits.
You will see tram tracks on EM, what causes the tram track appearnce? |
TYPE I MembranoProliferativeglomeruloNephritis (MPGN)
ends in itis so it has to be immune complex related The mesangial cell is extending between endothelial cell and BM producing tram track appearnce. |
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Membranous glomerulonephritis is associated w/ this hepatitis?
what else is associated w/ this hepatitis? |
Heptatitis B - polyarteritis B
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Type I MPGN is associated what type of hepatitis?
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Hepatitis C - cryoglobulinemia
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This nephrotic syndrome is assocaited w/ an antibody against C3 causing its levels to be lower than any other kidney disease,DX?
Can see tram tracks as well. |
dense deposit disease (entire BM is an immune complex)
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Big balls of pink stuff in the glom, DX?
what are the big balls of pink stuff?> |
diabetic glomerulosclerosis (technically nodular glomerulosclerosis or kimmielstien wilson disease)
Type IV collagen build up. |
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VHY******
What is the first problem to occur to the Diabetic kidney? How does microabluminuria occur in the diabetic kidney? |
efferent arterioloe first to be hyalinzed (narrows it causing in GFR), hyperfilitration damages the GLOM.
BM can become glycosylated (non-enzymatic glycosylation) making it permeable to protein...microalbuminuria results (tx w/ an ACE) |
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How does an ACE help a diabetic kidney?
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afferent is controlled by PGE2, and efferent is controlled by ACE II (causing constriction) so if you inhibit this you dialte the efferent decreasing pressure or GFR lowering the pounding on the GFR.
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Amyloid (beta protien) likes to deposit in the kidney, what does it look like underpolarized light
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apple green birifringance (light green)
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Amyloid and diabetic glomeruloscleroiss are considered what category of kidney disease?
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nephrotic
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Lipoid nephrosis (minimal change disease)
focal segmental glomerulosclerosis diffuse membranous glomerulopathy Typ I and Type II MPGN amyloid and diabetic glomerulosclerosis all have what in common? |
they are all nephrotic syndromes
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Kids episodic gross hematuria
adults have bouts of microscopic hematuria see RBC casts in the urine maybe a little bit of protein...goes away couple weeks later then comes back w/ a cold or something like that, DX? what type of hypersensitivity? what do you see on biopsy on the kidney? |
IgA glomerulopathy (Bergers disease)
type III immune complexes are only in the mesangium |
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what is the most common glomerulonephritis overall?
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IgA glomerulopathy (Bergers disaease)
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KNOW BUN/CREATINE RATIO
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Blood urea nitrogen (can be cleared and reabsorbed)
creatine (secreted) |
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what is the normal BUN/creatinine ration
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10:1
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prerenal azotemia, what is it?
pathophysioloigy? |
increase in BUN
problem is decrease in cardiac output not the kidney decrease in CO causes a decrease in GFR (allows proximal tubule to absorbtion of urea) creatinine is also elevated because not cleared as fast but not as much as urea because it is reabsorbed BUN RATIO is 15:1> means prerenal azotemia |
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patient has congestive heart failure and BUN is 80 and serum creatine is 2 DX?
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pre-renal azotemia does not have ATN
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Oliguria, renal tubular casts, and BUN 80 and creatinine is 8, DX
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RENAL FAILURE
effects urea and creatinine equally/proportionally because urea is not reabsorbed any (both are elevated and both have the same problems in the kideny) IF BUN/Creatinine raito is 1O:1 and both are increased then you have renal failure |
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What is the most common cause of acute renal failure?
patient will have oliguria and decreased cardiac output. |
ischemic acute tubular necrosis
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most common cause ischemic acute tubular necrosis
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untreated pre-renal azotemia
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BUN/creatinine 10:1 (but overall elevated), renal tubular casts and oliguria, DX?
why does it have such a bad prognosis |
ischemic ATN
renal tubular casts slough off and contribute to oliguria has a bad prognosis because ischemia causes tubules and BM is destroyed so structure integritiy is destroyed...then you can't regenerate and get normal function. |
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what do you worry about the most in patient who has decreased CO and oliguria?
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ischemic ATN, watch their BUN/creatinine ration.
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two parts of the nephron that are the most susceptible to necrosis?
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1.straight portion of proximal tubule
2.thick ascending limb in the medulla these are the ones that undergo coagulation necrosis and slouph off. |
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Drugs that are nephrotoxic
which ones are the most common in nephrotoxic ATN? |
gentamycin
aminoglycasides (MCC) intravenous pylograms (2nd) |
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nephrotoxic ATN, what part of the kidney is effected and what is the progonosis?
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proximal tubules,
prognosis is better than ischemic because BM is still intact and only the proximole tubule is effected |
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what is the most common cause of acute renal failure?
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acute tubular necrosis
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what is the most common type of actue tubular necrosis?
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ischemic acute tubulare necrosis
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what is the most common cause of ischemic ATN?
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pre-renal azotemia
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Renal tubular casts are key to what diagnosis?
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ATN
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***VHY
what is the mechanism of all type of urinary tract infections (upper and lower)? |
ASCENDING INFECTION FROM THE BEGINING OF URETHRA.
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dysuria, infrequency, no flank pain, no white blood cell casts no suprapubic pain, DX?
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lower UTI
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fever, flank pain and white blood cell casts diagnosis?
mechanism |
acute pylonephritis-mechanism vesical ureteral reflux (VUR, during micturition w/ an ascending infection...
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recurrent attacks of pyelonephritis causes
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chronic pyelonephritis...can cause HTN and ARF
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intrascared kidney and
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chronic pylonephrtis
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put a patient on a drug and they develop an abrupt, fever rash, oliguria, eosinophiluria...DX?
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acute drug induced tubular nephritis (TIN)
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what is the most common cause of TIN?
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acute pyelonephritis
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what does chronic pyelonephritis do to the kidney?
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causes hydronephrosis
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what causes renal papillary necrosis?
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amalgesic nephropathy: combination of acetaminophen and aspirin
acetaminophen causes free radical damage to the renal tubules in the medulla (most vulnerable do to lack of blood supply) aspirin inhibits PGE2 allowing ATII unopossed which constricts and decreases blood flow to the kidney. results from chronic use of these drugs, effect is cumulative |
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after aggressive treatment of a disseminated cancer urate crystals begin to deposit in the tubules and interstium...followed by oligouria, renal tubular casts...(acute renal failure), how could this of been prevented?
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aggressive treatment w/ allopurinol...prevents the urate nephropathy (massive purines are released (tumor lysis syndrome) when killing cancer cells
lead poisioning and gout are also cause of uric acid crystals |
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ring sign
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acute tubular necrosis, diabetic nephropathy and
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what happens to the the kidney in chronic renal failure (by definition it is a BUN creatinine ratio of 10:1 for three months)?
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Overall concept is kidney can't do its normal functions
normocytic anemia (can't make EPO) increase in organic acid waste because we can't secrete it so we get a high anion gap metabolic acidosis... bones tru to buffer extra H+ ions and wears away bones Hypervitamin doses D (don't make alph 1 hydroxylase)...results in chronic hypocalcemia so body responds by elevating PTH elevates (secondarly)...get osteoporosis and osteomalacia Have bilateral shrunken kidneys BUN/Creatinine ration 80/8 |
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Patient presents w/ rapid increase in blood pressure to over 210/120, you see papilledema on a fundiscopic exam adn flame hemorrhages (retinopathy), hematuria w/ RBC CASTS, DX?
what is the Treatment what do the kidneys look like on groww appearnce |
malignant HTN
introvenous nitroprusside on gross appearnce yo see a flea bitten kidney (petechiae, from blood vessels rupturing, remeber these vessels had the onion skin appearnce vessl) |
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waxy casts are a sign of?
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chronic renal failure
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what is the most common renal disease of esential HTN?
what is the cause? |
benign nephrosclerosis (BNS)
due to hyaline arteriolosclerosis causing tubular atrophy, interstital and glomerulosclerosis kideny appears as a finley granular cortical surface. |
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patient has BP greater than 210/120mmHg, encephalopathy, renal failure, DX?
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malignant HTN - causes vascular damage to the aterioles and small kidneys
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irregular irregular is caused by
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a-fib
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VHY***
kidney appears w/ depressed and pale areas, the patient had an irregular irregular pulse what is the dx? |
A-fib causing embolization to the kidney causing kidney infarction
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little white dots and abscess is a sign of?
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pyelonephritis
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what is the most common complication of uppper urinary tract obstuction (what does it do to the kidneyh), what what is the most common cause of obstruction?
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Hydronephrosis causes ishcemia and atrophy (Compression atrophy, see a thin cortex)
renal stone |
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what is the most comon metabolic abnormality causing calcium stones?
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hypercalciuria
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what is the treatment for stone formation by hypercalciuria
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thiazide - increases reabsorption of calcium
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most kidney stones contain?
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calcium (look for them on X-ray if you don't see them then get IVP)
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VHY****LOVE THIS QUESTION
see a picture w/ a staghorn calculus, urine pH is alkaline, urine smells like ammonia what is the cause? what is the calculus made of? |
proteus-urase prodcuer - break urea into ammonia
magnesium ammonia phosphate Treatment - surgical remove |
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see a big mass in the kidney in a adult?
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Renal adenocarcinoma - clear cells full of glycogen
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large mass in the kidney that is a kid, DX
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Wilms tumor
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MC of renal adenocarcinoma?
what do they derive from what do they release? what do they like to do? |
from smoking
proximle tubule ectopic hormones: EPO, parathyroid like hormone (hypercalcemia) invade the renal vein (forget they are a carcioma) clear cells-full of glycogen. |
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VHY***
KID, w/ a flank mass and HTN what does he have to have? why does HTN Result |
wilms tumor
HTN from tumor making renin |
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VHY***
what are the two finding on physical diagnosis that you see w/ wilms tumor? |
anaredia*** (abscent iris in the eye)
hemihypertrophy of a limb (one limbe is bigger than the other) NOTE: likes to met to the lung |
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what common cause hemorrhagic cystitis?
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E. coli and if a virus adenovirus
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most common cause of UTI
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E. Coli
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common things a dipstick picks up?
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hematuria is common
neutrophils luekocyte esterase - because of neutrophils most are nitratate reduceers (make nitrites) pos |
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patient who has dysuria, increased frequncy,
suprapubic pain, neutrophils RBC or bacteria on UA or on dipstick has: hematruria, leukocyte esterase positive and nitrite positive, DX? |
Lower or upper UTI
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how do you tell a lower from an aupper UTI?
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upper -flank pain, WBC casts and fever
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increased frequency, neutorphils in urine but no bacteria, culture is negative positve leukocyte esterase and person is sexually active, DX?
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Chlamhydia most common sexually active disease
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VHY***
sterile pyuria causes (they have signs UTI but nothing grows (sterile) but they do have neutrophils) what are the two most common causes? |
chlamydia
TB can also cause this (miliary TB most commonly goes to kidney, typical UA dosn't pick it up.) |
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most comon cause of transitional cell carcinoma of the bladder?
what are two other common causes |
SMOKING - MOST COMMON CAUSE
aniline dye cyclophosphamide |
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VHY***ALWAYS asked
what is the embryology of hypospadias (pie on your shoe) and epispadias (urethra opens on upper surface so you pie up) |
failure of closure of urethral fold
epispadias - defect in a genital tubercle |
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priapism is common in what disease
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sickle cell disease
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VHY***Always
most common type of cancer of the penis and most common cause of it? |
SCC
poor hygiene of an uncircumsized penis |
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patients w/ cryporchidism have an increased risk of?
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increased risk of cacner (seminoma-it is a germinoma)in both testicles...
if not descended by age to they must be removed surgically |
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Patients w/ Turner sydnrome (menapause before menarche) are at an increased risk of developing what type of ovarian cancer?
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they have streak ovaries (ovary w/o follicles) and they can develop germ cell tumor - dysgerminoma (analagous to male seminoma)
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complications of mumps
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orhcits, parotitis
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VHY****BIG TIME
less than 35 epididymitis cause what if you are over 35? |
gonorrhea and chlamydia
pseudomonas and E. coli |
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patient has scrotal pain w/ radiation into the spermatic cord, DX?
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epididymitis
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VHY***BIG TIME
adult patient has left-sided scrotal enlargment, feels like a bag of worms, DX? what is the most common location and where does the spermatic vein empty into? |
Varicocele
left side-pressures are greater from...spermatic vein epmtying into the left renal vein |
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VHY***BIG TIME
what would happen if you blocked the left renal vein? |
varicocele
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VHY** ON EVERY TEST
Patient has a painful testicle that is raised a little bit (high in the inguinal canal) and they have lost there cremaster refelex (when you scratch the scrotum it dosn't elevate), DX? |
testicular torsion
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patient has a scrotal enlargment, it transluminates, DX?
what does it result form? |
Hydrocele - persistant tunica vaginalis
most common cause of testicular enlargment. |
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painless enlargment of the testicle, it does not tranluminate, dx?
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testicular cancer
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most common testicular cancer
treatament where do the mets go to? |
seminoma - big cells w/ lymphocytic infiltrate
radiation is works very well mets to the para-aortic lymph nodes |
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what is the most common testicular cancer of a kid?
what is the tumor marker |
yolk sac tumor
marker - alpha-fetal protein |
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25 yr old man had gynecomasatia, and dyspnea has mutliple nodular masses in the lungs (mets), where is the primary?
what causes the gynecomastia? |
choriocarcinoma (worst prognosis)
from beta-hCG acts just like LH, which increases breast growth...*** |
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Older man gets testicular cancer what is the type
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malignant lymphoma (not a primary but a mets)
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what area of the prostate does BPH (hyperplasia) effect
what area of the prostate does cancer effect? |
paraurethral - located around the urethra and that why you see the symptoms of retention...
Cancer-in the periphery where you can fill it |
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75 yr old man has urinary retention and dribbling what is the most likley cause?
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BPH - prostate hyperplasia
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what hormone is responsible for prostate developoment?
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dihydrotestosterone
also fused the labia, fomed kidney and prostate |
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what hormone is responsible for prostate cancer?
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dihydrotestosterone...also cause hypertrophy of the prostate
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what does 5 alpha reductase inhibitors increase what?
what does this treat? |
testosterone but decrease dihydrotestosterone
used to treat cancer |
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most common cancer of men, where does it metastasize to?
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prostate
bone...osteoblastic |
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Hirsutism
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hair non-normal b
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Hirsutism + secondary male characeristics (cliteromegaly is the key one)
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Virilization
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most testosterone is from where in the female?
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ovary
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dehydepiandosterone sulfate (DHEA-sulfate), this is an androgen, is made primary in the_____of women
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adrnals
thinkging: hydroxalse deficiecny, cushings...) |
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when trying to figure out the increase in androgens in a women what are the two things the test that you need and why?
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Check to see if the androgen is testosterone or is it DHEA...this clues you into the source
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Why do we see excess androgens and estrogens in PCOD?
what abnormalities result from this? |
FSH is suppressed and LH is increased causing the theca interna to make its products(17-ketosteroids and testosterone)...hursitism
women also have obesity and adipose has aromatase (creates excess estrogen products from circulating DHEA and estodiol (makes the strong estrogen estrane)...inc. risk of endometrial carcinoma...also suppresses FSH and enhancing LH |
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VHY***COMMMON
why do people w/ PCOD develop cysts? |
FSH - prepares teh follicle and it is suppresed in this case leaving behind a cystic space.
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Most common cause of primary dysmenorrhea?
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tom much PGEF - causes contraction of uterine muslce
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Most common secondary cause of dysmenorrhea?
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endometriosis
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dysfunctional uterine means?
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hormone imbalance causing and abnormality in bleeding
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causes of dysfunctional uterine bleeding
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1. anovulatory cycle (most common cause of abnormal bleeding in a women from menarche to 20)
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what is
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persistant estrogen w/o progesterone cuaseestimulation on the mucosa...build up of mucosa and
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primary ammenorrhea causes
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1. hypothalmus problem (GnRH)
2. pituitary (FSH, LH) 3. ovarian problem (Estrogen, progestin) 4. endo-organ problem (anatomical: no vagina, imperforate hymen) |
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Patient has menstral irregularities, hirsutism, infertility and obesity, labs show elevated LH and low FSH w/ a ration of 2:1?
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PCOS
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First step in the work-up of anyone w/ amenorrhea is?
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pregnancy test
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What is the genetics and what is a common presentation of infants at birth in turner syndrome?
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defects in lymphatics (swelling of hands or feet in an infanct)...4 metacarpal is underdeveloped (knuckle, knuckle, dipple, knuckle)
XO |
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why do patients w/ turners have webbed necks?
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cystic hydromas - dialted lymphatics that fill w/ fluid and stretch the skin
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Common heart abnormality in Turner patients
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pre-ductal Coarctation of the aorta
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what pelvic abnormality do you see in turner syndrome?
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streak gonad - susceptible to dysgerminoma
have menapause by the time they are 2...they have no follicles |
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glands and stroma in the myometrium, DX?
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adnemyosis
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functioning glands and stroma outside uterus,DX?
most common location? |
endometriosis - ovarian cysts (chocolate cysts
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what bacteria is common in a women who has intrauterine device?
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actinomyces israeli
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acute endometritis most common cause?
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group B strep
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Pouch of douglas is common to collect?
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seeding from endometriosis
pus uncloated blood cancer |
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Most common cause of endometrial cancer is?
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unapossed estrogen (e.g. obesity, early menarche, late menapause)
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patient presents w/ dysmenorrhea, painful stool in menses, enlargement of ovaries, DX?
How do you make the diagnosis and Tx? |
endometriosis
laparoscopy |
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most common gyn cancer in patients of the following ages?
45 55 65 |
45-cervical
55-endometrial (post-menapausal) 65-ovarian |
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most common benign tumor of the women?
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leiomyoma-not a precursor for leiomyosarcoma
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what is the most common gynelogical cancer is?
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endometrial cancer-best prognosis
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patient has post-menopausal bleeding, DX?
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endometrial carcinoma until proven otherwise
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women has suden onest of lower abdominal pain and bleeding, DX?
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ectopic pregnancy, do a pregnancy test to rule it out (beta HcG)
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what is the most common cause of Ectopic pregnancy?
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previous PID
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what is the most common cause of PID?
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N. gonorrhoeae
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what are the three classes of ovarian tumors
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surface-derived
Germ cell tumor sex-Cord tumors |
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surface dervied ovarian tumors derive from?
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derive from the lining of the ovary (serosa)
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What is the most common ovarian mass?
why does it form what is a commn sign what lab test are helpful in making the call? |
follicular cyst-non-neoplastic
follicle that ruptured and accumiltated fluid and can produce peritonitis... ultrasound and beta-hHCG help in distinguishing it |
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OCP decrease the risk of?
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enometrial and ovarian cancers
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most common overall benign and malignant neoplasm of the ovary?
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serous cystadenoma and serous cystadenocarcinoma
also most commonly bilateral |
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what histological structure are you looking for in serous cystadenocarcinoma?
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has psommoma bodies...apoptotic bodies that have become calcified
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65 year old women has bilaterally enlarged ovaries, what is the most likley diagnosis?
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serous cystadenocarcinoma
this is why, most common gyn cancer in womne over 65 is ovarian and the most common ovarian neoplasia if over 35 is cystadenocarcinoma |
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most common overally germ cell tumor
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teratoma - most are benign
if it has thyroid tissue then it is called...stuma ovarii |
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VHY****
patient has a bengin tumor (thecoma-fibroma) ascites and right-sided pleural effusion, DX? |
Meigs syndrome - seen in a thecoma fibroma
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Female patient has a low-grade malignant tumor that produces estrogen (feminizing tumor) and has call-exner bodies on biopsy, DX?
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granulosa theca-cell tumor
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what is the ovrian tumor that causes masculinization?
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sertoli-leydig cell tumor
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on a biopsy of the ovary you see signet ring cells, DX?
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mets from an adenocarcinoma of the stomach
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which cell of the chorionic villi makes the placenta hormones, name two?
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beta-hcg and humanplacental lactogen
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patient develops preeclampsia in the first trimester (hypertension, proteinuria...), uterus is to large for gestational age and has an increased hCG, DG?46XX both chromosomes come from daddy
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complete MOLE
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what is the genetics of a complete mole?
what is the risk of cancer? |
46XX the egg is fertalized by two haploid spermatozoa w/ X chromosomes (both come from dad)
increased risk for developing choriocarcinoma entire placenta is neoplastic |
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what is the most common ovarina tumor
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surface derived
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what is the tumor marker for ovarian cancer
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CA 125
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where do surface derived ovarian cancers commonly seed to?
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abdominal cavity (think about they arise from the serosa0)
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this placental hormone directly correlates w/ placental mass and has anti-insulin activity?
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HPL (human placental lactogen)
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Dichorionic twon placentas means?
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identical (monozygotic) or fraternal twins (dizygotic)
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what is the genetics of a partial mole
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tripoloid 69XXY (egg is fertalized
no increased risk of cancer...not all villi are neoplasticneoplastic |
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malignant tumor of trophoblastic tissue?
where do the mets go? treatment |
choriocarcinoma - do not see chorionic villi
mets to the lungs responds well to chemo |
