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57 Cards in this Set
- Front
- Back
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Klinefelter Syndrome(Number)
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Male: XXY, 1:850 (3s(3chrom/3Prob(male, female, hormone
Female-Gynacomastia, hair Distribution, bar-body Male- Tall, eunuchoid shape, hypogonadism Hormones-Seminif Tubes-->Decrease inhibin-> IncreaseFSH -Broken Leydig-->decrease test(infertility)-->increase LH-->increase estrogen |
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Turner Syndrome
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Turns--preduct-Coarctation(notched ribs,<femoral pulse, bicusped aorta, horshoe Kidney, X(O), lymphedema, oakenshield.
Clinical--#1 primary amenorhea, Ms(menopause, meiosis/mitosis, monosomy(XO), mosaicism 45XO/46XX. Pregnancy with HRT or donation. |
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Double YY males(Letter)
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(TrippleAAA) antisocial/autism, acromegdaly, acne (1/1(000))
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True Heraphroditism
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46XX or 47XXY ovotestis, ambiguous genitalia, Rare. Key Word External
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Diagnosing Disorders of Sex Hormones (ABCD)
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Testerone LH Problem
A Up Up Androgen Receptor B Up Down Tumor (Testicular) C Down Up 1 hypogonad D Down Down 2 Hypopit/thal hogonad |
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Other Disorders of Sex Development (3)
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hermapherdite, psuedohermaphrodite, intersex. Difficult with external vs. internal genitalia.
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Female Psuedohermaphrodite (XX)
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(New Born Smith) Internal Normal/External ambiguous or Masculine
Excessive Androgens--> Congenital Adrenal Hyperplasia(21aHydroxylase) or Exogenous Administration of Androgens. |
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Male Psuedohermaphrodite (XY)
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(HOUSE) Testes present but female/ambiguous external genitalia. (androgen insensitivity syndrome)
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Aromatase Deficiency
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(Mr. Mom) Increased Testosterone and androstiendione-->masculinzation of female (XX)-->ambiguous genitalia-->masculinization of the mother(androgens can cross placenta.
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Androgen Insensitivity (XY)
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(HOUSE) Testes present(in labia majora) but female phenotype, with rudimentary vagina. However, Uterus and fallopian tubes absent (no periods). Increase Testosterone, estrogen, and LH.
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5alph Reductase Deficiecy
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(Late Bloomers) 5alphaReduc---->Convert Testosterone DHT(ExternalG/Prostate)--->Ambigous until Puberty
Autosomal Recessive, Only Males(46XY), Normal Testosterone(normal internal) and LH levels. |
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Kallmann Syndrome
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(Smell-mann) Hypogonadotropic Hypogonadism- No GnRH or olifactory bulbs. anosomia, Decr. LH, FSH, Test, infertility/amenorea.
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Hydatiform Mole
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Chorionic Villi Swell/Prolif (trophoblasts)-trt D&C/Methotrexate--Note BhCG
Complete vs Incomplete Completely dad(x2) Partial Mom(2sperm) Complete Absence of Fetal Partial Fetal Tissue Complete Hydropic Villi Partial Hydropic Villi Compl Hydrophic Prolif-BhCG Partial/Focal prolif Complete(2-3%) Carcinoma Partial/minimalrisk HonyCOMbed/Snow/Grapes Fetal Parts Hyperthyroid(bhCG),HTN(PEc), VagBleed/Abpain Hyperuterus,Hyperbleed |
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Gestational Hyptertension (Pregnancy induced)(Criteria and treatment)(Numbers)
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No pre-existing condition--49ers(140/90)--at 20weeks
Treatment (antihypertensives-alphaMethyldopa, labetalol, hydralizine, nifedipine), deliver at 39 weeks. (49,39.29) |
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Preeclampsia (Criteria)
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Criteria-49er,(P)r(E)(E)clampsia(protienUrea), 20weeks(<20week MOLAR) (see, pee, AST, thrombocy)
Causation-Placental Arteries-->endo, neuro, vaso (auto, BP, CRD, diabetes) Complication- eclampsia/coagulopathy/CRF---abruption/insufficieny Correction-Antihypertensive, severe(34), small(37), Mg/Sulfate siezure |
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Eclampsia
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Pre-eclampsia + Siezures---imediate delivery, MgSulfate, antihypertensives
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HELLP Syndrome
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Hemolysis, elevated liver enzymes, low platelets, severe eclampsia or not...Treat with imediate delivery (same as siezure)
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Placental Abruptions
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(Ab)rupt--Ab(d)uction from uterine lining
(auto, BP, cigarrets, drugs(cocaine))--DIC/Distress/DoubleDanger--Complete/Conceled--Partial/a(pp)arent |
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Placenta accret/increta/percreta
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Decidual Dysfunction--anchor tissue-no placental delivery--massive bleeding.
Accreta(concrete)-attaches to myometrium w/o penitrate. Increta-invades myometrium percreta-perforates past uterus to rectum/bladder |
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Amniotic Fluid Abnormalities (Polyhydramnios, Oligohydramnios)
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(head/breath/intestines-abcd)Polyhydraminios- >1.5-2L of amniotic fluid--malformations--esophogeal/dueodenal atresia(tube overflow), anencephaly(increased pressure)--anemia(fetal), babies constantly (gestations), diabetes.
(PRPP)Oligohydramnios- <.5L-amniotic fluid, placental insufficiency (PRPP) |
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Dysplasia and CIN
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Growth- Transformation zone, basal to outward
Grade- CIN1(1/3) CIN2(2/3) CIN3(CIN-All)=>endothelial invasion. Genes- p53(E6), Rb(E7), High--HPV(Koilocytes-glycogen/raisens) 16,18 Low--HPV 6,11 General Risk- early sex, smoking, sodomy(HIV)(lose normal auto immune protection) |
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Invasive Cervical Carcinoma
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Pap Screen--cataches squamos not adeno
Side(Lateral Carcinoma)-can block ureters causing hydronephrosis. |
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Acute Endometritis and Chronic Endrometritis
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C(hroni)C (A)&(C) -Fever, abnormal bleed, pain
Bacterial Infection of Endometrium, Acute=Acumulated products of conceptions Chronic= Plasma (C)ells, contraceptive(IUD), conceptions, chronic granulosa disease(TB), chlamydia(PID) Treat-(c)lindamycin + gentamycin w/ amp |
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Endometryl Polyp
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(breast in endometrium(tamoxifen)) (bleeding)
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Endometreosis
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Catagories, chocolate, cannon (gunpowder), cycle, cancer, (normal size uterus)-Trt-OCP, GnRHant, surg, NSAID,
Catagories- ligaments(pelvic pain), Douglas(defication), bladder (urination), bowl( pain/adhesions), fallopian tube (incr. ectopic), adenomyosis(myometrium) (gunpowder), Lymph,MullarianMetplas, Retrograde Ovary-chocolate cysts, endometrial cancer |
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Endometrial Hyperplasia
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(Increased Estrogen(Gland to stroma Ratio)-(POS, Granulosa Cell, HRT, abnormal cycles). Postmetapausal Bleeding. Atypia-simple complex (atypia=carcinoma predictor)
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Endometrial Carcinoma
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Common, Catagories, Comorbidities--
S(p)oradic-papillary, p53, psamoma, patriarchs(>70), serous, ATRO(P)HIC(picnotic) Hyperplasic-Hyperplasia-->endometriod tissue, PTEN mutation Risk(HRT-sole estrogen, nulparity, infertility, obesity, diabetes. Incerase Myometrial invasion increase mortality. |
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Fibroid (Leoimyoma)
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First, Fluctuates(increase with estrogen), Iron(Deficiency Anemia-increased bleeding), Independant(does not progress to leomyosarcoma, Blacks, Blizzard(white(benign(premetapause), whorled mass(multiple masses-benign(premetapuase)),
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Gyno Tumor Epindemiology
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Incidence--Endometrial>ovarian>cervical (US-PAP) World (asending) cervical>endo>ovarian
Worst Prognosis-ovarian>cervical>endometrial (1,2,3) |
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Anovulation Causes
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(Preg, POCs,prolactinoma) (Obesity, OPH axis, ovarian fail), Eating (female athlete, throid, eating disorders) Adrenal(Cusing syndrome)
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Premature Ovarian Failure
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Premature Menopause (decrease Estrogen, increase LH and FSH
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Polycystic Ovarian Disease (SteinLeventhal Syndrome)
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#1 Cause Infertility--LH:FSH (3:1)- LH-->Theca Cells-->Increased Androgen->Broken Granulosa Cells-->Increase Testosterone-->Hirtuism & Free Testosterone converted in adipose tissue to estrone--->decrease FSH--->cystic follicles & endometrial carcinoma(no progesterone)
Type 2 diabetes and insulin resistance |
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Treat Polycystic Ovarian Disease
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Treat-- General Weighloss, hirtuatism: OCPs (estrogen-increase SHBG decr free testosterone), antiandrogns, fertility: clomiphene citrate (estrogen partial agonist-block estrogen feedback--Increasing FSH, LH to normal), metformin(type II), progestin(carcinoma)
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Pregnancy Complications (Ectopic(AABc) and Placental Remnants)
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Remnants--post-partum hemorage and infections
Ectopic- Ampulla/Fallopian tube, appendix, BhCG, cuts/scarring. (PID, Prior Tubal Surgury, appendix, a-fertile) |
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Placenta Previa
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Preview of placenta. Lies near to cervical internal os, mulparity and c-section, 3rd semester bleed
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Ovarian Tumor Principles
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Three main layers--
Outer fibrous layer-surface epithelium Sex chord Stromal Tumors Germ Cell Tumors Tumors arise out of each or metastasis |
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Surface Epithelial Tumors
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70%,-CbA-125(days), (ABC)
Coelomic epithelium- serous(watery) cells(fallopian) and mucos(mucoid) cells(endocervix) B-(benign(single and simple=younger 30-40s), borderline, bad= complex, shaggy, thicker), BRCA1=serous, surgury Additions:Brenner Bean Bladder, Endometriod(endometrial hyperplasia carcinoma) spreads to the ovary--PeritoneumSpread(Omentum Caking) . Silent(poor prog)--late vauge and compression (urine) |
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Germ Cell Tumors Basics
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4 Types (Pluripotent Stem Cells)
Fetal Tissue (Teratoma and embynal Carcinoma) Oocytes (dysgerminoma) Yolk Sac (endodermal sinus) Placental Tissue (choriocarcinoma) |
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Teratoma
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Twenty(era)Thirty(oma)
All embryological parts, BhCG, Stuma ovarii-hyperthyroid in teratoma, somatic malignancy-cancer, has a cancer, that could give cancer-Skin cancer. Neural/Thyroid tissue(maturity) |
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Dysgerminoma
Yolk Sac Tumor |
scrambled eggs or oocyte scrambled, increased LH(hirtuism/carcinoma) and BhCG markers. #1 malignant
YolkSAC-Schiller Duval(glomerulus like),AFP, children |
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Choriocarcinoma
Embrynal |
syncytiotrophoblasts and cytotrophoblasts, increase BhCG(-->thecal cysts), no villi, eager hematogenous spread, poor chemo,
Embryonal- Embryo like(large primative cells--moves around--early metastasis |
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Sex Cord Stromal Tumor Basics
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Granulosa/Theca Cells-Increase Estrogen EEE
Early(Precocious Puberty)Ejection(Repro)(menorrhagia/metro) Elderly (endometrial hyperplasia-bleed) Sertoli/Lydeig-Reinke-produce andogens Fibroblast-Fibroma-ascites(Meigs (mass, effusion, intestinal ascites) Syndrome). |
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Metastasis
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K jewlers(kruckenburg), two people(bilateral), signet ring(mucos), sick to your stomach(gastric carcinoma)
Psudomyxoma Peritonei- Peritoneal Mucos from pseudo (don't really need it) structure appendix |
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Ovarian Cysts
Follicular Corpus Lueteum Theca Lutein Hemorragic Cyst Dermoid Endometrioid |
Follicular-unruptured Gnaffian folicle increaesed estrogen, you female
Corpus L-Hemorage into CL THeca Leuti- Increased BhCG(LH) choriocarcinoma and moles(complete). Dermoid-Teratoma-all tissue Endometroid Cyst- Endometriod(endometriosis in the ovary) chocalate cyst--carcinoma |
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Vaginal Tumors
SCC CC Rhab |
SCC- Secondary to cervical SC carcinoma. HPV precursor VAIN. Spread upper/illiac lower/inguinal.
CC- secondary to adenosis, DES (Adenosis-columnar in the vaginal column Rhabdo(botryoides)-boisen berry, skeletal muscle, kids, desmin and myognin positive. |
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Gynecomastia
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Some dope drugs easily create awkward Hairy DD knockers. Spironolactone, Digitalis, Estrogen, cimetidine, alcohol, heroin, dopamine D2 ag, Ketoconazole.
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Cryptorchidism
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Undescended Testicle-increase germ cell cancer risk, normal testosterone in unilateral, infertility, prematurity
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Varicocele
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Bag of worms, Pampiniform plexus- increase on left side due to flow into the renal vein, infertility, check for RCC. Treat varicocelecotomy or embolization.
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Testicular Germ Cell Tumors,
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95%, young, (Crypt and Klinefelter), mixed no transl.
Seminoma-painless,poached egg(fried Egg), positive, ALP, player bird |
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Yolk Sac
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Schiller Duval(glomulus), AFP, child
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Testicular Choriocarcinoma
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Malignant, BhCG, hematogenous(hemorragic stroke), synsitrophoblast, (analog alphahCG-TSH, LH)-gynacomastia/hyperthyroidism.
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Teratoma
Embrynal Carcinoma |
Male=Malignant for Teratoma, increase BhCG and AFP.
Embryo like- worse prognosis in males, mixed, mass of pappillary, Purity(normal AFP)(incr Mixed) |
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Leydig Cell Tumor
Sertoli Tumor Testicular Tumor |
Reinke crystals, red hair, androgen producing (increases prolactin to shut down androgen synth)
Androblastoma from sex cord stroma. Diffuse Large B-cell Lymphoma Agressive/Aged |
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Tunica Vaginalis
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peritoneal or lymphatics, translumination
Hydrocele- obliteration of process vaginalis Spermatocele- dialated epidiymal duct |
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Hypospadias
Epispadius Condyloma Acuminatum |
below, urethral folds
Above GT placement, bladder extrophy HPV 6,11 Koilocytic change, wart |
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Lymphogranuloma Venereum
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Necrotizing granulomatous infection, inguinal lymphatics Chlymidea L1-L3 (RB/EB), watch renal stricuture
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Penile Squamos Cell Carcinoma
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Risk: High Risk HPV, Circumcision
Bowen(CIN-leukoplacia), Bowenoid(CIN-red), Erythroplasia Queyat(CIN Glans, erythroplakia) |
