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142 Cards in this Set
- Front
- Back
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On which side is varicocele more common?
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On the left (left testis --> left gonadal vein --> left RENAL vein --> IVC)
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What structure connects the ovaries to the lateral pelvic wall?
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suspensory ligament of ovaries
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What structure connects the cervix to the side of the pelvis?
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cardinal ligament
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What structure connects the uterine fundus to the labia majora?
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round ligament of the uterus
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What structure connects the uterus, fallopian tubes, and ovaries to the pelvic side wall?
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broad ligament
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What structure connects the ovaries to the uterus?
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ligament of the ovary
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What is contained in the suspensory ligament of the ovary?
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ovarian vessels
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What is contained in the cardinal ligament?
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uterine vessels
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What is contained in the round ligament of the uterus?
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nothing
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What is contained in the broad ligament?
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ovaries
fallopian tubes round ligaments |
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squamous epithelium is found in
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vagina, cervix
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nonciliated columnar epithelium is found in
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endometrium, some ovarian cysts
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ciliated columnar epithelium is found in
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fallopian tubes
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cuboidal epithelium is found in
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ovary, some ovarian cysts
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What nerve is responsible for erection?
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pelvic nerve (parasympathetic)
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What nerve is responsible for emission?
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hypogastric nerve (sympathetic)
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What nerve is responsible for ejaculation?
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pudendal (visceral and somatic nerves)
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From what cellular structures are the following derived?
- acrosome - tail/flagellum - middle/neck |
- acrosome: Golgi apparatus
- tail/flagellum: centriole - middle/neck: mitochondria |
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produce primary spermatocytes
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spermatogonium
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create blood-testis barrier
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sertoli cells
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secrete androgen-binding protein
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sertoli cells
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secrete inhibin
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sertoli cells
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produce anti-mullerian hormone
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sertoli cells
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nourish, support, protect developing spermatozoa
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sertoli cells
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secrete testosterone
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leydig cells
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What are the components of semen produced by the seminal vesicle?
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60% of semen:
- fructose - ascorbic acid - prostaglandins - phosphrylcholine - flavins |
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What are the components of semen produced by the prostate?
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- zinc
- citric acid - phospholipids - acid phosphatase - fibrinolysin |
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Which gland contributes the alkaline portion of sperm?
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bulbourethral gland
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List the stages in the development of sperm
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1. Spermatogonia
2. Primary spermatocyte (diploid) 3. Secondary spermatocyte (haploid) 4. Spermatid 5. Spermatozoa |
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What tissue(s) make estradiol?
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ovary
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What tissue(s) make estriol?
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placenta
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What tissue makes estrone?
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adrenal
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Where is aromatase active?
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blood
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What tissues make progesterone?
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corpus luteum
placenta adrenal cortex testes |
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In what phase are oocytes arrested until ovulation?
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Prophase of meiosis I
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In what phase are oocytes arrested between ovulation and fertilization?
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Metaphase of meiosis II
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Name the stages of ovum development
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oogonium (2N)
primary oocyte (2N) secondary oocyte (N) ovum (N) + 3 polar bodies |
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When does implantation occur relative to fertilization?
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6 days after fertilization
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When is B-hCG detectable in blood and urine tests?
What produces it? |
In blood: 1 week post-conception
In urine: 2 weeks post-conception Trophoblast |
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Menorrhagia
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heavy, regular bleeding
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Metrorrhagia
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irregular bleeding ("spotting")
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Menometrorrhagia
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irregular, heavy bleeding
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How are maternal steroids, suckling, prolactin, and oxytocin related to lactation?
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- decrease in materal steroids following labor--> lactation
- suckling --> stimulates prolactin/ oxytocin --> maintains lactation - prolactin --> induces and maintains lactation - oxytocin --> milk letdown |
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Excess hCG
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choriocarcinoma
gestational trophoblastic tumor hyatidiform moles |
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Describe the maintenance of the corpus luteum and placenta during pregnancy
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hCG is secreted by the trophoblast (syncytiotrophoblast) --> maintains the:
- corpus luteum (til week 10) - placenta (weeks 10-end of first trimester) In second trimester, placenta makes its own estriol and progesterone |
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Levels of FSH and LH in Klinefelter's syndrome
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Increased FSH (decreased inhibin)
Increased LH (decreased testosterone) due to dysgenesis of seminiferous tubules and abnl Leydig cell function |
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Levels of FSH and LH in Turner syndrome
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Increased FSH (decreased inhibin)
Increased LH (decreased estrogen) |
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shield chest
bicuspid aortic valve preductal coarctation of the aorta |
Turner syndrome
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Increased testosterone
Increased LH |
defective androgen receptor
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Increased testosterone
Decreased LH |
Testosterone-secreting tumor
Exogenous steroids |
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Decreased testosterone
Increased LH |
Primary hypogonadism
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Decreased testosterone
Decreased LH |
Hypogonadotropic hypogonadism
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Causes of internal female genitalia, external virilzation/ambiguity
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Exogenous androgens during pregnancy
Congenital adrenal hyperplasia |
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Causes of internal male genitalia, external female/ambiguity
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Androgen insensitivity
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ambiguous genitalia until puberty
normal levels of testosterone, estrogen, and LH |
5a-reductase deficiency
external masculinization at puberty |
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Treatment of:
- increased B-hCG - large uterus - "honeycombed"/"cluster of grapes" |
hyatidiform mole:
- MTX - dilation and curettage |
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Which type of mole has significantly increased B-hCG
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complete mole
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What events produce a complete v. partial mole?
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Complete: 2 sperm + empty egg
Partial: 2 sperm + 1 egg |
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Which type of mole contains fetal parts?
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partial mole
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Which type of mole has higher risk of progressing to choriocarcinoma or malignant trophoblastic disease?
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complete mole
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What is the most common cause of miscarriage in the first few weeks of pregnancy?
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low progesterone
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What is the most common cause of miscarriage in the first trimester of pregnancy?
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chromosomal abnormalities
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What is the most common cause of miscarriage in the second trimester of pregnancy?
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bicorunate uterus
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What causes pre-eclampsia?
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placental ischemia due to impaired vasodilation of spinal arteries
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What does HELLP stand for?
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Hemolysis
Elevated LFTs Low Platelets |
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Treatment for:
blurred vision, headache, abdominal pain, edema of face/ extremities, altered mentation, hyperreflexia, thrombocytopenia, hyperuicemia |
Mg sulfate
If eclampsia: benzodiazepines |
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painful bleeding in 3rd trimester
smoking, HTN, cocaine predispose associated with DIC |
abruptio placentae
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massive bleeding after delivery
prior CS, inflammation, placenta previa predispose |
placenta accreta (defective decidual layer, attaches to myometrium)
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painless bleeding in any trimester
multiparity, prior CS predispose |
placenta previa (over cervix/lower uterus)
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pain with or without bleeding
increased hCG |
ectopic pregnancy
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postpartum hemorrhage
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retained placental tissue
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polyhydramnios
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anencephaly
duodenal atresia (difficulty swallowing) |
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oligohydramnios
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renal agenesis
placental insuffiency posterior urethral valves |
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cyclic bleeding (hormone responsive)
chocolate cysts menstrual-related pain |
endometriosis
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postmenopausal vaginal bleeding
risk with anovulatory cycles, HRT, PCOS, granulosa cell tumor |
endometrial hyperplasia (predisposes to endometrial carcinoma)
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adenomyosis
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endometrium within myometrium
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risk factors for most common gynecological malignancy
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endometrial carcinoma:
- obesity - diabetes - endometrial hyperplasia - use of estrogens without progestins - nulliparity - late menopause |
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whorled pattern of smooth muscle bundles
well-demarcated estrogen sensitive most common tumor in females |
leiomyoma
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irregularly shaped uterine mass
areas of necrosis and hemorrhage highly aggressive |
leiomyosarcoma
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hormones in premature ovarian failure
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decreased estrogen
increased LH increased FSH |
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Hormone profile in PCOS?
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Increased GnRH -->
Increased LH Decreased FSH Increased testosterone |
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distention of unruptured graffian follicule
hyperestrinism endometrial hyperplasia |
follicular cysts
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hemorrhage into persistent corpus luteum
spontaneously regresses |
corpus luteum cyst
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bilateral/multiple cysts
due to gonadotropin stimulation choriocarcinoma/moles |
theca-lutein cyst
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blood-containing cyst
varies with cycle |
"chocolate" cyst (endometriosis)
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adolescent with:
- increased LDH - increased hCG - sheets of uniform cells |
dysgerminoma
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young mother with:
- increased hCG - large, hyerchromatic syncytiotrophoblastic cells - theca-lutein cysts |
choriocarcinoma
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adolescent with:
- increased AFP - yellow, friable, solid mass - structures resembling glomeruli - endodermal sinuses |
yolk sac tumors
(in ovaries, testes, or sacrococcygeal area of young children) |
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teratoma presenting with hyperthyroidism
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struma ovarii
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most common ovarian germ cell tumor
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mature teratoma
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ovarian tumor with columnar epithelium
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serous cystadenoma (20%)
serous cystadenocarcinoma (50%) |
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multilocular cyst lined by mucus-secreting epithelium
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mucinous cystadenoma
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malignant, mucus-secreting
can cause intraperitoneal accumulation of mucinous material |
mucinous cystadenocarcinoma
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benign tumor
transitional epithelium |
Brenner tumor
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tumor with bundles of spindle shaped fibroblasts
may be accompanied by ascites, hydrothorax, pulling sensation in groin |
fibroma
Meigs' syndrome |
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precocious puberty or post-menopausal bleeding
small follicles filled with eosinophilic secretions solid, yellow mass in ovary |
granulosa cell tumor (estrogen-secreting)
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mucin-secreting
signet cells adenocarcinoma of the ovary |
Krukenberg tumor (GI origin)
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women who had exposure to DES in utero
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vaginal clear cell adenocarcinoma
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girls <4
spindle-shaped tumor cells desmin-positive cells |
sarcoma botryoides
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small, mobile breast mass with sharp edges
increases in size with pregnancy, menstruation |
fibroadenoma (not pre-malignant)
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small tumor in lactiferous ducts
below areola middle-age/elderly serous or bloody nipple discharge |
intraductal papilloma
slight increased risk for carcinoma |
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large tumor in breast
connective tissue and cysts "leaf-like" projections women in 50s |
phyllodes tumor
some become malignant |
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breast neoplasm filling ductal lumen, arising from ductal hyperplasia
does not penetrate basement membrane associated with Paget's |
DCIS
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"rock hard" mass in breast
sharp margins small, glandular, duct-like cells most common worst prognosis associated with Paget's |
invasive ductal carcinoma
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breast mass
orderly rows of cells not associated with Paget's |
invasive lobular carcinoma
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breast mass
fleshy, cellular, lymphatic infiltrate good prognosis |
medullary carcinoma
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breast neoplasm filling ductal lumen, arising from ductal hyperplasia
does not penetrate basement membrane caseous necrosis in ducts |
comedocarcinoma (DCIS subtype)
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breast mass with dermal lymphatic infiltration
Peau d'orange |
inflammatory carcinoma
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bilateral breast lumps
fluctuation in size premenstrual breast pain hyperplasia of breast stroma on histology |
fibrosing fibrocystic disease
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bilateral breast lumps
fluctuation in size premenstrual breast pain fluid filled with blue dome and ductal dilation on histology |
cystic fibrocystic disease
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bilateral breast lumps
fluctuation in size premenstrual breast pain increased acini and intralobular fibrosis calcifications |
sclerosing adenosis fibrocystic disease
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bilateral breast lumps
fluctuation in size premenstrual breast pain increased epithelial layers in terminal duct lobule women > 30 |
epithelial hyperplasia in fibrocystic disease
increased risk of carcinoma with atypia |
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most common agent of breast abscess during breast feeding
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S. aureus --> mastitis
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painless, benign lump that forms in response to breast injury
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fat necrosis
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causes of gynecomastia
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old age
puberty drugs (spironolactone, digitalis, cimetidine, alcohol, ketoconazole) illegal drugs (marijuana, heroine, psychoactives) cirrhosis testicular tumor |
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What is the most common etiology of chronic prostatitis?
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abacterial
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Treatment of enlargement of middle and lateral lobes of prostate, increased PSA
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BPH: terazosin, tamsulosin
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Treatment of enlargement of posterior lobe of prostate, increased PSA and prostatic acid phosphatase, possible increased alkaline phosphatase
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prostatic adenocarcinoma: surgical/radiation, etc
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painless, homogenous testicular enlargement
most common testicular tumor large cells in lobules with watery cytoplasm, "fried egg" radiosensitive increased placental alkaline phosphatase |
testicular seminoma
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painful
glandular/papillary undifferentiated increased AFP, hCG |
embryonal carcinoma of testis
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bilateral breast lumps
fluctuation in size premenstrual breast pain increased acini and intralobular fibrosis calcifications |
sclerosing adenosis fibrocystic disease
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bilateral breast lumps
fluctuation in size premenstrual breast pain increased epithelial layers in terminal duct lobule women > 30 |
epithelial hyperplasia in fibrocystic disease
increased risk of carcinoma with atypia |
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most common agent of breast abscess during breast feeding
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S. aureus --> mastitis
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painless, benign lump that forms in response to breast injury
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fat necrosis
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causes of gynecomastia
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old age
puberty drugs (spironolactone, digitalis, cimetidine, alcohol, ketoconazole) illegal drugs (marijuana, heroine, psychoactives) cirrhosis testicular tumor |
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What is the most common etiology of chronic prostatitis?
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abacterial
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Treatment of enlargement of middle and lateral lobes of prostate, increased PSA
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BPH: terazosin, tamsulosin
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Treatment of enlargement of posterior lobe of prostate, increased PSA and prostatic acid phosphatase, possible increased alkaline phosphatase
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prostatic adenocarcinoma: surgical/radiation, etc
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painless, homogenous testicular enlargement
most common testicular tumor large cells in lobules with watery cytoplasm, "fried egg" radiosensitive increased placental alkaline phosphatase |
testicular seminoma
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painful
glandular/papillary undifferentiated increased AFP, hCG |
embryonal carcinoma of testis
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yellow, mucinous testicular mass
cells resemble glomeruli increased AFP |
testicular yolk sac tumor
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increased hCG
disordered syncytiotrophoblastic and cytotrophoblastic elements small primary tumor with hemorrhagic necrosis |
choriocarcinoma
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What type of testicular tumor is most common
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germ cell (95%)/ mixed type (60%)
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Reinke crystals
androgen producing gynecomastia or precocious puberty golden brown color |
Leydig cell tumor
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androblastoma from sex cord stroma
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sertoli cell tumor
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most common testicular tumor in older men
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testicular lymphoma
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dilated vein in pampiniform plexus
"bag of worms" |
varicocele
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increased fluid in tunica vaginalis due to incomplete fusion of processus vaginalis
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hydrocele
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dilated epididymal duct
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spermatocele
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opaque, gray-white plaque on penis
dysplasic squamous epithelium |
Bowen's disease
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red, velvety plaques usually involving glans of penis
dysplastic squamous epithelium |
erythroplasia of Queyrat
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multiple reddish-brown papular lesions on penis
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bowenoid papulosis
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