Reproduction Usmle First Aid

Front 1

Incidence of gyn tumors
Put these in order
1) cervical
2) endometrial
3) Ovarian

Back 1

endo>ovarian>cervical

Front 2

Prognosis of gyn tumors
which of these is worst???
1) cervical
2) endometrial
3) ovarian

Back 2

ovarian>cervical>endometrial

Front 3

PCOS
1) LH, FSH, Test
2) Effect of LH change
3) enlarged cystic ovaries-->?
4) other risk associations
5) Treatment?

Back 3

1) LH and Test incr...FSH decr
2) incr. LH->anovulation, hyperandrogen
3) amenorrhea, infertility, obesity, hirsutism
4) insulin resist, incr. endometr. cancer risk
5) wt. loss and OCPs gonadotropin analogs, clomiphene or surgery

Front 4

Ovarian Cysts
1) distended grafian follicle. assoc. hyperestrinism and endo hyperplasia
2) hemorrhage into persistent corpus luteum. Menstr. irreg
3) bilat. multiple b/c of gonadotropin stim. assoc choriocarcinoma and moles
4) blood containing cyst from ovarian endometriosis varies w/menstrual cycle

Back 4

1) Follicular cysts
2) Corpus luteum cyst
3) Theca lutein cyst
4) chocolate cyst

Front 5

Germ Cell Tumors of Ovary
1) similar to male seminoma
sheets of uniform cells
2) rae, malig. develop during preg
Large hyperchromatic syncitiotrophoblasts. incr. frequency of theca lutein cysts
3) Found ovaries, testes, sacrococcygeal region young kids
very aggressive
4) 90% germ cell tumors
2-3 germ cell layers
5) dermoid cyst vs. immature teratomoa vs. struma ovarii

Back 5

1) Dysgerminoma
2) Choriocarcinoma
3) Yolk sac (endodermal sinus tumor)
4) Teratoma
5) mature: dermoid cyst (benign)
immature: aggressive malig
struma; thyroid tissue-->hyperthyroid

Front 6

Serous cystadenoma

Back 6

20 % non germ cell tumors
bilater w/ fallopian tube-like epi
Benign

Front 7

Serous cystadenocarcinoma'
Of what organ is this a tumor?
1) malignant or benign?
2) how common are they?
3) often unilateral or bilateral?

Back 7

50% ovarian tumors
malignant and *often* bilateral

Front 8

Mucinous cystadeoma
1) what type of cell secretes the mucin?
2) malignant or bening?
3) one cystic structure or many?

Back 8

mutilocular cyst w/ mucus secreting epi; benign

Front 9

mucinous cystadenocarcinoma

Back 9

malig. intraperitoneal accumulation of mucinous material from ovarian or appendiceal tumor

Front 10

Brenner tumor

Back 10

Benign. looks like bladder

Front 11

bundles of spindle shaped fibroblasts

Back 11

Fibroma

ovarian, non-germ cell tumor

Front 12

Meig's syndrome
1) What is the triad?
2) What is the sensation felt in the groin?
3) What organ is this a tumor of? What cell type is it?

Back 12

triad of ovairan fibroma, ascites, hydrothorax
Pulling sensation in the groin

ovarian non-germ cell tumor

Front 13

Secretes estrogen-->precocious puberty (kids)
causes endometrial hyperplasia or carcinoma in adults. There may be a mass that is visualized on exam.

Back 13

Granulosa cell tumor

Front 14

Call Exner boides

Back 14

Granulosa cell tumor

ovarian non-germ cell tumor

Front 15

small follicles filled with eosinophilic secretions in Granulosa cell tumor

Back 15

Call Exner bodies

Front 16

GI malg that met to ovary--mucin secreting signet cell adenocarcinoma

Back 16

Krukenberg tumor

ovarian/non germ cell tumor

Front 17

Vaginal carcinoma
What are the 3 types??

Back 17

1) Squamous Cell
2) Clear Cell
3) Sarcoma botryoides

Front 18

Vaginal squamous cell

Back 18

Secondary to cervical SCC

Front 19

Clear cell adenocarcinoma of vagina

What exposure is this associated with?

Back 19

Esposure to DES

Front 20

Sarcoma of vagina (rhabdo variant)

Back 20

girls<4; spindle shaped tumor that is desmin positive

Front 21

Ovarian cancer markers

Back 21

1) incr. CA-1,25 ig general marker

Risk factors: BRCA-1, HNPCC

Front 22

Benign Breast Tumors

Back 22

1) Fibroadenoma
2) Intraductal papilloma
3) Phyllodes tumor

Front 23

Malignant breast tumors

Back 23

1) Non-invasive
Ductal carcinoma in-situ
2) invasive
a) invasive ductal
b) invasive lobular
c) medullary
d) comedocarcinoma
e) inflammatory
f) paget's disease of the breast

Front 24

Most common breast tumor
,25 y/o
small mobile firm masss w/ sharp edges
incr. size and tenderness w/preg
not a precursor to breast cancer

Back 24

Fibroadenoma

Front 25

Benign tumor of lactiferous ducts
serous or bloody discharge from nipple

Back 25

intraductal papilloma

Front 26

large bulky mass of connective tissue cysts

tumor has leaf-like projections. some
may be malignant

Back 26

Phyllodes tumor
malignant is called cystosarcoma phyllodes

Front 27

1) At what stage in life are malignant tumors of breast most common in women?
2) From what tissue do they typically arise? (2)

Back 27

1) common postmenopause
2) mammary duct epithelium or lobular glands

Front 28

1) Which receptors and hormones are expressed in malignant breast tumors?
2) What do you give for ER/PR positive tumors?

Back 28

1) estrogen/progesterone receptors (erbB2) HER-2 is an EGF receptor
2) Tamoxifen

Front 29

What is the most impt. prognostic factor for malignant breast tumors?

Back 29

1) Axillary lymph node involvement

Front 30

Malignant breast that is noninvasive; cancer early malig w/o basement membrane penetration

Back 30

DCIS (Ductal carcinoma in-situ)

Front 31

invasicve breast cancer
firm fibrous mass. worst and most invasive very common

Back 31

Invasive ductal

Front 32

multiple, bilateral orderly rows of cells

Back 32

invasive lobular

Front 33

flshey cellular lymphocytic infiltrate good prognosis

Back 33

medullary breast tumor

Front 34

ductal tumor w/caseous necrosis

Back 34

comedocarcinoma

Front 35

lymphatic involvement; red, swollen; peau d'orange (breast skin resembles an orange peel)

Back 35

inflammatory

Front 36

eczematous pathces on the nipple
large cells with clear halo suggest underling carcinoma (also seen on vulva)

Back 36

1) Paget's dz of breast
2) Paget cells

Front 37

Risk factors for malignant breast tumors

Back 37

1) gender 2) age 3) <12 b/f 1st period
4) 30 b/f 1st preg 5) >50 b/f menopause 6) FHX

Risk NOT increased by fibroadenoma or nonhyperplastic cyst

Front 38

Common breast conditions
1) most common cause of breast lumps
2) breast abscess
3) benign painless lump
4) boobs on a dude

Back 38

1) fibrocystic disease
2) acute mastitis
3) fat necrosis
4) gynecomastia

Front 39

1) Fibrocystic disease
a. common age
b. symptoms
c. risk of other conditions
d. histo types (4)

Back 39

a. 25-meno
b. breast pain and lesions
c. no incr. risk carcinoma
d. 1) Fibrosis : hyperplasia stroma
2) Cystic: fluid filled, blue dome
3) Sclerosing; incr. acini and intralob. fibrosis
4) Epith. hyperplasia; incr. number epi layers in term duct lobule *incr. carcinoma w/atyp cells
chics >30y/o get it.

Front 40

occurs during breast feeding.
incr. risk of staph infection through cracks in nipples

Back 40

acute mastitis

Front 41

What is the most common pathogen associated w/ breast feeding?

Back 41

staph aureus

Front 42

what causes fat necrosis

Back 42

injury to breast tissue-->benign painless lump. Fat necrosis

Front 43

What causes gynecomastia?
1)
2)
3) Drugs: (4) + Some Drugs Create Awesome Knockers

Back 43

1) hyperestrogenism
a. cirrhosis, testicular tumor, puberty, old age
2) klinefelter's
3) Drugs:
a. estrogen
b. marijuana
c. heroin,
d. psychoactive drugs+ Sprironolactone, Digitalis, Cimetidine, Alcohol, ketoconazole

Front 44

Prostatitis
a. symptoms
b. acute vs. chronic

Back 44

a. dysuria, frequency, urgency, low back pain
b. acute; bact staph
chronic: bact. or abacterial

Front 45

Men >50 y/o

incr. frequ. nocturia, can't start and can't stop stream. dysuria

Back 45

Benign prostatic hyperplasia!!
NOT hypertrophy
Not pre-malignant

Front 46

pathophys of BPH

Back 46

incr. estradiol and sensitization to DHT growth promoter

Front 47

complications of BPH

Back 47

1) Distension and hypertrophy of the bladder
2) hydronephrosis
3) UTI

Front 48

Signs BPH
1) physical exam
2) lab

Back 48

1) nodular enlargement of periurethral lobes ofthe prostate gland compressing the urethra into a vertical slit
2) incr. PSA

Front 49

Man >50 y/o
Low back pain-->
DRE-->hard nodule in periph zone

In what lobe does the growth typically arise?
Serum alk phos (incr)
PSA (incr)

Back 49

Prostatic Adenocarcinoma

typically a posterior lobe growth

Front 50

Cryptorchidism

Back 50

Undescedned testis; lack of spermatogenesis due to incr. body temperature a

Front 51

1) what tumors are cryptorchidism associated with?
2) Waht incr. your risk of cryptoorchidism?

Back 51

Associated with incr. risk of germ cell tumors
prematurity incr. risk of cryptorchidism

Front 52

What are the tersticular germ cell tumors?

Back 52

1) seminoma
2) embryonal carcinoma
3) Yolk sac (endodermal sinus) tumor
4) choriocarcinoma
5) Teratoma

Front 53

Malignant pianless testicular enlargement; most common testicular tumor.

Back 53

1) seminoma

Front 54

Test. tumor: Affects males age 15-35. Large cells in lobules with watery cytooplasm and a fried egg appearance.

Back 54

Seminoma