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142 Cards in this Set

  • Front
  • Back
What hormone stimulates endometrial proliferation?
estrogen
What hormone maintains the endometrium to support implantation?
progesterone
Menopause is defined as cessation of ovulation and menstruation lasting more than _________ months.
9-12 months
median age of menopause
50
Early menopause is associated with three things, what are they?
smoking, low body weight, poor nutrition/chronic infection
What three things are associated with late menopause?
obesity, diabetes, endometrial and breast cancer
Why do obese women have late menopause?
Estrogen and estrdiol are synthesized in adipose tissue after menopause, and decreased serum hormone binding globulin (SHBG) increases the bioavailability
What types of HPV cause genital warts?
6,11
What types of HPV are high risk for cancer?
16, 18, 31, 33, 35, 51
What is the most common type of ovarian tumor?
surface epithelial tumor (adenoma, cystadenoma, borderline, adenocarcinoma, cystadenocarcinoma)
Which of theses is not a symptom of menopausal syndrome?
a) hot flashes
b) increased sexual desire
c) headache
d) SOB
e) loss of urinary control
b) increase sexual desire. its decreased
According to the National Osteoporosis Foundation Guidelines, at what T-score should you consider prophylactic treatment?
T-score < -2.0
or
T-score< -1.5 with risk factors
What drug that increases bone mass density should be avoided in patients with esophageal abnormalities and renal impairment?
Alendronate
T/F hormone therapy is approved for the prevention of cardiovascular disease in post menopausal women
false
How does Prolia work?
its a rank ligand inhibitor, which prevents osteoclast maturation
At how man weeks can you detect a fetal heartbeat with doppler? with a stethoscope?
10
20
How does the anemia of pregnancy physiologically occur?
there is a plasma volume increase of 50-70% and a RBC mass increase of 20-35%. there is a disproportionate increase in plasma volume over RBC volume. also more iron is needed to make RBCs, so iron deficiency anemia is also possible
Cardic output increase by ____ L/min during pregnancy
1.5 L/min
What effect does progesterone have on the respiratory system?
directly stimulates ventilation
increases the sensitivity of the respiratory centers to CO2
What is Chadwicks sign?
violet color of the vagina that occurs during pregnancy
What is melasma?
"the mask of pregnancy"; increased melanin deposition usually in the face. ususally fades after pregnancy
What strains of HPV cause genital warts?
6,11
What strains of HPV are high risk for carcinoma?
16, 18 mostly
31, 33
What structures come from the wolffien ducts?
epididymus, seminal vesicles, ejaculatory duct
What structures come from the mullerian ducts?
fallopian tubes, uterus, upper 2/3 of the vagina, ovarian surface, lines pelvic peritoneum
What is the most common type of ovarian tumor (surface epithelial cell, germ cell, sex cord, metastasis)
surface epithelial cell
Name the types of ovarian surface epithelial cell tumors
serous tumor
mucinous tumor
endometrioid tumor
clear cell tumor
Brenner tumor
cystadenofibroma
Name the types of ovarian germ cell tumors
teratoma
dysgeminoma
endometrial sinus tumor
choriocarcinoma
Name the types of ovarian sex cord stroma tumors
fibroma
granulosa theca cell tumor
sertoli-Leydig cell tumor
What are the two theories for endometriosis?
Metastatic theory: retrograde menstruation through fallopian tubes implantation of endometrial tissue at abnormal locations
Metaplastic theory: direct development of endometrium from coelomic (müllerian) epithelium
What is the most common invasive cancer of the female genital tract
adenocarcinoma of the endometrium
What is endosalpingiosis?
the presence of fallopian tube like epithelial rests in the peritoneum
95% of testicular neoplasms are (epithelial/germ cell/sex cord)?
germ cells
mature teratomas in the ovary are usually benign/malignant? in the testis?
benign in ovary, malignant in testis
Most common neoplasm of the ovary?
teratoma
most common testicular neoplasm
seminoma...or maybe mixed tumors..they dont know
What is struma ovarii?
a teratome comprized of mature thyroid tissue
What is the most common testicular tumor in boys under 4 years of age?
yolk sac tumor
What tumor are schiller-duval bodies seen in?
yolk sac tumors (endodermal sinus tumors)
What cells are Reinke crystalloids associated with?
Leydig cells
What hormone stimulates the endometrium during the proliferative phase?
estrogen
What hormone stimulates the endometrium during the secretory phase?
progesteron
What is the most common molecular genetic abnormality associated with endometrial hyperplasia?
PTEN tumor suppresor gene mutations
What percent of women with complex atypical endometrial hyperplasia will progress to cancer?
25%
What is the prognosis for malignant mixed mullerian tumors of the uterus?
5 year survival rate is 25%
Gynandroblastoma is ______% malignant
100%
Germ cell tumors all all benign/malignant except for mature teratomas and gonadoblastomas.
malignant
What is the most common malignant ovarian tumor?
serous cystadenoma
What is involved in Meigs syndrome?
benign ovarian tumor (usually fibroma)
ascites
pleural effusion
What is the action of human chorionic gonadotropin in pregnancy?
maintains the corpus luteum
What does the syncytiotrophoblast secrete?
hCG, HPL, progesterone
What does HPL (human placental lactogen) do?
It modifies the metabolic state of the mother during pregnancy to facilitate the energy supply of the fetus. HPL decreases maternal insulin sensitivity, and, therefore, raises maternal blood glucose levels, whilst decreasing maternal glucose utilization. HPL induces lipolysis with the release of free fatty acids.
What is phimois?
stenosis of orifice prepuce, preventing retraction of the foreskin
a cryptorchid testicle is _____ times more likely to get a germ cell tumor and the contralateral testis has ___ times the likelihood
20-40 x
4x
How and where do seminomas metastasize?
lymphatic, aortic lymph nodes
How and where do NSGCT metastasize?
hematogenous; lymph nodes, lungs, liver
What is the most common testicular neoplasm in men over 60 years old? Whats the prognosis?
testicular lymphoma
poor prognosis
How would you differentiate hyperplastic prostate tissue from low grade malignant prostate tissue?
the cancerous tissue will have an absent basal cell layer
Which zone is the site of most prostate hyperplasia?
transitional zone
What zone of the prostate is the most common site of carcinoma?
peripheral
Where does prostate cancer metastasize?
bone, spine in particular
55 year old man comes in fr his yearly physical and is found to have a PSA of 5.0. The doctor does not seem concerned about this high number. When you ask why the doctor says because he just got off the phone with the mans urologist. What did the urologist tell him?
the man recently had a cystoscopy, which can temporarily raise PSA along with acute urinary retention, bacterial prostatitis, and recent prostate biopsy.
A man with prostate cancer asks about HIFU. What is HIFU and what do you tell him?
High Intensity Frequency Ultrasound

its not approved in the USA, theyd have to travel outside the US
Whats the most common non-germ cell tumor in the testis?
leydig cell
Gonorrhea is a
a) gram + cocci in clusters
b) gram + dipliococci
c) gram + bacilli in chains
d) gram - diplococci
e) gram - bacilli in clusters
b) gram + dipliococci
What is the normal pH environemnt of vaginal mucosa?
a) acidic with a range 3.8-4.2
b) basic with pH with range 6.0-7.4
c) neutral with pH 7.0
d) basic with pH 8.0
a) acidic with a range 3.8-4.2
Which of the following is the most common cause of non-gonococcal urethritis?
a) Hemaphilus ducreyi
b) chlamydia trochomitis
c) papilloma virus
d) herpes simplex virus
e) syphilis
b) chlamydia trochomitis
Which one of the following is a protozoa related STD?
a) genital papilloma
b) painless chancre
c) lymphogranuloma venerum
d) trichomonas vaginitis
e) granuloma inguinale
d) trichomonas vaginitis
What is the 6 most common STDs in order of decreasing annual incidence?
trichomonoiasis
HPV
chlamydia
Herpes
gonorrhea
syphilis
What do you use to treat gonorrhea?
Cefixime or Ceftriaxone or Ciprofloxacine or Oflaxacin
Whats the most common cause of prostatitis? (which bug)
e coli
In order for a diagnosis of bacterial vaginosis to be made, 3 out of 4 of the amsel criteria must be met. What are these 4 criteria?
vaginal pH>4.5
presence of >20% per HPF of clue cells
positive whiff test
homogenous, nonviscous, milky white discharge adherent to the vaginal walls
How do you treat bacterial vaginosis?
oral metronidazole, clindamycin vaginal cream
How do you treat trichomoniasis?
oral metronidazole
Woman comes in with thick clumpy white cottage cheese discharge, negative whiff test, no WBCs on wet mount. what does she have
candidiasis
What type of virus is HPV?
double stranded DNA
A woman is worried because she is pregnant and has herpes. She wants to know if she should get a C section. What do you tell her?
c section only if she has had active genital lesions 5 days prior to birth
What is teh treatment for syphilis?
penicillin
How do you diagnose syphilis?
rapid plasmin reagin, if this is positive a FTA-Ab to confirm
How do you treat LGV?
doxycycline 100 mg twice daily for 21 days
What bug causes a chancroid?
Haemophilus ducreyi
What test would you use to test if a 30 week old baby is getting adequate blood flow?
fetal non stress test
Whats the normal fetal heart rate?
120-160 bpm
What do you do if a fetus has am abnormal OCT and an abnormal doppler?
deliver, more than 2 abnormal tests means delivery
What are Nabothian cysts?
a mucus filled lump on the cervix caused by an obstruction of the endocervical gland
On average, how long does it take CIN 1 to progress to CIN 3? what about CIN 3 to invasive carcinoma?
9 years in 50% of women
1-20 years in 30-70% of women
A woman comes in with a history of warts from HPV. She wants to know what she needs to do to cure it. What do you tell her?
there is no cure, treatments, but no cure
What percent of malignant cervical cancers are squamous cell carcinoma?
90%
What is the most important prognostic indicator in cervical squamous cell carcinoma?
teh stage
How common is adenocarcinoma of the cervix?
very rare, usually seen in combination with squamous cell carcinoma of the cervix
What hormones does the placenta produce?
HCG, growth hormone like hormone, HPL, estrogen, progesterone
What is placenta previa?
placenta that has implanted across the internal os of the cervix
What is placenta accreta?
attachment of the placenta directly to the muscle without intervening decidua
What is placenta membranacea?
most of the chorion is covered with villi, leading to a thin placenta
What is the usual length of an umbilical cord?
60 cm
What are some of the problems that can arise from only having one umbilical artery?
associated with infant mortality in 14% and associated with congenital malformations in 53%
What is amnion nodosum? What is it associated with in the fetus?
an abnormality of the placenta associated with scant fluid and small nodules of fibrin and desquamated squamous cells on the surface of the amnion

renal abnormalities
a complete/partial hydatiform mole is cause by fertilization of a normal egg by two sperms, resulting in triploid DNA
partial
a complete/partial mole is caused by the fertilization of an empty egg and results in diploid DNA.
complete
____% of moles develop into choriocarcinoma
3%
What are some options of treatment for genital warts?
cryotherapy with liquid nitrogen
podophyllin resin
trichloroacetic acid (TCA)
patient applied-podofilox or imiquimod
What is the chance that a couple has a child with an unbalanced translocation if one of the parents is a balanced translocation carrier?
5-10%
What is teh chance that a 35 year old woman has a child with down syndrome?
0.2%
At what fetal age can you get a CVS done? an amniocentesis?
10-12 weeks
16 weeks
risk for birth defects in first cousin mating is ____% greater than the general population.
2-3%
a CVS has a ___% risk procedure related miscarriage. Amniocentesis has a ____%
.5-1%
.06%
congenital bilateral absence of the vas deferens nearly always associated with ____________ mutations.
cystic fibrosis
What are the TORCH infections?
Toxoplasmosis
Other (syphilis)
Rubella
Cytomegalovirus
Herpes Simplex
What is the triad of symptoms for toxoplasmosis in a newborn?
chorioretinitis, intracranial calcification, and hydrocephalus
What are some noninfectious causes of abortions?
lupus, chromosomal abnormalities
What are hutchinson teeth associated with?
congenital syphilis that wasnt treated
How do you treat congenital syphilis?
PENICILLIN
What is teh triad for rubella in an infant?
sensorineural hearing loss
cataracts and glaucoma
cardiac malformations
What is the most common congenital viral infection?
CMV
What is the treatment for congenital CMV?
ganciclovir
What is the treatment for congenital HSV?
acylovir
In the female breast, 20 lobules drain to the nipple via the _______ duct.
lactiferous
What percent of breast masses are cancerous?
10%
What is the most common causative organism for mastitis in a breastfeeding mother?
stapylococcus aureus
A womans risk for breast cancer whos mother developed breast cancer at 42 is ____ xs the regular population
50
What gene translocation is seen with BRCA1?
17q21
What gene translocation is seen with BRCA2?
13q12
Is age of onset younger with BRCA1 or BRCA2?
BRCA1
Is male breast cancer associated with BRCA1 or BRCA2?
BRCA2
What is the most common type of invasive breast cancer?
invasive ductal carcinoma
What percent of comedocarcinomas have calcifications present? cribiform DCIS?
94%
50%
What percent pts with early invasive breast carcinoma without lymph node metastasis will have recurring disease and die from it?
20-30%
What is a phyllodes tumor?
giant tumors 10 to 15 cm with fibroadenoma like ductular adn stromal proliferation. malignant changes within the stromal component occurs in 15% of cases.
What is the definition of preeclampsia?
1) blood pressure of 140 mm Hg systolic or higher or 90 mm Hg diastolic or higher that occurs after 20 weeks of gestation in a woman with previously normal BP
2) proteinuria, define as urinary excretion of 0.3 g protein or higher in a 24 hr urine specimen
What is eclampsia?
the occurrence of seizures in a woman with preeclampsia
How do you manage severe preeclampsia?
admit to labor and delivery suite
maternal-fetal evaluation for 24 hr
magnesium sulfate for 24 hrs
what are the differences between a leiomyoma and leiomyosarcoma?
leiomyoma= smaller, usually multiple, firm whorled surface, white, hemorrhage and necrosis infrequent
leiomyosarcoma= bigger, solitary, soft, fleshy cut service, yellow, hemorrhage and necrosis frequent
Would you rather have a mucinous ovarian cyst or a serous ovarian cyst?
mucinous is usually benign
serous is most common ovarian death
and ovarian cancer is 50% of all female deaths from cancer.
you would rather have mucinous
75-90% of cervical cancers are of _________ origin,
squamous cell
What are the 3 drugs you would give a preeclampsic woman in a HTN emergency?
hydralazine, Labetalol, Nifedipine
You are more likely to see an asymmetric growth pattern in a IUGR fetus with ________
uteroplacental insufficiency
A patient comes in at 16 weeks pregnangt. She has had 2 previous preterm deliveries, where neither fetus survived. What drug could you give her to help this fetus make it to term?
17-alpha-hydroxyprogesterone caprorate 250 mg
Most common cause of primary amenhorrea?
turners syndrome
Woman is diagnosed with a hydatidiform mole thats has fetal components to it. is this complete or partial? triploid or haploid?
partial, triploid
what breast cancer is associated with peau d'orange?
inflammatory breast cancer
streak ovary results from what? it is most often seen in what syndrome?
an ovary that has no more follicles
turner syndrome
T/F You lose your cremasteric reflex with testicular torsion
True