Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
110 Cards in this Set
- Front
- Back
|
HCG
|
produced by placenta syntiotrophoblast
stimulates production of PR by corpus luteum |
|
|
HPL
|
made by placenta
induces lipolysis elevating FFA in mom it is a growth hormone in latter part of pregnancy |
|
|
Pregnancy
PR |
produced by Corpus luteum until 8 weeks
then by placenta until birth Prepares endometrium for implantation and maintains endometrium used as a precursor for fetal androgen synthesis |
|
|
Naegle's rule
|
LMP - 3mos + 1 year and 7 days
preg nl 40 wks from LMP |
|
|
time at which fetal heart beat is doppler audible
|
1st trimester
week 12 |
|
|
Quickening - 1st fetal mvmt
|
16-18 wks in multiparous
18-20wks in primagravida |
|
|
fetal sex determination
|
wk 18
|
|
|
Fetal bradycardia HR
|
HR<120
|
|
|
Return to menses
|
non lactating 2-4wks postpartum ovulation returns and menstrual flow returns in 6-8 wks
lactating - 10 wks post partum - birth controlled for only 6 wks guaranteed. |
|
|
SRY gene
|
found on Y Cr encodese for TDF
Leydig cells and sertoli cells produce testosterone mullerian inhibiting factor In the presence of TDF, test, and MIF - indifferent embryo will be direct to male phenotype |
|
|
Gubernaculum
processus vaginals |
Ovary:
extends from ovary to jx of uterus and uterin tubes forming OVARIAN LIGAMENT and then continues into labia majora forming ROUND LIGAMENT OF UTERUS. Processus vaginalis is obliterated in the female becomes tunica vaginalis in males |
|
|
paramesonephric duct
mesonephric duct |
paramesonephric duct - mullerian duct
mesonephric duct - wolffian duct |
|
|
Gonads
F + M |
Female: ovary, primordial follices,
Male: testiclees, sertoli cells, leydig cells, seminiferous tubes, tubuli recti, rete testes |
|
|
Paramesonephric
M + F |
Female: uterine tubes, uterus, cervix, upper third of vagina
Hydatid of Morgani Male: appendix testes |
|
|
Mesonephric ducts
M+F |
Wolffian ducts
Female: Appendix vesculosa, duct of gartner Male: Epididymis, ductus deferens, ejaculatory duct, seminal vesicles Appendix epididymis |
|
|
Mesonephric tubules
M+F |
F: Epoophoron + paroophoron
M: Efferent ductules, paradidymis |
|
|
hypospadies
|
incomplete fusion of the urethral folds - ventral surface pee on leg
|
|
|
Epispadies
|
ass with exstrophy of the bladder
pee in face dorsal opening |
|
|
Female pseduohermaphrodite
|
internal female
external male Congenital adrenal hyperplasia |
|
|
Male pseudohermaphrodite (XY)
|
Testicles inside
Outside female #1 5 alpha reductase def: underdevelopment of penis, scrotum, and prostate. Epididymis, ductus deferens, seminal vesicle, ejaculatory duct are all nl. Striking virilization at pubery #2 17alpha hydroxylase def: underdeveloped penis, prostate, prostate. Epididymis, ductus D, ejac duct, seminal vesicle all nl. #3 Testicular insensitivity - androgen rec def. Testes (in labia majora), female externa genitalia. Nl appearing females. |
|
|
Bowen dz
Erythroplasia of Querat |
SCC of the penis
presents with single erythematous plaque often on shaft or scrotum E of Q: singl E plaque often on glans penis or prepuce both occur after the 6th decade |
|
|
Bowenoid Papulosis
|
Penile
multiple verrucoid lesions with HPV16 Younger ppl - premalignancy |
|
|
Orchitis
|
Bacterial will involve epididymis
Syphillis mumps |
|
|
Epididymitis
|
#1 neisseria
#2 chlamydia trachomatis #3 E. Coli #4 TB |
|
|
tumors of elevated HCG
|
seminoma
Choriocarcinoma Embryonal carcinoma |
|
|
Seminoma
|
Malignant
elevated HCG Most common germ cell tumor enlarged painless testiclees 4th decade Exquisitely radiosensitive Dysgerminoma in females |
|
|
Embryonal carcinoma
|
malignant germ cell tumor -testiclees
painful, mets poor prognosis 2nd most common germ cell tumor elevated HCG |
|
|
Endodermal sinus tumor (yolk sac tumor)
|
malignant germ cell tumor - male/female
most common in infants and children |
|
|
elevated alpha fetoprotein
|
Hepatocellular carcinoma
Neural tube defect Endodermal sinus tumor (yolk sac) |
|
|
Testicular teratoma
|
Involves 2 or more embyronic layers
Most frequently malignant Mature T- malignant Immature T - T with malignant transformation -ex scc inside |
|
|
Choriocarcinoma of testiclees
histology |
incr HCG
2nd to 3rd decades can occur as an element of other gc tumors resembles syncytiotrophoblasts and cytotrophoblasts |
|
|
Mixed germ cell tuma
|
Variable prognosis determined by the least mature element
|
|
|
Testiclees Leydig cell tumor - interstitial
|
non germcell tumor
testicular stroma most often benign intracytoplasmic Reinke crystals produces androgens ass with precocious puberty and gynenocomastia |
|
|
testicular tumor ass with ass with precocious puberty and gynenocomastia
|
leydig cell tuma
|
|
|
sertoli cell tuma (androblastoma)
|
benign
testicle non germ cells, sex cord stomal tumor |
|
|
Prostatic zones and associations
|
posterior zone - prostatic carcinoma
periurethral + transitional + less central zone -- BPH |
|
|
Gleason system of grading
|
Prostate cancer grading
based on differentiation |
|
|
PSA
|
Elevations of PSA
1. reflect a complexed form bound to alpha 1 antichymotrypsin - this becomes elevated in Prostate Cancer 2. Or represent an incr in free PSA which is BPH Thus and incr in bound PSA and decr frax of free PSA suggest cancer. |
|
|
Prostate cancer
mets |
Thus and incr in bound PSA and decr frax of free PSA suggest cancer.
Mets osteoblastic incr serum alk phos, |
|
|
Most common infant and childhood testicular tuma
|
Endodermal yolk sac tumor
elevated afp |
|
|
treatment for trichomonas vaginalis
|
metronidazole
strawberry mucosa |
|
|
Gardnerella vaginosis
|
stinky vag, most common cause of vag discharge, fishy
Nl vaginal lactobacilli STD clue cells (pap smear - epith cells stipled bc of bug) |
|
|
Painful chancre
|
Haemophilus ducreyi
STD |
|
|
Most common cause of purulent monoarticular arthritis
|
neisseria gonorrhea
|
|
|
Most common STD
|
Chlamydial TRachomatis urethritis - most often asxq
|
|
|
Lymphogranuloma venereum
|
tropics
C. Trachomatis L1,L2,L3 small papule ulcer-> superficial ulcers-> enlarged regional LN that can become matted together. |
|
|
Calymmatobacterium Donovania granulomatis
|
Granuloma inguinale
GNR STD donovan bodies large bug filled histiocytes ulceration, coalescing to form large genital or inguinal ulcerations. |
|
|
Vulvular dz
|
papillary hidradenoma
condyloma acuminatum SCC paget dz of vulva malginant melanoma |
|
|
SCC of vagina
|
usually from spread from cervical scc.
|
|
|
Clear Cell adenocarcinoma
|
vaginal
caused by maternal ingestion of DES Vaginal adenosis is a precursor |
|
|
Sarcoma Botryoides
|
Rhabdomyosarcoma of the vagina
<5yo multiple botryoid masses projecting into vagina protruding form vulva |
|
|
Acute endometritis
|
most commonly caused by S. Aureus, and strep
Due to intrauterine trauma, placental remnants, uterine contraceptive device, |
|
|
Endometriosis
|
most common in ovary, uterine ligaments, rectovaginal septum, pelvic peritoneum,
menstrual pain chocolate cysts |
|
|
Adenomyosis
|
islands of endometrium in myometrium
|
|
|
Endometrial Hyperplasia
|
abnl prolif of endometrial glands
most often ass with ER excess because of: amenorrhea, anovulatory cycles, PCOS, ER secr tumor (granulosa cell tumer), HRT Postmenopausal bleeding Can be precursor to endometrial carcinoma |
|
|
Uterine fibroids
|
leiomyoma
Most common benign uterin tumor ER sensitive Incr in size in preggers and decr in menopause Can lead to menorrhagia |
|
|
Endometrial Carcinoma
presentation predisposing factor |
Most common gynecologic malignancy
Peaks in older women where this is more common than carcinoma of the cervix Postmenopausal bleeding Often preceeded by endometrial hyperplasia Predisposing Factors - exogenous ER, ER tumors, obesity, DM, HTN |
|
|
Salpingitis
|
PID
N. Gonorrhoeae, anaerobes, C. Trachomatis, Strep, others |
|
|
PCOS
|
young women
important cause of infertility amenorrhea, obesity, DM, hirsuitism excess LH and androgens. Hyperinsulinemia leads to incr ovarian androgen prod leading to Incr LH |
|
|
Ovarian Tumors epith origin
|
75% most common of ovarian tumors
serous: serous cystadenocarcinoma half of ovarian carcinomas mucinous: mucinous cystadenoma multilocular cysts with mucus secr epith mucinous cystadenocarcinoma -rupture leads to pseudomyxoma peritonei with peritoneal tumor implants. endometroid - usually malignant clear cell - always malignant brenners- transitional epithelium like with fibrous stroma |
|
|
Pseduomyxoma peritonei
|
#1 Mucinous cystadenocarcinoma
#2 mucinous cystadenoma #3 carinomatous mucocele of the appendix |
|
|
Ovarian teratomas
|
Immature: aggressive and malignant
Mature Teratoma: dermoid cyst most freq benign ovarian tumor teeth etc Monodermal: struma ovarii (thyroid) |
|
|
ovarian chorionic carcinoma
|
highly malignant secrets HCG
|
|
|
Ovarian sex cord stromal tumors
|
Fibroma: meigs syndrome
Thecoma: fibroblasts + lipid containing cells - may secr ER GRanulosa cell tuma Sertoli-leydig cell tumr |
|
|
Ovarian Granulosa cell tumor
|
ER secr causing precocious puberty
Endometrial hyperplasia, endometrial carcinoma Call Exner bodies: small follicles with eosinophillic secr |
|
|
Meigs syndrome
|
Ovarian fibroma, ascites, hydrothorax
|
|
|
Sertoli Leydic cell tuma
|
Androblastoma, arrhenoblastoma
androgen secr tumor ass with virilization |
|
|
Tumor ass with female virilization
|
Sertoli-leydig cell tumor
|
|
|
PLacental Acreta
|
Direct implantation on the myometrium
ass with prior surgeries or C-section Impaired placetal separation - massive hemorrhage. |
|
|
Toxemia of pregnancy
|
Severe HTN often denovo in preg or complicates preexisting HTN
affects kids, liver, CNS - third trimester 1. Preeclampsia - HTN, albuminuria, edema HELLP syndrome Hemolysis, elevated liver enzymes, low platelets 2. Eclampsia: severe, convulsions, DIC, reverses rapidly with termination. |
|
|
Chorioamnioitis
|
premature rupture of membranes
ascending infection from vagina or cervix |
|
|
Complete vs Partial hydatiform mole
|
Complete - no embryo, 46XX, exclusively paternal
Partial mole- embryo present, tripoidy or tetraploidy. Fertilization of ovum by 2 or more spermatozoa 69 Cr - 2 paternal 1 maternal can progress to disseminated choriocarcinoma |
|
|
Gestation Choriocarcinoma
|
Most common than ovarian type
High HCG, early hematogenous spread to lungs, responsive to chemo Causes 50% from hydatiform mole abortion of ectopic nl term preg |
|
|
Fibrocystic breast dz
|
Ages of virility
ER related Risk of cancer with atypia Fibrois Cysts Epith Change - aporcine metaplasia, adenosis |
|
|
Fibroadenoma of breast
|
most common breast tumor in <25
completely benign |
|
|
Serous or bloody discharge of breast
|
adenoma of nipple
intraductal papilloma malignancy |
|
|
Phyllodes tumor
|
large bulky mass of variable malignancy with ulceration of overlying skin
cystic spaces with myxoid contents |
|
|
Incr risk of breast carcinoma
|
incr age
fam hx - 1st degree female relative with breast cancer Hx of breast cancer early menarche late menopause obesity nulliparity 1st preg after 30 Diet high in animal fat Proliferative fibrocystic dz with atypical epith hyperplasia |
|
|
Comedocarcinoma
|
intraductal carcinoma in situ
tumor cells fills ducts tumor cell necrosis leads to cheesiness |
|
|
Invasive ductal carcinoma
|
most common type
abundant fibrous tiss firm |
|
|
Paget dz of the breast
|
eczematoid lesion of nipple or areola
clear halo like cell invade epidermis uncerlying ductal carcinoma |
|
|
Lobular carcinoma in situ
|
often bilateral
or invasive carcinoma in contralat breast years later. |
|
|
Invasive lobular carcinoma
|
better prognosis than invasive ductal cell carcinoma
multicentric, bilateral, linear cells indian file |
|
|
Inflammatory breast carcinoma
|
Lymphatic involvement of the skin by underlying carcinoma, red swollen hot skin
poor prognosis |
|
|
Predisposing factors of endometrial carcinoma
|
exogenous ER, ER tumors, obesity, DM, HTN, Nulliparity
|
|
|
Brenner tumor
|
transitional epithelium benign
ovarian |
|
|
serous cystadenoma
|
ovarian epith tumor
benign often bilateral |
|
|
Sertoli leydig cell tumor vs granulosa cell tumor
|
Sertoli leydig- androgen secr - virulization
Granulosa cell - ER secr precocious puberty |
|
|
Breast mass in postmenopausal individual
|
Most commonly a carcinoma
|
|
|
HCG
in pregnancy |
As fertilization occurs HCG begins being produced by placenta which keeps the corpus luteum from involution.
In the first trimester the corpus luteum will produce the ER and PR needed - peak levels of HCG occur at 9 weeks then decline. |
|
|
embryological derivative
parathyroids thyroid c-cell |
Parathyroid - sup 2 are from 3rd pharyngeal pouch
while inf 2 are from 4th inf pouch Thyroid begins as endoderm on the floor of the pharynx C-cells come from the 4th pouch |
|
|
FSH
|
stimulates granulosa cells to make estrogen (via aromatase), also stimulates sertoli cells for spermatogenesis (inhibited by inhibin
stim by pulsatile GnRH inhibited by constant incr GnRH Also follicular development |
|
|
LH
|
Stimulate Leydig cells to produce testosterone. Stimulates theca cells to make testosterone.
LH surge leads to ovulation Luteinization |
|
|
Finasteride vs Flutamide
|
Finasteride is a 5 alpha reductase inhibitor used in BPH
Flutamide is a testosterone blocker for prostate carcinoma |
|
|
Lipocortin
|
Inhibitor of PLP A2 from cortisol
Lipocortin thus inhibiting PG synth |
|
|
Causes of epididymitis
|
1. N. GONORRHEA
2. C. TRACHOMATIS 3... E. Coli, TB |
|
|
Preeclampsia
Eclampsia rx |
Preeclampsia:
HTN, proteinuria, edema Eclampia: + SZ Deliver asap Eclampsia tx: sulfate, diazepam, IV magnesium |
|
|
Polyhydraminos
Oligohydraminos |
Poly: esophageal/duodenal atresia, anencephaly
Oligo: bilateral renal agenesis or post urethral valves in male |
|
|
Most common gynenocologic malignancy
|
Endometrial Carcinoma
|
|
|
Schiller Duval bodies (primitive glomeruli)
|
Yolk sac tumor
afp sacrococcygeal area of young children |
|
|
Leydig cell tumor
|
precocious puberty in boys
gynecomastia in men |
|
|
Most common testicular cancer in older men
|
testicular lymphoma
|
|
|
Cystosarcoma Phylloides
|
Benign breast tumor
large bulky mass of CT and cysts leaflike projections |
|
|
Serious contraindication for sildenafil
|
combined with nitrates can lead to life threatening HoTN
|
|
|
Pros and Cons of Oral Contraception
|
Pros: reliable, decr risk of endometrial and ovarian cancer, regulation of menses, decr pelvic infections, decr ectotpic
Cons: hypercoaguble, depression, HTN, INCR TGs |
|
|
Fusion of processus vaginalis:
lack thereof or incomplete |
Lack thereof leads to congenital inguinal hernia
incomplete fusion leads to hydrocele |
|
|
Pleomorphic GNR
|
School of fish pattern on grams stain
Haemophilus Ducreyi |
|
|
G6PD def
what drugs will cause hemolytic anemia |
Sulfonamides (TMP/SMX), nitrofurantoin, dapsone, primaquine, quinine
|
|
|
Progression to choriocarcinoma
Complete mole vs partial mole |
Complete mole - invasive mole 10%, choriocarcinoma 2%. 46XX or XY from fertilization of an empty ovum by 2 sperm.
Incomplete mole - 2 sperm 1 egg - fetal parts - rarely progresses to choriocarcinoma |
|
|
Asherman Syndrome
|
The endometrium can be traumatized, typically D&C done after a miscarriage, abortion, or delivery, and then develops intrauterine scars which can obliterate the cavity to a varying degree. In the extreme, the whole cavity has been scarred and occluded. Even with relatively few scars, the endometrium may fail to respond to estrogens and rests. The patient experiences secondary amenorrhea and becomes infertile. An artificial form of Asherman's syndrome can be surgically induced by uterine ablation in women with uterine bleeding problems, in lieu of hysterectomy.
|
