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110 Cards in this Set

  • Front
  • Back
produced by placenta syntiotrophoblast
stimulates production of PR by corpus luteum
made by placenta
induces lipolysis elevating FFA in mom
it is a growth hormone in latter part of pregnancy
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
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
processus vaginals
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
F + M
Female: ovary, primordial follices,
Male: testiclees, sertoli cells, leydig cells, seminiferous tubes, tubuli recti, rete testes
M + F
Female: uterine tubes, uterus, cervix, upper third of vagina
Hydatid of Morgani
Male: appendix testes
Mesonephric ducts
Wolffian ducts
Female: Appendix vesculosa, duct of gartner
Male: Epididymis, ductus deferens, ejaculatory duct, seminal vesicles
Appendix epididymis
Mesonephric tubules
F: Epoophoron + paroophoron
M: Efferent ductules, paradidymis
incomplete fusion of the urethral folds - ventral surface pee on leg
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
multiple verrucoid lesions with HPV16
Younger ppl - premalignancy
Bacterial will involve epididymis
#1 neisseria
#2 chlamydia trachomatis
#3 E. Coli
#4 TB
tumors of elevated HCG
Embryonal carcinoma
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
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)
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
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
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
strawberry mucosa
Gardnerella vaginosis
stinky vag, most common cause of vag discharge, fishy
Nl vaginal lactobacilli
clue cells (pap smear - epith cells stipled bc of bug)
Painful chancre
Haemophilus ducreyi
Most common cause of purulent monoarticular arthritis
neisseria gonorrhea
Most common STD
Chlamydial TRachomatis urethritis - most often asxq
Lymphogranuloma venereum
C. Trachomatis L1,L2,L3
small papule ulcer-> superficial ulcers-> enlarged regional LN that can become matted together.
Calymmatobacterium Donovania granulomatis
Granuloma inguinale
donovan bodies large bug filled histiocytes
ulceration, coalescing to form large genital or inguinal ulcerations.
Vulvular dz
papillary hidradenoma
condyloma acuminatum
paget dz of vulva
malginant melanoma
SCC of vagina
usually from spread from cervical scc.
Clear Cell adenocarcinoma
caused by maternal ingestion of DES
Vaginal adenosis is a precursor
Sarcoma Botryoides
Rhabdomyosarcoma of the vagina
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,
most common in ovary, uterine ligaments, rectovaginal septum, pelvic peritoneum,
menstrual pain
chocolate cysts
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
Most common benign uterin tumor
ER sensitive
Incr in size in preggers and decr in menopause
Can lead to menorrhagia
Endometrial Carcinoma
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
N. Gonorrhoeae, anaerobes, C. Trachomatis, Strep, others
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 cystadenocarcinoma half of ovarian carcinomas
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.
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
50% from hydatiform mole
abortion of ectopic
nl term preg
Fibrocystic breast dz
Ages of virility
ER related
Risk of cancer with atypia
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
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
1st preg after 30
Diet high in animal fat
Proliferative fibrocystic dz with atypical epith hyperplasia
intraductal carcinoma in situ
tumor cells fills ducts
tumor cell necrosis leads to cheesiness
Invasive ductal carcinoma
most common type
abundant fibrous tiss
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
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
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
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
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
Stimulate Leydig cells to produce testosterone. Stimulates theca cells to make testosterone.
LH surge leads to ovulation
Finasteride vs Flutamide
Finasteride is a 5 alpha reductase inhibitor used in BPH

Flutamide is a testosterone
blocker for prostate carcinoma
Inhibitor of PLP A2 from cortisol
thus inhibiting PG synth
Causes of epididymitis
3... E. Coli, TB
HTN, proteinuria, edema
Eclampia: + SZ
Deliver asap
Eclampsia tx: sulfate, diazepam, IV magnesium
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
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.