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103 Cards in this Set
- Front
- Back
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What secretes androgen binding protein
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Sertolie cells
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What cells make up the blood testets barrier
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Sertoli tight junctions
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Where are leydig cells located
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In the intertitutum
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Where are sertoli cells located
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Lining the seminderous tubules, they are irreg shaped and acidophilic
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how long does spermatogeneisis take
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2 months
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What spermatogonium undergoes mitosis only (to maintain pool)
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Type A
B enters meiosis I at pub |
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What internal male genetalia doesn't come from the wolffian ducts
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the prostate
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Where does the prostate derive from
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urogenital sinus
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What are the early and late affects of DHT
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early - differentation of penis, scrotum, prostate
Late - prostate growth, blading, sebaceaous |
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what hormone stimulates the growth of the follicle?
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Estrogen
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What are the effects of E on the HDL and LDL
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inc HDL dec LDL
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What are sources of prog
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CL, placenta, adrenal cortex, testes
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What hormone decreases myometrial excitability
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Prog, it also dec E receptor expressivity
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WHich menstrual cycle is always 14 days
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Leutal phase prog dominates this phase, follicular can vary
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When do oocytes begin Meiosis one
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at 4 weeks stuck in pro I
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What secretes hCG first
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trophoblasts (synctio) detectabe 1 week after conception and home urine test = 2 weeks
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What induces lactation
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dec prog
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What is OCT resp for in laction
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milk let down and uterine contractions
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What pathological states have elevated hCG
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Hydatidaform mole, choriocarcinoma, gestational trophoblastic tumors
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What are the changes in menopause
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Hirsuitism, hot flashes, atrophy of the Vagina, Osteoporosis, Coronary artery disease
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What are the labs in XXY
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Low T and inhibin high FSH, LH, and E (gynecomastia) smal testes
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how do you treat short stature in turners
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GH
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what are the labs in turners
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High LH and FSH low E NO BARR BODY
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What heart condition is assoc with turners
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coartation of the aorta
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What is the most common cause of primary amenorrhea
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Turners
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what causes a female pseudohermaphrodite
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Excessive exposure to androgen during gestation (CAH, exogenous) external genitalia masculinized
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WHat causes male pseudo
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androgen insensitivity - ext gen are fem of ambiguous
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True hermaphrodite genotype
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Very rare 46 xx or 47xxy
Both ovary and testicular tissue present, ambiguous genitalia |
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What presents with a normal ext female with no secondary hair growth
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Androgen insensitiity syndrome, do have testes, show inc testosterone, estrogen and LH
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what causes penis at 12
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5 alpha R deficiency ambig genitalia until puberty when masculinization happens
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What is the presentation of kallmans
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dec gnrh, anosmia, lack of secondary sex
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what is the karyotype of a partial mole
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60xxy, rare coversion to chorio carc, low risk of malig, some fetus parts
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Most common causes of 1st trimester miscarriage
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Low prog (no response to Bhcg) or chromo abn,
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Most common cause of 2nd tri ab
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bicornuate uterus
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what does precalmpsia before 20wks suggest
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molar preg
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What are some assoc with preeclamspia
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DM, HTN, chronic renal dz, AI disorders
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whats the patho of preclampsia
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Placental ischemia due to impaired vasodilation of the spiral arteries resluting in inc vasc tone
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What is HELLP syndrome
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Hemolysis, elevated LFT, and low plates
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What is mortality due to in eeclam/preclam
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cerebral hemorrhage and ARDS
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What are the clinical features of pre/eeclamp
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HA, blurred vision, abd pain, edema, altered mentation, hyperreflexia, may see thrombocytopenia nad hyperuricemia.
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tx for preclampsia
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deliver, treat HTN, salt restrict, bed rest Mag sulfate, and diazepam to prevent seizure
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what is abruptio placentia assoc with
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DIC, smoking, HTN, cocaine - 3rd trimester painful bleeding
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whats the RF for placenta accreta
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C section previously, inflamm and placenta previa - masive post delivery bleeding
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what are causes of polyhydraminos
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esophageal/duodenal atresia, anacephaly
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What are causes of oligohydramnios
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placental insufficiency, potters, posterior urethral valves in males
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where does cerv carc begin?
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basal layer of squamo columnar junction extends outward
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most common type of cervical cancer
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Squamous
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what do E6 and E7 inhibit
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E6 - p53 leads to inc mitosis
E7 - Rb t supp |
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Is endometriosis neoplastic
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NO
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What are s/sx and comps to endometriosis
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Dysmenorrhea, dyspareunia, dyschezia, nodularity of the uterosacral ligaments, fixed retroversion of the uterus, OFTEN RESULTS IN INFERTILITY
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Rfs assoc with endo prolif
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anovulatroy cycles, HRT, PCOS, grnulosa cell tumor
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What is the most common gyn malig and what is the worst prog
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Incidence - endo>ovarian>cerv
Worst - Ov>cervic>endo ** this is US data cerv cancer is most common worldwide |
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What typically precedes endo carc
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Hyperplasia, RF - obesity diabaestes nulliparty late menopause. Myometrial invasion --> worse prog
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What is the histo and sx of fibriod
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Whorled patter of smooth muscle bundles, see abn bleeding,asymptomatic, anemia, miscarriage
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What are common causes of anovulation
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PCOS, obestiy, HPO axis abn, premature ovarian failure, hyperprolactinemia, thyroid disorers, eating disorder, cushings syndrome, adrenal insufficiency
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What does a leiomyosarcoma look like
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Bulky, irreg shaped tumor with areas of necrosis and hemorrhage, esp arising de novo, inc incidence in blacks highly agressive, tend to recur, may protrude from cervix and bleed. Common in middle aged women
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how do you treat PCOS
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weight loss, ocp, gonadotropin, clomiphene, spironolactone, or surgery
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what do you see in labs of PCOS
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LH inc T inc, Fsh dec
LH/FSH >2 |
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what is a follicular cyst assoc with
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Hyperestrinism and endometrial hyperplasia...its a distension of an unruptured graafian follicle
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What is caused by hemorrhage into a persistent corpus luteum
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corpus luteum cyst
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What cyst is assoc with choricarcinoma and moles
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Theca lutein cyst
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What tumor is sheets of cells with inc hCG and LDH
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common in males Dysgerminoma
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What tumor has large hyperchromaticsynctiotophoblast cells
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Choriocarcinoma inc hCG
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What malignancy often occurs in the sacrococcygeal area of young children.
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Yolk sac has AFP and yellow friable, solid mass, with schiller duval bodies
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What is the most common teratoma in women
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Mature 'dermoid' cyst
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What ov tumor has fallopian tube like epi
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Serous cystademona
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whattumor has intestinal type epithelium
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Mucinous cystadenoma
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What is pseudomyxoma peritonei and whats it assoc with
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Intraperitoneal accum of mucious material from ovaria (muc carcinoma) or appediceal tumor
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what is assoc with Meigs
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Ovarian fibroma, ascites, hydrothorax, pulling sensation in groin, spindle shaped fibroblasts
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Where do you see cal-exner bodies
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small follicles filled with eosinophilic sec, abn uterine bleeding , typically unilateral
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What is sarcoma botryoides
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Rhabdomyosarcoma variant that afects girls <4 years old, spindle shaped tumor cells that are desmin positive
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what do you see in an intraductual papilloma?
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small tumor that growns in lactiferous ducts, typically beneath the aerola. Can see serious or bloody nipple discharge, slight inc risk for carinoma
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where do breast cancer tumors arise from
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mammary duct epithelium or lobular glands
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What is the single most impt prog factor in breast cancer
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ax lymph node inovlement
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IMPT THING TO REMEMBER ABOUT OBESITY
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bc adipose converts adrosetnedione to estrone so it is assoc with higher estrogen and inc likelihood of estrogen resonsive cancers
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What does DCIS arise from
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ductal hyperplasia, assoc with calcification
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what is the most common and worst carcinoma of the breast
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lnvasive ductal - firm fibrous with sharp margins and small glandular duct-like cells
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Invasive lobular - histo
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orderly row of cells, often multiple bilateral
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Medullar cancer - histo
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Fleshy, cellular, lymphocytic infiltrate.
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What subtype of DCIS has caseious necrosis
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comedocarcinoma
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What breast cancer has lymphatic invasion by breast carcinoma, and peau dorange
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inflammatory
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besides the nipple where can pagets be seen
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the vuluva
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what are the types of fibrocystic changes
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Fibrosis, cysts, sclerosing adenosis (assoc w/ calc), epithelial hyperplasia (>30)
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What are some causes of acute prostatitis
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bacteria - e coli
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What are some causes of chronic prostatitis
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Bacterial or abacterial
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What is the patho of BPH
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possible inc in estradiol with possible sensitization to DHT, charac by nodular enlargement of the periurethral lobes.
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what are complications of BPH
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in feq of urination, nocturia, difficulty starting and stopping urination, dysuria, hydropephrosis and UTIs
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What is the tx of BPH
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a1 antag - teraosin, tamsulosin, finasteride
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where does prostate cancer most commonly arise from?
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Peripheral zone of the posterior lobe, hard nodule
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what are useful prostate cancer markers
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PAP, and PSA, if metastatic may see inc in ask phos
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What increases the risk of cryptorchidism
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prematurity
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What is the most common testicular tumor
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seminoma - 15-35, large cells in lobules with watery cytoplasm and a fried egg appearance. Radiosensitive.
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What testitcular tumor is painful with glandular/papillary mophology with inc AFPand hcG
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Embryonal carcinoma
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What test tumor is yellow mucinous with inc AFP
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yolk sac tumor
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What is the most often malignatn teratoma in males
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mature (unlike females which is immature)
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What testicular tumor contains reinke crystals and produces androgen causing gynecomastia, and precocious puberty
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Leydig cell- has reinke crystals
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What does sertoli cell cancer arise from
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sex cord stroma
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What is the most common testicular cancer in older men
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lymphoma
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what is a spermatocele caused by
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dilated epididymal duct
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What causes a gray solitary placque on the shaft of the penis
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Bowens 50s, can go to SCC
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what causes red velvety plaques on the penis, glands, similar to bowens
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erythroplasia of queyrat
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What are papular lesions on young guys that do not become invasive
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bowenoid papules
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What cacner is assoc with HPV and lack of circumcision
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SCC
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