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;
137 Cards in this Set
- Front
- Back
|
venous drainage of left ovary/testis?
|
left gonadal vein -> left renal vein -> IVC
|
|
|
venous drainage of right ovary/testis?
|
right gonadal vein -> IVC
|
|
|
lymphatic drainage of ovaries/testes?
|
para-aortic lymph nodes
|
|
|
lymphatic drainage of scrotum/vulva/distal vagina?
|
superficial inguinal nodes
|
|
|
lymphatic drainage of uterus/proximal vagina?
|
obturator, external iliac, ypogastric nodes
|
|
|
which side is varicocele more common on?
|
left (more complicated venous drainage)
|
|
|
cardinal vs. round vs. broad ligament?
|
cardinal: cervix to side wall of pelvis, containes uterine vessels
round: uterine fundus to labia majora, no contained structures broad: connects uterus, fallopian tubes, ovaries to pelvic side wall; contains round uterus |
|
|
histology of ovary?
|
simple cuboidal epithelium
|
|
|
histology of fallopian tube?
|
simple columnar epithelium, ciliated
|
|
|
histology of uterus?
|
simple columnar epithelium, pseudostratified, tubular glands
|
|
|
histology of endocervix?
|
simple columnar epithelium
|
|
|
histology of ectocervix?
|
stratified squamous epithelium
|
|
|
histology of vagina?
|
stratified squamous epithelium, nonkeratinized
|
|
|
opening of urethra on ventral surface of penis?
|
hypospadias; failure of urethral folds to close (analagous to female labia minora)
|
|
|
opening of urethra on dorsal surface of penis?
|
epispadias; failure of positioning of genital tubercle (analagous to clitoris in female)
|
|
|
pathway of sperm during ejaculation?
|
Seminiferous tubules
Epididymis Vas deferens Ejaculatory ducts (Nothing) Urethra Penis |
|
|
histology of epididymis?
|
pseudostratified columnar epithelium with stereocilia
|
|
|
histology of vas deferens?
|
pseudostratified columnar epithelium
|
|
|
MOA of sildenafil and vardenafil?
|
inhibit cGMP breakdown
|
|
|
nerves involved in male sexual response?
|
Erection: Parasympathetic (pelvic nerve)
Emission: Sympathetic nervous system (hypogastric) Ejaculation: visceral and somatic (pudendal) |
|
|
organelle that developes into sperm's acrosome?
|
golgi aparatus
|
|
|
organelle that developes into sperm's middle piece?
|
mitochondria
|
|
|
organelle that developes into sperm's tail?
|
centrioles
|
|
|
what cells are found in interstitium of the seminiferous tubules?
|
Leydig cells (stimulated by LH to produce testosterone)
|
|
|
what cells line the seminiferous tubules?
|
Sertoli cells (stimulated by FSH to make inhibin, androgen binding protein)
|
|
|
what cells make inhibin?
|
Sertoli cells
|
|
|
what cells make androgen binding protein?
|
Sertoli cells
|
|
|
what cells make anti-mullerian hormone?
|
Sertoli cells
|
|
|
what cells make testosterone (in testes)
|
Leydig cells
|
|
|
what cells in the testes are stimulated by FSH?
|
Sertoli cells (stimulated by FSH to make inhibin, androgen binding protein)
|
|
|
what cells in the testes are stimulated by LH?
|
Leydig cells (stimulated by LH to produce testosterone)
|
|
|
what cells make up blood-testes barrier?
|
Sertoli cells
|
|
|
what cells produce anti-mullerian hormone?
|
Sertoli cells
|
|
|
what androgens are made in testis?
|
DHT and testosterone
|
|
|
what androgens are made in adrenal?
|
androstenedione
|
|
|
comparative potency of androgens?
|
DHT > testosterone > androstenedione
|
|
|
how is DHT produced?
|
produced from testosterone by 5-alpha reductase (inhibited by finasteride)
|
|
|
function of enzyme aromatase?
|
converts testonsterone and androstenedione to estrogen; found in adipose tissue and Sertoli cells
|
|
|
what hormones control development of male internal/external genitalia?
|
Testosterone: internal
DHT: external + prostate |
|
|
what hormone controlls growth of prostate?
|
DHT
|
|
|
what type of estrogen is indicator of fetal well-being?
|
estriol (produced by placenta)
|
|
|
where in cell are estrogen receptors?
|
in cytoplasm; translocate to nucleus when bound by ligand
|
|
|
what cell in ovaries is stimulated by FSH?
|
granulosa cell (produces estrogen from androstenedion)
|
|
|
what cell in ovaries is stimulated by LH?
|
theca cell (produces androstenedion)
|
|
|
where is prolactin produced?
|
in anterior pituitary; inhibited by dopamine from hypothalamus
|
|
|
where is progesterone produced?
|
corpus luteum, placenta, adrenal cortex, testes
|
|
|
what hormone increases body temperature?
|
progesterone (peak core body temp at time of ovulation)
|
|
|
effect of progesterone on uterine smooth muscle?
|
relaxes, prevents contractions
|
|
|
effect of progesterone on LH, FSH?
|
inhibits
|
|
|
what controlls endometrial proliferation?
|
estrogen stimulates, progesterone maintaines
|
|
|
when during menstrual cycle is progesterone hightest?
|
during secretory phase (day 21ish)
|
|
|
when during menstrual cycle is estrogen highest?
|
two peaks
1. right before LH surge (just prior to day 14 and ovulation) 2. broader hump during luteal/secretory phase (day 21ish) |
|
|
when during menstrual cycle is LH highest?
|
LH surge just before ovulation (day 14)
|
|
|
corona radiata?
|
layer of granulosa cells surrounding egg
|
|
|
primary oocytes are arrested in what stage of meiosis?
|
prophase I (until ovulation)
|
|
|
secondary oocytes are arrested in what stage of meiosis?
|
metaphase II (until fertilization)
|
|
|
chromomes and genetic material of primary oocyte?
|
diploid 4N (46 sister chromatids)
|
|
|
chromomes and genetic material of secondary oocyte?
|
haploid 2N (23 sister chromatids)
|
|
|
what cells secrete beta-hCG?
|
trophoblasts
|
|
|
at what point is beta-hCG detectible?
|
detectible in blood 1 week after conception; home urine test 2 weeks after conception
|
|
|
decrease in what hormone induces lactation after delivery?
|
decrease in progesterone
|
|
|
role of oxytocin in lactation?
|
helps with milk letdown
|
|
|
hormone that induces and maintains lactation?
|
prolactin
|
|
|
discriminatory threshold for beta-hCG?
|
1500-2000; at this point IUP should be visible by transvaginal sonography
|
|
|
what mechanisms prevent double fertilization?
|
calcium influx causes swelling of space vitelline layer and plasma membrane
inactivation of bindin receptors causes hardening of vitelline layer |
|
|
best test to confirm menopause?
|
increased FSH
|
|
|
level of GnRH in menopause?
|
increased (no negative feedback due to decreased levels of estrogen)
|
|
|
common cause of hypogonadism seen in infertility workup?
|
Klinefelter's syndrome (XXY male)
|
|
|
hormone levels seen in Klinefelter's syndrome (XXY male)?
|
• increased FSH (decreased inhibin due to dysgenesis of seminiferous tubules)
• decreased testosterone -> increased LH -> increased estrogen |
|
|
hormone levels seen in Turner syndrome (XO female)?
|
decreased estrogen leads to increased LH and FSH
|
|
|
most common cause of primary amenorrhea?
|
Turner syndrome (XO female)
|
|
|
very tall male with severe acne and antisocial behavior?
|
XYY male; normal fertility
|
|
|
causes of female pseudohermaphrodism?
|
exposure to androgens during early gestation (eg congenital adrenal hyperplasia)
|
|
|
most common cause of male pseudohermaphrodism?
|
androgen insensitivity syndrome (causing testicular feminization)
|
|
|
presentation of 5-alpha reductase deficiency?
|
inability to convert testosterone to DHT; "penis at 12"
|
|
|
Kallmann syndrome?
|
decreased synthesis of gonadotropin in anterior pituitary leading to lack of secondary sexual characteristics and anosmia
|
|
|
karyotype of complete mole?
|
46,XX or 46,XY (all paternal)
|
|
|
karyotype of partial mole?
|
69,XXY (2 sperm + 1 egg)
|
|
|
preeclampsia symptoms prior to 20 weeks?
|
suggests molar pregnancy
|
|
|
HELLP syndrome (associated with preeclampsia)?
|
Hemolysis
Elevated LFTs Low Platelets |
|
|
meds used to treat preeclampsia?
|
IV magnesium sulfate and diazepam to prevent/treat seizures
|
|
|
pregnancy complications associated with DIC?
|
preeclampsia, placental abruption
|
|
|
environmental factors that increase risk of placental abruption?
|
smoking, hypertension, cocaine
|
|
|
massive bleeding after delivery?
|
placenta accretia or retained placental tissue
|
|
|
HPV types associated with cervical pathology?
|
16, 18
|
|
|
how can cervical cancer cause renal failure?
|
local invasion blocks ureters
|
|
|
how do leiomyomas respond to pregnancy? Menopause?
|
increase in size with pregnancy; decrease with menopause
|
|
|
relative incidence of gyn tumors in USA?
|
endometrial > ovarian > cervical
|
|
|
hormone levels in PCOS?
|
increased LH
decreased FSH increased testosterone |
|
|
germ cell tumor that can develop during pregnancy in mother or baby?
|
choriocarcinoma of synctiotrophoblastic cells
|
|
|
aggressive yolk gonadal malignancy in young children that resembles glomeruli?
|
yolk sac tumor; Schiller-Duval bodies
|
|
|
most common ovarian germ cell tumor?
|
teratoma
|
|
|
dermoid cyst?
|
mature teratoma
|
|
|
struma ovarii?
|
teratoma with functional thyroid tissue, presents as hyperthyroidism
|
|
|
Brenner tumor?
|
benign non-germ cell tumor of ovary; looks like Bladder
|
|
|
ovarian tumer with bundles of spindle shaped fibroblasts?
|
fibroma
|
|
|
Meig's syndrome?
|
triad of ovarian fibroma, ascites, and hydrothorax
|
|
|
ovarian pathology associated with hydrothorax?
|
ovarian fibroma; "Meig's syndrome"
|
|
|
Krukenberg tumor?
|
stomach cancer that metastasizes to ovaries; mucin-secreting signet cell adenocarcinoma
|
|
|
clear cell adenocarcinoma in vagina?
|
in women who had in utero exposure to DES
|
|
|
vaginal carcinoma in girls <4 years old?
|
sarcoma botryoides; spindle-shaped tumor cells, desmin positive
|
|
|
breast tumor with serous or bloody nipple discharge?
|
ductal; can benign or malignant
|
|
|
Phyllodes tumor?
|
benign breast tumor; large bulky mass of connective tissue and cysts with leaf-like projections
|
|
|
most important prognostic factor in malignant breast cancer?
|
axillary lymph node involvement
|
|
|
most common (and most invasive) malignant breast tumor?
|
invasive ductal
|
|
|
what chromosomes are BRCA genes on?
|
BRCA1 on chromosome 17
BRCA2 on chromosome 13 |
|
|
most common cause of breast lumps age 25 - menopause?
|
fibrocystic disease
|
|
|
most common pathogen in acute mastitis?
|
S. aureus
|
|
|
pathogen associated with acute prostatitis?
|
E. coli
|
|
|
what part of prostate is involved in BPH?
|
transitional cell zone
|
|
|
increased PSA?
|
BPH and prostate cancer; in prostate cancer, increased total PSA with decreased fraction of free PSA
|
|
|
what part of prostate is involved in prostate cancer?
|
peripheral zone
|
|
|
cause of back pain 2/2 prostate cancer?
|
bone mets
|
|
|
testicular tumor with large cells in lobules with watery cytoplasm and "fried egg" appearance?
|
seminoma
|
|
|
testicular tumor that resembles primitive glomeruli on histology?
|
yolk sac tumor; Schiller-Duval bodies
|
|
|
testicular tumor with disordered synctiotrophoblastic and cytotrophoblastic elements?
|
choriocarcinoma of synctiotrophoblastic cells
|
|
|
Reinke crystals?
|
Leydig cell tumor
|
|
|
testicular tumor associated with gynecomastia or precocious puberty in males?
|
Leydig cell
|
|
|
most common testicular cancer in older men?
|
testicular lymphoma
|
|
|
testicular masses that can be transilluminated?
|
1. varicocele
2. hydrocele 3. spermatocele |
|
|
gray, solitary, crusty plaque on shaft of penis of man in 40s?
|
Bowen's disease (carcinoma in situ); progresses to invasive SCC in <10%
|
|
|
red velvety plaques on penis?
|
Erythroplasia of Queyrat (carcinoma in situ)
|
|
|
Bent penis due to acquired fibrous tissue formation?
|
Peyronie's disease
|
|
|
MOA of leuprolide?
|
GnRH analog that is agonist if used pulsatile, antagonist if given continuously
|
|
|
MOA of finasteride?
|
5-alpha reductase inhibitor (decreases conversion of testosterone to DHA)
|
|
|
why is ketoconazole used in PCOS?
|
prevents hirsutism by inhibiting steroid synthesis
|
|
|
why is spironolactone used in PCOS?
|
prevents hirsutism by inhibiting steroid binding
|
|
|
Flutamide?
|
nonsteroidal competitive inhibitor of androgens at testosterone receptor; used in prostate carcinoma
|
|
|
hormone replacement therapy (HRT) increases risk of what?
|
• invasive breast cancer
• endometrial cancer (if unopposed) • heart attack and stroke |
|
|
hormone replacement therapy (HRT) decreases risk of what?
|
• osteoporotic fractures
• colorectal cancer |
|
|
aromatase inhibitors used in postmenopausal women with breast cancer?
|
anastrozole, exemestane
|
|
|
MOA of clomiphene?
|
partial agonist at estrogen receptors in hypothalamus; prevents normal feedback inhibition, increases release of LH, FSH from pituitary
|
|
|
MOA of mifepristone?
|
competitive inhibitor of progestins at progesterone receptors
|
|
|
dinoprostone?
|
PGE2 analog used to induce labor
|
|
|
ritodrine, terbutaline?
|
beta-2 agonists that relax uterus and reduce premature uterine contractions
|
|
|
defect in Kartagener's syndrome?
|
dyneine defect leading to immotile cilia; results in infertility, bronchiectasis, situs inversus
|
|
|
isolated elevated alpha-fetoprotein?
|
neural tube defect
|
