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88 Cards in this Set
- Front
- Back
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Lymphatic drainage for the uterus
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obturator
External iliac and hypogastric nodes |
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Lymphatic drainage for the penis
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Superficial inguinal nodes
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Suspensory ligament of the ovaries connects what & contains what?
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Connects ovaries to lateral pelvic wall
contains the ovarian vessels |
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Role of hypogastric nerve in male sexual response
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Emission
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Role of pudendal nerve in male sexual response
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Ejaculation
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Purpose of Androgen binding protein
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Maintain high local level of testosterone
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Components of Semen
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60% from seminal vesicles (prostaglandins, fructose, flavins, ascorbic acid, phosphorylcholine)
40% from prostate (citrate, fibrinolysin, zinc, phospholipids) |
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What is DHT's function?
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Early - differentiation of penis, scrotum, prostate
Late - prostate growth, balding, sebaceous gland activity |
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Function of estrogen:
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Stimulate follicle, breast, endometrium growth
Increase myometrial excitability Inhibit FSH and LH, but then is positive feedback for LH surge Upregulate estrogen, LH, and progesterone receptors Increase transport of proteins, SHBG Inc HDL and dec LDL |
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Potency of various estrogens
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Estradiol > estrone > estriol
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What is menotropin?
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Works like FSH
(human menopausal gonadotropin) |
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What stimulates the dominant follicle formation?
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FSH
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What are the functions of progesterone?
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1. Relaxation of uterine smooth muscle
2. Inhibit gonadotropins 3. Production of thick cervical mucus to prevent entry of sperm 4. Endometrial glandular secretion and development of spiral arteries 5. Dec estrogen receptor expressivity 6. Dec myometrial excitbility 7. Increase body temperature 8. Maintain pregnancy |
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Menometrorrhagia
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Heavy menstruation
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Metrorrhagia
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Frequent but irregular menstruation
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Mittelschmerz
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Blood from ruptured follicle causes peritoneal irritation that mimics appendicitis
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When is b-hCG detectable in blood?
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1 week after conception
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When is b-hCG detectable on home preg test?
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2 weeks after conception
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How does the 17-OH progesterone profile look during pregnancy
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Decreases after 1st trimester, b/c is only made in corpus leuteum
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hCG
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Secreted by the syncitiotrophoblast of the placenta
Maintains the corpus luteum, and therefore progesterone for first trimester (acts like LH) |
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Hormone profile in XXY patient
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Inc LH, FSH, Estrogen
Dec Inhibin, testosterone |
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Cardiac issues in XO
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Bicuspid aortic valve
Preductal coarctation |
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How LH and FSH work on the ovary
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LH stimulates theca cells
cholesterol --> androstendione (desmolase) FSH stimulates granulosa cells Androstenedione --> estrogen (aromatase) |
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What determines if you have testes?
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SRY gene
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Androgen insensitivity syndrome
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46, XY
Testes (but inside labia majora; surgically removed to prevent malignancy) Normal-appearing female Female external genitalia Rudimentary vagina No sexual hair Labs: Inc testosterone, estrogen, LH |
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Female Pseudohermaphrodite
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46 (XX)
Ovaries present External genitalia virilized or ambiguous |
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5-alpha reductase deficiency
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Cannot convert testosterone to DHT
Penis at 12 Ambiguous genitalia until puberty At puberty get masculinization and growth of external genitalia Internal genitalia are normal Test/est - normal LH - normal/elevated |
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What is responsible for testicular enlargement?
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FSH
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Hydatitiform mole
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Benign tumor of the chorionic villus
Complete: All parts paternally derived 46, XX Risk of choriocarcinoma Inc hCG No fetal parts |
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Common cause of recurrent miscarrage in 1st weeks
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low progesterone
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Common cause of recurrent miscarrage in 1st trimester
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chromosomal abnormalities
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Common cause of recurrent miscarrage in 2nd trimester
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Bicornuate uterus
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Preeclampsia
Ecclampsia |
HTN + proteinuria + Edema
+seizures = eclampsia |
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Clinical findings in eclampsia
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Headache
Hemolysis Elevated LFTs Low platelets Blurry vision Cerebral hemorrage ARDS Abdominal pain Hyperreflexia Hyperuricemia |
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RF for abruptio placentae
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Smoking, cocaine, HTN
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Placenta accreta
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Placenta attach to myometrium
Massive bleeding after delivery RF: Prior C-section, inflammation, placenta previa |
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Placenta previa
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placenta attach to lower uterine segment
RF: Multiparity and prior C-section |
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Painful bleeding in 3rd trimester
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Abruptio placentae
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Cervical dysplasia risk factors
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Multiple sex partners
Smoking Early sexual intercourse HIV |
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Risk factors for endometrial hyperplasia
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Early menarche or late menopause
Taking estrogen w/o progestins Nullipartiy Anovulatory cycles Obesity PCOS Granulosa cell tumor |
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Precursor of leiomyosarcoma
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Most often de novo...NOT from leiomyoma
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Causes of anovulation
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PCOS
Obesity Asherman's syndrome HPO axis abnormalities Premature ovarian failure Hyperprolactinemia Thyroid disorders Eating disorder Cushing's Adrenal insufficiency |
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Meig's Syndrome
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R side pleural effusion
Ascities Thecoma-fibroma |
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Yolk sac tumor
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Ovarian germ cell tumor
Yellow and friable Secretes AFP Schiller-Duval bodies (resemble glomeruli) |
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Pseudomyxoma peritoni
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Intraperitoneal accumulation of mucinous material from ovarian or appendiceal tumor
Mucinous cystadenocarcionma |
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Fibroma of the ovary
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Spindle-shaped fibroblasts
Associated w/ Meig's syndrome Pulling sensation in the groin |
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Granulosa cell tumor
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Produce extrogen
Looks yellow Can cause precocious puberty Call-Exner bodies (follicles filled w/ eosinophilic secretions) Endometiral hyperplasia or carcinoma |
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Desmin positive vaginal tumor
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Sarcoma botryoides
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Phyllodes tumor
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Most common in 6th decade
Large mass of CT and cysts Leaf-like projections in CT |
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Breast tumor with histology of indian file pattern/targetoid
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Invasive lobular
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Comedocarcinoma
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Subtype of DCIS
Caseous necrosis |
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Can produce serous or blood nipple discharge
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Intraductal papilloma
slight inc risk carcinoma |
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Zone enlargement in BPH v carcinoma
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BPH: lateral and middle lobes (transitional zone)
Carcinoma: posterior lobe (periopheral zone) |
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Inc free PSA vs Inc bound PSA
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Inc free PSA: BPH
Dec free PSA: Cancer |
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Malignancy of mature teratoma in female vs male
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More often malignant in males
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Seminoma
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Painless
Malignant Excellent prognosis CD 117 positive PLAP- positive Most common Radiosensitive |
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Embryonal carcinoma of the testes
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Painful
Malignant AFP & hCG increased Can differentiate into other tumros Glandular/papillary morphology |
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Golden brown testicular tumor
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Leydig cell
Contains Reinke crystals |
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Bowen's disease
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Gray, solitary, crusty plaque on shaft or scrotum
<10% progress to cancer Peak incidence 5th decade |
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Erythroplasia of Queyrat
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Req plaque of glans
Peak incidence 5th decade |
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Bowenoid papulosis
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No invasiveness
Younger age group Multiple papular lesion |
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SCC of penis RF
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Smoking, HPV, lack of circumsision
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Peyronies disease
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Bent penis due to fibrous tissue
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Portion of placenta that secretes hCG
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Syncitiotrophoblast
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Why must the placenta secrete hCG?
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Simulate corpus luteum to secrete progesterone!
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Most common cause for Turner syndrome?
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Mosaicism (46XX/45XO) due to mitotic error after fertilization has occured
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Rheumatic fever can follow what kind of infections?
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Group A strep pharyngitis only
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Ligament containing the ovarian vessels
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Suspensory ligament
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Ligament containing the uterine vessels
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Cardinal ligament
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Acrosome is derived from
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Golgi
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Fluid collection in the tunica vaginalis
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Hydrocele
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Role of theca externa/interna & granulosa
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Theca externa is a CT capsule of fibroblasts and smooth muscle
Theca interna, under the influence of LH, produce androstenedione and progesterone Granulosa cells have aromatase, so obviously produce estrogen. (FSH needed, duh) |
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Where is progesterone & estradiol secreted from throughout pregnancy?
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Corpus luteum for 1st trimester
Prog from placenta during 2-3 trimesters Estrogen from fetal adrenal gland in 2-3 trimesters |
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Tissue type:
Vagina |
Stratifed squamous nonkeritinized
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Tissue type:
Cervix |
Endo - Simple columnar
Ecto - Stratified squamous |
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Tissue type:
Fallopian tube |
Simple columnar
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Tissue type:
Ovary |
Simple cuboidal
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Tissue type:
Uterus |
Simple (psuedostratified) columnar
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Stage of mitosis for egg at:
Birth Prior to fertilization |
Birth: prophase of Meiosis I
Prior to fertilization: Metaphase of Meiosis II |
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pH that promotes formation of the different types of stones
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low pH for calcium, cystine, uric acid
neutral and low for calcium high pH for struvite (ammonium, magnesium, phosphate) |
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Normouricemia, hyperuricosuria
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High protein diet
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Hernia that presents lateral to the pubic tubercle and below the inguinal ligament
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Femoral
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Most common location for choriocarcinoma metastasis?
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Lungs
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RCC paraneoplastic syndromes
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EPO
PTH-rp |
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Condylomata lata
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Secondary syphillis
Large, grey, wart-like growths |
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Condyloma accuminata
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Anogenital warts associated w/ HPV 6 & 11
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Cytokines responsible for systemic inflammatory response (shock)
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TNF
IL-1 IL-6 |
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Defective transport of cysteine, ornithine, lysine, and arginine
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Cystinuria
Occurs at PCT Need acid urine AR |
