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78 Cards in this Set
- Front
- Back
What are some risk factors for endometrial hyperplasia?
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PCOS, > 40 years old, estrogen treatment, increased exposure (early menarche, granulosa theca cell, late menopause), nulliparity, obesity, DM (type 2), hypertension
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What does estrogen stimulate?
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endometrial lining and hyperplasia
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What are the causes of cervicitis?
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gardnella vaginalis, trichomonas vaginalis, candida albicans, and chlamydia trichomatis
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What is associated with HPV?
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inhibition of tumor suppressor genes p53 and RB
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What is the treatment for low grade CIN (CIN 1)?
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mild dysplasia. cryotherapy, laser, loop electric excision procedure
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What is the treatment for high grade CIN (CIN 2 and CIN 3)?
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cone biopsy
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What are the stages of invasive cervical carcinoma?
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stage 0 = CIS
stage 1 = invasive carcinoma (cervix) stage 2 = cervix + upper vagina stage 3 = pelvic wall stage 4 = pelvic wall + bladder |
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What are the benign uterine disorders?
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endometrial polyps, PCOS (polycystic ovarian syndrome), endometriosis, uterine leiomyoma,
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What is the cause of polycystic ovarian syndrome?
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EXCESS LH
-->stimulates ovarian theca cells (produce androgen) -->androgen causes acne and hirtuism & estrogen -->estrogen inhibits ant pituitary ( decreased FSH) |
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What are some causes of anovulatory periods?
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pregnancy and polycystic ovarian syndrome
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Patient presents w/ infertility, amenorrhea, oligomenorrhea, acne, and hirstuism, obesity, and diabetes. What does the patient have?
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polycystic ovarian syndrome
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Patient has dysmenorrhea, dyschezia (difficulty in defecating), and dyspareunia. What does the patient have?
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endometriosis (chocolate cysts may also be present)
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Black patient has a biopsy and shows "whorled pattern of smooth muscle bundles" and abnormal menstrual bleeding. What is the cause?
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uterine leiomyoma ie fibroma (benign, estrogen sensitive masses). In reproductive females
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What are some side effects of having uterine leiomyoma?
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urinary frequency, impaired infertility, increased risk of spontaneous abortion, postpartum hemorrage
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What is the genetic component for a "complete mole"?
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completely paternal
2 "X" chromosome, containing sperm that have fertilized one ENUCLATE ovum **higher risk for malignancy than incomplete mole (immature) |
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What is the genetic components of an incomplete mole?
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ovum with 2 or more sperm. paternal and maternal genetic material. Yielding-->triploidy, tetraploidy
**lower risk for malignancy (than complete mole) |
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Patient has cystic swelling of villi (grape like cysts) with trophoblastic proliferation with VERY high levels of beta-HcG. What is the dz?
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hydatidiform mole
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What is choriocarcinoma?
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malignant neoplasm of trophoblastic cells (placenta) in ovary or testes
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What are some causes of choriocarcinoma?
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retained gestational trophoblast, retained placenta from deliver or placenta, spontaneous
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What are the 3 benign breast cancers
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fibroadenoma (most common)
phyloiddes tumor (+ 60 yo) intraductal papilloma (nipple discharge) |
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What are the most common malignant breast cancers?
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ductal carcinoma, lobular carcinoma, paget's dz of the nipple
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What are the 5 types of ductal carcinoma in situ?
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comedocarcinoma (solid sheets of malignant cells)
solid cribriform (nests) papillary micropapillary |
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Patient has "scirrhous" (hard) mass that is fixed. The skin is peau d'orange with nipple retraction, dimpling. What is the dz?
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invasive ductal carcinoma
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Patient has bilateral masses in the breast with signet ring cells.
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Lobular Carcinoma
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What breast cancer is associated with BRCA 1 mutation?
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medullary carcinoma
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What breast cancer has a gelatinous consistency?
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colloid (mucinous) carcinoma
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What is the MC mass in the breast associated with calcifications?
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ductal carcinoma in situ
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What are the oncogenes associated with breast cancer?
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c-erb-B2 (HER-2/neu)
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What are the tumor suppressor genes associated with breast cancer?
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BRCA-1, BRCA-2, p53
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Glossitis
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B2 or B12 deficiency
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Cheilosis
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drying and scaling of the lips
B2 deficiency |
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Smooth beefy red tongue
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B12 deficiency
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Strawberry tongue--white coated tongue with bumps
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scarlet fever (due to strep pyogenes),
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What are the three locations of esophageal diverticula?
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above UES--ZENKER
midpoint--TRACTION above LES--EPIPHRENIC |
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Where does chronic gastritis type A due to autommune response and glandular atrophy normally occur?
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fundus (top part of the stomach),
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Where does chronic gastritis type B due to H pylori normally occur?
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antrum (bottom)
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What disorders are associated with chronic gastritis A?
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autoimmune-->hashimotos disease, addisons, vitiligo
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What are the major types of intestinal polyps?
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hyperplastic
hamartomatous inflammatory lymphoid adenomatous (malignant) |
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What type of polyps form with hamartomaous polyps (overgrowth in natural area)?
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Peutz Jeghers syndrome (autosomal dominant)
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What are the three types adenomatous polyps (neoplastic)?
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tubular
villous (worst) tubulovillous |
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Hyperpigmentation of lips, palms and soles. Polyps with risk of colon cancer.
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Peutz Jeghers Syndrome
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What is the cause of familial polyposis syndrome of the colon (autosomal dominant)?
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loss of tumor suppressor gene, APC
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classic familial polyposis syndrome colon polyps + benign mandible and skull tumors + epidermal cysts + high risk abnormal dentition
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Gardner's Syndrome (autosomal dominant)
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classic FAP colon polyps + malignant brain tumors
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Turcot's syndrome (autosomal dominant)
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colon malignancies in multiple sites, NO polyps, no association with adenomas
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hereditary non-polyposis colorectal cancer syndrome (defective DNA mismatch repair)
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What are the two molecular mechanisms in which colon cancer develops?
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1. APC/Beta-catenin pathway
-->APC becomes inactivated 2. k-RAS (oncogene) -->k-RAS mutated and p53 is inactivated |
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What medications are colon cancer protective?
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NSAIDS and aspirin
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What are some S/S of right colonic cancer?
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INCREASED bleeding
hemorrage, hemoccult stool, iron-deficiency anemia |
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>50 yo with iron deficiency anemia
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colon cancer (MUST do the work up)
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What are the S/S of left colon cancer?
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crampy, discomfort, tenesmus (spasm, feels like they need to use the restroom)
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MC mets from the colon
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liver and lungs
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What is the MC site for diverticulums (outpouchings)?
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sigmoid colon
-due to high pressure |
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Painless + hemooccult stool
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diverticulosis
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How do you diagnose a diverticulosis?
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barium enema, xray or colonscopy
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LLQ pain, (-) hemoocult stool, inflammation present
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Diverticulitis
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What is the dx and trmnt of diverticulitis?
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Dx-CT
Trmnt-ciprofloxacin, metronidazole |
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What do we use fluorquinolones for?
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G+/G- bacteria, cancer
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recurrent, unpredictable bowel habits (diarrhea an/or constipation), plus abdominal cramping, worse with stress
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irritable bowel syndrome
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What is the treatment for Crohn's dz?
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anti-inflamm-->sulfsalazine, 5-ASA
vit B12 metroniadazole plus corticosteroids |
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What is the treatment for ulcerative colitis?
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anti-inflamm-->sulfsalazine or 5-ASA +/- immunsuppresives (6-MP, methotrexate, azathioprine)
bowel rest |
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Patient has transmural skip lesions (rectum spared) with granulomas (non-caseating), ulcers, strictures/fistulas/fissurs
+ string sign. Painful. |
Crohn's dz
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Patient has mucosa/submucosal continous lesions with pseudopolyps. Lead pipe colon (xray). Bleeding.
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Ulcerative Colitis
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What is the gold standard stool test?
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stool fat analysis (qualitative)
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What does the schilling test show us?
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patient has vit B12 deficiency (no B12 in urine)
improves with instrinsic factor-->pernicous anemia (B12 in urine) doesn't improve (B12 in urine)-->pancreatitis, bacteria, dz of ileum |
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chronic diarrhea, steatorrhea, and weight loss in tropical population
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tropical sprue
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anti-gliadin lab with dermatitis herpetiformis. What cancer is the patient is at risk for?
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MALT mucosa-associated lymphoid tissue lymphoma (celiac dz)
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Steatorrhea, arthralgia, fever, PAS +macrophages.
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Whipple's Dz
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What is the trmnt for Whipple's Dz?
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any antibiotic therapy (TMP-SMZ or penicillin) for at least 4-6 months
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What is the most common type of galllstone?
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cholesterol
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What are the risk factors for cholesterol gallstones?
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female, fertile, fat, fourty
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What is a lab that is elevated with biliary disorders?
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alkaline phosphatase (bile duct injury)
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porcelain gallbaldder, asymptomatic
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cholelithiasis
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fever, RUQ pain, murphy's sign
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cholecystitis
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RUQ pain, jaundice, clay-colored stool, tea-colored urine, elevated alk phos, conjugated bilirubin
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choledo-cholithiasis (common bile duct blockage)
-->choledo: common bile duct |
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RUQ pain + jaundice + fever
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charcot's triad, ascending cholangitis
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High levels of unconjugated bilirubin + brain damage in an infant.
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Crigler Najjar: inherited non-hemolytic jaundice, affects metabolism of bilirubin
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Pruiritis + RUQ pain, jaundice, cirrhosis. Labs-elevated conjugated bilirubin and alk phosphatase.
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Primary Sclerosing Cholangitis (intra and extrahepatic ducts affected)
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Pruiritis, jaundice, steatorrhea, xanthelasmas, anti-mitochondrial antibody
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Primary Biliary Cirrhosis (autoimmune destruction intrahepatic ducts)
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