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107 Cards in this Set
- Front
- Back
- 3rd side (hint)
suspensory ligament of the ovaries
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carries ovarian vessels
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cardinal ligament
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carries uterine vessels
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round ligament
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carries 0 vessels.
round # like round. |
from gubernaculum. travels thru inguinal canal
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anti-erection
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NE-->incr Ca-->smooth muscle contraction-->vasoconstriction
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sertoli
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line seminiferous tubules
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leydig
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interstitium
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spermatogonium
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outside blood-testis barrier. 2N diploid.
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primary spermatocyte
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diploid 4N
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androstenedione
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comes from adrenal
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testosterone and androstenedione are converted to
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estrogen by fat cells and sertoli cells by aromatase
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DHT
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early differentiation of penis, scrotum, prostate
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late: prostate growth, balding, sebaceous glands
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pregnancy hormones
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50x increase in estradiol and estrone (most potent)
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1000x increase in estriol (least potent)
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estrogen transport proteins
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increases SHBG, HDL, decr LDL
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theca cell
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LH-->desmolase, which turns cholesterol into androstenedione
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granulosa cell
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FSH stimulates aromatase, which turns androstenedione from theca into estrogen
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mittelschmerz
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blood from ruptured follicle causes peritoneal irritation that can mimic appendicitis
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lactation
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after labor, decrease in progesterone induces lactation
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syncytiotrophoblast
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maintains corpus luteum (and thus progesterone) during first trimester by acting like LH, then placenta makes its own estriol and progesterone and corpus luteum degens
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menopause dx test
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high FSH
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Klinefelters
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testicular atrophy, eunuchoid body, tall, long extremities, gynecomastic, female hair distrubution, sometimes developmental delay.
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Barr body (inactivated x). primary hypogonadism. dysgenesis of seminiferous tubules-->decr inhibin and incr FSH. abnormal leydig--> decr testosterone, incr LH, incr estrogen
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Turner
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short, ovarian dysgenesis (streak ovary), shield chest, BICUSPID aortic valve, webbed neck (cystic hygroma), preductal COARCTATION of aorta
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no barr body. most common cause of primary amenorrhea. incr LH and FSH because no estrogen
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double Y males
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very tall, severe acne, antisocial (1-2%). normal fertility
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androgen insensitivity syndrome
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defect in androgen receptor resulting in normal-appearing female (no uterus/fallopian)
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no sex hair, develops testes (in labia majora). increased T, E, LH
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5 alpha reductase def
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AR. ambig genit til puberty
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T/E norm, LH norm or incr
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kallman syndrome
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decr synth of gonadotropin in ant pit
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anosmia, lack of sec sex char
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SRY gene
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testis-determining factor. tells sertoli to make anti-mullerian and thus parameso (mullerian) degenerates. if no anti-mullerian, than develop both male and female internal genitalia and male external
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hyaditiform mole
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cystic swelling of chorionic villi and prolif of chorionic epithelium (trophoblast). complete moles have snowstorm appearance with no fetus on US. can lead to uterine rupture. tx: D/C or MTX
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abnormal vaginal bleeding. most common precursor to choriocarcinoma. high hCG. honeycombed uterus, cluster of grapes, abnormally large uterus
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complete mole
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46, XX or 46 XY. TONS of hCG, no fetal parts, empty egg. 20% malignant trophoblastic dz
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partial mole
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69XXY, less hCG than complete, less big uterus, choriocarcinoma rarer. fetal parts, maternal DNA, lower risk of malignancy
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causes of recurrent miscarriages
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1st weeks - low progesterone (no response to hCG)
1st trimester - chromosomal abnormalities 2nd trimester - bicornuate uterus |
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HTN before 20 weeks
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molar pregnancy
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ecclampsia
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placental ischemia due to impaired vasodilation of spiral arteries, resulting in increased vascular tone
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cerebral hemorrhage, ARDS
tx: IV Mg and diazepam |
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HELLP syndrome
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ecclampsia. hemolysis, elevated LFTs, Low Platelets
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abruptio placentae
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detachment of placenta. fetal death. DIC.
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smoking, HTN, cocaine
painful bleeding in 3rd trimester |
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placenta accreta
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defective decidual layer allows placenta to attach to myometrium. no separation of placenta after birth
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prior c-section, inflammation, placenta previa risk factors
massive bleeding after delivery |
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placenta previa
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attachment of placenta to lower uterine segment. may occlude internal os.
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multiparity and prior c section predispose
painless bleeding in any trimester |
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ectopic preg
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incr hCG and sudden LQ pain
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retained placental tissue
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postpartum hemorrhage
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polyhydramniosis
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>1.5L fluid. esophageal/duodenal atresia. unable to swallow amniotic fluid. anencephaly.
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oligohydramnios
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<0.5L fluid. placental insuffic, bilateral renal agenesis, or posterior urethral valves (males), no urine. potters.
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endometrial proliferation
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postmenopausal vaginal bleeding
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risk: anovulatory cycles, HRT, PCOS, granulosa cell tumor
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leiomyoma
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whorled pattern of smooth muscle bundles
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Asherman's syndrome
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anovulation due to adhesions
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PCOS
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High LH leads to anovulation. deranged steroid synthesis by theca
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spironolactone can treat hirsutism
high LH, low FSH, high T |
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ovarian germ cell tumors
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adolescents
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dysgerminoma (germ cell)
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malignant, equal to seminoma but rarer. sheets of uniform cells
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hCG, LDH
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choriocarcinoma (germ cell)
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rare, malignant, in preg can be in mom or baby. large hyperchromatic syncytiotrophoblasts. incr freq of theca-lutein cysts.
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hCG
a gestational trophoblastic neoplasia |
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yolk sac (endodermal sinus) tumor (germ cell)
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aggressive malignancy in ovaries (testes in boys) and sacrococcygeal area of young kids. yellow, friable, solid masses. 50% have Schiller-Duval bodies (look like glomeruli)
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AFP
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teratoma (germ cell)
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90% of ovarian germ cell tumors. dermoid cyst (mature) is most freq benign. immature malig. struma ovarii is thyroid.
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serious cystadenoma (non-germ)
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20% of ovarian tumors. freq bilat, lined with fallopian tube-like epithelium. benign.
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CA-125
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general ovarian CA marker
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serous cystadenocarcinoma
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50% of ovarian tumors, malig, can be bilat
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BRCA1 and HNPCC risks
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mucinous cystadenoma
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multilocular cyst lined by mucus-secreting epithelium. benign. intestine-like tissue
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muscinous cystadenocarcinoma
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malig. pseudomyxoma peritonei is intraperit acc of mucin
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Brenner tumor
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benign, looks like bladder
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fibromas
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spindle-shaped fibroblasts.
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Meig's syndrome
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ovarian fibroma, ascites, hydrothorax. pulling sensation in groin
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granulosa cell tumor
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secretes estrogen. can lead to precoc puberty. can cause endometrial hyperplasia/carcinoma in adults. abnormal uterine bleeding
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Call-Exner bodies
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small follicles filled with eosinophilic secretions. granulosa cell tumor
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Krukenberg tumor
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GI malig mets to ovaries. mucin-secreting signet cell adenocarcinoma
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sarcoma botryoides (rhabdomyosarcoma variant)
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affects girls <4, spindle-shaped tumor cells desmin positive
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fibroadenoma
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benign. small, mobile, firm mass with sharp edges. most common tumor <25yo
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incr size and tender with E
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intraductal papilloma
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benign. small tumor in lactiferous ducts. beneath areola
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serous or blood nipple discharge. slight incr in risk for carcinoma
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phyllodes tumor
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benign. large bulky mass of connective tissue and cysts. leaf like projections. most common in 6th decade.
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some can be malig
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malig breast tumors
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common post-meno. from mammary duct epi or lubular glands.
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risks: incr E, incr menstrual cycles, older age at first birth, obesity
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ductal carcinoma in situ
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malig. fills ductal lumen. from hyperplasia
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no BM penetration
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invasive ductal
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firm, fibrous, rock hard mass with sharp margins and small, glandular, duct-like cells
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worst, most invasive. most common (76%) breast cancer
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invasive lobular
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orderly row of cells
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multiple, bilateral
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medullary
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fleshy, cellular, lymphocytic infiltrate
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good prog
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comedocarcinoma
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ductal, caseous necrosis, DCIS subtype
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inflammatory
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dermal lymphatic invasion by breast carcinoma. peau d'orange. lymph drain blocked
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50% survival at 5 years
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paget's dz
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eczematous patches on nipple. large cells in epidermis with clear halo
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suggest underlying carcinoma. also on vulva
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fibrocystic dz
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most common cause of breast lumps from age 25 to menopause. premenstrual pain, bilateral, size changes.
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types: fibrosis (hyperplasia of stroma), cystic (fluid filled blue dome, ductal dilation), sclerosing adenosis (incr acini and intralob fibrosis. calcifications), epithelial hyperplasia (incr # epi cell layers in terminal duct lobule. incr risk carcinoma, >30)
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acute mastitis
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breast abscess (feeding), s aureus can infect
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far necrosis
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benign painless lump from injury
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gynecomastia
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hyperE (cirrhosis, testes tumor, puberty, old), Klinefelters, drugs (E, THC, heroin, psychoactive) Spironolactone, Digitalis, Cimetidine, Alcohol, Ketoconazole
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Some Drugs Create Awesome Knockers
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BPH
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hyperplasia
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prostatic adenocarcinoma
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peripheral zone. decr fraction of free PSA
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cryptorchidism
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prematurity a risk
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testicular germ cell tumors
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95% of testicular tumors
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seminoma (germ)
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malig, painless, homogeneous enlargement, most common 15-35. large cells in lobules with watery cytoplasm. fried egg.
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radiosens. late mets, good prog
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embryonal carcinoma (germ)
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malig, pain, worse prog than seminoma. glandular/papillary morphology. high AFP, hCG
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yolk sac (endodermal sinus) tumor (germ)
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yellow, mucin. Schiller-Duval bodies. incr AFP
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choriocarcinoma (germ)
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malig, incr hCG. disorder syncytio and cytotropho elements. hematog mets
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teratoma
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mature malig
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testic non-germ
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5% of test tumors, most benign
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leydig cell tumor
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benign. contains reinke crystals, usu androgen producing. golden brown color
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gynecomastia or prec pub
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sertoli cell tumor
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androblastoma from sex cord stroma
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testicular lymphoma
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older men
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tunica vaginalis lesions
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varicocele (dilated pampiniform plexus, bag of worms, can cause infert). hydrocele (fluid from incomplete fusion of processus vaginalis) spermatocele (dilated epididymal duct)
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Bowen's dz
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CIS. gray, solitary, crusty plaque on shaft
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5th decade, invades <10%
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erythroplasia of queyrat
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red velvey plaques of glans
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like bowens
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bowenoid papulosis
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papular lesions
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younger, less invasive
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SCC of penis
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Asia, Africa, S Am.
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HPV, lack of circumcision
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Peyronies
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fibrous tissue
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ketoconazole
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inhibits p450
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anastrozole
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inhibits aromatase
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leuprolide
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use for prostate ca, fibroids
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tox: antiandrogen, N/V
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Testosterone
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stim anabolism after burns, ER+ breast CA
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tox: premature close of epiphys, incr LDL, decr HDL
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flutamide
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nonsteroidal comp inhib at T receptor. prostate CA
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ketoconazole, spironolactone
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inhibit steroid synth (K), binding (S)
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prevent hirsutism in PCOS. cause amenorrhea and gynecomastia
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estrogen use in men
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androgen-dep prostate CA
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clomiphene
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SERM. partial agonist.
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can cause hot flash, ovarian enlarge, multiple simult preg, vision prob
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anastrozole/exemestane
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used in post-meno breast CA
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ritodrine/terbutaline
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beta agonists relax uterus, reduce premature contractions
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tamsulosin
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alpha 1 antag for BPH by inhib SM contract
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viagra
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inhibit cGMP phophodiesterase
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tox: HA, flush, dyspepsia, impaired blue-green vision, hypotension if nitrates
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