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MC Reproduction
Reproduction
| Question | Answer |
|---|---|
| enzyme deficiency causes inadequate production of DHT | 5-alpha reductase deficiency |
| 46XY, testes, female external genitalia | Complete androgen insensitivity |
| Ovaries, masculinization of the external genitalia | Congenital adrenal hyperplasia |
| Muscle forming the floor of the pelvis | pelvic diaphragm |
| Muscular sling for the rectum | levator ani |
| fat-filled region below the pelvic diaphragm | ischioanal fossa |
| nerve (S2, S3, S4) | Pudendal nerve |
| selectively inhibits PDE5 | sildenafil, vardenafil, tadalafil |
| synthetic prostaglandin E1 (PGE1) | aprostadil |
| aprostadil | increases cAMP which causes SM relaxation |
| urethra opens onto the ventral surface of the penis | hypospadias |
| prepuce orifice is too small to be retracted normally | phimosis |
| thick ulcerated plaque on the shaft of the penis and scrotum; carcinoma in situ | Bowen's disease |
| plaque progressing to an ulcerated papule or fungating growth; metastases to local lymph nodes; HPV 16 and 18 | Squamous cell carcinoma |
| urinary problems and a palpable mass on DRE | Prostatic carcinoma |
| elevated PSA together with an enlarged prostate on DRE | Prostatic carcinoma |
| formation of large nodules in the periurethral region of the prostate | BPH |
| most common pathogen causing prostatitis | E. Coli |
| androgen receptor antagonist | flutamide |
| androgen receptor antagonist and K+ sparing diuretic | spironolactone |
| GnRH analog | leuprolide |
| 5-alpha reductase inhibitor | finasteride |
| inhibits steroid hormone synthesis | ketoconazole |
| treatment for prostate cancer | flutamide |
| treatment for hirsutism | spironolactone |
| treatment for BPH | finasteride |
| treatment for androgen receptor-positive prostate cancer | ketoconazole |
| evagination of parietal peritoneum that descends through the inguinal canal during fetal life | processus vaginalis |
| patent remnant of the processus vaginalis | tunica vaginalis |
| accumulation of serous fluid in the tunica vaginalis | hydrocele |
| conveys sperm from the epididymis to the ejaculatory duct | ductus deferens |
| origin of the testicular artery | from the abdominal aorta between L2 and L3 |
| origin of the artery to the ductus deferens | branch of the iliac artery |
| drainage of the right testicular vein | IVC |
| drainage of the left testicular vein | L renal vein |
| LN that drain the testis | lumbar nodes |
| afferent arm of the cremasteric reflex | ilioinguinal nerve |
| efferent arm of the cremasteric reflex | genitofemoral nerve |
| failure of normal descent of testes into the scrotum | cryptoorchidism |
| most common location of a cryporchid testis | inguinal canal |
| sudden onset of testicular pain and loss of cremasteric reflex | torsion of testis |
| dilation of tributaries of testicular vein in pampliniform plexus | varicocele |
| location of the spermatogonia | in the seminiferous tubules adjacent to the basement membrane of the Sertoli cells |
| maturation of spermatids into mature spermatozoa | spermiogenesis |
| hydrolytic enzyme-containing region on the sperm cell head | acrosome |
| reduced sperm motility; bronchiectasis | Kartagener's sydrome |
| protein that aids sperm motility | forward motility factor |
| sperm near to the corona radiata release hyaluronidase | acrosome reaction |
| sperm bind to a glycoprotein and release acrosin | zonal reaction |
| sperm fuses with the plasma membrane of the ovum and causes a Ca2+ dependent release of granules | cortical reaction |
| hormome released from the preoptic nucleus | GnRH |
| constant GnRH stimulation | downregulation of GnRH receptors in the anterior pituitary |
| stimulates the conversion of cholesterol to testosterone in the Leydig cells | LH |
| increases transcription of androgen-binding protein and growth factors mediating spermatogenesis in the Sertoli cells | testosterone |
| stimulates transcription of androgen-binding protein, conversion of testosterone to estradiol and secretion of inhibins in the Sertoli cells | FSH |
| orchitis develops in 25% of patients over age 10, but is less common under age 10 | Mumps |
| neglected urethral infection may spread to prostate, seminal vesicles, and epididymis, but rarely the testes | gonorrhea |
| may involve testes; gummas or diffuse interstilial/lymphocytic plasma cell infiltrate; sterility | syphilis |
| spreads from epididymis; associated with another foci of infection | TB |
| most common germ cell tumor in men 40+ | seminoma |
| most common germ cell tumor in men 20-30 | embryonal carcinoma |
| marker associated with embryonal carcinoma | AFP |
| radiosensitive germ cell tumor | seminoma |
| highly malignant germ cell tumor in men 15-25; metastasizes hematogenously; associated with testicular enlargement or gynecomastia | choriocarcinoma |
| marker of choriocarcinoma | elevated urine and serum hCG |
| rare germ cell tumor more common in children and infants | yolk sac tumor |
| germ cell tumor in children with nerve, muscle, cartilage and hair | teratoma |
| golden-brown testicular tumor that produces androgens and estrogens; gynecomastia in adults and masculinization or femininization in children | Leydig cell tumor |
| gray-white to yellow testicular tumor secretes small amounts of hormones, presents with testicular enlargement, microscopically forms cordlike structures resembling seminiferous tubules | Sertoli cell tumor |
| most common testicular cancer in elderly men | lymphoma |
| scrotal neoplasm nodes | superficial inguinal lymph nodes |
| testicular neoplasm nodes | lumbar lymph nodes |
| stimulates production of androstenedione/testosterone in the theca cells | LH |
| stimulates production of progesterone in the granulosa cells during the luteal phase | LH |
| stimulates aromatization of androgens to estradiol and synthesis of new LH receptors in the granulosa cells | FSH |
| stimulates the production of inhibin in the granulosa cells which inhibits the pituitary secretion of LH/FSH | FSH |
| inhibits the hypothalamic and pituitary secretion of GnRH and LH/FSH | estradiol |
| arrested in prophase I of meiosis until maturation | primordial follicle |
| secretes estrogen and progesterone; reaches max development 7 days after ovulation; maintained by hCG for three months | corpus luteum |
| proliferation of endometrial cells, increase in length and number of glands and increased blood flow to uterus | proliferative phase, estrogen |
| endometrial cell hypertrophy, increased vascularity, and edema | secretory phase, progesterone |
| increased uterine contractility | proliferative phase, estrogen |
| decreased uterine contractility | secretory phase, progesterone |
| constriction of arteries causing ischemia and anoxia, superficial layer of endometrium degenerates | premenstrual phase, decreased estrogen and progesterone |
| location of fertilization | ampulla |
| hCG is synthesized by the blastocyst | 8-12 days after fertilization |
| stimulate the development of the mammary glands for lactation while preventing milk production | progesterone and estrogen |
| stimulates milk production | prolactin |
| stimulates milk ejection | oxytocin |
| prevents pregnancy if used within 72 hours after intercourse | unopposed estrogens, unopposed progestins, combination pills, mifepristone |
| estrogen antagonist in breast; agonist in endometrium and bone | tamoxifen |
| partial estrogen agonist in bone, antagonist in breast and uterus | raloxifene (You can relax with ralox because you won't get endometrial cancer). |
| nonsteroidal agent that selectively blocks estrogen receptors in the pituitary, increasing FSH and LH | clomiphene |
| inhibits ovarian steroid synthesis | danazol |
| therapeutic used in endometriosus and fibrocystic breast disease | danazol |
| aromatase inhibitor used in breast cancer | anastrozole |
| progesterone and glucocorticoid antagonist | mifepristone |
| verrucous, wart like lesions; koilocytosis, acanthosis, hyperkeratosis and parakeratosis | condyloma acuminata |
| HPV 6 and 11 | condyloma acuminata |
| benign tumor similar to an intraductal papilloma of the breast | papillary hidradenoma |
| erythematous, crusted rash of the labia majora; intraepidermal malignant cells with pagetoid spread | extramammary Paget disease of the vulva |
| erthema, thick white discharge | candida vulvovaginitis |
| benign precursor of clear cell carcinoma | vaginal adenosis |
| females exposed to diethylstilbestrol in utero | clear cell adenocarcinoma |
| polypoid, grapelike soft tissue masses protruding from the vagina | embryonal rhabdomyosarcoma |
| spindle-cell tumor, may show cross-striations, positive for desmin, indicating skeletal muscle origin | embryonal rhabdomyosarcoma |
| Fitz-Hugh-Curtis syndrome | PID |
| HPV 16, 18 | cervical carcinoma |
| Associated with pregnancy or abortions, PID and IUDs | endometritis |
| Ureaplasma, Peptostreptococcus, Gardnarella, Bacteroides, GBS and C. trachomatis all cause | endometritis |
| presence of endometrial glands and stroma outside the uterus | endometriosis |
| red-brown serosal nodules ("powder burns")and ovarian chocolate cysts | endometriosis |
| benign smooth muscle tumor that grows in response to estrogen | leiomyoma |
| well-circumscribed, rubbery white-tan whorled masses | leiomyoma |
| most common malignant tumor of the female genital tract | endometrial adenocarcinoma |
| tan polypoid endometrial mass | endometrial adenocarcinoma |
| young, hirsute, obese females | PCOS |
| elevated LH, low FSH, elevated testosterone | PCOS |
| bilaterally enlarged ovaries with multiple follicular cysts | PCOS |
| most common benign ovarian tumor; unilocular cyst with simple serous or mucinous lining | cystadenoma |
| most common malignant ovarian tumor; complex multiloculated cyst with sold areas | cystadenocarcinoma |
| ovarian tumor containing cysts with serous or mucinous lining with tufting; papillary structures with psammoma bodies | cystadenocarcinoma |
| cystadenocarcinoma marker | CA 125 |
| risk factors for cystadenocarcinoma | BRCA-1 and Lynch syndrome (HNPCC) |
| production of mucous in the abdominal cavity | pseudomyxoma peritonei |
| germ cell tumor containing primitive cells | immature teratoma |
| risk factors for dysgerminoma | Turner syndrome, pseudohermaphroditism |
| malignant germ cell tumor that affects young women | dysgerminoma |
| ovarian fibroma, ascites, pleural effusion | Meig's syndrome |
| solid yellow ovarian tumor; polygonal cells with formation of follicle-like structures (Call-Exner bodies); produces estrogen which leads to postmenopausal bleeding | granulosa cell tumor |
| androgen producing ovarian tumor, presents with virilization | Sertoli-Leydig cell tumor (androblastoma) |
| size greater than dates, vaginal bleeding, passage of edematous, grape-like tissue, elevated beta-hCG | hydatidiform mole |
| results from fertilization of an ovum that lost all its chromosomal material | complete mole |
| results from fertilization of an ovum by two sperm | partial mole (triploid) |
| malignant germ cell tumor; hemorrhagic, necrotic; containing cytotrophoblasts, intermediate trophoblasts, and syncytiotrophoblasts | choriocarcinoma |
| dense rubbery mass in the UOQ of the breast, unilateral, increase in breast stromal connective tissue, cysts are rare, not premalignant, 35-49 | fibrosis |
| serous cysts in the breast that are firm to palpation, hemorrhagic, multifocal, bilateral; cysts lined with cuboidal epithelium, papillary projections, premalignant, 45-55 | cystic disease (chronic cystic mastitis=stromal lymphocytic infiltrate) |
| palpable, ill-defined, firm area most often in UOQ of the breast, unilateral, mass has a glandular patterns of cells in a fibrous stroma, 35-45 | sclerosing adenosis |
| ill-defined breast masses, ductal epithelium is multilayered and produces glandular or papillary configurations, premalignant, 30+ | epithelial hyperplasia |
| most common benign breast tumor, single movable nodule, UOQ, round and encapsulated with a gray-white cut surface, mass has glandular epithelial-lined spaces in a fibroblastic stroma | fibroadenoma |
| fibroadenoma-like tumors of the breast that have become large, cystic, and lobulated; malignant fibrous, cartilagenous, or bony elements may be present in mass | cystosarcoma phyllodes |
| subareolar tumor in ducts of the breast that cause bloody or serous nipple discharge | intraductal papilloma |
| tumor suppressor genes increase risk for breast cancer | BRCA1 and BRCA2 |
| rock hard, cartilagenous, 2-5cm, foci of necrosis and calcification in the breast, anaplastic duct epithelial cells invade stroma | infiltrating ductal carcinoma |
| form of ductal carcinoma in situ involving areolar skin and nipple; large anaplastic, hyperchromatic cells; older women | Paget's disease of breast |
| duct epithelial cell proliferation, ductal dilation; cheesy necrotic tumor tissue expressed from ducts | noninfiltrating intraductal carcinoma |
| fleshy mass in the breast, 5-10cm, little fibrous tisue, foci of hemorrhage; sheets of large, pleomorphic cells with increased mitotic activity and a lymphocytic infiltrate | medullary carcinoma |
| soft, gelatinous breast tumors; islands of tumor cells with copious mucin; older women | colloid carcinoma |
| multicentric, estrogen + breast tumors, arise from terminal ductules, rubber and ill-defined mass; cells small and arranged in rings | lobular carcinoma |
| fissures in nipples during early nursing predispose to bacterial infection | mastitis |
| pain, redness, and induration around the areola with thick secretions; 50+ yo | mammary duct ectasia |
| Klinefelter, testicular tumors, puberty, old age | gynecomastia |
| GN diplococci in PMNs in urethral exudate | N. gonorrhea |
| Invasive, pili, antigenic variation, antiphagocytic, IgA protease | N. gonorrhea |
| growth on thayer-martin agar, DNA probes | N. gonorrhea |
| Tx for N. gonorrhea infection | ceftriaxone |
| culture (-), inclusion bodies | C. trachomatis |
| obligate intracellular in epithelial cells, CMI and DTH cause scarring | C. trachomatis |
| tissue culture, glycogen-containing inclusion bodies in cytoplasm | C. trachomatis |
| Tx for C. trachomatis | tetracycline/doxycline, erythromycin |
| flagellated protozoa with corkscrew motility | T. vaginalis |
| Tx for T. vaginalis | metronidazole |
| friable, inflamed cervix with mucopurulent discharge | N. gonorrhea, C. trachomatis, HSV |
| Tx for HSV | Acyclovir |
| adherent, yellowish discharge, pH>5, fishy amine odor in KOH | bacterial vaginosis |
| bacterial vaginosis pathogen | Gardnarella vaginalis |
| Clue cells, GNR | G. vaginalis |
| Tx G. vaginalis | metronidazole |
| vulvovaginitis, pruritis, erythema, cottage-cheese discharge | Candida |
| Germ tube test, gram (+) yeast in vaginal fluids | Candida |
| Tx for Candida | Nystatin, miconazole |
| Strawberry cervix, foamy, purulent discharge; many PMNs and motile trophozoites | T. vaginalis |
| Pear-shaped trophozoites with corkscrew motility | T. vaginalis |
| Papillary wart-like lesions, sessile or pedunculated; koilocytotic atypia | HPV |
| Proteins E6 and E7 inactivate cellular antioncogene | HPV |
| dsDNA, naked, icosahedral, intranuclear inclusion bodies | HPV |
| multiple, painful, vesicular, coalescing recurring | HSV |
| latent virus in sensory ganglia, reactivates | HSV |
| virus culture, intranuclear inclusions, syncytia, dsDNA, enveloped,icosahedral | HSV |
| painless chancre; heals 1-8 weeks | Primary syphilis |
| 2-8 weeks after chancre; flu-like symptoms, local or generalized rash lasting 1-3 months, palms and soles; condyloma lata | Secondary syphilis |
| gummas in liver, testes, bones; CNS; cardio | Tertiary syphilis |
| tabes dorsalis | neurosyphilis |
| obliterative endarteritis of vasa vasorum of the aorta can lead to thoracic aneurysm | Tertiary syphilis |
| VDRL and FTA-ABS | T. pallidum |
| Tx for T. pallidum | penicillin |
| nonindurated, painful ulcer, suppurative with adenopathy, slow to heal | Haemophilus ducreyi |
| GNR, chocolate agar (NAD and hemin) | H. ducreyi |
| Tx for H. ducreyi | Cefotetan, ceftriaxone |
| Initial papule heals, LNs enlarge and develop fistulas, genital elephantiasis | Lymphogranuloma venereum |
| Lymphogranuloma venereum | C. trachomatis serotypes L1-3 |
| ulcerating lesion in or near the nipple with malignant glandular cells in epidermis | Paget's disease of breast |
| suspect in young, athletic women with dysfunctional uterine bleeding | anovulation |
| test of anovulation | progestin challenge |
| tumors composed of sheets of uniform polyhedral cells with intervening fibrous septa of connective tissue, lymphocytes and multinucleated giant cells | dysgerminomas, rare, 30s seminomas, common, 40s |
| recurrent miscarriages in the first trimester | chromosomal abnormalities |
| Granulosa cells begin to express LH receptors | midcyle, graafian follicle transitions to a functional corpus luteum |
| Pouch of Douglas | rectouterine space |
| Avoid anticholinergic agents | BPH, anti-SLUDG (salivation, lacrimation, urination, defecation, GI) |
| HER2 EGF receptor blocker | trastuzumab |
| elevated testosterone, decreased GnRH, Leydig cell hyperplasia, seminiferous tubules don't develop, low FSH | incomplete precocious puberty |
| constitutively active LH receptors | incomplete precocious puberty |
| cystic tumor of ovary with cytological atypia and architectureal disorganization of epithelium without frank invasion of stroma | borderline |
| endometrial glands within the myometrium of the uterus | adenomyosis |
| indicator of fetal well being | estriol: 16-OH DHEA-S from the fetal adrenal cortex and liver is converted to estriol in the placenta |
| decreased estrogen, increased LH, increased FSH, increased GnRH | menopause |
| Spermatogenesis | spermatogonia --> primary spermatocytes --> secondary spermatocytes --> spermatids --> spermatozoa |
| Otherwise normal male with a small uterus | Mullerian inhibitory deficiency |
| testicular mass containing endodermal sinuses that resemble primitive glomeruli | yolk sac tumor |
| second and third trimester pregnancy losses | chorioamnionitis |
| third-trimester pregnancy losses | abruptio placentae and placenta previa |
| Have 2% risk of developing choriocarcinoma | complete mole |
| signet ring cells | Krukenberg tumor |
| ovarian metastasis of a gastric mucin-producing adenocarcinoma | Krukenberg tumor |
| yellow, mucinous testicular mass | yolk sac tumor |
| dysfunctional uterine bleeding and endometrial hyperplasia with or without atypia | anovulatory cycles, unopposed estrogenic stimulation |
| progesterone and 17-beta estradiol decrease; LH and FSH are low and begin rising; body temperature falls | menstruation |
| clinical indication of premature menopause | reduced inhibins: the ovary stops responding normally to pituitary hormones, causing decreased production of sex steroids |
| effect of low levels of estrogen and high levels of estrogen on the hormones of the anterior pituitary | inhibit FSH; stimulate FSH and LH |
| hormone that stimulates maternal IGF-1 secretion so that the fetus can receive more glucose and amino acids "anti-insulin effects" | hGH |
| testicular tumor with syncytiotrophoblasts and cytotrophoblasts | choriocarcinoma |
| testicular tumor with sheets of undifferentiated cells with focal glandular differentiation | embryonal carcinoma |
| testicular tumor with large cells that have watery cytoplasm | seminoma |
| testicular tumor with endodermal sinuses that resemble primitive glomeruli | yolk-sac tumor |
| mixed tumor | testicular tumor with cells that differentiate along other testicular cell lines |
| cause of inflammatory breast cancer | dermal lymphatic invasion by breast cancer cells |
| aromatase inhibitor | exemestane |
| contents of prostatic secretions | zinc, citric acid, acid phosphatase, calcium, clotting enzymes, proteolytic enzymes, proteins, and profibrinolysin |
| predisposes to endometrial adenocarcinoma | complex hyperplasia with atypia |
| protein necessary for the transport of cholesterol from the outer to the inner membrane in the adrenals and gonads | steroidogenic acute regulatory protein (StAR) |
| StAR deficiency | congenital lipoid adrenal hyperplasia: adrenal insufficiency and male pseudohermaphroditism |
| hyalinized seminiferous tubules without sperm | Klinefelter syndrome |
| 17q | BRCA-1 |
| BRCA-1 chromosome | 17q |
| primary oocyte surrounded by one or more layers of cuboidal-like granulosa cells | primary follicle |
| appearance of the antrum | secondary follicle |
| oocyte surrounded by a single layer of flattened follicular cells | primordial follicle |
| follicle extends through the entire cortex and bulges out at the ovarian surface | graafian follicle |
| a single fertilized egg divides into two at the blastocyst stage | monozygotic twins |
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