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MC Reproduction

Reproduction

QuestionAnswer
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
Created by: chessia