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Reproductive
FA review Round 1 2020
| Question | Answer |
|---|---|
| Which HPV strains are associated with Cervical cancer? | HPV 16 & 18 |
| Which tumor suppressor genes are inhibited by cervical cancer HPV strains? | p53 and Rb tumor suppressors |
| Which HPV strain inhibits p53 tumor suppressor? | HPV 16 |
| Which HPV strain inhibits Rb tumor suppressor? | HPV 18 |
| HPV 16 inhibition of p53 tumor suppressor causes: | Inhibition of E6 gene |
| Which gene is inhibited by the actions caused by HPV 18 on Rb tumor suppressor? | Inhibition of E7 gene |
| What tumor characteristic is used to grade the severity of HPV-causing cervical cancer? | Extent of epithelial invasion on cervical biopsy |
| What are the grading scales used for Cervical carcinoma? | CIN 1, CIN 2, and CIN 3. |
| What is the extension of CIN 1 cervical cancer? | 1/3 invasion of epithelial cervical cells |
| What is the most common pathogen that causes Lactation Mastitis? | S. aureus |
| Classical presentation of Lactational mastitis: | Swelling, tenderness, fever, and formation of abscess and drainage of pus from the nipple |
| C. trachomatis or N. gonorrhea infection of the female reproductive organs | PID |
| What pathogen infections are the MCC of PID? | C. trachomatis and N. gonorrhea |
| What is the the treatment for PID? | Ceftriaxone and Doxycycline |
| Clinical features of PID: | - Purulent vaginal discharge - Severe abdominal tenderness and discomfort on bimanual examination of cervix - Adnexal masses |
| What is an Adnexal mass? | Growth that occurs near the uterus, ovaries, Fallopian tubes, and connecting tissues |
| What other conditions are often seen in PID patient? | Salpingitis, Endometritis, Hydrosalpinx, and Tubo-Ovarian abscess formation |
| Which infection does the "R" in ToRCHes stands for? | Rubella |
| What are the baby (congenital) defects due to Rubella infection? | PDA, Cataracts, Hepatosplenomegaly, and sensorineural hearing loss |
| Which ToRCHes infection show congenital sensorineural hearing loss? | Rubella |
| What are the mother clinical features of Rubella infection while pregnant? | Rash, lymphadenopathy, polyarthritis, and polyarthralgia |
| What are Fibrocystic breast changes? | One of the MCC of breast lumps in young women, preventing as multiple bilateral lesions that tend to fluctuate in size with menstruation |
| Which condition of young women is associated with breast mass lumps that increase in size during menstruation? | Fibrocystic changes of the breast |
| What are the histological features of Fibrocystic changes of the breast? | Fibrosis (fibrous stroma), cysts, and proliferation of acini |
| Histological description of Paget disease of the breast: | Large cells with clear "halos" |
| What is the histological description of Comedocarcinoma of the breast? | Central necrosis |
| Which type of neoplasm of the breast is associated with lymphatic involvement? | Inflammatory carcinoma of the breast |
| Which type of breast cancer is associated with Peau de Orange? | Invasive ductal carcinoma of the breast |
| What is the histological description of Invasive ductal carcinoma of the breast? | Sheets fo pleomorphic cells with nuclear atypia, which invade the adjacent stroma |
| What serum level can indicate "Non-functional ovaries"? | Elevated FSH |
| Color of the vaginal discharge due to Trichomonas infection? | Greenish |
| Which female reproductive ligament contains the Ovarian vessels? | Suspensory ligaments |
| True or False. Ovarian ligament contains the Ovarian vessels. | False Ovarian ligament does not contain any structures |
| SERM example: | Tamoxifen |
| What type of drug is Tamoxifen? | SERM |
| What type of breast cancers use Tamoxifen? | ER+ |
| Significant associated adverse effect of Tamoxifen | Induce development of endometrial hyperplasia/cancer with manifest in painless, vaginal bleeding in postmenopausal women |
| How is Endometrial hyperplasia presented in person on Tamoxifen due to breast ER+ cancer? | Painless, vaginal bleeding in postmenopausal women |
| Which type of breast cancer are treated with Trastuzumab? | HER-2(+) |
| What is the associated adverse effect of Trastuzumab? | Cardiotoxicity |
| Monoclonal antibody that binds or attaches to HER-2 protein. | Trastuzumab |
| Invasive carcinoma of the breast is often preceded by? | Carcinoma in situ of the breast |
| What causes the progression from DCIS into Invasive carcinoma of the breast? | Metalloproteinases that allow the degradation of the basement membrane |
| Which enzymes are known to cause the progression of DCIS into invasive carcinoma of the breast? | Metalloproteinases |
| Invasive breast cancer cells are seen with an upregulation or downregulation of CADHERIN? | Downregulation |
| What causes cancer cells in Invasive carcinoma of breast to break off from original site? | Downregulation of Cadherin |
| What proteins ar used by cancer cells, once they break off due to downregulation of cadherin, to new sites? | Laminin and Integrin |
| List of amniotic fluid levels used to diagnose possible trisomies: | 1. AFP 2. Unconjugated Estriol 3. B-hCG 4. Inhibin A |
| What is the quadruple screen of trisomy 18? | AFP, Estriol, and B-hCG are decreased, and only Inhibin A is normal |
| In Edwards syndrome, all levels used to diagnose trisomies are low, except for ________________ that is normal. | Inhibin A |
| Which is the only abnormal amniotic fluid protein level in Trisomy 13 screening? | Decreased B-hCG |
| If AFP, Inhibin A, and Estriol are normal, but B-hCG is decreased, what is the most likely trisomy? | Trisomy 13 |
| In Down syndrome screening, which levels are elevated? | B-hCG and Inhibin A |
| In Down syndrome screening, which CSF protein levels are decreased? | AFP and Estriol |
| - Decreased AFP and Estriol - Increased B-hCG and Inhibin A Dx? | Down syndrome |
| What is endometritis? | Condition in which products of conception are restrained in the uterus and become infected by opportunistic bacteria from the vagina |
| What is the clinical presentation of Endometritis? | Fever, pelvic pain, vaginal discharge and heavy menses |
| Which conditions increase risk of Endometritis development? | 1. After delivery, miscarriage, and abortion, and, 2. Patients with UIDs |
| Common treatment for Endometritis | Gentamicin + Clindamycin (+/-) ampicillin |
| Which bacterial infections cause STIs are often caught in late-stages? | N. gonorrhoeae and C. trachomatis |
| The late identification of N. gonorrhea and C. trachomatis-STIs leads to: | Infection ascending the uterine tubes and into peritoneum causing pelvic pain and tubal scarring consistent with PID. |
| Trichomonas vaginalis infection: | Vaginal itching, greenish vaginal discharge, and strawberry cervix. Not associated with cervical motion tenderness |
| 5-alpha Reductase deficiency leads to: | Failure of normal MALE EXTERNAL genitalia, resulting in Phenotypically female 46 XY |
| What occurs during puberty that leads to physical changes in a person with 5a-Reductase deficiency? | Increase in testosterone in puberty leads to masculinization of genitalia, development of masculine secondary sex characteristics, and accompanied with Primary amenorrhea |
| What is the definition of Efficacy? | Maximal effect a drug can produce |
| What is potency of a drug? | Amount of drug required to reach a given effect |
| A downward shift of a drug Efficacy vs Potency curve means? | Less efficacy |
| A change in efficacy is represented by what type of changes in a curve? | Upward or downward changes |
| A more efficient drug will have _________________ shift in a graphed curve. | Upward |
| A change in potency, either more or less potent, of a drug is represented with what changes in a curve? | Right and Left |
| An more potent drug has a ___________ shift. | Left |
| A less potent drug has a ____________ shift. | Right |
| What is the cause of "Open" neural tube defects (NTDs)? | Defective primary neurulation |
| Which maternal conditions are often associated with Open NTDs? | Maternal diabetes and Folate deficiency |
| How is the AFP in maternal serum in associated with Open NTDs? | Elevated AFP |
| What type of Neural tube defects, Open or Closed, are associated with an elevated AFP level in the mother's serum? | Open Neural Tube defects |
| What are some examples of Open NTDs? | Meningocele, Myelomeningocele, Encephalocele, and Anencephaly |
| Which "Open" neural tube defect is the only one with normal AFP levels? | Spina bifida occulta |
| What is the confirmatory test for NTDs? | Elevated AChE in amniotic fluid |
| An elevated AChE level in amniotic fluid is confirmatory of? | Neural tube defects |
| What is the cause of Closed NTD? | Defective secondary neurulation |
| Missing enzyme in Niemann-Pick disease? | Sphingomyelinase |
| What is the role of Sphingomyelinase ? | Conversion of Sphingomyelin into Ceramide |
| What are the important clinical and histological features of Niemann-Pick disease? | 1. Neurodegeneration 2. Cherry-red spot on macula 3. Foam cells 4. Hepatosplenomegaly |
| What is the distinguishing factor between Tay-Sachs and Niemann-Pick disease? | Niemann-Pick disease develops HEPATOSPLENOMEGALY, which is not seen in Tay-Sachs disease |
| What is probably the strongest risk associated for Cervical cancer? | HPV infection in early life |
| How does HPV infection contributes to development of cervical cancer? | HPV creates products that inhibit tumor suppressor genes, awih allow dysplastic changes to occur in the cell of the cervix |
| What is another name for Primary Ciliary Dyskinesia? | Kartagener syndrome |
| What is the main cause for Kartagener syndrome? | Dynein arm defect that results in impair ciliary function |
| What are the clinical features of Kartagener syndrome? | - Subfertility in women, - Infertility in men - Recurrent URIs - Situs inversus (Dextrocardia) |
| What are Dynein arms? | Heavy chains with coils and stems that attach from a microtubule pair within the axoneme of cilia or flagella toward adjacent pair. |
| What is the main clinical feature of Paget disease of Breast? | Eczematous lesions of the nipple or areola |
| What is the typical histological description of Paget disease of Breast? | Large, halo-like cells |
| In which location of does sperm acquire motility? | In the Epididymis |
| What type of epithelium lines the Epididymis? | Pseudostratified Columnar epithelium with stereocilia |
| Which male genitalia structure is lined with Pseudostratified columnar epithelium with stereocilia? | Epididymis |
| Neutrophils are: | Multilobular, large, spherical azurophilic nuclei |
| From which major artery does the Ovarian artery branch off? | Abdominal Aorta |
| What are common risk factors for Ovarian torsion? | - Ovarian enlargement (pregnancy, tumor, cysts) - Tubal ligation - Physical activity (exercise) |
| What is the most severe ovary torsion symptom? | Ischemia and necrosis to the ovary and possible risk of infertility |
| Another form to refer to Ectopic pregnancy? | Extrauterine Embryo implantation |
| What is a very severe complication of PID? | Extrauterine Embryo implantation |
| What is the MCC of Adenomyosis? | Due to the presence of endometrial glands and stroma within the uterine myometrium |
| What is the main sonography of Adenomyosis? | Diffusely enlarged uterus |
| What are the common clinical features of Adenomyosis? | Menorrhagia, Dysmenorrhea, and pelvic pain |
| Which pathogen causes a sexual tramitted infection due to a gram negative rod? | H. ducreyi |
| What is the natural course of H. ducreyi infection? | Painful erythematous papule turned pustule and eventually painful ulcer. |
| When does a Complete Mole occur? | Haploid sperm replicates with an empty egg |
| What are karyotypes are found in Complete Mole? | 46, XX and 46, XY |
| What are significant features of Complete mole? | Extremely elevated hCG and no fetal parts |
| What causes a Partial mole? | Occurs when the ovum is fertilized with 2 sperm |
| What are karyotypes are associated with Partial mole? | 69 XXY, 69 XYY, and 69 XXX |
| Which type of mole, partial or complete, is seen with minimal to no elevation of h-CG and fetal parts? | Partial mole |
| What causes Menopause? | Results when the ovaries cease to produce Estrogen |
| A decrease of estrogen in menopause causes: | Secondary increase in FSH & LH levels, due to negative feedback on the anterior pituitary. |
| What is the MOA of GnRH agonists? | Constant stimulation of GnRH receptors on the pituitary gland, which initially increases the release of gonadotropins but eventually leads to desensitization and downregulation of the receptors |
| What is the end result of the desensitization of GnRH receptors? | Hypogonadal state resembling menopause |
| What are two common GnRH agonists? | Goserelin and Leuprolide |
| What is the common triad of symptoms associated with Mullerian Agenesis? | 1. Primary amenorrhea by the age of 16 2. Normal secondary sexual characteristics 3. Blind vaginal pouch |
| What is the MCC of Mullerian Agenesis? | Congenital absence of the Paramesonephric (Mullerian) duct in utero |
| Congenital abscess of the Paramesonephric (Mullerian) ducts in utero. Dx? | Mullerian Agenesis |
| Where are Sertoli cells found? | Periphery of the Seminiferous tubules |
| What hormones are produced by Sertoli cells? | ABP and AMH |
| Which cells produce ABP (Androgen binding protein) and AMH? | Sertoli cells |
| Which hormones stimulate Sertoli cells? | FSH |
| What hormone/substance inhibits the function of Sertoli cells? | Inhibin |
| Which hormone stimulate the function of Sertoli cells? | FSH |
| What are clinical features of Paget disease of the Breast? | 1. Unilateral Eczematous patch around the nipple and areola 2. Serosanguinous nipple discharge |
| Which breast condition is seen with bloody nipple discharge? | Paget disease of the Breast |
| What important glycoprotein hormone secreted by the Sertoli cells? | Mullerian-Inhibiting Factor (MIF) |
| What cells secrete MIF? | Sertoli cells |
| What is prevented by MIF? | Prevents the development of the female reproductive orgnas |
| Which protein prevents the development of the female reproductive organs? | Mullerian-Inhibiting Factor (MIF) |
| Painful vaginal bleeding in the 3rd trimester, in a mother that smokes cigarettes. Dx? | Placental abruption |
| What risk factors of Placenta abruptio? | Smoking, trauma, HTN, and cocaine use during pregnancy |
| What is the deficient enzyme in von Gierke disease? | Glucose-6-phosphatase |
| Deficengt Glucose-6-phosphatase. Dx? | von Gierke disease |
| What are some clinical features of von Gierke disease? | Hypoglycemia, seizures, hepatomegaly, lactic acidosis, hypertriglyceridemia, and hyperuricemia |
| An infant with seizures, low blood glucose, elevated triglycerides and uric acid, and lactic acidosis. Dx? | von Gierke disease |
| What is the most common type of testicular cancer in a male between 25-35 years old? | Seminoma |
| Unilateral, hard testicular mass and testicular pain or a "dragging sensation" in a 30 year old man. Dx? | Seminoma |
| What lymph node is associated of Seminoma? | Para-aortic lymph nodes |
| What is an important serum marker of Seminoma? | Placental Alkaline Phosphatase |
| MOA of Fluoroquinolones | Inhibit DNA gyrase |
| What is the most common adverse effect of Fluoroquinolones? | GI symptoms |
| What are some Fluoroquinolone adverse effects? | GI disturbances (MC), rash, tendonitis, and myalgias (children) |
| Failure of fusion of the Urogenital folds during fetal development of a male. Dx? | Hypospadias |
| Which failed to form/fuse properlyHypospadias? | Urogenital folds |
| What does a the Urogenital folds become in a male? | Penile urethra and ventral shaft of penins |
| What does the proper fusion of urogenital folds in women produce? | Labia minora |
| What is the relationship between PDE-5 inhibitors and cGMP? | Increase the amount of cGMP |
| The use of sildenafil increases or decrease the amount of cGMP? | Incrase |
| Do PDE-5 inhibitors increase the amount of Nitric Oxide (NO)? | No, it only enhancers nitric oxide effect |
| Which type of drugs enhance actions of NO but not its actual amount? | PDE-5 inhibitors |
| PDE-5 inhibitors increase levels of cGMP or cAMP? | cGMP |
| What is the immediate effect of OCP therapy? | Change in estrogen concentration during the follicular phase |
| In which phase of the menstrual cycle, does the ingestion of exogenous OCP causes immediate effect (incrase estrogen)? | Follicular phase |
| What is the initial symptom management of PCOS in a teenager with obesity? | Weight loss |
| What causes Bifid scrotum? | Congenital anomaly resulting from malunion of the Labioscrotal swellings during embryogenesis. |
| Which embryological part or area is defective in Bifid scrotum? | Labioscrotal swellings |
| Abnormal labioscrotal swelling development in male embryo leads to: | Bifid scrotum |
Created by:
rakomi
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