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Reproductive

FA review Round 1 2020

QuestionAnswer
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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