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UWORLD
Reproductive
| Question | Answer |
|---|---|
| What is the description of the vaginal discharge in bacterial vaginosis? | Grayish-white and malodorous vaginal discharge |
| What is the MC organism causing bacterial vaginosis? | Gardnerella vaginosis |
| What is the structural composition of Gardanella vaginosis? | Facultative anaerobic gram-variable rod |
| Common facultative anaerobic gram-variable rod | Gardnerella vaginosis |
| What are Clue cells? | Squamous epithelial cells covered with bacteria |
| What is the main finding in Wet Mount microscpy and/or cytology of Gardenella vaginosis? | Clue cells |
| How is the vaginal discharge seen with Vulvovaginal candidiasis? | Thick, white, clumpy vaginal discharge |
| What are some physical features of Vulvovaginal candidiasis? | Vulvovaginal erythema and pruritis |
| What is shape of Candidiasis under wet mount examination? | Pseudohyphae |
| What is used to treat Vulvovaginal candidiasis? | Fluconazole |
| What vaginal infection is often treated with Fluconazole? | Vulvovaginal candidiasis |
| What are the maternal manifestations of Rubella infection? | Maculopapular rash with cephalocaudal progression, joint pain, and Postauricular lymphadenopathy |
| Location of lymphadenopathy of Maternal Rubella infection? | Postauricular lymphadenopathy |
| What are the congenital features caused by Maternal Rubella infection to the fetus? | Sensorineural deafness, cataracts, PDA, and growth restriction (microcephaly) |
| Which TORCHES infection is known to cause deafness to the newborn? | Rubella |
| What is Ectopic pregnancy? | Occurs when embryo implants in a extrauterine location, most commonly the Fallopian tube |
| What are some risk factors for ectopic pregnancy? | 1. Tubal scarring (PID, prior pelvic surgery) 2. Tobacco use 3. In Vitro fertilization |
| What is the most common gross appearance of Mature cystic teratomas? | Multicystic mass containing yellow sebaceous fluid, solid components (teeth, cartilage), and hair |
| What is a possible risk or symptomatic event caused by Mature Teratomas? | Ovarian torsion |
| What part of the prostate develops prostate cancer? | Arises in the peripheral zone of the gland, which abuts the recturm |
| What is the best approach (path) for obtaining a biopsy for Prostate cancer? | Transrectal approach |
| Why is Prostate cancer not seen commonly with urinary symptoms? | Only a small part of the peripheral zone of the prostate encases the distal urethra |
| What is Endometriosis? | Presence of Endometrial glands and stroma outside the uterus |
| What are the symptoms often present in symptomatic endometriosis? | Dysmenorrhea, dyspareunia, and/or infertility |
| What are three causes of abnormal menstrual bleeding? | 1. Fibroids 2. Adenomyosis 3. Endometrial cancer/hyperplasia |
| What are some symptoms associated with Fibroids? | Heavy menses Constipation, urinary frequency, and pelvic pain/heaviness Enlarged uterus |
| What are some symptoms of Adenomyosis? | 1. Dysmenorrhea and pelvic pain 2. Heavy menses 3. Bulky, globular and tender uterus |
| What condition, causing abnormal menstrual bleeding, is associated with a bulky, globular and tender uterus? | Adenomyosis |
| What are some risk factors indicative of increased risk for Endometrial hyperplasia? | Hx of obesity, nulliparity, or chronic anovulation |
| How is the menstrual bleeding of a person with Endometrial cancer or hyperplasia? | Irregular, intermenstrual, or postmenopausal bleeding |
| How is the uterus described by patients of Endometrial hyperplasia? | Nontender uterus |
| What is another name for Uterine fibroids? | Uterine leiomyomas |
| Commonly benign, tumors arising for the uterine myometrium that occur due to monoclonal proliferation of myocytes and fibroblast | Uterine fibroids |
| What leads to development of Uterine Fibroids? | Monoclonal proliferation of myocytes and fibroblasts |
| Which cells undergo monoclonal proliferation, leading to development of Uterine fibroids? | Myocytes and fibroblasts |
| What cells are initially affected by HPV infection in the cervix? | Basal cervical cells |
| What does CIN refer to? | Atypical squamous cells and is classified as low to high grade squamous intraepithelial lesions |
| What does breaching the basement membrane of cervix by HPV infection indicate? | Invasive disease |
| What gives rise to Sertoli-Leydig cell tumors of the Ovary? | Arise from sex cord stroma and secrete testosterone |
| What is secreted by Sertoli-Leydig cell tumors of the Ovary? | Testosterone |
| What are typical features of Sertoli-Leydig cell tumor of the Ovary? | Large ovarian mass and signs of virilization |
| What are histological findings of Sertoli-Leydig cell tumor of the Ovary? | Tubular structures lined by rund Sertoli cells and surrounded by a fibrous stroma |
| What is the most common type of ovarian malignancy? | Epithelial Ovarian cancer |
| What are the main histological findings of Epithelial ovarian cancer? | 1. Anaplasia of epithelial cells with invasion into the stroma 2. Multiple papillary formation with cellular atypia |
| What are "atypical" cells? | Cells that are not normal but are not cancerous. Atypical cells could become a cancer over time or may increase a person's risk of cancer |
| What serum marker is associated with Epithelial ovarian cancer? | CA-125 |
| What type of cancer is indicted by (+) serum marker CA-125? | Epithelial Ovarian cancer |
| What the main two types (cases) of most Testicular cancer? | Seminomatous and Nonseminomatous germ cell tumors |
| What are the Testicular nonseminomatous germ cell tumors composed of? | Partially differentiated germ cells, which often retain the ability to secrete h-CGH and AFP |
| What hormones are secreted by Non-seminomatous testicular cancer? | AFP and human chorionic growth hormone (human-CGH) |
| Which type of testicular tumors, seminomatous or non-seminomatous germ cell tumors, are known to secrete FP and h-CGH? | Nonseminomatous testicular germ cell tumors |
| What is a serum marker for tissue injury and cell turnover? | Lactate dehydrogenase |
| Besides AFP and h-GCH, what other serum marker is often elevated in non-seminomatous testicular germ cell tumors? | Lactate dehydrogenase |
| Which phase of the menstrual cycle is fixed at days? | Luteal phase |
| Which phase of the menstrual cycle is responsible for shorter or longer cycles? | Follicular phase |
| Which hormone is at highest concentration in the Follicular phase? | Estrogen |
| Which hormone is at highest concentration in the Luteal phase of the menstrual cycle? | Progesterone |
| Which 2 hormones during the menstrual cycle have their highest concentration point nearly or at day 14 of the cycle? | LH >> FSH |
| What is the main source of estrogen and progesterone at the beginning of the Follicular phase of the menstrual cycle? | Corpus luteum |
| What is the effect on the pituitary by toe low levels of Estrogen at the beginning of the follicular phase? | Decrease feedback effect on anterior pituitary production of FSH, leading to a slow increase in FSH secretion |
| What is the effect of result of the rising levels of FSH during the Follicular phase? | Stimulation development of several ovarian follicles, eventual causing the emergence of a dominant follicle, which become a site of estrogen synthesis |
| What cells secrete Inhibin? | Granulosa cells |
| What is particular of Inhibin? | Secreted by granulosa cells of the developing ovary and selectively inhibits FSH without affecting LH secretion |
| Does inhibin inhibits FSH and LH secretion? | Inhibin only inhibits secretion of FSH |
| What happens to the Uterus during the Follicular phase? | Estrogen secreted by ovaries stimulates proliferation of endometrial lining of the uterus |
| What triggers the end of the follicular phase? | Plasma estrogen levels reach critical level, leading to switch into positive feedback effect on pituitary by sensitizing gonadotrophs to GnRH, which cause the LH surge |
| How long does the LH surge remains elevated for? | 24 hours |
| What is the cause of pathogenesis of Epithelial ovarian cancer? | The frequency of trauma and repair of the ovarian surface |
| What are protective elements or practices for epithelial ovarian cancer? | Oral contraceptive, multiparity, and breastfeeding, by decreasing frequency of ovulation |
| What are common risk factors for developing Epithelial ovarian cancer? | BRCA mutation, nulliparity, and infertility |
| What does the Vitamin K deficiency results in ? | Impaired clotting factor carboxylation |
| What is the reason for newborns being at risk of vitamin K deficiency? | Poor transplacental transfer of vitamin K and low content in breast milk |
| What is Preeclampsia? | New onset hypertension with proteinuria and/or signs of end-organ damage in pregnancy |
| What causes Preeclampsia? | Widespread of maternal Endothelial dysfunction, which occurs due to increased anti-angiogenic factor reasese and decrease proangiogenic factor activity (VEGF) |
| What is a common Proangiogenic factor? | VEGF |
| What are the physiological effects of widespread endothelial dysfunction due to preeclampsia? | Dysregulated vascular tone, increased vascular permeability, and decreased end-organ perfusion |
| What are common clinical signs of Preeclampsia? | Headaches and visual changes (scotoma) due to dysregulated cerebral blood flow and retinal artery vasospasm |
| What is common in first several years after menarche and the last few years before menopause? | Anovulation |
| What are the common physiological renal adaptation during pregnancy? | 1. Increased GFR 2. Greater basement membrane permeability 3. Decreased tubular resorption of filtered protein |
| What is a common urine finding in a pregnant woman? | Trace protein excretion in the urine (<300 mg/24hours) |
| What are the most common pathogens involved in Septic abortion? | Staph aureus and E. coli |
| How is primary HSV-2 infection commonly presented? | Fever and a painful vesical genital rash |
| What part of the ganglia is infected by HSV-2? | Sacral Dorsal root ganglia |
| What is a complication of reactivated HSV-2 infection? | Recurrent genital lesions |
| What type of HSV infection is presented with atender vesicular genital rash? | HSV-2 |
| What is the most common cause of Vulvovaginitis? | Trichomonas vaginalis infection |
| What is a key diagnostic test or tool for Trichomonas vulvovaginitis? | Wet mount microscopy |
| What is the common presentation of T. vulvovaginitis? | Yellow-green, frothy vaginal dischgare and vulvovagina erythema |
| What is the classic triad of Congenital Rubella syndrome? | Cataracts, sensorineural hearing loss, and PDA |
| How is Congenital Rubella syndrome prevented? | Maternal preconception immunization with the live attenuated rubella vaccine |
| What are the common findings of upper and lower UTIs? | Pyuria and Bacteriuria |
| Where are the WBC cast formed only? | Renal tubules |
| WBC casts are pathognomonic for: | Pyelonephritis |
| Acute UTI symptoms + WBC casts. Dx? | Pyelonephritis |
| Which strains of HPV develop cervical dysplasia and cancer? | HPV 16 and HPV 18 |
| Which viral infections are common to occur simultaneously leading to CIN? | HPV and HIV |
| How does a person with HIV facilitate the risk for HPV risk for cervical cancer? | HIV co-infection allow HPV infection to persits and enhances expression of HPV oncogenes, increasing risk of cervical dysplasia/cancer |
| What is an Uterine Sarcoma? | Rare but aggressive malignant tumor of the uterine myometrium and/or endometrial stroma tissue |
| What is distinguitive of an uterine sarcoma from an uterine leiomyoma? | Microscopy of a sarcoma shows malignant features such nuclear atypia, abundant mitosis, and tumor necrosis |
| Which organ is most likely Prostate cancer to metastasize to? | Bone |
| What are the bone manifestation of prostate cancer spread to to it? | Osteoblastic lesions that result in new bone growth |
| WHat does the biopsy of a bone with prostate cancer metastases would show? | Disordered trabeculae and signs of prostate cancer such as irregular glands with enlarged nuclei and prominent nucleoli |
| What is placenta accreta? | Placental invasion into the myometrium through defects in the decidua basalis |
| What is a structural placental cause of postpartum hemorrhage? | Placenta accreta |
| What condition is known to case incomplete detachment of the placenta after delivery due to a defective decual basalis, leading to postpartum hemorrhage? | Placenta accreta |
| What is the main form of preventing STI, including HPV? | Consistent use of barrier contraceptives |
| What strains of HPV are known to cause increase risk for Squamous cell carcinoma of the cervix? | HPV 16 and HPV 18 |
| WHat type of malignancy is due to chronic infection with HPV 16/18? | Squamous cell carcinoma of the cervix |
| What are the common stages of the pathogenesis of Lower UTIs? | 1. Suppression of endogenous flora 2. Colonization of the distal urethra by pathogenic gram (-) rods, 3, Attachment of theses pathogens to the bladder mucosa |
| What is an almost always necessary factor for the development of acute pyelonephritis? | Anatomic (short) or functional vesicoureteral reflux |
| What condition is most associated with Vesicoureteral reflux? | Pyelonephritis |
| What is Peau' de Orange? | Erythematous, itchy breast rash with skin texture changes |
| What type of breast cancer is associated strongly with Peau d'orange? | Inflammatory breast cancer |
| What is a very distinctive feature in the breast in a patient with inflammatory breast cancer? | Peau d'orange |
| What leads to development of Peau d'orange? | Cancerous cells spreading to the dermal lymphatic spaces and ostcuting lymphatic drainage |
| Is pregnancy a Prothrombotic state or anti-thrombotic state? | Prothrombotic state |
| What procoagulant factor is increased during pregnancy? | Fibrinogen |
| What are anticoagulant factors decreased or reduced in normal pregnancy? | Decreased anticoagulant factor (Protein S) and reduced fibrinolysis |
| What is a common anticoagulant factor decreased in pregnancy? | Protein S |
| Is protein S reduced or increased during pregnancy? | Reduced |
| What cell is stimulated by LH in the ovary to produce androgens? | Theca interna |
| What is produced by the Theca interna of the ovaries? | Androgens |
| What enzyme helps the granulosa cell to convert androgens into estradiol? | Aromatase |
| Which cell converts Androgens into Estradiol in the ovaries? | Granulosa cell |
| What is the purpose of the Theca Externa cells? | Serve as connective tissue support structure of the follicle |
| Which anterior pituitary hormone stimulates the Granulosa cell to produce Estradiol in the ovaries? | FSH |
| LH stimulates which cell in the ovaries? | Theca interna |
| FSH simulates with cell the ovaries? | Granulosa cell |
| Which ovarian cell produces androgens? | Theca interna |
| Which ovarian cell produces estradiol? | Granulosa cell |
Created by:
rakomi
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