click below
click below
Normal Size Small Size show me how
Repro/Endo
Question | Answer |
---|---|
Describe the pathogenesis and features of chancroid. | painful ulcer w/ ragged border caused by gram (-) rod H. ducreyi; "school of fish" appearance on gram stain |
Describe the pathogenesis and features of LGV. | papules w/ no ulceration, inguinal lymhadenitis; caused by L1-3 of C. trachomatis |
Describe Gardnerella vaginalis infection. | gram (-) rod produces bacterial vaginosis w/ malodorous discharge; clue cells = epithelial cells w/ adherent coccobacilli |
Embryonal rhabdomyosarcoma | girls <5 years old, necrotic, grape-like mass protrudes from the vagina |
What happens to plasma volume and RBC mass in pregnancy? | Both are increased, but plasma volume increased more causing a drop in Hgb |
What effects do progesterone and estrogen have on the respiatory center during pregnancy? | stimulate it causing respiratory alkalosis |
What is a common cause of hirsutism in women? | decreased estrogen, decreased SHBG, increased free testosterone |
Define metrorrhagia | excessive flow and duration at irregular intervals |
Define adenomyosis. | invagination of the stratum basalis intot he myometrium; glands and stroma thicken the myometrial tissue |
What is the most common cause of endometriosis? | reverse menses through fallopian tubes |
What is Fitz-Hughes-Curtis syndrome? | RUQ pain (perihepatitis) associated with PID |
What is Salpingitis isthmica nodosa? | invagination of mucosa into muscle (diverticuli) produces nodules in tube that narrows lumen |
What is stromal hyperthecosis? | vacuolated stromal hilar cells that synthesize excess androgens; associated with obesity |
Where do surface-derived ovarian tumors most commonly seed? | omentum; abdominal enlargement due to malignant ascites is most common sign |
What is placenta accreta? What is the mother at risk for? | direct implantation into muscle w/o intervening decidua; risk for hemorrhage during delivery |
In placental development, what forms first, amnion or chorion? | chorion at day 3, amnion day 8 |
What is the pathogenesis of preeclampsia? | mechanical/functional obstruction of spiral arteries due to abnormal trophoblastic tissue invasion into spiral arteries favoring vasoconstriction; placental ischemia |
What is the most common cause of increased maternal AFP? | open neural tube defect |
What is the most common cause of decreased maternal AFP? | Down syndrome |
Describe process of estriol synthesis. | fetal zone of adrenal cortex makes DHEA-sulfate which is hydoxylated in the liver; placental sulfatase and aromatase convert it to unbound estriol, conjugated in maternal liver, excreted in urine |
Mammary duct ectasia | dilation, rupture, inflammation of ducts; greenish brown nipple discharge |
What are the microscopic findings of traumatic fat necrosis of the breast? | lipid-laden macrophages w/ foreign body giant cells; fibrosis and dystrophic calcification |
Common breast tumor in women < 35 y.o. | fibroadenoma, stroma proliferates and compresses the ducts; increases in size during pregnancy |
What is the most common cause of bloody nipple discharge in women < 50 y.o.? | intraductal papilloma; develops in lactiferous ducts or sinuses |
What is Paget's disease of the nipple? | extension of DCIS into lactiferous ducts and skin of nipple; rash w/ or w/o nipple retraction |
What lymph nodes do the ovaries/testes drain to? | para-arotic lymph nodes |
Which nerve controls emission from the penis? ejaculation? | emission - hypogastric n (SNS); ejaculation - pudendal n. (visceral and somatic n.) |
What protects gametes from autoimmune attack in the seminiferous tubules? | blood-testis barrier formed by tight junctions between Sertoli cells |
How long does full development of sperm take (spermatogenesis)? | 2 months |
What is the process of converting spermatid to spermatozoan? | loss of cytoplasmic contents, gain of acrosomal cap |
What are the functions of DHT in male development? | EARLY - penis, scrotum, prostate; LATE - BPH, balding, sebaceous gland activity |
When is endometrial receptivity the best? What contributes to it? | Days 20-24 ; pinopods (surface epithelial cells) lose their microvilli and develop smooth protrusions (after peak in progesterone) |
5-alpha reductase deficiency | ambiguous genitalia until puberty when testosterone surges |
What is a common cause of death in preeclampsia? | cerebral hemorrhage and ARDS |
Which type of ovarian cyst is associated with choriocarcinoma? | theca-lutein cysts |
Describe Paget cells | large cells in epidermis with clear halo |
What are the microscopic findings of a testicular seminoma? | large cells in lobules with watery cytoplasm, "fried egg" appearance |
Which type of testicular cancer is painful? | embryonal carcinoma; worse prognosis than seminoma; often glandular/papillary |
What is a PGE2 analog that causes cervical dilation and uterine contraction? | Dinoprostone |
Which type of ovarian cyst is associated with endometrial hyperplasia? | follicular cyst |
What are the microscopic findings of serous cystadenocarcinoma? | epithelial cells in papillary arrangement w/ psammoma bodies |
What is a Schiller Duval body? | papillary structure w/ central blood vessel, resembles a glomeruli |
What is the most common benign ovarian tumor? | dermoid cysts; will see calcifications; presents as a single mural mass (Rokitanski nodule) |
Where does gestational choriocarcinoma spread to? | lungs (hematogenous) |
What is the histologic finding in Medullary carcinoma of the breast? | lymphocytic infiltrate |
Where do the islets of Langerhans arise from? Where are they most numerous? | pancreatic buds; tail of the pancreas |
What interactions keep the alpha and beta chain of human proinsulin together? | disulfide bonds between cysteine residues |
How does Cortisol have permissive effects on NE and Epinephrine? | upregulates alpha1 receptors on arterioles |
How does Mg affect PTH? | Decr free Mg, Decr PTH secretion; Common causes: diarrhea, aminoglycosides, diuretics, alcohol abuse |
Which endocrine hormones use IP3 as signaling pathway? | GnRH, GHRH, Oxytocin, ADH (V1), TRH = "GGOAT" |
Which endocrine hormones use cAMP as signaling pathway? | FSH, LH, ACTH, TSH, CRH, hCG, ADH (V2), MSH, PTH, Calicitonin, Glucagon = "CG is a FLAT CHAMP" |
Which endocrine hormones use tyrosine kinase as a signaling pathway? | Insulin, IGF-1, FGF, PDGF, Prolactin, GH |
What is the function of thyroid peroxidase? | oxidation and organification of iodide and couple of MIT and DIT |
How do thyroid hormones increase BMR? | increase Na/K ATPase activity and increase O2 consumption |
What is the most common tumor of the adrenal medulla in children? What do you look for in uine? | neuroblastoma (N-myc oncogene), anywhere along sympathetic chain; look for HVA (DA breakdown) |
What are Hurthle cells? What are they characteristic of? | epithelial cells w/ eosinophlic granular cytoplasm; Hashimoto's thyroiditis |
Which HLA is Hashimoto's associated with? | HLA-DR5 |
What are some clinical sx of Subacute (de Quervain's) thyroiditis? | painful thyroid gland w/ granulomatous inflammation; elevated ESR, follows flu-like illness |
What is the Jod-Basedow phenomenon? | thyroxtoxicosis occurs if a pt with a iodine deficiency goiter is made iodine replete |
Which type of thyroid cancer demonstrates nests of polygonal clear cells with congo red (+) amyloid deposits? | Medullary Carcinoma, associated with MEN 2a and 2b syndromes |
What is the mutation in Albright's hereditary osteodystrophy? | GNAS1 which encodes certain G proteins |
What are the HLA associations with DM1? | HLA-DR3 and DR4 |
What is the most common tumor of the appendix? When will you see sx and what are they? | carcinoid tumor; only see sx if mets to other areas (liver clears it); flushing, diarrhea, right-sided valvular disease, wheezing |
What gene mutation do MEN 2a and 2b have? What is its function? | ret - transmembrane receptor tyrosine kinase |
What are the side effects of the 1st gen sulfonylureas (chlorpropamide, tolbutamide)? | disulfram-like effects; acetaldehyde syndrome |
What is the probably MOA of Metformin? | alters intracellular enzymes to decrease gluconeogenesis and incr glycoslysis; decreases insulin resistance |
What are the side effects of the thiazolidinediones? | wt gain, edema, hepatotoxicity - check LFTs!! |
What is the MOA of Exenatide? | incr insulin, decr glucagon release (GLP-1 mimetics) |
What type of visual disturbance is caused by a pineal gland tumor? | Parinaud's syndrome (paralysis of upward conjugate gaze) |
What is the most common cause of hypopituitarism in children? | craniopharyngioma (benign Rathke's pouch tumor); cystic w/ hemorrhage and calcifications |
What is the most common cause of death in a pt with acromegaly? | cardiomyopathy |
Describe the pathogenesis of Hashimoto's thyroiditis | cytotoxic T cells destroy parenchyma (type IV HSN); IgG Ab block TSH receptor; antimicrosomal and thyroglobulin Ab DEVELOP but have no causal role |
What is the cause of yellowing of the skin in hypothyroidism? | less conversion of beta-carotenes into retinoic acid |
What happens to T3 conversion in Euthroid Sick Syndrome? | an OUTER ring deiodinase is blocked and INNER ring deiodinase converts T4 to inactive reverse T3 |
What are the functions of calcitriol? | incr Ca reabsorption in duodenum, incr phosphorus reabsorption in jejunum and ileum, incr bone resorption (induces monocytic stem cells to become osteoclasts) |
How can Primary HPT lead to PUD? | Ca stimulates gastrin, stimulates gastric acid secretion |
What is the most common cause of hypophosphatemia in the hospital setting? | respiratory/metabolic alkalosis activates PFK-1 which leads to phosphorylation of glucose |
What is a good screening test to distinguish b/w the different types of CAH? | 17-OH progesterone (Incr in 21, 11 OH deficiency but Decr in 17OH deficiency) |
What enzyme converts NE to EPI? Where is it found? | N-methyltransferase; adrenal medulla and organ of Zuckerkandl |
What are the clinical findings of neuroblastoma? | opsoclonus-myoclonus syndrome: myoclonic jerks of extremities and chaotic eye movements |
What is the treatment for peripheral neuropathy associated with DM? | duloxetine, topical capsaicin, amitriptyline |
What electryoltes are important to watch when treating a pt with DKA? | potassium (rapid shift back into cells and lost in osmotic diuresis) and phosphate (follows glucose into cells) |
What disorders are associated with TYPE I polyglandular syndrome? | AR; Addison's disease, Primary HypOparathyroidism, mucocutaneous candidiasis |
What disorders are associated with TYPE II polyglandular syndrome? | AD; HLADR3 and DR4; Addison's disease, Hashimoto's thyroiditis, DM1 |
What are the clinical signs of fasting hypoglycemia? | neuroglycopenic: dizziness, confusion, HA, seizures, visual disturbances, coma |
What are the microscopic findings of a craniopharyngioma? | nests and cords of sqamous or columnar cells in loose stroma, resemble embryonic tooth bud; tumor is often cystic and filled yellow cholesterol remnants |
Define Plummer disease. | hyperthyroidism, nodular goiter, absence of exopthalmos |
Besides MEN IIa and IIb, what are diseases can pheochromocytoma be associated with? | Neurofibromatosis or von Hippel-Lindaus |
What are the clinical features of Maturity-onset diabetes mellitus of the young? | AD; mild hyperglycemia and hyposecretion of insulin, but no loss of beta cells |
What are the clinical features of Cretinism? | developmental delay, dwarfism, protuberant abdomen, macroglossia |