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75 Cards in this Set

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Which female ligament, and what does it contain?
connects ovaries to lateral pelvic wall
suspensory ligament of the ovaries
- contains ovarian vessels
Which female ligament, and what does it contain?

connects cervix to sidewall of pelvis
cardinal ligaments
- contains uterine vessels
Which female ligament, and what does it contain?

uterine fundus to labia majora
Round ligament of the uterus
- contains ZERO structures!
Which female ligament, and what does it contain?
connects the uterus, fallopian tubes, and ovaries to the pelvic sidewall
Broad ligament
- contains ovaries, fallopian tubes, and round ligaments of uterus
Which female ligament, and what does it contain?
connects ovary to latearl uterus
ligament of the ovary
- not much
Which female ligament travels through the round inguinal canal?
the ROUND ligament!
Where do these estrogens come from?

Estradiol
Estrone
Estriol
Estradiol - ovaries
Estrone - peripheral fat
Estriol - placenta
Which phase of the menstrual cycle is most variable?
follicular!
> 35-day cycle
oligomenorrhea
< 21-day cycle
polymenorrhea
Frequent but irregular menstruation
metrorrhagia
- think of a metro..like a bus which makes frequent stops
Heavy, irregular menstruation at irregular intervals
menometrorrhagia
Peritoneal irritation that can mimic appendicitis in some women is called what?
Mittelschmerz
- blood from the RUPTURED FOLLICLE causes peritoneal irritation!
1* oocyte is arrested in __________ until _______

How many N's does it have?
1* oocyte is arrested in prOphase I of Meiosis I for yrs until Ovulation

- Diploid (4N)
2* oocyte is arrested in ___________
until ________

How many N's does it have?
2* oocyte is arrested in metaphase II of meiosis II until it is fertilized

- Haploid (2N)
The single released ovum has how many N's?
Haploid ovum = N
- meets up with sperm
How soon after a female misses her period can BhCG be detected in the blood?

How about in the urine with a home pregnancy test?
Blood - 3 weeks after LMP (BhCG is secreted 1 week after conception, since it takes that long for the fertilized egg to implant)

Urine - 4 weeks after LMP (2 weeks after conception)
What role do prolactin & oxytocin play in breastfeeding?
prolactin - INDUCES and MAINTAINS lactation; also decreases reproductive function so it's harder for a female to get pregnant while she's breast feeding

Oxytocin - helps with milk letdown (ejection)..........also plays a role in uterine contraction
What is the best hormone test to confirm menopause?
increased FSH levels
Early menopause can indicate what?
premature ovarian failure
What are the levels of estrogen, FSH, LH and GnRH that are seen with menopause?
↓ estrogen
↑↑ FSH
↑LH (no surge)
↑GnRH

- same sx as premature ovarian failure!
Which hormone is given to women with hypogonadism or ovarian failure?
estrogens
Which hormone is given to women with abnormal uterine bleeding?
progestins
If a young woman presents with hypertension, what is the 1st question you want to ask her?
If she's taking OCP (which can cause HTN!)
What are the risk factors for cervical cancer?
#1 --> multiple sex partners (more chance of getting HPV passed to you)
- SMOKING!
- Early sexual intercorse
- HIV infection
Two types of cervical cancer
90% d/t squamous cell carcinoma (see koilocytes & keratin pearls)

10% d/t adenocarcinoma (less favorable prognosis than SCC!)
A woman has cervical cancer. Recently she started having renal problems. What's going on?
lateral invasion of the cancer can block ureters, leading to renal failure
Vulvar neoplasia is a precursor to ___________ cancer
vaginal carcinoma
What are the 3 possible carcinoma's of the vagina?
squamous cell carcinoma (d/t cervical SCC)
Clear cell carcinoma (DES)
Rhabdomyosarcoma in females <4yo
Mc gynecologic malignancy in the US
endometrial carcinoma
What is the key hormone elevation which leads to polycystic ovarian syndrome?
↑ LH
What is a theca-lutein cyst?
it's due to high BhCG (gonadotropin)
- often bilateral/multiple
- associated with choriocarcinoma and moles (both have very high BhCG!)
Tumor markers for dysgerminoma
hCG
LDH
- malignant (equivalent to male seminoma!)
A woman gets a biopsy done of her ovaries, which resembles glomeruli.

Dx?
Yolk sac (endodermal sinus) tumor
- these are the Schiller-Duval bodies
- not actual glomeruli, but look like them; they are blood vessels enveloped by germ cells
- aggressive malignancy
- tumor maker: AFP
What is the most frequent BENIGN OVARIAN tumor?
MATURE teratoma ("dermoid cyst")
A woman has a hyperthyroid sx. You check her thyroid gland and it's functioning as it should. Let's just say you decide to image her pelvis...what would you find there?
Struma ovarii - a teratoma which contains functional THYROID tissue and can present as hyperthyroidism
Which female teratoma is malignant, the mature teratoma or immature teratoma?
immature teratoma (usually more immature growths have a higher rate of malignancy)
What is the most important risk factor of ovarian non-germ cell tumors?
Family history!! (even more than tumor markers)
This ovarian tumor has psammoma bodies
serous cystadenocarcinoma
What is pseudomyxoma peritonei?
- which 2 tumors may cause it?
intraperitoneal accumulation of mucinous material
- associated with ovarian or appendicieal tumors
This ovarian tumor looks like fallopian tube-like epithelium

This ovarian tumor has intestine-like epithelium

This ovarian tumor has bladder-like epithelium
serous cystadenoma (fallopian tube)

mucinous cystadenoma (GI)

Brenner tumor = Bladder!
This ovarian tumor has bundles of spindle-shaped fibroblasts
Fibroma
Megis' syndrome
triad of ovarian fibroma, ascites, pleural effusion (hydrothorax)
What are Call-Exner bodies and which ovarian tumor are they associated with
Call-Exner bodies
- small follicules filled with EOS secretions inside
- associated with granulosa cell tumor
A female presents with tumor cells on her ovary. Biopsy shows that nucleus is pushed to the periphery by what looks like to be mucous. Where did these cells come from?
Stomach = Krukenberg tumor
- mucin-secreting signet cell adenocarcinoma
- may occur after abdominal surgery of stomach (ie. linutis plasticus)
Which mole has 46XX or 46XY?

Which mole has 69XXY?
complete (2 sperm + empty egg)

partial (2 sperm + 1 egg)
Which mole has a bigger chance of becoming malignant trophoblastic dz?
complete mole (46XX & 46XY)
Which mole has fetal parts?
PARTial mole (69XXY) has fetal PARTs!
What is the most likely cause of preeclampsia?
placental hypoperfusion (net vasoconstriction effect)
What is HELLPS syndrome stand for and what is it associated with?
HELLPS syndrome is associated with pregnancy-induced HTN (preeclampsia-eclampsia)

Hemolysis
Elevated LFT's
Low Platelet's
A 30wk gestational pregnant female presents w/ ↑ BP, brusing & bleeding gums, and yellowing of the skin & sclera.

Dx?
HELLP syndrome (hemolysis, elevated LFT, low platelets)

- associated with pregnancy-induced hypertension (preeclampsia)
What is the DOC for eclampsia?
IV magnesium sulfate

(then you can give diazepam if needed...but can cause resp depression...so not DOC!)
What gives rise to Potter's syndrome....polyhydramnios or oligohydramnios?
oligohydramnios (<0.5L of amniotic fluid)
Which situations can cause gynecomastia?
- Cirrhosis (decreased SHBG = increased free estrogen)
- testicular tumor
- puberty
- old age

AND drugs: estrogen, marijuana, heroin, psychoactive drugs + "Some Drugs Cause Awesome Knockers"

- Spironolactone
- Digoxin
- Cimetidine
- Alcohol (chronic)
- Ketoconazole
What is the most common cause of a serous or bloody nipple discharge from the breast?

Is it benign or malignant?
Intraductal papilloma
- slight increase in carcinoma, but mainly benign
Phyllodes tumor...is it benign or malignant?
Benign...but may become malignant
- it's a LARGE bulky mass of CT and cysts w/ "leaf-like" projections
Mc breast lumps in a woman 0-35yo

Mc breast lumps in a woman >35yo
0-35 yo = fibroadenoma

>35 yo = fibrocystic change
What is the single most important prognostic factor for malignant breast tumors?
axillary lymph node involvement
Which nerve mediates erection?

Emission?

Ejaculation?
erection = pelvic nerve

emission = hypogastric nerve

ejaculation = pudendal nerve
Which drug can cause impaired blue-green color vision?

Which drug can cause impaired red-green color vision?
blue-green = sildenafil, vardenafil

red-green = ethambutol
What does FSH stimulate in a male?

What does LH stimulate in the male?
FSH = stimulates sertoli cells to produce ABP & Inhibin (which feeds back and decreases FSH secretion)

LH = stimulates testosterone release from Leydig cells
Where are the sertoli cells located?

Where are the Leydig cells located?
Sertoli - surround the spermatogonium

Leydig - in the interstitium
Which androgen causes prostate growth, balding and sebaceous gland activity later in life?
DHT
Which enzyme convertes testosterone and androstenedione to estrogen in adipose tissue and Sertoli cells
aromatase
A young teenager was taking a lot of steroids to bulk one. He noticed that he is no longer growing. What happened?
testosterone causes premature closure of epiphyseal plates
What does the lipid profile look like in woman who is receiving estrogen?

What does the lipid profile look like in a male receiving testosterone?
estrogens = decrease LDL, increase HDL (GOOD STUFF!)

testosterone = increase LDL, decrease HDL (BAD STUFF!)
What are the PSA & PAP values in BPH and prostatic adenocarcinoma?
BPH = increase in free PSA

Prostatic adenocarcinoma = increase TOTAL PSA & increase in Prostatic acid phosphatase;
- but DECREASE in FREE PSA!!!!
Tender, boggy prostate means what?
Prostatitis
- Acute = WBC + bacteria
- Chronic = WBC +/- bacteria
How is a teratoma in males and a teratoma in females differ?
Teratomas (mature) in females are BENIGN

Teratomas (mature) in males are MALIGNANT!
Malignant and PAINLESS testicular tumor

Malignant and PAINFUL testicular tumor
Seminoma (germ cell tumor)

Embryonal carcinoma (germ cell tumor)
Which testicular tumor has increased alkaline phosphatase?
Seminoma
What is the most common testicular tumor overall?

What is the most common testicular cancer in older males (>50yo)?
seminoma

testicular lymphoma
A pt was a chimney sweeper when he was a kid, and now presents with a scrotal mass. What type of cancer is it most likely?
Scrotal squamous cell carcinoma
A gray, solitary crusty plaque on the shaft of penis or on the scrotum

A red velvety plaque, usually on the glans
Bowen's dz (~50 yo old)
- a milder form, called Bowenoid papulosis, presents in young age group & with multiple papular lesions.

Erythroplasia of Queyrat


Both Bowen's dz & erythroplasia of Queyrat (but NOT Bowenoid papulosis) can progress to SCC!!!
Squamous cell carcinoma of the penis/scrotum is usually acquired how?
HPV