Term
| Describe the function of the Wolfian ducts and Mullerian ducts in males and females. |
|
Definition
| Wolfian will turn into testis for males and will remain vestigal for females . Mullerian ducts turn into the upper vagina, cervix, uterus and oviducts in females and the duct degenerates in males. |
|
|
Term
| What are the external signs of puberty (Tanner stages) for females? |
|
Definition
Nipples and breast buds swell and the areola enlarges
Axillary and pubic hair develops
Hips widen
Growth spurt occurs |
|
|
Term
| : the development of breast |
|
Definition
|
|
Term
| : the development of axillary and pubic hair |
|
Definition
|
|
Term
| : the first menstrual period. This is followed by a period of anovulatory cycles that continue for about approximately 1 -2 years |
|
Definition
|
|
Term
| What is the function of LH on the ovaries and testes? |
|
Definition
Ovaries = ovulation and sex hormone production.
Testes = testosterone production |
|
|
Term
| What is responsible for the production of progesterone during the menstrual cycle? |
|
Definition
|
|
Term
| What is the function of FSH on the ovaries and testes? |
|
Definition
Ovaries = release estrogen and growth.
Testes = stimulate the release of inhibin and growth. |
|
|
Term
:drug that was widely prescribed from 1938 until 1971 to prevent miscarriage but actually led to:
adenosis - ovary is anomalous,
anatomic differences in the vagina, cervix or uterus,
cervical dysplasia,
clear cell adenocarcinoma, and a
higher frequency of pregnany problems/infertility |
|
Definition
|
|
Term
| Which days of the menstrual cycle are considered the "fertile time"? |
|
Definition
| Days 9-15 of a 28 day cycle |
|
|
Term
| What is the average amount of blood lost in menstruation? |
|
Definition
|
|
Term
| What days of the menstrual cycle make up the follicular(proliferative) phase of a 28 day cycle? |
|
Definition
| Days 1-14 = Follicular phase |
|
|
Term
| Which days of a 28 day menstrual cycle make up the ovulatory phase? |
|
Definition
|
|
Term
| Which days of a 28 day menstrual cycle makes up the luteal(secretory) phase? |
|
Definition
|
|
Term
| Which days of the 28 day menstrual cycle make up menstruation? |
|
Definition
| Days 1-7 (can be slightly more or less) |
|
|
Term
| Describe the changes in the endometrial thickness through a 28 day menstrual cycle. |
|
Definition
| Menstruation is occurring for the first 7 days so the endometrium is getting thinner, the endometrium slowly grwos for the rest of the cycle as it prepared for pregnancy, when it does not occur it is sloughed off to start another cycle. |
|
|
Term
| Describe the changes in estrogen, LH, FSH and progesterone during a 28 day menstrual cycle. |
|
Definition
| Estrogen rises around day 10 and LH then follows with a sharp rise around day 13, inducing ovulation. LH then drops off sharply after ovulation but estrogen stays slightly elevated until menstruation starts. Progesterone is only increased during the luteal phase and rises after the estrogen induced LH surge. FSH levels are very low for the entire cycle except the day before and after ovulation. |
|
|
Term
| Describe the changes in body temperature seen in the 28 day menstrual cycle. |
|
Definition
| It rises roughly 0.4 degree during ovulation and stays elevated until the end of the luteal phase. |
|
|
Term
| Describe the ovarian histology during a 28 day menstrual cycle. |
|
Definition
| The follicle is maturing during the follicular phase (days 1-14), ovulation occurs on day 14 and the corpus luteum secretes progesterone anticipating pregnancy, if pregnancy occurs then the placenta will take over the progesterone production, if not the corpus luteum degenerates and progesterone production stops, inducing menstruation. Corpus luteum also secretes estrogen. |
|
|
Term
| What is the the function of estrogen in regards to the uterus? FSH? Progesterone? |
|
Definition
Estrogen = causes the uterine lining to thicken.
FSH = induces the growth of the endometrium.
Progesterone = increases blood supply to the newly thickened endometrium. |
|
|
Term
| :a fertilized egg is implanted in a fallopian tube. |
|
Definition
|
|
Term
| What drug can be used to stop development of an embryo, useful with ectopic pregnancy? |
|
Definition
|
|
Term
| How do estrogen and progesterone effect breast development? |
|
Definition
Estrogen causes proliferation of mammary ducts.
Progesterone causes growth of lobules and alveoli. |
|
|
Term
| Why do some women experience breast swelling, pain and tenderness 10 days prior to menstruation? |
|
Definition
| BC of estrogen and progesterone secretion. |
|
|
Term
| :abnormally heavy or long menstrual periods |
|
Definition
|
|
Term
| :uterine bleeding other than that caused by menstruation; between periods |
|
Definition
|
|
Term
| :Abnormally heavy or long uterine bleeding other than that caused by menstruation; bleeding at irregular intervals |
|
Definition
|
|
Term
| :Frequent menstrual periods |
|
Definition
|
|
Term
| :Unusually light menstrual flow |
|
Definition
|
|
Term
| :Mentrual bleeding at more than 35-day intervals; decreased amount |
|
Definition
|
|
Term
| Bleeding after coitus; caused by erosion, cervical polyps, vaginitis, or cervicitis |
|
Definition
|
|
Term
| When should a workup for amenorrhea be initiated? What needs to be ruled out? |
|
Definition
| If there is no onset of pubertal onset by age 14 or a lack of menstruation within 2 years of onset of thelarche or adrenarche. Must rule out pregnancy, anemia, DM and thyroid abnormalities. |
|
|
Term
| What are the 4 categories of characteristics seen with primary amonorrhea? |
|
Definition
1. No secondary sexual characteristics.
2. Breast development but no pubic/axillary hair.
3. Normal secondary sex characteristics.
4. Incompletely developed secondary sex characteristics. |
|
|
Term
| What are some causes of primary amenorrhea? |
|
Definition
| Lack of FSH/LH, absence of androgen, imperforate hymen, cervical agenesis, hypothyroidism or premature ovarian failure. |
|
|
Term
| What is the most likely diagnosis for primary amenorrhea with an increased FSH? Normal or decreased FSH? |
|
Definition
Increased FSH = primary ovarian failure.
Nl/decreased FSH = hypothalamus or pituitary issue. |
|
|
Term
| What is secondary amenorrhea? |
|
Definition
| Absence of menses in a women who previously had regular periods for at least 6 months OR the absence of menses for 12 months in a patient with a history of oligmenorrhea. |
|
|
Term
| What is the leading cause of secondary amenorrhea? |
|
Definition
|
|
Term
| What are the most likely causes of secondary amenorrhea in a patient that is hypoestrogenic? |
|
Definition
|
|
Term
| What are the most likely causes of secondary amenorrhea in a patient that has adequate estrogen? |
|
Definition
| Polycystic ovarian syndrome or Asherman's syndrome (intrauterine adhesions). |
|
|
Term
| :Painful menses that limit normal activity or cause a woman to seek medical care |
|
Definition
|
|
Term
| Can the symptoms of dysmenorrhea improve with age? |
|
Definition
|
|
Term
| What conditions can cause secondary dysmenorrhea? |
|
Definition
| Endometriosis, leimyomas and pelvic adhesions |
|
|
Term
| What causes dysmenorrhea? |
|
Definition
| Progesterone causes the secretion of prostaglandins from the endometrium which causes uterine contraction and ischemia of the endometrial capillaries, leading to cramping pain. |
|
|
Term
| How do you treat dysmenorrhea? |
|
Definition
|
|
Term
| :permanent end to menstruation and fertility |
|
Definition
|
|
Term
| any bleeding after____months of amenorrhea is abnormal, and must be investigated to rule out carcinoma. |
|
Definition
|
|
Term
| Osteoporosis occurs in_____% of women within 15 to 20 years following menopause. |
|
Definition
|
|
Term
| What are the major fractures seen with menopause related osteoporosis? |
|
Definition
| Vertebral fractures, Colles' fractures and Hip fractures |
|
|
Term
| How do you treat the osteoporosis associated with menopause? |
|
Definition
| Bisphosphonates, calcium and vit D. |
|
|
Term
| What are the absolute contraindications to estrogen hormone replacement in postmenopausal women? |
|
Definition
| Estrogen dependent tumors, genital bleeding of unknown cause, DVT, cerebrovascular disease and liver disease. |
|
|
Term
| Will postmenopausal women undergoing HRT have menstrual bleeding? |
|
Definition
| 50% due to the cyclic fashion of estrogen and progesterone given with HRT. |
|
|
Term
| :constellation of physical and mood symptoms occurring in the week prior to menses and remit within a few days after the onset of menses. Interferes with occupational or social functioning |
|
Definition
| PMS - Premenstrual syndrome |
|
|
Term
| :Disabling mood sx that occur exclusively during the premenstrual period and is actually listed in the diagnostic statistical manual of mental disorders and may increase the risk of developing major depression later on. |
|
Definition
| PDD - Premenstrual Dysphoric Disorder |
|
|
Term
| How do you treat premenstrual syndrome (PMS)? |
|
Definition
| antidepressants (Prozac, Zoloft) and lifestyle changes (decrease alcohol and caffeine) |
|
|
Term
| :autosomal recessive mutation leading to genetic defect of the adrenal glands→ inability to produce corticosteroid hormones, pts are at an increased risk of common illness and stress inducing situations and can lead to masculanization in women |
|
Definition
| Congenital adrenal hyperplasia |
|
|
Term
| What are the treatment options for congenital adrenal hyperplasia? |
|
Definition
| Replace cortisol and refer to an endocrinologist |
|
|
Term
| What is the etiology of congenital adrenal hyperplasia? |
|
Definition
| deficiency of an adrenal enzyme called 21-hydroxylase – involved in cortisol production |
|
|
Term
| :Most common sex chromosome anomaly in females, missing or incomplete X chromosome leading to a short stature, a lack of secondary sex characteristics and being infertile. Leads to an increased risk for HTN, kidney problems, DM, cataracts, osteoporosis and thyroid problems. |
|
Definition
|
|
Term
| What are some frequent abnormalities seen with Turner's syndrome? |
|
Definition
| webbed neck, low-set ears, amenorrhea, broad chest, short stature, coarctation of the aorta and horseshoe kidney. |
|
|
Term
| What is the treatment for Turner's syndrome? |
|
Definition
| There is no cure but you can give GH to increase height and stimulate sexual development and some assisted reproductive techniques have enables soem women to become pregnant. |
|
|
Term
| :X linked recessive abnormality where the males (XY) are unresponsive to androgen and develops mostly female sex characteristics or signs of both male and female development. |
|
Definition
| Androgen Insensitive Syndrome (AIS) |
|
|
Term
| How will individuals with Androgen Insensitivity Syndrome be raised? Do they have testes? What are the common complicatons of the testes? |
|
Definition
| They are raised on females and have a female gender ID but they are actually male. They have testes but they must be removed do to their likelihood to cause cancer. |
|
|
Term
| Briefly describe the 3 types of Androgen Insensitivity Syndrome (AIS) - (Complete, Partial and Mild). |
|
Definition
Complete - raised female and identify themselves as female.
Partial - (Reifenstein syndrome), can have male or female characteristics and can be raised as either sex.
Mild - Male sex characteristics but are infertile and have gynecomastia at puberty. |
|
|
Term
| :abnormal endometrial bleeding not associated with: tumor, pregnancy, trauma, hormonal effects or inflammation. |
|
Definition
| Dysfunctional uterine bleeding |
|
|
Term
| When is dysfunctional uterine bleeding most common? |
|
Definition
| Most common at menarche & menopause |
|
|
Term
| Describe why adolescents can get Dysfunctional Uterine Bleeding. |
|
Definition
| It is due to a dysfunction between the pituitary and ovary leading to decrease in progesterone which causes the endometrium to lack structural support and lead to spontaneous hemorrhage. The blood vessels in the endometrium also fail to constrict so they increase the bleeding even further. |
|
|
Term
| Describe why perimenopausal women can get Dysfunctional Uterine Bleeding. |
|
Definition
| The ovary fails to produce estrogen or FSH/LH production can be unpredictable. |
|
|
Term
| Who does endometrial cancer affect more commonly? S&S? |
|
Definition
Affects postmenopausal women mostly.
S&S = bleeding between periods or postmenopausal bleeding. |
|
|
Term
| What is the difference between a colposcopy and a hysteroscopy? |
|
Definition
| Colposcopy can only reach the cervix and a hysteroscopy can go past the cervix. |
|
|
Term
| What are the treatment options for endometrial cancer? |
|
Definition
| Radiation, TAH (Total Abdominal Hysterectomy) or a BSO (bilateral salpingo-oophorectomy) |
|
|
Term
| What is the 5 year prognosis for endometrial cancer if caught in early stages? If it has already METS? |
|
Definition
|
|
Term
| :Presence of endometrial tissue outside the lining of the uterine cavity |
|
Definition
|
|
Term
| Describe the Induction theory of endometriosis. |
|
Definition
| Endometrial tissue flows retrograde and implants on other organs. Epithelium at those sites converts to endometrial epithelium. |
|
|
Term
| What does endometriosis look like? |
|
Definition
| There is fibrous tissue deposition and adhesions and it looks like spider webs. |
|
|
Term
| What are the S&S of endometriosis? |
|
Definition
| dysmenorrhea (pain in lower abdomen, vagina, posterior pelvis and back), dyspareunia, pain with defecation and menorrhagia. |
|
|
Term
| What are the treatment options for endometriosis? |
|
Definition
| Depends on the stage of disease. Can give hormonal agents to induce a pregnancy or menopausal like state, you can surgically remove the endometriosis or if it is extensive then TAH (total abdominal hysterectomy) or BSO (bilateral salpingooophorectomy) are your options. |
|
|
Term
| What is the most common uterine growth? |
|
Definition
| Leiomyoma (myoma, fibroid or fibromyoma) |
|
|
Term
| Describe when Leiomyoma's grow and what they are composed of. What enhances its growth? What diminished it? |
|
Definition
| They grow during the reproductive years and are composed of smooth muscle and fibrous tissue. Its growth is enhanced by large doses of estrogen and late stages of pregnancy. It will shrink or disappear after menopause. |
|
|
Term
What are the S&S for a leiomyoma?
Treatment options? |
|
Definition
S&S = abdominal pain/pressure, abnormal vaginal bleeding/discharge, backache, constipation and urinary frequency/urgency.
Tx = observation, hysterectomy or a uterine myomectomy (take out the fibroid). |
|
|
Term
| :most common infection after C-section, it is polymicrobial and is characterized by fever, uterine tenderness, adnexal tenderness (ovarian ligaments), and peritoneal irritation. |
|
Definition
|
|
Term
| How is Metritis diagnosed? Treatment? |
|
Definition
Dx = CBC w/ diff and a pelvic ultrasound.
Tx = broad spectrum IV antibiotics. |
|
|
Term
| :Descent of the uterus into the vagina, caused by relaxation of supporting structures, compromise of the vaginal wall, ligament trauma during childbirth or multiple deliveries. |
|
Definition
|
|
Term
| Describe degrees I-III of uterine prolapse. |
|
Definition
I - Uterus is halfway between the introitus(vaginal opening) and the level of the ischial spines.
II - end of cervix has begun to protrude through the introitus.
III - (complete), body of the uterus is outside of the vaginal introitus. |
|
|
Term
| What are the treatment options for uterine prolapse? |
|
Definition
| Tx = hysterectomy or a pessary ((ring that goes up in front of the cervix and holds the uterus up) |
|
|
Term
| :Sacs on an ovary that contain fluid or semisolid material that may increase and decrease in size with the menstrual cycle. |
|
Definition
|
|
Term
| Describe a follicular, corpus luteum and theca-lutein ovarian cyst. |
|
Definition
Follicular = maturing ovarian follicle fails to release an ovum and continues to enlarge, releasing estrogen.
Corpus luteum = The corpus luteum fails to degenerate and enlarges, producing progesterone.
Theca-lutein = often bilateral and is associated with a mole, choriocarcinoma or hormone therapy. |
|
|
Term
| What are the treatment options for an ovarian cyst? |
|
Definition
| Observation of possible surgery with rupture. |
|
|
Term
| What is the leading cause of death from genital cancer for women aged 60-80? |
|
Definition
|
|
Term
| Why is there a high mortality rate seen with ovarian cancer? |
|
Definition
| Disease is often diagnosed in the late stages. |
|
|
Term
| What are the S&S seen with ovarian cancer? |
|
Definition
| vague discomfort, increased abdominal girth, weight loss, dysuria and constipation. |
|
|
Term
| What is the treatment for ovarian cancer? What is the prophylactic treatment for those at high risk? |
|
Definition
Tx = chemo, radiation and surgery.
Prophylactic = oophorectomy or salpingo-oophorectomy. |
|
|
Term
| If two or more first-degree relatives have ovarian cancer, a woman has a___% chance of developing it. |
|
Definition
|
|
Term
| What are the recommendations for women that are at high risk for ovarian cancer? |
|
Definition
| BRCA1/2 testing, annual transvaginal US, annual CA 125, and possible prophylactic oophorectomy or salpingo-oophorectomy at age 35 for women in this high-risk group. |
|
|
Term
| How is cervical cancer detected? What is the main risk factor for cervical cancer? |
|
Definition
Detected by the PAP smear.
Main risk factor is HPV. |
|
|
Term
| What are the S&S of cervical cancer? What kind of cancer is it usually? |
|
Definition
S&S = usually asymptomatic, abnormal vaginal bleeding and persistent vaginal discharge.
95% are Squamous cell carcinoma. 5% are adenocarcinoma. |
|
|
Term
| What do ASCUS, LSIL and HSIL stand for with regards to PAP smear results? |
|
Definition
ASCUS = atypical squamous cells of undetermined significance.
LSIL = low-grade squamous intraepithelial lesion.
HSIL = high-grade squamous intraepithelial lesion. |
|
|
Term
| :abnormal growth of the cervical cells |
|
Definition
|
|
Term
| :neoplastic/cancer cells are localized in the cervical epithelium; no metastasize |
|
Definition
| Cervical carcinoma in situ |
|
|
Term
| What is the next step to an abnormal PAP smear? |
|
Definition
| Follow up with a colposcopy and biopsy. |
|
|
Term
| What are the treatment options for cervical cancer? |
|
Definition
| Depends on the stage of the tumor. Cryotherapy, excision, laser and hysterectomy are all options. |
|
|
Term
| :Inflammation of the uterine cervix from STDs (gonorrhea, nongonococcal infection, syphilis, etc) |
|
Definition
|
|
Term
| :Protrusion of part of the bladder into the anterior of the vagina usually from a defect in the vaginal wall from injury, surgery, obesity or lifting heavy objects. The anterior vaginal wall bulges downward. |
|
Definition
|
|
Term
| What are the treatment options for a cystocele? |
|
Definition
| pelvic floor exercises (Kegal's), surgical repair with reinforcement of the weakened portion of the anterior wall. |
|
|
Term
| :Protrusion of the anterior rectal wall into the posterior of the vagina due to injury, surgery, aging, inherent weakness, obesity or multiparity (twins, triplets, etc). |
|
Definition
|
|
Term
| What is the treatment of a rectocele? |
|
Definition
|
|
Term
| :inflammation of the vagina due most commonly to candida albicans (50%) due to increased glycogen content of the vagina during the secretory (luteal) phase of the menstrual cycle |
|
Definition
|
|
Term
| What are the S&S of vulvovaginitis? How is the diagnosis made? Treatment? |
|
Definition
S&S = thick/white discharge, red/edematous mucous membranes, intense pruritis, painful urination and painful intercourse.
Diagnosis made by C&S.
Treatment = local and systemic antifungal therapy, cool compresses and sitz baths. |
|
|
Term
| What age group is most commonly affected by vaginal cancer? What kind of cancer do the daughters of women that took DES during their pregnancy most commonly get? Does vaginal cancer have a high rate of metastasis? What is the treatment for vaginal cancer? |
|
Definition
Occurs in women in their mid 50s.
DES daughters have a much greater risk of developing clear cell carcinoma of the vagina.
Vaginal cancer can METS very easily.
Tx = surgery and radiation. |
|
|
Term
| What is the most common type of vulvar cancer? What factors increase the likelihood of developing vulvar cancer? |
|
Definition
Most common is squamous cell carcinoma.
Risk factors = venereal disease, HPV, chronic vulvar pruritis/edema/dryness, obesity, HTN, DM and nulliparity (no offspring). |
|
|
Term
What is a preceding sign of vulvar cancer?
What are the treatment options? |
|
Definition
Leukoplakic changes (whitish plaque-like or ulcerated lesions) to the vulva.
Tx = partial or total excision. |
|
|
Term
| What kind of gland is the female breast? Describe the composition of the breast. |
|
Definition
It is a modified sebaceous gland.
It consists of 15-20 pyramid shaped lobes, each lobe contains 20-40 lobules (alveoli) and the lobules (alveoli) are subdivided into acini. |
|
|
Term
| Where does secretion of milk and contraction to squeeze milk occur? How does this milk reach the nipple? |
|
Definition
| The acini, they empty into a network of collecting and ejecting ducts that go to the nipple. |
|
|
Term
| What separates and supports the female breast? |
|
Definition
|
|
Term
| What is the most common site for breast cancer? |
|
Definition
|
|
Term
| What is the function of the glands of Montgomery regarding the female breast? |
|
Definition
| They aid in lubrication of the nipple during lactation. |
|
|
Term
| During the female reproductive years, which hormone promotes development of the lobular ducts of the breast? |
|
Definition
|
|
Term
| During the female reproductive years, which hormone stimulates development of cells lining the acini? |
|
Definition
|
|
Term
| During the female reproductive years, which hormone is increased after childbirth, stimulates the production of milk and is increased by breast feeding? |
|
Definition
|
|
Term
| During the female reproductive years, which hormone is responsible for milk ejection (let down)? |
|
Definition
|
|
Term
| What is contained in breast milk that can help the newborn fight infection? |
|
Definition
| IgA and nonspecific antimicrobial factors (lysozymes, lactoferrin) that protect against infection. |
|
|
Term
| What is the treatment for a breast abscess? |
|
Definition
| Usually have to do excision and drainage because antibiotics often provide poor results do to the fact that the abscess is encapsulated. |
|
|
Term
| :retrograde infection in lactating women that results from disruption of the epithelium of the breast, risk factors include: fissures, milk stasis, skipped breast feedings, changes in feeding patterns or mechanical obstruction. |
|
Definition
|
|
Term
| What are the most common organisms to cause Mastitis? What are some preventative measures? |
|
Definition
MCC = Staph aureus and streptococcus.
Prevention = regular breast feeding, complete emptying of the breast, preventing fissures, good hygiene and avoid tight clothing. |
|
|
Term
| What are the S&S of Mastitis? What is the easiest way to differentiate between staph or strep induced Mastitis? |
|
Definition
S&S = tender, warm, erythema, "wedge-shaped" area of involvement, fever, chills and purulent drainage.
Staph is localized cellulitis and strep is diffuse cellulitis. |
|
|
Term
| How is the diagnosis of mastitis made? What is the treatment? What can result if not treated properly? |
|
Definition
Diagnosis is made by C&S of the discharge.
Tx = antibiotics.
If not treated properly, it can lead to abscess or sepsis. |
|
|
Term
| What should be initiated in women with suspected Mastitis that do not respond to antibiotics? |
|
Definition
| Thorough exam, US and possible mammography. |
|
|
Term
| What is the most common benign neoplasm of the breast? |
|
Definition
|
|
Term
| :benign breast condition in which palpable breast masses fluctuate with the menstrual cycle including macroscopic cysts, microscopic cysts, fibrosis or overgrowth of stromal fibrous tissue. |
|
Definition
| Fibrocystic Breast Disease |
|
|
Term
| What is the etiology and common age range seen with Fibrocystic Breast Disease? |
|
Definition
| Hormonal imbalance in women 30-50 years old. |
|
|
Term
| How is Fibrocystic breast disease diagnosed? What are the treatment options? |
|
Definition
Dx = needle aspiration of a cyst.
Tx = Danazol (suppresses LH/FSH), local heat, support bra, a low-fat/high-carbohydrate diet and avoidance of tea, coffee, soda and chocolate. |
|
|
Term
| :may appear at any time in a woman’s life from childhood to old age, do not metastasize, and are freely moveable, sharply delineated, encapsulated masses. |
|
Definition
| Fibroadenomas, adenomas and papillomas (Benign Neoplasms) |
|
|
Term
| What must be done with any breast mass found in a woman? |
|
Definition
| Biopsy and histological evaluation |
|
|
Term
| What is the most common cancer in women from 25-75 and the leading cause of death from all causes in women between 40-44? |
|
Definition
|
|
Term
| Describe how hormones can be a risk factor in breast cancer? |
|
Definition
| Longer exposure to estrogen and progesterone such as in early menses or late menopause or Hormone Replacement Therapy can increase the risk of breast cancer. |
|
|
Term
| Describe how reproduction can have a protective effect or be a risk factor for breast cancer. |
|
Definition
| Giving birth older than 35 years old shows an increased risk of breast cancer. Giving birth younger than 18 and having more babies has been shown to decrease the risk of breast cancer. |
|
|
Term
| What are the S&S of breast cancer? |
|
Definition
| S&S = skin dimpling (peau d'orange), nipple retraction, change in breast contour and bloody nipple discharge. |
|
|
Term
| What are the most common sites of metastasis with breast cancer? |
|
Definition
|
|
Term
| What is the 5 year survival rate for breast cancer without lymph node involvement? With lymph node involvement? |
|
Definition
Without LN = 84%.
With LN = 56%. |
|
|
Term
| What are the treatment options for breast cancer? What does follow up care include for a breast cancer survivor? |
|
Definition
Tx = chemo, radiation, and surgery (lumpectomy, simple mastectomy, modified radical mastectomy or radical mastectomy).
Follow up care includes frequent SBEs, yearly mammograms and regular checkups. |
|
|
Term
| :breast cancer surgery involving removal of the lesion only |
|
Definition
|
|
Term
| :breast cancer surgery involving removal of the affected breast only (no lymph system or muscles) |
|
Definition
|
|
Term
| :breast cancer surgery involving affected breast is removed as well as part of the axillary lymph system (no pectoral muscles are removed though). |
|
Definition
| Modified Radical mastectomy |
|
|
Term
| :breast cancer surgery involving affected breast, all lymphatic drainage and underlying pectoral muscles are removed |
|
Definition
|
|
Term
| What type of breast surgery is appropriate for DCIS? |
|
Definition
|
|
Term
| Describe primary and secondary lymphedema. |
|
Definition
Primary = swelling produced by obstruction of lymph flow due to congenital absence, decrease in the number of lymphatics or obstruction.
Secondary = Swelling produced by obstruction of lymph flow due to surgical removal of lymph nodes or from lymphatic destruction due to radiation treatment. |
|
|
Term
| How does the edema seen with lymphedema usually progress? |
|
Definition
| Usually progresses distally to centrally. |
|
|
Term
| What skin changes are seen with lymphedema? What are the treatment options? |
|
Definition
Pigmentation, ulceration and fibrosis.
Tx = pneumatic compression devices, elastic garments, exercise, diuretics and massage. |
|
|
Term
| :Acute inflammatory process caused by infection caused by sexually transmitted organisms (gonorrhea, chlamydia, mycoplasma hominis, ureaplasma urealyticum, etc) that can involve any organ of the upper genital tract (fallopian tubes, ovaries, etc) |
|
Definition
| Pelvic Inflammatory Disease |
|
|
Term
| What are the long-term complications of PID? What can it lead to if left untreated? |
|
Definition
Infertility and ectopic pregnancy.
If left untreated it can progress to septic shock. |
|
|
Term
| What is "Chandelier sign" and what condition is it in reference to? |
|
Definition
| Seen with PID where the patient will jump towards the ceiling(chandelier) when touching the involved area. |
|
|
Term
| How is the diagnosis of PID made? |
|
Definition
| Dx = H&P, wet mount of cervical discharge testing for gonorrhea and chlamydia, pelvis US, laporoscopy and/or culdocentesis (procedure that checks for abnormal fluid in the space just behind the vagina). |
|
|
Term
| What is the treatment for PID? |
|
Definition
Combined antibiotic therapy that may need hospital admission for IV therapy, bed rest and avoidance of intercourse.
***Also need to treat all partners!!! |
|
|
Term
| :comma shaped structure that lies over the posterior of each testis, conducts sperm from efferent tubules to the vas deferens and supplies nutrients & testosterone to enhance their maturity for fertilization |
|
Definition
|
|
Term
| :transports the sperm toward the urethra via powerful peristalsis |
|
Definition
|
|
Term
| What is the function of the prostate gland? |
|
Definition
| It secretes prostatic fluid which is an alkaline pH and helps the sperm survive the acidic environment of the female reproductive tract. |
|
|
Term
| What is the function of Cowper's (bulbourethral) glands? |
|
Definition
| It secretes "pre-ejeculate" into the urethra to lubricate it for sperm to pass through. |
|
|
Term
| Where does spermatogenesis occur? How long does it usually take? |
|
Definition
| Spermatogenesis occurs in the seminiferous tubules and takes 70-80 days. |
|
|
Term
| Which cells produce androgens in males? |
|
Definition
| Leydig cells of the testes. |
|
|
Term
| :nonmalignant overgrowth of the prostate gland characterized by urinary frequency, urgency, nocturia, hesitancy, etc. |
|
Definition
| Benign prostatic hyperplasia (BPH) |
|
|
Term
| How is BPH diagnosed? How is it treated? |
|
Definition
Dx = DRE, cystoscopy, transrectal US or IVU (intravenous urography).
Tx = 5a-reductase inhibitors, alpha-blockers or surgery. |
|
|
Term
| What level of PSA is considered abnormal? What is the next step if a PSA or DRE is abnormal? |
|
Definition
| PSA over 4 ng/mL is considered abnormal. If PSA or DRE is abnormal the next step is to do a transrectal biopsy. |
|
|
Term
| :hidden testes”, refers to any testis that occupies an extrascrotal position, incomplete descension, within the inguinal canal, or just external to the inguinal canal, just above the scrotum |
|
Definition
|
|
Term
| What does Cryptorchidism increase your risk for later on in life? |
|
Definition
| Increased risk for infertility and testicular malignancy. |
|
|
Term
| What are the treatment options for Cryptorchidism? |
|
Definition
| Tx = Surgical repositioning of the testes (orchipexy) or an IM series of human chorionic gonadotropin. |
|
|
Term
:the inability to attain or sustain an erection for sexual intercourse 25% of the time.
Primary vs secondary? |
|
Definition
Erectile Dysfunction.
Primary = inability to sustain an erection throughout life.
Secondary = Patient can no longer sustain an erection but could in the past. |
|
|
Term
| What are some common causes of ED? |
|
Definition
| Atherosclerosis, HTN, DM, PVD, prostate cancer treatment and medications. |
|
|
Term
| What are the treatment options for ED? |
|
Definition
| Tx = insertion of an inflatable or semi-rigid prosthesis into the corpora cavernosa, intracavernous injection of vasoactive substance (for paraplegics), or Viagra/Cialis/Levitra. |
|
|
Term
| :Common intrinsic scrotal mass from excessive accumulation of sterile fluid that can be transilluminated |
|
Definition
|
|
Term
| What is the difference between a congenital and adult hydrocele? |
|
Definition
| Congenital = Hydrocele communicates with the abdominal fluid so it fills when the patient is upright and empties when he lays down. Adult does not communicate and size fluctuations occur when there is an imbalance between production and absorption of fluid. |
|
|
Term
| What are the treatment options for a scrotal hydrocele? |
|
Definition
| Surgical hydrocelectomy if persistent of aspiration for temporary treatment. |
|
|
Term
:a collection of large veins superior to the testicle that are present in the upright position and empty in the supine position. Feels like a "bag of worms".
What is the treatment? |
|
Definition
Varicocele.
Tx = Surgery only if symptomatic. |
|
|
Term
:usually occurs at the upper pole of the testis adjacent to the epididymis
appears as a cystic scrotal mass and is painless and exhibits transillumination. |
|
Definition
|
|
Term
| How is a spermatocele diagnosed? How is it treated? |
|
Definition
Dx = US.
Tx = surgical excision if it becomes bothersome. |
|
|
Term
| :a strong & immediate urge to void caused by involuntary detrusor contractions |
|
Definition
|
|
Term
| :incontinence from ↑ abd pressure combined with pelvic muscle laxity. More women than men. |
|
Definition
|
|
Term
| :incontinence with concurent sx of stress & urge incontinence |
|
Definition
|
|
Term
| :incontinence from urinary retention and an overextended bladder secondary to: obstruction, detrusor underactivity, inactivity of/or from sphincteric malfunction and S&S: constant or intermittent dribbling |
|
Definition
|
|
Term
| What is Urolithiasis? What is it usually composed of? What is it usually indicative of? |
|
Definition
| It is bladder caliculi and are usually composed of uric acid and usually indicate urinary retention. |
|
|
Term
| What is the treatment for Urolithiasis? |
|
Definition
| Pain management (NSAIDs, Opioids), relieve the obstruction and treat any infection. |
|
|
Term
| What is Nephrolithiasis? What is the most common composition? What is the hallmark symptom? |
|
Definition
Renal calculi, most common composition is calcium oxalate or calcium phosphate.
Hallmark symptom is Ureteral colic (pain as the calculi moves down the ureter). |
|
|
Term
| How can you differentiate calcium and cystine stones from uric acid stones with nephrolithiasis? |
|
Definition
| Calcium and cystine stones are radiopaque and uric acid stones are radiolucent. |
|
|
Term
| What are the treatment options for Nephrolithiasis? What size calculi should be able to pass spontaneously? What do you have to do if they are larger than that? |
|
Definition
Tx = narcotics for analgesia, IV fluids for diuresis and lithotripsy.
Stones less than 5mm should pass spontaneously, if larger than send to urology for removal. |
|
|
Term
| :Inability to retract the foreskin over the glans penis |
|
Definition
|
|
Term
| What is the treatment for Phimosis? |
|
Definition
| Tx = circumcision or nothing if asymptomatic. |
|
|
Term
| :Entrapment of a retracted foreskin behind the glans penis |
|
Definition
|
|
Term
| What are the treatment options for Paraphimosis? |
|
Definition
| Tx = manual correction, if unsuccessful then do surgical correction or circumcision. |
|
|
Term
| :Emergency condition involving rotation of the testis and strangulation of its blood supply characterized by acute scrotal pain/swelling, nausea, vomiting and an absent cremasteric reflex on the affected side. |
|
Definition
|
|
Term
| How is the diagnosis of Testicular torsion confirmed? Treatment? |
|
Definition
Dx confirmed by Color Doppler.
Tx = immediate manual outward detorsion followed by surgical intervention. |
|
|
Term
| :fibrosis of the cavernous sheaths of the corpora cavernosa leading to contracture and deviation towards the effected side. Painful, incomplete erection. |
|
Definition
|
|
Term
| What are the treatment options for Peyronie's Disease? |
|
Definition
| surgical removal of the fibrosis & replacement with a patch graft that may be successful for may lead to further scarring or you can give a series of local injections of verapamil or corticosteroids into the plaque. |
|
|
Term
| :inflammation or bacterial infection (E. coli) of the bladder epithelium that ascends from the urethra and is characterized by irritative voiding, frequency, urgency, dysuria, cloudy urine, suprapubic discomfort, gross hematuria and flank/low back pain. |
|
Definition
|
|
Term
| What is the gold standard diagnostic test for Cystitis? Treatment? |
|
Definition
GS Dx = urine C&S.
Tx = antibiotics. |
|
|
Term
| What is the typical bacterial etiology of Epididymitis? Non-bacterial etiology? |
|
Definition
Bacterial (men under 35 is usually sexually transmitted - gonorrhea or chlamydia)
Non-bacterial is usually do to a retrograde flow of urine into the epididymis. |
|
|
Term
| What is the etiology of Orchitis? How is it diagnosed? Treatment? |
|
Definition
Etiology = ascending bacterial infection from the urinary tract or from mumps infection.
Diagnosis made by pyuria (pus) and bactieruria on UA, urine C&S and US.
Tx = antibiotics (bacterial) or ice/analgesics (mumps). |
|
|
Term
| What is the most common form of Prostatitis? |
|
Definition
| 90% are Type III (chronic abacterial/chronic pelvic pain syndrome) |
|
|
Term
| Describe Types I-IV Prostatitis. |
|
Definition
I - acute bacterial.
II - chronic bacterial.
III - chronic abacterial/chronic pelvic pain syndrome.
IV - Asymptomatic. |
|
|
Term
| :bacterial infection of the renal pelvis & interstitum due to an ascending infection from the lower urinary tract |
|
Definition
|
|
Term
| What are the S&S of acute Pyelonephritis (including the hallmark)? How is it diagnosed? What is the treatment? |
|
Definition
S&S = CVA tenderness (hallmark), fever/chills, flank pain and UTI symptoms.
Dx = H&P, UA (increased WBCs and RBCs), urine C&S and increased WBCs on CBC.
Tx = antibiotics and hydration. |
|
|
Term
| :characterized by unilateral or bilateral pathologic changes in the kidneys from infection, small atrophic kidneys with diffuse scarring & blunting of the calices and is the second leading cause of renal failure. |
|
Definition
|
|
Term
| How is chronic pyelonephritis diagnosed? Treatment? |
|
Definition
Dx = UA (WBC casts), IVP (wedge shaped scars in the cortex and papillae), US (small kidney with clubbing of the calices) and a voiding cystourethrogram (detects vesicoureteral reflux).
Tx = treat the underlying cause and antibiotics for potentially 3-6 months. |
|
|
Term
| :bacterial infection of the urethra commonly by sexually transmitted pathogens (gonorrhea or chlamydia) amd characterized by dysuria and urethral discharge. |
|
Definition
|
|
Term
| How is urethritis diagnosed? Treatment? |
|
Definition
Dx = C&S.
Tx = antibiotics towards the causative pathogen. |
|
|
Term
| What sex is more affected by bladder cancer? What is the most common type of bladder cancer? What are the risk factors for bladder cancer? |
|
Definition
Males are affected 3x more and the most common type is transitional cell cancer.
Risk factors = smoking, occupational exposures, antineoplastic agents, diesel exhaust, pelvic radiation and pesticides in drinking water. |
|
|
Term
| What are the treatment options for bladder cancer? |
|
Definition
| Tx = Transurethral resection (TUR), radical or simple cystectomy with urinary diversion and/or radiation therapy. |
|
|
Term
| Which cells do 95% of testicular cancers arise from? |
|
Definition
| The germ cells (sperm-producing lining of seminiferous tubules). |
|
|
Term
| What are the common sites of METS for testicular cancers? |
|
Definition
| ipsilateral retroperotoneal lymph nodes, lungs, liver, bone and brain. |
|
|
Term
| Why might gynecomastia occur with testicular cancer? |
|
Definition
| BC the testis are not producing enough testosterone so hCG accummulates. |
|
|
Term
| What are the treatment options for testicular cancer? |
|
Definition
| Tx - close observation, surgical removal of the testis and spermatic cord, chemo and radiation. |
|
|
Term
| What are the 5 year survival rates seen with Stage I-III testicular cancer? |
|
Definition
Stage I Disease confined to the testis--99%.
Stage II Disease extends to retroperitoneal lymph nodes--98%.
Stage III Disease above the diaphragm--80%. |
|
|
Term
| What is the most common type of prostate cancer? What is typically the first symptom? |
|
Definition
| Most common type is adenocarcinoma (95%) and symptoms are usually rare until urethral obstruction occurs. |
|
|
Term
| How is prostate cancer typically diagnosed? What is the prognosis if it has not METS? What are the treatment options? |
|
Definition
Dx = DRE, PSA and confirmed by biopsy.
Prognosis if not METS is very good.
Tx = prostatectomy, radiation therapy or watchful waiting. |
|
|
Term
| What are the risk factors for Renal Cell Carcinoma? |
|
Definition
| RF = 50-70 years old, occupational exposures, high protein diet, smoking, obesity, HTN and horseshoe kidney. |
|
|
Term
| What is the classic triad of Renal Cell Carcinoma? What is the prognosis? What is the treatment? |
|
Definition
Triad = hematuria, flank pain and a palpable trunk/abdominal mass.
Prognosis is poor (40% will die within several years).
Tx = Radical nephrectomy (includes adrenal gland and lymph nodes), it is resistant to radiation and chemo. |
|
|
Term
| What is the most common abdominal tumor in children? What is the treatment? |
|
Definition
Wilm's tumor (aka Nephroblastoma).
Tx = tumor and kidney removal and possible radiation and chemo. |
|
|
Term
| What are the S&S of a Wilm's tumor? |
|
Definition
| palpable flank/abdominal mass, abdominal pain, HTN and microscopic hematuria. |
|
|
Term
| What volume or urine must be collected to stimulate the stretch receptors of the bladder? |
|
Definition
|
|
Term
| Describe the flow of urine from the PCT to the urethra. |
|
Definition
| PCT, proximal straight tubule, descending limb, loop of henle, ascending limb, distal straight tubule, DCT, collecting duct, papillary duct, minor calyx, major calyx, renal pelvis, ureter, urinary bladder, urethra. |
|
|
Term
| What is the function of the nephron? What percentage of nephrons have to be damaged to get serious renal impairment? |
|
Definition
| The nephron performs all filtration, reabsorption and secretory functions of the kidney. Serious renal impairment occurs between 75 – 90% of nephron damage. |
|
|
Term
| What are the endocrine functions of the kidney? |
|
Definition
| Produce EPO and activate vitamin D. |
|
|
Term
| How much fluid is filtered per hour by the kidneys? |
|
Definition
| More than 7L of fluid/hour. |
|
|
Term
| What percentage and volume/min of cardiac output goes to the kidneys? |
|
Definition
| 25% of all CO goes to the kidneys (1200ml/min) |
|
|
Term
| What are the components of the nephron? |
|
Definition
| Glomerulus, Bowman's capsule, PCT, Loop of Henle, DCT and the Collecting Duct. |
|
|
Term
|
Definition
|
|
Term
| Where are most of the water and electrolytes reabsorbed in the nephron? |
|
Definition
|
|
Term
| What are the functions of the descending limb, ascending limb and juxtamedullary nephrons? |
|
Definition
Descending limb - is permeable to water only.
Ascending limb - transports Na+, K+ and Cl- from the filtrate into the interstitium around the loops.
Juxtamedullary - create concentrated urine. |
|
|
Term
| What are the actions and site of action for aldosterone/angiotensin II and ANP/urodilatin? |
|
Definition
Aldosterone/Angiotensin II - stimulate resorption of sodium and water in the DCT.
ANP/Urodilatin - inhibit resorption of water. |
|
|
Term
| Where does ADH affect the nephron? |
|
Definition
| It works in the collecting duct to resorb water. |
|
|
Term
| When does autosomal recessive and autosomal dominant polycystic kidney disease typically manifest? |
|
Definition
AR = in infants and young children.
AD = in adulthood. |
|
|
Term
| What is the etiology of autosomal dominant polcystic kidney disease? |
|
Definition
| Defect on the short arm of chromosome 16 that leads to epithelial cell hyperplasia and cyst development. |
|
|
Term
| What are some associated abnormalities seen with autosomal dominant polycystic kidney disease? |
|
Definition
| Cerebral aneurysms, cardiac valve dysfunction, colonic diverticula, HTN and cysts on other organs. |
|
|
Term
| How do you treat autosomal dominant polycystic kidney disease? |
|
Definition
| Tx = treat HTN/UTIs/cirrhosis/renal failure, dialysis, transplantation and possible genetic counseling with FH x3 generations. |
|
|
Term
| :inflammation of the glomeruli characterized by an abrupt onset of hematuria, proteinuria, azotemia, and renal sodium/water retention (edema/ascites). |
|
Definition
|
|
Term
| What are some triggers of acute glomerulonephritis? |
|
Definition
| Bacerial, viral, parasitic, primary disease (Berger's disease), multisystem disease (Goodpasture syndrome, SLE, vasculitis), or Miscellaneous (Guillain-Barre syndrome, serum sickness, radiation) |
|
|
Term
| What is the etiology of acute glomerulonephritis? |
|
Definition
| Inflammatory cells infiltrate the glomerulus walls and create antibody-antigen complexes activating compliment and leading to damage do the glomerular wall and a more permeable membrane. |
|
|
Term
| What are the classic S&S of acute glomerulonephritis seen on UA? |
|
Definition
| S&S = coffee colored or smoky urine, RBC casts (classic indicator), WBC casts and proteinuria. |
|
|
Term
| How is acute glomerulonephritis definitively diagnosed? Treatment? |
|
Definition
Dx = renal biopsy.
Tx = depends on the cause (antibiotics, antihypertensives, steroids, diuretics, dietary sodium restriction and dialysis). |
|
|
Term
| What are the most common causes of rapidly progressing glomerulonephritis? What will it look like on histology? What is the treatment? |
|
Definition
Post-strep infection or infective endocarditis.
Histology = crescent formation in the glomerulus.
Tx = Dialysis, sodium/fluid restriction, diuretics and prednisone. |
|
|
Term
| :Continuing or persistent hematuria & proteinuria → slowly progressive deterioration in renal function with an end result of HTN, small/scarred kidneys and renal failure. |
|
Definition
| Chronic Glomerulonephritis |
|
|
Term
| What is the cause more likely to be with chronic glomerulonephritis? Treatment? |
|
Definition
More likely to be of autoimmune etiology.
Tx = same as acute GN but they will need long term dialysis and possible renal transplantation. |
|
|
Term
| :a collection of sx caused by glomerular disease characterized by a loss of large amounts (>3.5 g/day) of protein in the urine from ↑ glomerular wall permeability |
|
Definition
|
|
Term
| What are the S&S/complications of Nephrotic Syndrome? |
|
Definition
| Hypoalbuminemia, hyperlipidemia, lipiduria, edema, hypercoagubility, decreased immunity and vitamin D deficiency leading to secondary hyperparathyroidism. |
|
|
Term
| What are the 6 disorders that are related to Nephrotic Syndrome? |
|
Definition
| Diabetic nephropathy, Minimal Change Disease, Focal Segmental Glomerulosclerosis, Membranous Glomerulopathy, Membranoproliferative Glomerulonephritis and Amyloidosis. |
|
|
Term
| Describe why you see hyperlipidemia with Nephrotic Syndrome. |
|
Definition
| Decreases in plasma albumin levels stimulate the liver to produce cholesterol, TGs and lipoproteins. |
|
|
Term
| What is the most common cause of Nephrotic Syndrome in adults? Children? |
|
Definition
Adults = Diabetic nephropathy.
Children = Minimal Change Glomerulonephritis. |
|
|
Term
| What is the treatment for kids with Minimal Change Disease leading to Nephrotic Syndrome? |
|
Definition
| 12-16 weeks of tapered steroids, sodium restriction, diuretics, vitD, calcium and iron supplementation. |
|
|
Term
| :sudden, severe decrease in renal function with an acute rise in serum creatinine, azotemia and a mortality rate of 40-60%. |
|
Definition
|
|
Term
| What are some risk factors for Acute Renal Failure? |
|
Definition
| RF = preexisting renal impairment, atherosclerosis, HTN, DM, heart failure, liver disease and advanced age. |
|
|
Term
| Describe the etiology of prerenal, postrenal and intrarenal acute renal failure. Which is the most common? |
|
Definition
Prerenal failure (decreased renal perfusion).
Postrenal (bilateral obstruction).
Intrarenal (damage to the nephron - MC = acute tubular necrosis).
Most common is Prerenal. |
|
|
Term
| Describe the GFR percentage decrease that corresponds to kidney: Risk, Injury and Failure. |
|
Definition
Risk = GFR decrease greater than 25%.
Injury = GFR decrease greater than 50%.
Failure = GFR decrease greater than 75%. |
|
|
Term
| Describe the serum Creatinine level that corresponds to kidney: Risk, Injury and Failure. |
|
Definition
Risk = 1.5x normal.
Injury = 2x normal.
Failure = 3x normal. |
|
|
Term
| :Progressive loss of renal function over mos to yrs defined by a GFR < 60ml/min x at least 3 months. |
|
Definition
|
|
Term
| Can chronic or acute renal failure be reversed? |
|
Definition
| Acute can be reversed, chronic can only be slowed. |
|
|
Term
| What percentage of nephron loss corresponds to the decreased renal reserve stage of CRF? Renal insufficiency stage? ESRD stage? |
|
Definition
Decreases renal reserve = Less than 75% loss.
Renal insufficiency = 75-90% loss.
ESRD = Greater than 90% loss. |
|
|
Term
| In general, a doubling of serum creatinine implies a___% reduction in GFR. |
|
Definition
|
|
Term
| How do you measure GFR (procedure and formula)? |
|
Definition
24 hours urine collection.
GFR = (140-age)x(wt in kg) / (72)x(serum Cr in mg/dl) |
|
|
Term
| How does Chronic Renal Failure typically present on labs? |
|
Definition
| Severe hypocalcemia, decreased EPO, increase potassium and metabolic acidosis. |
|
|
Term
| What are the treatments involved with Chronic Renal Failure? |
|
Definition
| Manage HTN, metabolic acidosis, anemia, fluid/sodium/phosphate restrictions, low protein diet, calcium/vit D supplements, antacids, dialysis, etc. |
|
|
Term
| What can result from the chronic hypocalcemia seen with chronic renal failure? |
|
Definition
| Secondary hyperparathyroidism leading to osteitis fibrosa and osteomalacia. |
|
|
Term
| :type of dialysis where hypertonic dialysate is placed into the peritoneal space via a surgically implanted catheter and the peritoneum acts as a semipermeable membrane where fluid & solute removal occurs by diffusion |
|
Definition
|
|
Term
| What organ transplantation has the highest rate of success? What must these patients be on lifelong therapy for? |
|
Definition
| Renal transplantation, patients must be on livelong immunotherapy. |
|
|
