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First Aid 2012 pp530-552
78
Medical
Graduate
02/05/2013

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Term
female ligaments
suspensory ligament of ovaries, cardinal ligament, broad ligament, ligament of ovary
Definition
suspensory ligament of the ovary -- ovaries to pelvic wall; ovarian vessels
ligament of ovary -- ovary to uterus; nothing!!
cardinal ligament = cervix to pelvic wall; uterine vessels
broad ligament = mesosalpinx (fallopian tube to ovary) + mesometrium (ovary to uterus) + mesovarium (ovary)
Term
female histology
Definition
simple cuboidal -- ovaries
simple columnar -- fallopian tubes (ciliated) --> uterus (pseudostratified, glands), endocervix
stratified squamous -- ectocervix (goes further up pre-puberty) --> vagina (glycogen --> acid!!)
Term
posterior vs. anterior urethral injury
Definition
posterior -- pelvic fx, above urogenital diaphragm
anterior -- straddle injury, below urogenital diaphragm
Term
semen contributors
Definition
seminal vesicle -- white/yellow, viscous; fructose!!
prostate -- PAP, PSA (liquifies semen!)
Cowper's gland -- clear, slippery; pre-seminal fluid
Term
innervation of sexual response
Definition
erection -- parasympathetic (NO)
emission (semen to ejaculatory ducts) -- sympathetic (hypogastric n.)
ejaculation -- visceral and somatic (pudendal n.)
Term
blood barriers (3)
Definition
1. blood-brain
2. blood-testes
3. maternal-fetal
Term
cryptorchidism
Definition
Leydig cells unaffected --> normal testosterone
Sertoli cells can't handle it --> decreased inhibin/sperm
Term
spermatogenesis vs. spermiogenesis
Definition
spermatogenesis -- make spermatids
spermiogenesis -- make mature spermatozoon
Term
testosterone (5) vs. DHT (4)
Definition
testosterone -- internal genitalia MINUS prostate, growth spurt, deep voice, close epiphyseal plates, libido
DHT -- external genitalia PLUS prostate; prostate, balding, sebaceous glands
Term
follicle and lutein cells (hormones they respond to, what they make)
Definition
theca interna -- LH, androstenedione
granulosa -- FSH, estrogen (estradiol)
theca and granulosa lutein cells -- BOTH make PE
Term
random thing that PE does
Definition
increase body temp
Term
order of puberty stuff
Definition
girls -- thelarche < adrenarche < menarche
boys -- gonadarche < adrenarche
Term
fastest follicular growth
Definition
2nd week of proliferative phase
Term
length of follicular and luteal phase
Definition
luteal ALWAYS 14 days
Term
oligomenorrhea, polymenorrhea
Definition
21 days
35 days
Term
egg meiosis arrest
Definition
prophase I until ovulation
metaphase II until fertilization
Term
timing of ovulation, fertilization, implantation, hCG production
Definition
fertilization 1 day after ovulation
implantation 6 days after fertilization
hCG (syncytiotrophoblast) detected 1 wk after conception in blood, 2 wks in urine; peaks at 9 wks
Term
FSH/LH over lifetime
Definition
child -- lowest, FSH > LH
puberty/repro yrs -- LH > FSH (LH for surge!!)
menopause -- highest, FSH > LH
Term
random stuff associated with Turner's (6)
Definition
bicuspid aortic valve, cystic hygoma and lymphedema, preductal coarctation, horseshoe kidney, dysgerminoma
Term
androgen insensitivity
Definition
defect in androgen receptor
Sertoli cells make AMH --> no female internal genitalia
no testosterone activity --> no male internal genitalia
no DHT activity --> female external genitalia

high LH (no feedback) --> high testosterone and estrogen
Term
"penis at 12"
Definition
5alpha-deficiency -- ambiguous external genitalia until increased testosterone at puberty
Term
mortality in pre-eclampsia
Definition
cerebral hemorrhage, ARDS/DIC
Term
polyhydramnios, oligohydramnios
Definition
1.5 L
0.5 L
Term
what HPV 16 and 18 do to our DNA
Definition
HPV 16 -- E6 inhibits p53
HPV 18 -- E7 inhibits Rb
Term
endometriosis vs. adenomyosis (and treatments)
Definition
endometriosis -- normal-sized uterus; danazol
adenomyosis -- enlarged uterus (boggy); hysterectomy
Term
most common tumor in all females
Definition
leiomyoma
Term
whorled pattern of smooth muscle bundls
Definition
leiomyoma
Term
incidence of gyn tumors; and prognosis
Definition
incidence: endometrial > ovarian > cervical (cervical #1 worldwide)
prognosis: ovarian > cervical > endometrial
Term
premature ovarian failure
Definition
< 40 yo
Term
PCOS -- hormones, treatment
Definition
high LH --> high testosterone --> high estrogen

OCPs or medroxypogesterone, spironolactone, clomiphene
Term
cysts -- follicular, corpus luteum, theca-lutein, hemorrhagic, dermoid
Definition
follicular -- unruptured follicle, may make estrogen, most common ovarian mass
corpus luteum -- bleed into corpus luteum
theca-lutein -- high hCG (i.e. mole) --> bilateral/multiple cysts
hemorrhagic -- blood vessel rupture in cyst wall
dermoid -- mature teratoma
Term
dysgerminoma
Definition
malignant, painless (men)
hCG, LDH
"fried egg"
radiosensitive, great prognosis
most common testicular tumor
Term
choriocarcinoma
Definition
malignant
hCG, hematogenous to lungs
Term
yolk sac = endodermal sinus tumor
Definition
malignant
AFP
sacrococcygeal
Schiller-Duval bodies (look like glomeruli!!)
Term
teratoma
Definition
2-3 germ layers
mature --> benign
immature --> malignant
struma ovarii - functional thyroid!!
most common ovarian germ cell tumor
Term
embryonal carcinoma
Definition
men only
2nd most common testicular tumor
malignant, painful!!
hCG
glandular, papillary
Term
serous cystadenoma vs. cystadenocarcinoma
Definition
adenoma benign; adenocarcinoma malignant
freq bilateral
most common
fallopian tube-like
psammoma bodies
Term
mucinous cystadenoma vs. mucinous cystadenocarcinoma
Definition
adenoma benign; adenocarcinoma malignant
mucus-secreting, pseudomyxoma peritonei (adenocarcinoma)
Term
Brenner
Definition
Benign, looks like Bladder, "coffee bean" nuclei
Term
fibromas
Definition
spindle-shaped fibroblasts
Term
Meigs' syndrome
Definition
ovarian fibroma, ascites, hydrothorax
Term
granulosa-theca cell
Definition
estrogen secreting
Call-Exner bodies (circular pattern)
Term
Krukenberg tumor
Definition
GI malig (i.e. stomach) that mets to bilateral ovaries
mucin-secreting
signet cell adenocarcinoma
Term
Sertoli-Leydig cell tumor
Definition
testosterone secreting
Term
sarcoma botryoides
Definition
rhabdomyosarcoma variant in vagina
girls < 4 yr
spindle-shaped tumors cells
desmin positive
"bunch of grapes"
Term
breast stroma
Definition
fibroadenoma, phyllodes
Term
lobules
Definition
lobular carcinoma, sclerosing adenosis
Term
terminal duct
Definition
tubular carcinoma
Term
major duct
Definition
fibrocystic change, ductal cancer
Term
lactiferous sinus
Definition
intraductal papilloma, breast abscess, mastitis
Term
nipple
Definition
Paget's disease, breast abscess
Term
weird thing about fibroadenoma
Definition
responsive to estrogen
Term
large bulky mass, "leaf-like" projections
Definition
phyllodes
Term
comedocarcinoma
Definition
subtype of DCIS with caseous necrosis!!
Term
"stellate"
Definition
invasive ductal
Term
invasive ductal -- feel, epidemiology, prognosis
Definition
most common, worst prognosis
firm and fibrous
Term
"Indian file"
Definition
invasive lobular
Term
invasive lobular -- where
Definition
multiple, bilateral
Term
fleshy, lymphocytic
Definition
medullary, good prognosis
Term
Paget cell
Definition
large cells in epidermis with clear halo
Term
fibrocystic disease types
Definition
1. fibrosis -- stroma hyperplasia
2. cystic -- blue dome
3. sclerosing adenosis -- increased acini, intralobular fibrosis, calcifications
4. epithelial hyperplasia -- increased epithelial cell layers in terminal duct lobule (atypia --> cancer risk)
Term
acute mastitis pathogen
Definition
Staph aureus
Term
prostate markers
Definition
PSA -- increased free --> PSA; increased complexed --> cancer
PAP -- cancer penetrated capsule!!
Term
Leydig cell testicular cancer
Definition
Reinke crystals, androgen producing --> gynecomastia/precocious puberty
Term
Sertoli cell
Definition
no endocrine stuff
Term
testicular lymphoma
Definition
from mets; most common testicular cancer in older men
Term
squamous cell carcinoma associations
Definition
HPV, uncircumsized
Term
Peyronie's disease
Definition
bent penis 2/2 SQ fibrosis of dorsum of penis
Term
phimosis
Definition
abnormally tight foreskin
Term
Schiller-Duval
Definition
yolk sac tumor
Term
Call Exner
Definition
granulosa tumor
Term
coffee been nuclei
Definition
Brenner tumor
Term
fried egg
Definition
seminoma
Term
Reinke crystals
Definition
Leydig
Term
skin dimpling from cancer
Definition
infiltration of Cooper's ligaments
Term
nipple inversion from cancer
Definition
infiltration of central region of breast
Term
check that she has menopause
Definition
FSH
Term
random stuff anabolic steroids do
Definition
increase RBC prod --> polycythemia
hepatic abnormalities
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