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Reproductive

Instructions:

Answer 50 questions in 15 minutes.
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Match each statement with the correct term.
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This is a study tool. The 3 wrong answers for each question are randomly chosen from answers to other questions. So, you might find at times the answers obvious, but you will see it re-enforces your understanding as you take the test each time.

1. How does exogenous testosterone create azoospermia
Necrosis - hemorrhage - can protrude from the cervix and bleed - tendency to recur
Inhibition of HCG access
Osteoblastic in bone
Lateral invasion can block ureters causing renal failure

2. Arrange the androgens in order of most potent to least potent
Weight loss - OCP - gonadotropin analogs - clomiphene - sprinolactone - surgery
Serous cystadenoma
Endometrial carcinoma
DHT - testosterone - androstenedione

3. What is the expected increase of estradiol and estrone in pregnancy
BPH
The anterior pituitary and hypothalamus
50 times
Good - late metastasis

4. Where does prostatic adenocarcinoma arise from?
Complete
Fertilization 'an egg met a sperm'
Posterior lobe peripheral zone
Increase

5. atypical cells in epithelial hyperplasia
Hyperthyroidism - contains functional thyroid tissue
DIC
Testosterone secreting tumor - exogenous steroids
Inc risk for carcinoma

6. Does a leiomyoma progress to leiosarcoma
No
Estrogen/progesterone receptors - erb - B2 - HER2 an EGF receptrs
Inhibit cGMP breakdown
PANS - pelvic nerve

7. When is follicular growth the fastest?
Choriocarcinoma
2nd week of proliferative phase
Call exner bodies
Placenta acreta

8. hyperandrogenism due to deranged steroid synthesis by theca cells - inc LH leading to anovulation
Choriocarcinoma
PCOS
Production of a thick cervical mucus
Sprinolactone - digitalis - cimetidine - alchohol - ketoconazole

9. breast path - diseases of the terminal duct
Prophase
Decrease
Estradiol
Tubular carcinoma

10. What is the most common cause of breast lumps from age 25 to menopause
Fibrocystic disease
Granulosa cell tumor
Corpus luteum cyst
Decreasing progesterone

11. What is the right venous drainage of the ovary/testis
Defective androgen receptor
Right gonadal vein - IVC
Distention and hypertrophy of bladder - hydronephrosis - UTIs - not premalignant
Mucinous cystadenoma

12. cystic swelling of chorionic villi and proliferation of chorionic epithelium that presents with abnormal vaginal bleeding
Hydatidiform mole
Complete
BPH
Prematurity

13. attachment of palceta to lower uterine segment that may occlude internal os - painless bleeding in any trimester
Placenta previa
Lack of spermatogenesis due to inc temp of testis inside body and associated risk of germ cell tumors
Inhibit FSH
Granulosa cell tumor

14. defect in androgen receptor resulting in normal appearing female - rudimentry vagina - no uterus or uterine tubes
Abruptio placentae
Ovary
Androgen insensitivity syndrome - 46 XY
Testosterone

15. How does progesterone inhibit sperm entry to uterus
Testosterone
Final stage of spermatogenesis - spermiogenesis - spermatid to spermatozoa
Round ligament of the uterus
Production of a thick cervical mucus

16. Connects ovary to lateral uterus
Oligohydramnios
Ligament of the ovary
Paget's disease - breast abscess
Inc freq of urination - nocturia - difficulty starting/stopping urination - dysuria

17. What does estrogen do to FSH and LH
Post menopausal
Feedback inhibition
Development of genitalia and breast - growth of follicle - hormonal interactions with HPG accesss - and inc transport proteins like SHBG inc HDL and dec LDL
Right gonadal vein - IVC

18. <0.5 L of amniotic fluid
Prior c section - inflammation - placenta previa
Oligohydramnios
Relaxation
Development of genitalia and breast - growth of follicle - hormonal interactions with HPG accesss - and inc transport proteins like SHBG inc HDL and dec LDL

19. What estrogen does the ovary secrete
Tight junctions between sertoli cells
Krukenburg tumor
S aureus
17beta estradiol

20. decreased synthesis of gonadotropin in the ant pit - anosmia - lack of secondary sex characteristics
Differentiation of penis - scrotum and prostate
Kallman
Slight increase - 1.5 to 2
Unopposed estrogen - obesity - diabetes - HTN - nulliparity - late menopause

21. How many days after fertilization does implantation occur?
Alpha1 antagonists - terazosin - tamsulosin - finasteride
17beta estradiol
Testosterone - DHT - androstenedione
6

22. What is HELLP syndrome
Hydrocele
Hemolysis - elevated liver enzymes - low platelets
In the 6th decade of life
Squamous cell carcinoma

23. in postmenopausal women Where is androstenedione converted to estrone
Squamo - columnar jxn
69 xxy
Theca cell - desmolase - androstenedione
Peripheral adipose tissue

24. What cellular structure is the acrosome derived from?
Golgi
Epithelial hyperplasia
Stimulate glandular secretions - and spiral artery development
Asia - Africa - S. America - HPV - lack of circumcision

25. histologic type of fibrocystic with hyperplasia of breast stroma
Inc size and tenderness with inc estrogen
Tubular carcinoma
Fibrosis
Tight junctions between sertoli cells

26. What does progesterone do for pregnancy
Inc in total - and dec in free fraction
Tight junctions between sertoli cells
Maintenance
Final stage of spermatogenesis - spermiogenesis - spermatid to spermatozoa

27. What occurs to a fibroadenoma during pregnancy and menstruation and why
The ampulla - occurs within 1 day of ovulation
Myometrial tumors
Testosterone - DHT - androstenedione
Inc size and tenderness with inc estrogen

28. What does inhibin do?
Inhibit FSH
Preductal coarctication
Serous cystadenoma
Fructose

29. breast path - diseeases of the lobules
Enlarged bilateral cystic ovaries - amenorrhea - infertility - obesity - and hirsutism
Multiple sexual partners - also HIV and early sexual intercourse
Lobular carcinoma - sclerosing adenosis
Anovulatory cycles - hormone replacement therapy - PCOS - granulosa cell tumor

30. What pathologic states cause increases in hCG
95%
Feedback inhibition
Prostate growth - balding - and sebaceous gland activity
Hydatidiform moles - choriocarcinoma - gestational trophoblastic tumors

31. What are the effects of prolactin?
Induces and maintains lactation - decreases reproductive function
Stimulates testosterone release from leydig cells
Serous cystadenocarcinoma
The ampulla - occurs within 1 day of ovulation

32. Which gynecologic tumors have the worst prognosis?
Post menopausal
Granulosa cell - aromatase - androstenedione - estrogen
Intraductal papilloma - breast abscess - mastitis
Ovarian > cervical > endometrial

33. when do primary oocytes complete meiosis I
Abruptio placentae
Andogren binding protein - anti mullerian hormone
Just prior to ovulation
Severe bleeding iron def anemia - miscarriage

34. headache - blurred vision - abdominal pain - edema of face and extremeties - altered mentation - hyperreflexia in pregnancy
Bowenoid papulosis - carcinoma in situ of the penis
Uterus
Preeclampsia clinical
Stimulates sertoli cells to produce ABP and inhibin

35. What does HHAVOC stand for in menopause
Osteoblastic in bone
Hirsutism - hot flashes - atrophy of the vagina - osteoporosis - coronary artery disease
Cyclic bleeding - chocolate cysts - severe menstrual related pain - infertility
Small infiltrating glands with prominent nucleoli

36. What is the single most important prognostic factor for malignant breast tumors
Visceral - somatic nerves in pudendal
Axillary node involvement
2 months
Low progesterone

37. tumor with firm fibrous - 'rock hard' mass with sharp margins and small glandular duct like cells - worst prognosis and most common
Menometrorrhagia
Necrosis - hemorrhage - can protrude from the cervix and bleed - tendency to recur
Down regulation
Invasive ductal

38. What is the lymphatic drainage of the proximal 2/3 of the vagina/uterus
Obdurator - exterinal iliac - hypogastic nodes
Good - late metastasis
Varicocele
Turner's XO

39. Multiple papular lesions on the penis - affects younger age group - usually does not become invasive
Malignant in males not in females
Defective androgen receptor
Relaxation
Bowenoid papulosis - carcinoma in situ of the penis

40. which cysts results from gonadotropin stimulation and is associated with choriocarcinoma and moles
Theca - leutin cysts
Prior c section - inflammation - placenta previa
DCIS
Tubular carcinoma

41. hyperplasia - not hypertrophy of the prostate gland
Upregulation
BPH
Female pseudoHerm
Estrogen overstimulation

42. increases in which hormone are associated with BPH
Medullary
Estradiol and possible growth promoting effects of DHT
Congenital adrenal hyperplasia - exogenous administration of steroids
Severe bleeding iron def anemia - miscarriage

43. What are the treatments for PCOS
Seminiferous tubules - epididymis - vas deferens - ejaculatory ducts - nothing - urethra - penis
Para - aortic lymph nodes
Mammary duct epithelium or lobular glands
Weight loss - OCP - gonadotropin analogs - clomiphene - sprinolactone - surgery

44. Which androgen is responsible for differentiation of epididymis - vas deferens - seminal vesicles - internal genitalia (except prostate)
Andogren binding protein - anti mullerian hormone
Testosterone
GnRH from hypoTh - LH and FSH from ant pituitary
Cyclic bleeding - chocolate cysts - severe menstrual related pain - infertility

45. How is dyslpasi and carcinoma in situ of the cervix classified
Dysgerminoma
CIN 1 - 2 - 3
Blacks
No

46. What does progesterone do to estrogen receptors
Down regulation
Phyllodes tumor
Choriocarcinoma
PCOS - obesity - Asherman's - HPO axis defect - Pof - hyperprolactinemia - thryoid - eating disorders - cushging's - adrenal insuff

47. inc fluid secondary to incomplete fustion with processus vaginalis
Partial
Theca cell - desmolase - androstenedione
Medullary
Hydrocele

48. What metastasis is most common with prostatic adenocarcinoma
Testis determining factor
Call exner bodies
Puberty
Osteoblastic in bone

49. tumor is fleshy - cellular - with a lymphocytic infiltrate - good prognosis
Hemorrhage
Medullary
Ovary
Mature teratoma

50. What serum markers are associated with embyronal carcinoma
Peripheral adipose tissue
Inc AFP and hCG
Periurethral lobes - lateral and middle
Seminoma