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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. Which teratoma - mature or immature - is aggresively malignant
Immature
Metrorrhagia
6
Adolescents

2. What is the genetic material in the secondary oocyte?
Haploid - 2N - 23 sister chromatids
Bowenoid papulosis - carcinoma in situ of the penis
Dysgerminoma
Inhibit FSH

3. gray - soliarty - crusty plaque - usually on the shaft of the penis or on the scrotum - peak incidence in 5th decade of life - can progress to invasive SCC in < 10% of cases

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4. What is the venous drainage of the left ovary/testis?
Left gonadal vein - left renal vein - IVC
Esophogeal/duodenal atresia - can't swallow - anencephaly
Meigs syndrome
Low progesterone

5. What does LH do
Stimulates testosterone release from leydig cells
Cyclic bleeding - chocolate cysts - severe menstrual related pain - infertility
Paget's disease
Serous cystadenocarcinoma

6. malignant - painless homogenous testicular enlargement - most common testicular tumor - affecting males ages 15 to 3 - large cells in lobules with watery cytoplasm and a 'fried egg' appearnace
Mucinous cystadenoma
Seminoma
Choriocarcinoma
Tubular carcinoma

7. How does endometrial hyperplasia manifest clinically
Post menopausal bleeding
Preductal coarctication
Down regulation
Chromosomal abnormalities

8. What is the number 1 risk factor for cervical dysplasia or carcinoma in situ
Choriocarcinoma
Serous cystadenoma
Multiple sexual partners - also HIV and early sexual intercourse
DRE - hard nodule and biopsy

9. what metabolic disorder is assocaited with PCOS
Insulin resistance
Oligomenorrhea
Increase (and LH)
Haploid - 2N - 23 sister chromatids

10. Which androgens are responsible for the growth spurt of the penis - seminal vesicles - sperm - muscle - RBCs
Placenta previa
6
Lack of spermatogenesis due to inc temp of testis inside body and associated risk of germ cell tumors
Testosterone

11. tumor with firm fibrous - 'rock hard' mass with sharp margins and small glandular duct like cells - worst prognosis and most common
Differentiation of penis - scrotum and prostate
E coli
Invasive ductal
No

12. When are phyllodes tumors most common
Bowenoid papulosis - carcinoma in situ of the penis
S aureus
Mimics LH
In the 6th decade of life

13. what stimulation is required to maintain milk production and What is the pathway
Estradiol > estrone > estriol
Suckling - inc oxytocin - prolactin
Premature ovarian failure (Pof)
Unopposed estrogen - obesity - diabetes - HTN - nulliparity - late menopause

14. Where does prostatic adenocarcinoma arise from?
Sprinolactone - digitalis - cimetidine - alchohol - ketoconazole
Posterior lobe peripheral zone
Good - late metastasis
Serous cystadenoma

15. From What tissues to malignant breast tumors arise?
Mammary duct epithelium or lobular glands
SANS - hypogastric nerve
Left gonadal vein - left renal vein - IVC
Tight junctions between sertoli cells

16. What are the 3 androgens
Sertoli cells
Follicular cyst
Testosterone - DHT - androstenedione
Delivery of fetus

17. What are the associated risk factors for malignant breast tumors
Prostatic acid phosphatase and PSA
Inc risk for carcinoma
Cerebral hemorrhage and ARDS
Inc estrogen - inc total nunmber of cycles - older age at 1st live birth - obesity

18. gynecological tumors from highest incidence to lowest
Endometrial > ovarian> cervical (in US)
Testosterone
Squamous cell carcinoma
Mucinous cystadenocarcinoma

19. What is the lymphatic drainage the ovaries/testis
Visceral - somatic nerves in pudendal
Development of genitalia and breast - growth of follicle - hormonal interactions with HPG accesss - and inc transport proteins like SHBG inc HDL and dec LDL
Theca - leutin cysts
Para - aortic lymph nodes

20. histo: stratified squamous epithelium - nonkeratinized
Myometrial tumors
Vagina
Asia - Africa - S. America - HPV - lack of circumcision
Just prior to ovulation

21. Which system and nerve are responsible for emission
Whorled pattern of smooth muscle bundles
Endocervix
SANS - hypogastric nerve
Partial

22. What changes are seen with total PSA and fraction of free PSA
Inc in total - and dec in free fraction
Testosterone - DHT - androstenedione
Placental ischemia due to impaired vasodltn of spiral arteries resulting in increased vasc tone
SANS - hypogastric nerve

23. What estrogen does the placenta secrete
Delivery of fetus
Haploid - 2N - 23 sister chromatids
Mucinous cystadenocarcinoma
Estradiol

24. common cause of recurrent miscarriage in the 1st week
Low progesterone
Left gonadal vein - left renal vein - IVC
Sertoli cell tumor
Primary hypogonadism

25. breast path - diseases of the major duct
Embryonal carcinoma
Haploid - 2N - 23 sister chromatids
Spermatogonia (germ cells)
Fibrcystic change - ductal cancer

26. What pathologic states cause increases in hCG
Left
Complete
Hydatidiform moles - choriocarcinoma - gestational trophoblastic tumors
Good - late metastasis

27. Which side is varicocele more common on...
Left
Sertoli cells
Neoplastic cells block lymphatic drainage
Smoking - HTN - cocaine

28. Which cells line the seminiferous tubules and secrete inhibin
Defective androgen receptor
6
Sertoli cells
Haploid - 2N - 23 sister chromatids

29. histo: simple columnar epithelium
Endocervix
Stimulates testosterone release from leydig cells
No
Inc in total - and dec in free fraction

30. What is the risk for carcinoma among patients with intraductal papilloma
Mimics LH
4
Slight increase - 1.5 to 2
Immature

31. What does progesterone do in the endometrium
Stimulate glandular secretions - and spiral artery development
Low back pain with increased serum alk phos
Ectocervix
Theca - leutin cysts

32. Why does the skin resemble an orange peel in inflammatory type of maligantn breast tumor
Theca cell - desmolase - androstenedione
Neoplastic cells block lymphatic drainage
Haploid - N - 23 single chromatids
Placental insufficiency - bilateral renal agenesis - posterior urethral valves - potter's syndrome

33. What is the source of estrogen after menopause
Peripheral conversion of androgens
20 to 40
Round ligament of uterus
Placenta previa

34. In what phase is meiosis I arrested
Axillary node involvement
Testis determining factor
Fibroadenoma
Prophase

35. breast path - diseases of the stroma
Proliferation
Estradiol
Fibroadenoma - phyllodes tumor
Ectopic preg

36. What are the effects of prolactin?
Testosterone
CIN 1 - 2 - 3
Whorled pattern of smooth muscle bundles
Induces and maintains lactation - decreases reproductive function

37. What are the four functions of estrogen
One of the centrioles
Blacks
Hyperestrogenism
Development of genitalia and breast - growth of follicle - hormonal interactions with HPG accesss - and inc transport proteins like SHBG inc HDL and dec LDL

38. What is the prognosis for seminoma
Endometrial > ovarian> cervical (in US)
Dilation and curettage and methotrexate
Good - late metastasis
Vagina

39. What increase in estriol is an indicator offetal well being in pregnancy
1000 times
Haploid - N - 23 single chromatids
Brenner tumor
Hemorrhage

40. tumor is fleshy - cellular - with a lymphocytic infiltrate - good prognosis
Turner's XO
Spermatogonia (germ cells)
Medullary
DCIS

41. atypical cells in epithelial hyperplasia
Post menopausal bleeding
1 week - 2 weeks
Inc risk for carcinoma
Primary hypogonadism

42. benign painless lump - forms as a result of injury to breast tissue - possible history of trauma
Fat necrosis
Stimulates testosterone release from leydig cells
Prior c section - multiparity
Testosterone

43. What is DHT responsible for in late development
Stimulation of secretion - but blocks its action at the breast
DHT - testosterone - androstenedione
Haploid - N - 23 single chromatids
Prostate growth - balding - and sebaceous gland activity

44. decreased estrogen - inc FSH - LH - signs of menopause after puberty but before 40
Fibrocystic disease
Asia - Africa - S. America - HPV - lack of circumcision
Premature ovarian failure (Pof)
Tunica vaginalis lesions

45. 90% of ovarian germ cells tumors - contains cells from 2 or 3 germ layers
Chromosomal abnormalities
Whorled pattern of smooth muscle bundles
Inc risk for carcinoma
Teratoma

46. premature detachment of placenta from implantation site leading to fetal death
Theca - leutin cysts
Theca cell - desmolase - androstenedione
DCIS
Abruptio placentae

47. Where does LH work - what enzyme works there and what product is secreted
IV mag sulfate - diazepam
Theca cell - desmolase - androstenedione
Blacks
Ovary

48. Which cells secrete beta hCG
Testosterone - DHT - androstenedione
Necrosis - hemorrhage - can protrude from the cervix and bleed - tendency to recur
Trophoblasts
Cystic

49. breast path - diseases of the lactiferous sinus
Medullary
Testicular lymphoma
Preeclampsia + siezures
Intraductal papilloma - breast abscess - mastitis

50. histo: simple cuboidal epithelium
Smoking - HTN - cocaine
Low back pain with increased serum alk phos
DES in utero (DES is a sythetic estrogen)
Ovary