Block 7 Reproduction Creighton Univ W Xpl Pt 4

Explanation
The initial changes following HPV infection occur in the transitional zone, which begins at the meeting of endo and ectocervix (aka the squamo-columnar junction).

Explanation
PCO, or polycystic ovary syndrome, is a condition that is typically characterized by enlarged ovaries, hirsutism (excessive hair growth), amenorrhea (absence of menstrual periods), obesity, and anovulation (lack of ovulation). Therefore, the given answer stating that PCO often displays all of these characteristics is correct.

Explanation
GCTs account for about 1 in 5 tumors in the ovary. Most GCTs are mature teratomas, which are are common and benign. Other GCTs include the dysgerminoma and yolk sac tumor. They tend to be rare and malignant. Dysgerminoma should recognized as the female equivalent to the seminoma. It is the most common malignant GCT.

Explanation
Robbins states that 1 in 40 hydatidiform moles will give rise to choriocarcinoma (7th ed pg 1113). Choriocarcinomas are aggressive (local invasion and metastasis) but respond well to chemotherapy. They often appear as large hemorrhagic masses in the uterus. Answers A,B, and C are unrelated to hydatidiform moles in both origin and location. Mature teratomas (aka dermoid cysts) are germ cell tumors of the ovary that are both common and benign. They are all of karyotype 46,XX because they arise from a single ovum. Paget disease is a rare complication of ductal carcinoma in situ of the breast (and less frequently extramammary sites). The malignant cells push through to the surface of the nipple, allowing fluid to seep out and dry into a crust. Embryonal rhabdomyosarcoma is a vaginal tumor found in toddlers. It appears as a grape-like mass protruding from the vagina.

Explanation
The L1, L2 and L3 serotypes of Chlamydia can cause Lymphogranuloma Venerum. This presents first as painless ulcers followed by lymphadenopathy with bubo formation and finally drainage of buboes. Treat with a macrolide. Since the ulcer was painless, answers C, D, and E can be ruled out. Syphilis would be a reasonable possibility in this case. VDRL, RPR, and FTA should be explored.

Explanation
The most common germ cell tumor in a man is a seminoma. It occurs in the third decade, and it appears as a uniform population of cells. A dysgerminoma occurs in the ovaries, and it parallels the seminoma.

Explanation
This is most likely a spermatogonia, which divides to create primary spermatocytes. Sertoli cells maintain the blood-testis barrier as well as produce inhibin, and Leydig cells produce testosterone.

Explanation
This cell is near the perimeter of the seminiferous tubule. It is most likely a primary spermatocyte, which is a differentiated spermatogonia. It's DNA content is diploid 4N. The primary spermatocytes go through the first meiotic division to produce secondary spermatocytes with haploid 2N DNA content. One more meiotic division produces haploid spermatids with 1N. If you thought the cell was a Sertoli cell, it would also be diploid with 2N. However, we wouldn't expect a Sertoli cell to have the DNA that looks like its dividing

Explanation
Memorization from Casey's lecture. The other important fact is that uterine corpus cancer has decreasing 5 year survival rates.

Explanation
Only the granulosa cell tumor is associated with estrogen secretion. Leiomyomas, on the other hand, are estrogen sensitive, and may cause symptoms as estrogen levels normally go up. Therefore, they may cause menorrhagia and increase in size during pregnancy.+

Explanation
At the pelvic outlet, the baby is +3. At the ischial spines, 0. At the pelvic inlet, -3.

Explanation
The first stage involves cervical effacement and dilatation and ends with complete dilation of the cervix. The second stage ends with the expulsion of the fetus. The third stage ends with the expulsion of the placenta. There is no fourth stage.

Explanation
Syncytiotrophoblasts produce beta-HCG.

Explanation
The presentation of intraperitoneal mucus is indicative of mucinous cystadenocarcinoma. Since the presentation is fairly unique, this makes for a good test question. All of the answers listed are the major surface-derived tumors of the ovary, but only the Brenner tumor is benign (think B as in Benign).

Explanation
Painful vaginal bleeding is most indicative of abruptio placentae, or premature detachment of the placenta. This usually happens in the third trimester. Risk factors include advanced age, hypertention, smoking, and cocaine use. Remember that cocaine is a potent vasoconstrictor.


FINAL BULLET POINTS:
In what age group is mammography most effective? 50-60
Lowest stage of breast cancer with lymph node involvement? Stage 2
What antibody against Her-2-Neu is given for breast cancer? Trastuzumab
What is the incidence and death rate of breast cancer? Highest incidence (30%), 2nd highest death rate (15%)
What is the incidence and death rate of prostate cancer? Highest incidence, 2nd highest death rate
What is the source of HCG in the first trimester? syncytiotrophoblasts in the placenta
What is the most common cystic fibrosis mutation? delta F508
Most common endocrine abnormality in male? DM, second most common is hypogonadism
Most common cause of breast lump? fibrocystic changes, 2nd most common is no disease
Most common cause of bloody discharge from nipple? intraductal papilloma (and piercings?)
Lifetime risk of breast carcinoma? ~1 in 9
Chromosome of BRCA1? 17
Chromosome of BRCA2? 13
Recommended age for mammography screening to begin for high risk? 30, for normal population: 40
Most common HPV associated with penile malignancies? HPV-16
Serum markers used to stage testicular cancer? LDH, beta-hCG, AFP
What hormones does the corpus luteum secrete? progesterone and estrogen
Most common benign tumor of the breast? fibroadenoma
Best test for diagnosing testicular mass? ultrasound Sharma L32 33:50
Most common penile carcinoma? squamous cell carcinoma
Most common testicular tumor in child under 3? yolk sac tumor
Most common prostatitis? Chronic abacterial
Definition of infertility: 1 year without conception (with unprotected sex)
Most common form of breast cancer? infiltrating ductal carcinoma
Percent of pregnancies that end in spontaneous abortion? 15%
Most common ovarian cancer? serous cystadenocarcinoma
Most common benign tumor in females? leiomyoma
Most common place to find endometriosis? ovaries
Karyotype of benign ovarian teratoma? 46,XX
Post-menopausal women most likely to die from? cardiovascular disease
Most common STD worldwide? Chlamydia trachomatis
The only gynecological cancer with decreasing survival rates? uterine corpus cancer