USMLE - Reproduction Part 2
**Cleft Lip** is a congenital anomaly resulting from the **failure of fusion between the maxillary and medial nasal processes** during embryonic development. This defect affects the formation of the **primary palate**, leading to a gap or split in the upper lip, which may be unilateral or bilateral.
Ketoconazole
Kind of drug
MoA
Uses
Toxicity
Antiandrogen
Inhibits steroid synthesis (--/ 17,20 desmolase)
Treats PCOS to prevent hirsutism
Tox: gynecomastia and amenorrhea
Key Terms
Ketoconazole
Kind of drug
MoA
Uses
Toxicity
Antiandrogen
Inhibits steroid synthesis (--/ 17,20 desmolase)
Treats PCOS to prevent hirsutism
Tox: gynecomastia and amenorrhea
Spironolactone
Kind of drug
MoA
Uses
Toxicity
Antiandrogen
Inhibits steroid binding
Treats PCOS to prevent hirsutism
Tox: gynecomastia and amenorrhea
Estrogens
Names
MoA
Use
Tox
Contraindication
Ethinly, Estradiol, DES, Mestranol
Binds Estrogen receptors
Treats Hypogonadism or Ovarian Failure, Menstrual abnormalities, HRT in postmenop...
Names of Selective Estrogen Receptor Modulators (SERMs)
Clomiphene, Tamoxifen, Raloxifene
Clomiphene
Kind of Drug
MoA
Uses
Toxicity
SERM
Partial agonist at estrogen receptors in hypothalamus. Prevents normal feedback inhibition and ↑ LH and FSH from pituitary.
Treats infer...
Tamoxifen
Kind of Drug
MoA
Uses
SERM
Antagonist of estrogen receptors in breast tissue
Treats and prevents recurrence of ER+ breast cancer
Related Flashcard Decks
Study Tips
- Press F to enter focus mode for distraction-free studying
- Review cards regularly to improve retention
- Try to recall the answer before flipping the card
- Share this deck with friends to study together
| Term | Definition |
|---|---|
Ketoconazole Kind of drug MoA Uses Toxicity | Antiandrogen |
Spironolactone Kind of drug MoA Uses Toxicity | Antiandrogen |
Estrogens Names MoA Use Tox Contraindication | Ethinly, Estradiol, DES, Mestranol |
Names of Selective Estrogen Receptor Modulators (SERMs) | Clomiphene, Tamoxifen, Raloxifene |
Clomiphene Kind of Drug MoA Uses Toxicity | SERM |
Tamoxifen | SERM |
Raloxifene | SERM |
Hormone Replacement Therapy | Used for the relief or prevention of menopausal symptoms (hot flashes, vaginal atrophy, etc) and osteoporosis (by ↑ estrogen --> ↓ osteoclast activity) |
Anastrozole/Exemestane | Aromatase inhibitor used to treat postmenopausal women with breast cancer |
Progestins | Binds progesterone receptors. Reduces growth and ↑ vascularization of endometrium |
Mifepristone (RU-486) MoA Co-administered with... Use Tox | Competitive inhibitor of progestins at progesterone receptor |
Oral Contraception | Progestins + Estrogen |
Terbutaline | β2 agonist that relaxes uterus | Reduces premature uterine contractions |
Tamsulosin | α1 antagonist used to treat BPH by inhibiting smooth muscle contraction |
Sildenafil, Vardenafil MoA Uses Tox Contraindications | --/ Phosphodiesterase 5 causing an ↑ in cGMP, smooth muscle relaxation in corpus cavernosum, ↑ blood flow, and penile erection |
Danazol | Synthetic androgen that is a partial agonist at androgen receptor |
Endometriosis What is it? What tissue is affected? What does it cause? What causes it? | Non-neoplastic endometrial glands/stroma in abnormal locations In Ovary or on Peritoneum Cyclic bleeding (menstrual type) resulting in blood filled "chocolate cysts" Caused by retrograde menstrual flow |
Endometriosis Clinical manifestation? Treatment | Dysmenorrhea, Menorrhagia, Dyspareunia, Infertility |
Adenomyosis | Endometrium within myometrium |
Cervical Dysplasia and Carcinoma In Situ Description Where does it begin and extend? Classification Histology | Disordered epithelial growth |
Cervical Dysplasia and Carcinoma In Situ Viral cause? Mechanism of viral cause? Prevention? Risk if untreated Risk factors | HPV16 and HPV18 (E6 --/ p53 andE7 --/ RB) |
Cervical Invasive Carcinoma | Often squamous cell carcinoma |
PCOS PathoPhys Gross Clinical manifestation Associated w/ Increased risk for | ↑ frequency of pulsatile GnRA release --> ↑LH + ↓FSH --> anovulation --> no progesterone |
PCOS treatment | Wt reduction |
Endometrial hyperplasia What is it? What causes it? Increased risk for... Presentation Risk factors | Abnormal endometrial gland proliferation Caused by excess estrogen stimulation ↑ risk for endometrial carcinoma Postmenopausal vaginal bleeding Anovulatory cycle, HRT, PCOS, Granulosa Cell Tumor |
Endometrial Carcinoma Frequency Epidemiology Presentation Typically preceded by Risk factors Prognosis | Most common gynecologic malignancy |
Types of Myometrial tumors | Leiomyoma (fibroid) | Leiomyosarcoma |
Leiomyoma Type of tumor Frequency Gross Epidemiology What kind of tissue Malignant? | Myometrial tumor |
Leiomyoma Hormone sensitive? Presentation Complications Histology | Estrogen sensitive: tumor size ↑ w/ pregnancy and ↓ w/ menopause |
Leiomyosarcoma Kind of tumor Gross Where does it arise from? Epidemiology Prognosis | Myometrial tumors Bulky, irregular shaped tumor with areas of necrosis and hemorrhage. May protrude from cervix and bleed Typically arising de novo ↑ incidence in middle aged black women Highly aggressive w/ tendency to recur |
Hydatidiform Moles What are they? Types Presentation Precursor of... Serum marker Gross Potential complication Treatment | Cystic swelling of chorionic villi and proliferation of chorionic epithelium (trophoblast) Complete vs Partial Presents with abnormal vaginal bleeding Most common precursor of choriocarcinoma ↑βhCG Honeycomb uterus or cluster of grapes appearance. Enlarged uterus Uterine rupture dilation and curettage and methotrexate |
Complete Hydatidiform moles Appearance Fetus? Karyotype hCG Uterine size Conversion to choriocarcinoma Fetal parts Components Risk of complications | Snowstorm appearance with no fetus during 1st sonogram 46XX, 46XY ↑↑↑↑ hCG ↑ uterine size 2% choriocarcinoma No fetal parts 2 sperm (from same sperm that replicated) + empty egg 15-20% malignant trophoblastic disease |
Partial Hydatidiform moles Karyotype hCG Uterine size Conversion to choriocarcinoma Fetal parts Components Risk of complications | 69XXX, 69XXY, 69XYY ↑ hCG No change in uterine size Rare choriocarcinoma Has fetal parts 2 sperm + 1 egg Low risk of malignancy |
Classical Preeclampsia presentation | Pregnant women with HTN, Proteinuria, and Edema |
Classical Presentation of Eclampsia | Preeclampsia + Seizures |
Preeclampsia Frequency When ↑ risk in... Caused by Associated w/ Mortality results from | 7% of pregnant women from 20 weeks to 6 weeks postpartum |
HELLP Syndrome | Hemolysis, Elevated Liver enzymes, Low Platelets |
Clinical Manifestations of Preeclampsia | Lab findings | Headache, Blurred vision, Abdominal pain, Edema of face and extremities, altered mentation, hyperreflexia |
Treatment Preeclampsia | Delivery of fetus as soon as possible, Bed rest, monitoring, treat HTN |
Ovarian germ cell tumors most common in… | Adolescents |
Dysgerminoma What kind of tumor? Malignant? Equivalent in male? Histology Associated w/ Markers | Ovarian germ cell tumor Malignant Equivalent to male seminoma but rarer (1% over 30%) Sheets of uniform cells Associated with Turners Syndrome hCG and LDH |
Choriocarcinoma in females What kind of tumor? Frequency Malignant Who develops it? When does it develop? Source Histology What other pathologies is it related to? Metastases Serum markers | Ovarian germ cell tumor Rare but malignant Develops during or after pregnancy in mother or baby From trophoblastic tissue No chorionic villi and ↑ theca-lutein cysts On spectrum with moles as gestational trophoblastic neoplasms Early homogenous spread to lungs hCG |
Yolk Sac (Endodermal Sinus) Tumor in women What kind of tumor? Malignant? Location What kind of pt? Gross Histology Marker | Ovarian germ cell tumor Aggressive malignancy in ovaries/testes and sacrococcygeal area of young children Yellow, friable, solid masses 50% of Schiller-Duval bodies (resemble glomeruli) AFP |
Teratoma in women What kind of tumor Frequency Types of tissue? Types | Ovarian germ cell tumor 90% of ovarian germ cell tumors Contains cells from 2 or 3 germ layers Mature vs. Immature |
Mature Teratoma in women | Dermoid Cyst |
Immature Teratoma in women | Aggressively malignant |
Serous Cystadenoma Kind of tumor Frequency Distribution Histology Malignant? | Ovarian non-germ cell tumor 45% of ovarian tumors Bilateral Lined with fallopian tube-like epithelium Benign |
Marker for Ovarian cancer? | ↑ CA-125 | Good for monitoring progression but not screening |
Serous cystadenocarcinoma Kind of tumor Frequency Distribution Histology Malignant? Genetic risk factors | Ovarian non-germ cell tumor 45% of ovarian tumors Bilateral Psammoma bodies Malignant BRCA1, BRCA2, HNPCC |
Mucinous Cystadenoma | Ovarian non-germ cell tumor |
Mucinous Cystadenocarcinoma | Ovarian non-germ cell tumor |
Brenner Tumor Kind of tumor Malignant Distribution Gross Histology | Ovarian non-germ cell tumor Benign Unilateral Looks like Bladder. Solid tumor that is pale yellow-tan color and appears encapsulated Coffee bean nuclei on H&E |
Fibromas Kind of tumor? Histology Complication Clinical Manifestation | Ovarian non-germ cell tumor |
Meigs Syndrome | Ovarian fibroma + ascites + hydrothorax |
Granulosa Cell Tumor What kind of tumor Hormones Complications in kids vs adults Histology Presentation | Granulosa Cell Tumor What kind of tumor Hormones Complications in kids vs adults Histology Presentation |
Krukenberg Tumors | Ovarian non-germ cell tumor |
Squamous Cell Carcinoma of the Vagina Usually secondary to… | SCC of cervix |
Women at risk for Clear Cell Adenocarcinoma of the Vagina | DES exposure in utero |
Sarcoma Botryoides (rhabdomyosarcoma variant) | Vaginal Tumor |
Dizygotic twins Frequency Egg # Amniotic sacs Placentas | 80% of twins |
Monozygotic twins that split day 0-4 Stage Frequency Placenta Amniotic sacs Chorion | Morula 25% Fused or separate placenta Diamniotic Dichorionic |
Monozygotic twins that split day 4-8 Stage Frequency Amniotic sacs Chorion | Blastocyst |
Monozygotic twins that split day 8-12 | Less than 1% |
Monozygotic twins that split after day 13 | Monoamniotic |
Fetal Components of the placenta | Cytotrophoblast and Syncytiotrophoblast |
Cytotrophoblast | Inner layer of chorionic villi |
Syncytiotrophoblast | Outer layer of chorionic villi | Secretes hCG |
Maternal component of placenta | Decidua Basalis | Derived from endometrium |
Where is maternal blood in the placenta? | In Lacunae |
What makes up the Umbilical Cord? | 2 Umbilical arteries and 1 Umbilical vein |
Function of umbilical arteries | Source? | Return deoxygenated blood from fetal internal iliac arteries to placenta |
Function of umbilical vein? | What does it drain into? | Supplies oxygenated blood from placenta to fetus | Drains via ductus venosus into IVC |
Single umbilical artery is associated with… | Congenital and Chromosomal Anomalies |
What are the umbilical arteries and veins are derived from? | The Allantois |
Urachal Duct | A duct between bladder and yolk sac |
Vitelline duct Name Function When is it obliterated Failure to obliterate | Omphalo-Mesenteric Duct |
1st Aortic Arch forms | Maxillary artery (branch of external carotid) |
2nd Aortic Arch forms | Stapedial artery and Hyoid artery |
3rd Aortic Arch forms | Common Carotid artery and proximal part of Internal Carotid artery |
4th Aortic Arch forms | L: Aortic arch |
6th Aortic Arch forms | Proximal part of pulmonary arteries and (on left only) ductus arteriosus |
Branchial Apparatus | Pharyngeal Apparatus "CAP" Clefts (grooves) from Ectoderm Arches from Mesoderm (muscles, arteries) and neural crest cells (bones, cartilage) Pouches from Endoderm |
Branchial Clefts develop into | 1st: External auditory meatus | 2nd - 4th: form temporary cervical sinus which are obliterated by proliferation of 2nd arch mesenchyme |
Persistent Cervical Sinus | Branchial cleft cyst within lateral neck |
1st Branchial Arch Cartilage Muscles Nerves Pathology | Meckel's cartilage: Mandible, Malleus, incus, spheno-Mandibular ligament |
2nd Branchial Arch | Reichert's Cartilage (Stapes, Styloid Process, Lesser horn of the Hyoid, Stylohyoid ligament) |
3rd Branchial Arch Cartilage Muscles Nerves Pathology | Greater horn of hyoid |
4th - 6th Branchial Arch | Thyroid, Cricoid, Arytenoids, Corniculate, Cuneiform |
Branchial Arches Mnemonic | Chew, Smile, Swallow Stylishly, Simply Swallow, Speak |
What forms posterior 1/3 of tongue | Branchia Arches 3 and 4 |
What does Branchia Arch 5 become? | 5 makes no major developmental contributions |
1st Branchial Pouch | Middle Ear Cavity, Eustachian Tube, Mastoid Air Cells | Contributes to Endoderm-lined structures of ear |
2nd Branchial Pouch develops into… | Epithelial lining of palatine tonsil |
3rd Branchial pouch | Dorsal wings develop into inferior parathyroids |
4th Branchial pouch develops into… | Dorsal wings develop into superior parathyroids |
DiGeorge Syndrome | Aberrant development of 3rd and 4th Branchial pouches | T cell deficiency (Thymic aplasia) and Hypocalcemia (parathyroid doesn't develop) |
Cleft Lip | Failure of fusion of maxillary and Medial Nasal Processes (formation of primary palate) |
Cleft Palate | Failure of fusion of the lateral palatine processes, the nasal septum, and/or the median palatine process (formation of secondary palate) |
Cleft Lip vs Cleft Palate | 2 distinct etiologies but often occur together |
Female genital development | Default pathway | Mesonephric duct degenerates and Paramesonephric duct develops |