TABLE OF CONTENTS

PATHOLOGY....................................................................................2
Semen Analysis......................................................................................2
The Lower Urinary Tract..........................................................................5
Penis.....................................................................................................9
Testis and Epididymis...........................................................................11
Prostate...............................................................................................14
Breast 1...............................................................................................17
Breast 2...............................................................................................21
Vulva, Vagina, and Cervix.....................................................................25
Uterus and Fallopian Tubes...................................................................28
Ovaries................................................................................................28
MICROBIOLOGY.............................................................................29
Sexually Transmitted Infections............................................................29
SURGERY......................................................................................33
PE of the Male Reproductive System.....................................................33
Sexual and Erectile Dysfunction............................................................35
Male Congenital Disorders....................................................................37
PHARMACOLOGY...........................................................................40
Sexual and Erectile Dysfunction............................................................40
Agents of Uterotonics and Tocolytics.....................................................43
Drug Use in Pregnancy and Lactation....................................................45
RADIOLOGY................................................................................... 50
Imaging of the Urinary Tract.................................................................50
Imaging of the Reproductive System.....................................................52
PARASITOLOGY.............................................................................. 53
Sexually Transmitted Parasites.............................................................53
OBSTETRICS.................................................................................. 54
Approach to STI in Pregnancy...............................................................54
 PATHOLOGY

SEMEN ANALYSIS
4 organs that contribute to semen| Testes and epididymis
Seminal vesicles
Prostate
Bulbourethral glands;
Immature form of the sperm| Spermatozoa;
Site of spermatogenesis and production of Seminiferous tubules;
spermatozoa|
Maturation and storage site of spermatozoa| Epididymis;
Contributes 5% of semen volume| Epididymis
Bulbourethral gland;
Contributes 60% of semen volume| Seminal vesicles;
Secretes fructose as source of energy for Seminal vesicles;
sperm motility|
Contributes 20-30% of semen volume| Prostate;
Secretes acid phosphatase, citric acid, zinc, Prostate;
and proteolytic enzymes in semen|
Responsible for coagulation and liquefaction Proteolytic enzymes;
of semen following ejaculation|
Has a thick, alkaline mucus to neutralize Bulbourethral gland;
acidity from prostatic secretions and vaginal
acidity|
First gland to release secretions for Bulbourethral gland;
lubrication and acid neutralization|
Period of sexual abstinence in specimen 3-5 days;
collection|
Methods of specimen collection| Masturbation
Non-lubricant-containing
polymeric silicone (Silastic)
condoms;
8 parameters in Semen Analysis| Appearance
Volume
Viscosity
pH
Sperm concentration
Sperm count
Motility
Morphology;
Normal appearance of semen| Gray-white color, translucent,
musty odor (Clorox-like smell);
Abnormalities in appearance| Increased white turbidity
(WBCs and infection)
Red coloration (RBCs)
Yellow coloration;
Yellow coloration of the semen may Prolonged abstinence
indicate?| Medications
Urine contamination;
Normal semen volume| 2 to 5 mL;
Increased semen volume may indicate?| Periods of extended
abstinence;
Decreased semen volume is associated Infertility
with?| Incomplete specimen
collection;
Normal viscosity of semen| Easily drawn into pipette
Able to form droplets that do
not appear clumped or stringy
when discharged from the
pipette;
Viscosity rating| 0 (watery) to 4 (gel-like);
Normal pH of semen| 7.2 to 8.0;
Associated with an increase in pH of semen| Infection within reproductive
tract;
Associated with a decrease in pH of semen| Increased prostatic fluid;
Normal sperm concentration| >20 million sperm/mL;
Normal sperm count| >40 million/ejaculate;
Formula for total sperm count| Sperm concentration x
specimen volume;
WHO recommended method for counting Neubauer Counting Chamber;
sperm|
Possible abnormal findings in sperm > 1 million WBCs/mL
count/concentration| >1 million spermatids/mL;
Formula for sperm concentration/mL using a # of sperm x 1,000,000 RBC
1:20 dilution| squares;
Method for counting undiluted specimens| Makler Counting Chamber;
Normal sperm motility| Forward, progressive
movement;
WHO criteria for motility| 4.0 A rapid, straight line
motility
3.0 B slower speed, some
lateral movement
2.0 B slow forward
progression, noticeable lateral
movement
1.0 C no forward movement
0 D no movement;
Provides objective determination of both Computer-Assisted Semen
sperm velocity and trajectory| Analysis;
Stains used to view sperm morphology| Wrights
Giemsa
Papanicolaou;
Part of the sperm which contains enzymes Acrosomal cap;
critical to ovum penetration|
Enzymes in the acrosomal cap| Hyaluronidase
Acrosin;
Enzyme in the acrosomal cap, which eats up Hyaluronidase;
cells in the corona radiata|
Enzyme in the acrosomal cap, which aids in Acrosin;
penetrating the zona pellucida|
Head structure abnormalities| Double heads
 Giant and amorphous geads
Pinheads
Tapered heads
Constricted heads;
Sperm tail structure abnormalities| Double
Coiled
Bent;
Sperm morphology criteria which measures Krugers Strict Criteria;
the head, neck and tail size, size of
acrosome, and presence of vacuoles|
Used to evaluate sperm viability| Smear preparation, eosin
nigrosine stain (count number
of dead cells in 100 sperm);
Normal sperm viability| 75% living cells (not infiltrated
by dye);
Checks for presence of fructose in semen| Resorcinol test;
Tests to detect presence of antibody-coated Mixed Agglutination Reaction
sperm| (MAR) Test
Immunobead test;
Screening procedure used to detect Mixed Agglutination Reaction
presence of IgG antibodies| Test;
Screening procedure used to detect Immunobead test;
presence of IgG, IgM, and IgA antibodies|
 THE LOWER URINARY TRACT
Lining of the renal pelves, ureters, bladder, Urothelium, a special form of
and urethra (except the terminal portion)| transitional epithelium;
Three points of narrowing of the ureter| 1. Ureteropelvic junction
2. Where they enter the
bladder
3. Where they cross the iliac
vessels;
Congenital anomalies of the ureter| Double and bifid ureters
Ureteropelvic junction
obstruction
Diverticula;
Congenital disorder that is the most Ureteropelvic junction (UPJ)
common cause of hydronephrosis in obstruction;
infants and children|
Saccular outpouchings of the ureteral wall| Diverticula;
Inflammation of the ureters with Ureteritis follicularis;
accumulation or aggregation of
lymphocytes forming germinal centers
in the sub-epithelial region that may
cause slight elevations of the mucosa
and produce a fine granular mucosal
surface|
Inflammation of the ureter Ureteritis cystica;
characterized by mucosa sprinkled with
fine cysts varying in diameter from 1 to
5 mm lined by flattened urothelium|
Two forms of Ureteritis| Ureteritis follicularis
Ureteritis cystica;
A tumor-like lesion that presents as a Fibro-epithelial polyp;
small mass projecting into the lumen of
the ureter, often in children|
Uncommon cause of ureteral narrowing Sclerosing Retroperitoneal
or obstruction characterized by a Fibrosis;
fibrotic proliferative inflammatory
process encasing the retroperitoneal
structures and causing hydronephrosis|
Congenital anomalies of the urinary bladder| Vesicoureteral reflux
Diverticula
Exstrophy of the bladder
Urachal anomalies;
Most common and serious congenital Vesicoureteral reflux;
anomaly in the urinary bladder|
Abnormal connections between the bladder Congenital vesico-uterine
and the vagina, rectum, or uterus| fistulae;
Pouchlike evaginations of the bladder wall Diverticula;
that vary from less than 1 cm to 5 to 10 cm
in diameter and may be congenital or
acquired|
Urinary bladder diverticula due to a focal Congenital diverticula;
failure of development of the normal
musculature or to some urinary tract
obstruction during fetal development|
Diverticula most often seen with Acquired diverticula;
prostatic enlargement, producing
obstruction to urine flow and marked
muscle thickening of the bladder wall|
Developmental failure in the anterior Exstrophy;
wall of the abdomen of the bladder|
The bladder mucosa undergoes _____ in the Colonic glandular metaplasia;
exstrophy of the bladder|
Patients with exstrophy of the bladder Adenocarcinoma;
have an increased risk for?|
Canal that connects the fetal bladder with Urachus;
the allantois|
A totally patent urachus leads to a?| Fistulous urinary tract
(connects the bladder with the
umbilicus);
A persisting central region of the urachus Urachal cysts;
can lead to?|
Common etiologic agents of cystitis| Escherichia coli
Proteus
Klebsiella
Enterobacter;
Morphology (Acute Cystitis)| Hyperemia of the mucosa
Neutrophilic infiltrate;
Cystitis associated with the use of cytotoxic Hemorrhagic cystitis;
antitumor drugs sucha s cyclophosphamide|
Cystitis characterized by the presence Follicular cystitis;
of lymphoid follicles within the bladder
mucosa and underlying wall|
Triad of symptoms in cystitis| 1. Frequency
2. Lower abdominal pain
3. Dysuria;
Form of chronic cystitis that occurs Interstitial cystitis (Chronic
more frequently in women and Pelvic Pain Syndrome);
characterized by intermittent, often
severe, suprapubic pain, urinary
frequency, urgency, hematuria, and
dysuria, and cystoscopic findings of
fissures and punctate hemorrhages
(glomerulations) in the bladder mucosa
after luminal distention|
A distinctive inflammatory reaction Malakoplakia;
that appears to stem from acquired
defects in phagocyte function|
Gross morphology (Malakoplakia)| Soft, yellow, slightly raised
mucosal plaques, 3 to 4 cm
in diameter;
Microscopic morphology (Malakoplakia)| Plaques contain large, foamy
 macrophages with
abundant granular
cytoplasm and Michaelis-
Gutmann bodies;
Laminated mineralized concretions Michaelis-Gutmann bodies;
resulting from deposition of calcium in
enlarged lysosomes, found in
Malakoplakia|
Inflammatory lesions resulting from Polypoid cystitis;
irritation of the bladder mucosa|
Common cause of polypoid cystitis| Indwelling catheters:
Metaplastic lesions in the urinary bladder| Cystitis glandularis
Cystitis cystica
Squamous metaplasia
Nephrogenic adenoma;
Common lesions of the urinary bladder Cystitis glandularis
in which nests of urothelium (Brunn Cystitis cystica;
nests) grow downward into the lamina
propria|
Lesion in the urinary bladder where Cystitis glandularis;
epithelial cells in the center of the nest
(that grow downward) undergo
metaplasia and take on a cuboidal or
columnar appearance|
Lesion in the urinary bladder where Cystitis cystica;
epithelial cells in the center of the nest
(that grow downward) retract to
produce cystic spaces lined by
flattened urothelium|
Unusual lesions that result from Nephrogenic adenoma;
implantation of shed renal tubular cells
at sites of injured urothelium|
Most common bladder tumor| Urothelial tumor;
Two distinct precursor lesions to invasive Non-invasive papillary tumors
urothelial carcinoma| Flat non-invasive urothelial
carcinoma (carcinoma in situ);
Most common precursor lesion for invasive Non-invasive papillary tumor;
urothelial carcinoma|
WHO/ISUP Grading of Urothelial tumors| Urothelial papilloma
Urothelial neoplasm of low
malignant potential
Papillary urothelial carcinoma
(low grade)
Papillary urothelial carcinoma
(high grade);
Associated with a major decrease in survival Invasion of the muscularis
in urothelial carcinoma| propria:
Most important risk factor in urothelial Cigarette smoking;
carcinoma|
Urothelial carcinoma risk factors| Cigarette smoking
Industrial exposure to aryl
 amines
Schistosoma haematobium
Long-term use of analgesics
Heavy long-term exposure to
cyclophosphamide
Irradiation;
Common genetic alteration in urothelial Losses of genetic material on
carcinoma| chromosome 9 (includes
CDKN2A and ARF);
Genetic alterations in low-grade superficial FGFR3 and RAS mutations
papillary tumors| Chromosome 9 deletions;
Part of the urinary bladder where most Lateral or posterior walls of
urothelial tumors arise from| the bladder base;
Tumors that typically arise singly as Papilloma;
small, delicate structures, superficially
attached to mucosa by a stalk|
Tumors that have individual finger-like Papilloma;
papillae with a central core of loose
fibrovascular tissue, covered by
epithelium identical to normal
urothelium|
Benign lesions consisting of inter- Inverted papilloma;
anastomosing cords of cytologically
bland urothelium that extend down into
the lamina propria|
Tumor with histologic features with a Papillary urothelial neoplasms
papilloma but with a thicker of low malignant potential;
urothelium|
Urothelial tumor with orderly Low-grade papillary urothelial
architectural and cytologic appearance, carcinomas;
cells are evenly spaced and cohesive,
mild degree of nuclear atypia
consisting of scattered hyperchromatic
nuclei|
Urothelial tumor with architectural High-grade papillary urothelial
disarray, loss of polarity, dyscohesive cancer;
cells with large hyperchromatic nuclei
and some highly analplastic cells|
Presence of cytologically malignant Carcinoma in situ|
cells within a flat urothelium|
Dominant clinical manifestation of bladder Painless hematuria;
tumors|
Given to patients at high risk of recurrence Bacillus Calmette-Guerin/BCG
and/or progression| (Attenuated strain of
Mycobacterium bovis);
Most common benign mesenchymal tumor Leiomyoma;
in the bladder|
The most common sarcoma of the bladder in Embryonal
infancy or childhood| rhabdomyosarcoma;
Most common sarcoma of the bladder in Leiomyosarcoma;
adults|
Most common cause of obstruction of the Enlargement of the prostate
bladder in males| gland due to nodular
hyperplasia;
Inflammatory lesion that presents as a Urethral caruncle;
small, red, painful mass about the external
urethral meatus, typically in older females|
 PENIS
Congenital anomalies of the Penis| Hypospadias
Epispadias
Phimosis;
Abnormal urethral opening on the Hypospadias;
ventral surface of the penis|
Abnormal urethral opening on the Epispadias;
dorsal surface of the penis|
When the orifice of the prepuce is too small Phimosis;
to permit its normal retraction|
Infection of the glans and prepuce| Balanoposthitis;
Most common agents of Balanoposthitis| Candida albicans
Anaerobic bacteria
Gardnerella
Pyogenic bacteria;
Accumulation of desquamated epithelial Smegma;
cells, sweat and debris|
Benign sexually transmitted wart caused by Condyloma Acuminatum;
human papillomavirus (HPV)|
Most frequent agents of condylomata HPV 6 and 11;
acuminata|
Benign penile tumor with single or multiple Condylomata acuminata;
sessile or pedunculated, red papillary
excrescences in the coronal sulcus and inner
surface of the prepuce|
Benign penile tumor with a branching, Condylomata acuminata;
villous, papillary connective tissue stroma
covered by epithelium that may have
superficial hyperkeratosis and acanthosis|
Cytoplasmic vacuolization of squamous cells Koilocytosis;
in Condylomata Acuminata, characteristic of
HPV infection|
Disorder which results in fibrous bands Peyronie disease;
involving the corpus cavernosum of the
penis|
Penile lesion which results in penile Peyronie disease;
curvature and pain during intercourse|
Two distinct lesions in the Carcinoma In Situ Bowen disease
of the external male genitalia| Bowenoid papulosis;
HPV type strongly associated with HPV 16;
Carcinoma in Situ of the male genitalia|
CIS lesion that occurs in men and women, Bowen disease;
usually in those older than 35 years|
CIS lesion that grossly appears as solitary, Bowen disease;
thickened, gray-white, opaque plaque or as
a single or multiple shiny red, sometimes
velvety plaques on the glans and prepuce|
CIS lesion which can transform into Bowen disease;
infiltrating squamous cell carcinoma|
CIS lesion that occurs in sexually active Bowenoid papulosis;
adults|
CIS lesion that virtually never develops into Bowenoid papulosis;
an invasive carcinoma and many regress
spontaneously|
Most frequent cause of squamous cell HPV 16;
carcinoma of the penis|
Two macroscopic patterns in squamous cell Papillary
carcinoma of the penis| Flat;
Histological morphology of papillary lesions Simulate condylomata
in squamous cell carcinoma of the penis| acuminata and may produce a
cauliflower-like fungating
mass;
Histological morphology of flat lesions in Appear as areas of epithelial
squamous cell carcinoma of the penis| thickening accompanied by
graying and fissuring of the
mucosal surface;
Exophytic well-differentiated variant of Verrucous carcinoma;
squamous cell carcinoma that is locally
invasive, but rarely metastasize|
 TESTIS AND EPIDIDYMIS
Complete or partial failure of the intra- Cryptochordism;
abdominal testes to descend into the
scrotal sac and is associated with
testicular dysfunction and increased
risk of testicular cancer|
Most common site of arrest in the pathway Inguinal canal;
of descent of the testes|
Histologic changes in the undescended Arrested germ cell
testes| development
Marked hyalinization and
thickening of the basement
membrane of spermatic
tubules
Increase in interstitial stroma;
Possible causes of testicular atrophy| 1. Progressive atherosclerotic
narrowing of the blood supply
in old age
2. End stage inflammatory
orchitis
3. Cryptochordism
4. Hypopituitaryism
5. Generalized malnutrition or
cachexia
6. Irradiation
7. Prolonged administration of
anti-androgens
8. Exhaustion atrophy;
Frequent causes of Non-specific Epididymitis C. trachomatis
and Orchitis in sexually active men younger N. gonorrhoeae;
than 35 years|
Frequent causes of Non-specific Epididymitis Urinary tract pathogens (E.
and Orchitis in men older than 35| coli and Pseudomonas);
Twisting of the spermatic cord| Torsion;
Two settings in which testicular torsion 1. Neonatal lacks anatomic
occurs| defect
2. Adult bilateral anatomic
defect that leads to increased
mobility of the testtes;
Increased mobility of the testes| Bell-clapper abnormality;
Common lesions involving the proximal Lipoma;
spermatic cord, identified at the time of
inguinal hernia repair|
Most common benign paratesticular tumor| Adenomatoid tumor;
Most common malignant paratesticular Rhabdomyosarcoma;
tumor in children|
Most common malignant paratesticular Liposarcoma;
tumor in children|
Two classifications of germ cell tumors| Seminomatous
Non-seminomatous;
Seminomatous tumors| Seminoma
 Spermatocytic seminoma;
Non-seminomatous tumors| Embryonal carcinoma
Yolk sac (endodermal sinus)
tumor
Choriocarcinoma;
Most common tumor of men in the 15 to 34 Testicular germ cell tumors;
year age group|
Components of the testicular dysgenesis Cryptochordism
syndrome| Hypospadias
Poor sperm quality;
Testicular tumors composed of cells that Seminomatous tumors;
resemble primordial germ cells or early
gonocytes|
Testicular tumors composed of Non-seminomatous;
undifferentiated cells|
Precursor lesion of most testicular germ cell Intratubular germ cell
tumors| neoplasia (ITGCN);
Testicular tumors that do not arise from Pediatric yolk sac tumors
Intratubular Germ Cell Neoplasia| Teratomas
Adult spermatocytic
seminomas;
Most common type of germ cell tumor| Seminomal
Gross morphology (Seminoma)| Bulky masses
Homogenous, gray-white,
lobulated cut surface
Microscopic morphology (Sminoma) Sheets of uniform cells divided
in poorly demarcated lobules
by delicate septa
Cells are large and round to
polyhedral, has a distinct cell
membrane, clear or watery-
appearing cytoplasm, large
central nucleus with one or
two prominent nucleoli;
Immunohistochemistry stains positive in KIT
Seminoma| OCT4
PLAP (Placental alkaline
phosphatase);
Gross morphology (Spermatocytic Soft, pale gray, cut surface
Seminoma)| that sometimes reveal mucoid
systs;
Microscopic morphology (Spermatocytic Three cell populations
Seminoma)| (medium-sized, smaller,
scattered giant cells);
Microscopic morphology (Embryonal Cell growth in alveolar or
carcinoma)| tubular patterns, sometimes
with papillary convolutions
Neoplastic cells epithelial
appearance, large and
anaplastic, hyperchromatic
nuclei with prominent nucleoli;
Markers for Embryonal carcinoma| OCT 3/4
PLAP
Cytokeratin
CD30
(-) KIT;
Other term for Yolk sac tumor| Endodermal sinus tumor;
Most common testicular tumor in infants and Yolk sac tumor or endodermal
children upto 3 years of age| sinus tumor;
Structures in Yolk sac tumor that resemble Schiller-Duval bodies;
primitive glomeruli|
Structures consisting of a mesodermal core Schiller-Duval bodies;
with a central capillary and a visceral and
parietal layer of cells resembling primitive
glomeruli|
Markers for Yolk Sac tumor| AFP
1-antitrypsin

Testicular tumor which often cause no Choriocarcinoma;

testicular enlargement and are
detected only as a small palpable
nodule|
Histological morphology (Choriocarcinoma)|
Marker for Choriocarcinoma|
Testicular tumors having various
cellular or organoid components
reminiscent of the normal derivatives
of more than one germ layer|
Testicular tumor which may be composed of
neural tissue, muscle bundles, islands of
cartilage, or structures reminiscent of
thyroid gland|
True or false?
Teratomas in children are always considered
malignant.|
Characteristic feature of germ cell
neoplasms|
True or false?
Metastases from seminomas usually involve
lymph nodes.|
Most aggressive non-seminomatous germ
cell tumor|
Best prognosis among testicular tumors|
Syncytiotrophoblasts (large
multinucleated cells
containing HCG)
Cytotrophobalsts (tend to be
polygonal, with distinct
borders and clear cytoplasm);
HCG (from
syncytiotrophoblasts);
Teratoma;
Teratoma;
False. Teratomas in children
usually follow a benign course.
Teratomas in a postpubertal
male are regarded as
malignant.;
Painless enlargement of the
testis;
True. Hematogenous spread
occurs later.;
Pure choriocarcinoma;
Seminoma (tends to remain
 localized and is
radiosensitive);
Two classifications of sex cord-gonadal Ledyig cell tumors
stroma| Sertoli cell tumors;
Gross morphology (Leydig cell tumors)| Circumscribed nodules, less
than 5 cm in diameter, with a
distinctive golden brown,
homogenous cut surface;
Testicular tumor which contains rod- Leydig cell tumors;
shaped crystalloids of Reinke|
Most common form of testicular neoplasms Testicular lymphoma;
in men older than 60|
Most common testicular lymphomas| Diffuse large b-cell lymphoma
(> Burkitt lymphoma > EBV-
positive extranodal NK/T cell
lymphoma);
Most common cause of painless testicular Testicular tumors;
enlargement|
Part of the testis that enlarges in hydrocele| Tunica vaginalis;
Method of identifying fluid in hydrocele| Transillumination;
Presence of blood in the tunica vaginalis| Hematocoelee;
Accumulation of lymph in the tunica Chylocele;
vaginalis|
Small cystic accumulation of semen in Spermatocoele;
dilated efferent ducts or ducts of the rete
testis|
Dilated vein of the spermatic cord| Varicocoele;

PROSTATE
Zone where most hyperplasia occur| Transitional zone;
Zone where most carcinomas occur| Peripheral zone;
Special immunohistochemical stain for High molecular weight keratin
prostatic basal cells, whose presence rules 34E12 :
out usual type adenocarcinoma|
2 layers of cells lining prostatic glands| Basal layer of low cuboidal
epithelium
Columnar secretory cells;
Inflammatory diseases of the prostate| Acute bacterial prostatitis
Chronic bacterial prostatitis
Chronic abacterial prostatitis
Granulomatous prostatitis;
Etiology of acute bacterial prostatitis| Bacteria that causes UTI (E.
coli)
Follows surgical manipulation
on urethra or prostate;
Acute bacterial prostatitis clinical Fever, chills, dysuria
manifestations| Tender and boggy prostate on
DRE;
Acute bacterial prostatitis histopathology| Minute abscesses
Focal areas of necrosis
 Diffuse edema
Congestion and suppuration;
Gross morphology in acute bacterial Soft, spongy, enlargement;
prostatitis|
Chronic bacterial prostatitis etiology| History of recurrent UTIs by
same organism;
Chronic bacterial prostatitis clinical Low back pain, dysuria,
manifestations| perineal and suprapubic
discomfort
Commonly asymptomatic
WBCs in prostatic secretions
Positive bacterial cultures;
Inflammation of the prostate with the Chronic abacterial prostatitis;
presence of inflammatory cells but no
infection involved|
Most common cause of granulomatous Instillation of BCG within the
prostatitis in the US| bladder;
Most common cause of enlargement of the Benign Prostatic hyperplasia;
prostate|
BPH etiology| Impaired cell death
accumulation of senescent
cells
Androgen action;
Ultimate mediator of prostatic growth| Dihydrotestosterone;
Enzyme which synthesizes testosterone into 5-reductase;
DHT|
Gross morphology (BPH)| 60-100 grams (normal: 20)
Yellow-pink, soft consistency in
nodules with primarily
glandular proliferation
Nodular
Pale gray and tough in nodules
with fibromuscular
proliferation;
Histologic hallmark in BPH| Nodularity due to glandular
proliferation and to fibrous or
muscular proliferation of
stroma;
BPH clinical manifestations| Urinary frequency
Nocturia
Difficulty starting and stopping
stream of urine
Dribbling
Dysuria;
Most common cancer in men, tied with Prostatic CA;
colorectal cancer in terms of mortality|
Gross morphology (prostatic Gritty, hard, and firm prostate
adenocarcinoma)| in DRE
Yellowish nodules (areas
involved in carcinoma);
Bones commonly involved in prostatic CA| Lumbar spine (most)
 Proximal femur
Pelvic
Thoracic spine
Ribs;
Most common variant of prostate CA| Adenocarcinoma;
Characteristic histological finding in prostate Large nuclei with prominent
CA| nucleoli;
Lining of neoplastic glands in prostate CA| Single uniform layer of
cuboidal or low columnar
epithelium (no outer basal
layer);
Precursor lesion of adenocarcinoma of the High grade prostatic
prostate| intraepithelial neoplasia;
Grading system for prostatic CA| Gleason grading system;
Grade 1 (Gleason)| Well-differentiated, unform
and round glands packed into
well circumscribed nodules;
Grade 5 (Gleason)| No glandular differentiation,
tumor cells infiltrate prostatic
stroma arranged in cords,
sheets, nests;
Two numeric grades in the gleason grading Primary grade (dominant
system| pattern)
Secondary grade
(subdominant pattern);
Feature more commonly seen in cancer than Prostatic crystalloids;
in benign glands, and more frequently seen
in lower grade than higher grade prostate
CA|
Usual method of diagnosis for prostatic CA| Transperineal or transrectal
biopsy;
Other conditions that may show elevated Inflammation (prostatitis)
PSA| BPH;
Ratio between serum PSA and prostate PSA density;
gland volume|
Rate of change of PSA| PSA velocity;
Most valuable in discriminating Percentage of free PSA;
between benign and malignant tumors
(when total PSA is gray zone of 4-10
ng/mL)|
Diagnostic test for staging of prostate CA| Pelvic lymphadenopathy;
Used for detection of osseous metastasis in Radionuclide bone scanning;
prostate CA|
Most aggressive variant of prostate cancer| Small cell carcinoma
(neuroendocrine);
Most common tumor to secondarily involve Urothelial tumor;
the prostate|
 BREAST 1
Changes in the normal breast| First half of cycle quiescent
After ovulation cell
proliferation, increase in
number of acini, edematous
intralobular stroma
Menstruation regression of
lobules, disappearance of
edema;
Changes in the breast in pregnancy| Lobules progressively increase
in number and size;
Changes in the breast after pregnancy| Scant stroma
Permanent increase in number
and size of lobules;
Changes in the breast with age| Decrease in size and number
of lobules
Interlobular stroma replaced
by adipose tissue;
Result from the persistence of Supernumerary nipples or
epidermal thickenings along the milk breasts;
line, which extends from the axilla to
the perineum|
Disorders of development of the breast| Milk line remnants
(supernumerary nipples or
breast)
Accessory axillary breast
tissue
Congenital nipple inversion;
Most common symptoms reported by Pain
women with breast disorder| Palpable mass
Nipple discharge;
Most common palpable lesions| Cysts
Fibroadenoma
Invasive carcinoma;
Most common location of palpable lesions Upper outer quadrant;
associated with carcinoma|
Most common means to detect breast Mammography;
cancer|
Principal mammographic signs of breast Densities
carcinoma| Calcifications;
Benign lesions are usually______ in Rounded;
mammography

a. Rounded
b. Irregular|
Malignant lesions ______ in mammography Irregular;

a. Rounded
b. Irregular|
Acute mastitis typically occurs during what First month of breast feeding;
period?|
Common causative agent in acute mastitis| S. aureus;
Occurs because of local bacterial infection Acute mastitis;
due to cracks and fissures in the nipples
during lactation|
Clinical manifestation in Acute Mastitis| Breast is erythematous and
painful
Fever;
Also known as Zuska disease, periductal Squamous metaplasia of
mastitis, and recurrent subareolar abscess| Lactiferous ducts;
Clinical manifestation of Zuska disease| Painful, erythematous
subareolar mass (appears to
be a bacterial abscess)
Fistula tract (recurrent cases);
Inflammatory disorder of the breast Squamous metaplasia of
associated with smoking as a result of Lactiferous ducts;
Vitamin A deficiency|
Key histological feature in periductal Keratinizing squamous
mastitis| metaplasia of the nipple ducts
( plug dilation and rupture
chronic granulomatous
inflammation);
Inflammation of the breast, which presents Duct ectasia;
as a palpable periareolar mass with thick,
white nipple secretions|
Inflammatory disorder of the breast Duct ectasia;
which typically presents in the 5th and
6th decade of life and among
multiparous women|
Inflammatory disorder of the breast, which Duct ectasia;
may present as an irregular palpable mass
that mimics invasive carcinoma|
Inflammatory disorder with dilated ducts Duct ectasia;
filled with inspissated secretions and
numerous lipid-laden macrophages;
Inflammatory disorder presenting as Fat necrosis;
painless palpable mass, skin thickening or
retraction, or mammographic densities or
calcifications that closely mimics cancer|
Inflammatory disorder associated with a Fat necrosis;
history of breast trauma or prior surgery|
Inflammatory disorder with ill-defined, Fat necrosis;
firm, gray-white nodules containing
small chalky-white foci|
Also known as lymphocytic Mastopathy| Sclerosing Lymphocytic
Lobulitis;
Inflammatory disease common in women Lymphocytic Mastopathy;
with type 1 diabetes and autoimmune
thyroid disease|
Inflammatory disease caused by Cystic neutrophilic
Cornyebacteria| granulomatous mastitis;
Inflammatory diseases of the breast| Acute mastitis
 Squamous metaplasia of
Lactiferous ducts
Duct ectasia
Fat necrosis
Sclerosing Lymphocytic
Lobulitis
Lymphocytic Mastopathy;
Three principal morphologic changes in Non- Cystic change
proliferative breast changes or Fibrocystic Fibrosis
changes| Adenosis;
Morphology of cystic change in Fibrocystic Contain turbid, semi-
changes of the breast| translucent fluid of brown or
blue color
Lined by flattened atrophic
epithelium or metaplastic
apocrine cells;
Defined as an increase number in acini per Adenosis;
lobule|
True or false? True.;

Adenosis is normal in pregnancy|

Palpable mass in pregnancy or lactating Lactational adenoma;
women, which may represent exaggerated
local response to gestational hormones|
Lining of acini in adenosis| Columnar cells, which may be
benign or show nuclear atypia;
Morphologic changes in Proliferative Breast Epithelial hyperplasia
Disease without Atypia| Sclerosing adenosis
Complex sclerosing lesion
Papilloma;
Increased number of luminal and Epithelial hyperplasia;
myoepithelial cells in Proliferative Breast
Disease without Atypia|
Increased number of acini that are Sclerosing Adenosis;
compressed and distorted in the central
portion of the lesion in Proliferative Breast
Disease without Atypia|
Lesions that have components of sclerosing Complex sclerosing lesion;
adenosis, papillomas, and epithelial
hyperplasia|
A central nidus of entrapped glands in a Radial scar (radial sclerosing
hyalinized stroma surrounded by long lesion);
radiating projections into the stroma|
Morphologic lesion in Proliferative Breast Papilloma;
Disease without Atypia that produces a
nipple discharge|
Enlargement of the male breast| Gynecomastia;
Gross morphology (Gynecomastia)| Button-like subareolar
enlargement that maybe
unilateral or bilateral;
Microscopic morphology (Gynecomastia)|
Clonal proliferation having some, but not all,
of the histologic features required for the
diagnosis of carcinoma in situ|
Two forms of Proliferative Breast Disease
with Atypia|
Morphology of Atypical Ductal Hyperplasia|
Difference between Lobular Carcinoma In
Situ and Atypical Lobular Hyperplasia|
Form of Atypical Ductal Hyperplasia that
shows loss of E-cadherin|
Benign Epithelial Lesions|
Increase in dense collagenous
connective tissue
Epithelial hyperplasia of duct
lining with tapering
micropapillae
Lobule formation is absent;
Proliferative Breast Disease
with Atypia;
Atypical Ductal Hyperplasia
Atypical Lobular Hyperplasia;
Monomorphic proliferation of
regularly spaced cells,
sometimes with cribiform
spaces
Proliferation only partially
fills the ducts;
Cells do not fill or distend
more than 50% of the acini in
Atypical Lobular Hyperplasia;
Atypical Lobular Hyperplasia;
Fibrocystic changes or
Nonproliferative breast
changes
Proliferative breast disease
without atypia
Proliferative breast disease
with atypia;
 BREAST 2
True or false? False. Age 11;

Menarche at age younger than 14 increases

risk of breast by 20%.|
True or false? False. Halves the risk;

A full term pregnancy before the age of 20

increases the risk of breast cancer.|
True or false? True.;

Very dense breasts have a four-to-five fold

higher risk of both ER-positive and ER-
negative breast cancer.|
True or false?
Obese women under the age 40 have a
decreased risk of breast cancer.|
True or false?
Postmenopausal obese women have a
decreased risk of breast cancer.|
True or false?
True. Results from anovulatory
cycles and low progesterone
levels.;
False. Increase in risk
attributed to synthesis of
estrogens in fat deposits;
True.

The longer women breastfeed, the greater

the reduction in risk for breast cancer.|
Gene mutation responsible for 80% to 90% BRCA1
of single gene familial breast cancers and BRCA2;
about 3% of all breast cancers|
Major known susceptibility genes for familial BRCA1
breast cancer| BRCA2
TP53
CHEK2;
Mutations in this gene is associated with an BRCA1;
increased risk of developing ovarian
carcinoma|
Mutations in this gene is more frequently BRCA2;
associated with male breast cancer|
Three major biologic subgroups in breast ER-positive and HER2-negative
cancer| HER2-positive and ER-
positive/negative
ER-negative and HER2-
positive;
Subtype of cancer which arises from the ER-positive and HER2-
dominant pathway of breast cancer negative;
development|
Most common subtype of breast cancer in ER-positive and HER2-
individuals who inherit germline mutations negative;
in BRCA2|
Recognizable precursor lesions in the Flat epithelial atypia
dominant pathway in breast cancer Atypical duct hyperplasia;
development|
Subtype of cancer which arises from HER2-positive;
pathway strongly associated with
amplifications of the HER2 gene on
chromosome 17q|
Most common subtype of breast cancer HER2-positive;
associated with TP53 mutations|
Most common subtype of breast cancer ER-negative and HER2-
observed in patients with germline BRCA1 negative;
mutations|
Subtype of breast cancer termed as ER-positive and HER2-
luminal because of similarities with normal negative;
breast luminal cells|
Recognizable precursor lesions in the Atypical apocrine adenosis;
pathway leading to HER2-positive cancers|
Subtype of cancer termed as basal-like| ER-negative and HER2-
negative;
True or false? False. Adenocarcinoma;

Majority of breast cancers are small cell

carcinomas.|
Malignant clonal proliferation of epithelial Ductal Carcinoma in Situ
cells limited to ducts and lobules by the (DCIS);
basement membrane|
Two major architectural subtypes of DCSI| Comedo
Non-comedo;
Identify the architectural subtypes of DCSI Comedo;

1. Tumor cells with pleiomorphic, high grade

nuclei
2. Areas of central necrosis|
Identify the architectural subtypes of DCSI Non-comedo;

Can be Cribiform or Micropapillary|

Identify the architectural subtypes of DCSI Non-comedo;

No area of central necrosis or tumor cells

with pleiomorphic, high grade nuclei|
DCIS with round, cookie-cutter spaces| Cribiform DCIS;
DCIS with bulbous protrusion without a Micropapillary;
fibrovascular core, often arranged in
complex intraductal pattern|
Rare manifestation of breast cancer which Paget disease of the nipple;
presents as unilateral erythematous
eruption with a scale crust|
Clonal proliferation of cells within ducts and Lobular Carcinoma In Situ;
lobules that grow in discohesive fashion,
usually due to an acquired loss of the tumor
suppressive adhesion protein, E-cadherin|
CIS of the breast with uniform population of Lobular Carcinoma In Situ;
cells with oval or round nuclei and small
nucleoli involving ducts and lobules. Lobular
architecture is preserved.|
Subtype of breast cancer with well- ER-positive, HER2-negative,
differentiated lobular, tubular, or mucinous low proliferation;
patterns|
Subtype of breast cancer typical in older ER-positive, HER2-negative,
women, men, and cancers detected by low proliferation;
mammographic screening|
Subtype of breast cancer with a poorly ER-positive, HER2-negative,
differentiated, lobular pattern| high proliferation;
Subtype of breast cancer typical in BRCA2 ER-positive, HER2-negative,
mutation carriers| high proliferation;
Subtype of breast cancer some apocrine HER2-positive;
pattern|
Subtype of breast cancer common in young HER2-positive;
women, non-white women, and TP53
carriers|
Subtype of breast cancer with a medullary, ER-negative, HER2-negative;
adenoid cystic, secretory, and metaplastic
pattern|
Subtype of breast cancer common in young ER-negative, HER2-negative;
women, BRCA1 mutation carriers, African
American and Hispanic women|
Second most common molecular subtype of HER2-positive;
invasive breast cancer|
A humanized monoclonal antibody that Trastuzumab (Herceptin);
specifically binds and inhibits HER2 and has
markedly improved the outlook for patients
with HER2 expressing cancers|
Also known as triple negative carcinoma| ER-negative, HER2-negative;
Tumors that typically produce a Invasive breast carcinoma;
characteristic grating sound when cut or
scraped|
Grading for invasive carcinoma| Nottingham Histologic Score;
Components in the Nottingham Histologic Tubule formation
Score| Nuclear pleomorphism
Mitotic rate;
Identify the Nottingham Histologic Score. Grade I;

Grow in a tubular pattern with small rounded

nuclei aand have a low proliferative rate|
Identify the Nottingham Histologic Score. Grade II;

Show some tubule formation, but solid

clusters or single infiltrating cells are
present. There is greater degree of nuclear
pleomorphism and mitotic figures are
present|
Identify the Nottingham Histologic Score. Grade III;
Carcinomas invade as ragged nests or solid
sheets of cells;
Special histological type of invasive Lobular carcinoma;
carcinoma, which mostly shows loss of
expression of CDH1, a gene that encodes for
E-cadherin|
Special histological type of invasive Medullary carcinoma;
carcinoma that have features characteristic
of BRCA1 associated carcinomas|
Special histological type of invasive Medullary carcinoma;
carcinoma with lymphocytic infiltrates within
tumors that is associated with higher
survival rates and greater response to
chemotherapy|
Special histological type of invasive Micropapillary carcinoma;
carcinoma, which shows an anchorage-
independent growth|
Special histological type of invasive Lobular carcinoma;
carcinoma with discohesive infiltrating cells
and signet-ring cells containing intraplasmic
mucin droplets|
Special histological type of invasive Mucinous (colloid) carcinoma;
carcinoma with a pale gray-blue gelatin
appearance and pushing or circumscribed
borders|
Special histological type of invasive Tubular carcinoma;
carcinoma, which consists of well-formed
tubules and is sometimes mistaken for a
benign sclerosing lesion|
Special histological type of invasive Papillary carcinoma;
carcinoma, which produces fronds of
fibrovascular tissue line by tumor cells|
Special histological type of invasive Apocrine carcinoma;
carcinoma with cells that resemble sweat
glands|
Special histological type of invasive Micropapillary carcinoma;
carcinoma that forms hollow balls of cells
that float within intercellular fluid, creating
structures that mimic the appearance of
papillae|
Special histological type of invasive Medullary carcinoma;
carcinoma with
1. solid, syncytium-like sheets of large cells
2. frequent mitotic figures
3. moderate to marked lymphoplasmacytic
infiltrate
4. pushing (noninfiltrative border)|
Special histological type of invasive Secretory carcinoma;
carcinoma, which mimics the lactating
breast|
Most important prognostic factor for invasive Axillary lymph node status;
carcinoma in the absence of distant
metastases|
Intralobular stromal tumors| Fibroadenoma
Phyllodes tumor;
Most common benign tumor of the female| Fibroadenoma;
Stromal tumor common in women in their Fibroadenoma;
20s and 30s|
Stromal tumor that is well-circumscribed, Fibroadenoma;
rubbery, and have grayish white nodules
and slitlike spaces|
Stromal tumor more common in the 6th Phyllodes tumor;
decade of life|
Stromal tumor with bulbous protrusions and Phyllodes tumor;
have higher cellularity, higher mitotic rate,
nuclear pleomorphism, stromal overgrowth
and infiltrative borders|
Most common stromal malignancy| Angiosarcoma;

VULVA, VAGINA, AND CERVIX

HSV serotype which commonly results in HSV-1;
oropharyngeal infection|
HSV serotype which commonly results in HSV-2;
genital mucosa and skin infection|
Skin or mucosal lesions in the lower genital Molluscum contagiosum;
tract caused by poxvirus |
Lower genital tract infection which presents Molluscum contagiosum;
as pearly, dome-shaped papules with a
dimpled center and central waxy core|
Lower genital tract infection which presents Fungal (Candida);
with vulvovaginal pruritus, erythema,
swelling, and curd-like vaginal discharge|
Lower genital tract infection which presents Trichomonas vaginalis;
with yellow, frothy vaginal discharge,
vulvovaginal discomfort, dysuria,
dyspareunia, and strawberry cervix|
Main cause of bacterial vaginosis| Gardnerella vaginalis;
Lower genital tract infection which presents Gardnerella vaginalis
with thin, green-gray malodorous (fishy) (bacterial vaginosis);
vaginal discharge|
Infection that begins in the vulva or vagina Pelvic Inflammatory Disease;
and spreads upward to involve most of the
structures in the female genital system,
resulting in pelvic pain, adnexal tenderness,
fever, and vaginal discharge|
Common cause of Pelvic Inflammatory Neisseria gonorrhoeae;
Disease|
Microscopic morphology (Acute Salpingitis)| Dilated tubal lumen filled with
neutrophils, plasma cells,
lymphocytes, and pus
 Sloughing of plicae;
Microscopic morphology (Chronic Scarring and fusion of plicae;
Salpingitis)|
Descriptive clinical term for opaque, white, Leukoplakia;
plaquelike epithelial thickening that may
produce pruritus and scaling|
Major non-neoplastic causes of Leukoplakia| Lichen sclerosus
Squamous cell hyperplasia;
Presents as smooth, white plaques or Lichen sclerosus;
macules grossly and upon histological
examination, presents as marked
thinning of the epidermis,
hyperkeratosis, sclerotic changes of
the superficial dermis, and bandlike
lymphocytic infiltrate in the underlying
dermis|
Other terms of Squamous Cell Hyperplasia| Hyperplastic dystrophy
Lichen simplex chronicus;
Cause of Squamous Cell Hyperplasia| Rubbing or scratching of the
skin to relieve pruritus;
Presents as smooth, white plaques or Squamous Cell Hyperplasia;
macules grossly and upon histological
examination, presents as thickening of
the epidermis and hyperkeratosis|
Benign genital wards caused by HPVs 6 and Condyloma acuminata;
11|
Characteristic viral cytopathic change in HPV Koilocytic atypia nuclear
infections| enlargement, hyperchromasia,
cytoplasmic perinuclear
halo;
Most common histologic type of vulvar Squamous cell carcinoma;
cancer|
Two groups of vulvar squamous cell Basaloid and warty carcinoma
carcinomas| Keratinizing squamous cell
carcinoma;
Type of vulvar squamous cell carcinoma Basaloid and warty carcinoma;
related to infections with high risk HPVs|
Precursor lesion of Basaloid and warty Classic vulvar intraepithelial
carcinoma| neoplasia;
Type of vulvar squamous cell carcinoma Keratinizing squamous cell
relted to individuals with long standing carcinoma;
lichen sclerosus or squamous cell
hyperplasia|
Precursor lesion of Keratinizing squamous Differentiated vulvar
cell carcinoma| intraepithelial neoplasia;
Type of vulvar squamous cell carcinoma Basaloid and warty carcinoma;
common in younger ages|
Type of vulvar squamous cell carcinoma Keratinizing squamous cell
common in older women| carcinoma;
VIN characterized by epidermal thickening, Classic;
nuclear atypia, increased mitosis, and lack
of cellular maturation|
Type of vulvar squamous cell carcinoma, Basal carcinoma;
which consists of nests and cords of small,
tightly packed cells that lack maturation and
resemble the basal layer of normal
epithelium|
Type of vulvar squamous cell carcinoma, Warty carcinoma;
characterized by exophytic, papillary
architecture and prominent koilocytic atypia|
VIN with marked atypia of the basal Differentiated;
layer of the squamous epithelium and
normal-appearing differentiation of the
squamous epithelium|
Glandular neoplastic lesions of the vulva| Papillary hidradenoma
Extramammary Paget disease;
Presents as a sharply circumscribed nodule Papillary hidradenoma;
most commonly on the labia majora or
interlabial folds and is identical to the
intraductal papillomas of the breast|
Presents as a pruritic, red, crusted, maplike Extramammary Paget Disease;
area usually in the labia majora|
Immunostain which highlights Cytokeratin 7;
intraepidermal Paget cells|
Most common malignant tumor to involve Carcinoma spreading from the
the vagina| cervix;
Most common histologic type of vaginal Squamous cell carcinoma;
cancers|
Uncommon vaginal tumor composed of Sarcoma botyroides
malignant embryonal rhabdomyoblasts, (Embryonal
most frequent in infants and children Rhabdomyosarcoma);
younger than 5 years of age|
Common benign exophytic growths that Endocervical polyps;
arise within the endocervical canal|
Third most common cancer in women| Cervical cancer;
Most important factor in the development of High-risk HPVs;
cervical cancer|
Cells infected by HPV| Immature basal cells of the
squamous epithelium in areas
of epithelial breaks
Immature metaplastic
squamous cells at the
squamocolumnar junction;
HPV viral proteins that give the virus the E6 and E7;
ability to act as a carcinogen|
2 (current) classifications of Squamous Low-grade (LSIL)
Intraepithelial Lesions| High-grade (HSIL);
SIL associated with productive HPV infection| LSIL;
SIL associated with progressive deregulation HSIL;
of the cell cycle|
SIL with immature squamous cells confined LSIL;
to the lower third of epithelium|
SIL immature squamous cells confined to the HSIL;
upper third of the epithelium|
Most common histological subtype of Squamous cell carcinoma;
cervical carcinoma|
Cervical carcinoma composed of nests and Squamous cell carcinoma;
tongues of malignant squamous epithelium,
which invade the underlying cervical stroma|
Cervical carcinoma characterized by the Adenocarcinoma;
proliferation of glandular epithelium
composed of malignant endocervical cells
with large, hyperchromatic nuclei and
relatively mucin-depleted cytoplasm|
Identify the cervical cancer stage. Stage 0;

Carcinoma in situ|
Identify the cervical cancer stage. Stage Ia;

Preclinical carcinoma, diagnosed only by

microscopy|
Identify the cervical cancer stage. Stage Ia1;

Stromal invasion no deeper than 3mm and

no wider then 7 mm|
Identify the cervical cancer stage. Stage Ia2;

Maximum depth invasion of stroma deeper

than 3 mm and no deeper then 5 mm taken
from base of epithelium; horizontal invasion
not more than 7 mm|
Identify the cervical cancer stage. Stage Ib;

Histologically invasive carcinoma confined to

the cervix and greater than stage Ia2|
Identify the cervical cancer stage. Stage II;

Carcinoma extends beyond the cervix but

not to the pelvic wall and the vagina but not
the lower third|
Identify the cervical cancer stage. Stage III;

Carcinoma extends to the pelvic wall and

lower third of the vagina|
Identify the cervical cancer stage. Stage IV;

Carcinoma involves the mucosa of the

bladder or rectum|

UTERUS AND FALLOPIAN TUBES

Functional endometrial disorders| Anovulatory cycle
 Inadequate luteal phase;
Most frequent cause of dysfunctional Anovulatory cycle;
bleeding|
Women with this disorder have Anovulatory cycle;
endometrium that lacks progesterone-
dependent morphologic features (glandular
secretory changes and stromal pre-
decidualization)|
A condition that manifests clinically as Inadequate luteal phase;
infertility associated with either increased
bleeding or amenorrhea|
Usual predisposing influence in Acute Retained products of
Endometritis| conception;
This cell, when seen in the stroma, supports Plasma cells;
the diagnosis of Chronic Endometrits|
Defined as the presence of ectopic Endometriosis;
endometrial tissue at a side outside of the
uterus|
Most common site where endometriosis can Ovaries;
occur|
Theories in the pathogenesis of Regurgitation theory
Endometriosis| Benign metastases theory
Metaplastic theory
Extrauterine stem/progenitor
cell theory;
Theory, which proposes that endometrial Regurgitation theory;
tissue implants at ectopic sites via
retrograde flow of menstrual endometrium|
Theory, which proposes that endometrial Benign metastatic theory;
tissue from the uterus can spread to distant
sites via blood vessels and lymphatic
channels|
Theory which proposes that endometrial Metaplastic theory;
tissue arises directly from coelomic
epithelium|
Theory which proposes that stem cells from Extrauterine stem/progenitor
the bone marrow differentiate into cell theory;
endometrial tissue|
Disorder which causes an ovary markedly Endometriosis;
distorted by large cystic masses filled with
brown fluid resulting from hemorrhage,
referred to as chocolate cysts|
2 morphologic appearances of Atypical Cytologic atypia
Endometriosis| Glandular crowding due to
excessive epithelial
proliferation;
Clinical signs and symptoms of Severe dysmenorrhea
endometriosis| Dyspareunia
Pelvic pain;
Presence of endometrial tissue within the Adenomyosis;
uterine wall|
Exophytic masses of variable size that Endometrial polyps;
project into the endometrial cavity|
Important cause of abnormal bleeding and a Endometrial hyperplasia;
frequent precursor to the most common
type of endometrial carcinoma|
Increased proliferation of endometrial glands Endometrial hyperplasia;
relative to the stroma, resulting in an
increased gland-to-stroma ratio|
Common genetic alteration in both Inactivation of PTEN;
endometrial hyperplasia and endometrial
carcinoma|
Cardinal feature of this endometrial disease Non-atypical endometrial
is increase in gland to stroma ratio, without hyperplasia;
abnormal cytologic features|
Most common invasive cancer of the female Endometrial carcinoma;
genital tract|
Most common type of endometrial Type I (Endometrioid);
carcinoma|
Mutations in Type I Endometrioid carcinoma PI3K/AKT pathway;
are involved in this pathway|
Type of endometrial carcinoma that mimics Type I;
proliferative endometrial glands|
Type of endometrial carcinoma which occurs Type I;
in the setting of endometrial hyperplasia|
Type of endometrial carcinoma which usually Type II;
arises in the setting of endometrial atrophy|
Most common subtype of Type II endometrial Serous carcinoma;
carcinoma|
Mutations in this gene is found in 90% of TP53;
serous endometrial carcinoma|
Endometrial carcinoma which arise in small Serous endometrial
atrophic uteri and are often large bulky carcinoma;
tumors or deeply invasive into the
myometrium|
Peak incidence of endometrial carcinoma| Postmenopausal women 55 to
65 years of age;
Endometrial adenocarcinomas with a Malignant Mixed Mullerian
malignant mesenchymal component| Tumors;
Other term for Malignant Mixed Mullerian Carcinosarcoma;
Tumors|
Tumors of endometrial stroma| Adenosarcoma
Benign stromal nodules
Endometrial stromal
sarcomas;
Present most commonly as large broad- Adenosarcoma (of the
based endometrial polypoid growths that endometrial stroma);
may prolapse through the cervical os|
Tumors of the myometrium| Leiomyoma
Leiomyosarcoma;
Most common tumor in women| Uterine leiomyoma (fibrinoid);
Presents microscopically as a whorled Uterine leiomyoma;
pattern of smooth muscle bundles and
grossly as a sharply circumscribed, discrete,
round, firm, and gray-white tumors in the
uterus|
2 distinctive patterns in Uterine Bulky, fleshy masses that
Leiomyosarcoma| invade the uterine wall
Polypoid masses that project
into the uterine lumen;
Most common primary lesions of the Paratubal cysts;
fallopian tubes|
0.1 0 2 cm translucent cysts filled with clear Paratubal cysts;
serous fluid in the fallopian tubes|

OVARIES
HSV serotype which commonly results in HSV-1;
oropharyngeal infection|
 MICROBIOLOGY

SEXUALLY TRANSMITTED INFECTIONS

Curable bacterial and parasitic infections| Chlamydia
Gonorrhea
Trichomoniasis
Syphilis
Chancroid (H. ducreyi);
Incurable viral infections| HIV
Genital warts (Human
Papillomavirus or HPV)
Herpes (Herpes Simplex or
HSV)
Hepatitis B;
Common symptoms of STIs| Vaginal discharge
Urethral discharge or burning
in men
Genital ulcers
Abdominal pain;
Most common STI| Chlamydia;
Three species of Chlamydia that cause C. trachomatis (GU)
disease| C. pneumonia
C. psittaci (eyes);
True or false? False.;

Chlamydia has a peptidoglycan layer|

True or false? True.;

Chlamydia is non-motile and has no pili and

exotoxins.|
Two forms of Chlamydia in the host cell| Elementary body
Reticulate body;
Infectious extracellular form of Chlamydia| Elementary body;
Environmentally stable, metabolically inert, Elementary body;
and inactive form of Chlamydia|
Form of Chlamydia with a rigid outer Elementary body;
membrane with extensive disulfide bond
cross-linkages|
Elementary bodies of Chlamydia have an Non-ciliated columnar
affinity for what kinds of cell?| epithelial cell;
Non-infectious intracellular form of Reticulate body;
Chlamydia|
Metabolically active form of Chlamydia that Reticulate body;
divides by binary fission|
Form of Chlamydia that has a fragile Reticulate body;
membrane, lacking extensive disulfide
bonds|
Urogenital infection that usually co-exist Chlamydia trachomatis;
with N. gonorrhoeae|
Painless papule or ulceration on the genitals Lymphogranuloma venereum;
that heal spontaneously|
Causative agent of Lymphogranuloma Chlamydia trachomatis;
venereum|
Serovars of Chlamydia trachomatis D-K;
associated with STDs, conjunctivitis, and
eosinophilic pneumonia|
The presence of ____ has been used for Inclusion bodies;
diagnosis of Chlamydia|
Most specific method for diagnosis of C. Culture;
trachomatis infections|
The presence of iodine-staining inclusion C. trachomatis;
bodies is specific for?|
Test of choice to diagnosis genital C. Nucleic Acid Amplification Test
trachomatis| (NAAT);
Treatment for Chlamydia infections| Erythromycin
Doxycycline
Azithromycin
Levofloxacin
Ofloxacin;
Transmission efficiency of Gonorrhea Anatomic site of infection
depends on the?| Number of sexual exposures;
True or false? False. Gram-negative
diplococci.;
Neisseria gonorrhea is a gram-positive
diplococci.|
Best culture medium for Neisseria Chocolate agars or Thayer-
gonorrhoeae| Martin agars;
Second most common STD| Gonorhhea;
Virulence factors of Neisseria gonorrhoeae| Pili
IgA1 protease
Outer membrane proteins
Endotoxin;
Virulence factors of Neisseria gonorrhoeae Pili
with antigenic variation| Outer membrane protein;
Causative agent of opthalmia neonatorum Neisseria gonorrhoeae;
and neonatorum conjunctivitis|
Gram stain results for (+) Neisseria Polymorphonuclear leukocytes
gonorrhoeae| with intracellular gram-
negative diplococci;
True or false? False. NAAT is more sensitive;

Culture is more sensitive in diagnosing

Gonorrhea infections.|
Diagnostic work up for cases of suspected or Culture and anti-microbial
documented Gonorrhea treatment failure| susceptibility testing;
Gonorrhea infection treatment| Penicillin
Ceftriaxone
Azithromycin or Doxycyclin
(Chlamydia);
New antibiotic regimen against Gonorrhea| Injectable gentamicin + oral
 azithromycin
Oral gemifloxacin + oral
azithromycin
Causative agent for Syphilis| Treponema pallidum;
Helical/spiral bacteria with corkscrew Treponema pallidum;
motility|
Clinical manifestation of primary syphilis| Highly infectious painless
chancre with regional non-
tender lymph node swelling
that resolves without a scar;
Clinical manifestation of secondary syphilis| Systemic bacteremic stage
Generalized rash
Condyloma latum (painless,
wart-like lesion)
Generalized lymphadenopathy
Systemic symptoms (CNS,
eyes, bones, kidneys, joints);
Clinical manifestation of tertiary syphilis| Slow inflammatory damage to
organ tissue
Gummatous
Cardiovascular
Neuro;
Indolent lesions with centers of rubbery, Gummas;
gray-whie coagulation necrosis surrounded
by epitheloid cells, fibroblastic cells, and
sometimes giant cells|
Diagnostic tests for syphilis| Direct examination (darkfield
microscopy)
Immunofluorescence
ELISA
Silver stain
Serologic tests;
Result in RPR test for latent syphilis| Reactive RPR (+ absence of
signs and symptoms;
Non-specific treponemal tests| VDRL (Venereal disease
research laboratory)
RPR (Rapid plasma reagin);
Specific treponemal tests} FTA-ABS
MHA-TP;
Treatment for syphilis| Penicillin (DOC)
Erythormycin
Doxycycline;
Cells infected by HPV| Squamous cells;
Non-oncogenic HPV types| 6 and 11;
Oncogenic HPV types| 16 and 18;
Most common viral STD| HPV;
Causative agent for Condyloma acuminata| HPV 6 and 11;
Disease presenting as warts with a Condyloma acuminata;
cauliflower appearance|
Causative agent for Condyloma planum| HPV 16, 18, 31, 33;
Diseases which presents as flat, cervical Condyloma planum;
warts and can cause cervical neoplasia|
Vaccines for HPV| Cervarix (16 and 18)
Gardasil (6, 11, 16, 18);
Virus which can only be infected by direct Herpes simplex virus;
contact with mucosal surfaces or secretions
of an infected person|
Virus which has an ability to infect epithelial Herpes simplex virus;
mucosal cells and/or lymphocytes;
HSV with presentations generally above the HSV-1;
waist|
HSV with presentations generally below the HSV-2;
waist|
Lesion with a dewdrop on a rose petal HSV lesion;
appearance|
Diagnostic tool for HSV infections| Tzanck smear;
Pathognomonic structure in HSV that can be Cowdry Type A inclusion
observed in a Tzanck smear| bodies;
Causative agent of chancroids| Haemophilus ducreyi;
Ulcer that is deeply invasive, tender, painful, Chancroid;
purulent with ragged/uneven lesion edges|
Disease with single, painless, deep and Primary syphilis;
defined ulcers with induration|
Disease with multiple, painless, shallow Genital herpes;
ulcers with bilateral lymphadenopathy|
Disease with painful, undermined and deep Chancroid (H. ducreyi);
ulcers with purulent base and tender
lymphadenopathy|
 SURGERY

PE OF THE MALE REPRODUCTIVE SYSTEM

Foreskin cannot be fully retracted over the Phimosis;
glans penis|
Uncommon medical condition where the Paraphimosis;
foreskin becomes trapped behind the glans
penis and cannot be reduced|
Persistent paraphimosis can lead to?| Gangrene (medical
emergency);
Other terms for Peyronies disease| Induratio penis plastica/
Inflammation of the tunica
albuginea;

Disease with growth of fibrous plaques in the Peyronies disease;

soft tissue of penis leading to an abnormal
curvature of the penis|
Management for Peyronies disease| Surgical removal;
Painful erection, which does not return to its Priapism;
flaccid state despite absence of physical and
physiological stimulation within 4 hours|
Most common pediatric condition that may Sickle cell disease;
cause Priapism|
Hematological disorders that may cause Sickle cell anemia
priapism| Leukemia
Thalassemia
Fabrys disease;
Neurological causes of priapism| Spinal cord lesions/trauma;
Drugs that may induce priapism| Sildenafil citrate (Viagra)
Drugs for erectile dysfunction
Desyrel (Trazodone HCl, used
to treat depression)
Thorazine (for certain mental
illnesses)
Illicit drug use;
Other causes of priapism| Trauma to genital are
Black widow spider bites
Carbon monoxide poisoning;
Recurrent/unwanted/painful erection Stuttering/Intermittent
common sickle cell disease| Priapism;
Abnormally placed male urethral meatus on Hypospadias;
the ventral side of the penis|
Downward curvature of the penis| Chordee (Peyronies disease is
upward);
Most frequent causes of Penile warts| HPV 6 and 11;
Common form of penile cancer| Squamous cell carcinomas;
Direct or indirect inguinal hernia? Direct;

Less common, usually in men older than 40|

Direct or indirect inguinal hernia? Indirect;
Most common, often in children|
Direct or indirect inguinal hernia? Direct;

Point of origin is above the inguinal

ligament, close to the pubic tubercle (near
the external inguinal ring)|
Direct or indirect inguinal hernia? Indrect;

Point of origin is above the inguinal

ligament, near its midpoint (the internal
inguinal ring)|
Direct or indirect inguinal hernia? Direct;

Rarely occurs in the scrotum|

Direct or indirect inguinal hernia? Indirect;

Often occurs in the scrotum|

Direct or indirect inguinal hernia? Direct;

Internal ring is closed, hernia is caused by

the weak floor|
Direct or indirect inguinal hernia? Indirect;

Internal opening, does not close, abdominal|

Direct or indirect inguinal hernia? Direct;

Medial to inferior epigastric vessel|

Direct or indirect inguinal hernia? Indirect;

Lateral to inferior epigastric vessel|

Pathologic accumulation of serous fluid Hydrocoele;
within a body cavity|
Hydrocoele that occurs as a result of Non-communicating
inflammation or injury within the scrotum| hydrocele;
Method to determine if swelling is due to Transillumination (lights up
hydrocele| with red glow);
In surgery of testicular cancer, incision is Inguinal canal;
made at the ______ .|
Twisting of the spermatic cord| Torsion;
Helps determine whether presenting Prehns sign;
testicular pain is caused by acute
epididymitis or from testicular torsion|
Positive Prehns sign| Pain relief with lifting the
affected testicle (epididymitis
or orchitis);
Negative Prehns sign| No pain relief when lifting the
affected testicle (testicular
torsion);
Management for testicular torsion| Surgically relieved within 6
hours;
Engorgement/dilation of the pampniform Varicocele;
venous plexus|
True or false? False. It is more common on
the left because of the angle
Varicocele is more common on the right at which the left testicular
testicular veins| vein enters the left renal vein
and the lack of effective
valves in these veins;
Positions to do a Digital Rectal Examination| Dorsal lithotomy
Lateral recumbent;
DRE finding in Acute prostatitis| Indurated and tender gland;
Common sites of metastasis in Prostate Bone
cancer| Lymph node;
Network of valveless veins in the human Batson Venous Plexus;
body that connect the deep pelvic veins and
thoracic veins to the internal vertebral
venous plexuses|

SEXUAL AND ERECTILE DYSFUNCTION

3 cylindrical structures in the penis| Paired corpora cavernosa
Corpus spongiosum;
Acts as struts to augment the septum in the Intracavernous pillars;
Tunica albuginea|
True or false? False. Outer longitudinal
layer.;
The inner circular layer of the tunica
albuginea is absent at the 5-7 oclock
positions.|
Low pressure structure during erection| Corpus spongiosum;
Structure which contains the urethra| Corpus spongiosum;
Structure filled with blood during erection| Corpus cavernosa;
Main artery of the penis| Internal pudendal artery
(branch of the internal iliac
artery);
Branches of the internal pudendal artery| Bulbourethral
Cavernous/Cavernosal
Dorsal;
Artery which supplies the bulbar urethra and Bulbourethral;
Corpus spongiosum|
Artery which effects tumescence and Cavernous/Cavernosal;
erection of Corpora Cavernosa|
Artery which gives of helicine arteries to Cavernous/Cavernosal;
supply trabecular erectile tissue and
sinusoids|
Artery responsible for the engorgement of Dorsal;
the glans during erection|
Main venous drainage of the glans penis and Deep dorsal vein;
distal 2/3 of the corpora cavernosa|
Erectile dysfunction is higher in Diabetes mellitus
patients with:| Treated heart disease
Treated hypertension;
Drugs that may induce ED| Anti-HPN (Non-selective beta
blockers, alpha blockers,
thiazide diuretics)
Anti-psychotics
(phenothiazines)
Cytotoxic agents
(cyclophosphamide,
methotrexate)
Opiates (Morphine)
Anti-ulcer (cimetidine)
Anti-androgens (flutamide,
cyprotene acetate);
Classification of ED| Organic
Psychogenic;
ED with sudden onset| Psychogenic;
ED with complete/immediate loss| Psychogenic;
ED with situational dysfunction| Psychogenic;
ED with present waking erections| Psychogenic;
ED with gradual onset| Organic;
ED with incremental progression| Organic;
ED with global dysfunction| Organic;
ED with absent waking erections| Organic;
International Index of Erectile Function 5-7: severe
scoring| 8-11: mild to moderate
12-16: moderate
17-21: mild
22-25: no ED;
Basic management for ED| PDE5 inhibitor
Intracavernous inection
Urethral suppository;
PDE5 inhibitors| Sildenafil (Viagra)
Tadalafil (Cialis)
Vardenafi (Levitra);
Surgical interventions for ED| Penile prosthesis surgery
Penile revascularization
surgery
Excision of cavernosal fibrosis
in Peyronies disease;
Full or partial erection that continues for Priapism;
more than 4 hours beyond sexual
stimulation and orgasm or is unrelated to
sexual stimulation|
Management for priapism| Drain blood;
Shunting procedure performed with a large Winters procedure;
biopsy needle or scalpel inserted
percutaneously through the Glans to
manage Priapism|
Ejaculation that always or nearly always Premature ejaculation;
occurs before or within about 1 minute of
vaginal penetration|
Emission of the seminal fluid is controlled by Sympathetic;
the ______ nervous system, activating
propulsion contraction of the smooth muscle
of the prostate, vas deferens, and seminal
vesicles|
When seminal fluid or ejaculate Retrograde ejaculation;
preferentially flows into the bladder due to
failure of bladder neck to close|
Usual cause of anejaculation| Spinal cord injury;
Options for spinal cord injury patients| Penile vibratory stimulation
Electroejaculation
Sperm retrieval (percutaneous
or open biopsy);

MALE CONGENITAL DISORDERS

One or both fetal kidneys fail to develop| Renal agenesis;
Causative agent of Potters sequence| Bilateral renal agenesis;
With one or two accessory kidneys| Supernumerary kidney;
Abnormal position of the kidney outside the Renal ectopia;
renal fossa|
Types of renal ectopia| Thoracic
Crossed renal
Iliac
Pelvic;
Differential diagnosis for pelvic kidneys| Horseshoe kidneys;
Inferior poles of the kidneys are fused| Horseshoe kidneys;
What arrests the embryonic ascent of the Isthmus
horseshoe kidney?| Inferior Mesenteric Artery;
Anatomical variation in the position of the Renal malrotation;
kidneys|
Common complications in renal malrotation| Hydronephrosis
Stone formation;
Normal rotation of the renal hilum| Anteromedial;
Section of the renal parenchyma in the Brodels line;
posterior kidney that is relatively avascular|
Two separate pelvocalyceal systems Duplex kidney;
draining a single renal parenchyma|
Insertion of an ectopic ureter in males| Above the external urinary
sphincter;
Insertion of the ureter in females that may Distal to the external
lead to incontinence| sphincter;
3 possible site of ureteric orifice causing Vagina
incontinence| Vestibule of vagina
Urethra;
Two ureters that unite before emptying into Bifid ureter;
the bladder|
Most frequent site of ureteral stenosis| Ureteropelvic junction;
Round pouch of smooth, thin-walled tissue Simple kidney cyst;
or a closed pocket that is usually filled with
fluid|
Most common type of kidney cyst| Simple cyst;
Classification for renal cysts| Bosniak classification
Identify the Bosniak classification. Class I;

Water density homogenous

Non-calcified, smooth margin
No enhancing component|
Identify the Bosniak classification. Class II;

Thin septae (<1mm)

Thin calcification (<1mm)
Hemorrhagic cyst|
Identify the Bosniak classification. Class I and II;

Benign (0% malignancy)|

Identify the Bosniak classification. Class IIF;

Minimal thickening of wall.|

Identify the Bosniak classification. Class IIF;

Likely benign (5% malignancy)|

Identify the Bosniak classification. Class III;

Thick septa
Thick calcification
Thick wall
Multilocular +/- enhancement|
Identify the Bosniak classification. Class III;

=50% malignant|
Identify the Bosniak classification. Class IV;

Thick septa
Thick calcification
Thick wall
Multilocular +/- enhancement
Enhancing solid mass of wall or septa|
Identify the Bosniak classification. Class IV;

100% malignant|
Progressive cyst development and bilaterally Polycystic kidney disease;
enlarged kidneys with multiple cysts in a
functional kidney|
Congenital disorder of the kidney Medullary sponge kidney;
characterized by cystic dilatation of the
collecting tubules|
Abnormal urine flow from bladder to upper Vesicoureteral reflux;
urinary tracts|
Type of VUR that typically affects only one Primary VUR;
ureter or kidney|
Type of VUR that occurs when blockage in Secondary VUR;
the urinary tract causes an increase in
pressure and pushes urine back up into the
ureters|
VUR grade indicated for surgical correction| Grade V (and Grade IV with
medical treatment failure);
Protrusion of the urinary bladder through a Bladder exstrophy;
defect in the abdominal wall|
A confluence of the rectum, vagina, and Cloacal malformation;
urethra into a single common channel|
Malformation of the penis in which the Epispadias;
urethra ends in an opening on the upper
aspect (dorsal) of the penis|
Urethra opens anywhere along a line Hypospadias;
running from the tip along the underside
(ventral) aspect of the shaft to the junction
of the penis and scrotum or perineum|
Absence of a testis in the scrotum| Cryptochordism;
Treatment for cryptochordism| Orchidopexy (remove
undescended testis);
Definitive treatment of undescended testis 6-12 months;
should take place between?|
 PHARMACOLOGY

SEXUAL AND ERECTILE DYSFUNCTION

Persistent failure to generate sufficient Erectile dysfunction;
penile body pressure to achieve vaginal
penetration and/or the inability to maintain
this degree of penile rigidity
Erection is controlled by the ______ nervous Parasympathetic
system while the _____ nervous system Sympathetic;
controls ejaculation|
PDE5 MOA| Increase and maintain levels
of cGMP by inhibiting its
degradation by
phosphodiesterases;
Most common group of drugs that addresses PDE5 Inhibitors;
ED|
PDE5 inhibitors| Sildenafil (Viagra)
Tadalafil (Cialis)
Vardenafil (Levitra)
Avanafil (Stendra, Spedra);
Adverse effects of Sildenafil| Color vision (blue-green
discrimination)
Blurring of vision
Headache, flushing, rhinitis,
dyspepsia
Hypotension effects
MI
Priapism;
PDE5 inhibitor with longest onset and Tadalafil;
longest action and half-life|
PDE5 inhibitor with quickest onset, shortest Avanafil (Stendra, Spedra);
time of duration|
PGE1 Analogs MOA| Unknown but may possibly be
associated with an increase in
cGMP and cause smooth
muscle relaxation of corpora
cavernosa;
PGE1 Analog| Alprostadil;
Alprostadil routes of administration| Intracavernosal/intracorporal
(injection)
Intraurethral
(insertion/minisuppository/pell
et);
Adverse effect of Alprostadil| Penile pain;
cAMP PDE inhibitor and alpha 1-receptor Papavarine;
blocker|
Adverse reaction of Papavarine| High incidence of priapism
and corporeal fibrosis;
Alpha-adrenoreceptor antagonists MOA for Smooth muscle relaxation of
ED| corpora cavernosa;
Alpha-adrenoreceptor antagonists for ED| Phentolamine
Yohimbine;
Phentolamine MOA| Alpha receptor blocker (mainly
1 , some 2) vasodilatory
effects;
Phentolamine route of administration| Intracavernosa/intracorporeal
injections
Oral;
Alpha blockers for ED precautions | May increase blood pressure
and sympathetic nervous
outflow in hypertensives and
those taking tricyclic
antidepressants;
Alpha blockers for ED adverse reactions | Fibrotic reactions
Orthostatic hypertension
Priapism;
Critical mediator of prostatic growth in Dihydrotestosterone (DHT);
Benign Prostatic Hyperplasia|
Enzyme involved in the conversion of 5-reductase;
testosterone to dihydrotestosterone|
5-reductase inhibitors| Finasteride
Dutasteride;
5-reductase inhibitors adverse effects| Decreased libido
Ejaculation problems
Erectile dysfunction, but
resolves;
Drug for BPH treatment that can also be Finasteride;
used for hair growth and hair loss
prevention|
Alpha blockers for BPH MOA| Block alpha adrenergic
receptors in the smooth
muscle of the bladder
neck/base, prostate,
vasculature reduced smooth
muscle tone rapidly
decreasing resistance to urine
flow and obstructive
symptoms;
Alpha blockers for BPH| Prazosin
Terazosin
Doxazosin
Tamsulosin;
Alpha blocker for BPH with the most adverse Prazosin;
effect (vasodilation)|
Alpha blocker for BPH, which causes the Terazosin;
most significant orthostatic hypotension|
Alpha blocker for BPH with the longest half- Terazosin (20 hours);
life|
Best alpha blocker for BPH because of its Tamsusolin;
specificity|
Most important alpha subtype mediating -1a;
prostate smooth muscle contraction, that is
inhibited by Tamsusolin|
Only phosphodiesterase inhibitor used in Tadalafil;
treatment of BPH|
Treatment for localized prostate cancer| Surgery or radiation therapy;
Treatment for prostate cancer with distant Hormonal therapy;
metastasis|
GnRH agonists| Leuploride
Goserelin
Triptorelin
Buserelin;
GnRH agonists MOA| Stimulate LH production
production of testosterone
surge of LH, FSH, testosterone
negative feedback
decreased testosterone;
GnRH agonists adverse effect| Transient flare of disease
(because of initial surge);
Management of flares caused by GnRH Androgen receptor blockers
agonists| Complete androgen blockade:
androgen receptor blockers (1
week before) + GnRH agonists
GnRH antagonists;
GnRH antagonists| Abarelix;
Two types of androgen receptor blockers| Steroidal
Non-steroidal;
Steroidal androgen blockers; Cyproterone;
Cyproterone adverse effects| Liver toxicity
Suppression of adrenal glands;
Non-steroidal androgen blockers MOA| Inhibit ligand binding and
consequent androgen
receptors translocation from
cytoplasm to nucleus;
Non-steroidal androgen blockers| Flutamide
Bicalutamide
Nilutamide;
Flutamide adverse effects| Gynecomastia
Reversible hepatitis toxicity;
Non-steroidal androgen blocker for Bicalutamide
metastatic prostate CA| Nilutamide;
Experimental drug for prostate CA treatment Ketoconazole;
that inhibits adrenal and gonadal steroid
synthesis|
Drug for refractory prostate CA| Ketoconazole;
Ketoconazole adverse effects; Vasomotor flushing
Loss of libido
Reversible gynecomastia
Increased weight
Loss of bone mineral density
Loss of muscle mass;
Treatment for gonococcal infections| Ceftriaxone (3rd gen)
 Cefixime (DOC, 3rd gen)
Ofloxaxin (also for Chlamydia);
Treatment for chlamydial infections| Doxycycline
Azithromycin;
Treatment for syphilis| Benzathine penicillin G;
Treatment for Herpes Simplex} Acyclovir
Valacyclovir
Famciclovir;
Treatment for chancroid| Azithromycin
Ceftriaxone
Erythromycin
Ciprofloxacin;
Treatment for genital warts| Podofilox
Imiquimod;
Treatment for Pediculosis pubis| Premithrin
Pyrethins and piperonyl
butoxide;

AGENTS OF UTEROTONICS AND TOCOLYTICS

Uterine stimulants| Oxytocin
Methylergonovine
Prostaglandins;
Drug of choice among uterine stimulants| Oxytocin;
Site of oxytocin production| Hypothalamus;
Site of oxytocin storage and secretion| Posterior pituitary gland;
Uses of oxytocin| Induction and reinforcement of
labor
Postpartum hemorrhage
Impaired milk ejection;
Route of administration of oxytocin for IV;
induction|
Route of administration of oxytocin for IM;
postpartum hemorrhage|
Adverse effects of oxytocin| Uterine rupture
Fetal death
Abruptio placentae
Hypertension
Water retention;
Effects of oxytocin at high concentrations| Weak anti-diuretic
Pressor effects;
Contraindications for oxytocin| Fetal distress
Prematurity
Abnormal fetal presentation
Cephalopelvic disproportion;
Other term for methylergonovine| Methylergometrine;
Methylergonovine MOA| Directly stimulates uterine
muscles to increase force and
frequency of contractions;
Methylergonovine use| Postpartum hemorrhage;
Contraindications of Methylergonovine| Pregnancy
 Unstable angina, recent MI
Hypertension, pre-eclampsia,
eclampsia;
Methylergonovine side effects| Nausea
Diarrhea
Vasopasm;
Prostaglandins MOA| Muscle contraction by
interacting with prostaglandin
receptors on myometrial cells

Soften cervix by increasing

proteoglycan content and
changing biophysical
properties of collagen;
Uses of prostaglandins| Postpartum hemorrhage
Priming and softening of
cervix prior to terminating
pregnancy in any trimester;
Most common side effect of prostaglandins| Diarrhea;
Contraindications of prostaglandins| Fetal distress;
Tocolytic drugs| Beta agonists (Terbutaline,
Isoxsuprine)
Magnesium sulfate
Calcium channel blockers
(nifedipine)
Prostaglandin inhibitor
(indomethacin);
Drug of choice among tocolytic drugs| Terbutaline;
Side effects of beta 2 agonists| Palpitation
Termors
Hypokalemia
Nausea
Headache
Pulmonary edema
Arrhythmia;
Calcium channel blocker used to decrease Nifedipine;
uterine contractions|
Side effects of nifedipine| Hypotension
Tachycardia
Palpitation
Flushing
Headaches
Dizziness
Nausea;
Side effects of magnesium sulfate| Muscle weakness, loss of deep
tendon reflexes
Decreased effort in breathing
(respiratory depression)
Vasodilation
Flushing
Headache;
Prostaglandin inhibitor which inhibits Indomethacin;
production of cytokines that may trigger
labor|
Side effects of indomethacin| Maternal: nausea, heartburn
Fetal: constriction of ductus
arteriosus, pulmonary
hypertension,
oligohydramnios;
Tocolytic used for preterm labor < 32 weeks| Indomethacin;
Drugs used to decrease uterine Tocolytics;
contractions|
DRUG USE IN PREGNANCY AND LACTATION
Changes in drug absorption| Decreased intestinal motility
Nausea and vomiting
Increased maternal blood flow
to the skin
Hyperventilation;
Changes in drug distribution| Decreased serum
concentration ( increased
body water)
Increased free drug
concentration ( decreased
plasma albumin
concentration);
Changes in drug metabolism| Increased CYP 3A4, 2D6, 2C9
Decreased CYP 1A2, 2C19,
xanthine oxidase, N-
acetyltransferase
No change in liver blood flow
Placenta can metabolize drugs
and create toxic metabolites;
Example of a drug that can be metabolized Pentobarbital;
by the placenta|
Changes in drug excretion| Increased excretion (
Increased renal blood flow
progressively);
Drug, which affects the development of Diethylstilbestrol;
reproductive structures and lead to
adenocarcinoma of the cervix and vagina of
the female offspring if given at AOG < 18
weeks|
Drug linked to babies born with flipper-like Thalidomide;
extremities (Phocomelia)|
Any agent that acts during embryonic or Teratogen;
fetal development to produce a permanent
alteration of form or function|
Drugs which may cause disruption of folic Carbamazepine
acid absorption or metabolism| Lamotrigine
Phenobarbital
Hydantoin
Phenytoin
 Valproic acid;
Drugs which may cause homeobox genes to Retinoids
malfunction| Valproic acid;
True or false? True.;

An increase in lipid solubility of a drug leads

to an increased effect of the drug to the
baby.|
True or false? False. Decreased effect of the
drug;
An increase in ionization of a drug leads to
an increased effect of the drug to the baby.|
True or false? False. Decreased effect of the
drug.;
An increase in molecular size of a drug leads
to an increased effect of the drug to the
baby.|
Drug exposures during the embryonic Anatomical abnormalities;
stage (2nd to 8th week) can lead to?|
Drug exposures during the fetal stage Physiologic/functional
(8th week to term) can lead to?| abnormalities;
Identify the US-FDA Category for drug use in A;
pregnancy.

Controlled studies show no risk|

Identify the US-FDA Category for drug use in B;
pregnancy.

No evidence of risk in humans.|

Identify the US-FDA Category for drug use in C;
pregnancy.

Risk cannot be ruled out|

Identify the US-FDA Category for drug use in D;
pregnancy.

Positive evidence or risk|

Identify the US-FDA Category for drug use in X;
pregnancy.

Contraindicated in pregnancy|
Identify the US-FDA Category for drug use in B;
pregnancy.

Ibuprofen.|
Identify the US-FDA Category for drug use in C;
pregnancy.

Aspirin|
Identify the US-FDA Category for drug use in C;
pregnancy.
Mefenamic acid|
Identify the US-FDA Category for drug use in C;
pregnancy.

Celecoxib|
Identify the US-FDA Category for drug use in B;
pregnancy.

Paracetamol|
Drugs used for infections in pregnancy| Beta-lactams;
Identify the US-FDA Category for drug use in D;
pregnancy.

Tetracycline
Aminoglycosides|
Identify the US-FDA Category for drug use in C;
pregnancy.

Gentamicin|
Identify the US-FDA Category for drug use in C;
pregnancy.

Sulfonamides|
Identify the US-FDA Category for drug use in C;
pregnancy.

Quinolones|
Drug which can cause gray baby syndrome| Chloramphenicol;
Identify the US-FDA Category for drug use in B;
pregnancy.

Penicillin|
Anti-hypertensive drugs contraindicated ACE inhibitors
during pregnancy| ARBs;
Drug of choice for pre-eclampsia| Hydralazine;
Anti-hypertensive drugs that can be used Methyldopa (B)
during pregnancy| Labetalol
Nifedipine (C)
Hydralazine (C);
Identify the US-FDA Category for drug use in X;
pregnancy.

Isotretinoin/Etretinate/Acitretin|
X-drug which can lead to Microtia Isotretinoin/Etretinate/Acitretin
(abnormality of the external ear)| ;
Identify the US-FDA Category for drug use in X;
pregnancy.

Aminopterin, Methotrexate|
Identify the US-FDA Category for drug use in X;
pregnancy.

Thalidomide|
Identify the US-FDA Category for drug use in X;
pregnancy.

Sex hormones DES, androgens|

Identify the US-FDA Category for drug use in X;
pregnancy.

HMGCoA reductase inhibitors|

Identify the US-FDA Category for drug use in X;
pregnancy.

Misoprostol|
Identify the US-FDA Category for drug use in X;
pregnancy.

Parenteral vitamin A > 1800 RE or 6000 U|

Identify the US-FDA Category for drug use in X;
pregnancy.

Benzodiazepine|
X drug which can cause fetal clefting| Benzodiazepine;
Identify the US-FDA Category for drug use in X;
pregnancy.

Warfarin|
X drug which can cause bone X;
abnormalities (epiphyseal stippling)
and hemorrhage in the 3rd trimester|
Identify the US-FDA Category for drug use in X;
pregnancy.

Ergots|
Identify the US-FDA Category for drug use in B;
pregnancy.

Co-amoxiclav|
Identify the US-FDA Category for drug use in B;
pregnancy.

Metronidazole|
Identify the US-FDA Category for drug use in B;
pregnancy.

Azithromycin|
Identify the US-FDA Category for drug use in C;
pregnancy.
Clarithromycin|
True or false? False. High milk to plasma
ratio;
A low milk to plasma ratio means that there
is a greater amount of drug in milk
compared to plasma.|
True or false? False. Lower concentration.

Weak acids have a higher concentration in

milk.|
Examples of drugs that are weak acids| Penicillin
Diuretics
Sulfonamides
Warfarin;
Examples of drugs that are weak bases| Erythromycin
Isoniazid
Beta-blockers
H2 blockers;
Drug (given during breastfeeding) which can Diazepam;
cause drowsiness|
Drug (given during breastfeeding) which can Morphine;
cause apnea and bradycardia |
Drug (given during breastfeeding) which can Anti-TB;
cause jaundice|
Drug (given during breastfeeding) which can Propanolol;
cause bradycardia and hypoglycemia|
Drugs to be avoided, if possible during Chloramphenicol
breastfeeding, because of side effects in the Tetracycline
infant| Fluoroquinolone
Metronidazole
Clindamycin
Antipsychotics
Lithium;
Drugs to be avoided, if possible during Estrogen
breastfeeding, because they may inhibit Thiazide
lactation| Loop diuretics
Ergometrine;
Drugs to be completely avoided during Anticancer drugs
breastfeeding| Radioactive substances;
 RADIOLOGY

IMAGING OF THE URINARY TRACT

Films taken in intravenous urography| Nephrogram (1-2 min post
contrast)
Pyelogram (5 min)
Ureters (6-7 min)
Full bladder (20-45 min)
Post void;
Imaging modality to opacify the collecting Retrograde pyelography;
systems|
CT to best see calculi| Plan CT scan/CT sonogram;
CT to best view renal masses| Contrast enhanced CT scan/CT
urogram;
CT scan phases| Venous phase (nephrogram)
Delayed phase (pyelogram);
Congenital absence of one or both kidneys| Renal agenesis;
One or two accessory kidneys| Supernumerary kidney;
Normal rotation of the renal hilum| Anteromedial;
Condition where the kidney is seen in the Crossed renal ectopia
opposite retroperitoneal space| (commonly left kidney ectopic
on the right);
Developmental renal anomaly characterized Ectopic kidney;
by abnormal anatomical location of one or
both kidneys|
Most common type of fusion anomaly| Horseshoe kidney;
Fusion of the kidneys, usually at the lower Horseshoe kidney;
poles by an isthmus|
Fusion anomaly that is an independent risk Horseshoe kidney;
factor for the development of renal calculi
and transitional cell carcinoma of the renal
pelvis|
Rare renal fusion anomaly of the crossed Pancake kidney
fused variety type with the kidneys fused (discoid/disc/lump/fused
together in both upper and lower poles| pelvic/cake);
Fusion of both kidneys with at least one Crossed fused ectopy;
kidney on the opposite side of its normal
location|
Abnormality in renal size which implies a Unilaterally small kidneys;
global injury to the parenchyma as a result
of a local unilateral process rather than a
systemic process|
Abnormality in renal size which implies a Bilaterally small kidneys;
systemic disease process that injures both
kidneys and reduces their function|
Size of a small kidney| < 9 cm;
Size of an enlarged kidney| > 13 cm;
Unilaterally enlarged kidneys are a result of Duplicated collecting system
acute local insult to the affected kidney Compensatory hypertrophy;
except for?|
Abnormality in fetal outline which represent Fetal lobulation;
incomplete fusion of the developing renal
tubules|
Presence of a prominent focal bulge on the Splenic impression;
lateral border of the left kidney|
Imaging findings in chronic renal infarction| Hypodense
Parenchymal thinning or
indentation on affected areas;
Imaging findings in chronic atrophic Thinning of the cortex and
pyelonephritis| irregularities along the cortex;
Causes of calyceal and ureteral strictures| Renal TB (different areas of
strictures and fibrosis)
Post-inflammatory (one area)
Post-traumatic;
Weigert-Meyer Rule| With duplex kidney and
complete ureteral duplication,
upper renal and lower moiety
have their own ureters with
each ureter having its own
ureteral orifice in the bladder;
Renal moiety more prone to obstruction| Upper;
Upper renal moiety insertion| Ectopic insertion medial and
inferior to the lower;
Lower renal moiety insertion| Orthotopic insertion lateral
and superior to upper;
Renal moiety more prone to vesicoureteral Lower;
reflux|
Sign, which shows that the upper moiety is Drooping lily sign;
obstructed and non-functioning|
A cobra head or spring onion appearance of Ureterocoele;
the ureters may indicate?|
Type of ureterocoele which occur in normal Orthotopic;
position in the trigone, and associated with a
single collecting system|
Type of ureterocoele associated with the Ectopic;
ipsilateral complete duplication of the
collecting system and the ureter from the
upper moiety|
A champagne glass appearance of the Tumor (transitional cell
ureteral dilation distal to a filing defect in carcinoma);
the ureter indicates?|
Best tool to diagnose vesicoureteral reflux| VCUG;
Identify the vesicoureteral reflux grading. Grade I;

Up to lower ureter only. Not dilated.|

Identify the vesicoureteral reflux grading. Grade II;

Up to ureter and enters the renal pelvis. Not

dilated.|
Identify the vesicoureteral reflux grading. Grade III;
Begins to cause the ureter and calyces to
dilate. Mildly dilated calyces, slightly
tortuous ureter.|
Identify the vesicoureteral reflux grading. Grade V;

Severe reflux, ballooning of calyces,

enlarged kidney.|
Results from an aperistaltic segment of the Congenital megaureter;
lower ureter, causing functional obstruction
and dilatation of the proximal ureter|
Herniation of the urinary bladder through an Exstrophy;
anterior abdominal wall defect, seen as
widening of the symphysis pubis on X-ray|
A pine cone or Christmas tree appearance of Neurogenic bladder;
the bladder may indicate?|
Dysfunctional urinary bladder that results Neurogenic bladder;
from an injury to the central or peripheral
nerves|
Most common cause of bladder outlet Posterior urethral valve;
obstruction in male newborns|
A Mickey Mouse bladder may indicate?| Urinary bladder diverticula;
Common location of urethral valves| Prostatic part of the urethra;
A putty kidney can be seen in?| Renal TB calcification;
Caseous material and flocculent calcification Putty kidney;
outline the renal shadow indicative of
extensive destruction of the parenchyma
and end-stage disease|
Characteristic gas formation within or Emphysematous
around the kidneys| pyelonephritis;
Best diagnostic modality for diagnosis of CT scan;
Emphysematous Pyelonephritis|
Seen as pockets of airs surrounding the Perirenal abscess;
kidneys|
Imaging of choice for perirenal abscess| Ultrasound;
Most common unifocal renal mass| Renal cysts;
Criteria for diagnosis of renal cysts in Enhancement of sound
ultrasound| transmission beyond the cyst
Absence of internal echoes
Smooth, clearly demarcated
walls
Spherical or ovoid shape;
Criteria for diagnosis of renal cysts in Homogenous attenuation
ultrasound| value near that of water
density
No enhancement with IV
contrast
No measurable thickness of
cyst wall
Smooth interface with renal
parenchyma;
Most common abdominal neoplasm of WIlms tumor or
infancy and childhood| nephroblastoma;

IMAGING OF THE REPRODUCTIVE SYSTEM

Films taken in intravenous urography| Nephrogram (1-2 min post
contrast)
Pyelogram (5 min)
Ureters (6-7 min)
Full bladder (20-45 min)
Post void;
 PARASITOLOGY

SEXUALLY TRANSMITTED PARASITES

Habitat of Trichomonas vaginalis| Vagina and Skenes glands
(female)
Urethra (male);
Trichomonas vaginalis morphology| Pear-shaped
10-23 um
Visible axostyle
Undulating membrane
Single nucleus and 4 flagella;
Trichomonas vaginalis infective stage| Trophozoite (in vagina or
urethra);
Trichomonas vaginalis diagnostic stage| Trophozoite (in vaginal or
prostatic secretions and
urine);
Trichomoniasis symptoms in males| Rarely symptomatic
Mild urethritis and/or
prostatitis;
Trichomoniasis symptoms in females| Often symptomatic
Mild to severe vaginitis
Copious, foul-smelling, yellow-
colored, frothy discharge
Strawberry cervix;
pH that favors growth of Trichomonas Basic (> 5.9);
vaginalis|
Diagnostics for Trichomonas vaginalis| Wet mount (detect highly
active motile organisms,
polymorphonuclear cells);
Treatment for Trichomoniasis| Metronidazole
Vinegar douche|
Causative agent of Pediculosis Pubis| Phthirus pubis;
Pubic lice is often found on| Eyelashes
Pubic hair
Axillary hair;
Transmission modes of Phthirus pubis| Sexual contact
Fomites (clothing, towels);
Phthirus pubis infective stage| Adult lice;
Three stages in the life cycle of Phthirus Egg
pubis| Nymph (3 molts)
Adult;
Symptoms of Pediculosis pubis| Severe itching of the infested
area;
Treatment for Pediculosis pubis| Permethrin
Mousse containing pyrethrins
or piperonyl butoxide
Lindane (refractory);
 OBSTETRICS

APPROACH TO STI IN PREGNANCY

Most common causes of vaginitis| Bacterial vaginosis
Trichomoniasis
Vulvovaginal candidiasis;
May present with fishy smelling discharge Bacterial vaginitis;
and vaginal pruritis|
Gold standard for diagnosis of Bacterial Nugent criteria (Gram Stain);
Vaginosis|
Maternal and fetal complications in Bacterial Abortion
vaginosis| Preterm delivery. Premature
rupture of membranes
Chorioamnionitis
Pospartum endometritis
Post-Caesarean wound
infection;
Treatment for Bacterial Vaginosis| Metronidazole (500 mg/tab
BID for 7 days);
True or false? False. Not recommended for
both;
Routine screening and treatment of sex
partners is recommended for Bacterial
Vaginosis|
May present with green-yellow, frothy Trichomoniasis;
vaginal discharge, offensive odor,
dyspareunia, vulvovaginal soreness and
itching, dysuria, and strawberry cervix|
Gold standard for diagnosis of Culture;
Trichomoniasis|
Maternal complications in Trichomoniasis| Pre-term labor and birth
Premature rupture of
membranes
Post-partum endometritis;
Fetal complications in Trichomoniasis| Low birth weight infant;
Treatment for Trichomoniasis| Metronidazole (2 grams single
dose);
True or false? True;

Metronidazole must be withheld during the

firt trimester|
True or false? False. Breastfeeding must be
withheld up to 12-24 hours
Breastfeeding can commence right after the after the last dose.;
treatment for Trichomoniasis|
May present as vulval pruritis, thick, white, Vulvovaginal candidiasis;
curdy, discharge attached to vaginal walls,
erythema, irritation, external dysuria, and
dyspareunia|
Used for diagnosis of Vulvovaginal KOH or saline wet prep;
candidiasis|
Treatment for Vulvovaginal candidiasis| Clotrimazole (azole cream,
applied for 7 days);
Azole cream contraindicated in pregnancy| Fluconazole;
May present as mucopurulent cervicitis, Chlamydia;
vaginal spotting, endocervical edema,
erythema, and friability|
Maternal complications of Chlamydia| Pre-term labor with PROM
Post-partum endometritis
PID
Salpingitis
Fitz-Hugh-Curtis Syndrome
Reiters syndrome;
Fetal effects of Chlamydia| Neonatal pneumonia
Opthalmia neonatorum;
Treatment for Chlamydia| Azithromycin (DOC)
Amoxicillin;
May present as mucopurulent cervical Gonorrhea;
discharge, friable cervix, intermenstrual
bleeding, dysuria, and dyspareunia|
Gold standard for diagnosis of Gonorrhea| Modified Thayer-Martin
culture;
Maternal effects of Gonorrhea| Septic abortion
Pre-term delivery
PROM
Chorioamnionities
Post-partum infection
(endometritis, PID)
Accessory gland infection
Perihepatitis (Fitz-Hugh-Curtis
syndrome)
Meningitis and endocarditis
(rare);
Fetal effects of gonorrhea| Opthalmia neonatorum
Pharyngeal and respiratory
tract infection
Anal canal infection;
Treatment for gonorrhea| Ceftriazone
Cefixime
Single dose injectable
cephalosporin regimens plus
azithromycin
Plus treatment for Chlamydia
infection;
Causes of genital ulcers| Syphilis
Genital herpes
Donovanosis
Chancroid
Lymphogranuloma;
Presents as non-suppurative Primary syphilis;
lymphadenopathy and a painless chancre
that is raised, red, has a firm border and
smooth base, and regresses spontaneously|
Presents as palmar and macular rash, Secondary syphilis;
lymphadenopathy, condyloma lata, and
mucous patches|
Presents as ulcerative lesions affecting the (Gummas) Tertiary syphilis;
viscera, bones, etc|
Non-treponemal screening tests| VDRL
RPR;
Treponemal confirmatory tests| FTA-ABS
MHA-TP
TP-PA;
Maternal effect of syphilis| Pre-term labor;
Fetal effects of syphilis| Hepatic abnormalities
Ascites
Anemia
Thrombocytopenia
Non-immune hydrops;
Neonatal effects of syphilis| Jaundice with petechiae or
purpuric lesions
Lymphadenopathy
Rhinitis
Pneumonia
Myocarditis
Nephrosis;
Treatment for Primary, Secondary, and early Benzathine penicillin G (single
Latent Syphilis| dose);
Treatment for Late Latent and Tertiary Benzathine penicillin G (once
Syphilis| a week for three weeks);
Often appears after penicillin treatment of Jarisch-Herxheimer Reaction;
women with primary and secondary syphilis|
Presents with papular eruption with itching HSV;
and tingling, then becomes painful and
vesicular|
Maternal effect of HSV infection| Pre-term labor;
Treatment for HSV| Acyclovir;
True or false? False. Indicated for women
with active genital lesions or
Ceasarean delivery is indicated for all HSV prodromal symptoms;
infections.|
True or false? True.;

Women with HSV may breastfeed if there

are no active HSV breast lesions.|
True or false? True;

Acyclovir and Valacyclovir may be used

during breast feeding|
Gram-negative rod that has chaining or Haemophilus ducreyi;
school of fish appearance on Gram stain|
Presents as painful non-indurated genital Chancroid;
ulcers (soft chancre) accompanied by painful
suppurative inguinal lymphadenopathy
(bubo)|
Treatment for chancroid| Azithromycin
Ceftriaxone;
Treatment for chancroid that is Ciprofloxacin;
contraindicated in pregnancy|
True or false? False. Recommended for all
patients;
HIV testing is not recommended in all
patients diagnosed with chancroid.|
May present as painful inflammation and Lymphogranuloma inguinale;
enlargement of inguinal lymph nodes and
presence of the Groove sign (enlarged
matted glands above and below the inguinal
ligament)|
Treatment for LGV| Erythromycin;
Maternal effects of HPV infection| Genital warts increasing in
number and size during
pregnancy
Resolve spontaneously after
puerperium;
Fetal/neonatal effects of HPV infection| Juvenile Onset Recurrent
Respiratory Papillomatosis (6
and 11)
Laryngeal Papillomatosis;
Treatment for HPV infections| Trichloroacteic (TCA) or
Bichloroactic acid
Cyrotherapy
Laser ablation
Surgical excision;
True or false? True;

Caesarean delivery is not recommended

solely to prevent HPV infections|
Presents as shiny, dome-shaped, white Molluscum contagiosum;
papules with umbilicated center containing
caseous material|
Common sites of Molluscum contagiosum Labia majora
lesions| Mons pubis
Buttocks Inner thighs;
Treatment for Molluscum contagiosum Trichloroacteic (TCA) or
Bichloroactic acid
Cyrotherapy
Laser ablation
Surgical excision;
Treatment for pediculosis pubis| Permethrin 1% cream
Pyrethrin with piperonyl
butoxide;
Presents as slightly raised sinuous burrows Scabies;
which appear as short, wavy, dirty-
appearing lines|
Treatment for scabies| Permethrin 5% cream;
True or false? False. Not all;

All babies born with HIV+ mothers will

acquire HIV|
Indications for vaginal delivery for HIV+ Viral load <1,000 copies/mL at
mothers| 36 weeks AOG
Has prenatal care throughout
pregnancy
On HIV medications at least 4
weeks during pregnancy
No previous uterine surgery or
a previous elective CS
Free from genital infections
No indications that the labor
would be prolonged
Indications for CS delivery for HIV+ mothers| Viral load is unknown or
>1,000 copies/mL at 36 weeks
AOG
No HIV medications or < 3
weeks on ARV during
pregnancy
No prenatal care prior to 36
weeks of pregnancy
True or false? True;

HIV+ mothers should avoid all breastfeeding

when replacement feeding is acceptable,
feasible, affordable, sustainable, and safe|
Triple ARV for HIV treatment| Tenofovir
Lamivudine
Efavirenz;