Unit 7 SIGs Cases 7-12 | Baamboozle - Baamboozle

Explain the pathogenesis and clinical features of torsion and adhesions as sequelae of an ovarian neoplasm. (SIGs 7.6b)

fibroma continues to grow-> twisting of ligaments (suspensory lig)-> compression of ovarian artery and vein-> ischemia-> acute abdominal pain

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Relate human chorionic gonadotropin levels to ultrasound findings for normal pregnancies. (SIGS Case 7.4b)

Pregnancy will generally be visible on ultrasound if beta-hCG is greater than 1500-2000

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List diagnostic criteria for PCOS (SIGs 7.4a)

Rotterham Criteria:2+ of: oligoovulation/anovulation, hyperandrogenism, enlarged/polycystic ovary, ovarian volume>10mL, multiple cystic follicle(string of pearl

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trap

No points!

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star

Double points!

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shark

Other team loses 20 points!

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lifesaver

Give 15 points!

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Contrast the diagnostic work-up and management for a hemodynamically stable vs. unstable patient with ectopic pregnancy. (SIGS Case 7.4b)

stable: laparoscopic surgery OR methotrexate ; unstable: immediate laparotomy and treatment for hemorrhagic shock

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Describe the pathways by which synthetic progesterones or progestins act to stabilize the endometrium (Sigs 7.7b)

blocks proliferative effect of estrogen; induces expression of 17beta-hydroxysteroid dehydrogenase type 2 (metabolizes estradiol to less potent estrone)

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Relate the clinical features of intraductal papilloma to the tumor's characteristic morphology. (SIGs 7.6a)

papillary growth of luminal cells into a large duct, bloody nipple discharge; finger-like projections; benign, but if no myoepithelial--> papillary carcinoma

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Compare/contrast the clinical presentation and underlying pathophysiology of Sertoli-Leydig cell tumors and polycystic ovary syndrome (PCOS) (Sigs 7.4a)

S-L: neoplasm; hypersecrete testosterone/estrogen; PCOS: not neoplasm, disbalance of hormonal axis-> overgrowth dominant follicle-> hypersecrete horm.

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banana

Go to last place!

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fairy

Take points!

fairy

Take points!

baam

Lose 10 points!

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What factors increase and what factors decrease risk of developing serous carcinoma ovarian tumor? (Wild Card WFA 7.6)

increase risk: nulliparity, FHx BRCA1 and BRCA2 germline mutation; decrease risk: hx oral contraceptive use, tubal ligation

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Discuss human chorionic gonadotropin levels in normal and abnormal pregnancies. (SIGS Case 7.4b)

Normal: levels double every 48 hours; Abnormal: falling= failed IUP or ectopic; drop >21% = failed IUP; drop < 21% = ectopic pregnancy

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How can you confirm a diagnosis of HSV-2 infection? (** indicates gold standard) (Wild Card week 7)

PCR for HSV genome**;Tzanck smear (syncytia & Cowdry type A inclusion bodies); immunofluorescence assay (DFA); observe cytopathologic effects in cell culture

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lifesaver

Give 25 points!

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star

Double points!

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rocket

Go to first place!

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thief

Give points!

What is the MOA and indications for medroxyprogesterone acetate (MPA) (Sigs 7.7a)

inhibits production of gonadotropin-> no follicular maturation and ovulation, thins endometrium;heavy menstrual bleeding, contraception, endometrial hyperplasia

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List two major products of the cells within the box in the image on the right and explain the significance of the presence of plasma cells in the breast stroma (“P” in the left image- lactating breast) during lactation. (Wild Card WFA 7.6)

products: proteins, carbs/sugars, lipids; plasma cells secrete IgA which passes into breast milk to convey passive immunity to the neonate

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What are risk factors for progression from endometrial hyperplasia to endometrial carcinoma, including specific genetic mutations (Sigs 7.7a)

See image

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