What are the roles of cell types and androgen production in the pathogenesis of BPH? (Sigs 7.7b)
AR of epithelial attracts macrophages-> TGF-b2-> EMT-> proliferation epithelial; AR of stromal attracts macrophages-> incr CCL3-> proliferation stromal
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15
Discuss the role of serum CA-125 levels in the diagnosis and monitoring of ovarian neoplasms (SIGs 7.6b)
biomarker for ovarian cancer; can be used to monitor response to treatment. See image
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15
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 (āPā 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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15
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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15
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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15
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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15
Describe the pathogenesis of the three principal morphologic features of non-proliferative fibrocystic breast changes (SIGs 7.6a)
Apocrine metaplasia, fibrosis, adenosis (see image for details)
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15
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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15
Relate the actions of methotrexate to the underlying pathophysiology of ectopic pregnancy. (SIGS 7.4)
folic acid antagonist that competitively inhibits folate-dependent steps in nucleic acid synthesis. inhibits DNA synthesis/reproduction in proliferating cells
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15
What factors increase and what factors decrease risk of developing serous carcinoma ovarian tumor? (Wild Card WFA 7.6)
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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15
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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15
Describe structure of the normal and hypertrophied prostate and the significance of the prostatic zones to the development of proliferative lesions (Sigs 7.7b)
4 zones: ant. fibromuscular stroma, central, peripheral, transition; transition zone is the exclusive site of BPH