Anatomy Spot Question 1. Prostate, anatomical lobe ( enumerate and relation) a.

Median lobe behind prostatic urethra , ejaculatory duct on each side b. Right and left lateral lobe on each side of prostatic urethra c. Ant. Lobe(isthmus) connect the lateral lobes d. Post lobe Sources: ms 153 2. Urogenital triangle enumerate either superficial or deep perinea pouch a. Content of Superficial Perineal Pouch i. Roof of penis ii. Muscles 1. Superficial transverse perineal 2. Ischiocavernous 3. Bulbo-spongiosus iii. Arteries- 3 branches of IPA and 2 term branch of scrotal artery iv. Nerves dorsal nerve of penis, scrotal nerves v. Vein deep dorsal vein of penis b. Content of deep perineal pouch i. Membranous urethra ii. Bulbourethral glands iii. Muscles : sphinter urethra, deep transverse perinea iv. Dorsal nerves of penis v. IPA Sources: 157-158

3. Covering of Penis (Enumerate) a. Skin b. Superficial fascia c. Tunica albuginea 4. Enumerate either Arterial or Venous Drainage of Penis Arterial 1. 2. 3. 4. Sources: ms 162 Dorsal artery of penis Deep artery of penis Artery of bulb Superficial external pudendal artery Venous drainage 1. Superficial dorsal vein 2. Deep dorsal vein

5. Structures related to the ala of sacrum a. Sympathetic chain b. Iliolumbar artery c. Lumbosacral trunk d. Obturator nerve Sources: ms 28 6. Content of sacral canal a. Dura and arachnoid mater b. Roots of sacral nerves and coccygeal nerve c. Filum terminale d. Lateral sacral artery e. Loose areolar CT Sources: ms 30 Embryology 1. Anomalies of testis ( enumerate) a. Gonadal dysgenesis b. Klinefelter syndrome c. Hermaphroidites d. Cryptochism e. Ectopic testis Sources: ms 199-200 2. Congenital anomalies of male external genitalia ( enumerate ) a. Hypospadius b. Epispadius c. Exstrophy of bladder d. Micropenis Sources: ms 209 3. Sources of indifferent gonads and end-formation ( apa yg akan jadi last2 T-T) a. Intermediate mesoderm stroma of gland b. Coelomic epi primitive sex cord of indifferent gonads c. Primordial germ cell development of gonads either to testis or ovary Sources: ms 196

4. Fate of Muellerian duct a. Male - appendix of testis , prostatic utricle b. Female i. cranial and middle part fallopian tube ii. Caudal uterus , superior part of vagina Sources: ms 205

Histology 1. Histological characteristic and function of seminal vesicle a. Histology i. Mucosa 1. Lined by pseudo. Str. Columnar 2. Tall cell show yellowish apical secretory granules ii. Musculosa 1. IC + OL iii. Fibrous layer 1. Thin CT connect gland to surround structures b. Function i. Secrete most of human semen ejaculate ii. Secretion contain fructose and nutrient substances for sperm iii. Produce large PG and fibrinogen Sources: ms 150-152

2. Histological characteristic and function of prostate a. Histology i. Mucosa 1. Central, small 2. Lined by pseudo. Str. Columnar ii. Submucosa 1. Medium 2. Lined by psuedostratified columnar iii. Subcapsular 1. Peripheral, large 2. Llined by simple columnar epithelium b. Function i. Secretes milky, acidic fluid 1. Contain citric acid, acid phosphate, calcium, clotting enzyme , profibrinolysin ii. Secretion neutralizes by seminal fluid Sources: ms 154-156

3. Nuclues , size and cytoplasm of Interstitial cell of Leydig a. Nucleus large, central or eccentric, some cell are binucleated b. Size large , polyhedral c. Cytoplasm acidophilic, appear pale and vacuolated d. Function secrete testosterone Sources: ms 142-143 4. Histological structure of cervix a. Supravaginal lined by simple partially ciliated columnar epi b. Vaginal part ( endocervix) lined by NKSSE, contains mucous cervical gland Sources : ms 35

5. Differentiate of epithelial lining of seminal vesicles and fallopian tube Seminal vesicle Psudestratified columnar with secretory granule F.tube ^-^ Simple columnar with 2 types of cell 1. Non ciliated with secretory 2. Ciliated cell

Sources: ms 151

6. Differentiate between prostate and lactating mammary gland prostate Secretory acini 1. Arranged in 3 anatomical group 2. Rosette shape outline 3. Lumen contain corpora amylacia

stroma Myoepithelial cell Sources: ms 155

SM fibre absent

Lactating mammary gland 1. No special anatomical arrangement 2. Lobules acini show different states of activity 3. Lumen filled with milk Fat cell Around acini

Microbiology 1. Diagnosis and treatment of Haemophilus Ducreyi a. Lab diagnosis i. Films scrap the ulcer and stained by Gram s method ii. Culture - on blood agar + iso vitalex + vanccubaomycin incubated in air + CO2 b. Treatment i. Ceftriazone/ erythromycin Sources: ms 216

2. Demonstration of T.Pallidum a. Dark Ground Illumination b. Immuno-fluorescent staining Sources : ms 217

3. Lab diagnosis of syphilis a. Primary stage i. Specimens exudates from chancre, squeeze gentle ii. NA probe, PCR b. Secondary stage i. Specimen exudates from skin lesion, mucous patches ii. DG microscopy, IF microscopy, NA probe , PCR c. Latent syphilis i. Serum sample all positive except old syphilis/partially treated ii. CSF sample positive Sources: ms 221 4. Lab diagnosis of chalamydia a. Cytologic examination b. Direct IF c. Isolation in Cycloheximide treated McCoy cells d. NA probe e. Micro IF assay Sources: ms 223 5. Lab diagnosis of HPV a. PCR b. NA probe Sources: ms 226

6. Diagnosis of Trichomonas Vaginalis a. Female: sedeminted urine and vaginal secretion, vaginal smear from vaginal fornices b. Males : sedimented urine/ prostatic secretion Sources: ms 232

Pathology 1. Type and morphology of teratoma a. Mature Cystic Teratoma i. Grossly unilocular, thin wall , teeth structure protrude ii. Micro cyst wall lined by str. Squamous epi with hair and sebaceous gland, teeth structure b. Immature Solid Teratoma i. Grossly bulky , solid , hair , cartilage may present ii. Micro bone, muscle, nerve , gland present Sources : ms 95

2. Type of hydatiform mole a. Grossly i. uterine filled with delicate, friable mass of think wall translucent cyst ii. Fetal part seen in partial mole, not in complete b. Micro i. Partial villous edema in some villi, trophoblastic proliferation focal and sight ii. Complete hydropic swelling in almost all villi, no vascularization Sources: ms 100

3. CIN types a. CIN 1 dysplastic changes involve the lower third of epithelium b. CIN2- dysplastic changes involve the lower 2 third c. CIN 3 epithelial cell are totally replace by immature atypical cells, no sfc differentiation, BM is intact d. CIN 1 and 2 are reversible while CIN 3 is irreversible Sources : ms 80

4. Types and morphology of carcinoma of endometrium a. Grossly i. Exophytic type 1. Nodular, firm to soft, polyps ii. Infiltrative type 1. Diffuse infiltrating b. Micro i. 85% are well differentiated adenocarcinoma ii. Some show benign foci squamous metaplasia adenoacanthoma iii. 15% are moderately or poorly differentiated adenocarcinoma Sources: ms 87 5. Hystophatology and clinical feature of fibroadenoma a. Ductal and glandular space are open pericanalicular fibroadenoma b. Ductal and glandular space are compressed intracanalicular fibroadenoma Clinically a. Discete movable masses b. Increase in size c. Regreesion of tumor after menopause Sources: ms 122

6. Histological features of Invasive cervical carcinoma a. 90-95% - squamous cell carcinoma, large cells either keratin or non keratizing b. 5% are adenocarcinoma or mixed adenosquamous Sources:ms 80 7. Histological features of Endocervical polyps a. Polyps covered with mucus secreting columnar epithelium b. Cystically dilated and filled with mucus secretion c. Stroma is edematous d. Superadded chronic inflammation lead to squamous metaplasia and ulceration Sources: ms 78

8. Incidence of carcinoma of cervix a. Early age at first intercourse b. Multiple sexual partner c. A male partner with multiple sexual partner d. Low socioencomic statenic cervicitis and increase parity e. ST infectios agent f. Genetic Sources: ms 79

9. Clinical feature and complication of endometriosis a. Severe dysmenorrhea and pelvic pain b. sterility c. dysparunia d. pain on defecation e. dysuria f. acute abdomen

sources: ms 83

10. Risk factor for endometrial carcinoma a. Obesity b. DM c. Hypertension d. Infertility e. Endometrial hyperplasia f. Hyperestrinism Sources: ms 86

11. Complication of leiomyoma a. Hyalinization b. Cystic degeneration c. Red degeneration d. Ischemic necrosis e. Parasitic leiomyoma

Sources: ms 88

12. Risk factor of breast carcinoma a. Age b. Age at menarche c. Pregnancy d. Family history e. Benign breast lesion f. Race g. Prolonged exposure to endongenous estrogen h. Radiation exposure i. Diet j. Obesity Sources : ms 124-125

Pharmacology 1. Mechanism of action of clomiphene a. Drug competitively block estrogen receptors in hypothalamus and ant. Pituitary b. Normal estrogen-mediated negative feedback is prevented c. FSH and LH secretion increased Sources: ms 259 2. Mechanism of action of male hormonal contraception a. Both FSH and high conc. Of intra-testicular testosterone essential for spermatogenesis b. Decrease Gonadotropin decread decreased effect of FSH on sperm production and decrease intratesticular testosterone , reversible inhibition of spermatogenesis Sources: ms 244

3. Therapuetic use of estrogen a. Oral contraception + progestin b. Hypo-ovarian condition c. To alleviate menopausal symptoms d. Osteoporosis e. Dysmenrorrhea f. Treatment of hirsutism and amenorrhea g. Prostatic carcinoma Sources: ms 236- 237

4. Adverse effect of estrogen a. GIT upset b. Withdrawal uterine bleeding c. Thromboembolism d. Edema e. Associated with incidence gall bladder and endometrial carcinoma f. Gynaecomastia and impotence Source: ms 237enesis

5. Adverse effect of combined pills a. GIT upset b. Breaththrough bleeding c. Edema d. Thromboembolism e. Increase weight f. Carcinogenesis g. Gall bladder disease Sources : ms 241

6. Indication of tocolytic therapy a. Inhibit uterine contraction b. Postpone delivery in cases of preterm labor c. Can prolong pregnancy from 46hours to 1 week d. Provide sufficient time for administration of antenatal glucocorticoid

Sources: ms 246-247 7. Sideeffect of PDE 5 a. Hypotension b. Flushing c. Headache d. Visual disturbance

Sources : ms 249

8. Therapeutic use of cetrorelix a. In vitro fertilization b. Treatment of endometriosis Sources: ms 234

9. Uses of HCG a. Pituitary or hypothalamic hypoganadism with infertility in both sexes b. Controlled ovarian hyperstimulation in in vitro fertilization program c. Stimulate descendant of testis Sources: ms 236 10. Uses of anabolic steroid ( nandrolone phenpropionate/ methandroestenolone) a. For short stature b. Hypoproteinemia of nephrosis c. Debilitated postoperative patients, burns and premature babies Sources: 243 11. Drugs for tocolytic therapy and its mechanism of action a. Magnesium sulphate antagonize IC CA2+ in uterine muscle b. CCB nifedipine block calcium channel and decrease calcium entry into uterine SM c. B-adregenic agonist(salbutamol) IV until contraction stop or maternal HR more than 140 beats d. NSAIDS- indometachin- inhibit production of PG Sources: ms 247

Physiology 1. Hormonal factor that stimulate spermatogenesis a. FSH stimulate sertoli cells to convert spermatid to sperm b. LH- stimulate leydig cell to secrete testosterone c. Testosterone stimulate meiotic division of 1ry spermatocyte to form 2ry spermatocyte d. Estrogen essential for spermiation process e. Growth hormone- control metabolic function of testes, promotes early division of spermatogonia Sources: ms 165

2. Different between spermiogenesis and oogenesis a. Males i. spermatogonia enter meiosis and produce sperm from pubery to death ii. 100-200 million sperms made each day iii. Each ejaculation has 100-500 million sperm b. Female i. Meiotic division starts before birth but fail to proceed ii. Only one ovum produced per ovulation iii. Meiosis ended in females at menopause , due to exhaustion of oocyte Sources: ms 169-170

3. Function of testosterone a. On external genitalia enlargement of penis, scrotum and testes b. Internal genitalia enlargement of seminal vesicles , prostate and bulbourethral c. Secondary characteristic beard and moustache, growth of hair over pubis, decrease hair on top of head (clan lord.. wakaka ) Sources: ms 172

4. Roles of placenta and HCG a. Placenta i. Allow diffusion of foodstuff from maternal to fetal blood ii. Diffusion of excretory product from F to M iii. Diffusion of Oxygen thhroug placental membrane iv. Diffusion of CO2 b. HCG i. Prevention of normal involution of corpus luteum ii. Causes corpus luteum to secrete larger quantities of progesterone and estrogen iii. Stimulate production of testosterone in male fetus Sources: ms 66-67

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