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1- a- Effect of estrogen on uterus: it promotes the
proliferation of epithelial linging ( glands + stroma) and
increases the size of uterus.
b-Effect on breast: it promotes the development of
mammary gland (ducts + stroma ) and increases its size.
It also promotes fat deposition in the breast.
It causes pigmentation of areola.
c- Effect on the skeleton: - it has inhibitory effect on
osteoclasting activity and promotes the osteoblasting
activity.
- It also promotes fusion of epiphyses with shaft of long
bones.
- It promotes changes in configuration in females (
narrow shoulders and wide pelvis).
2- Male sexual functions control :
a. Hypothalamic control : arcuate nuclei secrete GNRH
stimulate anterior pituitary gland to secrete
LH(stimulate testosterone secretion) and FSH(
stimulate spermatogenesis)
b. Anterior pituitary regulation: secrete LH and FSH
c. Feedback control of testosterone secretion: secreted
testosterone feedback negatively to hypothalamus
inhibit production of GnRH so decrease anterior
pituitary gland secretion of LH and FSH.

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d. Feedback control of spermatogenesis: sertoli cells
secrete inhibin direct inhibitory on FSH secretion from
anterior pituitary gland.
3- Contents of broad ligament:
a- Mesosalpinx
b- Mesometrium
c- Suspensory ligament.
4- Contents of deep perineal pouch in male:
a- Membranous urethra.
b- Muscles: sphincter urethra- deep transverse perinei.
c- Internal pudendal artery.
d- Bulbourethral glands.
e- Vessels of the bulb.
f- Dorsal nerve of penis.
5- Boundaries of ovarian fossa:
a- Anteriorly: medial umbilical ligament.
b- Posteriorly: ureter and internal iliac artery.
c- Laterally: obturator nerve.
6- Causes of genital ulceration:
1-herpes simplex virus 2
2- syphilis “ Treponema pallidum”

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3- Lymphogranuloma venerum “ chlamydia trachomatis
serotypes L1,L2,L3”
4- Chancroid “ haemophilus ducreyii”
Value of microscopy:
1- It can be used to detect cytological changes which are
large giant cells with intrnuclear inclusions.
2- It can be seen only by the dark ground microscopy as
thin cylinders– immunofluorescence microscopy.
3- It is obligatory intracellular parasite can’t be detected
by microscopy.
4- It appears as gram negative bacilli or coccobacilli.
7- Culture is done for:
1- Confirmation of gonococcal infection.
2- To determine the antibiotic sensitivity of the organism.
3- For medicolegal issues.
8- Types of invasive ductal carcinoma:
1- invasive ductal carcinoma of no special type ( NOS)
2- Medullary type.
4- Colloid ( mucinous) type.
5- Tubular type.
6- Inflammatory type.

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9- Paget’s disease:
a- It is ( in situ or invasive) ductal carcinoma accompanied
by involvement of the epidermis of the nipple.
b- The epidermis is invaded by tumor giant cells “ paget’s
cells”
c- The skin over the nipple appears like erythematous
eruption that can be misdiagnosed as eczema, there
may be subareolar mass or not.
10- a-Types of endometrial carcinoma:
Type 1 “ Estrogen dependent neoplasm”
- It occurs mainly in post menopausal women.
- It is dependent on estrogen stimulation.
- It has better prognosis.
Type 2 “ Non- estrogen dependent”
- It occurs mainly in old age females.
- It doesn’t depend on prolonged estrogen stimulation.
- It has worse prognosis.
b- Borderline serous tumors:
- Increase in stratification of the lining epithelium which
is partially ciliated columnar epithelium.
- Complex papillae.
- No invasion of the stroma.
- Mild degree of atypia and mitotic figures

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11- Complications of benign prostatic hyperplasia
-lower urinary tract manifestations
- Frequency, urgency, nocturia.
-difficulty in starting and stopping of urinary stream.
-painful urinary bladder distension.
-infection.
-Stone formation.
-hypertrophy, dilatation and urinary bladder diverticulae.
-bilateral hydronephrosis
12- Virilizing androgen : Testosterone
Anabolic androgen: nandrolone phenopropionate
13- Testosterone alone – Testosterone and
progesterone.
14- Oxytocin : 1- induction of uterine contraction when
vaginal labour is necessary as in DM or preeclampsia.
2- augmentation of weak uterine contractions.
3- to prevent post partum or post abortal hemorrhage.
4-to induce milk ejection.
15- Composed of :

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1. Middle piece : from neck to annulus , contain :
axoneme , 9 outer dense fibers , mitochondrial sheath.
2. Principal piece : from annulus to end piece contain
axoneme , 7 outer dense fibers , fibrous sheath
3. End piece : axoneme covered b flagellar membrane.
16- Histological structure of epididymis: multiple oval
cut sections with sperms in their lumina , epididymal duct
lined by psuedostratified squamous epithelium formed of
two types of cells : principal cells and basal cells ,
supported by vascular connective tissue , smooth muscles
- Function: sperms short term storage , absorption of
excess fluid and removal of residual bodies , final
maturation of sperm.
17- Histological features of mucosa of fallopian tube:
Lining epithelium is partially ciliated columnar epithelium
wthich is formed of : - columnar cells which are secretory
cells that produce mucous film over the lining epithelium.
- Ciliated columnar cells which beat in one direction to
move the overlying mucos in one direction towards the
uterus.
Lamina propria formed of loose connective tissue rich
in blood vessels.
Parts of fallopian tube:
1- Intramural part

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2- Isthmus
3- Ampulla
18- Infundibulum.
4 differences:
Point of
comparison
Primary ovarian
follicle
Secondary
ovarian follicle
Size Small er Larger and
reaches about
200 micrometer
Granulosa cells Oocyte may be
surrounded by
unilaminar or
multilaminar
granulosa cells
Oocyte is
surrounded by 6-
10 layers of
granulosa cells
Theca cells They begin to
appear around
the multilaminar
primary follicle
They
differentiate into
2 layers: theca
interna and theca
externa.

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Antrum absent Granulosa cells
begin to secrete
liquor folliculi
which will form
the antrum

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1-functions of estrogen on breast and bone:
On breast:
- initiate growth of breast and milk producing apparatus
-stromal tissue development
-duct system growth
-fat deposition that give external appearance of mature
female breast
-areola pigmentation
On bone:
-inhibit osteoclastic activity so stimulate bone growth
- uniting of epiphyses with the shaft of long bones

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- Changes in body configuration, narrow shoulders and a
broad hip
2-hormonal control of spermatogenesis:
-testosterone: stimulate meiotic division of primary to
secondary spermatocyte.
-LH: stimulate testosterone secretion from lyding cell.
-FSH: stimulate sertoli cell conversion of spermatid to
sperm.
-estrogen: essential for spermiogenesis.
-growth hormones: control testes metabolic function
Promote spermatogonia early division.
3- Normal uterus position, its ligaments:
-normal position is anteflexion and anteversion
*anteflexion: the forward angle between long axis of
body of uterus and that of cervix = 170
*anteversion: the forward angle between long axis of
vagina and that of the cervix = 90
-if uterus directed backward is retroverted and
retroflexed

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*retroverted: angle between vagina and cervix is more
than 90
*retroflexed: angle between cervix and the body is more
than 170
-ligaments:
*uterosacral ligament
*pubocervical ligament
* Transverse cervical (cardinal, lateral cervical)
*ovarian ligament
*round ligament
* Broad ligament
4- Prostatic gland lobes, structures passing inside it:
-prostatic lobes:
*median lobe: behind prostatic urethra, bounded by
ejaculatory ducts, projects up to form bladder uvula .
* right and left lateral lobes:
On each side of prostatic urethra.
*anterior lobe (isthmus): connect lateral lobes, contain
few glandular tissue.
* Posterior lobe.
-structures inside:
Prostatic urethra, ejaculatory ducts and prostatic utricle.

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5-male superficial perineal pouch contents:
-root of penis
- Superficial perineal muscles:
Superficial transverse perineum, ischo cavernous, bulbo
spongiosus.
-internal pudendal artery and its two terminal branches
and scrotal artery.
- Deep dorsal vein of the penis.
-dorsal nerve of the penis and scrotal nerves .
6-Benign prostatic hyperplasia:
-lower urinary tract manifestations
- Frequency, urgency, nocturia.
-difficulty in starting and stopping of urinary stream.
-painful urinary bladder distension.
-infection.
-Stone formation.
-hypertrophy, dilatation and urinary bladder
diverticulae.
-bilateral hydronephrosis.

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7-Breast proliferative fibrocystic changes:
a. Cyst formation:
-Smaller cysts lined by cuboidal to columnar
epithelium but larger cysts lined by flattened or
atrophic epithelium
-apocrine metaplasia in lining epithelium
-cuboidal or columnar epithelium transforms to
large polygonal cells with abundant granular
cytoplasm.
b. Fibrosis:
Stroma is composed of compressed fibrous
tissue and infiltrated by lymphocytes.
c. Adenosis:
Increase in acini number
d. Epithelial hyperplasia:
Mild moderate or severe ductal epithelial lining
hyperplasia
Project into duct lumen forming papillae lead to
nipple discharge
May show atypical nuclear features
e. Sclerosing adenosis:
Proliferation of lining epithelium and
myoepithelial cells
Marked stromal fibrosis compress lumina of
ducts and acini

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8-short account on:
a. endometrial hyperplasia
increase in endometrial number results from
prolonged unopposed estrogen stimulation may
be :
-simple: increased endometrial glands number.
- Complex.
- complex with atypia
b. ovarian teratomas
20% of ovarian tumors
a- mature benign cystic : cyst composed of
stratified squamous epithelium with hair shaft
and sebaceous gland (ectodermal origin) teeth
structure , bone , cartilage ( mesodermal)thyroid
tissue , bronchial or GIT epithelium (endodermal)
b- teratoma with malignant transformation.
c- Immature (malignant) solid teratoma : solid
tumor with necrosis and hemorrhage
d- Monodermal ( highly specialized ) teratoma : the
most common
Struma ovarii : mature thyroid tissue
Ovarian carcinoid : intestinal epithelium
c. prognostic factors for carcinoma of the breast

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1. Tumor stage: size, lymph node involvement,
distant metastasis.
2. Histologic type: non metastasizing,
uncommonly metastasizing, moderately to
aggressively metastasizing.
3. Tumor grade.
4. Receptor status of the tumor :
Estrogen and progesterone receptor
Human epidermal growth factor 2
5. Abundant growth of new vessels
6. chromosomal aneuploidy and proliferative
index .
9- Combined contraceptive pills side effects.
1. GIT disturbances
2. Edema , headache
3. Thromboembolism , bleeding
4. Mental depression
5. Gall bladder disease
6. Ocular reactions
10- Anabolic steroids therapeutic uses.
1. Short stature
2. Hypoproteinaemia of nephrosis.

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3. Debilitated postoperative patients , burns and
premature babies .
11- gram – diplococci inside PNL:
a- cause: neisseria gonorrhea
b- another investigations:
oxidase test (positive )
production of acid from glucose
c- 2 other bacteria cause urethritis
Chlamydia trachomatis and mycoplasma
12- Cause of soft cancre and its lab diagnosis:
Heamophilus Ducreyi
- By gram method: short gram negative rods
- Culture is done on chocolate blood agar +
isovitalex + vancomycin in co2 at 37 c for 48
hours .
13- Differences between mucosa of:
Seminal vesicle Fallopian tube
Extremely folded
thrown into primary ,
secondary and 3ry folds
Numerous long
Branching primary ,
secondary and 3ry folds

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especially at the
ampulla.
14- Lyding interstitial cells LM and EM and their site:
Site: in tunica vasculosa between seminiferous
tubules or singly or clusters with fibroblasts ,
macrophages and mast cells .
LM: large polyhedral cells with large nuclei and
eosinophilic vaculated cytoplasm.
EM: cytoplasm rich in sER and mitochondria ,
numerous lipid droplets with no secretory granules .
15- One reason for:
a- Presence of tight junction between sertoli cells.
Forming blood testis barrier above level of
spermatogonia dividing seminiferous epithelium
into two completely separated compartment :
- Basal: contain fibroblasts , myoid cells , blood
vessels , basal lamina and spermatogonia.
- Primary , secondary spermatocyte ,
spermatids and sperms.
b- Vacuolated appearance of vaginal mucosa in H
and E stain

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Due to accumulation of large amount of glycogen
c- Vacuolated appearance of granulose lutein cells
in H and E
Lipid droplets and lipochrome pigments
16- Uterus myometrium layers:
1. Sub mucosal layer (stratum submucosum )
2. Vascular layer
3. Supravascular layer
4. Subserosal layer

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