Q #01…Describe the female reproductive system. Begin by first identifying
significant anatomical parts and explaining what role each organ plays in the
reproductive process. Then, name important pathology that afflict those particular
anatomical parts just named. Also, choose which laboratory tests and diagnostic
procedures would be used in compliance with that specific pathology.
Answer:
The reproductive system in women is contained mainly in the pelvic cavity and
perineum, although during pregnancy, the uterus expands into the abdomen cavity.
Major components of the system consist of:


an ovary on each side; and
a uterus, vagina, and clitoris in the midline
In addition, a pair of accessory glands (the greater vestibular glands) is associated with
the tract.
Different Parts and Functions of Female reproductive system:
Pathologies and their laboratory Test:
Ovaries:
There are two well known pathologies of ovaries i.e.
1) Ovarian tumors.



Diagnosis is by
ultra sound
CT scan
Biopsy.
2) Polycystic ovarian syndrome.
There is a criterion for the diagnosis of PCOS i.e.
•
Rotterdam Criteria (2 out of 3)
–
Menstrual irregularity due to anovulation oligo-ovulation.
–
Evidence of clinical or biochemical hyperandrogenism.
–
Polycystic ovaries by US
•
Presence of 12 or more follicles in each ovary measuring 2 to 9 mm
in diameter and/or increased ovarian volume.
Other investigations include:
•
Ultrasound - transvaginal ultrasound is best
•
LH/FSH.
•
Free testosterone
•
Sex hormone binding globulin (SHBG)

Fasting insulin levels
Uterine tubes or fallopian tubules:
1) Tumors of fallopian tubules.
It is a rare condition diagnose by



Biopsy
Laparoscopy
Hysterosalpingogram
2) Ectopic tubal pregnancy.
It is diagnose by



Clinical symptoms
Beta HCG
Transvaginal ultrasound.
Uterus:
1) Endometriosis
It is diagnose by laproscopy.
2) Uterine tumors
 Biopsy
 Pap smear
 Ultra sound
 Hysteroscopy
 Clinical diagnosis
Cervix:
1) Ca cervix
Diagnose by




Biopsy
Screening is mandatory for prevention of cervical cancer. We can do screening
by following methods
Pap smear
Visual inspection with acetic acid (VIA).
Vagina:
1) Vaginitis
Diagnose by



Taking high vaginal swab
Gram staining
Culture of causative agents
These are just common diseases otherwise there is a long list of diseases. Some
diseases of reproductive tract involve more than 1 part e.g. pelvic inflammatory disease
(PID) that involves endocervix, vagina, uterus, fallopian tubules.
Q #02…Explain the workings of the lymphatic system. First, begin by identifying
important anatomical parts and indicating what each organ is responsible for in the
entire system. Next, specify any diseases or pathology that afflict those specific
anatomical parts just named. Then, select the laboratory tests and diagnostic
procedures that would be used in compliance with that particular disease or
pathology.
Answer:
The lymphatic system is a network of tissues and organs that primarily consists of
lymph vessels, lymph nodes and lymph. A network of vessels, tissues, organs, and cells
constitute the lymphatic system. Included in this network are lymph vessels, lymph
nodes, the spleen, the thymus, and lymphocytes. Running throughout this network is
watery fluid called lymph.
The major components of the lymphatic system include lymph, lymphatic vessels, and
lymphatic organs that contain lymphoid tissues.
Components of the Lymphatic System and their functions:
Components of lymphatic system
1. Lymph:
– a fluid similar to plasma
– does not have plasma proteins
2. Lymphatic vessels (lymphatics):
– network that carries lymph from peripheral tissues to the venous system
3. Lymphocytes, phagocytes, and other immune system cells
4. Lymphoid tissues and lymphoid organs:
– found throughout the body
Function of the Lymphatic System
• Collection of fluid and solutes lost by the capillaries
– 3.6L/day
• Distribution
– Hormones
– Waste products
• Protects us against disease
– Production, maintenance and distribution of lymphocytes.
The lymphatic system’s main functions are as follows:



Restoration of excess interstitial fluid and proteins to the blood
Absorption of fats and fat-soluble vitamins from the digestive system and transport of
these elements to the venous circulation
Defense against invading organisms
Diseases and their diagnostic tests:
There are many diseases related to lymphatic system but some are as follow:
1)
2)
3)
4)
5)
6)
7)
Lymphedema
Hodgkin's lymphoma
Lymphangiomatosis
Elephantiasis
Lymphangiosarcoma
Lymphatic filiaris
Lymphoid leukemias and lymphomas
We can diagnose these conditions by









CT scan
Lymph node biopsy
Excisional or incisional biopsy
Fine needle aspiration (FNA) or core needle biopsy
Bone marrow biopsy
Positron Emission Tomography (PET scan)
Immunohistochemistry
Complete blood count
microscopic examination for lymphatic filiaris

to see the metastatic lymph nodes we can do chect X-ray, ultrasound, bone
scan, MRI, pleural fluid tap, lumbar puncture, etc
Q #03…Examine the male reproductive system. Start by identifying key
anatomical parts and explaining what each organ is responsible for in the body
system. Then, indicate any diseases or pathology that afflicts those particular
anatomical parts just named. After indicating the diseases or pathology, decide
which of the laboratory tests and diagnostic procedures would be used in
compliance with that specific disease or pathology.
Answer:
The male reproductive system includes the two testes, the system of ducts that store
and transport sperm to the exterior, the glands that empty into these ducts, and the
penis. The duct system, glands, and penis constitute the male accessory reproductive
organs. The reproductive system in men has components in the abdomen, pelvis, and
perineum. The major components are a testis, epididymis, ductus deferens, and
ejaculatory duct on each side, and the urethra and penis in the midline. In addition,
three types of accessory glands are associated with the system:




a single prostate;
a pair of seminal vesicles; and
a pair of bulbourethral glands.
Male Reproductive Organs and Functions:
Diseases of male reproductive organs and their diagnostic tests:
Testes:
1) Undescended testes or cryptorchidism.
It is diagnose by



2)
Careful physical examination
Ultra sound
Ct scan
Testicular tumor
It can be diagnose by


Ultra sound
Tumor markers e.g. alpha fetoprotein, Beta-human chorionic gonadotropin,
Lactate dehydrogenase.
 Biopsy
 CT scan
 Chest X-ray
For pulmonary metastasis.
3) Testicular tortion
It can be diagnose by



Physical examination
Doppler ultrasound scan
technetium-99m Radionuclide scan
Prostate:
1) prostatitis
it can be diagnose by




DRE
Prostatic fluid analysis
Ultrasound
urinalysis
2) benign prostatic hyperplasia (BPH)
it can be diagnose by





Urinalysis
Serum urea and creatinine.
Ultrasonography of renal tract
Urodynamic studies
Digital rectal examination (DRE)
3) prostatic cancer
it can be diagnose by




DRE
Prostate specific antigen (PSA)
Transrectal ultrasonography (TRUS)
TRUS + TRUS guided biopsy
Other common diseases of male reproductive tract are:













Hypospadias
Hydrocele
Varicocele
Balanitis
Epididymitis
Epididymo-orchitis
Epispadias
Haematocele
Hydrocele
Hypospadias
Urethritis
Para phimosis
Peyronie’s disease
Most commonly used diagnostic tests include





Thorough physical examination is most effective in many conditions
Endoscopy
Ultra sound
DRE
Semen analysis
Q #04...Explore the musculoskeletal system. Begin by first matching the medical
term with the more commonly known term for the anatomical parts. For example,
“clavicle” is more commonly known as “collar bone” and “patella” is more often
called the “knee cap.” Then, name important pathology that afflict those
particular anatomical parts just named. Also, choose which laboratory tests and
diagnostic procedures would be used in compliance with that specific pathology.
Answer:
Musculoskeletal system is the system of muscles and tendons and ligaments and
bones and joints and associated tissues that move the body and maintain its form.
The musculoskeletal system includes the bones, joints, muscles, and tendons. The
resident looked for abnormalities and muscle wasting. Knowing which areas are
wasted identifies the nerve that supplies them. The musculoskeletal system of an
adult contains more than 200 bones and 600 muscles. Some of these are the
cranium, clavicle, scapula, sternum, humerus, ulna, radium, sacrum, pelvis, femur,
patella, fibula, tarsals, orbicularis oculi, platysma, trapezius, deltoid, pectoralis
major, biceps brachii, gluteus medius, adductor magnus, soleus, gluteus maximus,
gastrocnemius, and Achilles tendon
Common Names of Some Bones:

















The Head bone (or skull)- cranium
The jaw bone-mandible
The collar bone-the clavicle
The shoulder blades- the scapulars
The chest bone- the sternum
The ribs-costals
Funny bone-humerus
The hand bones-carpals
The finger bones-metacarpals
The tail bone-coccyx
The knee cap-patella
The ankle bone-talus
The heel bone-calcaneus
The foot bones-tarsals
The toe bones-metatarsals.
Finger bones – phalanges
Shin – tibia
Pathologies of Musculoskeletal System and their Diagnostic Tests:
1) Developmental dysplasia of hip (DDH)
It can be diagnose by
 Every newborn child must be screened for DDH by Ortolani and Barlow’s
tests.
 Ultra sound
 Von Rosen X-ray
 Clinical presentations e.g. inability to abduct hip in flexion, asymmetric skin
folds, galeazzi sign positive, waddling gait, trendelenburg’s gait.
2) Congenital Talipes Equino-Varus (CTEV)
It can be diagnose by
 General examination (Short Achilles tendon, High and small heel, No
creases behind Heel,Abnormal crease in middle of the foot, Foot is smaller in
unilateral affection, Callosities at abnormal pressure areas,Internal torsion of
the leg, Calf muscles wasting, Deformities don’t prevent walking)
 X-ray tells the kite’s angle
3) Spinal deformities e.g. , scoliosis, kyphosis etc
These can be diagnose by
 Physical examination (Limb length, Skin signs etc )
 Radiological assessment e.g. by X-ray
4) Rotator cuff tendinopathy
It can be diagnose by
 Clinical examination
 X-ray
 Ultrasound
 MRI
5) Biceps tendon rupture
It can be diagnose by
 Clinical examination e.g. popeye sign
 Ultrasound
 MRI
6) De Quervain’s tenosynovitis
It can be diagnose by
 Clinical diagnosis
 Finkelstein’s test
7) plantar fasciitis
it can be diagnose by
 clinical diagnosis
8) collateral ligament (LCL, MCL) tears
These injuries can be diagnose by
 usually investigations are not necessary
 diagnose on clinical examination.
9) Medial and lateral epicondylitis
These can be diagnose by
 Physical examination: for medial epicondylitis we find Pain on palpation
common tendon & medial epicondyle, Pain with resisted wrist flexion and
forearm pronation, Pain with passive wrist extension (stretch of wrist flexors)
and for lateral epicondylitis we find Pain on palpation common tendon & for

lateral epicondyle, Pain with resisted wrist extension and forearm supination,
Pain with resisted extension of 3rd digit, Pain with passive wrist flexion
(stretch of wrist extensors).
Investigations usually not necessary.
10) Compartment syndrome
It can be diagnose by
 Clinical diagnoses by symptoms e.g.PAIN OUT OF PROPORTION,
PALPABLY TENSE COMPARTMENT, PAIN WITH PASSIVE STRETCH,
PARESTHESIA/HYPOESTHESIA, PARALYSIS, and
PULSELESSNESS/PALLOR.
 Pressure measurement
11) Fractures
These can be diagnose by
 Taking thorough history
 X-ray
 Physical examination
12) Osteomyelitis
it can be diagnose by
 X-ray
 ASPIRATION OF PUS FOR Culture and sensitivity
 Total leukocyte count (TLC) INCREASED
 NEUTROPHILS INCREASED
 C- REACTIVE PROTIEN INCREASED
 BLOOD CULTURE
 E.S.R RAISED
 Hb REDUCED
 BONE SCAN TcM99
 GALLIUM 67 SCAN
 INDIUM LEUCOCYTE 111 SCAN
 M.R.I
13) Osteoporosis
It can be diagnose by
 Bone densitometry
 Dual-energy x-ray absorptiometry (DXA) or bone densitometry
Other blood test to rule out cause e.g. Serum calcium & phosphate, thyroid function test
(TFTs), Immunoglobins, ESR, Serum 25-hydroxy vitamin D test (serum 25(OH)D),
parathyroid hormone (PTH), sex hormones, Gonadotrophins, transiliac bone biopsy, etc
14) Carpal tunnel syndrome
It can be diagnose by
 Thorough history
 Physical examination (Thenar eminence wasting, Weakness of abductor pollicis
brevis it is a most sensitive motor sign, Palmar abduction, Weakness of
opponens pollicis, Tinel’s percussion test, Phalen’s test, Carpal tunnel
compression).
 Electrodiagnostic tests e.g. nerve conduction studies.
15) Thoracic Outlet Syndrome
It can be diagnose by







Physical examination e.g. stress tests or provocative maneuvers i.e. Roos
Maneuver, Wright maneuver, Elevated-arm stress test, Adson maneuveretc
X-ray
Cervical spine X-ray
Duplex
CT scan
MRI
Nerve conduction studies
There are many more conditions but these few are common.
Reference:



Medical terminology: A short course (6th Edition). St. Louis: Saunders Elsevier.
Gray’s anatomy for students. 2nd edition.
Clinically oriented anatomy 6th edition by Keith L. Moore.


Bailey and Love. A Short Practice of Surgery 25th edition
Apley's System of Orthopedics and Fractures 9th edition
Thank you 