13. Female genital tract/gestation Pathoma Flashcards
which hormones do prolactin inhibit
what inhibits prolactin secretion
GnRH
-dopamine
whats sheehan syndrome
what are some clinical signs
In pregnancy the pituitary gland doubles in size, however, the blood flow doesnt increase to match it so it doubles in size
-poor lactation and lossof pubic hair
Condyloma
what is it? whats main cause
Warty neoplasm of genital area
- HPV 6 and 11.
- koilocytic change
Lichen Sclerosis
Thinning of the epdiermis/fibrosis of the dermis of the vag
-cigarrete “parchment” paper skin
lichen simplex chronicus
what causes it
hyperplasia of vulvar epithelium
- thickening of the skin
- chronic itching and scratching
Pagets dz of the vulva
malignant epithelial cells of the epdiermis
-erythematous, pruritc, ulcerated skin
Clear Cell Adenocarcinoma
whats an old drug that causes this?
Malignant proliferation of glands with clear cytoplasm
-DES
Embryonal Rhabdomyosarcoma
Grape-like protrusion
malignant mesenychmal cells of immature skelatal muscle
Lymph node spread of upper and lower vag carcinomas
upper 2/3 – inguinal
lower 1/3 - illiac nodes
What causes acute endometriitis
left over products of conceptions
endometrial polyps
major presentation
painless uterine bleeding
Endometriosis
endometrial glands and stoma outside the uterine lining
whats a chocolate cyst?
its when the ovary is filled by endometriosis
Adenomyosis
Extension of the endometrial tissue (endometriosis) into the myometrium
Endometrial hyperplasia
what causes it?
how does it present
most important predictor for progression to carcinoma?
abnormal endometrial GLAND proliferation (relative to stroma)
- excess estrogen stimulation
- post menopausal vaginal bleeding
- nuclear atypia
Endometrial Carcinoma
how does it present
Malignant prolif of endometrial glands
post menopause bleeding
Leiomyoma (fibroid)
how dangerous are they?
Benign proliferation of smooth muscle from myometrium
multiple, well-circumscribed tumors that increase during pregnancy
-asymptomatic, but sometimes can cause bleeding
whats the functional unit of the ovary?
Follicle
Polycystic Ovariand Dz (PCOD)
what causes it?
classic presentation
what can it usually lead to?
hormone imbalnce -> incr. LH/ low FSH
-too much LH leads to incr. androgen production. that androgen goes to the periphery and gets converted to estrogen which then goes to pituitary and shuts down FSH (neg. feedback)
w/o FSH the ovary atrophies and creates a cyst
- obese woman, hirsutism, infertiliity,
- insulin resistance/diabetes
when would you use the serum marker CA 125
to monitor for treatment and Recurrance
Mature cystic teratoma of the ovaries
what type of tumor (Surface epithelia, Germ cell, Sex cord stroma)
what do the cysts contain
Immature cystic teratome
Germ cell
Contains fetal tissue from all 3 germ layers
Benign
______________________
Immature contains immature tissue (ie neuroectoderm)
cystic teratoma composed of thyroid tissue
Stuma ovarii
Dysgerminoma
malignant ovarian tumor
Sheets of uniform “fried egg” cells (large cells with central nuclei and clear cytoplasm)
Yolk sack tumor (whats another name for it)
most common germ cell in ____
whatst the major tumor marker
what cells do you see on histo
Endodermal sinus tumor
most common germ cell in kids
AFP
Schiller-Duval bodies (central vessel looks like glomeruli) *glomeruloid like structures
Choriocarcinoma
whats it composed of?
lab abnormalities?
how does it spread?
Malignant prolif of placenta tissue
-trophoblasts and Syncytiotrophoblasts
Villi are absent
Very high ß-hCG
-hematogenously
Granulosa-Theca cell tumor
sex cord stromal tumor
neoplasm of granulosa/theca cells (duh)
production of estrogen/progestorone which will have differnt affects at different ages
Fibroma
Associated with _____ syndrome. which is
Benign tumor of Fibroblsts
Meigs Syndrome: Fibroma, Ascites, Hydrothorax
Krukenberg tumor
what does it secrete?
Gi malignancy that mets to ovaries
mucin secreting signet cell adenocarcinoma
Psuedomyxoma peritonei
where does it usually come from
intraperitoneal accumulation of mucin material
usually arises from Appendix tumor
Ectopic pregnancy
whats the most common site?
big risk factor?
clinical presentation
fertilization and implantation of ovary at site other than uterine wall.
- ampulla of Fallopian tubes
- scarring (from PID-salpingitis, endometriosis)
- lower abdominal pain after missed period (ALWAYS DO PREGNANCY TEST)
Spontaneous abortion
loss of fetus before 20 wks
passage of fetal tissues
differences between
Placenta Accreta/Increta/percreta
and presentations
Accreta: placenta attaches to myometrium w/o penetration. difficulty delivering placenta
HELLP syndrome
Preeclampsia w/ thrombotic microangiopathy of the liver
Hemolysis, Elevated Liver enzymes, Low Platelet
HELLP
Sudden infant Death Syndrome (SIDS)
risk factors
Death of infant 1mo. - 1 yr. without cause
-sleeping on stomach, smoking in house,
Hydatidiform mole
how do you diagnos
Tx?
instead of growing a baby you grow abnormal placental tissue
swollen and edematous villi, proliferation of trophoblasts
-passage of “grape-like” masses / snowstorm on US
-dilation and curettage of mole, monitor b-hcg
Complete Hydatidiform Mole
whose fault? fetal parts? villi? b-hcg
All dads fault (only sperm and enucleated egg)
46,XX; 46, XY
- no fetal parts
- All villi are edematous/fucked up
- b-hcg much higher than partial mole
Partial Hydatiform mole
fetal tissue? villi?
2 sperm + 1 egg
69 XXX; 69, XXY; 69, XYY
Yes fetal parts
some villie are fucked
