2: Female Repro Pathology

Question 1

other names for paramesonephric and mesonephric ducts

Answer 1

1. parameso: Mullerian ducts

2. meso: Wolffian ducts

Question 2

what do mullerian vs wolffian ducts become in females?

Answer 2

1. mullerian: fallopian tubes, uterus, upper vagina

2. wolffian: regress

Question 3

bartholin glands

Answer 3

paired mucus-producing pea sized glands at vaginal opening

Question 4

koilocyte

Answer 4

cell with large hyperchromatic nuclei and a surrounding cleared-out halo space (seen in HPV)

Question 5

two HPV types most associated with cancer vs condylomas

Answer 5

1. CA: 16, 18

2. condylomas: 6, 11

Question 6

E6 and E7 proteins in HPV

Answer 6

E6: increases telomerase + degrades p53
E7: cell proliferation thru inactivation of p21 and RB

Question 7

what region of the cervix does HPV have a predilection for

Answer 7

transformation zone (btwn ectoderm squamous mucosa + endoderm columnar mucosa)

Question 8

what is ASCUS

Answer 8

atypical cells of undetermined significance

Question 9

cervical conization vs LEEP

Answer 9

1. cervical conization: cone-shaped piece of tissue is cut out
2. LEEP: loop electrosurgical excision procedure

Question 10

MC overall cause of AUB

Answer 10

hormonal imbalances during menarche or perimenopause

Question 11

four theories of how endometriosis occurs

Answer 11

1. retrograde flow of nl endometrial tissue
2. endometrium spreads thru lymph or blood stream
3. due to embryologic remnants
4. from bone marrow

Question 12

major risk factor for endometrial hyperplasia + some examples of that**

Answer 12

unopposed estrogen - obesity, PCOS, HRT, tamoxifen, E-producing tumors

Question 13

Lynch syndrome genetics

Answer 13

AD, mutation in MLH1 or MSH2 (mismatch repair genes)

Question 14

presentation of Lynch syndrome

Answer 14

increased risk of: colorectal carcinoma, endometrial CA, ovarian CA, other GI CAs

Question 15

most common ovarian malig

Answer 15

serous carcinomas

Question 16

if an ovarian mass is malignant, how does it usually present?

Answer 16

bilateral

Question 17

which ovarian tumor always presents unilaterally

Answer 17

mucinous tumors

Question 18

general features of ovarian tumors

Answer 18

often asx/vague; adnexal mass, vaginal bleeding, abd pain, UTI sx, GI sx, weight loss, ascites

Question 19

fibrothecoma

Answer 19

combo of fibroma + thecoma on the ovary

Question 20

factors that increase chances of having twins

Answer 20

fertility tx, advanced maternal age, higher pregnancy number, genetic factors