Breast Flashcards
Vulvitis
Inflammation of the external female genitalia
Vaginitis
Inflammation of the vaginal canal
Results in production of vaginal discharge
-bacteria, fungus, parasitic organism
_______ or _____ can predispose patients to vaginitis
Diabetes
Systemic antibiotic therapy
Cervix acts as
Barrier to the ingress of vaignal microflora into the uterus
Escape of mistrial flow
Diabetes to accommodate childbirth
Diseases of the cervical
Inflammatory (cervicitis)
Neoplastic
Cervicitis symptoms
Cervical inflammation is common can result in purple tooth vaginal discharge
May represent a specific infection (STD)
Often nonspecific infection
Cervical cancer (squamous cell carcinoma )
Deaths have decreased due to Pap smear
Papanicolaou smear
A screening test that detects precancerous cell
-Exfoliated cells collected from the cervix followed by special stain
Pap smear co screens for
High risk HPV subtypes in abnormal smears
Colposcopy
Direct examination procedure that provides n illuminated magnified view of the cervic
Cervic abnormalities appear as
White patches following application of acetic acid
Nearly all cases of squamous cell carcinoma arise from
Precursor epithelial changes : cervical intraepithelaila neoplasia
Do all CIN progress to cancer
Nope but many do
Epithelial dysplasia
Cytologic and maturational disturbances of epithelium seen microscopically
CIN stages
I-Mild dysplasia
II-Moderate dyspalsia
III-Carcinoma in situ
HIgh risk HPV
16, 18
Associated with cancer
Low Risk HPV types
6, 11
Associated Condyloma
HPV Risk factors
Early age at first intercourse
Multiple sex partners
Male partners with multiple previous sexual partners
Prolonged infection with high risk HPV
Myometrium
Muscular wall of the uterus
Composed of interlacing bundles of smooth muscle
Endometrium
Glandular lining of the uterus
Changes under hormonal influence
Menorrhagia
Abnormally heavy menstrual bleeding
Metrorrhagia
Bleeding between menstruated cycles
Dysmenorrhea
Unusually painful menstrual bleeding
Functional endometrium
Located outside the uterus which undergoes cycling bleeding
Intrapelvic bleeding and organization of blood leads to
Widespread fibrosis and periuterine adhesions
-results in sever dysmenorrhea and pelvic pain
Large blood filled cysts on the ovaries transform to
Chocolate cysts as the blood ages
Endometrial hyperplasia
Overgrowth of endometrium
Endometrial hyperplasia results from
Excess exposure to estrogen
Endometrial hyperplasia risk factors
Obesity
Hormone intake
Failure to ovulate
Estrogen producing ovaraian tumors
Endometrial hyperplasia may progress to
Adenocarcinoma
-Mild moderate atypical hyperplasia
Tumors of the uterus may arise from ______ or _______
Endometrium or muyometirum a
All tumors of the uterus produce
Abnormal uterine bleeding
Most common tumors of the uterus
Endometrial polyps
Smooth muscle tumors
Carcinomas
Leiomyoma (Fibroids)
Benign tumor of myometrial smooth muscle
-most common benign tumor in females
Leiomyoma (Fibroids) growth stimulated by
Estrogens; regress after menopause
Leiomyoma (Fibroids) may be totally asymptotic but can cause
Menorrhagia
Palpable pelvic mass
Infertility
Endometrial Carcinoma most common
Female genital tract cancer in US
55-65 years
Endometrial Carcinoma associated with
estrogen excess/endometrial hyperplasia
Endometrial Carcinoma symptoms include
Leukorrhea and irregular bleeding
Disorders of the ovaries
Non-neoplastic cysts of the ovaries are common but not generally a serious problem
Neoplasia
Polycystic Ovarian Diseae
Common hormonal disorder of females of reproductive age
Polycystic Ovarian Diseae multiple cystic follicles in ovaries produce
Excess androgens and estrogens
Polycystic Ovarian Disease presents with
Oligomenorrhea Hirsuitism Acne Fertility problems Obesity -Increased risk for type II diabetes, hypertension and cardiovascular disease
Ovarian Carcinoma mutations of
BRCA genes
BRCA1 BRCA2= increase risk for breast and ovarian cancer
90% of ovarian cancer arise from
Surface epithelial cells
Risk factors for ovarian cancer
Nulliparity and family history
Teratoma
Tumor of all 3 germ layers
First 2 decades of life
90% benign
Teratoma when malignant
Younger patient
Breast Pathology
Extremely common
Palpable nodules or masses
Most are benign
Must differentiate from malignancy
Fibrocystic change (breast) arise during
Reproductive years
Fibrocystic change (breast) exaggeration and distortion of
Normal cyclic breast changes occurring with mestraution
Fibrocystic change (breast) characterized by
Overgrowth of fibrous stroma and or glandular elements
Fibroadenoma (breast)
Most common benign neoplasm of breast
Fibroadenoma (breast)presents in
Prepubertal girls and young women; Preakness prevalence in 3rd decade
Results in increased estrogen
Fibroadenoma (breast) size
1-10 cm
Freely movable nodule
Solitary
Discrete
Fibroadenoma (breast)biopsy shows
Proliferation of stroma and glands
Breast cancer arise from
Glandular elements of the breast
2nd leading cause of cancer related death in women
Breast cancer mostly affect
Women after 50 (75%)
Breast Carcinoma Etiology
Genetics
Hormonal Influences
Environmental Variables
______ of all breast cancers are related to inherited mutations
10%
BRCA1 BRCA2
Where is breast cancer most often seen
Upper outer quadrant
Highest mortality breast cancer quadrant
Lower medial
Breast carcinoma detection
Discrete non-tender mass
Adherence to overlying skin may result in nipple reaction
Thickened overlying skin resembles surface of orange
2 categories of breast carcinoma
Ductal
Lobular carcinoma
Both have pre-invasive stages
Carcinoma survival
50%
Metastasis May occur many years after apparent therapeutic control of primary lesion
