Ch 13 Pathoma - Female Genital System and Gestational Pathology Flashcards
<p>Anatomically includes the skin and mucosa of the female genitalia external to the hymen (labia major and minor, mons pubis, and vestibule) and is lined by \_\_\_\_\_ epithelium.</p>
<p>Vulva; squamous</p>
<p>A Bartholin cyst arises from obstruction of the \_\_\_\_\_\_\_\_, (present on each side of the vaginal canal and drains a mucus like fluid in to the lower vestibule). Usually occurs in \_\_\_\_\_\_ and presents as a \_\_\_\_ and \_\_\_\_ cystic lesion.</p>
<p>Bartholin gland; women of reproductive age; unilateral; painful</p>
<p>\_\_\_\_\_ is a warty neoplasm of vulvar skin, most commonly due to \_\_\_\_\_. Histologically characterized by \_\_\_\_\_.</p>
<p>Condyloma; HPV 6 or 11 (less commonly secondary syphilis); koilocytes</p>
<p>\_\_\_\_\_\_ is characterized by thinning of the epidermis and fibrosis of the dermis. Presents as a \_\_\_\_\_\_ with parchment like vulvar skin. Most commonly seen in \_\_\_\_\_ women. Yes/No increased risk for SCC.</p>
<p>Lichen sclerosis; white patch (leukoplakia); postmenopausal; Yes</p>
<p>\_\_\_\_\_\_ is characterized by hyperplasia of the vulvar squamous epithelium. Presents as \_\_\_\_\_\_\_ with thick, leathery vulvar skin. Associated with \_\_\_\_\_\_\_. Yes/No increased risk of SCC.</p>
<p>Lichen simplex chronicus; leukoplakia; chronic irritation/scratching; No</p>
<p>Three potential causes of leukoplakia of the vulva</p>
<p>lichen sclerosis, lichen simplex chronicus, vulvar carcinoma</p>
<p>Vulvar carcinomas presents as \_\_\_\_\_\_. It can be related or not related to \_\_\_\_. When it is related, it arises from \_\_\_\_\_. When it is not related, it arises most often from \_\_\_\_. Age difference</p>
<p>leukoplakia; HPV; VIN (vulvar intraepithelial neoplasia); lichen sclerosis; HPV related seen in women of reproductive age; HPV non related seen in women >70 yrs</p>
<p>\_\_\_\_\_\_ is characterized by malignant epithelial cells in the epidermis of the vulva. Presents as \_\_\_\_, \_\_\_\_\_\_, \_\_\_\_\_\_ vulvar skin. It represents carcinoma in situ usually with no underlying carcinoma (different from \_\_\_\_\_). Must be distinguished from melanoma, done with these three stains.</p>
<p>Extramammary paget disease; erythematous; pruritic; ulcerated; paget disease of the nipple;
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paget = PAS+, keratin+, S100-
melanoma = PAS-, keratin-, S100+</p>
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<p>Adenosis; Increased incidence in females who were exposed to \_\_\_\_\_ in utero</p>
<p>focal persistence of columnar epithelium in upper vagina (lower 1/3 of vag is sq epith derived from urogenital sinus, which during development overtakes the columnar epith of the upper 2/3 derived from Mullerian ducts); diethylstilbestrol (DES)</p>
_______ is a malignant proliferation of glands with clear cytoplasm. It is a rare complication of ___-associated vaginal adenosis
Clear cell adenocarcinoma; DES
Embryonal rhabdomyosarcoma is a malignant ______ proliferation of ______. It presents as ______ and a ____ mass protruding from the vagina or penis of a child (usually
mesenchymal; immature skeletal muscle; bleeding; grape-like; sarcoma botryoides; cross-striations; desmin; myogenin
Vaginal carcinoma’s precursor lesion is ______. When spread to regional lymph nodes occur, cancer from lower 1/3 spreads to _____, and cancer from upper 2/3 goes to _____.
VAIN (vaginal intraepithelial neoplasia); inguinal nodes; iliac nodes
Vulvar intraepithelial neoplasia (VIN), CIN, VAIN are dysplastic precursor lesions characterized by these 4 things.
koilocytic change, disordered cellular maturation, nuclear atypia (high nuclear to cytoplasmic ratio, with hyper chromatic nuclei), and increased mitotic activity
Exocervix is lined by ______ and endocervix is lined by _____. The junction between the two is the ______.
nonkeratinizing stratified squamous epithelium; columnar epithelium; transformation zone
HPV is a sexually transmitted ___ virus that infects the _____, especially the ____.
DNA; lower genital tract; cervix (transformation zone)
High risk HPV types are _____. Low risk HPV types are _____. High risk HPV produces ___ and ___, which result in destruction of ____ and ____ respectively
16, 18, 31, 33
6 and 11
E6 and E7
p53 and Rb
p53 recruits ___, which inactivates ____, which normally stabilizes the mitochondrial membrane, so ____ can escape and cause apoptosis
BAX; bcl2; cytochrome c
Rb holds ____, which is needed to progress to the cell cycle.
E2F (transcription factor)
CIN I involves ___ of the thickness of the epithelium (also answer CIN II and CIN III, and CIS)
Cervical carcinoma is invasive carcinoma that arises in the cervical epithelium most commonly in _____ women, and presents as _____ or _____. Key risk factor is ____; 2ndary risk factors include ___ and ____. 80% of cases are ____ and 15% are ____.
middle aged; vaginal bleeding (especially post coital) or cervical discharge; HPV; smoking and immunodeficiency (AIDS defining illness); squamos cell carcinoma; adenocarcinoma
In advanced stages of cervical carcinoma, tumors often invade through the ____ into the _____ and blocking the _____. Common cause of death is _____ due to _____.
anterior uterine wall; bladder; ureters; postrenal failure; hydronephrosis
The goal of the pap smear is to catch ____ before it develops in to ____. An abnormal pap is followed by ______ and _____. There is limited efficacy in screening for _____.
dysplasia (CIN); carcinoma; confirmatory colposcopy; biopsy; adenocarcinoma
The quadrivalent vaccine is effective in preventing HPV types _____.
6, 11, 16, and 18
Endometrium
mucosal lining of the uterine cavity (it is hormonally sensitive)