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System P 2 > Chapter 18 > Flashcards

Chapter 18 Flashcards

1
Q

What is the most common condition in the Vulva?

A

Inflammation

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2
Q

Is neoplasia common or rare in the vulva?

A

Rare

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3
Q

What type of vulvitis is assorted with erythema, itching, oozing, and are caused by soaps lotions, detergents?

A

Allergic contact dermatitis

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4
Q

What are causes of infectious vulvitis?

A

Condylomata acuminata, HSV, preponema pallidum, N. Gonorrhoeae, C. Albicans

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5
Q

What condition associated with the vulva is an obstruction/dilation of the Bartholin gland?

A

Bartholin cyst

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6
Q

Is a Bartholin cyst painful or painless and how long does it take to develop?

A

Can be painless or painful, develops in days.

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7
Q

What condition of the vulva may possibly have a co-infection which my lead to an abscess?

A

Bartholin cyst

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8
Q

What condition is associated with epidermal thinning, with smooth white lesions near labia minor?

A

Lichen sclerosus

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9
Q

What is the cause of lichen sclerosus?

A

Idiopathic/autoimmune

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10
Q

Who is most common affected by lichen sclerosus and what is a risk factor?

A

Bimodal (old and young) cancer Risk (5% –>SCC)

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11
Q

What condition is associated epithelial hyperplasia and hyperkeratosis?

A

Lichen simplex chronicus

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12
Q

Does lichen sclerosus or lichen simplex chronicus has a cancer risk?

A

Lichen sclerosus

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13
Q

Is lichen simplex chronicus a thickening or thinning of epidermis ??

A

Thickening

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14
Q

What condyloma is associated with secondary syphilis and are flat, moist, painless?

A

Condylomata Alta

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15
Q

Are vulvar carcinomas rare or common?

A

Rare

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16
Q

In what age group are vulvar carcinomas most commonly seen?

A

> 60 (late mets)

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17
Q

What is the most common vulvar carcinoma?

A

Non-HPV-related SCC

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18
Q

What vulvar carcinoma is associated with vulvar intraepithelial neoplasia?

A

HPV-Related Squamous cell carcinoma (SCC)

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19
Q

Who as at risk for a HPV related (vulvar carcinoma) squamous cell carcinoma?

A

Middle aged, smokers, immunodeficiency

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20
Q

Who is at risk for a non-HPV-related (vulvar carcinoma) squamous cell carcinoma. ?

A

Older woman, isolated, lichen sclerosus.

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21
Q

What causes a white vaginal infection?

A

C. Albicans

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22
Q

What causes a green vaginal discharge in the vagina?

A

Trichomonoas vaginalis

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23
Q

What are risks for infections in the vagina?

A

Diabetes, immunodeficiency, antibiotics

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24
Q

Are congenital malformations of the vagina common or rare?

A

Rare

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25
Q

Leukorrhea (discharge), pain, and itching, that is most common benign and transient is associated with what condition?

A

Vaginitis

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26
Q

What form of vaginal cancer is most commonly seen in elderly (>60) ?

A

Squamous cell carcinoma

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27
Q

What form of vaginal cancer has a risk factor of HPV (early intercourse, multiple partners) and informs from a precancerous vaginal intraepithelial neoplasia.?

A

Squamous cell carcinoma

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28
Q

What form of vaginal cancer is usually seen in children less than 5 years old?

A

Sarcoma Botryoides

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29
Q

What vaginal cancer is from an ADR because their mothers took Diethylsthilbestrol (DES) ?

A

Clear cell adenocarcinoma

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30
Q

What form of vaginal cancer is is rare with red/granular forci?

A

Clear cell adenocarcinoma

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31
Q

Mothers who took DES this increases their child’s chances by________%of getting what form of vaginal cancer?

A

Clear cell adenocarcinoma

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32
Q

Embryonal Rhabdomyosacrcoma is associated with what vaginal cancer?

A

Sarcoma Botryoides

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33
Q

Where in the body is rhabdomyosarcoma commonly seen?

A

Areas with little skeletal muscle (head neck 40%, genitourinary 25%, extremities 20%, truck 7%)

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34
Q

What is the most common pediatric soft tissue sarcoma ?

A

Rhabdomyosarcoma

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35
Q

What percent of patients with rhabdomyosarcoma are cured?

A

2/3

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36
Q

Is cervicitis most commonly benign or malignant ?

A

Benign

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37
Q

What is the most common causes of infectious cervicitis ?

A

Chlamydia ( 40% of cases

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38
Q

What is the causes of acute non infections cervicitis?

A

Postpartum

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39
Q

What is the cause of chronic non infectious cervicitis?

A

Estrogen fluctuations or trauma ( reproductive aged woman)

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40
Q

What are 4 risk factors of neoplasia of the cervix?

A

Early 1st intercourse, multiple sex partners, male partner with several past partners, High risk HPV infection.

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41
Q

What HPV’s are involved with neoplasia of the cervix?

A

HPV16 and HPV18

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42
Q

Most HPV infections are______?

A

transient (months)

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43
Q

do most HPV infections persist to Cervical intraepithelial neoplasia?

A

No

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44
Q

what is the most common location for HPV?

A

transformation zone

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45
Q

Endocervix = what kind of epithelium ?

A

columnar

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46
Q

exocervix = what kind of epithelium?

A

squamous

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47
Q

What is eversion during puberty?

A

Columnar cells undergo squamous metaplasia

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48
Q

What is the most common pathology of the vulva?

A

Inflammation

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49
Q

What are causes of allergic vulvitis?

A

Contact dermatitis (eczema)

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50
Q

What are causes of infectious vulvitis?

A

HPV, HSV, preponderance pallium, gonorrheae

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51
Q

What is a Bartholin cyst?

A

Obstruction of the Bartholin gland (vulva)

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52
Q

Are Bartholin cysts painful?

A

May or may not be

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53
Q

What are two non neoplasticism epithelial disorders?

A

Lichen sclerosus, lichen simplex chronicus

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54
Q

What is thinning of the epidermis due to atrophy ?

A

Lichen sclerosus

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55
Q

What is a benign white lesion most common in the elderly near labia minor?

A

Lichen sclerosus

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56
Q

What is epithelial hyperplasia and hyperkeratosis?

A

Lichen simplex chronicus

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57
Q

What epithelial disorder is benign and caused by chronic irritation (leukocytes)

A

Lichens simplex chronicus

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58
Q

What is most likely though rare to have change of Turning into cancer?

A

Lichen sclerosus

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59
Q

What are 2 neoplasms of the vulva?

A

Condyloma, vulvar carcinoma

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60
Q

When do you see condylomata lata?

A

Secondary syphilis

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61
Q

When do you see condylomata culminate?>

A

Genital warts (HPV)

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62
Q

90% of vulvar carcinomas are what kind?

A

Squamous cell carcinoma

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63
Q

HPV related SCC are associated with what?

A

Vulvar intraepithelia neoplasia (VIN), HPV 16 and 18

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64
Q

What vulvar carcinoma is most common?

A

Non-HPV-related SCC

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65
Q

Non HPV related SCC are associated with what?

A

Older women, isolated, lichen sclerosis, NO VIN

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66
Q

Vaginitis is most commonly…..?

A

Benign and transient

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67
Q

What are common symptoms of vaginitis ?

A

Leukorrhea (discharge), pain.

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68
Q

Is vaginitis has a white discharge it is probably caused by what organism ?

A

C. Albicans

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69
Q

If vaginitis has a green discharge it is most commonly caused by what organism?

A

Trichamonas vaginalis

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70
Q

What vaginal cancer is most common in age 60 or older?

A

Squamous cell carcinoma

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71
Q

What are risk factors for squamous cell carcinoma?

A

HPV, VIN

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72
Q

Diethylstilbestrol (DES) is also acted with what vaginal cancer and what is the increased risk?

A

Clear cell adenocarcinoma, 40 times the risk

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73
Q

What vaginal cancer is most common in woman less that 5 years old??

A

Sarcoma botryoides

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74
Q

Sarcoma Botryoides is a type of what?

A

Embryonal rhabdomyosarcoma

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75
Q

Cervicitis is most commonly….?

A

Benign And has leukorrhea

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76
Q

What is the most common pediatric soft tissue sarcoma?

A

Rhabdomyosarcoma

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77
Q

Infectious cervicitis is most commonly caused by what?

A

Chlamydia

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78
Q

Acute (rare) Non infectious cervicitis is most common when?

A

Postpartum

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79
Q

Chronic (more common) cervicitis is most common in who? Due to?

A

Reproductive age woman due to estrogen fluctuations, trauma

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80
Q

If HPV persists what does it Turn into?

A

Cervical intraepithelial neoplasia (CIN)

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81
Q

What are high risks for cervical neoplasms?

A

HPV 16 and 18

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82
Q

Where does most of HPV take place?

A

Transformation zone

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83
Q

Eversion at puberty is what?

A

Changing from columnar cells to squamous metaplasia

84
Q

Cervical intraepithelial neoplasia (CIN) is associated with what 2 things? ?

A

HPV and dysplasia

85
Q

Cervical intraepithelial neoplasia (CIN) is most common in who?

A

30 year old, takes 15 years

86
Q

With low grade CIN what happens?

A

Observation —60% regress, 10% progress to high grade

87
Q

With high grade CIN what happens?

A

Excision- 30% regress, 10% get cancer

88
Q

What is cellular changes from HPV?

A

Kilocytosis

89
Q

What are characteristics of Koilocytosis ?

A

Enlarged nucleus, anaplaia, wrinkled boarders, dark

90
Q

Is CIN asymptomatic or no?

A

Yes

91
Q

What do we screen for CIN?

A

Pap smear

92
Q

Invasive carcinoma or the cervix is almost always (70%) what?

A

Squamous cell carcinoma (SSC)

93
Q

When is invasive carcinoma of the cervix diagnosed ?

A

Mid 40s

94
Q

Where does invasive carcinomas of the cervix happen?

A

Transformation zone

95
Q

Once invasive carcinomas get bigger than______ there is a higher likely hood of mets

A

Bigger than or equal to 3

96
Q

What is associated with cervical cancer ? (Cause of death)

A

Renal failure (due to local invasion which is most common)

97
Q

What kind of cells do you see in acute endometritis?

A

Neutrophils

98
Q

What kind of cells do you see with chronic endometritis?

A

Plasma cells

99
Q

Endomitritis is most common following what?

A

Pelvic inflammatory disease (from STDS, TB)

100
Q

Endometritis can happen (not common) following ?

A

Retained products (conception, abortion, IUD)

101
Q

Extrauterine endometrial tissue is associated with what?

A

Endometriosis

102
Q

Where does endometriosis develop?

A

Ovaries, peritoneum, pouch of Douglass, uterine lig, Fallopian tubes, does, Hearst, lung

103
Q

What is associated with 50% of all female infertility?

A

Endometriosis

104
Q

A chocolate cyst is associated with what?

A

Endometriosis

105
Q

What is the cause of endometrial hyperplasia ?

A

Increased estrogens

106
Q

What is the most common female genital tract cancer?

A

Endometrial carcinoma?

107
Q

When is someone diagnosed with endometrial carcinoma ?

A

55-65 years old

108
Q

What type of endometrial carcinoma is most common?

A

Endometriod (80%)

109
Q

What type of endometrial carcinoma occurs perimenopausal, causes infertility?>

A

Endometroid

110
Q

What type of endometrial carcinoma is endometrial atrophy, that is aggressive and POST-menopausal ?

A

Serous

111
Q

When are endometrial polyps most common?

A

Menopause

112
Q

What is a benign smooth muscle tumor?

A

Leiomyoma

113
Q

When are leiomyomas found?

A

Reproductive age

114
Q

What is a malignant smooth muscle tumor ?

A

Leiomyosarcoma

115
Q

When do we see leiomyosarcoms?

A

Postmenapause

116
Q

Leiomyosarcoms could possible met to where?

A

Lung (40% 5 year survival rate)

117
Q

What is inflammation of the Fallopian tubes called?

A

Salpingitis

118
Q

Salpingitis can contribute to what?

A

Possible ectopic pregnancy, sterility.

119
Q

What is the most common Fallopian tube carcinoma?

A

Adenocarcinoma

120
Q

Where in the Fallopian tube do we see adenocarcinomas most?

A

Fimbriae

121
Q

Fallopian tube adenocarcinomas are associated with what mutation

A

BRCA1 and BRCA2

122
Q

Ovarian cysts are what size?

A

1-4 cm

123
Q

Ovarian cysts are from what?

A

Graafian or ruptured follicles

124
Q

In polycystic ovarian disease (PCOD), the ovaries enlarge to what side?

A

2x the normal size

125
Q

What hormones are increased for polycystic ovarian disease?

A

Androgens, estrogen, LH. (FSH is decreased)

126
Q

Are ovarian cysts or POCD familial?

A

Both are q

127
Q

Talcum powder can increase you risk of ovarian cancer by what?

A

30%

128
Q

What are risks for tumors of the ovary?

A

Nulliparity, BRCA1/2 gene,

129
Q

Ovarian cancer is the _____mc cancer in us woman and is the _____mc cause of cancer related death?

A

8th, 5th

130
Q

90% of ovarian cancers are what?

A

Surface epithelial tumors

131
Q

What is the most common surface epithelial tumors ?

A

Serous

132
Q

Are most serous epithelial tumors benign or malignant?

A

Benign (60%)

133
Q

What is the most common malignant surface epithelial tumor?

A

Endometrioid

134
Q

What mutation is associated with Serous Surface epithelial tumors?

A

TP53

135
Q

______serous epithelial tumors are found in 30-40 Year olds, _______ are found in 45-65.

A

Benign, malignant

136
Q

What surface epithelial tumor is more likely to be bilateral?

A

Endometrioid

137
Q

Is a cystic or solid surface epithelial tumor have a higher cancer risk?

A

Solid

138
Q

What is cancer of the GI tract that has spread to the ovaries?

A

Krukenberg tumors

139
Q

What cells are associated with a Krukenberg tumor?

A

Signet-ring cells

140
Q

Are most krukenberg tumors unilateral or bilateral ?

A

Bilateral (80%)

141
Q

What is a tumor that Arises from all 3 germ layers?

A

Ovarian teratomas

142
Q

Are most ovarian teratomas being on cancerous ?

A

Benign ( 90% )

143
Q

When are ovarian teratomas most common?

A

In the first two decades

144
Q

What does BEAT stand for for ovarian cancer?

A

Bloated, Difficulty eating, Abdominal pain, Trouble with GI.

145
Q

What placental infection is most common?

A

Ascending

146
Q

Transplacental infections are assoacited with what?

A

Torch (toxoplasmosis, rubella, CMV, HSV, TB syphilis, hiv

147
Q

Where is the most common ectopic pregnancy?

A

Fallopian tube (90%)

148
Q

How common is ectopic pregnancy?

A

1%

149
Q

An acute rupture of an ectopic pregnancy happens when?

A

1st tri

150
Q

What is associated with a rupture of and ectopic pregnancy?

A

Hypovolemic shock

151
Q

What is a benign grape like cystic mass?

A

Hydatidiform mole

152
Q

What is a complete hydatiform mole?

A

2 sperm, no fetal parts, ( risk for invasive mole)

153
Q

What is a partial hydatidifrom mole?

A

1 egg + 2 sperm, early fetal parts

154
Q

And invasive mole is from what?

A

Complete hydatidiform mole

155
Q

Are invasive moles benign?

A

Yes (but locally invasive). If they rupture they’re life threatening

156
Q

What are choriocarcinoma form??

A

Complete mole(50%) or after pregnancy

157
Q

Extreme high hCG is assoacited with what?

A

Choriocarcinoma

158
Q

What is the treatment for choriocarcinoma?

A

Chemotherapy (100% cured)

159
Q

What most commonly when it metastasizes goes to the lung and is called a cannon ball metastasis?

A

Choriocarcinoma

160
Q

What are the 3 things associated with preeclampsia?

A

HTN, proteinuria, edema in the face or periphery

161
Q

When is preeclampsia diagnosed and most common?

A

3rd trimester, 1st pregnancy

162
Q

What is maternal endothelial dysfunction assoacited with ?

A

Preeclampsia ( 5-10% all pregnancy)

163
Q

What is eclampsia?

A

Seizures and coma after preeclampsia

164
Q

HEELP syndrome is assoacited with what?

A

Eclampsia

165
Q

What are symptoms of eclampsia?

A

Elevated BP, maternal end organ failure

166
Q

What are the treatments for Eclampsia ?

A

Delivery >37 weeks, magnesium sulfate

167
Q

What are 3 minor breast abnormalities?

A

Supernumerary nipple, inverted nipple (MC congenital), galactocele

168
Q

When do you see galactocele?

A

Later stages of nursing, self limiting inflammation.

169
Q

Are more break lesions benign or malignant?

A

Benign

170
Q

Is breast cancer commonly painful?

A

Nooooooo

171
Q

What is the number one most common female cancer? Number 2 in deaths?

A

Breast cancer

172
Q

Most breast lumps and caused by what?

A

Fibrocystic changes

173
Q

Fibrocystic changes occur when?

A

Premenopausal (reproductive age)

174
Q

Where do most fibrocystic changes occur?

A

Superolateral quadrant

175
Q

What type of fibrocystic changes are most common?

A

Nonproliferative

176
Q

Proliferative fibrocytic changes are associated with what

A

An additional cellular layer

177
Q

Mild proliferative fibrocytic changes =?

A

Orderly hyperplasia

178
Q

Atypical proliferative fibrocystic changes are a risk factor for what?

A

Breast cancer q

179
Q

What is plasma cell mastitis?

A

Mammary duct ectasia

180
Q

What is assoacited with a non bacterial chronic inflammation of the breast, that is diagnosed around 40-60 and there may be possible nipple retraction?

A

Mammary duct ectasia

181
Q

What is the most common benign breast lesion?

A

Fibroadenoma

182
Q

What breast tumor is asp acted with leaf like projects and rapid rapid growth?

A

Phyllodes tumor

183
Q

How lethal is breast cancer?

A

40k a year die(20%), 200k diagnosed

184
Q

What is the lifetime risk for breast cancer?

A

1:8

185
Q

Most breast cancer happens after what age?

A

50

186
Q

In what area do most breast cancers occur on the body?

A

Superolateral (4% bilateral)

187
Q

What breast lesion is rarely palpable, calcific, with mixed cells and has a great prognosis (97%) ?

A

Ducati carcinoma in Situ

188
Q

What breast lesion has uniform cells, mucin vacuoles, rarely calcific. ?>

A

Lobular carcinoma in situ

189
Q

What breast lesion adheres to pectorals, dimples the skin, nipple inversion?

A

Invasive carcinoma

190
Q

Is DCIS or LCIS more likely to be bilateral?

A

LCIS (DCIS unilateral)

191
Q

What invasive breast cancer makes up the majority (70-80%) of all breast cancer?

A

Invasive ducal carcinoma

192
Q

What invasive breast cancer has aggressive growth, occult, and may met to CSF ?

A

Invasive lobular carcinoma

193
Q

Medullary carcinoma is assoacited with what gene?

A

BRCA1

194
Q

What invasive breast cancer is “triple negative:

A

Medullary carcinoma

195
Q

Is invasive breast cancer mobile or fixed?

A

Mobile

196
Q

If invasive breast cancer is lateral and central (MC) met via what?

A

Axillary nodes

197
Q

If the invasive breast cancer is more medial it will met via what?

A

Internal mammary arteries

198
Q

What is gene amplification that has to do with breast cancer?

A

HER2/neu

199
Q

What receptors if both present get the best response (80%)

A

Estrogen (ER+) and progesterone (PR+)

200
Q

Is gynecomastia unilateral or bilateral?

A

Bilateral

201
Q

Gynecomastia is normally due to what what?

A

Ducati hyperplasia

202
Q

Carcinoma is the male breast rapidly invades what?

A

The thorax (50% mets)

203
Q

A button like appearance of the areola is associated with what?

A

Gynecomastia

204
Q

What are things that give breast cancer a poor prognosis?

A

Anaplaia, increased size, invasion, distant mets.

205
Q

What are some things that give breast cancer a better prognosis ?

A

Estrogen/progesterone receptors

System P 2 (6 decks)

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