CIS Flashcards
24 year old F. Vesicles bilaterally on labia majora. A few around urethral meatus. Mild inguinal adenoapthy present. Most likely?
HSV
Pap smear: numerous neuts with rare, multinucleated keratinocytes with”glassy” cytoplasm, no evidence of cerival intraepithelial neoplasia.
HSV
Not vesicular or ulcerative, but umbilicated.
Molluscum contagiosum
Five infecitons that present with ulcer
HSV, syphilis, chancroid, granuloma inguinale, LGV
Two infections that present with urethritis or cervitisis
gonorrhea, chlamydia
- gummas, saddle node, deformity, saber skin
- plasma cell infiltrates and endarteritis
- Steiner silver stain used to id plasma cells.
Syphilis
- *Vertical transmission during delivery (neonatal transmission = MORTALITY), possible latency in nerves later on.
- blindness, encephalitis
- increases HIV transmission
HSV
1) Multinucleation due to cell fusion and
2) viral replication has pushed chromatin to periphery
HSV
2=cowdry A
26 year old with dyspareunia for 2mo. 2cm swollen, tender mass on posterolateral-left labia. Culture positive for N. gonococus.
- What labial structure is involved?
- What potential complication if left untx?
Bartholin gland.
Complication - tuboovarian abscess.
HPV assoc with..
cervical dysplasia
DES assoc with…
Vaginal adenosis
Lichen sclerosis assoc with….
vaginal agglutination
Gonococcus and Chlamydia assoc with…
PID
yellow frothy discharge - most likely organism
Trichomonas Vaginalis
Strawberry cervix
stillbirth
listeria
Dyspareunia, red, crusted, maplike area on labia bilaterally. intraepithelial malignancy
extramammary paget disease
Dyspareunia, vulvar epidermis is thin, resembles “parchment”
lichen sclerosis
Slighty raised white lesions b/l on vulva. Biopsy: epidermal thickening with loss of maturation, increased mitosis and nuclear atypia, and surface koilocytes.
Classic type vulvar intraepithelial neoplasia (VIN)
**Koilocyte = what organism
HPV (classic VIN, condyloma (Low grade 6,11),
CIN (high grade))
dt E5
intraepithelial Ca, PAS, cytokeratin 7 - assoc with…
extramammary paget dz
differentiated VIN/TP53 - assoc with…
lichen sclerosis
sharply circumscribed nodule on the vulva. commonly of labia majora. ulcerative. B9 glandular “breast like” lesion - assoc with…
papillary hidradenoma
histo identical to intraductal papilloma of the breast
- Hyperkeratosis
- Thin epidermis
- Basal cell layer degeneration
- Sclerosis of superficial dermis
- Band like lymphocytic infiltrate in underlying dermis
Pathog histologic features of lichen sclerosis
Numerous squamous cells with nuclear enlargement, hyperchromasia, and “halos”, course chromatin granules
HPV
CIN1-4 - what is moderate v. moderate v. severe dyspasia? LSIL v. HSIL?
CIN1 = LSIL (mild dysplasia)
CIN2-4 = HSIL
all high grade HPV
Cervical biopsy: atypical cells in lower 1/3rd and koilocytes in upper 2/3
LSIL (CIN1)