Clinical Integration VIII Flashcards
75% of prostatic cancers are associated with elevated..?
serum PSA (prostate specific antigen)
What is PSA?
organ specific
not malignancy specfic
With what conditions is PSA high?
BPH prostatitis infarction following ejaculation DRE exercise biopsy
what measures should be used to diagnose prostate cancer?
DRE
PSA
biopsy
what is the problems with the cancerous lesions in the prostate gland?
they are not close to urethra (unlike the BPH), so you don’t get symptoms for a while…
what site is most BPH originate?
mucosal glands
submucosal glands
closer to urethra
where is most prostatic cancer found?
in the main prostate glands
far away from urethra
what happens to the columnar cells of the endocervix?
they undergo metaplastic changes to become more resilient cells of the ectocervix
what can happen to the endocervix metaplsia under persistent stress?
dysplasia and lead to cancer - HPV
what type of neoplasm is HPV?
cervical intraepithelial neoplasm (CIN)
what does HPV infect?
immature basal cells of squamous epithelium
or
metaplastic squamous cells at the squamocolumnar junction
HPV cannot infect mature cells!
characteristics of CIN?
asymptomatic
if dysplasia continues -> squamous cell carcinoma - because cancer is within epithelium
what are risk factors for cervical cancer?
- number of lifetime partners
- young age - age 20-24 ish
- tobacco use - increase risk by 2x
- BC pill more than 5 yrs.
- weak immune system
what are chaacteristics of leiomyoma/fibroid
well circumscribed’
does not infiltrate surrounding tissue
histology looks normal
where are leiomyomas usually found?
uterine myometrium
how are leiomyomas classified?
- subserosa - under serosa
- intramural - within myometrium
- subserosal - under endometrium
what are symptoms of leiomyomas?
- menorrhagia
- metorrhagia
- infertility
what are characteristics of proliferative epithelium?
highly cellular
straight glands
what are characteristics of secretory epithelium
coiled glands
glycogen stores
spiral arteries
progesterone
what is endometriosis
occurence of endometrial tissue other than the lining of the uterine cavity
what are some extra uterine locations for endometriosis?
ovary fallopian tubes parametrium gut serosa umbilicus pouch of Douglas
what are some morphological structures of endometriosis?
endometrial glands
endometrial stroma
hemosiderin pigment
what are clinical features of endometriosis?
dysmenorrhea
pelvic pain
dysparenunia
infertility
what is polycycstic ovarian symdrome?
- stein levanthal Syndrome
- hormonal imblanace (LH:FSH 2:1)
- affects women of repro age
what are clinical symptoms of POS?
oligomenorrhea - infreq. menstration anovulation obesity hirsutism - male pattern of body hair virilism - male secondary sex characteristics dev.
how do ovaries appear with POs?
- extremely large
- thick capsule with many unruptures follicles cysts which are lined by granulosa cells and hypertrophied theca intera cells
- stroma is thick and hypertrophies
- no corpus luteum
Thick tunica albuginea
- follicles arrested in different stages fo development
- cysts may contain clear gelatinous or serosangineous fluid
what is breast cancer due to?
family history
-mutation in BRCA1, BRCA 2, P53
describe the mammary glands?
modified sweat glands
15-25 lobes -compound tubuloalveolar glands
glandular elements - arranged in a radial fashion around the nipple into which ducts from secretory unit empty
-apocrine + merocrine gland!
what is breast cancer in postmenopausal women due to?
estrogen
where does the main souce of estogen come from?
aromatization of adrenal-produced androgen
