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Kaplan High yield: Reproductive > Diseases of Vulva, vagina, cervix/fallapian tubes, uterus > Flashcards

Diseases of Vulva, vagina, cervix/fallapian tubes, uterus Flashcards

1
Q

Etiology of condyloma acuminatum

A

HPV 6 and 11 associated;

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2
Q

condyloma acuminatum increases risk of what?

A

cervical CA

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3
Q

where is condyloma acuminatum distributed

A

vulva; perineum; vagina; cervix

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4
Q

Give gross and micro description of condyloma acuminatum

A

gross=> verrucous, wartlike lesions

micro=>koilocytosis, acanthosis, hyperkeratosis; parakeratosis

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5
Q

Give gross description of papillary hidradenoma

A

gross: benign tumor similar to intraductal papilloma of breast

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6
Q

distribution of papillary hidradenoma

A

occurs along milk line

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7
Q

Give gross and micro description of extramammary Paget disease of vulva

A

gross: erythematous, crusted rash
micro: intraepidermal malignant cells w/ pagetoid spread

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8
Q

distribution of extramammary Paget disease of vulva

A

labia majora

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9
Q

T/F extramammary Paget disease of vulva is always assoc w/ underlying tumor

A

FALSE => not associated w/ underlying tumor

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10
Q

Gross description of Candida vulvovaginitis

A

erythema, thick white discharge

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11
Q

distribution of Candida vulvovaginitis

A

vulva and vagina

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12
Q

Candida vulvovaginitis etiology

A

extremely common => especially in diabetics and after antibiotic use

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13
Q

Define vaginal adenosis

A

benign condition thought to be precursor of clear cell carcinoma

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14
Q

What increases risk for clear cell adenocarcinoma of vagina?

A

females exposed to deithylstilbestrol (DES) in utero during the 1940-1970s

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15
Q

What ages are associated with highest risk of clear cell adenocarcinoma of vagina?

A

40-70 years old

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16
Q

Define embryonal rhabdomyosarcoma

A

rare, grapelike soft tissue tumor affecting female infants and children <4

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17
Q

describe micro picture of embryonal rhabdomyosarcoma

A

polyploid;

spindle cell tumor showing cross striations

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18
Q

How can you prove the origin of the embryonal rhabdomyosarcoma?

A

positive for desmin => skeletal muscle origin

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19
Q

How would a patient with pelvic inflammatory disease present?

A

vaginal discharge/bleeding;
midline abdominal pain to bilateral lower abdominal/pelvic pain;
abdominal tenderness; peritoneal signs;
fever

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20
Q

Define pelvic inflammatory disease

A

ascending infection from cervix to endometrium, fallopian tubes and pelvic cavity

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21
Q

What are the 2 common etiologies of pelvic inflammatory disease?

A

Neisseria gonorrhoeae (gram neg diplococcus);

Chlamydia trachomatis (intracytoplasmic inclusion in mucosal cells)

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22
Q

What are the disease manifestations of pelvic inflammatory disease?

A

cervicitis; endometritis; salpingitis; peritonitis; PELVIC ABSCESS ; chandelier sign
perihepatitis (Fitz-Hugh-Curtis syndrome)

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23
Q

complication assoc w/ pelvic inflammatory disease

A

tubo-ovarian abscess; tubal scarring; infertility; ectopic pregnancy; intestinal obstruction

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24
Q

What is the 3rd most common malignant tumor of genital tract in US? when does it peak in incidence?

A

cervical carcinoma => peak in 40s

25
Q

Etiologies of cervical carcinoma

A

assoc w/ early 1st intercourse, multiple partners;
HPV 16, 18, 31, 33;
smoking and immunosuppression

26
Q

Describe how cervical carcinoma progesses

A

1) cervical intraepithelial neoplasia
2) carcinoma in situ
3) invasive squamous cell cancer

27
Q

How will a patient with cervical carcinoma present?

A

may be asymptomatic or may have postcoital bleeding, dyspareunia, discharge

28
Q

How might cervical carcinoma be detected early?

A

Pap smear => koilocytic cells

29
Q

Define endometritis

A

ascending infection from cervix

30
Q

Where is endometritis located?

A

endometrium and decidua

31
Q

What different pathologies can cause endometritis?

A

ureplasma, peptostreptococcus; Gardnerella; Bacteroides; Group B strept; Chlamydia trachomatis; Actinomyces

32
Q

If endometritis is caused by actinomyces, what will be present on IUD?

A

yellow granular filaments

33
Q

What are the 2 associations with endometritis?

A

associated w/ pregnancy or abortions (acute);

chronic PID (pelvic inflam disease) and IUD

34
Q

Etiology of endometriosis

A

presence of endometrial glands and stroma outside uterus;

women of reproductive age

35
Q

Location for endometriosis

A

ovary; ovarian and uterine ligaments;
Pouch of Douglas;
Serosa of bowel and bladder;
Peritoneal cavity

36
Q

How does endometriosis present grossly? include buzzwords

A

red brown serosal nodules => “powder burns”

37
Q

What are 2 types of endometriosis?

A

endometrioma;

adenomyosis

38
Q

Define endometrioma and buzz words

A

ovarian “chocolate” cyst

39
Q

Define adenomyosis

A

endometrial glands in myometrium

40
Q

How will a patient with endometriosis present?

A

chronic pelvic pain linked to menses
dysmenorrhea, dyspareunia;
rectal pain and constipation;
infertility

41
Q

Define Leiomyoma

A

benign smooth muscle tumor that grows in response to estrogen

42
Q

Define malignant form of leiomyoma

A

leiomyosarcoma => smooth muscle sarcoma of uterus

43
Q

Who has the highest incidence of leiomyoma?

A

African americans

44
Q

Where can a leiomyoma be located?

A

subserosal, intramural or submucosal locations in myometrium

45
Q

What does a leiomyoma look like?

A

well circumscribed;
rubbery, white tan ‘whorled’ masses

generally multiple

46
Q

How will a patient with leiomyoma present?

A

menorrhagia;
abdominal mass;
pelvic pain, back pain, suprapubic discomfort;
infertility

47
Q

Where is leiomyosarcoma located?

A

myometrium

48
Q

Gross pathology for leiomyosarcoma

A

bulky tumor w/ necrosis and hemorrhage

49
Q

micro pathology for leiomyosarcoma

A

malignant smooth muscle cells=> nuclear pleomorphism an dincreased mitotic rate

50
Q

Who is at highest likelihood to get a leiomyosarcoma?

A

increased incidence in blacks

51
Q

What are characteristics of leiomyosarcoma?

A

aggressive tumor that tends to recur;

may present w/ cervical bleeding

52
Q

most common malignant tumor of female genital tract

A

endometrial adenocarcinoma

53
Q

highest risk for endometrial adenocarcinoma

A

postmenopausal women

54
Q

location for endometrial adenocarcinoma

A

begins in endometrium and may invade myometrium

55
Q

gross pathology for endometrial adenocarcinoma

A

tan polyploid endometrial mass;

INVASION of myometrium is diagnostically important

56
Q

micro pathology for endometrial adenocarcinoma

A

endometrioid adenocarcinoma (most common)

57
Q

How will a patient present with endometrial adenocarcinoma?

A

postmenopausal vaginal bleeding

58
Q

What are the Risk factors for endometrial adenocarcinoma?

A 
EARLY MENARCHE / LATE MENOPAUSE;
NULLIPARITY;
HTN and diabetes;
obesity; 
CHRONIC ANOVULATION
ESTROGEN PRODUCING OVARIAN TUMORS;
ERT; 
TAMOXIFEN;
endometrial hyperplasia;
Lynch syndrome (colon, endometrial and ovarian cancers =HNPCC)

Kaplan High yield: Reproductive (18 decks)

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