dx

Question 1

ectopic preg

Answer 1

• hCG titers: Possible miscarriage or ectopic if bHCG incrase less than 35% in first 2 days
• Pelvic sonography (look for donut sign).
• Endometrial biopsy: decidua w/o chorionic villi or implantation site.
• Laparoscopy.

Question 2

Leiomyosarcoma

Answer 2

 10 mitoses /HPF.

 5 mitoses /HPF + nuclear atypia or large cells.

Question 3

Trichomonas vaginalis

Answer 3

Motile trophozoites in methylene blue wet mount, present with corkscrew motility.

Question 4

HSV

Answer 4

clinically, but can use tzank smear

Question 5

partial or early complete mole

Answer 5

abn villous findings on US (snowstorm pattern on US)

Question 6

SIL of cervix

Answer 6

Ki-67

Question 7

-Type 2 endometrial serous carcinoma

Answer 7

hist exam of tissue from biopsy or curettage

Question 8

complete mole

Answer 8

HCG rate of rise is markedly increased and rises more than in normal single or multiple pregnancies.

Question 9

Gardnerella vaginalis

Answer 9

• Pap smear: superficial, intermediate squamous cells covered by a shaggy coating of coccobacilli (clue cells).
• Whiff test: there is a fishy amine odor when KOH is added to it.

Question 10

endometriosis

Answer 10

 Diagnosis via presence of endometrial glands + stroma.
 +/- hemosiderin.
 May be obscured by secondary fibrosis.
 Rarely only stroma is identified.

Question 11

tuberculous salpingitis

Answer 11

“red snappers” on stain

Question 12

gonococcal PID

Answer 12

primary infection not visible on GS; dx the R/DNA

Question 13

granulosa cell tumor in ovary

Answer 13

increased serum inhibin

Question 14

yolk sac tumor

Answer 14

stained for hyaline droplets

-bc secrete aFP

Question 15

extramammary paget dis

Answer 15

cytokeratin 7
PAS
Alcian blu
mucicarmine strains

Question 16

hemolysis in HELLP synd

Answer 16

needs 2:
o Abn peripheral smear (schisocytes, burr cells)
o Elevated serum bilirubin
o Low serum haptoglobin
o Significant drop in hb leverl, unrelated to blood loss

Question 17

invasive mole

Answer 17

persistently increased HCG

Question 18

candida

Answer 18

Pseudospores or filamentous fungal hyphae in wet KOH mounts of discharge or on Pap smear