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Exam 10 Flashcards

1
Q

Unilateral, painful cystic lesion at lower vestibule region.

A

Bartholin Cyst

-Women of reproductive age

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2
Q

Warty neoplasm of of vulvar skin.

A

Condyloma (acuminatum)

–Due to LR HPV (6, 11)

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3
Q

Leukoplakia with “parchment-like” vulvar skin.

A

Lichen Sclerosis

  • -Thinning of epidermis and sclerosis of dermis
  • -Slight increased risk of SCC
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4
Q

Leukoplakia with “thick, leathery” vulvar skin.

A

Lichen Simplex Chronicus

  • -Hyperplasia of vulvar squamous epithelium
  • -NO increased risk of SCC
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5
Q

Carcinoma arising from squamous epithelium lining the vulva.

A

Vulvar Carcinoma

  • -Presents as leukoplakia
  • -Two major etiologies:
    1. HR HPV (16, 18)-women of reproductive age; arises from vulvar intraepithelial neoplasia (VIN)
    2. Non-HPV related-elderly women; due chronic lichen sclerosis
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6
Q

Erythematous, pruritic, ulcerated vulvar skin.

A

Extramammary Paget Disease

  • -Malignant epithelial cells in the epidermis of the vulva
  • -NO association with an underlying carcinoma
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7
Q

Seen in females who were exposed to diethylstilbestrol (DES) in utero.

A

Adenosis

–Focal persistence of columnar epithelium in upper vagina

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8
Q

Rare complication of DES-associated vaginal adenosis.

A

Clear Cell Adenocarcinoma

–Malignant proliferation of glands with clear cytoplasm

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9
Q

Presents as bleeding and a “grape-like” mass protruding from the vagina.

A

Embryonal Rhabdomyosarcoma (Sarcoma Botryoides)

  • -Malignant mesenchymal proliferation of immature skeletal muscle
  • -Children (usually < 5 y/o)
  • -Rhabdomyoblast (characteristic cell)
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10
Q

Carcinoma arising from squamous epithelium lining the vaginal mucosa.

A

Vaginal Carcinoma

  • -Related to HR HPV (16, 18)
  • -Precursor lesion is Vaginal Intraepithelial Neoplasia (VAIN)
  • -Lymph node spread:
    1. Lower 1/3 of vagina: inguinal nodes
    2. Upper 2/3: regional iliac nodes
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11
Q

Infection most often involving the endocervix.

A

Cervicitis

  • -Often asymptomatic
  • -May manifest with cervical discharge
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12
Q

Infection is usually eradicated by acute inflammation.

A

HPV

  • -HR HPV produce E6 and E7 proteins, which result in increased destruction of p53 and Rb, respectively
  • -Persistent infection leads to increased risk of Cervical Intraepithelial Neoplasia (CIN)
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13
Q

Invasive carcinoma that arises from the cervical epithelium.

A

Cervical Carcinoma

  • -Middle-aged females (50-60 y/o)
  • -Vaginal bleeding, postcoital bleeding, cervical discharge
  • -Associated with HR HPV
  • -Common subtypes are SCC (80%) and Adenocarcinoma (15%)
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14
Q

Lack of ovulation.

A

Anovulatory Cycle

  • -Estrogen-driven proliferative phase w/o progesterone-driven secretory phase
  • -Dysfunctional uterine bleeding during menarche or menopause
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15
Q

Bacterial infection presenting with fever, abnormal uterine bleeding, and pelvic pain.

A

Acute Endometritis

–Usually due to retained products of conception

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16
Q

Chronic inflammation presenting with abnormal uterine bleeding, pain, and infertility.

A

Chronic Endometritis

–Characterized by plasma cells (and lymphocytes)

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17
Q

Hyperplastic protrusion of endometrium.

A

Endometrial Polyps

  • -Presents as abnormal uterine bleeding
  • -Can arise as a side effect of tamoxifen
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18
Q

Endometrial glands and stroma outside of the uterine endometrial lining.

A

Endometriosis

  • -Presents as dysmenorrhea and pelvic pain
  • -“Chocolate cysts” seen with ovary involvement (most common site)
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19
Q

Endometriosis involving the uterine myometrium.

A

Adenomyosis

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20
Q

Hyperplasia of endometrial glands relative to stroma.

A

Endometrial Hyperplasia

  • -Due to unopposed estrogen
  • -Classically presents as postmenopausal uterine bleeding
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21
Q

Malignant proliferation of endometrial glands.

A

Endometrial Carcinoma

  • -Most common invasive carcinoma of female genital tract
  • -Two distinct pathways:
    1. Hyperplasia-75%; 60 y/o; endometroid; associated with PTEN mutation
    2. Sporadic-25%; 70 y/o; seropapillary structure; associated with p53 mutation
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22
Q

Benign neoplastic proliferation of smooth muscle arising from the myometrium.

A

Leiomyoma

  • -Most common tumor in females
  • -Related to estrogen exposure
  • -Premenopausal women, multiple, enlarges during pregnancy, shrinks after menopause
  • -Well-defined, white, whorled masses
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23
Q

Malignant proliferation of smooth muscle arising from the myometrium.

A

Leiomyosarcoma

  • -Arises DE NOVO
  • -Postmenopausal women
  • -Necrosis, mitotic activity, cellular atypia
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24
Q

Classically presents as a young obese woman with infertility, oligomenorrhea, and hirsutism.

A

Polycystic Ovarian Disease

  • -Characterized by increased LH and decreased FSH
  • -Increased risk of endometrial carcinoma
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25
Q

Most common type of ovarian tumor.

A

Surface Epithelial Tumors

  • -CA-125 is useful serum marker
    1. Serous tumors
    2. Mucinous tumors
    3. Endometroid tumors
    4. Brenner tumors
26
Q

Benign cystic surface epithelial tumor.

A

Cystadenoma

  • -Single cysts with a simple, flat lining
  • -Premenopausal women (30-40 y/o)
27
Q

Malignant cystic surface epithelial tumor.

A

Cystadenocarcinoma

  • -Complex cysts with thick, shaggy lining
  • -Postmenopausal women (60-70 y/o)
28
Q

Malignant surface epithelial tumor composed of endometrial-like glands.

A

Endometroid tumor

  • -May arise from endometriosis
  • -15% associated with an independent endometrial carcinoma
29
Q

Benign surface epithelial tumor composed of bladder-like epithelium.

A

Brenner tumor

30
Q

Second most common type of ovarian tumor usually occurring in women of reproductive age.

A

Germ Cell Tumors

31
Q

Most common germ cell tumor in females.

A

Cystic Teratoma

  • -Benign
  • -Composed of fetal tissue from two or three embryologic layers
32
Q

Teratoma composed primarily of thyroid tissue.

A

Struma Ovarii

–Monodermal type

33
Q

Testicular counterpart is a seminoma.

A

Dysgerminoma

  • -Composed of large cells with clear cytoplasm and central nuclei
  • -Responds to radiotherapy; good prognosis
34
Q

Most common germ cell tumor of children.

A

Endodermal Sinus Tumor

  • -Malignant tumor that mimics the yolk sac
  • -Schiller-Duval bodies (glomerulus-like structures)
  • -Increased AFP
35
Q

Malignant tumor composed of trophoblasts in women.

A

Choriocarcinoma

  • -High Beta-hCG is characteristic
  • -Early hematogenous spread
  • -Poor response to chemotherapy
36
Q

See precocious puberty in children and endometrial hyperplasia with uterine bleeding in postmenopausal women.

A

Granulosa-Theca Cell Tumor

–Call-Exner bodies

37
Q

See Reinke crystals.

A

Sertoli-Leydig Cell Tumor

–Associated with hirsutism and virilization

38
Q

Benign sex cord-stromal tumor of fibroblasts.

A

Fibroma

–Meigs Syndrome: when associated with pleural effusions and ascites

39
Q

Metastatic mucinous tumor that involves both ovaries.

A

Krukenberg Tumor

  • -Most commonly due to metastatic gastric carcinoma
  • -“Signet-ring” cells
40
Q

Massive amount of mucus in the peritoneum.

A

Pseudomyxoma Peritonei

–Due to mucinous tumor of the appendix

41
Q

Implantation of fertilized ovum at site other than the uterine wall.

A

Ectopic Pregnancy

  • -Most common site is lumen of the fallopian tube
  • -Scarring is major risk factor
42
Q

Implantation of the placenta in the lower uterine segment.

A

Placenta Pervia

–Presents in third-trimester bleeding

43
Q

Separation of placenta from the decidua prior to delivery of the fetus.

A

Placental Abruption

–Presents with third-trimester bleeding and fetal insufficiency

44
Q

Improper implantation of placenta into the myometrium.

A

Placenta Accreta

–Presents with difficult delivery and postpartum bleeding

45
Q

Pregnancy-induced hypertension, proteinuria, and edema.

A

Preeclampsia

–Eclampsia: preeclampsia with seizures

46
Q

HELLP

A
  • -Preeclampsia with thrombotic microangiopathy involving the liver
  • -Hemolysis, Elevated Liver enzymes, Low Platelets
47
Q

Clinically presents in second-trimester with passage of grape-like masses.

A

Hydatidiform Mole

  • -Abnormal conception characterized by swollen and edematous villi with proliferation of trophoblasts
  • -Uterus is much larger than normal
  • -Beta-hCG much higher than normal
  • -“Snowstorm” appearance on ultrasound
48
Q

Partial verus Complete Mole

A 
Partial:
--Normal ovum, XXY69
--Fetal tissue present
--Some villi, focal proliferation, minimal risk of choriocarcinoma
Complete:
--Empty ovum, XX46
--Fetal tissue absent
--Most villi, diffuse proliferation, 2-3% risk of choriocarcinoma
49
Q

Opening of urethra on the inferior surface of penis.

A

Hypospadias

50
Q

Opening of urethra on the superior surface of penis.

A

Epispadias

51
Q

Most common testicular tumor.

A

Seminoma

–Malignant tumor of large cells with clear cytoplasm and central nuclei

52
Q

Benign germ cell tumor in females but malignant in males.

53
Q

Causes precocious puberty in male children and gynecomastia in male adults.

A

Leydig Cell Tumor

–Reinke crystals

54
Q

Prostate is tender and boggy and patient presents with dysuria, fever, and chills.

A

Acute Prostatitis

55
Q

Associated with dihydrotestosterone (DHT).

A

Benign Prostatic Hyperplasia

  • -Present in most men by 60 y/o
  • -Problems starting/stopping, impaired emptying, dribbling
56
Q

Most common cancer in men.

A

Prostate Adenocarcinoma

  • -Often clinically silent
  • -Increased PSA
57
Q

Classically arises in women of late childbearing age and is associated with HLA-DR4.

A

Rheumatoid Arthritis

  • -Hallmark is synovitis leading to pannus
  • -Symmetric involvement of PIPJs (swan-neck deformity)
  • -Rheumatoid factor: IgM autoAb against Fc portion of IgG
58
Q

Characterized by triad of arthritis, urethritis, and conjunctivitis.

A

Reiter’s Syndrome

–Young male adults

59
Q

Bloody nipple discharge in premenopausal women.

A

Intraductal Papilloma

60
Q

See “indian file” pattern on histology.

A

Infiltrating Lobular Carcinoma

61
Q

Presents in adolescence as sudden testicular pain and absent cremasteric reflex.

A

Testicular Torsion

Pathology (3 decks)

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