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Systems Pathology II > Exam 2 > Flashcards

Exam 2 Flashcards

1
Q

MC condition of the vulva

A

Inflammation (vulvitis)

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2
Q

Two general causes of vulvitis

A
  • allergic contact dermatitis

- infection

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3
Q

These infections can cause??

HPV
HSV-2
N. Gonorrhoeae
C. Albicans
Treponema pallidum (Syphylis)
A

Vulvitis

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4
Q

Erythema, oozing/crusting and itching of vulva that may be caused by soaps, lotions, detergents, deoderants and urine

A

Allergic contact dermatitis

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5
Q

Obstruction/dilation of a barthholin gland

A

Bartholin cyst

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6
Q

Infection of a bartholin cyst is now called

A

Bartholin abscess

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7
Q

Characteristics of bartholin cyst

A

Develops quickly (days)

Can be painless or painful

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8
Q

When does a bartholin cyst become a bartholin abscess

A

During infection

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9
Q

What is an epithelial disorder that involves hyperplasia and hyperkeratosis anywhere external outside the vaginal canal (vulva) due to chronic irritation

A

Lichen simplex chronicus

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10
Q

Does lichen simplex chronicus have any CA risk

A

Nope

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11
Q

Does lichen sclerosus have any CA risk

A

Yes - SCC develops in 5%

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12
Q

What autoimmune condition causes atrophy and a smooth, white appearance near minora along with dermal fibrosis and vaginal constriction

A

Lichen sclerosus

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13
Q

Who is most likely to get lichen sclerosus

A

Females aged 8 and 60 (bimodal)

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14
Q

Name for wart like structure

A

Condyloma

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15
Q

What causes condylomata acuminata

A

HPV 6 and 11

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16
Q

What causes condylomata lata

A

Secondary syphilis

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17
Q

Who is most likely to get vulvar carcinoma and what type of CA

A

Women >60 years old

90% squamous cell carcinoma (lymphatic Mets)

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18
Q

What is the pre-cancerous legion associated with HPV 16 and 18 related SCC (vulvar carcinoma)

A

Vulvar intraepithelial neoplasia (VIN)

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19
Q

What HPV infections is HPV related SCC (vulvar carcinoma) associated with

A

16 and 18

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20
Q

Who is most likely to get non-HPV related SCC (vulvar carcinoma)

A

Older women with lichen sclerosus

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21
Q

What is MC?

HPV related SCC or non-HPV related SCC

A

Non HPV related SCC

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22
Q

What are different types of malformation of the vagina

A

Agenesis

Atresia (narrowing)

Septate vagina (double barrel vagina)

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23
Q

Vaginal inflammation

A

Vaginitis

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24
Q

Examples of benign and transient vaginitis

A

Candida albicans

Trichomonas vaginalis

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25
Q

Risk factors for vaginal infections

A

Diabetes
Immunodeficiency
Antibiotics

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26
Q

Symptoms of vaginitis

A

Leukorrhea (white discharge)
Pain
Itching

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27
Q

3 types of vaginal cancer

A

Squamous cell carcinoma

Clear cell adenocarcinoma

Sarcoma botryoides

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28
Q

Vaginal cancer that is rare, but MC in elderly and related to HPV

A

Squamous cell carcinoma

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29
Q

Regarding vaginal squamous cell cancer, what is VAIN

A

Vaginal intraepithelial neoplasia

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30
Q

Which vaginal cancer is associated with the drug, diethylstilbestrol (DES) in 1971

A

Clear cell adenocarcinoma

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31
Q

Which vaginal cancer is rare and has red/granular foci appearance and associated with mothers who took DES drug

A

Clear cell adenocarcinoma

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32
Q

Which vaginal cancer is rare, has soft/polyploid masses and occurs in young girls

A

Sarcoma botryoides

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33
Q

Which type of vaginal cancer is a form of rhabdomyosarcoma

A

Sarcoma botryoides

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34
Q

Inflammation of the cervix

A

Cervicitis

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35
Q

Examples of infectious cervicitis

A 
Chlamydia (MC)
Trichomoniasis
Candidiasis
Gonorrhea
Genital herpes
HPV
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36
Q

Non infectious examples of cervicitis (acute/chronic)

A

Acute = postpartum

Chronic = fluctuating estrogen levels in reproductive aged women

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37
Q

Main risk factor for CA of the cervix

A

HPV exposure!

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38
Q

70% of cervical CAs develop from what type of HPV

A

HPV 16 or 18

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39
Q

4 risks of HPV exposure / cervical CA

A
  • early intercourse
  • multiple sex partners
  • male partner with several past partners
  • high risk HPVs (16 and 18)
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40
Q

What does CIN stand for regarding CA of the cervix and persisting HPV infections

A

Cervical intraepithelial neoplasia

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41
Q

What precancerous lesion is associated with persisting HPV infections

A

Cervical intraepithelial neoplasia (CIN)

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42
Q

What are the characteristics of koilocytosis regarding CIN

A

Anaplasia/dysplasia

Enlarged nuclei

Irregular/wrinkled borders

Darker staining (hyperchromasia)

43
Q

What is precancerous CIN

A

HPV —> dysplasia

44
Q

CIN is MC at age

45
Q

What happens about 15 years after someone gets CIN

A

Cervical CA

~age 45

46
Q

What is the trt plan for CIN I (low grade)

A

Observation

60% regress and 10% progress

47
Q

What is the Tx for CN II and III (high grade)

A

Excision

30% regress and 10% —> CA

48
Q

What is LEEP

A

Loop electro surgical excision procedure

49
Q

Why do women get Pap smears

A

To look for CIN because it is asymptomatic

50
Q

Vaccinations for cervix neoplasia

A

HPV 6, 11, 16, 18

51
Q

Invasive carcinoma of the cervix originates from

A

HPV infection

52
Q

Invasive carcinoma of the cervix usually occurs to women around the age of

53
Q

MC—>LC invasive carcinomas of the cervix

A

SCC !!!! = 75%
Adenocarcinoma = 20%
Carcinoid = 5%

54
Q

What occurs in the transformation zone of cervical cancer

A

Asymptomatic early

Advanced cases = Leukorrhea, bleeding, dysuria, painful sex

55
Q

Mets % criteria for cervical cancer

A

1% Mets if <3mm

10% Mets if >/= 3mm

56
Q

Who is cervical cancer MC in

A

Women who lack screening

57
Q

MC cause of death regarding cervical cancer

A

Invasion leading to renal failure

58
Q

Tx for cervical cancer

A

Hysterectomy and lymph node excision

If a smaller lesion = cone biopsy or LEEP

59
Q

“Barrel cervix” is associated with

A

Invasive cervical cancer

60
Q

Endometritis

A

Endometrial inflammation

61
Q

Symptoms of endometritis

A

Fever, abdominal pain

Menstrual abnormalities

Infertility or ectopic pregnancy

62
Q

Where does endometritis occur

A

Where endometrium should be

Compared to endometriosis that involves endometrium growing in abnormal places

63
Q

PID (pelvic inflammatory disease) is caused by

What is main symptom

A

Gonorrhea, chlamydia, TB

Endometritis

64
Q

Other than PID what else can cause endometritis

A

Retained products

  • contraception
  • abortion
  • IUD

Tx = removal

65
Q

Extrauterine endometrium

A

Endometriosis

66
Q

Consequences of endometriosis

A

Dysmenorrhea
Dysuria
Pelvic pain
Sterility

Painful bowel movements and intercourse

67
Q

Prevalence of endometriosis

A

10% of reproductive aged women

68
Q

What causes half of all female infertility / sterility

A

Endometriosis

69
Q

Endometriosis causes

A

Multiple masses 1-2 cm of extrauterine endometrium

Can lead to bleeding and fibrosis

70
Q

Common sites of endometriosis

A 
Ovaries
Peritoneum
Pouch of Douglas 
Uterine ligaments
Fallopian tubes
71
Q

Rare sites of endometriosis

A

Nodes
Heart
Lungs
Bone

72
Q

What is a “chocolate cyst”

A

Endometriosis related mass on ovary

73
Q

What is menorrhagia

A

Profuse/prolonged menstruation

74
Q

What is metrorrhagia

A

Irregular bleeding between periods (spotting)

75
Q

Potential causes of abnormal uterine bleeding

A

Leiomyomas

Leiomyosarcomas

Endometritis

Endometrial hyperplasia

Endometrial carcinoma

Anovulatory cycle

Dysfunctional uterine bleeding

76
Q

What is anovulatory cycle and what may it cause

When does it occur

A

Inadequate luteal phase

Causing a retained endometrium which is prone to breakdown/bleeding

Occurs at extremes of reproductive life (12-14 ——> 50)

77
Q

What does hyperplasia mean

A

Increased # of cells

78
Q

What is endometrial hyperplasia

A

Overgrowth of endometrial cells

79
Q

Symptoms of endometrial hyperplasia

A

Increased estrogen (obesity, PCOS, HRT)

Failed ovulation

80
Q

What is endometrial hyperplasia a major risk factor for

A

Endometrial CA

3-50% —> carcinoma

Detected via “atypia” serial biopsies

81
Q

MC female genital tract CA

A

Endometrial carcinoma

82
Q

Who does endometrial carcinoma affect

A

Women aged 55-65 (post menopausal)

83
Q

Symptoms of endometrial carcinoma

A

Enlarged uterus

Leukorrhea (abnormal discharge)

Metrorrhagia

84
Q

How doe endometrial carcinoma metastasize

A

Lymphatics

Usually late so good prognosis

85
Q

2 types of endometrial carcinoma

A

Endometrioid (MC)

Serous

86
Q

Characteristics of endometrioid endometrial carcinoma

A

Endometrial hyperplasia
Perimenopausal

Increased estrogens
Diabetes
Lynch syndrome
Infertility 
HTN

MC type!!

87
Q

Characteristics of serous endometrial carcinoma

A 
Endometrial atrophy
(Occurs much later on in life)

TP53 gene mutations

aggressive!

88
Q

Two general categories of proiferative lesions of the uterus

A

Endometrial polyps

Smooth muscle tumors

89
Q

Characteristics of endometrial polyps

A

MC perimenopausal

Abnormal uterine bleeding

Small CA risk

90
Q

Two types of smooth muscle tumors of the uterus

A

Leiomyoma

Leiomyosarcoma

91
Q

Characteristics of leiomyomas

A

AKA uterine fibroids

Benign

Usually have multiple

Effects reproductive aged African American women

Increased estrogens

92
Q

Characteristics of leiomyosarcoma

A

Malignant smooth muscle tumor of the uterus

Usually only have one (solitary)

Effect post menopausal women (why an older woman randomly start bleeding again)

Mets—>lungs (MC)

Commonly recur

93
Q

MC asymptomatic menorrhagia

94
Q

What is salpingitis

A

Inflammation of the Fallopian tubes

95
Q

Symptoms of salpingitis

A

Fever
Abdomen pain
Pelvic mass

96
Q

Salpingitis is a risk for

A

Ectopic pregnancy or sterility

97
Q

Microbial causes for salpingitis

A

Chlamydia
Gonorrhea
Strep
Staph

PID or sepsis

98
Q

Characteristics of Fallopian tube carcinoma

A

Adenocarcinoma

MC on fimbriae

99
Q

What genes are associated with Fallopian tube carcinoma

A

TP53
BRCA1
BRCA2

100
Q

If Fallopian tube carcinoma is Dx late where does it commonly invade

A

Peritoneal cavity

101
Q

2 types of ovarian cysts

A

Follicular cysts

Luteal cysts

102
Q

What are ovarian cysts

A

Serous filled cysts 1-4 cm

103
Q

What causes ovarian cysts

A

Graafian or ruptured follicles

May be normal if they are small

104
Q

Symptoms of ovarian cysts

A

Increased size = increased complications

Bleeding
Pelvic mass
Pain
Acute abdomen

Systems Pathology II (2 decks)

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