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GM System Path 2 > Exam 2 - Female > Flashcards

Exam 2 - Female Flashcards

1
Q

When is breast cancer common and uncommon

A

Uncommon <40, MC when >50

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2
Q

What are some of the causes of breast cancer

A

Hormonal, genetic, environmental

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3
Q

Who is most likely to get breast cancer

A

> 50, white, family Hx, geography

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4
Q

Why would someone <30 have breast cancer

A

Nulliparous or chest irradiation

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5
Q

What are hormonal, and genetic risks for breast cancer

A

Increased estrogen, BRCA1/2, benign lesion

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6
Q

When breast cancer penetrates the BM what is it called

A

Invasive, infiltrating

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7
Q

When breast cancer does not invade the BM what is it called

A

In situ

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8
Q

Where is breast cancer most commonly located

A

In superolateral quadrant

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9
Q

What form of breast cancer is characterized by small “mixed” cells with necrosis and calcification

A

Ductal carcinoma in situ (DCIS)

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10
Q

If left untreated what would happen to a patient with DCIS

A

1/3 turn into invasive CA

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11
Q

If a female that was diagnosed with DCIS (underlying cancer) comes in showing manifests on skin near the areola that looks like eczema what is the disease

A

Paget disease of the nipple

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12
Q

A women comes in with a form of breast cancer with uniform cells, mucin vacuoles, and you incidentally diagnosed that left untreated would turn into CA on both breasts

A

Lobular carcinoma in situ

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13
Q

Patient comes in with breast cancer that has invaded and adhered to the pectorals what is it

A

Invasive (infiltrating) carcinoma

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14
Q

What type of breast cancer has possible lymphedema and lymphatic mets that shows as dimpling of skin and nipple inversion after it invaded/adheres to the pectorals

A

Invasive/infiltrating carcinoma

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15
Q

What type of breast cancer extends from DCIS making up 75% of all breast CA with heterogenous cells, irregular borders that also has firm/ fibrotic and palpable lumps

A

Invasive ductal carcinoma

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16
Q

What breast CA is from LCIS that has multiple masses that are palpable and when aggressivecan mets to GI, ovary, uterus, CSF, marrow

A

Invasive lobular carcinoma

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17
Q

What type of breast cancers lack 3 main receptors (ER,PR,HER2) and are linked to mutations on BRCA1/2

A

Triple negative breast Ca’s

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18
Q

What type of pathology report deals with estrogen receptors and progesterone receptors where if both + indicates 80%. Response

A

Hormone receptors

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19
Q

HER2 breast cancer pathology report indicates from what and is 30% of all breast Ca’s

A

Gene amplification

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20
Q

What breast cancer has solitary painless mass detected during palpation

A

Invasive breast cancer

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21
Q

Where is invasive breast cancer usually mets to

A

Lymphatic

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22
Q

What does the location of invasive breast cancer more lateral/central indicate

A

Route through axillary nodes

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23
Q

What does the location of invasive breast cancer more medial

A

Internal mammary arteries

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24
Q

What brings on poorer prognosis of invasive breast cancer

A

Anaplasia, increase in size, invasion or distant mets, overexpression of HER2/neu

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25
Q

What brings about better prognosis of invasive breast cancer

A

Estrogen receptors, and progesterone receptors

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26
Q

Patient comes in with enlarged male breast tissue that is non cancerous, you notice increased estrogen and going through puberty

A

Gynecomastia

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27
Q

Who is most likely to get male breast cancer

A

Mc in elderly

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28
Q

Where is male breast cancer likely to go to

A

Rapidly invades thorax, 50% mets at dx

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29
Q

Patient comes in with bilateral button like subareolar swelling what is it

A

Gynecomastia

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30
Q

Patiet has increase connective tissue, ductal hyperplasia, and is not lobule

A

Gynecomastia

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31
Q

What type of vulvitis produces erythema, oozing/crust, itching commonly caused form soaps, lotions and other things

A

Allergic contact dermatitis vulvitis

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32
Q

What type of vulvitis is caused by HPV/HSV, trep pallidum, gonorrheae, c albicans

A

Infectious vulvitis

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33
Q

Patient comes in and is dx with an obstruction/dilation of a bartholin gland what is the condition

A

Bartholin cyst

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34
Q

What is a co-infecx with a barhtolin cyst

A

Bartholin abscess

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35
Q

What condition is produced from hyperplasia/hyperkeratosis of epithelium due to chronic irritation

A

Lichen simplex chronicus

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36
Q

What epithelial disorder is from atrophy due to an AI whitening near the minora

A

Lichen sclerosus

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37
Q

Patient age 8 and patient age 60 comes in with dermal fibrosis around the minora what do you suspect is the cause

A

Lichen sclerosus

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38
Q

What type of CA is produced from lichen sclerosus

A

5% SCC

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39
Q

What do lichen simplex chronicus and lichen sclerosus resemble

A

Leukoplakia

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40
Q

What type of condyloma is a causitive of secondary syphilis

A

Condylomata lata

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41
Q

What type of condyloma is caused by HPV 6/11 (genital warts)

A

Condylomata acuminata

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42
Q

What type of neoplasia usually impacts >60 years, 90% SCC and has late lymph mets

A

Vulvar carcinoma

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43
Q

What hpv-related SCC deals with precancerous lesion of the vulva

A

Vulvar intraepithelial neoplasia

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44
Q

What type of vulvar carcinoma is the mc type and impacts older women with symptoms of lichen sclerosus (no VIN)

A

Non-HPV related SCC

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45
Q

What is the cause usually for vaginitis

A

Infections = fungi, protozoan (C.albicans, trichomonas)

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46
Q

What are risks of vaginitis

A

Diabetes,immunodeficiency, antibiotics

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47
Q

What of the vagina is benign/transient and has leukorrhea, pain, itching

A

Vaginitis

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48
Q

What type of vaginal cancer is rare, but mc in the elderly

A

Squamos cell carcinoma

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49
Q

What vaginal cancer is a pre-cancerous vaginal intraepithleial neoplasia

A

Squamos cell carcinoma

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50
Q

What are the risks of squamos cell carcinoma vaginal cancer

A

HPV, early intercourse, multiple partners

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51
Q

What type of vaginal cacer has symptoms of rare red/granular foci

A

Clear cell adenocarcinoma

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52
Q

What vaginal cancer is a 40x risk from mothers who took DES

A

Clear cell carcinoma

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53
Q

What type of vaginal cancer is rare but is characterized by embryonal rhabdomyosarcoma

A

Sarcoma botryoides

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54
Q

What type of vaginal cancer is mc <5 years, soft/polypoid mass

A

Sarcoma botryoides

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55
Q

What skeletal muscle tumor usually affects the head and neck and is mc pediatric soft tissue sarcoma

A

Rhabdomyosarcoma

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56
Q

Is cervicitis benign or malignant

A

Benign

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57
Q

What prompts a pelvic exam due to leukorrhea, pain, itching, bleeding, fever

A

Cervicitis

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58
Q

What is the mc cause of cervicitis

A

Infectious = chlamydia

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59
Q

What are the 2 types of non infectious cervicitis

A

Acute and chronic

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60
Q

Chronic cervicitis is common in who

A

Reproductive age women due to estrogen fluctuations or trauma

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61
Q

What type of cervicitis deals with postpartum

A

Non infectious acute cervicitis

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62
Q

Most cases of cancer in the cervix are from what

A

HPV 16 - 18

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63
Q

Most hpv infections last months and if they persist they can become what

A

Cervical intraepithelial neoplasia

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64
Q

What cervical neoplasia has columnar cells undergoing squamos metaplasia

A

Puberty = eversion

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65
Q

What darker stain indicates cervical intraepithelial neoplasia

A

Koilocytosis

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66
Q

What neoplasia of the cervix starts as HPV producing dysplasia and eventually precancerous

A

Cervical intraepithelial neoplasia

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67
Q

When is CIN most commonly diagnosed

A

Age 30 and peaks 15 years later

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68
Q

What CIN needs observation

A

Low grade CIN 1

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69
Q

What CIN needs excision

A

CIN 2/3

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70
Q

Why do we do screenings for CIN

A

It is asymptomatic

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71
Q

What neoplasia is dx in mid 40’s and is usually SCC from HPV infection

A

Invasive carcinoma of the cervix

72
Q

Where is cervical cancer located

A

Transformation zone

73
Q

What size determines cervical cancer mets

A

1% if <3 mm, 10% if >3mm

74
Q

Who is most likely going to get cervical cancer

A

Mc in women who lack screening

75
Q

Invasion of cervical cancer results in what mc cause of death

A

Renal failure = mc cause of death

76
Q

What is associated with barrel cervix

A

Invasive cervical cancer

77
Q

What is endometrial inflammation in its normal location

A

Endometritis

78
Q

What can endometritis left untreated from gonorrhea, chlamydia, TB produce

A

Pelvic inflammatory disease (PID)

79
Q

What type of enometritis needs a removal of an item for resolutin

A

Retained products

80
Q

What is a chocolate cyst associated with

A

Endometriosus

81
Q

What is extrauterine endometrial tissue with multiple masses causing bleeding and fibrosis

A

Endometriosus

82
Q

What is the cause of half of female infertility

A

Endometriosus

83
Q

What abnormal uterine bleeding is profuse/prolonged menstruation

A

Menorrhagia

84
Q

What abnormal uterine bleeding is irregular, between periods

A

Metorrhagia

85
Q

What is an inadequate luteal phase

A

Anovulatory cycle

86
Q

What can cause an anovuluntary cycle

A

Retained endometrium = prone to breakdown/bleeding

87
Q

What is an overgrowth of endometrial cells due to increased estrogen or failed ovulation

A

Endometrial hyperplasia

88
Q

What is the most common female genital tract cancer

A

Endometrial carcinoma

89
Q

Who is most impacted by endometrial carcinoma

A

Age 55-65

90
Q

What are symptoms of endometrial carcinoma

A

Enlarged uterus, leukorrhea, metorrhagia

91
Q

How does endometrial carcinoma mets

A

Late lymphatic mets

92
Q

What type of endometrial carcinoma is mc and deals with endometrial hyperplasia, increased estrogens, diabteses HTN

A

Endometrioid

93
Q

What type of endometrial carcinoma deals with endometrial atrophy, post menopausal and is aggressive

A

Serous

94
Q

What type of proliferative lesions is mc around menopause and causes bleeding, cancer risk

A

Enometrial polyps

95
Q

What smooth muscle tumore is bening, multiple, reproductive age women, and is fibroid

A

Leiomyoma

96
Q

Who is likely to get leiomyoma

A

Repro age women, increased estrogens, african americans

97
Q

What smooth muscle tumore is malgnant, solitary

A

Leiomyosarcoma

98
Q

What smooth muscle tumor is postmenopausal and mets to lungs mc

A

Leiomyosarcoma

99
Q

What is a microbial infection of the fallopian tubes

A

Salpingitis

100
Q

What else can cause salpingitis

A

Ectopic pregnancy, endometriosis, tumor

101
Q

What is an adenocarcinoma mc on fimbriae

A

Fallopian tube carcinoma

102
Q

What does fallopian tube carcinoma invade

A

Peritoneal cavity

103
Q

What are risks of fallopian tube carcinoma

A

BRCA 1/2

104
Q

What are ovarian cysts from

A

Graffian or ruptured follicles

105
Q

How big are ovarian cysts

A

Serous filled cysts 1-4 cm

106
Q

Patient comes in with multiple cystic follicles enlarged to 2x size

A

Polycystic ovarian disease

107
Q

Why does PCOD cause hirsutism and obesity

A

Increased androgens, estorgens, LH and decrease FSH

108
Q

Both PCOD and ovarian cysts are what genetically

A

Familial

109
Q

Increase the size of ovarian cyst increases the what

A

Complications

110
Q

What is the fifth mc cause of CA related death

A

Ovarian tumors

111
Q

What are risks of ovarian tumors

A

> 20 years, nulliparity, family hx, BRCA 1/2

112
Q

What can decrease the risk of ovarian tumors

A

Oral contraception

113
Q

Surface epithelial tumors of ovarian tumors are benign or malig

A

Benign

114
Q

What is 90% of ovarian cancers

A

Surface epithelial tumors

115
Q

Ovulation creates what in surface epithelial tumors

A

Metaplasia

116
Q

What are the mc surface epithelial tumors

A

Serous tumores

117
Q

95% of surface epithelial tumors have what

A

Mutated TP53

118
Q

When are most serous tumors benign

A

30-40 years old

119
Q

When are most surface epithelial tumors malignant

A

45-65 years old

120
Q

What are characteristics of serous tumors

A

Large = 40cm, 25% bilateral

121
Q

What type of surface epithelial tumor is malignant

A

Endometrioid tumors

122
Q

What are enometrioid tumors associated with

A

Endometrial CA and endometriosus

123
Q

Wha type of endometrioid tumor increases CA risk

A

Solid no cystic

124
Q

What is cancer of the GI tract that has spread to the ovaries with signet ring cells

A

Krukenburg tumore

125
Q

What type of mets goes with krukenburg tumor

A

Lymphatic

126
Q

Who is most likley to get krukenburg tumor

A

45 years old

127
Q

What is signet ring cells originally a characteristic of before spread to ovaries

A

Gastric adenocarcinoma

128
Q

Is ovarian teratomas benign or malignant

A

Benign, younger = increased cancer risk

129
Q

What disease of pregnancy is mc

A

Ascending

130
Q

What disease of pregnancy is from premature ruptrue of membranes sending neutrophils and edema there to combat mc bacteria

A

Ascending

131
Q

What type of disease of pregnancy has the acronym TORCH

A

Transplacental

132
Q

What is TORCH stand for

A

Toxoplasmosis, other, rubella, CMV, HSV

133
Q

Where do most ectopic pregnancies take place

A

Most are tubal

134
Q

When can ectopic pregnancies rupture

A

During 1st trimester

135
Q

Why would ectopic pregnancy have acute abdominal pain

A

Salpingitis

136
Q

What is a group of tumors resulting from abnormal fertilization

A

Gestational trophoblastic disease

137
Q

What can mimic early pregnancy and increases hCG

A

Gestational trophoblastic disease

138
Q

What is a benign tumor cystic mass that is grape like gestiational trophoblastic disease

A

Hydatidiform mole

139
Q

When is there a risk for invasive hatidiform mole

A

Complete 2 sperm

140
Q

What type of gestational trophoblastic disease is benign but locally invasive, from complete moles and can have possible life threatening hemorrhage

A

Invasive mole

141
Q

What type of gestational trophoblastic disease is malignant, from complete mole, causing severe uterine bleeding extreme hCG increase (blood/urine

A

Choriocarcinoma

142
Q

Choriocarcinoma commonly mets to where and is called what

A

Mc to the lungs, aka “cannonball metastasis”

143
Q

What other cancers may produce a “cannonball” appearance

A

Testicular choriocarcinoma, renal cell carcinoma, prostatic adenocarcinoma

144
Q

What is preeclampsia

A

Toxemia of pregnancy

145
Q

What are symptoms of preeclampsia

A

HTN (>20 wks gestation), proteinuria, edema in face or periphery

146
Q

What happens in preeclampsia around 3rd tirmester that can result in organ damage and placental hypoxia

A

Maternal endothelial dysfunx

147
Q

Who is at risk for preeclampsia

A

1st pregnancy, material age> 35 years old

148
Q

After preeclampsia what can develop due to endothelial damage that leads to clotting

A

DIC

149
Q

What are the main issues with eclampsia

A

Onset of seizures and possible coma

150
Q

What are the symptoms of eclampsia

A

Continued BP elevation, HA, diplopia, epigastric pain

151
Q

How does eclampsia affect the kidneys and liver

A

Maternal end organ failure

152
Q

What do 10% of cases of eclampsia develop (hint: what syndrome can develop)

A

HELLP syndrome

153
Q

What does HELLP syndrome stand for

A

Hemolysis, elevated liver enzymes, low platelets

154
Q

What type of minor abnormalities can happen in the breast

A

Supernumerary nipple, inverted nippled, galactocele

155
Q

What takes place in the later stages of nursing and can produce a possible cyst due to an obstructed mammary gland duct

A

Galactocele

156
Q

What can be common in the breast due to menstrual hormonal fluctuations

A

Fibrocystic changes

157
Q

Who is most likely to have fibrocystic changes

A

Reproductive age females

158
Q

Patient comes in with a fibrotic, cystic mass in the superolateral quadrant of the breast, what do you think it is

A

Fibrocystic changes

159
Q

How does oral contraceptive impact fibrocystic changes

A

Decreases the risk

160
Q

What are the categories of fibrocystic changes and which is mc

A

Nonproliferative (MC) and proliferative

161
Q

What type of fibrocystic change has dilated ducts, multiple/bilateral cysts (<5cm), and has fibrotic/calcific densities

A

Non proliferative fibrocystic changes

162
Q

What type of fibrocystic changes deals with ductal epithelial hyperplasia

A

Proliferative

163
Q

Where does ductal epithelial hyperplasia of proliferative fibrocystic changes take place

A

Extra layer of cells in ducts/lobules (>2 cell layers)

164
Q

What are the two types of proliferative fibrocystic changes and how are they categorized

A

Mild = orderly hyperplasia, atypical = dysplastic hyperplasia

165
Q

Which type of fibrocystic change has an increased risk of breast CA

A

Atypical = 5x risk

166
Q

What inflammatory breast lesion is indicated by small, chalky white painful mass

A

Fat necrosis

167
Q

What is fat necrosis inflammatory breast lesion most likely caused by

A

Alcoholism/trauma= pancreatitis

168
Q

What inflamm breast lesion is mc a S. Aureus infx in the ducts due to early nursing

A

Acute mastitis

169
Q

Patient comes in age 40-60 wiith a non bacterial inflamm breast lesion with nipple retraction, what is it

A

Mammary duct ectasia

170
Q

What inflamm breast lesion has chronic inflamm due to lymphocytes and plasma cells and is caused by ductal dehydration

A

Mammary duct ectasia

171
Q

What are tumors of the breast mc from

A

Epithleia (fibrotic and glandular)

172
Q

What is the mc benign breast tumor

A

Fibroadenoma

173
Q

Who is likely to get fibroadenoma tumor of the breast

A

Younger women 20-30

174
Q

What tumor of the breast is mostly bening but still has rapid growth with late mets

A

Phyllodes tumor

175
Q

What tumor of the breast has a leaf like appearance

A

Phyllodes tumor

GM System Path 2 (5 decks)

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