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Gen Path > Exam 3 Gynecological and Breast Diseases > Flashcards

Exam 3 Gynecological and Breast Diseases Flashcards

1
Q

Define vulvitis.

A

inflammation of the external female genitalia

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2
Q

Etiology of vulvitis

A

contact irritation, allergic reaction, infection, trauma

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3
Q

Define vaginitis.

A

inflammation of the vaginal canal

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4
Q

What is a result of vaginitis?

A

leukorrhea - vaginal discharge

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5
Q

Etiology of vaginitis.

A

bacteria, fungi, parasites, diabetes, antibiotics

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6
Q

What is the histology of the cervix?

A

NON-keratinized - should be no white changes in epithelium

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7
Q

Define cervicitis

A

inflammation of the cervix - can result in purulent vaginal discharge

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8
Q

Etiology of cervicitis.

A

Can represent a specific infection, like an STD, but often non-specific infection

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9
Q

What is often required in a patient with cervicitis to rule out cancer or precancer?

A

biopsy - always

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10
Q

What is the most common type of cervical cancer?

A

squamous cell carcinoma

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11
Q

Why has the prevalence of cervical cancer decreased?

A

papanicolaou (pap) smears (1940) - detects precancerous cells

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12
Q

Define/describe CIN.

A

cervical intraepithelial neoplasia –> this is preinvasive

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13
Q

What stain is used in a pap smear?

A

papanicolau stain

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14
Q

What cell types are screened in pap smears?

A

exfoliated cells collected from the cervix

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15
Q

What does a colposcopy examine?

A

it is a direct view of the cervix where abnormalities will appear white after washed in acetic acid

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16
Q

What is the precursor epithelial change that indicates squamous cell carcinoma in the cervix?

A

cervical intraepithelial neoplasia (CIN)

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17
Q

What is the peak age for CIN?

A

30 yrs

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18
Q

What is the peak age for squamous cell carcinoma in women?

A

45 yrs

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19
Q

Do all CINs progress into cancer?

A

no

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20
Q

What needs to be done if there is an atypical pap smear?

A

colposcopy or biopsy

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21
Q

What is epithelial dysplasia?

A

cytologic and maturational disturbances of epithelium seen microscopically

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22
Q

Explain the different grades of CIN.

A

CIN I - mild dysplasia
CIN II - moderate dysplasia
CIN III - Carcinoma in situ
higher grade = more likely to be cancer

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23
Q

What is the major factor in cervical neoplasia?

A

human papillomavirus

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24
Q

How is HPV transmitted?

A

direct contact

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25
Q

What are the high risk types of HPV?

A

16 and 18 - associated with cancer

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26
Q

What are the low risk types of HPV?

A

6 and 11 – associated with condyloma

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27
Q

What are risk factors for HPV/squamous cell carcinoma?

A

early age at first intercourse
multiple sex partners
male partner with multiple previous sexual partners
prolonged infection with high-risk HPV
*risk factors are secondary since there is an HPV vaccine

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28
Q

What is the treatment for squamous cell carcinoma?

A

laser vaporization or excisional biopsy of CIN
Surgery
radiation
chemotherapy

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29
Q

What vaccine is safe and effective in preventing HPV infection?

A

Gardasil 9

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30
Q

Describe the endometrium of the uterus.

A

glandular lining that changes under hormonal influence. (menstrual cycle)

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31
Q

Describe the myometrium of the uterus.

A

muscular wall composed of interlacing bundles of smooth muscle

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32
Q

Define menorrhagia.

A

abnormally heavy menstrual bleeding

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33
Q

Define metrorrhagia.

A

bleeding between menstrual cycles

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34
Q

Define dysmenorrhea

A

unusually painful menstrual bleeding

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35
Q

True or False-

Most endometrial diseases do not present with abnormal uterine bleeding.

A

False. they do present with abnormal bleeding

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36
Q

Describe endometriosis.

A

functional endometrium is located outside the uterus and undergoes cyclic bleeding (still has hormonal response)

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37
Q

What percentage of women with infertility also have endometriosis?

A

50%

38
Q

What can occur with endometriosis?

A

widespread fibrosis and periuterine adhesions –> severe dysmenorrhea and pelvic pain

39
Q

What is a chocolate cyst?

A

large blood filled cyst on the ovary - turns a brown color as blood ages

40
Q

What is endometrial hyperplasia?

A

an overgrowth of endometrium

41
Q

Name some risk factors for endometrial hyperplasia.

A

obesity, hormone intake, failure to ovulate, estrogen producing ovarian tumors

42
Q

What causes endometrial hyperplasia?

A

excess exposure to estrogen (exogenous or endogenous)

43
Q

What can result from endometrial hyperplasia?

A

adenocarcinoma

44
Q

How do you treat endometrial hyperplasia?

A

D&C , correct/tx underlying cause (like readjust medication dosage)

45
Q

Are there different stages of endometrial hyperplasia?

A

yes 3 stages:
mild
moderate
atypical hyperplasia

46
Q

From what tissues do uterine tumors arise?

A

endometrium or myometrium

47
Q

What are the most common uterine tumors?

A

endometrial polyps
smooth muscle tumors
carcinomas

48
Q

What is a leiomyoma (fibroids)

A

benign tumor of the myometrial smooth muscle

49
Q

What age group is leiomyoma common?

A

30-50% of women in reproductive age

50
Q

What stimulates the growth of a leiomyoma?

A

estrogens; so they can regress after menopause

51
Q

What are common symptoms of leiomyoma?

A

some are asymptomatic
menorrhagia
palpable pelvic mass
infertility

52
Q

What is the most common female genital tract cancer in the US?

A

endometrial carcinoma

53
Q

What age group usually does endometrial carcinoma usually affect?

A

55-65 yr olds

54
Q

What are some symptoms of endometrial carcinoma?

A

leukorrhea or irregular bleeding

55
Q

Describe treatment for endometrial carcinoma.

A

surgery and radiation or chemo

56
Q

Is there a good 5 year prognosis for endometrial carcinoma?

A

yes, 90% 5 yr survival rate

57
Q

Describe polycystic ovarian disease.

A

hormonal disorder in 5-10% of young females (reproductive age)

58
Q

What is the etiology of polycystic ovarian disease?

A

there isn’t a complete understanding; possible genetic influence

59
Q

What is being produced by the cysts in polycystic ovarian disease?

A

androgens and estrogens

60
Q

Describe some symptoms of polycystic ovarian disease.

A

oligomenorrhea, hirsuitism (male hair growth pattern in women), acne, fertility issues, obesity

61
Q

Who is at increased risk for polycystic ovarian disease?

A

type II diabetics, individuals w/ hypertension and cardiovascular disease

62
Q

What type of tissue does a majority of ovarian carcinomas arise? What are the other tissue types they arise from?

A

90% are from surface epithelial

Can arise from germ cells or stroma

63
Q

What are risk factors for ovarian carcinoma?

A

nulliparity (woman who has never given birth) or family history

64
Q

What gene mutations are a concern for ovarian carcinoma?

A

BRCA gene

BRCA 1 & 2 - increase risk for breast and ovarian cancer

65
Q

Are there symptoms associated with ovarian carcinoma?

A

most are asymptomatic until they are large

66
Q

What is the prognosis for ovarian carcinoma?

A

10 yr survival is less than 15% if cancer is spreads outside ovary

67
Q

What is a teratoma?

A

a tumor in all three germ layers: ectoderm, mesoderm, endoderm

68
Q

What age group do teratomas arise?

A

in someones first 2 decades of life

69
Q

Are benign or malignant teratomas more common?

A

90% are benign

malignant are seen in younger patients

70
Q

Is there a screening for a teratoma?

A

no, they are usually incidental findings during a routine pelvic exam/ultrasound

71
Q

What is seen in the microscopic pathology of a teratoma?

A

skin, hair, teeth, bone, respiratory epithelium, cartilage (remember all germ layers are represented)

72
Q

Describe a fibrocystic change in breast pathology?

A

overgrowth of fibrous stroma and/or glandular elements

73
Q

Describe a fibroadenoma in breast tissue.

A

solitary, freely movable nodule 1-10 cm

74
Q

What usually causes a fibroadenoma?

A

increased estrogen

75
Q

What age group is usually affected by fibroadenomas?

A

prepubertal girls, young women

peaks in 3rd decade

76
Q

Are fibroadenomas of the breast typically benign or malignant?

A

benign

77
Q

What is usually shown in the biopsy of fibroadenomas?

A

proliferation of stroma and glands

78
Q

What tissue does most breast cancer arise?

A

glandular elements of the breast

79
Q

What is the 2nd leading cause of cancer deaths in women?

A

breast cancer

80
Q

What age group is mostly affected from breast cancer?

A

women over 50 (75%)

81
Q

What are some risk factors related to breast carcinoma?

A

genetics
hormonal influences (prolonged exposure to estrogen)
environmental (radiation, diet, nursing habits, reproductive patterns)

82
Q

What genes are related to inheritable breast carcinoma?

A

BRCA 1 and BRCA 2 genes - typically occurs at a younger age

83
Q

What quadrant of the breast is breast carcinoma located in that has the highest mortality?

A

inner lower quadrant

84
Q

How is breast carcinoma detected?

A

clinically - non-tender mass, nipple retraction, thickened overlying skin –>surface of an orange
Mammography

85
Q

What is mammography detecting?

A

calcifications or soft tissue density

86
Q

How do you diagnose breast carcinoma?

A

biopsy

87
Q

What are the two types of breast carcinoma we discussed?

A

ductal carcinoma

lobular carcinoma

88
Q

Are there preinvasive stages with ductal or lobular carcinoma?

A

yes, ductal carcinoma in-situ

lobular carcinoma in-situ

89
Q

Describe ductal carcinoma.

A

arises from ductal epithelium - most common

90
Q

Describe lobular carcinoma.

A

arises from glandular acini - more terminal regions (?)

91
Q

How do you treat carcinoma of the breast?

A

surgery, radiation, chemo, tamoxifen (anti-estrogen therapy)

92
Q

What is the prognosis for someone with breast carcinoma?

A

10 yr survival - 50%

metastases can occur years after therapeutic control of primary lesion

Gen Path (7 decks)

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