F-S Path CIS Flashcards

1
Q

Tx imperforate hymen

A

foley catheter

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2
Q

ball of tissue on posterior wall of vagina

A

endometriosis

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3
Q

8y.o with stomach aches, bowel movements are thin and always scratching herself on examination there is white lesion around vulva with redness on borders dx?

A

lichen sclerosis

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4
Q

51 y.o with constant itching
had abnormal paps in past and at risk for HPV

what will you see on Bx?

A

hyperkeratosis and epidermal hyperplasia

Lichen simplex chronicus

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5
Q

26 y.o F at ED with staticus epilepticus

low BP

with rash, on arms and tampon was removed from vagina

culture was done on vagina

cocci gram + catalase +

A

staph aureus

Toxic shock syndrome

TSST-1 toxin

can have Ab to this if infected previously and appropriate immune response

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6
Q

19 y.o for papsmear

HPV liquid PCR + for type 16 and 18

image of cells shown

cervical Bx and endocervical cutterage negative, what should be done next?

A

large nuclei with scant cytoplasm

badness

high grade CIN III

need to do cone biopsy to sample cervix and get large portion of endocervical canal

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7
Q

19 y.o for papsmear

HPV liquid PCR + for type 16 and 18

image of cells shown

cervical Bx and endocervical cutterage negative, what should be done next?

A

small nuclei, lots of cytoplasm

ASCUS

atypical squamous cell of undetermined significance

inflammation induced? not sure

Need to re-screen

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8
Q

new born presents with fluid from eyes and aspirate is taken from swollen inflammed knee joint

glucose +

oxidase +

+ growth on thayer martin agar

diplococci

Dx?

A

gonorrhea

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9
Q

Following cells seen on sample from pap smear

what is it?

A

koilocytosis

HPV- both low grade and high grade can cause it

most likely low grade if this is only finding (type 6 or 11)

is maintained in nonintegrated episomal form

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10
Q

28 y.o F presenting with complaints of infertility

following histo from endometrial biopsy in workup

confident that?

A

proof that she has ovulated

early secretory phase

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11
Q

exudate characteristics of chlamydia

A

more clear

not as thick as gonorrhea

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12
Q

A 49 y o woman with a 30 year smoking history with irregular periods and abnormal bleeding.

bright red blood on her stools.

PE: moderately obese woman with large internal hemorrhoids identified on rectal examination.

Her GYN exam is normal. Endometrial biopsy is performed and the findings are seen in the image. The pathophysiology explaining her complaint is

A

no secretory changes

some mitotic figures

glands are not tubular like they should be because exposed to too much E

clusters of stromal cells (menstrual endometrium)

disordered proliferative pattern of shedding

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13
Q

A 31 y o female, G2;P4, presents to your office complaining of infertility. As part of your questioning you learn she is day 27 in her cycle and should menstruate in a day or two. An endometrial biopsy is performed and is seen in the image. The most likely explanation for her infertility is

A

endometrium does not match the date it should be

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14
Q

A 58 y o female presented with abnormal bleeding. Endometrial biopsy demonstrated complex hyperplasia with atypia. Endometrial curettage demonstrated complex hyperplasia with atypia. Hysterectomy was performed and the opened uterus is seen in the image. A section was taken from the area indicated and examined by the pathologist. The finding(s) (are)

A

Dx for invasion

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15
Q

A 54 y o female presents to your office complaining of irregular bleeding and a “fullness sensation” in her lower abdomen. Physical examination reveals a moderately obese woman. GYN exam reveals a probable 10 cm nodule associated with her uterus. Endometrial biopsy is performed and the patient is referred to radiology for a CT of the pelvis which is interpreted “Probable leiomyoma, Fundus of Uterus, (18 cm in diameter)”. The endometrial biopsy is read as “Insufficient for Diagnosis” so the patient undergoes an endometrial curettage which is seen below. What might you do next?

A

smooth muscle tumor

many many mitotic figures

hysterectomy

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16
Q

The x-ray seen in the image is from a 16 y o female who presented to her family physician for a yearly check up. Physical examination revealed lower abdominal fullness.

Finding suggests what?

A

mature teratoma(contains 2-3 germ lines)

can arise from ovum after first meiotic division

17
Q

If papillary malignant cells with psammoma bodies were to be found on cytology following aspiration, the cells would most likely

A

high grade

have to look for invasian with pathology to determine invasive or not

produce MUC16 gene

18
Q

frozen sections below of adenexal mass that has yellow fluid

A

not invading cyst

borderline papillary serous cystadenoma

not benign. borderline because of amount of papillaes ad atypia

19
Q

cyst emptied that has thick mucous fluid

mcroscopy seen below

what mutation does mass most likely have

A

looks benign, smooth borders

benign mucinous cystic adenoma

mutation: PTEN and KRAS proto-oncogene mutation

20
Q

23 y.o obese female has hair on face and acne

complaining of infertility

abdominal U/S as follows

expected lab findings?

A

elevated fasting insulin lvel

elevated testosterone, DHEAS, andostenedione levels

abnormal thyroid hormone levels (can be all over the place)

high prolactin level

LH:FSH>2:1

21
Q

A 48 y o obese woman presents to your office complaining of MMR. Endometrial biopsy is obtained and the findings are seen in the image. The pathology report states, Complex hyperplasia with atypia”. You would suggest

A

fractional D&C

because high likelyhood of cancer.

make sure endocervical canal is not involved before hysterectomy

22
Q

Sx would you expect from subserosal lesion

posterior uterus next to spine

A

back pain and vaginal bleeding

23
Q

knots in umbilical cord are associated with?

A

abnormally long cords

very active fetus

24
Q

umbilical cord shown

why did fetus die?

A

decreased O2 delivery to fetus

25
Q

A 24 y o female required immediate hysterectomy for post-partum hemorrhage after a successful delivery of a 6.5 lb male with Apgars of 9/9. Sections of her uterus were submitted by the pathologist for histological review, 4 of which are seen in the images. The finding(s) seen are probably a result of

A

show chrionic villae surrounded by smooth muscle! should never see this

placental tissue grows into uterine wall

“placenta acreta”

associated with 2 prior C sections

26
Q

An 8 y o presents to your clinic with findings consistent with major motor impairment. You call your radiology and pathology departments because you want to review the child’s historical fetal ultrasounds and neonatal CT of the brain (calcifications in brain), and sections of the placenta which were examined following the birth ( image). This child’s current clinical problems are secondary to a (an)

A

chorionic villae have abnormalities on slide

inclusion bodies– CMV TORCH complex

double stranded DNA

27
Q

A 47 y o woman underwent a needle guided breast biopsy following a mammogram which showed a cluster of linear micro calcifications. When the pathologist squeezed the gross specimen , tubes of white material were expressed from the cut surface. The pathologist examined the H&E slide (second image) and made a diagnosis. Which of the following statements is true?

A

high grade carcinoma

invasive tumor most likely in same quadrant

28
Q

A 39 y o female underwent a needle guided breast biopsy following detection of a clustered area of micro calcifications on mammogram. The pathologist wanted to examine more carefully an area identified at the inked margin of the specimen

H&E show small blue cells

e cadherin stain is negative– ?

myoepithelial IHC stain– localizes BM

what do we do?

A

e cadherin - : no brown staining. ductal cells + e cadherin… so we know it is lobular cells

follow because increased risk of ductal cell carcinoma. but do not need to go back in for clear marigns since is lobular

29
Q
A