Fallopian/Ovarian disorders/infections

Question 1

The most common disorders affecting the fallopian tube are

Answer 1

The most common disorders affecting the fallopian tube are infections and associated inflammatory conditions (salpingitis) > followed by ectopic (tubal) pregnancy and endometriosis.

Question 2

Answer 2

Tubo-ovarian abscess

Question 3

Answer 3

benign cyst in an ovary. This is probably a follicular cyst. Occasionally such cysts may reach several centimeters in size and, if they rupture, can cause abdominal pain.

Question 4

Answer 4

Tubo-ovarian abscess, gross

This condition followed Neisseria gonorrhoeae infection, although other organisms, including Chlamydia trachomatis, can cause this disease.

Gonorrhea leads to multiple complications in the female genital tract, including acute inflammation with abscess formation and chronic inflammation with tubal scarring (and a greater likelihood of ectopic pregnancy) and PID.

There is no clear boundary here between tube and ovary, and this dilated ovary on sectioning is filled with purulent materia

Question 5

Answer 5

1. tubal epithelium surrounded and infiltrated by numerous neutrophils. N. gonorrhoeae.
2. The next most likely causative organism for this acute suppurative process is C. trachomatis.
3. Multiple pyogenic bacterial species may be present with acute salpingitis that evolves to PID, including enteric bacteria, staphylococci, streptococci, and clostridia.
4. Clinical findings include pelvic pain and fever. Infertility may result from this process. Laboratory findings include leukocytosis with a left shift.

Question 6

Clinical findings include pelvic pain and fever.

Infertility may result from this process.

Laboratory findings include leukocytosis with a left shift.

Answer 6

suppurative salpingitis, tubo-avarian abscess, N gonorrhea

Question 7

hydrosalpinx

Answer 7

A hydrosalpinx is a distally blocked fallopian tube filled with serous or clear fluid. The blocked tube may become substantially distended giving the tube a characteristic sausage-like or retort-like shape.

Question 8

oophoritis

Answer 8

uncommon, usually autoimmune etiology, may lead to infertility

Question 9

follicule cyst may cause pain and be palpable when…

Answer 9

> 2/2.5cm then called

Question 10

Answer 10

normal cyst on the left, abnormal on the right

Question 11

Answer 11

a hemorrhagic corpus luteum. Note the dark red-black hemorrhagic region surrounded by a thin rim of yellow corpus luteum.

Question 12

Answer 12

benign theca lutein cyst in an ovary.

Note the luteinized cells forming the inner cyst lining at the left, with adjacent surrounding theca cells.

These cysts are rarely more than a few centimeters in diameter.

Question 13

Answer 13

PCOS

Question 14

estrogen review

E1 =

Answer 14

E1 = estrone–> menopausal estrogen produced by aromatization of androstenedione in peripheral fatty tissue. Less potent than E2 estradiol

Question 15

estrogen review

E2 =

Answer 15

E2 = estradiol predominates in reproductive years.

Most potent estrogen produced by aromatization of testosterone in Graafian follicle

Question 16

estrogen review

E3 =

Answer 16

E3 = estriol placental estrogen: originates in fetal adrenal gland as DHEA and converted in placenta.

Least potent.

Question 17

causes of hirsutism

Answer 17

1. most often idiopathic
2. PCOS
3. non-classical CAH (less frequently)

Question 18

the most common symptoms associated with tumor or cancer invasion

Answer 18

1. Abdominal pain and distention
2. urinary and gastrointestinal tract symptoms due to compression
3. vaginal bleeding are the most common symptoms.

Question 19

% of ovarian tumors that are benign and % that are bilateral

Answer 19

60%, 25%

Question 20

Answer 20

granulosa cell tumor attempts to form structures that resemble primitive follicles, as seen at the left. Most of these tumors are histologically benign, but some are malignant.

Question 21

Reinke crystalloids

Answer 21

hilus cell tumor- leydig ell neoplasms composed entirely of lipid-leydig cells.

Question 22

bilateral metastasis composed of mucin producing signet ring cancer cells

Answer 22

most of gastric origin

Question 24

Answer 24

syphilis, looks like candida

Question 25

VDRL test vs RPR vs FTA-ABS vs Trep-Agglutination vs EIA tests: primary syphilis

Answer 25

Trep Agglutination < VDRL < FTA-ABs < RPR < EIA (most sensitive)

Question 26

VDRL test vs RPR vs FTA-ABS vs Trep-Agglutination vs EIA tests: secondary syph

Answer 26

all 100% sensitive

Question 27

VDRL test vs RPR vs FTA-ABS vs Trep-Agglutination vs EIA tests: latent

Answer 27

FTA-ARBS = EIA > RPR> Trep agglutination > VDRL

Question 28

VDRL test vs RPR vs FTA-ABS vs Trep-Agglutination vs EIA tests: tert syphilis

Answer 28

FTA-ABS > Trep Agglutination > RDR > VDRL

Question 29

Answer 29

mulberry molars, congenital syphilis

Question 30

Severe purulent discharge and eyelid edema in a newborn with conjunctivitis (confirmed G- diplococci with Gram stain and culture). What would you treat with?

Answer 30

Severe purulent discharge and eyelid edema in a newborn with gonococcal conjunctivitis (confirmed with Gram stain and culture).

Treated with ceftriaxone (IV or IM) Topical antibiotic therapy alone is ill advised and not needed if systemic antibiotics used

Question 31

An asymptomatic 21 year old presents for initial Pap smear as part of her request for birth control. On colposcopic exam there is mucopurulent discharge at the os. Gram stain of the discharge reveals acute inflammation but no organisms. Swabs for nucleic acid tests is submitted. She says her only male sexual partner is asymptomatic. Which organism is most likely?

1. gardeneralla vaginalis
2. neisseria gonorrhea
3. trichomonas vaginalis
4. k granulomatis
5. c tichomatis

Answer 31

chlymdia trachomatis

Question 32

C. trachomatis infection are associated with different serotypes of the bacteria: urogenital infections and inclusion conjunctivitis

Answer 32

serotypes D through K

Question 33

C. trachomatis infection are associated with different serotypes of the bacteria: lymphogranuloma venereum

Answer 33

serotypes L1, L2, and L3

Question 34

C. trachomatis infection are associated with different serotypes of the bacteria: ocular infection of children

Answer 34

trachoma serotypes A, B, and C

Question 35

Rates of reported chlamydia blacks/indians/natives/whites

Answer 35

Blacks was 5.9 times the rate among Whites, and the rate among American Indians/Alaska Natives was 3.8 times the rate among Whites.

Question 36

he most common curable STD

Answer 36

trichamonas vaginalis, flagellated protozoan

Question 37

trichomonas vaginalis: epi

Answer 37

more common in women than in men, and older women are more likely than younger women to have been infected.

Question 38

Answer 38

Pediculosis ciliaris

Question 39

Answer 39

Pediculosis pubis