Fallopian tubes, Pregnancy, Breast Flashcards
1
Q
What is the term for inflammation of the fallopian tubes?
A
Salpingitis
2
Q
Salpingitis is a risk factor for what 2 conditions?
A
1 ectopic pregnancy
2 sterility
3
Q
What are the symptoms for salpingitis?
A
Pyrexia, lower abdominal pain, pelvic mass
4
Q
What is the most common location for a fallopian tube carcinoma?
A
On the fimbriae
5
Q
What genetic mutations are associated with a fallopian tube adenocarcinoma?
A
BRCA1 and BRCA2
6
Q
What fills ovarian cysts?
A
Serous fluid
7
Q
What is the condition that presents with multiple ovarian cystic follicles?
A
Polycystic ovarian disease (PCOD)
8
Q
What substances are produced by ovarian cysts?
A
Androgens, estrogens, LH
9
Q
What other hormone is affected by the increased LH from ovarian cyst production?
A
Decreased FSH (eventual sterility)
10
Q
What population is affected by PCOD?
A
Reproductive-age women (15%)
11
Q
What are the signs and symptoms of PCOD?
A
Oligomenorrhea, infertility, hirsutism, obesity
12
Q
What are the risk factors for developing ovarian tumors?
A
Nulliparity/low parity, older than 20 years old
13
Q
What genetic mutations are associated with the familial history of ovarian tumors?
A
BRCA1 and 2 (5-10%)
14
Q
What uniquely has been shown to decrease the risk of the development of ovarian tumors?
A
Prolonged oral contraception
15
Q
What kind of tumor makes up 90% of ovarian cancer?
A
Surface epithelial tumors
16
Q
What causes the metaplasia that develops into surface epithelial ovarian tumors?
A
Repeated ovulation/scarring
17
Q
Ovarian teratomas arise from what kind of cell?
A
Germ cells
18
Q
Ovarian fibromas arise from what kind of cell?
A
Sex cord-stroma
19
Q
Ovarian serous tumors arise from what kind of cell?
A
Surface epithelial cells
20
Q
Which age population is more likely to be associated with ovarian teratomas derived from germ cells? Ovarian serous tumors from surface epithelial cells?
A
Ovarian teratomas = 0-25 years
Ovarian serous tumors = 20+ years
21
Q
What is the most common type of ovarian tumor?
A
Serous tumors (60%)
22
Q
Are ovarian serous tumors benign or malignant?
A
Both: 60% benign, 25% malignant
23
Q
Are ovarian serous tumors unilateral or bilateral?
A
Mostly unilateral but 25% bilateral
24
Q
What kind of surface epithelial tumor is associated with endometriosis and endometrial cancer?
A
Endometrioid tumors
25
Are endometrioid tumors usually malignant or benign?
Malignant
26
95% of ovarian serous tumors have what genetic mutation?
TP53
27
What are the signs and symptoms of ovarian cancer?
Pelvic/abdominal pain, bloating, difficulty eating and easy satiety
28
What are the later-stage symptoms of ovarian cancer?
GI: nausea, vomiting, constipation, diarrhea
29
What is the BEAT acronym associated with beating ovarian cancer?
Bloating that is persistent
Eating less and feeling fuller
Abdominal pain
Trouble with your bladder and bowels
30
What are the two ways in which placental inflammation and infection can occur?
1 ascending infections
| 2 transplacental
31
What is the most common way in which placental inflammation and infection occurs?
Ascending infections (like candida, vaginal flora, mycoplasma)
32
What kinds of things can cause placental villitis?
Toxoplasmosis, rubella virus, CMV, HSV, TB, syphilis, HIV, HBV, P. falciparum (malaria) aka TORCH
33
What is the most common location for ectopic pregnancy?
Fallopian tube (90%) (can also be ovaries or abdominal cavity, however)
34
What is the issue with ectopic pregnancies?
Could rupture in 1st trimester and result in hypovolemic shock
35
How common is ectopic pregnancy?
1% of pregnancies are non-uterine
36
What is the clinical term for the presence of pregnancy tumors?
Gestational trophoblastic disease
37
Which type of gestational trophoblastic disease is malignant?
Choriocarcinoma
38
What types of gestational trophoblastic disease are being?
Hydatidiform mole, invasive mole
39
What race and age group are more at risk for hydatidiform moles?
Asians under 20 or over 40
40
What is the characteristic sign of hydatidiform mole?
No heart sounds upon ultrasound
41
Explain the two types development of hydatidiform moles.
Complete: 2 sperm (46, XX) with no fetal development
Partial: 2 sperm + 1 egg (69, XXY) with early fetal development
42
What hormone level is elevated with hydatidiform mole?
hCG
43
What can be a complication of an invasive mole (gestational trophoblastic disease)?
Possible rupture and severe myometrial hemorrhage
44
When do we see the development of a choriocarcinoma?
After normal pregnancy or abortion
45
What is the treatment for choriocarcinoma and what is unique about it?
Chemotherapy (100% cure)
46
Which type of gestational trophoblastic disease presents with extreme hCG levels in both blood and urine plus uterine bleeding?
Choriocarcinoma
47
Where does a choriocarcinoma tend to metastasize?
Lungs
48
A "cannon ball metastasis" seen on X-ray is associated with what pregnancy condition?
Choriocarcinoma metastasizing to lungs
49
What else can give the "cannon ball metastasis" appearance on X-ray besides a pregnancy choriocarcinoma metastasis?
Testicular choriocarcinoma, renal cell carcinoma, prostatic adenocarcinoma
50
What is the condition of toxemia of pregnancy?
Preeclampsia
51
What does preeclampsia essentially mean?
Hypertension at or after 20 week of gestation
52
What are the three signs of preeclampsia?
1 HTN
2 Proteinuria
3 Edema of face/periphery
53
What is the cause of placental hypoxia leading to preeclampsia?
Maternal endothelial dysfunction leading to anti-angiogenesis
54
During which trimester is preeclampsia most likely to occur?
3rd
55
What are the risk factors for preeclampsia?
First pregnancy (aka primigravida) or mother over 35 years of age
56
Why is eclampsia more severe than preeclampsia?
Onset of seizures, rising BP, hypercoagulability, possible coma
57
10% of eclampsia cases develop into what syndrome?
HELLP syndrome
58
What is HELLP syndrome?
Hemolysis
Elevated Liver enzymes
Low platelets
59
What is the treatment for eclampsia?
Delivery/induction (after 37 weeks) via magnesium sulfate, anti-hypertensive meds, corticosteroids
60
Although most commonly congenital, how else can one get inverted nipples?
Acquired with cancer
61
Are female breast lesions most commonly malignant or benign?
Benign
62
What is a galactocele?
Ductal obstruction during lactation leading to inflammation and cyst formation during late stages of nursing
63
Is a galactocele due to an infection?
NO (obstruction)
64
Up to 5% of the population has which minor breast abnormality?
Supernumerary nipple
65
What age group is more likely to be affected by fibrocystic changes of the breasts?
Premenopausal and reproductive-age females
66
What has been shown to reduce the risk of fibrocystic breast changes?
Oral contraception
67
What is the most common type of fibrocystic breast change?
Nonproliferative (benign)
68
What type of fibrocystic breast change increases the risk of breast cancer by 5X?
Proliferative with atypical dysplastic hyperplasia
69
Which type of fibrocystic breast change presents with an additional cellular layer via epithelial hyperplasia?
Proliferative
70
Which condition of the breast occurs during early nursing: acute mastitis or galactocele? Late nursing?
```
Early = acute mastitis
Late = galactocele
```
71
What is the most common pathogen that causes acute mastitis?
Staph. aureus
72
What is another name for mammary duct ectasia?
Plasma cell mastitis
73
What is the condition of ductal dehydration of the breasts?
Mammary duct ectasia
74
What is the most common age range for mammary duct ecstasia?
40-60
75
What condition of the breast involves chronic inflammation due to nonbacterial causes that results in excess lymphocytes and plasma cells?
Mammary duct ectasia (plasma cell mastitis)
76
What sign presents with mammary duct ectasia that can be confused with early signs of cancer?
Nipple retraction
77
What type of cells are most commonly involved with tumors of the breast?
Epithelial cells
78
What is the most common type of breast tumor?
Fibroadenoma
79
Fibroadenomas are most common among what age group?
20-30 year olds (young women)
80
Are fibroadenomas benign or malignant?
Benign
81
Which epithelial breast tumor can be benign or malignant and appears as leaflike projections?
Phyllodes tumor
82
Is a phyllodes tumor more commonly benign or malignant?
Benign (only 15% malignant)
83
Why does a phyllodes tumor generally have a good prognosis?
Late metastasis
84
What is the lifetime risk of developing breast cancer?
1:8
85
What are the risks of breast cancer development?
Over 30 years, Caucasians, familial history, geography, nulliparous, chest irradiation (under 30 years of age)
Increased estrogens, benign lesions, mutated BRCA1/2, obesity, high-fat diet, alcohol, cigarettes
86
What is the most common region of the breast to develop breast cancer?
Superolateral quadrant
87
Is breast cancer mostly unilateral or bilateral?
Unilateral (4% bilateral)
88
Breast cancer becomes invasive breast cancer when what area is penetrated?
Basement membrane
89
What are the two types of non-invasive breast cancer?
Ductal carcinoma in situ
| Lobular carcinoma in situ
90
Which form of non-invasive breast cancer is composed of mixed cells with possible necrosis?
Ductal carcinoma in situ
91
Which form of non-invasive breast cancer is composed of uniforms cells?
Lobular carcinoma in situ
92
If left untreated, what fraction of non-invasive breast cancer will progress into invasive cancer?
1/3 (both LCIS and DCIS)
93
What is the difference between LCIS and DCIS in terms of how untreated cases progress into invasive cancer?
DCIS - progresses into cancer of same breast
| LCIS - progresses into cancer of either breast
94
Paget disease of the nipple is an extension of what condition?
Ductal carcinoma in situ
95
What is Paget disease of the nipple?
DCIS travels up lactiferous ducts and manifests on skin near areola as eczema-like skin lesion (1-4% of all breast cancers)
96
Which form of non-invasive breast cancer would be treated with a bilateral mastectomy due to its mechanism of progression?
Lobular carcinoma in situ
97
What is the most common type of breast cancer?
Invasive ductal carcinoma (70-80%)
98
Compare the appearance of cells between invasive ductal and invasive lobular carcinoma.
```
Ductal = heterogenous, irregular borders
Lobular = identical to LCIS
```
99
What type of invasive breast cancer presents with E-cadherin mutations?
Invasive lobular carcinoma
100
Where can we see metastasis of invasive lobular carcinoma?
CSF, GI, ovary, uterus, marrow
101
Being positive for which protein that promotes cancer growth results in a worse prognosis for invasive lobular carcinoma?
HER2/neu (also anaplasia, invasion, increased size, distant metastasis)
102
Being positive for what two things can lead to a better prognosis for invasive lobular carcinoma?
Estrogen or progesterone receptors
103
What is unique about medullary carcinoma of the breast compared to the other forms of invasive breast cancer?
Triple negative (for HER2, progesterone, and estrogen)
104
Medullary carcinoma of the breast is more common among women with what genetic mutation?
BRCA1
105
When is the recommended age to start regular mammograms?
50 (some sources says 40)
106
What is the most common form of metastasis of invasive breast cancer: lymphatic of hematogenous?
Lymphatic
107
To what other body systems can invasive breast cancer metastasize?
Lungs, bone, liver, adrenals, brain
108
What is the most common location for metastasis for invasive breast cancer found in the lateral and central regions?
Axillary nodes (most common overall)
109
What is the most common location for metastasis for invasive breast cancer found in the medial regions?
Internal mammary arteries
110
What is the clinical term for bilateral breast enlargement seen in males?
Gynecomastia
111
When is gynecomastia commonly seen?
During puberty (70%), newborns, adverse drug reactions, increased estrogens, cirrhosis, obesity, Klinefelter's syndrome
112
Male carcinoma of the breast is more common among what age group?
Elderly males
113
What is the prognosis for male carcinoma of the breast?
50% metastasis by diagnosis usually accompanied by rapid invasion of the thorax
114
Which form of non-invasive breast cancer presents with calcifications? Which rarely does?
```
Calcifications = DCIS
Rarely = LCIS
```
