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Systems Pathology II Final > Fallopian tubes, Pregnancy, Breast > Flashcards

Fallopian tubes, Pregnancy, Breast Flashcards

1
Q

What is the term for inflammation of the fallopian tubes?

A

Salpingitis

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2
Q

Salpingitis is a risk factor for what 2 conditions?

A

1 ectopic pregnancy

2 sterility

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3
Q

What are the symptoms for salpingitis?

A

Pyrexia, lower abdominal pain, pelvic mass

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4
Q

What is the most common location for a fallopian tube carcinoma?

A

On the fimbriae

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5
Q

What genetic mutations are associated with a fallopian tube adenocarcinoma?

A

BRCA1 and BRCA2

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6
Q

What fills ovarian cysts?

A

Serous fluid

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7
Q

What is the condition that presents with multiple ovarian cystic follicles?

A

Polycystic ovarian disease (PCOD)

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8
Q

What substances are produced by ovarian cysts?

A

Androgens, estrogens, LH

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9
Q

What other hormone is affected by the increased LH from ovarian cyst production?

A

Decreased FSH (eventual sterility)

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10
Q

What population is affected by PCOD?

A

Reproductive-age women (15%)

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11
Q

What are the signs and symptoms of PCOD?

A

Oligomenorrhea, infertility, hirsutism, obesity

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12
Q

What are the risk factors for developing ovarian tumors?

A

Nulliparity/low parity, older than 20 years old

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13
Q

What genetic mutations are associated with the familial history of ovarian tumors?

A

BRCA1 and 2 (5-10%)

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14
Q

What uniquely has been shown to decrease the risk of the development of ovarian tumors?

A

Prolonged oral contraception

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15
Q

What kind of tumor makes up 90% of ovarian cancer?

A

Surface epithelial tumors

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16
Q

What causes the metaplasia that develops into surface epithelial ovarian tumors?

A

Repeated ovulation/scarring

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17
Q

Ovarian teratomas arise from what kind of cell?

A

Germ cells

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18
Q

Ovarian fibromas arise from what kind of cell?

A

Sex cord-stroma

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19
Q

Ovarian serous tumors arise from what kind of cell?

A

Surface epithelial cells

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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

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21
Q

What is the most common type of ovarian tumor?

A

Serous tumors (60%)

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22
Q

Are ovarian serous tumors benign or malignant?

A

Both: 60% benign, 25% malignant

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23
Q

Are ovarian serous tumors unilateral or bilateral?

A

Mostly unilateral but 25% bilateral

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24
Q

What kind of surface epithelial tumor is associated with endometriosis and endometrial cancer?

A

Endometrioid tumors

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25
Q

Are endometrioid tumors usually malignant or benign?

A

Malignant

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26
Q

95% of ovarian serous tumors have what genetic mutation?

A

TP53

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27
Q

What are the signs and symptoms of ovarian cancer?

A

Pelvic/abdominal pain, bloating, difficulty eating and easy satiety

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28
Q

What are the later-stage symptoms of ovarian cancer?

A

GI: nausea, vomiting, constipation, diarrhea

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29
Q

What is the BEAT acronym associated with beating ovarian cancer?

A

Bloating that is persistent
Eating less and feeling fuller
Abdominal pain
Trouble with your bladder and bowels

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30
Q

What are the two ways in which placental inflammation and infection can occur?

A

1 ascending infections

2 transplacental

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31
Q

What is the most common way in which placental inflammation and infection occurs?

A

Ascending infections (like candida, vaginal flora, mycoplasma)

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32
Q

What kinds of things can cause placental villitis?

A

Toxoplasmosis, rubella virus, CMV, HSV, TB, syphilis, HIV, HBV, P. falciparum (malaria) aka TORCH

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33
Q

What is the most common location for ectopic pregnancy?

A

Fallopian tube (90%) (can also be ovaries or abdominal cavity, however)

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34
Q

What is the issue with ectopic pregnancies?

A

Could rupture in 1st trimester and result in hypovolemic shock

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35
Q

How common is ectopic pregnancy?

A

1% of pregnancies are non-uterine

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36
Q

What is the clinical term for the presence of pregnancy tumors?

A

Gestational trophoblastic disease

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37
Q

Which type of gestational trophoblastic disease is malignant?

A

Choriocarcinoma

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38
Q

What types of gestational trophoblastic disease are being?

A

Hydatidiform mole, invasive mole

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39
Q

What race and age group are more at risk for hydatidiform moles?

A

Asians under 20 or over 40

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40
Q

What is the characteristic sign of hydatidiform mole?

A

No heart sounds upon ultrasound

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41
Q

Explain the two types development of hydatidiform moles.

A

Complete: 2 sperm (46, XX) with no fetal development
Partial: 2 sperm + 1 egg (69, XXY) with early fetal development

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42
Q

What hormone level is elevated with hydatidiform mole?

A

hCG

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43
Q

What can be a complication of an invasive mole (gestational trophoblastic disease)?

A

Possible rupture and severe myometrial hemorrhage

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44
Q

When do we see the development of a choriocarcinoma?

A

After normal pregnancy or abortion

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45
Q

What is the treatment for choriocarcinoma and what is unique about it?

A

Chemotherapy (100% cure)

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46
Q

Which type of gestational trophoblastic disease presents with extreme hCG levels in both blood and urine plus uterine bleeding?

A

Choriocarcinoma

47
Q

Where does a choriocarcinoma tend to metastasize?

A

Lungs

48
Q

A “cannon ball metastasis” seen on X-ray is associated with what pregnancy condition?

A

Choriocarcinoma metastasizing to lungs

49
Q

What else can give the “cannon ball metastasis” appearance on X-ray besides a pregnancy choriocarcinoma metastasis?

A

Testicular choriocarcinoma, renal cell carcinoma, prostatic adenocarcinoma

50
Q

What is the condition of toxemia of pregnancy?

A

Preeclampsia

51
Q

What does preeclampsia essentially mean?

A

Hypertension at or after 20 week of gestation

52
Q

What are the three signs of preeclampsia?

A

1 HTN
2 Proteinuria
3 Edema of face/periphery

53
Q

What is the cause of placental hypoxia leading to preeclampsia?

A

Maternal endothelial dysfunction leading to anti-angiogenesis

54
Q

During which trimester is preeclampsia most likely to occur?

A

3rd

55
Q

What are the risk factors for preeclampsia?

A

First pregnancy (aka primigravida) or mother over 35 years of age

56
Q

Why is eclampsia more severe than preeclampsia?

A

Onset of seizures, rising BP, hypercoagulability, possible coma

57
Q

10% of eclampsia cases develop into what syndrome?

A

HELLP syndrome

58
Q

What is HELLP syndrome?

A

Hemolysis
Elevated Liver enzymes
Low platelets

59
Q

What is the treatment for eclampsia?

A

Delivery/induction (after 37 weeks) via magnesium sulfate, anti-hypertensive meds, corticosteroids

60
Q

Although most commonly congenital, how else can one get inverted nipples?

A

Acquired with cancer

61
Q

Are female breast lesions most commonly malignant or benign?

A

Benign

62
Q

What is a galactocele?

A

Ductal obstruction during lactation leading to inflammation and cyst formation during late stages of nursing

63
Q

Is a galactocele due to an infection?

A

NO (obstruction)

64
Q

Up to 5% of the population has which minor breast abnormality?

A

Supernumerary nipple

65
Q

What age group is more likely to be affected by fibrocystic changes of the breasts?

A

Premenopausal and reproductive-age females

66
Q

What has been shown to reduce the risk of fibrocystic breast changes?

A

Oral contraception

67
Q

What is the most common type of fibrocystic breast change?

A

Nonproliferative (benign)

68
Q

What type of fibrocystic breast change increases the risk of breast cancer by 5X?

A

Proliferative with atypical dysplastic hyperplasia

69
Q

Which type of fibrocystic breast change presents with an additional cellular layer via epithelial hyperplasia?

A

Proliferative

70
Q

Which condition of the breast occurs during early nursing: acute mastitis or galactocele? Late nursing?

A 
Early = acute mastitis 
Late = galactocele
71
Q

What is the most common pathogen that causes acute mastitis?

A

Staph. aureus

72
Q

What is another name for mammary duct ectasia?

A

Plasma cell mastitis

73
Q

What is the condition of ductal dehydration of the breasts?

A

Mammary duct ectasia

74
Q

What is the most common age range for mammary duct ecstasia?

A

40-60

75
Q

What condition of the breast involves chronic inflammation due to nonbacterial causes that results in excess lymphocytes and plasma cells?

A

Mammary duct ectasia (plasma cell mastitis)

76
Q

What sign presents with mammary duct ectasia that can be confused with early signs of cancer?

A

Nipple retraction

77
Q

What type of cells are most commonly involved with tumors of the breast?

A

Epithelial cells

78
Q

What is the most common type of breast tumor?

A

Fibroadenoma

79
Q

Fibroadenomas are most common among what age group?

A

20-30 year olds (young women)

80
Q

Are fibroadenomas benign or malignant?

A

Benign

81
Q

Which epithelial breast tumor can be benign or malignant and appears as leaflike projections?

A

Phyllodes tumor

82
Q

Is a phyllodes tumor more commonly benign or malignant?

A

Benign (only 15% malignant)

83
Q

Why does a phyllodes tumor generally have a good prognosis?

A

Late metastasis

84
Q

What is the lifetime risk of developing breast cancer?

A

1:8

85
Q

What are the risks of breast cancer development?

A

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
Q

What is the most common region of the breast to develop breast cancer?

A

Superolateral quadrant

87
Q

Is breast cancer mostly unilateral or bilateral?

A

Unilateral (4% bilateral)

88
Q

Breast cancer becomes invasive breast cancer when what area is penetrated?

A

Basement membrane

89
Q

What are the two types of non-invasive breast cancer?

A

Ductal carcinoma in situ

Lobular carcinoma in situ

90
Q

Which form of non-invasive breast cancer is composed of mixed cells with possible necrosis?

A

Ductal carcinoma in situ

91
Q

Which form of non-invasive breast cancer is composed of uniforms cells?

A

Lobular carcinoma in situ

92
Q

If left untreated, what fraction of non-invasive breast cancer will progress into invasive cancer?

A

1/3 (both LCIS and DCIS)

93
Q

What is the difference between LCIS and DCIS in terms of how untreated cases progress into invasive cancer?

A

DCIS - progresses into cancer of same breast

LCIS - progresses into cancer of either breast

94
Q

Paget disease of the nipple is an extension of what condition?

A

Ductal carcinoma in situ

95
Q

What is Paget disease of the nipple?

A

DCIS travels up lactiferous ducts and manifests on skin near areola as eczema-like skin lesion (1-4% of all breast cancers)

96
Q

Which form of non-invasive breast cancer would be treated with a bilateral mastectomy due to its mechanism of progression?

A

Lobular carcinoma in situ

97
Q

What is the most common type of breast cancer?

A

Invasive ductal carcinoma (70-80%)

98
Q

Compare the appearance of cells between invasive ductal and invasive lobular carcinoma.

A 
Ductal = heterogenous, irregular borders
Lobular = identical to LCIS
99
Q

What type of invasive breast cancer presents with E-cadherin mutations?

A

Invasive lobular carcinoma

100
Q

Where can we see metastasis of invasive lobular carcinoma?

A

CSF, GI, ovary, uterus, marrow

101
Q

Being positive for which protein that promotes cancer growth results in a worse prognosis for invasive lobular carcinoma?

A

HER2/neu (also anaplasia, invasion, increased size, distant metastasis)

102
Q

Being positive for what two things can lead to a better prognosis for invasive lobular carcinoma?

A

Estrogen or progesterone receptors

103
Q

What is unique about medullary carcinoma of the breast compared to the other forms of invasive breast cancer?

A

Triple negative (for HER2, progesterone, and estrogen)

104
Q

Medullary carcinoma of the breast is more common among women with what genetic mutation?

A

BRCA1

105
Q

When is the recommended age to start regular mammograms?

A

50 (some sources says 40)

106
Q

What is the most common form of metastasis of invasive breast cancer: lymphatic of hematogenous?

A

Lymphatic

107
Q

To what other body systems can invasive breast cancer metastasize?

A

Lungs, bone, liver, adrenals, brain

108
Q

What is the most common location for metastasis for invasive breast cancer found in the lateral and central regions?

A

Axillary nodes (most common overall)

109
Q

What is the most common location for metastasis for invasive breast cancer found in the medial regions?

A

Internal mammary arteries

110
Q

What is the clinical term for bilateral breast enlargement seen in males?

A

Gynecomastia

111
Q

When is gynecomastia commonly seen?

A

During puberty (70%), newborns, adverse drug reactions, increased estrogens, cirrhosis, obesity, Klinefelter’s syndrome

112
Q

Male carcinoma of the breast is more common among what age group?

A

Elderly males

113
Q

What is the prognosis for male carcinoma of the breast?

A

50% metastasis by diagnosis usually accompanied by rapid invasion of the thorax

114
Q

Which form of non-invasive breast cancer presents with calcifications? Which rarely does?

A 
Calcifications = DCIS
Rarely = LCIS

Systems Pathology II Final (8 decks)

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