Female

Question 1

Vulvovaginal pathology

can be divided into two broad categories:

Answer 1

Non-neoplastic: include infections (STDs and non-STDs) and lekoplakias

Neoplastic: include in situ cancer, invasive (squamous and adeno) and sarcoma

Question 2

2 viral STDs:

Answer 2

HSV2, HPV

Question 3

usually causes genital lesions

Answer 3

HSV2

Question 4

How do ulcers form in HSV2?

Answer 4

red papules –> vesicles –> painful ulcers

Question 5

latency in the lumbosacral cranial nerves, can be reactivated any/many times, high transmission during active phase

Answer 5

HSV2

Question 6

HPV is a _____ virus.

Answer 6

DNA

Question 7

Many subtypes/strains of HPV: low-risk vs high-risk

Answer 7

“Low-risk” strains (6 and 11 most common) associated with wart-like lesions (condyloma)
- Vulva, perineal, and perianal region

Infection with “high-risk” strains (16 and 18 most common) is a risk factor for developing dysplasia and cancer (squamous cell carcinoma) of the genitals and cervix

Question 8

What does the Gardasil vaccine provide protection against?

Answer 8

nine HPV strains: 6, 11, 16, 18, and 5 other high-risk strains

Question 9

Histology: exophytic, papillary proliferation of squamous epithelium

Answer 9

HPV

Question 10

histology: koilocytes

Answer 10

HPV

*Koilocytes = cells with clear cytoplasm and condensed, shriveled nuclei (a morphologic sign of an HPV-infected epithelial cell)

Question 11

flagellated ovoid protozoan, asymptomatic or frothy yellow vaginal discharge

Answer 11

Trichomonas vaginalis

Question 12

Clinical appearance: fiery red mucosa of the vagina and cervix (strawberry cervix)

Answer 12

Trichomonas vaginalis

Question 13

bacterial infection—coccobacillus, fish odor, thin grey secretions

Answer 13

Gardnerella vaginalis

Question 14

Histology: clue cells (vaginal epithelial cells covered in bacteria)

Answer 14

Gardnerella vaginalis

Question 15

a clinical term used to describe an adherent white plaque, the white color is usually attributable to increased keratin production

Answer 15

leukoplakia

Question 16

may represent many possible conditions including hyperplasia, dysplasia, and squamous cell carcinoma

Answer 16

leukoplakia

Question 17

vulvovaginal neoplasms

Answer 17

VIN1-VIN3 / VAIN1-VAIN3 / CIN1-CIN3 –> vulvar/vaginal/cervical intraepithelial neoplasia

Question 18

vulvovaginal neoplasm grading

Answer 18

the 1-3 grading is based on how much of the thickness of the epithelium is involved, with 3 being the most

Question 19

all are caused by infection with high-risk HPV, as are SCCs that develop in these locations

Answer 19

vulvovaginal neoplasm

Question 20

vulvovaginal neoplasms that most commonly develop at the squamocolumnar junction (T zone)

Answer 20

cervical dysplasia (CIN) and SCC

Question 21

caused by high-risk HPV infection, most commonly develops at the squamocolumnar junction (T zone)

Answer 21

squamous cell carcinoma

Question 22

unique vaginal cancer with clear cell morphology

Answer 22

adenocarcinoma

Question 23

occurs in women who were exposed to DES (diethylstilbestrol) in the womb

DES = a synthetic estrogen given during pregnancy to women who experienced prior miscarriages or premature deliveries

Answer 23

adenocarcinoma

Question 24

o A type of rhabdomyosarcoma
o Young girls (under age 5)
o Presents as a polypoid mass (grape-like lesion) protruding from the vagina

Answer 24

sarcoma

Question 25

presence of endometrial glands and stroma in a site other than the uterus

Answer 25

endometriosis

Question 26

chocolate cyst

Answer 26

endometrial glands in the ovaries

Question 27

sites of endometrial glands other than the uterus

Answer 27

ovaries are most common site, pelvic ligaments, umbilical cord

Question 28

mechanism of endometriosis

Answer 28

regurgitation of endometrial tissue through the tubes

Question 29

benign neoplasm of smooth muscle, often called “fibroids” in the uterus

Answer 29

leiomyoma

Question 30

- Very common, 75% women | - Vaginal pain, bleeding, infertility

Answer 30

leiomyoma

Question 31

smooth muscle malignancy of the uterus

Answer 31

leiomyosarcoma

Question 32

Clinical signs of endometrial cancer:

Answer 32

post-menopausal bleeding

Question 33

risk factors for endometrial cancer

Answer 33

obesity, estrogen replacement therapy, diabetes mellitus

Question 34

causes pelvic pain, cervical motion tenderness (excruciating pain with bimanual pelvic exam), systemic symptoms, fever, vaginal discharge

Answer 34

pelvic inflammatory disease

Question 35

How is pelvic inflammatory disease transmitted?

Answer 35

sexually (gonorrhea, chlamydia)

Question 36

pelvic inflammatory disease complications

Answer 36

abscess, bacteremia, and infertility

Question 37

Signs and symptoms of polycystic ovary syndrome:

Answer 37

irregular periods (oligomenorrhea), obesity, hirsutism, diabetes mellitus, hormonal imbalance, increased risk of endometrial and breast cancer

Question 38

another name for polycystic ovary syndrome

Answer 38

Stein Leventhal syndrome

Question 39

Ovarian tumors are more likely to be benign or malignant? Primary or secondary (metastasis from somewhere else)?

Answer 39

benign / primary

Question 40

cancer marker for ovarian malignancies

Answer 40

CA125 (cancer antigen 125), protein elevated in the blood of patients with ovarian cancer

Question 41

Two types of ovarian tumors:

Answer 41

teratoma | Krukenberb tumor

Question 42

Name the ovarian tumor: most common germ cell tumor

Answer 42

teratoma

Question 43

Name the ovarian tumor: kids and adolescents

Answer 43

teratoma

Question 44

Name the ovarian tumor: contains more than one embryonal germ cell layer, can contain epithelium, teeth, glands, hair cartilage, brain, thyroid

Answer 44

teratoma

Question 45

Name the ovarian tumor: bilateral metastasis from a GI primary cancer (stomach or intestine)

Answer 45

Krukenberg tumor

Question 46

Name the ovarian tumor: cells have a "signet ring" morphology, described this way because the cells resemble a class ring when viewed sideways (nucleus is pushed to the edge of the cell)

Answer 46

Krukenberg tumor