Female Flashcards
The central pathologic abnormality of PCOS is?
Numerous cystic follicles or follicle cysts
In reproductive age women
Common S/Sx of PCOS
- Persistent anovulation
- Obesity (40%)
- Hirsutism (50%)
- Virilism (rare)
Recent studies link PCOS to {{…}}
Insulin resistance
Unlike PCOS, ovarian stroma, display…
- Post-menopausal women
- B/L symmetrical enlargement of ovaries
- Similar S/Sx: hirsutism, obesity
PCOS: cysts; pre-menopausal
What is the earliest sign of an endometrial cancer?
Post-menopausal bleeding
Why are ovarian neoplasms related to a higher rate of mortality when compared to cervical or other female reproductive tract cancers?
- Hard to detect early
- Not many S/Sx
- Most are benign & occur 20-45 yo (80%)
- Malignant tumors: 40-65 yo
What is the main risk factor for cervical cancer?
HPV infection
What is the main risk factor for endometrial cancer?
Estrogen excess
Exogenous estrogen; early menarche
What are the most common S/Sx of ovarian neoplasms?
- Abdominal pain
- Abdominal distention
- Urinary & GI Sx
General Sx due to non-functional nature of neoplasms
{{…}} are the origin of most ovarian cancers
Surface epithelial cells
90% malignant
What are the most common types of surface epithelial cell ovarian cancers?
- Serous tumor
- Mucinous tumor
- Endometroid tumor
The risk of malignancy of ovarian cancers is directly propertional to {{…}}
Solid mass
Not fluid –> solid mass only
{{…}}, are concentric calcifications that are frequently seen in serous ovarian neoplasms
Psamomma bodies
A cancer features the following histopathology image. What type of ovarian tumor do you suspect?
Serous ovarian tumor
The {{…}} type of ovarian tumors are more likley to grow in large size with less surface inolvement
Mucinous tumors
Upon exploratory laporotomy, it is found that a patient suffering from a large ovarian tumor and has a large quantity of mucin within their peritoneal cavity. What type of tumor do you suspect they suffer from?
Mucinous
{{…}} type of ovarian tumors are mostly carcinomas that involve the endometrium and can coexist with endometriosis
Usually found in 50-70 yo
Endometrioid
What biomarker may be used to evaluate for ovarian neoplasm in BRCA1 or BRCA2 patients?
Only used for those at risk or to monitor treatment
CA-125
What procedure(s) can be used to reduce the risk of ovarian cancer in those with BRCA mutations?
- Tubal ligation
- Oral contraceptive therapy
{{…}} are benign tumors that can undergo malignant transformation of any of the components
Teratomas
Teratomas are most commonly found in women of {{…}}
Reproductive years
Are dermoid cysts can be used to desribe benign cancerous lesions called {{…}}
Teratomas
The karyotype of all teratomas will be {{…}}
46,XX
Same # as female has
A {{…}} type of teratoma is composed almost of entirely mature thyroid tissue that can hyperfunction and cause hyperthyroidism
Tachycardia, exothalmos, etc
Struma ovarii
{{…}} is the most common germ cell tumor in children and can elaborate α-FP
Can contain schiller-duval bodies (glomerulus-like structures)
Endodermal sinus tumors
{{…}} produce large amounts of estrogen linked to endometrial hyperplasia, endometrial carcinoma, and breast carcinoma (breast cancer)
Granulosa-theca cell tumor
Krukenberg or metastatic tumors of the ovaries are highly related to {{…}} cancers
Signet ring histologic pattern
GIT
A {{…}} type of cancer is associated with right-sided hydrothorax known as Meign’s syndrome
Fibrothecoma
The {{…}} tumors can be masculinizing or defeminizing but are not as common as PCOS
Sertoli-Leydig cell tumors
The most common site of ectopic pregnancy is?
Fallopian tubes (90%)
The most common risk factor for ectopic pregnancy?
PID (w/ chronic salpingitis)
Diethylstilbestrol (DES) exposure increases the risk of what type of cancer?
Vaginal clear cell adenocarcinoma
In utero exposure
{{…}} is the Dx procedure of choice along with β-hCG testing to evaluate for ectopic pregnancy
Transvaginal ultrasound
A normal rise in {{…}} is not seen in ectopic pregnancy
β-hCG
First trimester bleeding is typically associated with?
Normal implantation
2nd/3rd trimester assoc. w/ abnormal implantation
A sudden onset of pain during 27-32 weeks gestation w/ or w/o vaginal bleeding you should suspect & rule out {{…}}
Abruptio placentae
In {{…}} the placenta is near the internal os of the cervix and can lead to significant hemorrhaging during delivery
Adv maternal age, multiple gestations, previous C-section, etc.
Placenta previa
In {{…}} there is partial or complete absence of the decidua of the endometrium w/ adherence of the placenta directly to the myometrium
Can be a cause of obstetric bleeding
Placenta accreta
S/Sx of preeclampsia
- HTN
- Proteinuria
Both must be present
After 20 weeks gestation; if < 20 weeks then chronic HTN
{{…}} is similar to preeclampsia (proteinuria & HTN) with new onset of seizures
Eclampsia
Can occur before & after delivery
What is the main mechanism behind preeclampsia?
Reduced placental perfusion
Maternal antioxidants & endothelial dysfunction –> reduced perfusion
What arteries display abnormal remodeling in the mechanism behind preeclampsia & eclampsia?
Remodeling of Spiral Arteries
What are some risk factors for preeclampsia/eclampsia?
- FMH of preeclampsia
- Preeclampsia w/ a previous pregnancy (man or woman)
- Fetus w/ a karyotypic abnormality
β-hCG level is much higher than that seen in pregnancy in what type of diseases?
Gestational trophoblastic disease
* Hydatidiform mole
* Invasive mole
* Choriocarcinoma
More hCG more malignant
{{…}} are a gestational trophoblastic disease characterized as “grape-like” swellings of the chorionic villi
Hydatidiform mole
Complete hydatidiform moles are genotypically {{…}}
Dilpoid (46,XX or 46,XY)
Partial hydatidiform moles are genotypically {{…}}
Triploid (69,XXY or 69,XXX)
Which type of hydatidiform mole will not display fetal parts?
Complete hydatidiform moles
Maternal egg is absent of DNA; All genes from paternal origin (sperm)
Which type of hydatidiform mole can produce fetal parts w/ a viable embryo maintained for up to weeks?
Partial mole (sperm has diploid DNA or 2 sperm fertilize the egg)
Maternal egg (DNA) is normal; Sperm or action of sperm is abnormal
A complete hydatidiform mole is completely a {{…}}
Cystic/villous mass
no fetal parts
Which type of hydatidiform mole is most likely to become a choriocarcinoma?
Complete hydatidiform mole (46,XX or 46,XY)
How are hydatidiform moles identified?
- Ultrasound at 12-14 weeks (too large for dates)
- Cystic appearance upon ultrasound
- Detected earlier via β-hCG