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Pathoma > Female > Flashcards

Female Flashcards

1
Q

Which HPV serotypes cause female genital condyloma?

A

6 and 11

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2
Q

What histological structure is indicative of being infected by HPV?

A

Koilocyte

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3
Q

Lichen sclerosis is most often seen in what age group of women?

A

post-menopausal

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4
Q

What is Lichen Simplex Chronicus?

A

hyperplasia of (vulvar) squamous epithelium

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5
Q

Is Lichen Simplex Chronicus benign or premalignant? How does it present?

A

benign

leukoplakia

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6
Q

Which HPV isotypes would vulvar carcinoma be indicative of? What does this result in?

A

16 and 18

Vulvar Intraepithelial Neoplasia (VIN)

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7
Q

What is Extramammary Pagets Disease characterized by?

A

malignant epithelial cells in the epidermis

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8
Q

What would the two stains of Pagets Disease be?

A

Keratin +

PAS +

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9
Q

What is adenosis of the vagina?

A

focal persistence of columnar epithelium in the UPPER 2/3 of the vagina

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10
Q

What embryological layer is the lower 1/3 of the vagina derived from? Epithelial type?

A

Urogenital Sinus

squamous

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11
Q

What is the upper 2/3 of the vagina derived from? Epithelial type?

A

Mullerian Duct

columnar

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12
Q

What drug is associated with adenosis?

A

Diethylstilbestrol (DES)

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13
Q

What is the neoplastic concern for women with diethylstilbestrol associated adenosis?

A

clear cell ADENOcarcinoma

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14
Q

What is Embryonal Rhabdomyosarcoma?

A

malignant mesenchymal proliferation of immature skeletal muscle

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15
Q

WHat is another name for Embryonal Rhabdomyosarcoma?

A

Sarcoma Botryoiodes

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16
Q

How does Embryonal Rhabdomyosarcoma often present?

A

grape-like mass extending from vagina or penis

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17
Q

What two stains would be present in a Rhabdomyosarcoma?

A

Desmin and Myogenin

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18
Q

What is desmin?

A

intermediate filament of skeletal muscle

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19
Q

Where is myogenin usually found?

A

immature skeletal muscle

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20
Q

What type of epithelium lines the endocervix?

A

columnar

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21
Q

What type of epithelium lines the exocervix?

A

nonkeratinized squamous

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22
Q

Is HPV RNA or DNA?

A

DNA

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23
Q

What are the high risk HPV isotypes?

A

16/18/31/33

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24
Q

What are the low risk HPV isotypes?

A

6 and 11

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25
Q

What does CIN I involve?

A

1/3 thickness

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26
Q

What does CIN II involve?

A

2/3 thickness

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27
Q

What does CIN III involve?

A

almost all thick thickness

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28
Q

What does CIS involve?

A

all thickness

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29
Q

Cervical carcinoma often arises in what age group? What are two ways in which it often presents?

A

middle-aged women

vaginal bleeding or post-coital bleeding

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30
Q

What is a common cause of death in advanced cervical carcinoma? What type?

A

hydronephrosis

post-renal failure

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31
Q

What are the two high-yield secondary risk factors for the development of cervical carcinoma?

A

smoking and immunodeficiency

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32
Q

Antibodies against which HPV isotype protect against condylomas? Protect against CIN?

A

condyloma = 6 and 11

CIN = 16 and 18

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33
Q

What is Ashermann Syndrome? What does this result in?

A

loss of basalis of endometrium

amenorrhea

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34
Q

What is Acute Endometritis? What usually causes this?

A

bacterial infection of endometrium

retained pieces of placenta

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35
Q

The presence of what cell is required to diagnose chronic endometritis? Why?

A

Plasma cells

lymphocytes are normally present in the endometrium

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36
Q

What drug can cause an endometrial polyp?

A

Tamoxifen

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37
Q

What is perfect definition endometriosis?

A

endometrial GLANDS and STROMA outside of uterine endometrium lining

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38
Q

What is the most common site for endometriosis? What does this result in?

A

ovary

chocolate cyst

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39
Q

How does endometriosis outside of the ovary appear? Where?

A

yellow-brown ‘gunpowder’ nodules

fallopian tube

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40
Q

What is it called if the uterine myometrium is found to contain endometriosis?

A

Adenomysis

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41
Q

Endometriosis can cause what life-threatening outcome? Especially where?

A

carcinoma

ovary

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42
Q

What causes Endometrial Hyperplasia?

A

unopposed effects of ESTROGEN

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43
Q

How does endometrial hyperplasia commonly present? In what type of patient?

A

post-menopausal uterine bleeding

obese

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44
Q

What four cancers are Psamomma Bodies indicative of?

A

Papillary cancer of the thyroid

Meningioma

Papillary serous (ovarian or endometrial) carcinoma

mesothelioma

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45
Q

What protein is commonly deficient during Sporadic Endometrial Carcinoma?

A

p53

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46
Q

What is a Leiomyoma? What is another name for leiomyoma?

A

benign neoplastic proliferation of smooth muscle

fibroid

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47
Q

The development of a leiomyoma is related to what?

A

exposure to estrogen

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48
Q

What layer of the uterus does a Leiomyoma commonly arise from?

A

myometrium

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49
Q

What is a leiomyosarcoma?

A

malignant proliferation of smooth muscle cells arising from the myometrium

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50
Q

Do leiomyosarcomas arise from leiomyomas?

A

no

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51
Q

In what population of women does a leiomyosarcoma often arise in?

A

post-menopausal

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52
Q

How many lesions are usually present during a leiomyosarcoma?

A

single

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53
Q

LH acts on what cells? To produce what?

A

Theca

androgens

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54
Q

FSH acts on what cells? To produce what?

A

granulosa

estradiol from estrogens

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55
Q

The surge of what hormone causes an LH spike? What is the result?

A

estrogen

ovulation

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56
Q

What hormone does the corpus luteum secrete?

A

progesterone

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57
Q

What are the levels of LH and FSH during PCOD?

A

high LH

low FSH

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58
Q

What is the result of excessive LH production during PCOD? Why?

A

hirsutism

increased androgens from Theca cells

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59
Q

During PCOD, what does excessive androgen get converted into? Where?

A

estrone

peripheral fat

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60
Q

High estrone inhibits the release of what hormone? What does this result in?

A

FSH

cystic degeneration of the follicles

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61
Q

What are the four common presenting symptoms of a woman with Polycystic Ovary Disease?

A

Obese

Oligomenorrhea

Infertile

Insulin resistance

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62
Q

What are the three cellular layers of the ovary?

A

surface epithelium

germ cells

sex chord stroma

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63
Q

What is the most common type of ovarian tumor?

A

surface epithelial tumor

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64
Q

What are the two types of ovarian surface epithelium tumor? Both are usually?

A

mucinous and serous

cystic

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65
Q

What is the name for a benign surface epithelium ovarian tumor?

A

cystadenoma

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66
Q

Is a cystadenoma more common in a premenopausal or postmenopausal woman?

A

premenopausal

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67
Q

What is the name for a malignant surface epithelium ovarian tumor?

A

cystadenocarcinoma

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68
Q

Is a cystadenocarcinoma more common in a premenopausal or postmenopausal woman?

A

postmenopausal

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69
Q

BRCA1 mutations carry an increased risk of cancer regarding which two structures in the female genitalia?

A

serous carcinoma of ovary

serous carcinoma of fallopian tube

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70
Q

What kind of tumor is an endometrioid? Are endometrioid tumors more often benign or malignant?

A

ovarian surface epithelium

malignant

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71
Q

Are Brenner or Endometrioid tumors malignant? What kind of cancer are these?

A

Endometrioid = malignant

ovarian surface epithelium

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72
Q

What is the tumor marker for ovarian cancer?

A

CA-125

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73
Q

What type of ovarian tumor occurs in women of reproductive age?

A

Germ cell tumor

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74
Q

What are the two tumors of fetal tissue?

A

cystic teratoma and embryonal carcinoma

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75
Q

What germ cell tumor mimmics Oocytes?

A

Dysgerminoma

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76
Q

What germ cell tumor mimmics the yolk sac?

A

enodermal sinus tumor

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77
Q

What germ cell tumor mimmics the placenta?

A

choriocarcinoma

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78
Q

What is the name for a teratoma composed of ovarian tissue?

A

struma ovarii

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79
Q

What is the most common malignant germ cell tumor?

A

Dysgerminoma

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80
Q

What is the male counterpart of a dysgerminoma?

A

seminoma

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81
Q

What lab value may be elevated during a dysgerminoma?

A

LDH

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82
Q

What is the most common germ cell tumor in children?

A

endodermal sinus tumor

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83
Q

What lab may be elevated during a Endodermal Sinus tumor?

A

alpa-fetoprotein

84
Q

Schiller-Duval bodies are indicative of what type of ovarian carcinoma? What do these structures look like?

A

Endodermal Sinus Tumor

‘Glomeruloid like’

85
Q

What do Schiller-Duval bodies look like?

A

Glomerulus

86
Q

What two blast cells compose a choriocarcinoma?

A

cytotrophoblasts and syncytiotrophoblasts

87
Q

What is the preferred medium of metastisis for choriocarcinoma?

A

hematogenous

88
Q

Granulosa-Thecal Tumors usually produce what hormone?

A

estrogen

89
Q

Reinke crystals are indicative of what cancer? Which cell specifically?

A

Leydig-Sertoli tumor

Reinke = Leydig

90
Q

What two findings on physical exam would be indicative of a Leydig-Sertoli tumor?

A

Hirsutism

Virilization

91
Q

What is the triad of Meigs tumor?

A

ascites

pleural effusion

fibroma of ovary

92
Q

What is Pseudomyxoma Peritonei?

A

massive amounts of mucus in peritoneum

93
Q

What is the primary location for a tumor during Pseudomyxoma Peritonei? Where is the additonal location site of metastasis?

A

appendix

ovary

94
Q

What is the classic presentation for an ectopic pregnancy?

A

lower abdominal pain a few weeks after a missed pregnancy

95
Q

What are the three risk factors for a spontaneous abortion?

A

Trisomy 16

hypercoaguable state

teratogens

96
Q

What is placenta previa?

A

When the placenta overlies the cervical os

97
Q

How does placenta previa present?

A

3rd trimester bleeding

98
Q

What is placenta accreta?

A

implantation of placenta into myometrium

99
Q

What birth defects are caused by alcohol?

A

mental retardation and microcephaly

100
Q

What two birth defects are caused by cocaine?

A

growth retardation

spontaneous abortion

101
Q

What birth defect is caused by thalidomide?

A

limb defects

102
Q

What birth defect is caused by cigarettes?

A

growth retardation

103
Q

What three birth defects are caused by Isotretinoin?

A

spontaeous abortion

hearing

visual impairment

104
Q

What birth defect is caused by phenytoin?

A

digit hypoplasia

cleft lip/palate

105
Q

What cell proliferates during a hyaditiform mole?

A

tropholasts

106
Q

What is a partial mole?

A

normal ovum fertilized by two sperm

107
Q

How many chromosomes does a partial mole possess?

A

69

108
Q

What is a partial mole?

A

empty ovum fertilized by two sperm

109
Q

Is fetal tissue present in a partial mole?

A

yes

110
Q

Is fetal tissue present in a complete mole?

A

no

111
Q

What do the villi look like in a partial mole?

A

some are normal and some are edematous

112
Q

What do the villi look like in a complete mole?

A

most are edematous

113
Q

Which mole would have abnormally high βHCG? Lower βHCG?

A

high = complete

lower = partial

114
Q

What type of cancer could a hyaditiform mole give rise to? Partial or complete mole?

A

choriocarcinoma

complete

115
Q

How does a hyaditiform mole present on ultrasound?

A

‘snow storm’

116
Q

Do condylomas progress to carcinoma?

A

no

117
Q

How does Lichen Sclerosis present?

A

Leukoplakia

118
Q

What is the key phrase for the presentation of lichen sclerosis?

A

“Parchment-like”

119
Q

Other than HPV, what is the 2nd cause of vulvar carcinoma?

A

long standing lichen sclerosis

120
Q

What is Extramammary Pagets Disease (vulva) characterized by?

A

malignant epithelial cells in the EPIDERMIS of the vulva

121
Q

What causes vaginal carcinoma?

A

high risk HPV

122
Q

Where does cancer from the lower 1/3 of the vagina spread?

A

inguinal nodes

123
Q

Where does cancer from the upper 2/3 of the vagina spread?

A

iliac nodes

124
Q

Where in the female genital tract does HPV like to infect the most?

A

transformation zone

125
Q

What molecule does p53 use to initially begin apoptosis?

A

Bax

126
Q

What is the function of bax?

A

inhibit bcl-2

127
Q

What protein does E7 inhibit? What protein does this protein inhibit?

A

Rb

E2F

128
Q

At what point is cervical epithelial dysplasia irreversible?

A

carcinoma in situ

129
Q

Does HPV drive squamous cell or adenocarcinoma of he cervix?

A

both

130
Q

What are the two limitations of the pap smear?

A

ineffective sampling of transformation zone

does not detect adenocarcinoma very well

131
Q

What serotypes in the HPV vaccine effective against?

A

6/11

16/18

132
Q

Do patients still need to get a pap smear after HPV vaccine?

A

yes

133
Q

When are the two most common times for an anovulatory cycle to arise?

A

menarche and menopause

134
Q

When does endometriosis often cause pain?

A

pain during menstruation

135
Q

How does endometrial carcinoma most often present?

A

post-menopausal bleeding

136
Q

What are the two pathways for the development of Endometrial Carcinoma?

A

hyperplastic and sporadic

137
Q

What is the classic histology of hyperplastic endometrial carcinoma?

A

Endometrioid

138
Q

What is the histology of Sporadic endometrial carcinoma?

A

Serous

139
Q

Does sporadic endometrial carcinoma occur in the young or elderly?

A

elderly

140
Q

What age group does hyperplastic endometrial carcinoma occur?

A

50-60

141
Q

What are Psamomma bodies composed of?

A

concentric calcifications

142
Q

What does gross examination of a leiomyoma reveal?

A

multiple well defined white whirled masses

143
Q

How does a leiomyosarcoma arise?

A

De novo

144
Q

High levels of estrone during PCOD correlates to an increased risk of what cancer?

A

endometrial carcinoma

145
Q

Where do ovarian carcinomas like to spread?

A

peritoneum

146
Q

What two types of tissue are most commonly found in an immature (malignant) Teratoma?

A

Neural

squamous cell

147
Q

What is the most common malignancy to arise in a teratoma?

A

squamous cell carcinoma

148
Q

Are villi present during a choriocarcinoma?

A

no

149
Q

Do choriocarcinomas respond well or poorly to chemo?

A

poorly

150
Q

Are embryonal carcinomas benign or aggressive?

A

aggressive

151
Q

What is the biggest risk factor for ectopic pregnancy?

A

fibrosis

152
Q

What is the presentation of an ectopic pregnancy?

A

lower quadrant abdominal pain weeks after a missed period

153
Q

What type of necrosis can occur during pre-eclampsia? Where?

A

fibrinoid

vessels of placenta

154
Q

Which cell type proliferates during a Hydatidiform Mole?

A

Trophoblasts

155
Q

What is the most abnormal lab during a Hydatidiform Mole?

A

very high β-HCG

156
Q

Choriocarcinoma is composed of what cell type?

A

trophoblasts

157
Q

Which type of choriocarcinoma responds to chemo? Which does not?

A

chemo = gestation

poorly = germ cell tumor

158
Q

What is the function of HPV E6 protein?

A

degrade p53

159
Q

What type of cancer can endometriosis lead to? Where?

A

carcinoma

ovary

160
Q

High levels of what hormone can drive endometrial carcinoma during Endometriosis?

A

Estrone

161
Q

What are the two birth defects caused by phenytoin?

A

cleft lip/palate and digit hypoplasia

162
Q

What is the second cause of a vulvar condyloma?

A

secondary syphillis

163
Q

Does the epidermis thicken or thin during Lichen Sclerosis?

A

thin

164
Q

Does the skin thicken or thin during Lichen Simplex Chronicus?

A

thicken

165
Q

Does Pagets Disease of vulva represent an underlying carcinoma?

A

no

166
Q

Does Pagets Disease of breast represent an underlying carcinoma?

A

yes

167
Q

Does epithelium in the vagina grow from bottom-up or top-down?

A

bottum-up

168
Q

Which female Genitourinary cancer is an AIDS defining illness?

A

cervical carcinoma

169
Q

What follows an abnormal pap smear?

A

colposcopy

170
Q

Which immune cell is usually present in the endometrium?

A

lymphocytes

171
Q

What factor is the largest predictor of progression of Endometrial Hyperplasia to Endometrial carcinoma?

A

cellular atypia

172
Q

‘Whorled’ refers to what mass?

A

leiomyoma

173
Q

Do leiomyosarcomas have hemorrhage?

A

yes

174
Q

Do leiomyosarcomas have necrosis?

A

yes

175
Q

What produces a corpus luteum cyst?

A

hemorrhage into corpus luteum

176
Q

Which epithelium is the surface epithelium of the ovary derived from?

A

coelemic epithelium

177
Q

Coelomic epithelium gives rise to what three cell types of the female genitourinary tract?

A

fallopian

endometrium

endocervix

178
Q

Which three cells comprise the sex chord stroma?

A

theca

granulosa

fibrocyte

179
Q

Teratogens during which time period can cause abortion?

A

first two weeks

180
Q

Teratogens during which time period can cause organ malformation?

A

3-8 weeks

181
Q

Teratogens during which time period can cause organ hypoplasia?

A

3-9 weeks

182
Q

During which trimester does placenta previa bleed?

A

third

183
Q

What are the three risk factors for SIDS?

A

smoking

sleeping on stomach

prematurity

184
Q

During which trimester can molar pregnancy pass grape like masses?

A

second

185
Q

What happens to the dermis during lichen sclerosis?

A

sclerosis

186
Q

Is Lichen Simplex Chronicus associated with the development of squamous cell carcinoma?

A

no

187
Q

What is the main cause of non-HPV vulvar carcinoma?

A

long standing lichen sclerosis

188
Q

What causes adenosis of the vagina?

A

DES

189
Q

What is myogenin?

A

transcription factor in immature skeletal muscle

190
Q

What is Desmin?

A

intermediate filament in muscle

191
Q

What is the more common cancer of the cervix, adeno or squamous?

A

squamous

192
Q

Which four isotypes are currently included in the cervical cancer vaccine?

A

6/11/16/18

193
Q

Where in the endometrium are the stem cells present?

A

basalis

194
Q

What can be the end outcome of endometriosis?

A

infertility

195
Q

What is the definition of Endometrial Hyperplasia?

A

proliferation of endometrial glands relative to endometrial stroma

196
Q

Does endometrial carcinoma involve stroma?

A

no

197
Q

What are the two histological subtypes of endometrial carcinoma?

A

endometrioid

sporadic

198
Q

Does leiomyoma occur in pre or post menopausal women?

A

pre

199
Q

Is leiomyoma a single or multiple mass?

A

multiple

200
Q

Are leiomyomas usually symptomatic or asymptomatic?

A

asymptomatic

201
Q

The presence of what type of tissue in a teratoma signales that it is immature?

A

neuroectoderm

202
Q

Does choriocarcinoma of the ovary respond to chemo poor or well?

A

poor

203
Q

Is metastatic tumor of the ovary more often unilater or bilateral?

A

bilateral

204
Q

Can endometriosis cause an ectopic?

A

yes

205
Q

What is the age range for SIDS?

A

one month to one year

Pathoma (19 decks)

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