Female Flashcards
1
Q
Which HPV serotypes cause female genital condyloma?
A
6 and 11
2
Q
What histological structure is indicative of being infected by HPV?
A
Koilocyte
3
Q
Lichen sclerosis is most often seen in what age group of women?
A
post-menopausal
4
Q
What is Lichen Simplex Chronicus?
A
hyperplasia of (vulvar) squamous epithelium
5
Q
Is Lichen Simplex Chronicus benign or premalignant? How does it present?
A
benign
leukoplakia
6
Q
Which HPV isotypes would vulvar carcinoma be indicative of? What does this result in?
A
16 and 18
Vulvar Intraepithelial Neoplasia (VIN)
7
Q
What is Extramammary Pagets Disease characterized by?
A
malignant epithelial cells in the epidermis
8
Q
What would the two stains of Pagets Disease be?
A
Keratin +
PAS +
9
Q
What is adenosis of the vagina?
A
focal persistence of columnar epithelium in the UPPER 2/3 of the vagina
10
Q
What embryological layer is the lower 1/3 of the vagina derived from? Epithelial type?
A
Urogenital Sinus
squamous
11
Q
What is the upper 2/3 of the vagina derived from? Epithelial type?
A
Mullerian Duct
columnar
12
Q
What drug is associated with adenosis?
A
Diethylstilbestrol (DES)
13
Q
What is the neoplastic concern for women with diethylstilbestrol associated adenosis?
A
clear cell ADENOcarcinoma
14
Q
What is Embryonal Rhabdomyosarcoma?
A
malignant mesenchymal proliferation of immature skeletal muscle
15
Q
WHat is another name for Embryonal Rhabdomyosarcoma?
A
Sarcoma Botryoiodes
16
Q
How does Embryonal Rhabdomyosarcoma often present?
A
grape-like mass extending from vagina or penis
17
Q
What two stains would be present in a Rhabdomyosarcoma?
A
Desmin and Myogenin
18
Q
What is desmin?
A
intermediate filament of skeletal muscle
19
Q
Where is myogenin usually found?
A
immature skeletal muscle
20
Q
What type of epithelium lines the endocervix?
A
columnar
21
Q
What type of epithelium lines the exocervix?
A
nonkeratinized squamous
22
Q
Is HPV RNA or DNA?
A
DNA
23
Q
What are the high risk HPV isotypes?
A
16/18/31/33
24
Q
What are the low risk HPV isotypes?
A
6 and 11
25
What does CIN I involve?
1/3 thickness
26
What does CIN II involve?
2/3 thickness
27
What does CIN III involve?
almost all thick thickness
28
What does CIS involve?
all thickness
29
Cervical carcinoma often arises in what age group? What are two ways in which it often presents?
middle-aged women
vaginal bleeding or post-coital bleeding
30
What is a common cause of death in advanced cervical carcinoma? What type?
hydronephrosis
post-renal failure
31
What are the two high-yield secondary risk factors for the development of cervical carcinoma?
smoking and immunodeficiency
32
Antibodies against which HPV isotype protect against condylomas? Protect against CIN?
condyloma = 6 and 11
CIN = 16 and 18
33
What is Ashermann Syndrome? What does this result in?
loss of basalis of endometrium
amenorrhea
34
What is Acute Endometritis? What usually causes this?
bacterial infection of endometrium
retained pieces of placenta
35
The presence of what cell is required to diagnose chronic endometritis? Why?
Plasma cells
lymphocytes are normally present in the endometrium
36
What drug can cause an endometrial polyp?
Tamoxifen
37
What is perfect definition endometriosis?
endometrial GLANDS and STROMA outside of uterine endometrium lining
38
What is the most common site for endometriosis? What does this result in?
ovary
chocolate cyst
39
How does endometriosis outside of the ovary appear? Where?
yellow-brown 'gunpowder' nodules
fallopian tube
40
What is it called if the uterine myometrium is found to contain endometriosis?
Adenomysis
41
Endometriosis can cause what life-threatening outcome? Especially where?
carcinoma
ovary
42
What causes Endometrial Hyperplasia?
unopposed effects of ESTROGEN
43
How does endometrial hyperplasia commonly present? In what type of patient?
post-menopausal uterine bleeding
obese
44
What four cancers are Psamomma Bodies indicative of?
Papillary cancer of the thyroid
Meningioma
Papillary serous (ovarian or endometrial) carcinoma
mesothelioma
45
What protein is commonly deficient during Sporadic Endometrial Carcinoma?
p53
46
What is a Leiomyoma? What is another name for leiomyoma?
benign neoplastic proliferation of smooth muscle
fibroid
47
The development of a leiomyoma is related to what?
exposure to estrogen
48
What layer of the uterus does a Leiomyoma commonly arise from?
myometrium
49
What is a leiomyosarcoma?
malignant proliferation of smooth muscle cells arising from the myometrium
50
Do leiomyosarcomas arise from leiomyomas?
no
51
In what population of women does a leiomyosarcoma often arise in?
post-menopausal
52
How many lesions are usually present during a leiomyosarcoma?
single
53
LH acts on what cells? To produce what?
Theca
androgens
54
FSH acts on what cells? To produce what?
granulosa
estradiol from estrogens
55
The surge of what hormone causes an LH spike? What is the result?
estrogen
ovulation
56
What hormone does the corpus luteum secrete?
progesterone
57
What are the levels of LH and FSH during PCOD?
high LH
low FSH
58
What is the result of excessive LH production during PCOD? Why?
hirsutism
increased androgens from Theca cells
59
During PCOD, what does excessive androgen get converted into? Where?
estrone
peripheral fat
60
High estrone inhibits the release of what hormone? What does this result in?
FSH
cystic degeneration of the follicles
61
What are the four common presenting symptoms of a woman with Polycystic Ovary Disease?
Obese
Oligomenorrhea
Infertile
Insulin resistance
62
What are the three cellular layers of the ovary?
surface epithelium
germ cells
sex chord stroma
63
What is the most common type of ovarian tumor?
surface epithelial tumor
64
What are the two types of ovarian surface epithelium tumor? Both are usually?
mucinous and serous
cystic
65
What is the name for a benign surface epithelium ovarian tumor?
cystadenoma
66
Is a cystadenoma more common in a premenopausal or postmenopausal woman?
premenopausal
67
What is the name for a malignant surface epithelium ovarian tumor?
cystadenocarcinoma
68
Is a cystadenocarcinoma more common in a premenopausal or postmenopausal woman?
postmenopausal
69
BRCA1 mutations carry an increased risk of cancer regarding which two structures in the female genitalia?
serous carcinoma of ovary
serous carcinoma of fallopian tube
70
What kind of tumor is an endometrioid? Are endometrioid tumors more often benign or malignant?
ovarian surface epithelium
malignant
71
Are Brenner or Endometrioid tumors malignant? What kind of cancer are these?
Endometrioid = malignant
ovarian surface epithelium
72
What is the tumor marker for ovarian cancer?
CA-125
73
What type of ovarian tumor occurs in women of reproductive age?
Germ cell tumor
74
What are the two tumors of fetal tissue?
cystic teratoma and embryonal carcinoma
75
What germ cell tumor mimmics Oocytes?
Dysgerminoma
76
What germ cell tumor mimmics the yolk sac?
enodermal sinus tumor
77
What germ cell tumor mimmics the placenta?
choriocarcinoma
78
What is the name for a teratoma composed of ovarian tissue?
struma ovarii
79
What is the most common malignant germ cell tumor?
Dysgerminoma
80
What is the male counterpart of a dysgerminoma?
seminoma
81
What lab value may be elevated during a dysgerminoma?
LDH
82
What is the most common germ cell tumor in children?
endodermal sinus tumor
83
What lab may be elevated during a Endodermal Sinus tumor?
alpa-fetoprotein
84
Schiller-Duval bodies are indicative of what type of ovarian carcinoma? What do these structures look like?
Endodermal Sinus Tumor
'Glomeruloid like'
85
What do Schiller-Duval bodies look like?
Glomerulus
86
What two blast cells compose a choriocarcinoma?
cytotrophoblasts and syncytiotrophoblasts
87
What is the preferred medium of metastisis for choriocarcinoma?
hematogenous
88
Granulosa-Thecal Tumors usually produce what hormone?
estrogen
89
Reinke crystals are indicative of what cancer? Which cell specifically?
Leydig-Sertoli tumor
Reinke = Leydig
90
What two findings on physical exam would be indicative of a Leydig-Sertoli tumor?
Hirsutism
Virilization
91
What is the triad of Meigs tumor?
ascites
pleural effusion
fibroma of ovary
92
What is Pseudomyxoma Peritonei?
massive amounts of mucus in peritoneum
93
What is the primary location for a tumor during Pseudomyxoma Peritonei? Where is the additonal location site of metastasis?
appendix
ovary
94
What is the classic presentation for an ectopic pregnancy?
lower abdominal pain a few weeks after a missed pregnancy
95
What are the three risk factors for a spontaneous abortion?
Trisomy 16
hypercoaguable state
teratogens
96
What is placenta previa?
When the placenta overlies the cervical os
97
How does placenta previa present?
3rd trimester bleeding
98
What is placenta accreta?
implantation of placenta into myometrium
99
What birth defects are caused by alcohol?
mental retardation and microcephaly
100
What two birth defects are caused by cocaine?
growth retardation
spontaneous abortion
101
What birth defect is caused by thalidomide?
limb defects
102
What birth defect is caused by cigarettes?
growth retardation
103
What three birth defects are caused by Isotretinoin?
spontaeous abortion
hearing
visual impairment
104
What birth defect is caused by phenytoin?
digit hypoplasia
cleft lip/palate
105
What cell proliferates during a hyaditiform mole?
tropholasts
106
What is a partial mole?
normal ovum fertilized by two sperm
107
How many chromosomes does a partial mole possess?
69
108
What is a partial mole?
empty ovum fertilized by two sperm
109
Is fetal tissue present in a partial mole?
yes
110
Is fetal tissue present in a complete mole?
no
111
What do the villi look like in a partial mole?
some are normal and some are edematous
112
What do the villi look like in a complete mole?
most are edematous
113
Which mole would have abnormally high βHCG? Lower βHCG?
high = complete
lower = partial
114
What type of cancer could a hyaditiform mole give rise to? Partial or complete mole?
choriocarcinoma
complete
115
How does a hyaditiform mole present on ultrasound?
'snow storm'
116
Do condylomas progress to carcinoma?
no
117
How does Lichen Sclerosis present?
Leukoplakia
118
What is the key phrase for the presentation of lichen sclerosis?
"Parchment-like"
119
Other than HPV, what is the 2nd cause of vulvar carcinoma?
long standing lichen sclerosis
120
What is Extramammary Pagets Disease (vulva) characterized by?
malignant epithelial cells in the EPIDERMIS of the vulva
121
What causes vaginal carcinoma?
high risk HPV
122
Where does cancer from the lower 1/3 of the vagina spread?
inguinal nodes
123
Where does cancer from the upper 2/3 of the vagina spread?
iliac nodes
124
Where in the female genital tract does HPV like to infect the most?
transformation zone
125
What molecule does p53 use to initially begin apoptosis?
Bax
126
What is the function of bax?
inhibit bcl-2
127
What protein does E7 inhibit? What protein does this protein inhibit?
Rb
E2F
128
At what point is cervical epithelial dysplasia irreversible?
carcinoma in situ
129
Does HPV drive squamous cell or adenocarcinoma of he cervix?
both
130
What are the two limitations of the pap smear?
ineffective sampling of transformation zone
does not detect adenocarcinoma very well
131
What serotypes in the HPV vaccine effective against?
6/11
16/18
132
Do patients still need to get a pap smear after HPV vaccine?
yes
133
When are the two most common times for an anovulatory cycle to arise?
menarche and menopause
134
When does endometriosis often cause pain?
pain during menstruation
135
How does endometrial carcinoma most often present?
post-menopausal bleeding
136
What are the two pathways for the development of Endometrial Carcinoma?
hyperplastic and sporadic
137
What is the classic histology of hyperplastic endometrial carcinoma?
Endometrioid
138
What is the histology of Sporadic endometrial carcinoma?
Serous
139
Does sporadic endometrial carcinoma occur in the young or elderly?
elderly
140
What age group does hyperplastic endometrial carcinoma occur?
50-60
141
What are Psamomma bodies composed of?
concentric calcifications
142
What does gross examination of a leiomyoma reveal?
multiple well defined white whirled masses
143
How does a leiomyosarcoma arise?
De novo
144
High levels of estrone during PCOD correlates to an increased risk of what cancer?
endometrial carcinoma
145
Where do ovarian carcinomas like to spread?
peritoneum
146
What two types of tissue are most commonly found in an immature (malignant) Teratoma?
Neural
squamous cell
147
What is the most common malignancy to arise in a teratoma?
squamous cell carcinoma
148
Are villi present during a choriocarcinoma?
no
149
Do choriocarcinomas respond well or poorly to chemo?
poorly
150
Are embryonal carcinomas benign or aggressive?
aggressive
151
What is the biggest risk factor for ectopic pregnancy?
fibrosis
152
What is the presentation of an ectopic pregnancy?
lower quadrant abdominal pain weeks after a missed period
153
What type of necrosis can occur during pre-eclampsia? Where?
fibrinoid
vessels of placenta
154
Which cell type proliferates during a Hydatidiform Mole?
Trophoblasts
155
What is the most abnormal lab during a Hydatidiform Mole?
very high β-HCG
156
Choriocarcinoma is composed of what cell type?
trophoblasts
157
Which type of choriocarcinoma responds to chemo? Which does not?
chemo = gestation
poorly = germ cell tumor
158
What is the function of HPV E6 protein?
degrade p53
159
What type of cancer can endometriosis lead to? Where?
carcinoma
ovary
160
High levels of what hormone can drive endometrial carcinoma during Endometriosis?
Estrone
161
What are the two birth defects caused by phenytoin?
cleft lip/palate and digit hypoplasia
162
What is the second cause of a vulvar condyloma?
secondary syphillis
163
Does the epidermis thicken or thin during Lichen Sclerosis?
thin
164
Does the skin thicken or thin during Lichen Simplex Chronicus?
thicken
165
Does Pagets Disease of vulva represent an underlying carcinoma?
no
166
Does Pagets Disease of breast represent an underlying carcinoma?
yes
167
Does epithelium in the vagina grow from bottom-up or top-down?
bottum-up
168
Which female Genitourinary cancer is an AIDS defining illness?
cervical carcinoma
169
What follows an abnormal pap smear?
colposcopy
170
Which immune cell is usually present in the endometrium?
lymphocytes
171
What factor is the largest predictor of progression of Endometrial Hyperplasia to Endometrial carcinoma?
cellular atypia
172
'Whorled' refers to what mass?
leiomyoma
173
Do leiomyosarcomas have hemorrhage?
yes
174
Do leiomyosarcomas have necrosis?
yes
175
What produces a corpus luteum cyst?
hemorrhage into corpus luteum
176
Which epithelium is the surface epithelium of the ovary derived from?
coelemic epithelium
177
Coelomic epithelium gives rise to what three cell types of the female genitourinary tract?
fallopian
endometrium
endocervix
178
Which three cells comprise the sex chord stroma?
theca
granulosa
fibrocyte
179
Teratogens during which time period can cause abortion?
first two weeks
180
Teratogens during which time period can cause organ malformation?
3-8 weeks
181
Teratogens during which time period can cause organ hypoplasia?
3-9 weeks
182
During which trimester does placenta previa bleed?
third
183
What are the three risk factors for SIDS?
smoking
sleeping on stomach
prematurity
184
During which trimester can molar pregnancy pass grape like masses?
second
185
What happens to the dermis during lichen sclerosis?
sclerosis
186
Is Lichen Simplex Chronicus associated with the development of squamous cell carcinoma?
no
187
What is the main cause of non-HPV vulvar carcinoma?
long standing lichen sclerosis
188
What causes adenosis of the vagina?
DES
189
What is myogenin?
transcription factor in immature skeletal muscle
190
What is Desmin?
intermediate filament in muscle
191
What is the more common cancer of the cervix, adeno or squamous?
squamous
192
Which four isotypes are currently included in the cervical cancer vaccine?
6/11/16/18
193
Where in the endometrium are the stem cells present?
basalis
194
What can be the end outcome of endometriosis?
infertility
195
What is the definition of Endometrial Hyperplasia?
proliferation of endometrial glands relative to endometrial stroma
196
Does endometrial carcinoma involve stroma?
no
197
What are the two histological subtypes of endometrial carcinoma?
endometrioid
sporadic
198
Does leiomyoma occur in pre or post menopausal women?
pre
199
Is leiomyoma a single or multiple mass?
multiple
200
Are leiomyomas usually symptomatic or asymptomatic?
asymptomatic
201
The presence of what type of tissue in a teratoma signales that it is immature?
neuroectoderm
202
Does choriocarcinoma of the ovary respond to chemo poor or well?
poor
203
Is metastatic tumor of the ovary more often unilater or bilateral?
bilateral
204
Can endometriosis cause an ectopic?
yes
205
What is the age range for SIDS?
one month to one year
