Female G/R overview- Dr. Bishop

Question 1

What are high risk strains of HPV (4)

Answer 1

16, 18, 31, 33

Question 2

HPV Produces two proteins that are oncogenic: what are they and what do they do

Answer 2

E6- knocks out p53

E7- knocks out Rb

Question 3

HPV vs HSV: which is oncogenic, what do they have in common

Answer 3

both are latent infections

HPV is oncogenic

Question 4

What are the 2 Low-risk HPV strains that cuase Condyloma:

Answer 4

6, 11

Question 5

What is MC reported bacterial infx in the US

Answer 5

chalmydia

Question 6

5 outcomes of chlamydia infx

Answer 6

pelvic Inlfammatory dz
 Fitzhugh-Curtis (perihepatitis)
early labor
Neonatal  PNA or 
neonatalconjunctivitis

Question 7

What two vaginal infx are treated together and the drugs for each (3 total)

Answer 7

Azithromycin or Doxycycline + ceftriaxone (for Gonorrhea because they co-infect so often)

Question 8

Which is more often symptomatic and what are the sx? Gonorrhea or CHlamydia?

Answer 8

Gonorrhea: Thick, purulent vaginal discharge

Question 9

4 waysyou evaluate vaginal discharge

Answer 9

i. Look and smell
ii. pH
iii. Wet mount, KOH prep
PCR for viral detection

Question 10

What predisposes cervix to HPV infx

Answer 10

The transformation zone

Question 11

In a Cervical Cancer Screening, what type of cells are you trying to sample

Answer 11

Endocervical

Question 12

What year do you start PAPs?

Answer 12

21

Question 13

When start checking HPV in serum

Answer 13

30 or older

Question 14

when stop PAPs

Answer 14

65 if nothing abnormal

Question 15

cervial cancer is what ype

Answer 15

Squamous Cell Carcinoma

Question 16

sx of Squamous Cell Carcinoma

Answer 16

Painless vaginal bleeding

Question 17

Does Squamous Cell Carcinoma more often locally extend or metastasize? to where? leading to what

Answer 17

locally to bladder–> kidney failure

Question 18

Risk factor for SqCC (3)

Answer 18

HIV, smoking HPV, 16, 18, 31, 33

Question 19

What is anovulatory bleeding and what is it due to?

Answer 19

dysfunctional uterine bleeding: continued proliferative phases will lead to build up and sloughing of the endometrium – (no ovulation = no secretory phase becuase no progestersone)

Question 20

What cuases endometrial hyperplasia

Answer 20

estrogen unopposed by progesterone

Question 21

Endometrial biopsy is ix for what? why?

Answer 21

All post-menopausal bleeding

higher cell turnover = increased risk for cnacer

Question 22

Endometrial cancer and hyperplasia are increased by what (1) general risk factor

Answer 22

anything that increases the exposure to estrogen:

more periods, less pregnancy, obesity, etc

Question 23

Endometrial hyperplasia eventually progresses to what

Answer 23

Endometrail Adenocarcinoma

Question 24

After ovulation the follicle beomes what

Answer 24

the corpus luteum

Question 25

What is the corpus luteum maintained by

Answer 25

BHCg

Question 26

If no BHCG maintians corpus luteum , what happens to it?

Answer 26

it beocmes the corpus albicans (white scar)

Question 27

What are 2 predisposing factors and sx of ovarian torsion

Answer 27

nausea, vomiting | anything that makes the ovary heavier:neoplasms, ovarian (luteal, follicular) cysts

Question 28

OCPs (oral contraceptives) have what effect on ovarian cancer risk

Answer 28

decrease risk

Question 29

2 types of epithelial cell carcinomas and which is benign/malignant

Answer 29

``` Adenocarcinoma/cystadenocarcinoma = malignant Cystadenoma = benign ```

Question 30

3 MC germ cell ovarian cancers in order from MC to LC

Answer 30

MC= immature teratoma Dysgerminoa = 2nd Yolk Sac = 3rd

Question 31

MC germ cell ovarian cancer in kids

Answer 31

dysgerminoma

Question 32

CA-125 is a marker used to test for what

Answer 32

recurrence of ovarian cancer

Question 33

Adnexal mass with these sx ix what? | fever = (2)

Answer 33

fever = tubo-ovarian abscess or PID

Question 34

Adnexal mass with these sx ix what? | Abrupt, severe pain = (2)

Answer 34

ruptured ectopic preg | Ovarian torsion

Question 35

Adnexal mass with these sx ix what? | 1st trimester bleeding = (2)

Answer 35

ectopic preg | luteal cyst

Question 36

Which gynecological cancers have highest prevalence in order (3)

Answer 36

Endometrial > Ovarian > Cervical

Question 37

Which gynecological cancers have worst prognosis in order (3) why?

Answer 37

Ovarian > cervical > endometrial Ovarian doesn't give sx until much later, endometrial gives early sx