Female Genital

Question 1

Produces warlike lesions on the vulva, perineum, vagina and cervix. Associated with HPV 6 and 11. Infected cells show koilocytosis, acanthosis, hyperkeratosis and parakeratosis.

Answer 1

Condyloma acuminatum

Question 2

Benign tumor of modified apocrine sweat glands of the labia majora or interlabial folds. Mimics carcinoma.

Answer 2

Papillary hidradenoma

Question 3

Presents with vulvar itching and burning with red, moist lesion on exam. Biopsy will show clear, vacuolated cells within the epidermis that stain positively for PAS and carcinogenic antigen.

Answer 3

Extramammary Paget disease

Question 4

Which form of Paget disease is associated with underlying carcinoma and which is not?

Answer 4

Extramammary is carcinoma in situ, usually no underlying carcinoma. Paget disease of the nipple almost always has underlying carcinoma with malignant epithelial cells in the epidermis of the nipple.

Question 5

Major risk factors for squamous cell carcinoma of the vulva

Answer 5

HPV 16
cigarette smoking
immunodeficiencies (AIDS)

Question 6

How can you distinguish between melanoma and Paget disease of the vulva?

Answer 6

Paget = PAS+, keratin + and S100 -
Melanoma = PAS -, keratin - and S100 +

Question 7

Epidermal thinning, white, parchment like skin is caused by what? In who? Increased risk of cancer?

Answer 7

Lichen sclerosis in postmenopausal women, slight increase in squamous cell carcinoma.

Question 8

Persistence of columnar epithelium in the upper vagina when it’s supposed to be replaced by squamous in development

Answer 8

Vaginal adenosis

Question 9

Grape-like soft tissue mass protruding from young girl’s vagina, desmin positiv

Answer 9

Embryonal rhabdomyosarcoma

Question 10

Primary vaginal squamous cell carcinoma is related to BLANK, while secondary is related to BLANK

Answer 10

Primary vaginal squamous cell carcinoma usually results from HPV infection while secondary is usually an extension of cervical cancer

Question 11

Persistence of a Wolffian duct remnant that appears as a cyst on the lateral wall of the vagina

Answer 11

Gartner cyst

Question 12

Rokitansky-Kuster Syndrome

Answer 12

Congenital absence of the vagina and uterus, though ovaries are usually fine. Anatomic cause of primary amenorrhea.

Question 13

High risk HPV strains

Answer 13

16
18
31
33

Question 14

Low risk HPV strains

Answer 14

6

11

Question 15

Labs for women with PCOD?

Answer 15

elevated LH
low FSH
elevated testosterone

Question 16

What do the high risk HPV strands do?

Answer 16

They produce E6 and E7 which knock out tumor suppressors p53 and Rb, this increasing risk of cervical intraepithelial neoplasia.

Question 17

What is the most common benign ovarian tumor? Describe it.

Answer 17

Cystadenoma - smooth-walled cyst with simple serous or mucinous lining.

Question 18

Risk factors and tumor marker for cystadenocarcinoma

Answer 18

BRCA1 and lynch syndrome

CA 125

Question 19

Meigs syndrome

Answer 19

Ascites
benign pleural effusion
Benign ovarian tumor (fibroma)

Question 20

Common primary sites for metastatic tumor of the ovary

Answer 20

breast
colon
endometrium
gastric signet-ring cell cancer