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Pathology > Female Genital (phathology) > Flashcards

Female Genital (phathology) Flashcards

0
Q

unfused proxima duct

A

Fallopian tubes

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1
Q

mullarian duct

A

para-mesonephric duct –> fallopian tubes

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2
Q

fused caudal part

A

uterine body
cervix
upper vagina

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3
Q

UROGENITAL SINUS FORMS?

A

lower vagina

vestibule

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4
Q

ovary contains?

A

follicle (germ cells) –> endodermal, from yolk sac (4th week)

outer epithelium/stroma –> mesodermal from urogenital ridge

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5
Q

When does ovulation occurs?

A

14 days before LMP = secretory phase

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6
Q

pregnancy mantainance hormone?

A

progestorone

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7
Q

disfunctional uterine bleeding cause?

A

unknown (MC)
fibroids
ovarian cycles

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8
Q

disfuncional uterine bleeding pathogenesis?

DUB

A

anovulatory
menorrhegia –> 3-5days
>80mL blood loss

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9
Q

ovary size?

A

4x3x2
cortex - graafian follicles
medulla - wolffian duct remnants (rete ovarii, hilus cells) - can form cysts

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10
Q

whats are the cysts formed by Wolffian duct remnants?

A

Gardner’s duct cysts

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11
Q

length of fallopian tubes?

A

10 cm in length
site of fertilization

ectopic preg can occur
C - rupture, obstruction

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12
Q

uterus anatomy?

A 
9x6x3
50g
1. corpus/body
2. lower uterine segment
3. uterine cervix (endo/ecto)
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13
Q

histology of vagina?

A

no glands

striatified squamous epitheilum

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14
Q

uterus histology?

A

endo - columnar

ecto - stratified squamous

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15
Q

where do cancers form?

A

ecto-endo junction (precancerous)

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16
Q

fallopian tube histology?

A

columnar

cuboidal

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17
Q

What can you tell about the glands in endometrium?

A 
if they are compact 
1. proliferative 
	early - glands tubes
	late - telescope glands 
2. secretory
	early - edema, corkscrew glands 
	late -
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18
Q

rule of 10?

A 
10 days (within menstral cycle)
except - Tb endometruritis -> 2* infertility F
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19
Q

pelvic inflammatory disease is characterize by?

A
  1. adnexal tenderness (tubes + ovary)

2. vaginal discharge

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20
Q

causes of PID?

A

pregnant - post partum

non-preg - sex

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21
Q

PUD complications?

A

peritonitis
intestinal obstruction
infertility long standing chronic PID

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22
Q

Tx for PID?

A

gonorrhea - Ceftriaxone

chlamydia - azythromicin (tetracyclines)

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23
Q

surgery for PID?

A

bilateral salpingo ooherectomy - entirely removed

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24
Q

vulva diseases?

A 
folluculitits - inflm hair
intertrigo - irritant derm
tinea - fungal infect. 
psoriasis - 
herpes - HSV-2, painful ulcers (no vaginal delivery)
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25
Q

what can happen to baby with herpes vaginal delivery?

A

HSV 2 - encephalitis

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26
Q

atrophy of vulva?

A

due to estrogen deprivation, pathological when remove ovaries in young age

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27
Q

leukoplakia in vulva?

A

cancer risk

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28
Q

circulatory disorders in vulva?

A

varicose veins
angioneurotic edema
elephantiasis

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29
Q

diabetic vulvitis?

A 
beefy red
fungal growth (candida)
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30
Q

secretion for candidiasis?

A 
thick discharge
severe itching (pruritis)

preg
diabetes
Oralcontraceptives

Dx; 10% KOH

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31
Q

gonorrhea infection site?

A

columnar epitelium

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32
Q

gonorrhea infection in children?

A

sexual abuse

vulvo-vaginitis

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33
Q

syphilis in vulva?

A

painless chancre can be missed if in vaginal folds

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34
Q

bartholin cysts results from ?

A

obstruction of Bartholin duct

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35
Q

inclusion cysts

A

after reparative operation of perineal laceration

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36
Q

benign conditions

A

condylomata acuminatum - venereal warts - cauliflower like growth

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37
Q

vulva intraepithelial neoplasia VIN

A

HPV 16, 18

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38
Q

malignancies in vulva?

A
  1. carcinoma (SCC), from VIN lesions

2. Paget dis (extra-mammary)

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39
Q

where do you see paget dis?

A

bone
vulva
nipple (100% malignant)

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40
Q

confirm paget’s?

A

basal layer - cells are big with mucin

“Paget cells”

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41
Q

Paget’s of bone?

A

infection by paramyxo virus
forming/breaking bones

“mosaic pattern”

“change hat size”

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42
Q

Malignant melanoma?

A

60-70s
looks like Paget but S100+
Melan A
Mucin (–)

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43
Q

double vagina

A

mullarian ducts developed
not fused
septum divides
one bigger than the other

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44
Q

hematocolpos

A

blood in vagina

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45
Q

hematosalpinx

A

blood in tubal isthmus

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46
Q

fistulaes

A

vesico-vagina (++infections)

recto-vaginal (++delivery)

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47
Q

herniations?

A

cystocele - bladder pushed forward, down

rectocele - has to pull all vagina
cystocele will always be there too

48
Q

Trichomona presentation?

A

edema
red vagina (strawberry)
green-yellow discharge + small bubles
severe burning/itching

49
Q

gardnerella vaginalis?

A

clue cells

50
Q

dystocia

A

difficulty delivery

Caused by Gartner’s cysts

51
Q

dyspareunia

A

pain during sex

Caused by Gartner’s cysts

52
Q

inclusion cysts in vagina

A

episiotomy incision if you don’t close it properly

53
Q

endometriosis

A

ectopic endometrial tissue
MC site - ovaries

Infertility

54
Q

benign in vagina

A
  1. condylomata accuminata - HPV 6,11

2. fibroma (MEIG syndrome)

55
Q

adenocarcinoma of vagina

A

“clear cells”
even with no glands
young

mom used med during pregnancy to prevent abortion - DiEthylStilbesterol
mom - endometrial carcinoma

56
Q

sarcoma botryoides

A

embryonal rhabdomyosarcoma
“tennis racket” cells
infancy/childhood (rare)

57
Q

metastases MC site?

A

vagina –> cervix

58
Q

cervicitis?

A

inflammation of cervix

acute - rare, postpartem
chronic non-specific - lymphocyte, obstructed dialated gland (Nebothian cyst)

59
Q

benign neoplasm in cervix

A

endo-cervical polyps

columnar lining

60
Q

premalignant neoplasms in cervix?

A

CIN (cervical intraepithelial neoplasm)

61
Q

CIN I
CIN II
CIN III
Koilocytic change?

A

I - superficial, maturation
II - superfiial, parabasal
III - and basal layer, no maturation

62
Q

classification for CIN?

A

“squamous intraepithelial lesions”

low grade (I, II)
high grade (III)
then stain them with iodine (colorless areas -->  cone biopsy)
63
Q

risk factors for premalignant cervical cancers?

A

1-first sexual intercourse at young age
2-multiple sex partners
3-HPV

Co-factors
HSV2
HIV

64
Q

malignant cervix conditions?

A

SCC (75%)
adenocarcinoma (25%)

large cell non-keratinized (RT good)
keratinized (RT-not good, Surgery-good)

65
Q

staging for cervical carcinoma?

A 
0 - 100% cure (15 yrs to develop to 1)
1 - limit to cervix (95%)
2 - extended beyond cervix but not wall (65%)
3 - into wall or lower vagina (35%)
4 - metastasis (15%)
66
Q

Endometritis

A

chronic inflammation
associated with PID

TB - endometrial biopsy in late secretory phase

67
Q

Adenomyosis

A

endometrial tissue is in myometrium

68
Q

Endometriosis

A

outside the uterus endometrial tissue

endometrial glands
endometrial stroma
hemosedirin latent macrophages
need 2/3

69
Q

endometrial hyperplasia

A

“pathological hyperplasia”
causes - hyperestrogenemia

ovarian tumors(endometroid, granulo seca)
Tamoxifen (breast cancer Tx)
70
Q

types of endometrial hyperpasia?

A

low grade - absent atypia
high grade - atypia

PTEN gene - suppressor gene

71
Q

MC endometrial cancer

A

adenocarcinoma

72
Q

Stroma tumors of endometrium

A

Stromal tumor with benign glands (adenosarcoma)

stromal tumors
stroma nodule
stroma sarcoma

73
Q

Risk factors for uterine malignancy?

A 
obesity
DM
HTN
infertility
prolonged estrogen exposure
74
Q

presentation of uterine malignancies

A

abnormal (post-menopausal) bleeding = 6 mons after

75
Q

myometrial tumors

A

leiomyoma

Leiomyosarcoma (mitosis visible)

76
Q

Fibroids

A

MC histological type of uterine neoplasms

grows really fast in reproductive period

77
Q

Change in fibroids specialy during pregnancy

A

red degeneration

78
Q

Presentation of fibroids?

A

hanging = “submucosal”

increase surface area –> heavier, infertility, torsion

79
Q

diagnose leiomyosarcoma?

A

10 mitosis/10 HPF +,- atypia

5-10 mitosis/10 HPF + cell atypia

80
Q

salpingitis

A

inflammation of fallopian tubes

81
Q

chronic salpingitis?

A

Tb
tube is aplastic
nonmotile
lead to infertility

82
Q

ectopic pregnancy

A

risk - rupture

“30s female, HX amenorrhea 6-8wks
sudden severe a. abd pain”
++B-hCG levels

US (best)
endometrial biopsy (decidual change)
83
Q

tumors in FT?

A

rare

MC adenocarcioma

84
Q

ovarian cystic lesions

A

non-neoplastic

noplastic

85
Q

non-neoplastic

A

follicular/leuteal cysts - common

if big then they can cause problems

86
Q

Stein-Leventhal syndrome

A 
young female
oligomennorhea/amenorrhea
obese
hirsutism
infertility

++androgens
– pituitary

87
Q

primary surface epithelial tumors

A

surface of epithelial cells
MC
20s

88
Q

germ cell tumors of ovaries

A

same as male

teratoma
dysgeminoma
endodermal sinus
choriocarcimoma

89
Q

sex-cord stroma tumors

A

all ages

granuloma - theca cells

90
Q

teratoma (mature cystic)

A

dermoid cysts

91
Q

stroma ovaries

A

teratoma with thyroid

92
Q

dysgeminoma

A

same as seminoma

93
Q

serous cyst adenoma

A

MC ovarian tumor
cuboidal
watery secretions
CA-125 tumor marker

60% benign
malignant if bilateral

94
Q

mucinous tumors

A

tall ciliated columnar
spread to other ovary

largest ovarian tumor with pseudomyxoma peritonei

95
Q

endometroid

A

malignant
secrete estrogens
bilateral 50%

1/3 pt have endometrium carcinoma

96
Q

bilateral tumors?

A

100 krukenberg
50 primary ovarian
20 benign tumors

97
Q

Brener’s

A

benign
yellow mass

cells - nests of transitional epithelium

98
Q

clinical features of surface epithelial tumors

A

abd distention
lower abd pain
GIT/urinary symptoms

99
Q

diagnosis for primary epithelial tumors

A

CT
US
Biopsy

100
Q

Treatmet

A

surgery

Combined Rx

101
Q

Prognosis

A

poor if malignant (due to early metastasis and peritoneal spread)

102
Q

germ cell neoplastic transformation

A 
mature
embryonal (dont differentiate)
103
Q

germ cell tumors arrise frome?

A

totipotential cells

104
Q

dys\germinoma

A

like seminoma
teens/20s
malignant
radiosensitive

105
Q

teratoma

A

3 germs layers

106
Q

yolk sac carcinoma what you see in histology?

A

schiller duval body

endodermal sinuses

107
Q

sex-cord stroma tumor

A

granulosa-theca
fibroma
sertoli

108
Q

granuloma-theca

A

granulosa
theca

post-mena
produce estrogens

109
Q

fibroma in ovaries

A

MEIG’s syndrome

110
Q

sertoli-leydig cell tumors

A

masculanization

look like seminiferous tubules

111
Q

secondary/metastasis

A

bilateral ovarian from GIT/breast
krukenberg

gastric carcinoma

112
Q

placental infection

A

ascending and bacterial

113
Q

hydatidiform mole features

A

+bhCG
complete/partial
hydrophilic villi

114
Q

invasive mole features

A

++BhCG
villi present
invade uterine wall (no metast)
Rx - chemotherapy

115
Q

complete mole

A

diploid
large uterus
++vaginal bleeding
fetal parts = very rare

116
Q

partial mole

A 
triploid
small uterus
\+ vaginal bleeding
fetal parts = common
no choriocarcinoma
117
Q

choriocarcinoma (gestational)

A 
\+++BhCG
no villi
metast --> lungs
Hx - preganancy, abortions
Rx - chemotherapy (methotrexate)

Pathology (5 decks)

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