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Basic Human Pathology 2 > Female Genital System > Flashcards

Female Genital System Flashcards

1
Q

germ cells become what in females

A

ovarian stroma/epithelium

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2
Q

mullerian ducts become what in females

A

tubes
uterus
cervix
upper vagina

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3
Q

urogenital sinus becomes what in females

A

lower vagina
external genitalia

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4
Q

mesonephric ducts become what in females

A

they actually regress into nothing

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5
Q

what is the round ligament

A

rope-like connective tissue that holds the uterus in place

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6
Q

what is the broad ligament

A

broad sheet of connective tissue that holds the uterus in place

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7
Q

what is the anterior cul-de-sac

A

space between the bladder and uterus

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8
Q

what is the posterior cul-de-sac

A

space between the uterus and rectum

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9
Q

which two infections cause cause infertility

A

chlamydia and neisseria gonorrhoeae

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10
Q

what are the two infections of pre-term labor

A

ureaplasma urealyticum and mycoplasma hominis

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11
Q

which three infections commonly cause discomfort of the reproductive tract

A

candida (yeast)
trichomonas (parasite)
gardnerella

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12
Q

HSV most commonly affects which of the female reproductive organs

A

cervix (most common)
vagina
vulva (least common)

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13
Q

HSV-1 most commonly causes which type of infection

A

oropharyngeal infection

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14
Q

HSV-2 most commonly causes which type of infection

A

genital mucosa and skin

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15
Q

what is the most common period of transmission of HSV

A

during the acute infection

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16
Q

where does HSV establish a latent infection

A

regional lumbosacral nerve ganglia

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17
Q

which two antiviral agents can shorten the length of HSV

A

acyclovir and famciclovir

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18
Q

where is molluscum contagiosum most common

A

genital area

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19
Q

what causes molluscum contagiosum

A

poxvirus

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20
Q

which type of molluscum contagiosum is most prevelant

A

MCV-1

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21
Q

which type of molluscum contagiosum is most often sexually transmitted

A

MCV-2

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22
Q

who is most affected by molluscum contagiosum

A

young children between 2 and 12

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23
Q

what is the main microscopic feature of molluscum contagiosum

A

handerson-patterson bodies

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24
Q

in which condition would you see handerson-patterson bodies

A

molluscum contagiosum

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25
Q

which four conditions are associated with fungal infections of the female genital tract

A

diabetes mellitus
antibiotics
pregnancy
being immunocompromised

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26
Q

what is trichomonas vaginalis

A

large, flagellated ovoid protozoan that causes infection within 4 days to 4 weeks following sexual contact

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27
Q

what are four common symptoms of a trichomonas vaginalis infection

A

yellow, frothy discharge
discomfort
dysuria
dyspareunia

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28
Q

what is the characteristic appearance of the cervix in a trichomonas vaginalis infection

A

firey-red strawberry cervix

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29
Q

which three conditions cause cervicitis

A

gardnerella vaginalis
ureaplasma/mycoplasma
chlamydia trachomatis

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30
Q

what is pelvic inflammatory disease (PID)

A

inflammation that starts in the vulva and spreads upwards causing pain, fever, and discharge

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31
Q

which three organisms can cause pelvic inflammatory disease (PID)

A

neisseria gonorrhoeae
chlamydia
infections spread through lymphatics after delivery (ex. strep/staph)

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32
Q

what is the pelvic inflammatory disease (PID) sequela

A

acute infective stage:
-acute suppurative salpingitis
-salpingo-oophoritis
-tubo-ovarian abscesses
-pyosalpinx
chronic non-infective stage:
hydrosalpinx - infertility

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33
Q

what is seen microscopically in acute salpingitis from PID

A

dilated tube lumen with swelling and puss

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34
Q

what is seen microscopically in chronic salpingitis from PID

A

scarring and glandlike spaces

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35
Q

what are 5 acute complications of pelvic inflammatory disorder (PID)

A

ectopic pregnancy
pelvic pain
endocarditis
meningitis
intestinal obstruction

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36
Q

what are 5 chronic complications of pelvic inflammatory disorder (PID)

A

infertility
tubal obstruction
ectopic pregnancy
pelvic pain
intestinal obstruction

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37
Q

what important gland do you find in the vulva

A

bartholin’s gland

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38
Q

what is the labia majora lined by

A

keratinized stratified squamous epithelium

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39
Q

what is a bartholin cyst

A

benign infection of the vulva caused by obstruction of the duct by an inflammatory process

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40
Q

how is a bartholin cyst treated

A

marsupialization (opened permanently) or excised

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41
Q

what is lichen sclerosus of the vulva

A

smooth white plaques or macules that produce a porcelain/parchment/cigarette paper surface of the vulva

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42
Q

what are three microscopic features of lichen sclerosus of the vulva

A

thinning of the epidermis
degeneration of basal epithelial cells
hyperkeratosis

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43
Q

what is squamous cell hyperplasia of the vulva

A

condition caused from rubbing or scratching of the skin
presents as leukoplakia
benign - not premalignant

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44
Q

what are two microscopic features of squamous cell hyperplasia of the vuvla

A

acanthosis and hyperkeratosis

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45
Q

what is condyloma acuminatum

A

papillomavirus induced, sexually transmitted genital wart
caused by HPV strains 6+11
benign

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46
Q

what are the four main types of benign exophytic vulva lesions

A

condyloma acuminatum
syphillitic condyloma latum
fibroepithelial polyps
vulvar squamous papillomas

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47
Q

what is a vulvar squamous papilloma

A

exophytic proliferation covered by nonkeratinized squamous epithelium
has an unknown etiology

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48
Q

what are the two main microscopic features of condyloma acuminatum

A

koilocytosis and perinuclear halos

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49
Q

who is mosted affect by vulvar intraepithelial neoplasia and vulvar carcinoma

A

women 60 and older

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50
Q

what is another name for vulvar intraepithelial neoplasia

A

bowens disease

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51
Q

the risk of vulvar intraepithelial neoplasia becoming cancerous is dependent on which two things

A

duration/extent of disease
immune status of the patient

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52
Q

what are the two groups of vulvar squamous cell carcinoma

A

basaloid and warty carcinoma
keratinizing squamous cell carcinoma

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53
Q

what are some features of vulvular basaloid and warty carcinomas

A

a less common type of vulvular squamous cell carcinoma
30% are HPV 16 related
mostly younger patients
considered vulvar intraepithelial neoplasia

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54
Q

what are some features of vulvular keratinizing squamous cell carcinoma

A

a more common type of squamous cell carcinoma
70% not HPV related
most common in older patients

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55
Q

once invasive vulvar squamous cell carcinoma develops, the risk of metastatic spread is linked to which three things

A

size of tumor
depth of invasion
involvement of lymphatic vessels

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56
Q

which size vulvar squamous cell carcinoma has the best prognosis

A

under 2 cm

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57
Q

what are the two types of vuvlar glandular neoplastic lesions

A

papillary hidradenoma
extramammary Paget disease

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58
Q

what is papillary hidradenoma

A

a type of vulvar glandular neoplastic lesion
mostly found on labia majora or interlabial folds
ulcerates

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59
Q

what is extramammary Paget disease of the vulva

A

a type of vulvar glandular neoplastic lesion
red, crusted map-like area usually on labia majora
not associated with underlying cancer
confined to epidermis

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60
Q

what is looked for to highlight the intraepidermal Paget cells in extramammary Paget disease

A

cytokertain 7

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61
Q

what is the most serious lesion of the vagina

A

squamous cell carcinoma

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62
Q

how can you tell the anterior aspect of the uterus from the posterior

A

anterior aspect: serosa does not extent as far and rounds off
posterior aspect: serosa extends farther down

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63
Q

what is an arcuate uterus

A

Müllerian duct anomaly where the uterus has a normal/very mildly abnormal septum shape
angle greater than 90 degrees

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64
Q

what is a septate uterus

A

deformity of the uterus where the septum divides the inner portion of the uterus

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65
Q

what is a bicornuate uterus

A

indentation in the fundus that’s greater than 1 cm
caused by a non-fusion of Müllerian ducts

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66
Q

what differentiates a complete vs partial bicornuate uterus

A

partial: septum is confined to fundus region
complete: septum extends past fundus region

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67
Q

what is a didelphus uterus

A

Müllerian ducts don’t fuse which leads to a double uterus with two cervices

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68
Q

what is a unicornuate uterus

A

small uterus with only one functioning fallopian tube

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69
Q

what is the most common type of unicornuate uterus

A

type B: no horn

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70
Q

what is vaginal adenosis

A

small patches of residual glandular epithelium in the vagina that may persist into adult life

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71
Q

what are Gartner duct cysts

A

cysts from wolffian (mesonephric) ducts on the lateral walls of the vagina

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72
Q

what are the three main types of benign tumors of the vagina

A

stromal tumors/polyps
leiomyomas
hemangiomas

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73
Q

what is the most common malignant tumor of the vagina

A

carcinoma from the cervix

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74
Q

what is vaginal embryonal rhabdomyosarcoma (sarcoma botryoides)

A

malignant vaginal tumor
appears as grape-like clusters

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75
Q

what are vaginal intraepithelial neoplasia and squamous cell carcinoma associated with

A

high-risk HPV infections

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76
Q

what is the greatest risk factor for vaginal intraepithelial neoplasia and squamous cell carcinoma of the vagina

A

previous carcinoma of the cervix or vulva

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77
Q

what is the most important thing for staging vaginal cancer

A

size and invasion through wall

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78
Q

lesions in the upper vagina tend to spread to which nodes

A

regional iliac nodes

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79
Q

lesions in the lower two thirds of the vagina tend to spread to which nodes

A

inguinal nodes

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80
Q

what is the junction between the cervix and cervical os called

A

squamocolumnar junction - moves upwards with time

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81
Q

what is squamous metaplasia of the cervix

A

replacement of glandular epithelium by advancing squamous epithelium

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82
Q

what is the transformation zone

A

area of cervix where the columnar epithelium abuts the squamous epithelium

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83
Q

estrogen produced by the ovary after puberty stimulates which two things

A

maturation of the cervical and vaginal squamous mucosa and formation of intracellular glycogen vacuoles in the squamous cells

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84
Q

why is glycogen important to vaginal cells

A

provides a substrate for vaginal aerobes and anaerobes

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85
Q

why are lactobacilli important

A

produce lactic acid to maintain a vaginal pH below 4.5

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86
Q

what is the normal cervical pH level

A

4.5 (slightly acidic)

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87
Q

what is an endocervical polyp

A

benign, exophytic growth within the endocervical canal
can cause spotting

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88
Q

what is the third most common cancer in women worldwide

A

cervical carcinoma - more than half are fatal

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89
Q

what is the most important factor in the development of cervical cancer

A

high-risk HPVs

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90
Q

which strain of HPV accounts for almost 60% of cervical cancer cases

A

HPV-16

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91
Q

which strain of HPV accounts for 10% of cervical cancer cases

A

HPV-18

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92
Q

which viral protein interferes with the tumor suppressor protein p53 and can contribute to cervical cancer

A

E6

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93
Q

which viral protein interferes with the tumor suppressor protein RB and can contribute to cervical cancer

A

E7

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94
Q

what is a low grade squamous intraepithelial lesion (LSIL) of the cervix

A

lesions of the cervix associated with HPV infection
most regress and do not progress to high grade (not premalignant)

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95
Q

LGSIL and HGSIL language is used for what

A

Pap smears

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96
Q

what is a high grade squamous intraepithelial lesion (HSIL) of the cervix

A

lesion that is caused by an HPV infection and it’s ability to disregulate the normal cell cycle leading to things like increased cell proliferation
high risk for carcinoma

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97
Q

low grade squamous intraepithelial lesions are how many times more common than high grade

A

10 times more common

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98
Q

CIN (cervical intraepithelial neoplasia) language is used for what

A

describing results of a tissue biopsy (pathology/histo)

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99
Q

what is the proliferation marker looked for in squamous intraepithelial lesions

A

Ki-67

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100
Q

which cyclin-dependent kinase inhibitor characterizes high-risk HPV infections

A

p16

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101
Q

what is the average age for cervical carcinoma

A

45

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102
Q

what is the most common histological subtype of cervical carcinoma

A

squamous cell carcinoma

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103
Q

what is the second most common histological subtype of cervical carcinoma

A

adenocarcinoma

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104
Q

how does cervical carcinoma spread

A

by direct extension in:
-paracervical soft tissue
-bladder
-ureters
-rectum
-vagina

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105
Q

how can cervical cancer be prevented

A

HPV vaccines for young girls and boys up to 26

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106
Q

what are the two major components of the uterus

A

endometrium (glands in a stroma)
myometrium (smooth muscle)

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107
Q

what is the luteal phase

A

between ovulation and period (12-16 days)

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108
Q

how does the body prepare for ovulation

A

FSH stimulates the production of mature eggs
those mature eggs produce estrogen to thicken the endometrium and create fertile-cervical mucous

109
Q

what is ovulation

A

rising estrogen and LH levels
LH causes follicle to rupture and release egg
typically day 14

110
Q

what happens after ovulation

A

egg lives for 24 hours, sperm 3-4 days
progesterone produces more endometrial lining
follicle eventually shrinks and so does the lining

111
Q

what rises when pregnancy occurs

A

HCG

112
Q

which four things can cause dysfunctional uterine bleeding

A

endometriosis
polyps
leiomyomas
neoplasm

113
Q

what is the most frequent cause of dysfunctional bleeding

A

anovulation (failure to ovulate)

114
Q

what is anovulation

A

failure to ovulate
usually caused by hormonal imbalances (estrogen unopposed by progesterone)

115
Q

when is anovulation most common

A

menarche (start of period) and perimenopausal period

116
Q

anovulation is less commonly associated with which three things

A

endocrine disorders
ovarian lesions
metabolic disturbances

117
Q

what is inadequate luteal phase

A

infertility associated with increased bleeding or amenorrhea
usually due to lack of progesterone production

118
Q

which two organisms can cause acute endometritis

A

hemolytic strep and staph

119
Q

what is the usual cause of acute endometritis

A

bacterial infections that arise after delivery or miscarriage
limited to stroma

120
Q

how is acute endometritis treated

A

curettage and antibiotic therapy

121
Q

chronic endometritis is associated with which four conditions

A

chronic pelvic inflammatory disease
retained gestational tissue
IUDs
tuberculosis

122
Q

which plasma cells are seen in chronic endometritis cases

A

CD138 plasma cells

123
Q

define endometriosis

A

ectopic endometrial tissue (glands and stroma) at a site outside of the uterus

124
Q

what is the most common site for endometriosis

A

ovaries

125
Q

what is the second and third most common sites for endometriosis

A

uterine ligaments and rectovaginal septum respectively

126
Q

endometriosis mostly affects women of which age range

A

30-40 years of age

127
Q

what are the four theories of endometriosis

A

1.) backwards flow of endometrium through tubes
2.) benign metastasis
3.) metaplasia of mesothelium
4.) stem cells become endometrial cells

128
Q

what is the most common symptom of endometriosis

A

pelvic pain

129
Q

endometriosis increases your risk for which two types of ovarian cancer by 3x

A

endometroid and clear cell ovarian cancers

130
Q

what three main things does endometriosis cause

A

bleeding
fibrous adhesions
cystic ovaries (chocolate cysts)

131
Q

what is adenomyosis

A

presence of endometrial tissue within the myometrium

132
Q

what are 4 symptoms of adenomyosis

A

menometrorrhagia (irregular and heavy periods)
colicky dysmenorrhea (period pain)
pelvic pain
dyspareunia

133
Q

what does adenomyosis look like grossly

A

nodularity
blood filled cysts

134
Q

what are 3 conditions associated with endometrial hyperplasia

A

obesity
menopause
polycystic ovarian syndrome

135
Q

what were the previous four categories of endometrial hyperplasia

A

simple w/o atypia
complex w/o atypia
simple atypical
complex atypical

136
Q

what are the two current categories of endometrial hyperplasia

A

non-atypical
atypical (endometrial intraepithelial neoplasia)

137
Q

23-48% of women with atypical endometrial hyperplasia are found to have what

A

carcinoma

138
Q

which gene is mutated in 20% of endometrial hyperplasia cases

A

PTEN tumor supressor gene

139
Q

what is the most common invasive cancer of the female genital tract

A

endometrial carcinoma - specifically endometrial adenocarcinoma

140
Q

what is the most common type of endometrial carcinoma

A

type 1 (endometroid) carcinoma

141
Q

what is type 1 (endometroid) carcinoma

A

well differentiated
mimic proliferative endometrial glands
arise from endometrial hyperplasia

142
Q

type 1 (endometroid) carcinoma is associated with which 5 conditions

A

obesity
diabetes
hypertension
infertility
unopposed estrogen stimulation

143
Q

which mutation is most commonly found in endometroid carcinomas

A

PTEN tumor supressor gene

144
Q

how does a type 1 (endometroid) carcinoma spread

A

myometrial invasion followed by direct extension into things like the broad ligaments

145
Q

what is the most important factor for staging malignant endometrial tumors

A

invasion, not size

145
Q

which group establishes GYN malignancy staging

A

FIGO - International Federation of Gynecology and Obstetrics

146
Q

what should you do with a malignant endometrial tumor

A

fix before you cut
tumors are very friable and you don’t want to accidentally upstage the patient

147
Q

what are the three main types of type 2 endometrial carcinoma

A

serous
clear cell
malignant mixed mullerian tumor

148
Q

what is the age range for type 2 endometrial carcinoma

A

65-75 years of age

149
Q

what is type 2 endometrial carcinoma

A

two main varients: serous and clear cell
arise in atropic uteri
poorly differentiated
fast growing

150
Q

what is the most common type of type 2 endometrial carcinoma

A

serous carcinoma

151
Q

which gene mutation is most common in serous (type 2) endometrial carcinoma

A

TP53

152
Q

what is the treatment for endometrial carcinoma

A

surgery and radiation - good prognosis

153
Q

what are endometrial malignant mixed mullerian tumors (MMMTs)

A

endometrial adenocarcinoma with malignant mesenchymal component
bulky and polypoid

154
Q

what’s another name for a malignant mixed mullerian tumor

A

carcinosarcoma

155
Q

what are the four types of endothelial malignant mixed mullerian tumors (carcinosarcomas)

A

stromal sarcoma
leiomyosarcoma
rhabdomyosarcoma
chondrosarcoma

156
Q

which three types of gene mutations are seen in malignant mixed mullerian tumors

A

PTEN
TP53
PIK3CA

157
Q

what are the microscopic features of an endometrial malignant mixed mullerian tumor

A

malignant mesenchymal stroma in a biphasic pattern

158
Q

who is most affected by malignant mixed mullerian tumors

A

postmenopausal women

159
Q

what is an endometrial adenosarcoma

A

malignant endometrial polypoid growth
estrogen sensitive
affects 40-50 year olds

160
Q

adenosarcomas mostly affect which age range of women

A

40-50 years of age

161
Q

what are the two types of pure stroma neoplasms of the endometrium

A

benign stromal nodules
endometrial stromal sarcomas

162
Q

endometerial stromal sarcomas are associated with which type of mutations

A

chromosomal translocations

163
Q

which GYN condition would you see “worm-like plugs”

A

endometrial stromal sarcoma - caused by myometrial veins

164
Q

what is the most common tumor in women

A

uterine leiomyoma

165
Q

uterine leiomyomas are most commonly found in which layer of the uterus

A

myometrium

166
Q

what are the three types of neoplastic disorders of the ovary

A

mullerian epithelium neoplasms
germ cell neoplasms
sex cord-stromal neoplasms

167
Q

which gene mutation is unique to uterine smooth muscle tumors

A

MED12

168
Q

what is the peak age range for a leiomyosarcoma

A

40 to 60 years of age

169
Q

myometrial leiomyosarcomas metastasize most commonly to which four locations

A

lungs
bone
brain
abdominal cavity

170
Q

how are leiomyosarcomas differentiated from leiomyomas

A

nuclear atypia
mitotic index
tumor necrosis

171
Q

how are leiomyosarcomas staged

A

size and invasion

172
Q

how are endometrial carcinomas staged

A

myometrial invasion/extension

173
Q

suppurative salpingitis is most commonly caused by which two organisms

A

gonococcus or chlamydia

174
Q

what are hydatids of Morgagni

A

paratubal cysts found at the fimbriated end or in the broad ligaments

175
Q

what is an adenomatoid tumor (mesothelioma) of the fallopian tube

A

benign, subserosal nodules on the fallopian tube or in the mesosalpinx

176
Q

how are fallopian tube tumors staged

A

T1 - tumor limited to fallopian tube
T2 - tumor involved one or both tubes with pelvic extension

177
Q

where do ovarian cysts originate from

A

unruptured graafian follicles that have ruptured and immediately sealed

178
Q

which type of ovarian cyst is present in the normal ovaries of women in reproductive age

A

luteal cysts (corpora lutea)

179
Q

what is the other name for polycystic ovarian syndrome (PCOS)

A

stein leventhal syndrome

180
Q

PCOS is associated with which three conditions

A

obesity
type 2 diabetes
premature atherosclerosis

181
Q

women with PCOS are at a higher risk for which two conditions

A

endometrial hyperplasia and carcinoma

182
Q

what is stromal hyperthecosis

A

disorder of ovarian stroma most often seen in postmenopausal women
bilateral, uniform enlargement of the ovary with a white-tan appearance

183
Q

PCOS can often overlap with which condition

A

stromal hyperthecosis

184
Q

what is theca lutein hyperplasia of pregnancy

A

condition where theca cells proliferate in the ovary during pregnancy

185
Q

benign ovarian tumors mostly affect which age range of women

A

20-45 years of age

186
Q

malignant ovarian tumors mostly affect which age range of women

A

45-65 years of age

187
Q

ovarian tumors typically arise from which three ovarian components

A

surface/fallopian tube epithelium
germ cells
stromal cells

188
Q

what is the most common type of ovarian cancer

A

serous cyst adenocarcinoma

189
Q

which two things increase your risk for ovarian cancer

A

nulliparity (no children)
family history (BRCA1 and 2 mutations)

190
Q

most primary ovarian neoplasms arise from what

A

mullerian epithelium

191
Q

what are the three major histologic types of epithelial ovarian tumors

A

serous
mucinous
endometrioid

192
Q

what are the three types of epithelial proliferation classifications of epithelial ovarian tumors

A

benign
borderline
malignant

193
Q

what is a type 1 epithelial ovarian tumor

A

low-grade tumor that arise in association with borderline tumors or endometriosis

194
Q

what is a type 2 epithelial ovarian tumor

A

high-grade serous carcinoma that arises from serous intraepithelial carcinoma

195
Q

what is the most common malignancy of the ovary

A

serous tumor

196
Q

what does a borderline serous epithelial ovarian tumor look like

A

increased number of papillary projections

197
Q

what is the gross appearance of a malignant serous epithelial ovarian tumor

A

larger areas of solid or papillary tumor mass, irregularly, and nodularity of the capsule

198
Q

the vast majority of mucinous epithelial ovarian tumors are which types

A

benign or borderline

199
Q

mucinous epithelial ovarian tumors often have which gene mutation

A

KRAS

200
Q

what differentiates a mucinous epithelial ovarian tumor from a serous epithelial ovarian tumor

A

rare surface involvement
unilateral
larger cystic masses

201
Q

what is ovarian pseudomyxoma peritonei

A

type of mucinous ovarian cancer
characterized by: mucinous ascites, cystic peritoneal surfaces and adhesions
typically arises from the appendix but can start in the ovaries

202
Q

what differentiates an endometrioid epithelial ovarian tumor from a mucinous or serous one

A

presence of tubular glands resembling benign or malignant endometrium

203
Q

what is an ovarian cystadenofibroma

A

epithelial ovarian tumor
benign and multilocular with simple papillary processes

204
Q

what is ovarian clear cell carcinoma

A

epithelial ovarian tumor in which the cells have a clear cytoplasm (looks like gestational endometrium)

205
Q

what is a Brenner tumor

A

transitional cell ovarian tumor that is most commonly unilateral
has fibrous stroma that in rare cases can represent theca cells with hormonal activity

206
Q

what is an important section to take in an ovarian teratoma

A

section of the pedicle because it has the highest chance of malignant transformation

207
Q

what are the three categories of teratomas

A

mature (benign)
immature (malignant)
monodermal or highly specialized

208
Q

immature or malignant ovarian teratomas often resemble what

A

embryonal and immature fetal tissue

209
Q

what are the two most common types of ovarian germ cell tumors

A

struma ovarii and carcinoid

210
Q

what is a struma ovarii

A

type of ovarian germ cell tumor composed of mature thyroid tissue

211
Q

what is the ovarian counterpart of a testicular seminoma

A

ovarian dysgerminoma

212
Q

dysgerminomas are most commonly seen in which age range of women

A

20-30 years of age

213
Q

is a dysgerminoma malignant or benign

A

malignant

214
Q

what is the gross appearance of an ovarian dysgerminoma

A

lobulated, flesh tumor with a yellow-tan or cream colored appearance

215
Q

what is the microscopic appearance of an ovarian dysgerminoma

A

monomorphic cells arranged in diffused sheets separated by delicate fibrous septae

216
Q

what is the second most common malignant ovarian tumor of germ cell origin

A

yolk sac tumor

217
Q

in which condition do the tumor cells elaborate alpha-fetoprotein

A

yolk sac tumors

218
Q

Schiller-duval bodies are seen in which condition

A

yolk sac tumors

219
Q

what is a Schiller-duval body

A

glomerulus like structure composed of a central blood vessel enveloped by tumor cells

220
Q

which type of germ cell ovarian tumor is highly aggresive

A

choriocarcinoma

221
Q

what is an ovarian embryonal carcinoma

A

highly malignant germ cell tumor of primitive embryonal elements that is histologically like embryonal carcinoma arising in the testes

222
Q

what is an ovarian polyembryoma

A

a malignant germ cell tumor containing embryoid bodies

223
Q

what is a granulosa ovarian tumor

A

sex cord stromal tumor
unilateral and mostly occurs in postmenopausal women
yellow cut surface

224
Q

in which condition would you see call-exner bodies

A

granulosa cell tumors

225
Q

what is the peak age range for sertoli-leydig cell tumors

A

20-30 years of age

226
Q

the most common metastatic ovarian tumors arise from which four structures

A

uterus
fallopian tubes
contralateral ovary
pelvic peritoneum

227
Q

the most common extra mullerian tumors metastatic to the ovary are

A

breast
GI tract

228
Q

what is a Krukenberg tumor

A

metastatic tumor of the ovary characterized by mucin producing, signet-ring cancer cells most often of gastric origin

229
Q

what is unique about the placenta’s vasculature

A

two umbilical arteries, one umbilical vein

230
Q

define spontaneous abortion

A

miscarriage or pregnancy loss before 20 weeks of gestation

231
Q

what percentage of pregnancies terminate in spontaneous abortion

A

10-15%

232
Q

what is the most common location for an ectopic pregnancy

A

fallopian tube

233
Q

what is associated with a twofold increase of ectopic pregnancies

A

IUD’s

234
Q

how are ruptures of tubal pregnancies diagnosed

A

through chorionic gonadotropin titers, pelvic sonography, and endometrial biopsies

235
Q

what are the 5 disorders that occur in the third trimester of pregnancy

A

1.) interruption of umbilical cord blood flow
2.) ascending infection
3.) retroplacental hemorrhage
4.) disruption of the fetal vessels in terminal villi
5.) uteroplacental malperfusion

236
Q

where would you find the decidua basalis

A

on the material side of the placenta covering the cotyledons

237
Q

what is the name for twins with two separate placentas

A

dichorionic diamniotic

238
Q

what is the name for twins that share one placental disc and are separated by a thin membrane

A

monochorionic diamnionic

239
Q

what is the name for twins that share a placental disc and are not separated by a membrane

A

monochorionic monoamniotic

240
Q

what is twin-twin transfusion syndrome

A

shunts between the arteriovenous anastomoses of twins can cause one twin to get more nutrients than the other

241
Q

define placenta previa

A

placenta implants in the lower uterine segment or cervix

242
Q

define complete placenta previa

A

placenta completely covers internal cervical os

243
Q

define placenta accreta

A

absence of the decidua causes placenta to adhere to the uterine wall

244
Q

define placenta increta

A

absence of the decidua causes placenta to adhere to myometrium

245
Q

define placenta percreta

A

absence of the decidua causes placenta to invade through the uterine wall and sometimes into the bladder

246
Q

what are the two pathways of infections of the placenta

A

1.) ascending through birth canal (most common)
2.) hematogenous (transplancental)

247
Q

define preeclampsia

A

material endothelial dysfunction that presents with hypertension, edema, and proteinuria

248
Q

who is most likely to be affected by preeclampsia

A

primipara women (those pregnant for the first time)

249
Q

define HELLP

A

hemolytic anemia, elevated liver enzymes, and low platelets

250
Q

HELLP is associated with what

A

preeclampsia

251
Q

which three things cause contribute to preeclampsia

A

1.) abnormal placental vasculature
2.) endothelial dysfunction
3.) coagulation abnormalities

252
Q

at which week is preeclampsia most common

A

week 34

253
Q

what are the four main changes of the placenta seen in preeclampsia

A

1.) infarcts
2.) ischemic changes in villi
3.) retroplacental hematomas
4.) abnormal decidual vessels

254
Q

define gestational trophoblastic disease

A

spectrum of tumors/conditions characterized by proliferation of placental tissue

255
Q

what are the three major gestational trophoblastic disorders

A

1.) hydatidiform mole
2.) invasive mole
3.) placental site trophoblastic tumor

256
Q

what is a hydatidiform mole

A

cystic swelling of chorionic villi with trophoblastic proliferation
common in teens and 50 year olds

257
Q

what is a good indication of a hydatidiform mole

A

elevated HCG levels above those normal for pregnancy

258
Q

how does a complete hydatidiform mole form

A

results from fertilization of an egg that has lost its females chromosomes

259
Q

what is the risk percentage for developing choriocarcinoma from a complete hydatidiform mole

A

2.5%

260
Q

how does a partial hydatidiform mole form

A

fertilization of an egg with two sperm - leads to a triploid zygote

261
Q

are partial moles associated with choriocarcinoma

A

no

262
Q

what is the morphology of a hydatidiform mole

A

friable mass made of cystic, grape-like structures made of swollen villi

263
Q

grape-like clusters are seen in which GYN condition

A

hydatidiform mole

264
Q

what is an invasive hydatidiform mole

A

villi penetrate the uterine wall

265
Q

where can invasive hydatidiform moles metastasize to

A

lungs and brain

266
Q

what are the two most common metastatic sites of ovarian choriocarcinomas

A

lungs (50%)
vagina (40%)

267
Q

what is a placental site trophoblastic tumor (PSTT)

A

proliferations of extravillous trophoblasts that presents as a uterine mass

268
Q

what is the incidence of gestational choriocarcinoma

A

1:20-30,0000

Basic Human Pathology 2 (14 decks)

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