female genital system and gestation- chapter 22 Flashcards
what age group do bartholin cysts typically occur
reproductive age
describe the lesion with bartholin cysts
unilateral, painful cystic lesion
where do bartholin cysts typically occur
lower vestibule adjacent to vaginal canal
what is the term for thinning of the epidermis and fibrosis of dermis of vulva
lichen sclerosis
describe the skin of the vulva with lichen sclerosis
leukoplakia with parchment-like vulvar skin
who is lichen sclerosis most common in
post-menopausal women
what cancer is lichen sclerosis have a slightly increased risk of
squamous cell carcinoma
describe the vulva with lichen simplex chronicus
leukoplakia with thick leathery vulvar skin
what clinical presentations are associated with lichen simplex chronicus
associated with chronic irritation and scratching
describe the lab findings with paget cells in extramammary disease
PAS+, Keratin + and S100-
what is the term for focal persistence of columnar epithelium in the upper 1/3 of the vagina
adenosis
what exposure to many women who have adenosis previously have
DES in utero
what cancer are people with adenosis more at risk for
clear cell adenocarcinoma
what does the IHC staining stain positive for with embryonic rhabdomyosarcoma
desmin and myoglobin
what is the precursor lesion for vaginal carcinoma
VIN (vaginal intraepithelial neoplasia)
what does the E6 of HPV destroy
p53
what does the E7 of HPV destroy
Rb
how does cervical carcinoma present
vaginal bleeding
what hormone drives endometrial growth
estrogen
what hormone preps the endometrium for implantation
progesterone
what is the term for secondary amenorrhea due to loss of basalis and scarring
asherman syndrome
what is Asherman syndrome the result of
overaggressive dilation and curettage (D and C)
what cells is chronic endometritis characterized by
plasma cells
how does chronic endometritis present
abnormal uterine bleeding, pelvic pain and infertility
what drug can cause endometrial polyps as side effect
tamoxifen
what disorder should be considered when you see gun powder lesions
endometriosis
what disorder should be considered when you see ovary- chocolate cyst
endometriosis
what is endometrial hyperplasia the consequence of
unopposed estrogen
how does endometrial hyperplasia present
post-menopausal uterine bleeding
how does endometrial carcinoma present
post menopausal bleeding
what should you think of when you see white worled masses
leiomyoma
what type of tumors are most common in the ovary
surface epithelium tumors
who are cyst adenomas most common in
pre-menopausal women (30-40)
describe the liming with cystadenocarcinoma
complex cysts with thick, shaggy lining
who is cystadenocarcinoma most common in
post menopausal women (60-70)
what is a useful surface marker for surface tumors of ovary
CA-125
what age do women typically get germ cell tumors
reproductive age
what is cystic teratoma of ovary composed of
fetal tissue derived from 2-3 embryologic layers
what is the term for a cystic teratoma composed primarily of thyroid tissue
struma ovarii
what may be elevated with dysgerminoma of ovary
LDH
what will youu see on histo of yolk sac tumor
increased serum AFP
what is the clinical presentation with ectopic pregnancy
lower quadrant abdominal pain weeks after missed period
what is the term for implantation of placenta in lower uterine segment
placenta previa
what are the common signs of preeclampsia
HTN, proteinuria and edema; arises in 3rd trimester
what does HELLP stand for with regards to eclampsia
hemolysis, increased liver enzymes, low platelets
what is the appearance of a hydatiform mole on ultrasound
snow storm
What infection of the lower genital tract should you consider when there is ground glass apperance
HSV
What causes molluscum contagiosum
Pix virus
What areas of the body does molluscum contagiosum most commonly affect
Trunk, arms and legs
What is the diagnostic characteristic with molluscum contagiosum
Pearly, dome-shaped papules
Describe the cervix with trichomonas vaginalis
Frothy, strawberry cervix
Describe the findings with Gardnerella vaginalis
Gram negative bacillus, fishy odor, clue cells
What is gardnerella vaginalis implicated in
Premature labor
What does bartholin cyst result from
Obstruction of the duct by inflammatory process
Describe the surface of the vulva with lichen sclerosis
Porcelain or parchment
Who is lichen sclerosis most common in
Postmenopausal women
What mutation is common in keratinizing squamous cell in vulva
TP53 mutations (not HPV)
What does septate/double vagina arise from
Failure of Müllerian duct fusion
Describe the appearance in the secretory phase in the endometrium
Saw tooth appearance
What does the corpus luteum make
Progesterone
What is the cardinal feature found in non-atypical hyperplasia
Increase in gland to stroma ratio
What is the most common invasive tumor of the female genital tract
Endometrial carcinoma
What is the most common mutation in type 1 endometrial carcinoma
PI3K/AKT pathway increased signaling
What is the most common mutation in type 2 endometrial carcinoma
TP53
What tumors of the endometrium are estrogen sensitive and respond to oophorectomy
Adenoma Roma
What mutation is common in leiomyosarcomas
MED12 mutations
Who do benign and borderline stromal ovarian tumors most commonly occur in
Age 20-24
What are the cysts of the serous type epithelial stroma tumors of ovarian lined with
Columnar epithelium
What type of surface epithelial stromal ovarian tumors has psammoma bodies (concentric calcifications0
Serious type
What do yolk sac tumors respond well to
Combination chemotherapy
What is included in meigs syndrome
Ovarian tumor, hydrothorax and ascites
How does fibroma present
Pelvic mass
What tumor should you think of when you see call-Exner bodies
Granulosa-theca cell sex cord tumor
What mutation is common in sertoli-keydic cell tumors
DICER1 mutation
