Female Genitourinary Tract Flashcards
1
Q
list histological changes seen in the atypia form of the condition in the image
A
- nuclear enlargement
- pleomorphism
- vesicular change
- chromatin irregularity
- loss of polarity
- prominent nucleoli
- cellular stratification
2
Q
____ and ____ makes the condition in the image grow bigger
A
estrogen and pregnancy (also estrogen) makes the condition in the image grow bigger
3
Q
in the condition seen in the image, the more ___ the tumor is, the higher the grade
A
in type I endometrial carcinoma, the more solid the tumor is, the higher the grade
4
Q
“periods regular but bleeding excessive and prolonged (10-14 days)”
which condition?
A
persistent luteal phase
5
Q
the type II form of the condition seen in the image commonly occurs in which age group?
A
thin physiqued 65-75 year old females
6
Q
name 3 scenarios where acute endometritis can occur
A
-
postpartum (puerperal sepsis, strep/staph)
- offensive smelling discharge
- ascending gonococcal/chlamydia infection from lower genital tract
- pyometrium = obstruction of os by neoplasm or fibrosis
7
Q
chronic cervicitis can lead to the formation of ____
A
chronic cervicitis can lead to the formation of retention (Nabothian) cysts
8
Q
list the causes of the type I form of the condition seen in the image
A
unopposed estrogen
- obesity
- diabetes
- hypertension
- nulliparous
9
Q
describe placenta accreta
A
the chorionic villi implants directly into the myometrium (instead of the decidua)
10
Q
list the causes of acute cervicitis
A
- Gonococcal, Chlamydia, Candida, Trichomonas, Herpes
- postpartum, post dilation and curettage
- purulent vaginal discharge
11
Q
____ makes the condition in the image become smaller
A
menopause makes the condition in the image become smaller
12
Q
the precursor lesion to the condition seen in the image is ____
A
the precursor lesion to the condition seen in the image is endometrial hyperplasia WITH atypia
13
Q
list predisposing factor for pre-eclampsia
A
- primigravida, over 35 years age
- multiple pregnancies
- hydramnios
- preexisting HTN
- hydatiform mole
14
Q
the effect of unopposed estrogen is persistent ____ leading to _____
A
the effect of unopposed estrogen is persistent proliferation leading to irregular bleeding, breakdown
15
Q
____ and ____ are 2 neoplasms that can cause anovulatory cycles due to increased estrogen
A
granulosa cell tumor and adrenal cortical adenoma are 2 neoplasms that can cause anovulatory cycles due to increased estrogen
16
Q
list the high-risk HPV strains
A
16, 18, 31, 33, 35, 45
17
Q
describe the histology of the condition seen in the image
A
koilocytes & epidermal thickening of stratum corneum (hyperkeratosis) and dermal mononuclear inflammatory infiltrate
18
Q
list 4 risk factors for tubal pregnancy
A
- chronic PID
- endometriosis
- IUD
- prior surgery
19
Q
“unliteral painful cystic lesion at lower vestibule adjacent to the vaginal canal”
which condition is this describing?
A
20
Q
adenosarcoma resembles ____
A
adenosarcoma resembles phyllodes tumor in the breast
21
Q
describe the 2 potential pathogenetic explanations of endometriosis
A
- metastatic pathogenesis = retrograde menstruation
- metaplasia of celomic epithelium
- inflammatory cascade (PGs, estrogen)
22
Q
describe the presentation of the condition seen in the image
A
post-coital bleeding, dyspareunia (painful sex) , leukorrhea
23
Q
describe persistent luteal phase
A
24
Q
describe the histology of the condition seen in the image
A
well-differentiated, whorling bundles of smooth muscle cells
25
in the MMMT type of the condition seen in the image, ___ and ___ have become malignant, which makes it a ___ tumor
in the MMMT type of the condition seen in the image, **the epithelial** and **mesenchymal components** have become malignant, which makes it a **biphasic** tumor
26
in the MMMT type of the condition seen in the image, the metastasis and behavior are defined by the ___ component
in the MMMT type of the condition seen in the image, the metastasis and behavior are defined by the **epithelial** component
27
\_\_\_ is used to visualize the warts seen in the condition in the image
**acetic acid** is used to visualize the warts seen in the condition in the image
28
if the condition in the image becomes too big, it can undergo ___ and then \_\_\_\_
if the condition in the image becomes too big, it can undergo **coagulative necrosis** and then **red degeneration/infarct (inflammation → pain, mediated by bradykinin)**
29
exogenous progesterone effect leads to abundant \_\_\_, plump ___ and small ____ (caused by lack of \_\_\_\_)
exogenous progesterone effect leads to abundant **stroma**, plump **cells** and small **glands** (caused by lack of **priming by estrogen**)
30
in acute endometritis, the glands are "stuffed" with \_\_\_\_
in acute endometritis, the glands are "stuffed" with **neutrophils (**NOT in stroma, in the glands)
31
vaginal adenosis is ____ in the vaginal wall
vaginal adenosis is **endocervical type glands** in the vaginal wall
32
describe the patient population normally affected by leiomyosarcoma
older women (40-60), postmenopausal bleeding
33
list the genetic mutations seen in the type I form of the condition seen in the image
what other conditions are these mutations similar to?
**PTEN, KRAS, MSI**
endometrioid tumor = PTEN, KRAS, B-catenin, MSI
34
the condition in the image is caused by HPV strains ___ and \_\_\_
the condition in the image is caused by HPV strains **6** and **11**
35
sarcoma botryoides, aka \_\_\_\_, is described as "\_\_\_\_" hanging in the vagina
sarcoma botryoides , aka **embryonal rhabdomyosarcoma**, is described as "**a bunch of grapes**" hanging in the vagina
36
describe the 2 types of vulvar carcinomas
37
the condition seen in the image can grow big enough to press on the ___ and the \_\_\_
the condition seen in the image can grow big enough to press on the **bladder (causing urgency/frequency)** and the **rectum (constipation)**
38
if endometriosis occurs near tubal tissues ___ can occur ultimately leading to \_\_\_
if endometriosis occurs near tubal tissues **tubal scars** can occur ultimately leading to **infertility**
39
VIN, differentiated type, is NOT caused by \_\_\_, but rather a mutation in \_\_\_
VIN, differentiated type, is NOT caused by **HPV**, but rather a mutation in **p53**
40
\_\_\_ test can be used to test for highly mitotic areas (site of carcinoma) in the condition seen in the image
**Schiller's test** can be used to test for **highly mitotic** areas (site of carcinoma) in the condition seen in the image
paint cervix with iodine & look for unstained pale patches
41
describe vulvar intraepithelial neoplasia (VIN), classic type
42
the most common cause of anovulatory cycles is \_\_\_\_
the most common cause of anovulatory cycles is **extremes of reproductive life**
43
chronic endometritis is characterized by the presence of \_\_\_
chronic endometritis is characterized by the presence of **plasma cells**
44
lichen sclerosis is \_\_\_, but there is a slightly increased risk for \_\_\_\_
lichen sclerosis is **benign**, but there is a slightly increased risk for **squamous cell carcinoma**
45
endometrial polyps are associated with certain drugs such as \_\_\_\_
endometrial polyps are associated with certain drugs such as **Tamoxifen**
46
list the low-risk HPV strains
6, 11, 40, 54
47
in inadequate luteal phase, there is decreased function of \_\_\_\_, leading to decreased levels of \_\_\_\_
in inadequate luteal phase, there is decreased function of **the corpus luteum**, leading to decreased levels of **progesterone**
48
the condition in the image can cause which 3 conditions due to mass effect?
1. **infertility** if it impinges on tubes
2. bladder → **urinary freq./urgency**
3. rectum → **constipation**
49
"multiple masses in uterus, no mitosis, no necrosis"
what is a consequence of this condition?
**infertility**
50
there is inguinal lymphadenopathy in ___ carcinoma and ___ carcinoma
there is inguinal lymphadenopathy in **squamous** carcinoma and **vulvar** carcinoma
51
pre-eclampsia is caused by ____ which leads to an imbalance in circulating ___ and ___ factors (such as \_\_\_\_)
pre-eclampsia is caused by **placental ischemia** which leads to an imbalance in circulating **angiogenic** and **antiangiogenic** factors (such as **sFlt1, endoglin**)
52
the condition in the image results in (painful or painless?) ____ that undergo ___ change but are benign
the condition in the image results in **painless** **genital warts** that undergo **koilocytic change** (indicates presence of HPV) but are **benign**
53
describe placenta previa
abnormal placental implantation; implants on lower os
54
\_\_\_ is the most common cause of death from the condition seen in the image
**bilateral hydronephrosis (ureteral obstruction), pyelonephritis, uremia** is the most common cause of death from the condition seen in the image
55
name 5 scenarios where chronic endometritis can occur
1. chronic PID
2. postpartum/postabortion (retained products)
3. IUCD
4. TB
5. chlamydia
56
endometriosis can lead to fibrosis; name 4 condition that occur from this
* infertility (tubes)
* intestinal obstruction
* risk of tubal pregnancy
* urinary obstruction
57
adenosarcoma has a benign ___ and a malignant \_\_\_\_
adenosarcoma has a benign **epithelium** and a malignant **stroma**
58
vaginal adenosis in girls is caused by women who received ___ during pregnancy
vaginal adenosis in girls is caused by women who received **diethyl stilbesterol (DES)** during pregnancy
59
describe the endometrium in the type II form of the condition seen in the image
**endometrial atrophy**
60
the condition seen in the image causes ____ in women, leading to iron deficiency anemia
the condition seen in the image causes **menorrhagia (heavy periods)** in women, leading to iron deficiency anemia
61
the condition seen in the image can be caused by a mutation in \_\_\_\_
endometrial hyperplasia can be caused by a mutation in **PTEN (tumor suppressor gene)**
62
Gartner's duct cyst are remnants of ____ that are located on \_\_\_\_
Gartner's duct cyst are remnants of **mesonephric/Wolfian ducts** that are located on **the anterolateral wall of the vagina**
63
the condition seen in the image is most common in ____ women
the condition seen in the image is most common in **nulliparous** women
64
the condition seen in the image is caused by excess, unopposed ____ effect
endometrial hyperplasia is caused by excess, unopposed **estrogen** effect
65
the condition seen in the image is (slow or fast?) growing benign tumor in the \_\_\_\_
the condition seen in the image is **fast** growing benign tumor in the **myometrium**
66
a complication of preeclampsia is ___ due to \_\_\_\_
a complication of preeclampsia is **DIC** due to **thromboplastic tissue factor and thromboxane released by ischemic placenta**
67
in lichen sclerosis, there is thinning of the ___ and fibrosis of the \_\_\_
in lichen sclerosis, there is thinning of the **epidermis** and fibrosis of the **dermis**
68
describe abruptio placenta
premature separation of placenta
hemorrhage behind maternal bed of placenta
69
list the 3 reasons tubal pregnancies are not viable
* lack of space
* poor vasculature
* limited placental size
70
type I of the condition seen in the image commonly occurs in which age group?
type I = **obese 55-65** year old females
71
list other causes of anovulatory cycles
**unopposed estrogen**
* PCOD
* estrogen producing neoplasms
* granulosa cell tumor & adrenal cortical adenoma (of zona reticularis)
72
vaginal adenosis may be caused by inhibition of \_\_\_\_
vaginal adenosis may be caused by inhibition of **transformation of Mullerian epithelium into squamous epithelium**
73
describe the pathogenesis of preeclampsia
74
the mutation commonly seen in the type II form of the condition seen in the image is \_\_\_\_
the mutation commonly seen in the type II form of the condition seen in the image is **p53**
75
"hyperkeratosis"
"atrophic epidermis"
"loss of ridges"
"hyalinzed dermis"
"lichenoid inflammatory band"
\_\_\_\_ (condition) affects the ____ and the cause is \_\_\_\_
"hyperkeratosis"
"atrophic epidermis"
"loss of ridges"
"hyalinized dermis"
"lichenoid inflammatory band"
**lichen sclerosus** affects the **vulva** and the cause is **autoimmune**
76
describe the etiology of the condition seen in the image
cervical metaplasia (columnar → squamous at T-zone) = physiological due to decrease in pH (increased latic acid)
77
\_\_\_\_, aka embryonal rhabdomyosarcoma, affects which age group in females?
**sarcoma botryoides**, aka embryonal rhabdomyosarcoma, affects **females \< 5 years old**
78
endometrial tissue within the uterine wall is called \_\_\_\_
endometrial tissue within the uterine wall is called **adenomyosis**
79
a common translocation in stromal sarcomas are t(\_\_\_), with fusion of genes ___ and \_\_\_
a common translocation in stromal sarcomas are **t(7:17)**, with fusion of genes **JAZF1** and **JJAZ1**
80
\_\_\_\_ is the precursor lesion for the type II form of the condition seen in the image
**endometrial intraepithelial carcinoma** is the precursor lesion for the type II form of the condition seen in the image
81
can leiomyoma become leiomyosarcoma?
**NOOOOOOOOOOOOOO**
82
what conditions are associated with the condition seen in the image?
* obesity
* PCOD
* menopause
* estrogen-producing tumors like granulosa cell tumor
* ERT
* adrenal disorders
83
\_\_\_ is the most important predisposing factor for in the condition seen in the image
**multiple sexual partners** is the most important predisposing factor for in the condition seen in the image
84
list the high-risk HPV strains that cause the condition in the image
**HPV 16, 18, 31, 33, 35, 45**
