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Pathophysiology Exam 3 > Female Repro 1 > Flashcards

Female Repro 1 Flashcards

1
Q

Which disease?

  • Infection of the female pelvic organs
  • Begins in vulva and ascends upwards
  • Follows the extension of a variety of microorganisms (usually acquired through sexual contact)
A

Pelvic Inflammatory Disease (PID)

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2
Q

In PID, the ascent of infection may resulte in what 3 things?

A
  1. Acute Salpingitis
  2. Pyosalpinx
  3. Tuboovarian abscess

2 salps and a tube

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3
Q

What is the principal single organism causing PID?

However, most infections are ________

A

Principal organism= N. gonorrhea (gram neg diplococci)

Most infections are polymycrobic

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4
Q

85% of PID is caused by what 2 organisms?

A
  1. ***N. gonorrhea (gram neg diplococci)–> principal organism
  2. Chlamydia (weakly gram neg)
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5
Q

Is the incidence of PID greater in sexually promiscuous women or those that are monogamous?

A

Sexually promiscuous women

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6
Q

T/F: PID is occasionally a sequel to postpartum endometritis

A

True

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7
Q

T/F: it is claimed that women with IUD’s are at an increased risk for PID

A

True

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8
Q

How do patients with PID usually present?

What does physical exam reveal?

A
  • Present w/ lower abdominal pain
  • PE:
    1. Bilateral adnexal tenderness
    2. Marked discomfort when the cervix is manipulated
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9
Q

What are 3 complications of PID?

A
  1. Rupture of a tubo-ovarian abscess
  2. Infertility from scarring of the fallopian tubes
  3. Increased rate of ectopic pregnancies

(the 2 main complications are infertility and ectopic pregs)

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10
Q

What organism is associated with women having endometritis and PID due to IUD use?

(This was a PANCE question)

A

Actinomyces israelii

(A long fillamentous gram positive that looks like a fungus)

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11
Q

What 6 bacteria are extremely common in genital infections?

A
  1. N. gonorrhea (gram neg)
  2. Gardnerella vaginalis (gram neg)
  3. Treponema pallidum (AKA Syphilis)- spirochete
  4. Granuloma inguinale (gram neg)
  5. Chancroid (gram neg)
  6. Mycoplasma (small gram neg)

“MY GRANdma CHAN GO Gardn TREes”

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12
Q

What 4 viruses cause genital infections (commonly acquired by sexual contact)?

What 3 places do they typically affect?

A

Viruses:

  1. Herpes Simplex
  2. HPV
  3. CMV
  4. Molluscum contagiosum

Locations:

  1. Vulva
  2. Vagina
  3. Cervix
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13
Q

Genital infections:

Fungal infections typically cause a _______ and includes_______ which lives on the moist surface of the vagina and does not invade deeper into the tissue.

A

vulvovaginitis; Candida albicans

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14
Q

Candida albicans is a fungal organism that normally lives in the vagina. What keeps this organism in check, preventing a yeast infection?

A

Kept in check by Lactobacillus, which keeps the vagina acidic

(Candida likes a basic environment)

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15
Q

Chlamydia trachomatis (C. trachomatis) are what type of organism?

Are they sexually transmitted?

A

Obligate intracellular organisms sharing features of both bacteria and viruses.

Yes- they are STDs

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16
Q

What 2 things do Chlamydial infections cause?

A
  1. Cervicitis
  2. Urethritis

(also causes a white curdy discharge)

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17
Q

Genital infections:

Protozoan infections are typically limited to the _______

What is the most important pathogen?

A

Vagina

Trichomonas vaginalis

Protozoans play tricks on the vagina

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18
Q

What is seen on histology with Candida albicans

A

Pseudohyphae

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19
Q

What are the local sxs of genital infections and which specific organisms cause them?

A
  1. Itching
  2. Pain
  3. Lesions depending on organism (all cause discomfort):
    1. Ulcers
    2. blisters/vesicles (Herpes)
    3. Chancres(syphilis)
  4. condilomatous lesions/ cauliflower type lesions= HPV
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20
Q

What are the 4 possible systemic sxs of genital infections?

A
  • Fever
  • Malaise
  • Possible peritonitis and sepsis if bacteria enters from the tubes into the abdominal cavity (G.C.)
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21
Q

Systemic sxs of genital infections:

______ & ______ are possible if bacteria enters from the tubes into the abdominal cavity (can be seen with which organism)

A

Peritonitis and Sepsis

Organism= Gonococcus

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22
Q

How does genital herpes typically present?

A

grouped blisters/vesicles on the vulva or the perineal skin

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23
Q

What causes the following?

can result in the formation of venereal warts on the vulva, vagina or cervix, called Condyloma accuminatum

A

HPV

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24
Q

What is now the most common venereal disease in the US?

A

HPV

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25
Q

What does syphilis present as?

A

vulvar ulcers, chancres, or as a cervicitis or vaginal lesions

26
Q

What can happen if syphilis is left untreated?

A

may progress to a secondary or tertiary form.

28
Q

What is seen on histology with HPV?

A

Koilocytosis

29
Q

What is seen on histology for Syphilis?

A

Spirochetes

30
Q

Which organism?

  • causes a genital infection that presents as nonspecific inflammation of the vulva and internal genital organs.
  • ​Infection may enter the fallopian tubes, causing lower abdominal pain and tenderness
  • often accompanied by fever
31
Q

What is one complication of Chlamydia?

A

infertility

32
Q

Which organism causes a genital infection where a urethritis is common and dysuria is a common symptom.

33
Q

Which 3 organisms cause infectious vaginitis?

A
    1. Trichomonas vaginalis*
    1. Gardnerella vaginalis*
    1. Candida albicans*
34
Q

which paired glands produce a clear mucoid secretion, which continuously lubricates the vestibular surface

A

Bartholin gland

35
Q

The ducts of which gland are prone to obstruction and consequent cyst formation?

Infection of this cyst leads to abscess formation

A

Bartholin gland

36
Q

Infection of the Bartholin Gland cyst causes an abscess which is most frequently caused by which 3 organisms?

A
  1. Staph
  2. Chlamydia
  3. anerobes
37
Q

What is the tx of a Bartholin gland cyst that has been infected and lead to an abscess?

A

Incisional drainage and abx

38
Q

What condition?

Abnormal growth of the vulvar skin characterized by white plaques, atrophy of the skin, and a parchment-like consistency to the skin with contracture of the vulvar tissue.

A

Lichen Sclerosis

39
Q

Who is Lichen Sclerosis is usually seen in?

A

Middle aged to older women

40
Q

Lichen sclerosis:

  1. Slow or fast developing?
  2. Malignant potential?
A
  1. Slowly developing (but progressive)
  2. NO malignant potential
41
Q

What does Lichen Sclerosis reveal histologically (3 things)?

A
  1. hyperkeratosis
  2. loss of rete ridges
  3. homogenous acellular dermal zone.
42
Q

Carcinoma of the vulva accounts for ____% of all GYN cancers

43
Q

Carcinoma of the vulva is a carcinoma of _____ women, the median age at diagnosis is ______ years.

A

older women

60 y/o

44
Q

Carcinoma of the vulva is a tumor can be recognized by gross inspection of the external genitalia and presents as what?

A

a wart-like or slightly raised mucosal lesion or ulcers.

45
Q

Carcinoma of the vulva:

Invasive cancer is preceded by _______, and this is called __________.

A

preceded by Carcinoma In-Situ (CIS)

this is called Vulvar Intraepithelial Neoplasia (VIN)

(can go 15-20 yrs as CIS before spreading to basement membrane and becoming invasive)

46
Q

Carcinoma of the vulva:

Preneoplastic lesions may also lead to invasive cancer, such as ______ and ________.

A

Leukoplakia

Bowen’s disease

(these are both pre-malignant in-situ lesions of vulva)

47
Q

Carcinoma of the vulva:

What are clinical symptoms of preneoplastic lesions of the vulva, such as Leukoplakia and Bowen’s disease?

A
  1. Itching
  2. discomfort
  3. pain
  4. bleeding
  5. asymptomatic (a significant number of pts)
48
Q

Histologically, how does Carcinoma of the vulva almost always present as?

Fast or slow growing?

A

squamous cell carcinoma

Slow growing (but relentless so must be removed)

49
Q

Carcinoma of the vulva:

If the diagnosis is made before it has metastasized to the lymph nodes, the patient has a ____% chance of a 5 year survival following surgical resection.

A

70%

(less favorable prognosis w/ tumors that have spread to the lymph nodes)

50
Q

How do you treat carcinoma of the vulva?

A

surgical resection of the tumor or the entire vulva

supplemented with radiation therapy and chemotherapy.

51
Q

____________ accounts for 2% of all GYN cancers

A

Carcinoma of the vagina

52
Q

Carcinoma of the vagina:

  • Disease of _____ women
  • histologically a ______cell carcinoma
  • accounts for >______% of all primary malignant tumors of the vagina
A

older

squamous

90%

53
Q

how is Carcinoma of the vagina detected?

A

Only upon GYN examination

54
Q

Carcinoma of the vagina:

5 yr. survival rate for tumors confined to the vagina (Stage I) is _____%

_____% for those with extensive spread (Stage IV).

A

stage I= 80%

Stage IV= 20%

55
Q

90% of vaginal cancers are of _______ origin

A

squamous cell

56
Q

What is the name of a rare tumor of the vagina that is encountered exclusively in women exposed to Diethly-stilbesterol (DES)?

(occurs in women whos mothers were given DES while they were pregnant with them)

A

Clear Cell Adenocarcinoma

57
Q

Where does clear cell adenocarcinoma develop most frequently?

A

anterior wall of the upper third of the vagina

58
Q

Clear Cell Adenocarcinoma is MC b/w ages ____ and ____

59
Q

__________ account for the clear nature of the cytoplasm in clear cell adenocarcinoma

A

Abundant glycogen

60
Q

T/F: Clear Cell Adenocarcinomas are essentially curable when large

A

FALSE

essentially curable when small

61
Q

What is the name of the rare vaginal tumor in children that appears as confluent polypoid masses that extend from the introitus of the vagina.

A

Embryonal Rhabdomyosarcoma (Sarcoma Botryoides)

Pathophysiology Exam 3 (12 decks)

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