Female Repro

Question 1

• infertility
• dull pelvic pain worse during menstruation
• multiple small hemorrhagic lesions over surface of both ovaries and fallopian tubes
• pelvic scarring
• “Chocolate Cysts”

Answer 1

Endometriosis

Question 2

• swelling in vagina
• Hx of prenatal exposure to Diethylstilbestrol
• mass in upper vagina
• glycogen within cell cytoplasm

Answer 2

Clear cell adenocarcinoma

Question 3

• painful genital lesion and bleeding
• exophytic ulcerated polypoid mass near external end of urethra
• usually after menopause

Answer 3

Caruncle

Question 4

• increasing abdominal girth and pelvic discomfort
• mass replacing ovary
• multilocular fluid filled with thick, viscous fluid
• lined by mucinous, columnar epithelial cells
• tumor most closely resembles mucosa of endocervix

Answer 4

Mucinous Cystadenoma

Question 5

• lower abdominal pain
• painful swollen knee
• vaginal discharge
• febrile
• elevated WBC’s
• most likely complication- tubo-ovarian abscess

Answer 5

Gonorhea

Question 6

• long hx of vulvular itching and burning
• red, moist lesion of labia majora
• biopsy shows clusters of pale vacuolated cells within epidermis
• stain + for PAS and CEA

Answer 6

Extramammary Pagets Disease

Question 7

hx of hypothyroidism

• vulvular itching and painful intercourse
• vulval white plaques, atrophic skin, and parchment like appearance
• hyperkeratosis, loss of rete ridges, acellular zone in upper dermis

Answer 7

Lichen Sclerosis (associated with autoimmune disorders)

Question 8

• HPV Infection
• benign, exophytic, papillomatous lesion on skin or mucous membranes of genital tract

Answer 8

Condyloma Acuminatum

Question 9

• infertility
• enlarged vulva
• inguinal lymph node enlargement with necrotizing granulomas, neutrophillc infiltrates and inclusion bodies in macrophages
• rectal stricture
• caused by Chlamydia Trachomatis

Answer 9

Lymphogranuloma Venereum

Question 10

• fever, chills, malaise
• painful genital sore
• vesticulopustular lesions on labium majorum and cervix
• bilateral inguinal lymphadenopathy with granulomatous inflammation

Answer 10

Chancroid caused by Haemophilus Ducreyi

Question 11

Pap smear shows loosely arranged cells with high nuclear:cytoplasmic ratio

-mosaic pattern in transformation zone

Answer 11

Dysplasia of cervix

Question 12

• atypical squamous cells through entire thickness of epithelium on cervical biopsy
• no evidence of epithelial maturation
• basal membrane intac

Answer 12

CIN-3

Question 13

• vaginal discharged, occasionally blood tinged
• Pedunculated, lobulated and smooth cervical growth

Answer 13

Endocervical Polyp

Question 14

-Most likely cause of death in patient with stage 4 cervical cancer without treatment

Answer 14

Renal failure

Question 15

• menorrhagia
• spotting through entire menstrual cycle
• Obese with hypertension
• polypoid mass in uterine fundus that is partially necrotic
• loss of function of PTEN gene

Answer 15

Endometrial Adenocarcinoma (precursor is atypical hyperplasia)

Question 16

• obese woman
• increased mentrual blood flow
• caused by increased exposure to estrogen

Answer 16

Endometrial Hyperplasia

Question 17

• menorrhagia
• 6 month hx if increasing fatigue
• hypochromic, microcytic anemia
• enlarged uterus with multiple irregular masses
• sharply circumscribed, fleshy tumor
• growth promoted by estrogen

Answer 17

Uterine Leiomyoma

Question 18

• chronic pelvic discomfort
• well circumscribed uterine mass with areas of necrosis and irregular borders extending into myometrium
• staining for actin is +, high number of mitoses

Answer 18

Leiomyosarcoma

Question 19

• intermenstrual bleeding
• mass in endometrial cavity
• arise from endometrial foci that are hypersensitive to estrogen and unresponsive to progesterone
• endometrial glands in a fibrous stroma

Answer 19

Endometrial Polyp

Question 20

• displacement of endometrial tissue into myometrium
• many patients with this are asymptomatic
• may have pelvic pain, dysfunctional uterine bleeding, dysmenorrhea, and dyspareunia

Answer 20

Adenomyosis

Question 21

• uterine bleeding post-menopausal
• enlarged uterus, large polypoid mass involving endometrium and myometrium
• malignant glands and malignant stromal elements with striated muscle and cartilage

Answer 21

carcinosarcoma

Question 22

• subcapsular ovarian cysts
• infertility, obesity, pronounced facial hair, irregular menstrual periods
• High levels of LH from increased ovarian production of androgens

Answer 22

Polycystic Ovarian Syndrome

Question 23

• malignant papilary structures with psammoma bodies
• ascites
• BRCA1 mutation
• derived from surface epithelium (hormonally inactive)
• occur less often in women who have had ovulation suppressed

Answer 23

Papillary Serous Cystadenocarcinoma

Question 24

• intermittent vaginal bleeding
• adnexal mass replacing ovary
• complex endometrial hyperplasia without atypia
• derived from sex cord stromal cells
• usually postmenopausal

Answer 24

Granulosa Cell tumors

Question 25

• ovarian metastases where tumor appears as nests of mucin filled “signet ring” cells within cellular stroma from ovary
• usually to stomach or colon
• bilateral ovarian involvement and multinodularity

Answer 25

Krukenberg Tumor

Question 26

• lower abd pain, recent breast enlargement
• last period 10 weeks ago, denies sex
• Hcg markedly elevated
• tumor mimics the epithelial covering of placental villi

Answer 26

Choriocarcinoma

Question 27

• increasing abdominal girth
• ascites
• composed of activated germ cells
• clear glycogen filled cytoplasm and irregularly flattened central nuclei

Answer 27

Dysgerminoma

Question 28

• hx of vulvular itching, bleeding and inflammation
• exophytic mass on labium majorum
• express cytokeratins

Answer 28

Squamous Cell Carcinoma (keratin pearls,

Question 29

• Last trimester of pregnancy
• proteinuria
• hypertension
• pitting edema of extremities
• dangerous complication: DIC

Answer 29

Pre-eclampsia

Question 30

• previous + pregnancy test
• hx of vaginal bleeding
• passed tissue w/ appearance of grapes
• dilated endometrial cavity with no evidence of fetus
• diploid cells

Answer 30

Complete Hydatidiform Mole

Question 31

• painful genital lesion
• tender, erythematous, submucosal lesion of labium minor

Answer 31

Bartholin Gland Cyst

Question 32

• causes by staph aureus
• diffuse, desquamative erythematous rash
• purulent exudate in the vagina
• fever, and shock
• risk for DIC

Answer 32

Toxic Shock Syndrome

Question 33

• vaginal discomfort for 2 weeks
• scanty vaginal discharge
• fishy odor after tx with 10% potassium hydroxide
• pap smear shows squamous cells covered by coccobacilli

Answer 33

Gardnerella vaginalis

Question 34

• mass on ovary
• focal calcifications within the mass
• germ cell origin

often contain skin, sebaceous glands, and hair follicles

Answer 34

Mature Teratoma

Question 35

• increasing abdominal girth
• ascites
• ovarian tumor that is solid and white
• cells resemble normal ovarian stroma surrounded by collagen

Answer 35

Fibroma

Question 36

• increasing facial hair
• deepened voice
• amenorrhea
• virilization
• ovarian mass with yellowish-tan appearance
• 2 distinct cell populations

Answer 36

Sertoli Leydig Cell Tumor

Question 37

• hx of breast enlargement and menstrual irregularities
• complex hyperplasia without atypia
• solid and yellow mass composed of lipid laden theca cells
• produce estrogen

Answer 37

Thecoma

Question 38

• increasing abdominal girth
• ovarian mass with ascites
• increased alpha fetoprotein level
• resembles mesenchyme of primitive yolk sac

Answer 38

Yolk sac tumor

Question 39

• history of vaginal bleeding
• dilated endometrial cavity
• grapelike clusters and fetal parts
• triploidy of cells

Answer 39

Partial Hyatidiform Mole

Question 40

Nulliparous women are at increased risk for neoplasm of….?

Answer 40

endometrium