Female Reproduction

Question 1

vulva is lined by

Answer 1

squamous epithelium

Question 2

unilateral, painful cystic lesion at the lower vestibule adjacent to the vaginal canal

women of what age
can develop what

Answer 2

bartholin cyst
repro age
develop abscess

Question 3

HPV infects what part of female repro tract

Answer 3

lower tract

vulva, vaginal canal, cervix

Question 4

lichen sclerosis

describe dermis and epidermis and what does it look like

what age women, cause
benign on nah?

Answer 4

thinning of epidermis and fibrosis of dermis
white patch (leukoplakia) with parchment like vulvar skin

postmenopausal women
autoimmune etiology
bening but slight increase risk squamous cell carcinoma

Question 5

hyperplasia of vulvar squamous epithelium
leukoplakia, with thick, leathery vuvlvar skin
associated with chronic irritation and scratching
risk of SCC?

Answer 5

lichen simplex chronicus

no risk

Question 6

causes of vulvar carcinoma

Answer 6

hpv related
or non hpv related from long standing lichen sclerosis in women over 70

-VIN precursor lesion

Question 7

extramammary paget disease

what does it look like histolo and gross

Answer 7

malignant epithelial cells in he epidermis of vulva
“walking way up to surface”

eryhematous pruritic ulcerated vulvar skiin

Question 8

extramammary paget disease and carcinoma

Answer 8

no underlying carcinoma

it is a CIS

Question 9

must distinguish extramammary paget disease from ____ and do this by which markers

Answer 9

melanoma
EMD: PAS+, keratin+, S100-

melanoma: PAS-, Keratin-, S100 +

Question 10

mom exposed to DES can have daughter with what

Answer 10

adenosis which can lead to clear cell carcinoma

also pregnancy and gestational problems

Question 11

cytoplasmic cross striations and positive desmin nad myogenin tumor in child under 5

Answer 11

embryonal rhabdomyosarcoma

malignant

Question 12

vaginal carcinoma is usually related to what
precursor

spread lymphatically

Answer 12

related to high risk hpv

VAIN precursor

spread from upper 2/3 spreads via iliac nodes

spread from lower 1/3 spreads via inguinal LNs

Question 13

exocervix lined by what epithelium

Answer 13

nonkeratinizing squamous

Question 14

endocervix lined by what

Answer 14

columnar cells

Question 15

how HPV can cause cancer molecular level

Answer 15

E6 degrades P53

E7 releases RB from E2F = G1–>S

Question 16

cervical intraepithelial neoplasia

CIN, I,II,III and regression
and CIS

Answer 16

CIN1 = 1/3 thickness, reverses 66% of time
CINII = 2/3 thickness, reverses 33% of time
CIN III = slightly less than entire thickness and rarerly reverses

CIS = entire thickness and cannot be reversed

Question 17

most common subtypes of cervical carcinoma are

Answer 17

scc

adenocarcinoma

Question 18

advanced cervical carcinomas can invade where

death?

Answer 18

anterior uterine wall into the bladder
blocking ureters
hydronephrosis with postrenal failure is common cause of death in advanced carcinoma

Question 19

an abnormal pap smear is followed by confirmatory what

Answer 19

colposcopy and biopsy

Question 20

limits of pap smear are what

Answer 20

inadequate sampling of transformation zone, if test wrong part then = false negative

limited efficacy in screening for adenocarcinoma

Question 21

quadrivalent vaccine covers what HPV types

Answer 21

6,11

16,18

Question 22

asherman syndrome

Answer 22

secondary amenorrhea due to loss of basalis and scarring
from overaggresssive dilation and curettage
(scrape away basalis layer)

Question 23

acute endometritis cause and presentation

Answer 23

usually retained products of conception after delivery or miscarriage

fever, abnormal uterine bleeding and pelvic pain

Question 24

chronic endometritis has to have what cell

causes?

Answer 24

plasma cells in the endometrium

retained products of coneption, chronic PID, IUD, TB (granulomas)

Question 25

how does chronic endometritis present

Answer 25

abnormal bleeding, pain and infertility

Question 26

abnormal uterine bleeding that can arise as a side effect of tamoxifen

hyperplastic protrusion of endometrium

Answer 26

endometrial polyp

Question 27

endometirosis and carcinoma

Answer 27

there is an increased risk of carcinoma at site of endometriosis especially the ovary

Question 28

endometrial hyperplasia defined by what

commonly presents as

Answer 28

increase in the glands relative to the stroma

post menopausal uterine bleeding

Question 29

most important predictor for progression of endometrial hyperplasia to carcinoma is what

Answer 29

cellular atypia
simple hyperplasia with atypia often progresses to cancer

complex hyperplasia without atypia rarely does

Question 30

hyperplastic pathway endometrial carcinoma

Answer 30

from unopposed estrogen
endometrial hyperplasia precursor
presents in 60s
histology is endometriod
75% of carcinomas this path

Question 31

sporadic pathway of endometrial carcinoma

endometrial size
avg age
histology
mutation
special feature

Answer 31

25%
atrophic endometrium with no precursor lesion
average age is 70
histo: serous and has papillary structures with psammoma body formation (necrosis then calcifications)
P53 mutation is common and is aggressive

Question 32

leiomyoma arises from what layer

Answer 32

myometrium

Question 33

leiomhyoma related to what

symptoms?

Answer 33

estrogen exposure

asymptomatic usually, but can present with abnormal uterine bleeding, infertility, and a pelvic mass

Question 34

leiomyoma in what women, how many, when do they disappear

Answer 34

premenopausal women, multiple, enlarge during preg and shrink after menopause

multiple = benign

Question 35

leiomyosarcoma

arise what
single or multiple?
what age

Answer 35

malignant sm from myometrium
arise de novo
single lesion with areas of necrosis and hemorrhage
cell atypia
postmenopausal women