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female reproductive Flashcards

1
Q

bartholin cyst

A

cystic dilation of bartholin gland; arises due to inflammation and obstruction of gland; usually occurs in reproductive age women

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2
Q

bartholin gland location

A

bottom of opening usually unilateral

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3
Q

clinical presentation of bartholian cyst

A

unilateral painful cystic lesion

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4
Q

condyloma

A

warty neoplasm of skin; due to HPV 6/11; koilocytic change (raisen nucleus); rarely progress to carcinoma

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5
Q

HPV low risk/high risk subtypes

A

low risk = 6,11 cause condyloma

high risk = 16,18,31,33 cause dysplasia then can become carcinoma

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6
Q

lichen sclerosis

A

thinning of epidermis and fibrosis of dermis; presents with leukoplakia that is thin parchment like; commonly seen in post menopausal women; benign–slight inc. risk for SCC

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7
Q

lichen simplex chronicus

A

hyperplasia of vulvar squamous epithelium; leukoplakia with thick leathery skin; assoc with chronic irritation and scratching; benign, no risk for SCC

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8
Q

vulvar carcinoma

A

arised from squamous spi lining; rare

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9
Q

vulvar carcinoma presentation

A

presents as leukoplakia

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10
Q

2 pathway for vulvar carcinoma

A

HPV (high risk ones) and non-HPV

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11
Q

HPV type of vulvar carcinoma

A

infection then leads to vulvar intraepithelia neoplasia (dysplasia); 40-50 years old

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12
Q

non HPV type of vulvar carcinoma

A

think long standing lichen sclerosis; >70 or so; chronic irriation from the lichen sclerosis

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13
Q

extramammary paget disease

A

malignamt epi cell in the epidermis of vulva

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14
Q

extramammary paget disease presentation

A

erythematous, pruritic, ulcerated skin which represents carcinoma in situ; usually NO underlying carcinoma

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15
Q

extramammary paget disease stains

A

PAS +, Keratin +, S100 -; used to distinguish it from melanoma which is PAS -, keratin -, S100 +

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16
Q

Adenosis of vagina

A

focal persistence of columnar epi in upper 1/3 of vagina; inc. incidince in females exposed to DES in utero

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17
Q

adenosis inc. risk for

A

clear cell carcinoma

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18
Q

clear cell adenocarcinoma

A

malignant glands with clear cytoplasm; complication of the adenosis from DES;

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19
Q

embryonal rhabdomyosarcoma

A

malignant mesenchymal proliferation of immature skeletal muscle; rare

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20
Q

embryonal rhabdomyosarcoma presentaion

A

bleeding and grape like mass protruding from cagina or penis of child; < 5 y/o of age

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21
Q

maligant cell in embryonal rhabdomyosarcoma

A

rhabdomyoblast; has cytoplasmic cross striations, positive IHC staining for desmin and myoglobin

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22
Q

vaginal carcinoma

A

arising from squamous epi lining of vagina; related to high risk HPV; precursor lesion is vaginal intraepithelia neoplasia

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23
Q

cancer in lower 2/3 of vagina means spread to

A

inguinal nodes

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24
Q

cancer in upper 1/3 of vagina means spread to

A

regional iliac nodes

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25
Asherman syndrome
secondary ammenorrrhea due to loss of basalis (regenerative layer) and scarring; resul;ts from overaggressive dilation and curettage
26
anovulatory cycle
lack of ovulation, results from estrogen driven growth phase but no progest driven secretory phase; common cause of dysfxn uterine bleeding especially during menarche and menopause
27
acute endometritis
bacterial infection; usually due to retained producst of conception
28
acute endometritis presentation
fever, abnormal uterine bleeding, pelvic pain
29
chronic endometritis
characterized by plasma cells; causes retianed products of conception, chronic PID, IUD, TB
30
chronic endometritis presentation
abnormal uterine bleeding, pelvic pain, infertility
31
endometrial polyp
abnormal bleeding, can arise as SE from tamoxifen; hyperplastic protrusion of endometrium
32
endometriosis
abnormal placement of endometrial glands and stoma outside of the unterine endometrial lining
33
endometriosis presentation
dysmenorrhea, pelvic pain; may cause infertility
34
common sites of involvement of endometriosis
Ovary (chocolate cyst, most common); uterine ligaments (pelvic pain); pouch of douglas (pain with defacation); bladder wall (pain with urination); bowel serosa (abdom pain and adhesions); fallopian tube mucosa (scarring)
35
gun powder lesions
endometriosis inside of soft tissue
36
involvement of uterine myometrium with endometriosis
adenomyosis
37
endometriosis inc risk for
carcinoma especuially in ovary
38
endometrial hyperplasia
hyperplasia in relation to the stroma; consequence of unopposed strogen
39
endometrial hyperplasia presentation
post menopausal uterine bleeding; due to now loss of progesterone but some estrogen can still be around
40
endometrial hyperplasia classified by
architecture and cellular atypia; cellular atypia is most important factor for progression to carsinoma
41
endometrial carcinoma
proliferation of endometrial glands; arised from 2 distincgt pathways (hyperplasia or sporadic)
42
endometrial carinoma presentation
post menopasual bleeding
43
hyperplasia pathway of endometrial carcinoma
exess estro leading to endometrial to grow grow grow then leading to carcinoma; histo is endometriod (looks like endometrium tissue); age group is 50
44
sporadic pathway of endometrial carcinoma
cancer from atrophic endometrium; histology is a serous form (and is called also papillary growth); more often elderly; p53 mutations driven; no precursor lesion; may get psammoma bodies and very aggressive
45
leiomyoma
benign proliferation of the smooth muscle from the myometrium; related to estro exposure; pre-menopausal; usually asymptomatic
46
leiomyoma histo
multiple, well define white whorled masses
47
leiomyoma presentation
usually no Sx; but can have abnormal uterine bleeding, infertility, pelvic mass
48
leiomyosarcoma
malignant prolif. f smooth muscle of myometrium; arised de novo; POST-menopasual women; SINGLE lesion with necrosuis and hemorrhage
49
leimyosarcoma histo
necrosis, mitotic activity, cellular atypia
50
leiomyoma does nto become what
leiomyosarcoma
51
LH hits what? FSH hits what in ovary
LH hits THecal, and FSH hits granulosa
52
hemorrhagic luteal cyst
bleeding into corpus luteum
53
degeneration of follicle leads to
cystic degeration of the follicle
54
poly cystic ovarian disease
multiple follicular cysts in ovary due to horemone imbalance; LH:FSH >2; increase LH and lower FSH
55
PCOD clinical features
obese young women with inferility, oligomenorrhea, hirsutism; some will have insulin resistence; the high levels of estrone inc. risk for endometrial carcinoma
56
surface epithelia tumors of ovary
most common ovarian tumor; derived from coelomic epi that lines ovary;
57
2 most common subtypes of surface epi tumors of ovary
serous and mucinous which both are cystic; other less common types are endometrioid and brenner
58
benign surface epi. tumors of ovary
cystadenoma; single cyst with simple flat lining, premenopausal (30-40)
59
malignant tumor of ovarian surface epi
cystadenocarcinoma; complex cysts with think chaggy lining; POST menopausal women (60-70)
60
borderline tumors of ovarian surface epi cells
features of benign and malignant; still have malignant potenial
61
BRCA1 mutauion carriers with ovarian cancers
inc. risk for serous carcinoma of ovary and fallopian tubes
62
endometriod surface epi. tumor of ovary
looks like endometrial; malignant; may be assoc with endometriosis; assoc with seperate endometrioid carcinoma in endometrium
63
Brenner tumor of surfacve epi of ovary
has cells that are urothelium
64
surface epi tumors presentaion
usually present late; vague abdom Sx; signs of compression; poor prognosis; usually spread locally especially to peritoneum
65
surface epi tumor marker
CA-125, can monitor Tx response or screen recurrence
66
germ cell tumors of ovary
2nd most common; occer in reproductive age; subtypes mimic tissues by germ cells
67
cystic teratoma
cystic tumor comprised of fetal tissue derived from 2-3 embryologic layers; most common germ cell tumor in females; benign
68
cystic teratoma is
benign unless it has signs of immature tissue then it is considered malignant (most commonly malignant tissue is of neuroectooderm cells); the tumor by its self can have cancer (most common is SCC)
69
struma ovarii
cystic teratoma primarily of thyroid tissue
70
dysgerminoma
large cells with clear cytoplasm and central nuclei; most common malignant germ cell tumor; good prognosis, responds to radiotherapy; serum LDH may be elevated
71
dysgerminoma male counter part
seminoma
72
endodermal sinus tumor
malignant tumor that mimics yolk sac; most common germ cell tumor in children; serum AFP elevated; schiller-duval bodies seen
73
schiller duval bodies
glomeruloid type structure on histology
74
choriocarcinoma
malignant of trophoblasts and syncytiotrophoblasts; no villi present; small, hemorrhagic tumor that spreads early; HIGH B-hCG; poor response to chemo; genetically programmed to find blood vessels
75
embryonal carcinoma
large primitive cells; aggressive with early metastasis
76
sex cord stromal tumors
granulosa cells, thecal cells, or sertoli-leydig cells
77
granulosa-theca cell tumor
often produces estrogen; Sx are of estrogen excess
78
sertoli-leydig cell tumor in ovary
leydig cells contain reinke crystals; sertoli cells form tubules; may produce androgens
79
fibroma
benign tumor of fibroblasts; assoc with pleural effusion and ascites (Meigs syndrome)
80
metastasis to ovary
kruckenburg tumor, psuedomyxoma peritonei
81
Kruckenburg tumor
mucinous carcinoma to ovary; classically from gastric carcinoma (diffuse type); signet ring cells; B/L
82
pseudomyxoma peritonei
term for excess muscin in the peritoneum; key tumor is a tumor in appendix (mucinous carcinoma of appendix); cuaes mucinous now onto ovary
83
ectopic pregnancy
implantation of fertilzed ovum at site other than uterine wall; most common site is fallopian tube
84
risk factor for ectopic pregnancy is
scarring
85
presentation of ectopic pregancy
LQ pain weeks after missing period; its a surgical mergency
86
spontaneuous abortion
miscarriage of fetus (20 weesk befor egestataion); common--1/4 of pregs
87
spontaneous abortion Sx
vaginal bleeding, cramp like pain, passage of fetal tissues
88
spontaneous abortion due to
chromosomal abnormalities; hypercoaguable states or exposure to teratogens or congenital infections are other causes
89
placenta previra
implantation of placenta on lower portion of cervical and overlys the Os; 3rd trimester bleeding; often requires fetus C-sextion delivery
90
placenta abruption
placenta abruptly seperaties prior ro delivery; common cause of still biurth;
91
placenta abruiption presentation
3rd trimester bleeding and fetal insuffiency
92
placenta accreta
improper implantation of placenta into myometrium with little to no intervening deciua
93
placenta accreta presentation
diff. delivery of placenta and post partum bleeding; often requires hysterctomy
94
preeclampsia
preg induced HTN, proteinuria and edema; arised in 3rd trimester; due to a maternal-fetal vascular interface in placenta
95
may see what in placenta in preeclampsia
fibrinoud necrosis
96
eclampsia
preeclamsia with seizures
97
HELLP
hemolysis, elevated liver enzymes, low plateles; thrombotic angiopathy involveing liver
98
SIDS
death of healthy infant (1 month to 1 year); usually during sleep;
99
SIDS risk factors
sleep on stomach, smoking in household, prematurity
100
hydatidiform mole
abnirmal conception characterized by swollen and edematous villie with proliferation of trophoblasts; uterus will expand as if the pregnancy is present
101
hydatidiform mole special Sx
uterus expands more than normal; B-hCG will be higher than normally expected; no prenatal care will cause pass of the grape like masses
102
hydatidiform mole presentation
2nd trimester with passage of grape lke masses from vaginal canal
103
hydatidiform mole presentation WITH prenatal care
Dx by routine ultrasound in early first trimester; absent fetal heart sounds; ''snow storm'' appearance on US
104
hydatidiform mole classifications
complete or partial
105
partial mole
normal ovum fertilized by 2 sperm; 69 chromosomes; fetal tissue present; hydropic and some normal villi; focal prolifeation of trophoblast around hydropic villie; minimal risk for choriocarcinoma
106
complete mole
empty ovum fertilized by 2 sperm; fetal tissue absent; most villi are hydropic; diffuse circumferential proliferation of trophoblast around hydropic villi; 2-3% inc chance for choriocarcinoma
107
Tx of molar pregnancy
D&C; monitor B-hCG to disceren if mole is gone
108
choriocarcinoma (gestational)
trophoblast tumor; no villi; gestation or germ cell tumor; gestation pathway responds well to chemotherapy while germ cell does not

Pathology (7 decks)

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