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Pathology > female reproductive > Flashcards

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
Q

Asherman syndrome

A

secondary ammenorrrhea due to loss of basalis (regenerative layer) and scarring; resul;ts from overaggressive dilation and curettage

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26
Q

anovulatory cycle

A

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

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27
Q

acute endometritis

A

bacterial infection; usually due to retained producst of conception

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28
Q

acute endometritis presentation

A

fever, abnormal uterine bleeding, pelvic pain

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29
Q

chronic endometritis

A

characterized by plasma cells; causes retianed products of conception, chronic PID, IUD, TB

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30
Q

chronic endometritis presentation

A

abnormal uterine bleeding, pelvic pain, infertility

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31
Q

endometrial polyp

A

abnormal bleeding, can arise as SE from tamoxifen; hyperplastic protrusion of endometrium

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32
Q

endometriosis

A

abnormal placement of endometrial glands and stoma outside of the unterine endometrial lining

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33
Q

endometriosis presentation

A

dysmenorrhea, pelvic pain; may cause infertility

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34
Q

common sites of involvement of endometriosis

A

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)

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35
Q

gun powder lesions

A

endometriosis inside of soft tissue

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36
Q

involvement of uterine myometrium with endometriosis

A

adenomyosis

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37
Q

endometriosis inc risk for

A

carcinoma especuially in ovary

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38
Q

endometrial hyperplasia

A

hyperplasia in relation to the stroma; consequence of unopposed strogen

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39
Q

endometrial hyperplasia presentation

A

post menopausal uterine bleeding; due to now loss of progesterone but some estrogen can still be around

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40
Q

endometrial hyperplasia classified by

A

architecture and cellular atypia; cellular atypia is most important factor for progression to carsinoma

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41
Q

endometrial carcinoma

A

proliferation of endometrial glands; arised from 2 distincgt pathways (hyperplasia or sporadic)

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42
Q

endometrial carinoma presentation

A

post menopasual bleeding

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43
Q

hyperplasia pathway of endometrial carcinoma

A

exess estro leading to endometrial to grow grow grow then leading to carcinoma; histo is endometriod (looks like endometrium tissue); age group is 50

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44
Q

sporadic pathway of endometrial carcinoma

A

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
Q

leiomyoma

A

benign proliferation of the smooth muscle from the myometrium; related to estro exposure; pre-menopausal; usually asymptomatic

46
Q

leiomyoma histo

A

multiple, well define white whorled masses

47
Q

leiomyoma presentation

A

usually no Sx; but can have abnormal uterine bleeding, infertility, pelvic mass

48
Q

leiomyosarcoma

A

malignant prolif. f smooth muscle of myometrium; arised de novo; POST-menopasual women; SINGLE lesion with necrosuis and hemorrhage

49
Q

leimyosarcoma histo

A

necrosis, mitotic activity, cellular atypia

50
Q

leiomyoma does nto become what

A

leiomyosarcoma

51
Q

LH hits what? FSH hits what in ovary

A

LH hits THecal, and FSH hits granulosa

52
Q

hemorrhagic luteal cyst

A

bleeding into corpus luteum

53
Q

degeneration of follicle leads to

A

cystic degeration of the follicle

54
Q

poly cystic ovarian disease

A

multiple follicular cysts in ovary due to horemone imbalance; LH:FSH >2; increase LH and lower FSH

55
Q

PCOD clinical features

A

obese young women with inferility, oligomenorrhea, hirsutism; some will have insulin resistence; the high levels of estrone inc. risk for endometrial carcinoma

56
Q

surface epithelia tumors of ovary

A

most common ovarian tumor; derived from coelomic epi that lines ovary;

57
Q

2 most common subtypes of surface epi tumors of ovary

A

serous and mucinous which both are cystic; other less common types are endometrioid and brenner

58
Q

benign surface epi. tumors of ovary

A

cystadenoma; single cyst with simple flat lining, premenopausal (30-40)

59
Q

malignant tumor of ovarian surface epi

A

cystadenocarcinoma; complex cysts with think chaggy lining; POST menopausal women (60-70)

60
Q

borderline tumors of ovarian surface epi cells

A

features of benign and malignant; still have malignant potenial

61
Q

BRCA1 mutauion carriers with ovarian cancers

A

inc. risk for serous carcinoma of ovary and fallopian tubes

62
Q

endometriod surface epi. tumor of ovary

A

looks like endometrial; malignant; may be assoc with endometriosis; assoc with seperate endometrioid carcinoma in endometrium

63
Q

Brenner tumor of surfacve epi of ovary

A

has cells that are urothelium

64
Q

surface epi tumors presentaion

A

usually present late; vague abdom Sx; signs of compression; poor prognosis; usually spread locally especially to peritoneum

65
Q

surface epi tumor marker

A

CA-125, can monitor Tx response or screen recurrence

66
Q

germ cell tumors of ovary

A

2nd most common; occer in reproductive age; subtypes mimic tissues by germ cells

67
Q

cystic teratoma

A

cystic tumor comprised of fetal tissue derived from 2-3 embryologic layers; most common germ cell tumor in females; benign

68
Q

cystic teratoma is

A

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
Q

struma ovarii

A

cystic teratoma primarily of thyroid tissue

70
Q

dysgerminoma

A

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
Q

dysgerminoma male counter part

A

seminoma

72
Q

endodermal sinus tumor

A

malignant tumor that mimics yolk sac; most common germ cell tumor in children; serum AFP elevated; schiller-duval bodies seen

73
Q

schiller duval bodies

A

glomeruloid type structure on histology

74
Q

choriocarcinoma

A

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
Q

embryonal carcinoma

A

large primitive cells; aggressive with early metastasis

76
Q

sex cord stromal tumors

A

granulosa cells, thecal cells, or sertoli-leydig cells

77
Q

granulosa-theca cell tumor

A

often produces estrogen; Sx are of estrogen excess

78
Q

sertoli-leydig cell tumor in ovary

A

leydig cells contain reinke crystals; sertoli cells form tubules; may produce androgens

79
Q

fibroma

A

benign tumor of fibroblasts; assoc with pleural effusion and ascites (Meigs syndrome)

80
Q

metastasis to ovary

A

kruckenburg tumor, psuedomyxoma peritonei

81
Q

Kruckenburg tumor

A

mucinous carcinoma to ovary; classically from gastric carcinoma (diffuse type); signet ring cells; B/L

82
Q

pseudomyxoma peritonei

A

term for excess muscin in the peritoneum; key tumor is a tumor in appendix (mucinous carcinoma of appendix); cuaes mucinous now onto ovary

83
Q

ectopic pregnancy

A

implantation of fertilzed ovum at site other than uterine wall; most common site is fallopian tube

84
Q

risk factor for ectopic pregnancy is

A

scarring

85
Q

presentation of ectopic pregancy

A

LQ pain weeks after missing period; its a surgical mergency

86
Q

spontaneuous abortion

A

miscarriage of fetus (20 weesk befor egestataion); common–1/4 of pregs

87
Q

spontaneous abortion Sx

A

vaginal bleeding, cramp like pain, passage of fetal tissues

88
Q

spontaneous abortion due to

A

chromosomal abnormalities; hypercoaguable states or exposure to teratogens or congenital infections are other causes

89
Q

placenta previra

A

implantation of placenta on lower portion of cervical and overlys the Os; 3rd trimester bleeding; often requires fetus C-sextion delivery

90
Q

placenta abruption

A

placenta abruptly seperaties prior ro delivery; common cause of still biurth;

91
Q

placenta abruiption presentation

A

3rd trimester bleeding and fetal insuffiency

92
Q

placenta accreta

A

improper implantation of placenta into myometrium with little to no intervening deciua

93
Q

placenta accreta presentation

A

diff. delivery of placenta and post partum bleeding; often requires hysterctomy

94
Q

preeclampsia

A

preg induced HTN, proteinuria and edema; arised in 3rd trimester; due to a maternal-fetal vascular interface in placenta

95
Q

may see what in placenta in preeclampsia

A

fibrinoud necrosis

96
Q

eclampsia

A

preeclamsia with seizures

97
Q

HELLP

A

hemolysis, elevated liver enzymes, low plateles; thrombotic angiopathy involveing liver

98
Q

SIDS

A

death of healthy infant (1 month to 1 year); usually during sleep;

99
Q

SIDS risk factors

A

sleep on stomach, smoking in household, prematurity

100
Q

hydatidiform mole

A

abnirmal conception characterized by swollen and edematous villie with proliferation of trophoblasts; uterus will expand as if the pregnancy is present

101
Q

hydatidiform mole special Sx

A

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
Q

hydatidiform mole presentation

A

2nd trimester with passage of grape lke masses from vaginal canal

103
Q

hydatidiform mole presentation WITH prenatal care

A

Dx by routine ultrasound in early first trimester; absent fetal heart sounds; ‘‘snow storm’’ appearance on US

104
Q

hydatidiform mole classifications

A

complete or partial

105
Q

partial mole

A

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
Q

complete mole

A

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
Q

Tx of molar pregnancy

A

D&C; monitor B-hCG to disceren if mole is gone

108
Q

choriocarcinoma (gestational)

A

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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