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pathology > Female Reproductive > Flashcards

Female Reproductive Flashcards

1
Q

33 yr old woman presents with pruritic vaginitis with white discharge. On examination, fiery red mucosa of vagina is seen. She gives h/o of OCP use. What do you expect to see on culture?

A

Yeasts with pseudo hyphae.

Causative organism is candida albicans.

OCP use/pregnancy is a risk factor

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2
Q

46 yr old woman presents with pruritis in the vagina with white discharge. On examination the vaginal mucosa is fiery red. She gives history of antibiotic use. What is the mode of transmission?

A

Endogenous.

Causative organism is Candida albicans which is part of normal flora

Antibiotic use is a risk factor

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3
Q

A 23 yr old woman presents with PID. She gives h/o having sexual intercourse 10 days back. What is the causative organism?

A

Chlamydia trachomatis.

It is the 3rd most common STD

It has an incubation period of 7-12 days

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4
Q

A 22 yr old woman presents with cervicitis. She gives history of sexual intercourse 1 week back. What is the infectious form of the causative organism?

A

Elementary body that resides extracellularly.

Causative organism is chlamydia trachomatis.

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5
Q

28 yr old pregnant mother is diagnosed with chlamydia trachomatis PID. What condition is her newborn at risk for?

A

Ophthalmia neonatorum and pneumonia

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6
Q

24 the old woman presents with cervicitis. Staining of cervical smear shows metaplastic endocervical squamous cells with intracellular inclusion bodies. What other STD is most commonly associated with this organism?

A

Gonorrhoea.

45% cases chalmydia trachomatis coexists with neisseria gonorrhea.

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7
Q

25 yr old woman presents with papules and ulcers on the vulva. There is also swelling. On examination, the inguinal nodes are found to be enlarged. What is the most likely causative organism?

A

Chlamydia trachomatis subspecies-LGV

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8
Q

25 yr old woman presents with papules and ulcers on the vulva. There is also swelling. On examination, the inguinal nodes are found to be enlarged. What do you expect to see histopathology of the lymph node biopsies?

A

Granulomatous microabscess.

Causative organism is C. Trachomatis-LGV

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9
Q

25 yr old woman presents with papules and ulcers on the vulva. There is also swelling. On examination, the inguinal nodes are found to be enlarged. What is a possible complication?

A

Formation of rectal strictures.

Causative organism is C. Trachomatis-LGV.

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10
Q

24 yr old woman presents with malodorous vaginal discharge. Examination reveals vaginitis. What is the most common organism?

A

Gradnella vaginalis

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11
Q

23 year old woman presents with malodorous vaginal discharge. What is the most common finding in vaginal smears in women with vaginitis?

A

Clue cells. Organisms adhere to squamous cells (do not invade)

Gardnerella vaginalis is the most common cause of vaginitis

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12
Q

27 yr old women in her 1st trimester presents with malodorous vaginal discharge. Vaginal smear shows clue cells. What is the foetus at risk for?

A

Low birth weight and preterm delivery

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13
Q

65 yr old diabetic woman presents with pruritic vaginitis with white discharge and fiery red mucosa is seen on examination. What is the causative organism?

A

Candida albicans.

It is the 2nd most common cause of vaginitis.

Diabetes is a risk factor

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14
Q

A 23 yr old man presents with painful perianal ulcers with suppurative inguinal nodes. He gives h/o intercourse 6 days back. What is the organism most likely to be?

A

Hemophilus ducreyi

Male preponderance (10:1)
Incubation period: 4-7 days
STD

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15
Q

27 yr old male presents with painful perianal ulcers with suppurative inguinal nodes. Gives h/o intercourse 7 days ago. What infection is he at risk for?

A

HIV infection- perianal ulcers

Causative organism is hemophilus ducreyi

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16
Q

34 yr old male presents with painful perianal ulcers and suppurative inguinal nodes. What are you most likely to see on gram stain?

A

School of fish appearance (gram - bacteria)

Causative organism is hemophilus ducreyi

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17
Q

25 yr old woman presents with recurrent episodes of vesicles that ulcerated in peri-anal region. What is the causative organism most likely to be?

A

HSV-2

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18
Q

22 yr old medical student preparing for her exams presents with recurrent episodes of vesicles that ulcerated in the cervix. What do you expect to find on staining scrapings procured from base of the ulcer?

A

Multi nucleated squamous cells with intra nuclear inclusions [Tzank preparation]

Infection is of HSV-2

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19
Q

22yr old woman in her 1st trimester complains of recurrent ulcers in the vulva region. Staining of scrapings from the base of the ulcer show presence of Tzank cells. Where else in the body is the organism found?

A

Infected with HSV-2

Lies latent in sensory ganglia

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20
Q

22yr old woman in her 3rd trimester complains of recurrent ulcers in the vulva region. Staining of scrapings from the base of the ulcer show presence of Tzank cells. What type of delivery is preferred in this patient?

A

Caesarean section

Patient infected with HSV-2

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21
Q

23 yr old gives h/o being sexually active. Presents with flat fern like lesions in genital area. What organism is most likely to cause her symptoms?

A

HPV type 6/11

Causes condyloma accuminata

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22
Q

22yr old woman gives h/o being sexually active and presents with fern like flat lesions in genital area. What do you expect on staining smear from the lesions?

A

Squamous epithelium with pyknotic wrinkled nuclei surrounded by clear halo.

Causative organism is HPV

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23
Q

56 yr old woman presents with persistent fern like flat lesions in the genital area. What is the most likely cause?

A

HPV infection with decreased cellular immunity

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24
Q

23 yr old gives h/o being sexually active. She presents with raised creeping sore. No lymphadenopathy. What is the causative organism?

A

Klebsiella granulomatis

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25
Q

22 yr old gives h/o being sexually active. Presents with raised creeping sore. No lymphadenopathy. What do you expect to see on staining of swab of lesion?

A

Donovan bodies- klebsiella granulomatis is phagocytosed by macrophages

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26
Q

22yr old woman in her 4th week of pregnancy presents with abdominal pain, bleeding PV, shortened amenorrhea. She gives h/o PID. What is the most likely causative organism of this complication?

A

Neisseria gonorrhoea can cause ectopic pregnancy

Shortened amenorrhea, bleeding PV and abdominal pain is the triad of ectopic pregnancy.

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27
Q

25 yr old female presents with septic arthritis of the knee, tenosynovitis of the hands and feet and pustules on the hands and feet. She gives h/o being sexually active. What condition is a risk factor for the development of this diseases?

A

C6-C9 deficiency is a risk factor of disseminated gonococcemia

28
Q

25 yr old presents with PID. Gives h/o last sexual intercourse 2 days back. Nucleic acid amplification test confirms neisseria gonorrhea infection. Which cells are these bacteri most likely to infect?

A

Transitional/ glandular epithelium

29
Q

23 yr old woman presents with solitary painless indurated chancre in labia. She gives h/o being sexually active. What is the most likely causative organism?

A

Treponema pallidum- primary syphillis

30
Q

25 yr old woman presents with maculopapular rash on trunk, palms and soles. She also complains of hair loss. On examination condylomata lata are found in the genital area. She gives + h/o sexual activity. What is the most likely diagnosis?

A

Secondary syphillis due to treponema pallidum

31
Q

22 yr old woman with maculopapular rash on trunk, generalised lymphadenopathy, condylomata Lata and alopecia. She is treated with penicillin for her secondary rash, however rashes intensify. What is the diagnosis?

A

Jarisch-herxheimer reaction due to proteins released from dead bacteria

32
Q

30 yr old woman presents with a solitary painless indurated chancre in the mouth. She gives h/o oral sex. What are the specific and non specific tests for this organism?

A

Specific- FTA-ABS
Non specific-VDRL, RPR

Causative organism is treponema pallidum

33
Q

22yr old woman presents with strawberry coloured cervix, fiery red vaginal mucosa and green frothy discharge. She gives h/o being sexually active. What is the most likely causative organism?

A

Trichomonas vaginalis

34
Q

22yr old woman presents with strawberry coloured cervix, fiery red vaginal mucosa and green frothy discharge. She gives h/o being sexually active. What do you expect to see in a wet preparation of discharge?

A

Flagellated protozoan with jerky motility

Causative organism is trichomonas vaginalis

35
Q

25 yr old woman in her 3rd trimester of pregnancy presents with strawberry coloured cervix, fiery red vaginal mucosa and green frothy discharge. What is her foetus at risk for?

A

Preterm delivery and low birth weight

Causative organism is trichomonas vaginalis

36
Q

25 yr old woman presents with strawberry coloured cervix, fiery red vaginal mucosa and greenish frothy discharge. She gives h/o sexually active. What is the reservoir of the infection?

A

Men-asymptomatic carriers

Causative organism is trichomonas vaginalis

37
Q

27 yr woman gives h/o being sexually active. She presents with green frothy vaginal discharge. Wet preparation of discharge shows flagellated protozoan with jerky motility. What infection is she at increased risk for?

A

Increased susceptibility for HIV and HIV shedding

She is infected with trichomonas vaginalis

38
Q

56 yr woman presents with parchment like appearance of vulva. What is your diagnosis?

A

Lichen sclerosus- non neoplastic dermatoses

Usually occurs in post menopausal women

39
Q

47 yr old woman presents with a white plaque like lesion on the vulva. What is the diagnosis?

A

Lichen simplex chronicus

40
Q

45 yr old woman presents with a painful nodule on vulva. What is your diagnosis?

A

Papillary hidradenoma-benign tumour of the apocrine sweat glands

41
Q

24yr woman presents with mass in the vulva. Histopathology of biopsy specimen reveals keratin squamous pearls. What are the risk factors of this neoplasm?

A

HPV type 16
Immunodeficiency
Smoking cigarettes

It is a case of squamous cell carcinoma

42
Q

26 yr woman presents with red crusted vulvar lesions in vulva. Lesions are PAS+. What is your diagnosis?

A

Extra mammary paget disease

Malignant paget cells contain mucin-PAS +

43
Q

24yr woman presents with mass in the vulva. Histopathology of biopsy specimen reveals keratin squamous pearls. What is your diagnosis?

A

Squamous cell carcinoma of vulva

44
Q

23 yr old woman’s vulva histopathology of biopsy specimen reveals singly disposed and clusters of malignant cells in the epidermis. They are PAS+. What is your diagnosis?

A

Extra Mammary Paget’s disease

45
Q

24yr old woman presents with red crusted lesions in vulva. Histopathology of biopsy specimen shows large clear cells with eccentric hyperchromic nuclei. What stain can be used to confirm diagnosis?

A

Periodic acid schiff + due to presence of mucin in paget cells

46
Q

26 yr old woman’s histopathology of vulva biopsy reveals large clear cells with eccentric hyperchromic nuclei. PAS negative. What is your diagnosis?

A

Malignant melanoma

47
Q

16yr old presents with amenorrhea. FSH, LH, estrogen and progesterone levels are all normal. What is the most likely diagnosis?

A

Rokitansky-kuster-hauser syndrome- vagina and uterus underdeveloped/absent but ovaries present and functional

48
Q

23 year old female comes to the obg dept. An cyst on the lateral wall of the vagina is an incidental finding. Diagnosis?

A

Gartner duct cyst

49
Q

23 year old female comes to the obg dept. An cyst on the lateral wall of the vagina is an incidental finding. What structure has the cyst developed from?

A

Gartner duct cyst

It is a remnant of wolffian (mesonephric) duct

50
Q

24 yr old presents with a mass in her vagina. Similar masses are detected in her heart. On microscopy these masses are found to be rhabdomyoblasts. What is your diagnosis?

A

Rhabdomyoma associated with tuberous sclerosis.

Tuberous sclerosis is a multi system genetic disease associated with benign tumours in brain and other vital organs

51
Q

24 yr old presents with a mass in her vagina. Similar masses are detected in her heart. On microscopy these masses are found to be rhabdomyoblasts. What is the prognosis?

A

These tumours are benign and do not progress to stage of malignancy.

Patient is afflicted with Rhabdomyoma associated with tuberous sclerosis.

52
Q

33 yr old woman presents with a mass in the vagina. On histopathology, vacuolated cells with ill defined glandular spaces are seen. What is your diagnosis?

A

Clear cell adenocarcinoma

53
Q

45yr old woman presents with red superficial ulceration in the upper part of the vagina. She gives h/o administration of DES for a threatened abortion. What is your diagnosis?

A

Vaginal adenosis

DES inhibits mullerian differentiation–> benign remnants of uterus, Fallopian tubes, cervix and vagina–> vaginal adenosis

54
Q

45yr old woman presents with red superficial ulceration in the upper part of the vagina. She gives h/o administration of DES for a threatened abortion. What is the prognosis of this condition?

A

Prognosis good. 1 in 1000 progress to clear cell adenocarcinoma.

She has vaginal adenosis.

Remnants of the mullerian gland formed due to inhibition of mullerian differentiation by DES

55
Q

30 yr old woman complains of problem with conceiving. She gives h/o recurrent abortions. LH, FSH, GnRH normal. Periods regular and normal. She gives h/o use of DES for a previous threatened abortions. Associated anomalies with DES use?

A

Abnormally shaped uterus- thwarts implantation

Cervical incompetence- recurrent abortions

56
Q

22 yr old woman presents with mass in her cervix and vagina. On histopathology of the specimen cells have a wrinkled pyknotic nucleus surrounded by a clear halo. What virus is this lesion associated with?

A

HPV type 16

SCC extending from cervix (MC presentation of this lesion)

57
Q

22 yr old woman complains of vaginal discharge, pelvic pain, and dyspareunia. On examination cervical OS is erythematous and covered with exudate. What are the causative organisms?

A

C. Trachomatis, N. Gonorrhoea, trichomonas vaginalis, HSV-2, HPV, candida

Patient has cervicitis

58
Q

22 yr old woman complains of vaginal discharge, pelvic pain, dyspareunia. On examination cervical OS is erythematous and covered with exudate. What investigation would you like to order?

A

DNA probe/culture for C. Trachomatis and N. Gonorrhea.

Account for >50% of cervicitis cases

59
Q

23 yr old sexually active woman presents with pelvic pain, dyspareunia. On examination follicles are seen on the cervix. What is the causative organism?

A

Chlamydia Trachomatis

60
Q

22 yr old sexually active woman presents with pelvic pain and dyspareunia. Pap smear of TZ shows vacuolated cells with inclusions. What is the infective form of the causative organism?

A

Elementary body

Vacuolated cells- phagosomes; inclusion bodies- reticulate bodies

The patient is infected with C. Trachomatis

61
Q

22 yr old sexually active patient presents with follicles in cervix. What do you expect to see in Pap smear of TZ?

A

Endocervical metaplastic squamous epithelium with vacoulations and inclusion bodies

Causative organism is C. Trachomatis.

Reticulate bodies (inclusion bodies) are phagocytosed by cells

62
Q

A Pap smear is done in a 24 yr old woman. It shows 70% superficial squamous cells and 30% intermediate squamous cells. Interpret the result?

A

Non pregnant woman with adequate levels of estrogen and progesterone

Superficial squamous cells indicate adequate estrogen

Intermediate squamous indicates adequate progesterone

63
Q

Pap smear done in a 25 yr woman shows 100% intermediate squamous cells. Interpret the results?

A

Pregnant woman

Intermediate squamous epithelium from progesterone effect

64
Q

Pap smear in a woman shows atrophy of cells with para basal cells and inflammation. What age is she most likely?

A

Elderly

Presence of para basal cells indicates lack of estrogen and progesterone

65
Q

Pap smear in a 23 yr old shows 100% superficial squamous cells. She gives no h/o of OCP use. What is your diagnosis?

A

Tumour secreting estrogen eg. Granulosa cell tumour of ovaries.

Superficial squamous cells due to the effect of estrogen

pathology (6 decks)

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