Female reproductive system and Gestational pathology Flashcards
1
Q
Bartholin cyst
A
- Cystic dilation of Bartholin gland
- Results from an obstruction of gland - can become secondary infected, most often by N. gonorrrhoeae, or less often by Staphylococcus.
- Usually occurs in women of reproductive age
- Risk of adenoid cystic carcinoma in older women
2
Q
Lichen sclerosis
A
- Thinning of epidermis and fibrosis of dermis
- White plaques and atrophic skin with a parchment-like vulvar skin - “paper-like” skin
- Most commonly seen in postmenopausal women
- Squamous cell hyperplasia (keratosis)
- Squamous cell carcinoma develops in a minority of patients
3
Q
Candidiasis
A
- Most common form of vaginitis
- Cause: Candida albicans, a normal component of the vaginal flora.
- Associated with DM, pregnancy, broad-spectrum antibiotic therapy, oral contraceptive use, and immunosuppression
4
Q
Trichomoniasis
A
- Second most common type of vaginitis
- Cause: Trichomonas vaginalis
- Most often transmitted by sexual contact
5
Q
Bacterical vaginosis
A
- Most common cause of vaginal discharge
- Cause: loss of normal vaginal lactobacilli, a consequent overgrowth of anaerobes, and a resultant superficial polymicrobial vaginal infection
- Associated with increased numbers of the facultative anaerobe Gardnerella vaginalis
- Characteristically appearance of “clue cells”
6
Q
Toxic shock syndrome
A
- Cause: exotoxin produced by Staphylococcus aureus, which grows in the tampon.
- Characteristic features include fever, vomiting, and diarrheah, sometimes followed by renal failure and shock
7
Q
Papillary hidradenoma
A
- Most common benign tumor of the vulva
- Originates from apocrine sweat glands
- Presents as a labial nodule that may ulcerate and bleed
8
Q
Condyloma acuminatum
A
- Benign squamous cell papilloma
- Caused by HPV, most frequently 6 or 11
- Multiple wart-like lesions, venereal warts, in the vulvovaginal and perianal regions
- Characterized by koilocytes
9
Q
Squamous cell carcinoma (vulva)
A
- Most common malignant tumor of the vulva (95%)
- Presents as leukoplakia
- May be HPV related or non-HPV-related
- HVP: due to types 16 and 18, arises from vulvar intraepithelial neoplasia; often basaloid or warty histology with VIN of similar histology
- Non-HPV: arises from long-standing lichen sclerosis, chronic inflammation and irritation eventually lead to carcinoma
10
Q
Extramammary paget disease
A
- Malignant epithelial cell in the epidermis of the vulva
- Represent carcinoma in situ (70-85% of cases), sometime associated with underlying adenocarcinoma of the apocrine sweat glands
- Crusting, weeping, oocing lesion; may be erythematous
11
Q
Squamous cell carcinoma (vagina)
A
- 95% of all vaginal carcinomas
- Most often due to extension of squamous cell carcinoma of the cervix
- Usually related to high-risk HPV
- Usually upper posterior vagina
- Regional LN spread: lower 2/3 of vagina goes to inguinal nodes, upper 1/3 of vagina goes to regional iliac nodes
12
Q
Clear cell adenocarcinoma
A
- Rare malignant tumor
- Greatly increased incidence in daughters of women who received diethylstilbestrol (DES) therapy during pregnancy
13
Q
Sarcoma botryoides
A
- Rare variant of embryonal rhabdomyosarcoma
- Present with bleeding and grape-like mass protruding from vagina or penis of child
- Occurs in children younger than 5 years of age
14
Q
Cervicitis
A
- Most often involves the endocervix
- Causes: ataphylococci, enterococci, G. vaginalis, T. vaginalis, C. albicans, and C. trachomatis
- Most often asymptomatic
15
Q
Cervical carcinoma
A
- Invasive carcinoma that arises from cervical epithelium
- Presents as vaginal bleeding
- Risk factors: High-risk HPV infection, smoking and immunodeficiency
- Most often squamous cell carcinoma; adenocarcinoma 5% of cases (endocervical type - 70-90% of adenocarcinomas)
- Advanced tumors - often invade through anterior uterine wall into bladder
- Dysplastic cells frequently demonstrate koilocytosis
16
Q
Endometritis
A
- Acute endometritis: Most often caused by S. aureus or Streptococcus. Related to intrauterine trauma from instrumentation, intrauterine contraceptive devices, or complications of pregnancy - retained products of conception
- Chronic endometritis: Most often caused by tuberculosis, PID, postpartum, post-abortion, IUD, symptomatic bacterial vaginosis. Also from retained products of conception
17
Q
Endometriosis
A
- Presence and proliferation of ectopic endometrial tissue
- Causes: Retrograde dissemination of endometrial fragments through fallopian tubes during menstruation, or blood-born or lymphatic-born dissemination of endometrial fragments.
- Ovary is the most common site, followed by uterine ligaments, rectovaginal septum, pelvic peritoneum.
- Presents with menstrual-related pain, infertility
18
Q
Adenomyosis
A
- Islands of endometrium within myometrium.
- Causes menorrhagia, pelvic pain during menstruation; rarely causes rupture during pregnancy
19
Q
Endometrial hyperplasia
A
- Abnormal proliferation of endometrial glands, relative to stroma
- Cause is usually excess estrogen stimulation
- Most often presents with postmenopausal bleeding
- Sometimes a precursor lesion of endometrial carcinoma; the risk of carcinoma varies with the degree of cellular atypia
20
Q
Leiomyoma
A
- Most common uterine tumor and the most common of all tumors in women
- Benign proliferation of smooth muscle arising from myometrium
- Related to estrogen exposure, often increase in side during pregnancy, and they almost always decrease in size following menopause
- Multiple, well-defined white whorled masses
21
Q
Leiomyosarcoma
A
- Malignant proliferation of smooth muscle arising from the myometrium
- Arises the novo (leiomyoma does not become leiomyosarcoma
- Usually seen in postmenopausal women
- Single lesion with necrosis and hemorrhage
- Necrosis, mitotic activity, and cellular atypic
- Tend to recur, 50% metastasize to lung, bone, brain, other; lymph node involvement unusual
