Female reproductive system- Vulva, Vagina, Cervix

Question 1

Viruses causing Vulvitis

Answer 1

1) HPV
2) HSV-1, HSV-2

Question 2

Fungus causing Vulvitis

Answer 2

Candida Albicans

Question 3

Bacteria causing Vulvitis

Answer 3

Neisseria Gonorrhoea

Question 4

Parasit causing Vulvitis

Answer 4

Trichomonas Vaginalis

Question 5

Complication of Vulvitis

Answer 5

Bartholin Gland Cyst

Question 6

Cause of Bartholin Gland Cyst

Answer 6

Obstruction of the excretory ducts of Bartholin glands

Question 7

Clinical presentation of Bartholin Gland Cyst

Answer 7

painful dilation of the glands
(Bartholin Cyst) and abscess formation

Question 8

Microscopic findings:
– Most common lining: Transitional-type epithelium
– However, cuboid, columnar, ciliated, and squamous
cells may be also observed
– The cyst wall contains a variable number of chronic inflammatory cells and normal or atrophic acini

Macroscopic findings:
- Unilocular cyst filled with serous fluid

features of?

Answer 8

Bartholin Gland Cyst

Question 9

patho of Lichen Scleroscus

Answer 9

Presence of activated T-cells in the subepithelial inflammatory infiltrate and the increased frequency of autoimmune disorders suggest an
autoimmune aetiology

Question 10

Epi of Lichen Sclerosus

Answer 10

post-menopausal women

Question 11

Clinical presentation of Lichen Sclerosus

Answer 11

White plaques (leukoplakia) or
papules

Question 12

Microscopic findings:
1. Thinning of the epidermis
2. Disappearance of rete pegs
3. Hydropic degeneration of the basal cells
4. Dermal fibrosis
5. Scant perivascular mononuclear inflammatory cell
infiltrate

features of?

Answer 12

Lichen Sclerosus

Question 13

DD of Lichen Sclerosus

Answer 13

Other causes of leukoplakia, such as Psoriasis, Lichen Planus and Squamous Cell Carcinoma (in situ or invasive)

Question 14

Progression & Prognosis of Lichen Sclerosus

Answer 14

Benign, but slightly increased (1-5%) risk of SCC

Question 15

patho of Lichen Simplex Chronicus

Answer 15

autoimmune aetiology

Question 16

Clinical presentation of Lichen Simplex Chronicus

Answer 16

White plaques (leukoplakia) or
papules

Question 17

Microscopic findings:
1. Epithelial thickening (particularly of the stratum granulosum)
2. Hyperkeratosis (thickening of the startum corneum, outer layer of skin)
3. Increased mitotic activity in the basal and suprabasal layers
4. No epithelial atypia
5. Leukocytic infiltration of the dermis

features of ?

Answer 17

Lichen Simplex Chronicus

Question 18

DD of Lichen Simplex Chronicus:

Answer 18

Other causes of leukoplakia, such as Psoriasis, Lichen Planus and Squamous Cell Carcinoma (in situ or invasive)

Question 19

progression & prognosis of Lichen Simplex Chronicus

Answer 19

Benign, isolated lesions, that do not have a risk of developing SCC

Question 20

Which has a risk of developing SCC, Lichen Simplex Chronicus/ Lichen Sclerosus

Answer 20

Lichen sclerosus

Question 21

Epi of Condylomata lata

Answer 21

• Rare, Benign lesions
• Manifestation of Secondary Syphilis

Question 22

Macroscopic picture: Flat, moist, minimally elevated lesions

features of?

Answer 22

Condylomata Lata

Question 23

Cause of Condylomata Acuminata

Answer 23

HPV infection (subtypes 6 and 11)

Question 24

Clinical presentation of Condylomata Acuminata

Answer 24

Condyloma - Papillary and distinctly elevated or somewhat flat lesions

Question 25

Microscopic findings: * **Epithelial hyperplasia** and * presence of epithelial cells with peri-nuclear cytoplasmic vacuolisation and **wrinkled nuclear contours (koilocytosis)** features of?

Answer 25

Condylomata Acuminata

Question 26

Epi of Valvular Carcinoma

Answer 26

* 3% of all female genital tract cancers (rare) * women > 60yrs

Question 27

Clinical presentation of Valvular CA?

Answer 27

– **Areas of leukoplakia** (especially in cases of in situ or early invasive carcinomas) – **Exophytic or ulcerated tumours** (especially in cases of infiltrating carcinomas

Question 28

Which form of Valvular SCC is associated w/ HPV infection and Valvular Intraepithelial Neoplasia (VIN)?

Answer 28

The **Less common From** (More common form is no ass/ with HPV and VIN)

Question 29

Epi of the Less common from of valvular SCC

Answer 29

Middle-aged women

Question 30

Which from of Valvular SCC has the following Microscopic features -> **Poorly differentiated Squamous Cell Carcinomas**

Answer 30

**Less common form**

Question 31

Which form of Valvular SCC has the following Micro features --> **Well-differentiated keratinising Squamous Cell Carcinomas**

Answer 31

**Common form**

Question 32

Epi of the More common form of Valvular SCC

Answer 32

**Older women**

Question 33

Cause of Valvular Extra-Mammary Pagest Disease

Answer 33

not ass. w/ an underlying carcinoma, unlike paget disease of the breast

Question 34

Clinical presentation of Valvular Extra-Mammary Paget Disease

Answer 34

Red, scaly, crusted plaque and Erythema

Question 35

Microscopic findings: - **Infiltration of the epidermis**, singly and in nests of neoplastic cells - Pleomorphic Nuclei w/ vesicular chromatin features of?

Answer 35

**Valvular Extra-Mammary Paget Disease**

Question 36

DD of Valvular Extra-Mammary Paget Disease

Answer 36

Vulvar Melanoma

Question 37

Congenital Vaginal Abnormalities

Answer 37

1) **Absence of the vagina** 2) **Septate or double vagina** (usually associated with a septate cervix and, sometimes, septate uterus) 3) Congenital, lateral **Gartner Duct Cysts, arising from persistent Wolffian duct rests** (Gartner’s Ducts = Mesonephric Ducts or Wolffian Ducts)

Question 38

Epi do Vaginitis

Answer 38

Common

Question 39

Cause of Vaginits

Answer 39

1. Fungus: **Candida Albicans** 2. Parasites: **Trichomonas vaginalis** 3. Bacteria: **Neisseria gonorrhoeae**

Question 40

Risk factors of Vaginitis

Answer 40

1) **DM**, 2) **systemic antibiotic therapy** (which causes disruption of normal microbial flora), 3) **immunodeficiency,** 4) **pregnancy, or recent abortion**

Question 41

Clinical presentation of Vaginitis

Answer 41

Vaginal discharge (leukorrhoea)

Question 42

Clinical presentation of Vaginitis caused by Candida Albicans vs Trichomonas Vaginalis

Answer 42

* Candida albicans --> Curdy, **white discharge** * Trichomonas vaginalis -> Watery, copious **gray-green discharge**

Question 43

Epi of Valvular SCC

Answer 43

Rare, women > 60yrs

Question 44

VAginal Intraepithelial Neoplasia (VAIN) is a precursor lesion that is nearly always associated with?

Answer 44

**HPV infection (subtypes 16 and 18)**

Question 45

Clinical presentation of Valvular SCC

Answer 45

1) Areas of leukoplakia (especially in cases of in situ or early invasive carcinomas) 2) Exophytic or ulcerated tumours (especially in cases of infiltrating carcinomas)

Question 46

Epi of Valvular Clear Cell Adenocarcinomas

Answer 46

**Very rare, In young women whose mothers took diethylstilbestrol during pregnancy** (to prevent threatened abortion)

Question 47

precursor of Valvular Clear Cell Adenocarcinomas

Answer 47

**Vaginal Adenosis**

Question 48

Embryonal Rhabdomyosarcoma are aka?

Answer 48

Sarcoma Botryoides

Question 49

Epi of Sarcoma Botryoides

Answer 49

Most common soft tissue sarcoma of childhood and adolescence (girls <4yrs)

Question 50

Clinical presentation of Sarcoma Botryoides

Answer 50

Soft, gelatinous, **grape-like mass**

Question 51

Microscopic findings: - **Rhabdomyoblast** (Granular eosinophilic cytoplasm, rich in thick and thin filaments) Macroscopic features: - **Polypoid, grape-like soft tissue** features of?

Answer 51

**Sarcoma Botryoides** - Embryonal Rhabdomyosarcoma

Question 52

Microscopic features: - **Hobnail-shaped cells** - Dark, atypical nuclei - Tubules, ductules, and cystic spaces features of?

Answer 52

Valvular Clear Cell Adenocarcinomas