GYN Flashcards
Which syndrome is Peutz Jeghers associated with in the gyn?
Adenoma Malignum
Ovarian Sex cord tumor with annular tubules
Peutz-Jeghers is due to Mutation in what gene? Chromosome?
STK11/LKB1
Chromosome 19p
In lynch syndrome:
_______% lifetime risk of endometrial cancer; often in the _________
_______% risk of ovarian cancer; often _______
___50_% lifetime risk of endometrial cancer; often in the lower uterine segment
___10____% risk of ovarian cancer; often clear cell type
What genes are associated with hereditary breast/ovary cancer (HBOC)?
BRCA1 and 2
What is the precursor lesion seen in hereditary breast/ovary cancer (HBOC) in the Fallopian tube?
Serous tubal intraepithelial carcinoma
What chromosome is BRACA 1?
17q21
What chromosome is BRACA 2?
13q12-13
High risk HPV
16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68, 73, 82
Infections that result in benign processes usually have _________ viral DNA
Episomal
How is mutated BRCA expressed?
AD with high penetrance
E6 gene product act through inhibition of what tumor suppressor gene?
p53
E7 gene product act through inhibition of what tumor suppressor gene? Which causes?
Retinoblastoma Over expression of p16
Is lichen sclerosis a precancerous lesion?
No
Does lichen sclerosis have a greater risk of carcinoma?
Yes; 1-4%
Lichen simplex chronicus: histologic
Hyperkeratosis with acanthosis
Collagenization of the superficial dermis with underlying chronic inflammatory infiltrate
DES is associated with alteration of what gene?
P63
Serous carcinoma IHC
p53 and p16 diffusekt positive
p53 maybe completely negative
Ovarian tumors with esteogenic effect
Granulosa cell tumor
Thecomas
Stromal luteoma
Ovarian tumors with androgenic effect
Sertoli leydig
Leydig/Hilus cell tumor
Steroid cell tumor
Ovarian tumor of the young <30
Sertoli leydig (retifrom variant seen ~15)
Juvenile granulosa
Sclerosing stromal tumor
Sex cord stromal tumor with annular tubules
Ovarian tumors of perimenopausal age
Fibromas
Ovarian tumors of post menopausal age
Adult granulosa
Thecomas
Leydig
Stromal luteoma
What is the maximum number of slides a tech can screen? What’s the calculation?
100 in 24 hours (in no less than 8 hours)
Number of hours * 100 /8
Whats the gene product of HPV that’s used in vaccines?
L1
Give the risk of developing HSIL or worse in the following scenarios…
Neg Pap and Neg HPV
Neg Pap and Positive Pooled HPV
Neg pap and Positive for HPV 16
ASCUS and Positive HPV
Neg Pap and Neg HPV : <2%
Neg Pap and Positive Pooled HPV: 3-5%
Neg pap and Positive for HPV 16: 20%
ASCUS and Positive HPV : 25-30%
Give the Regression %, Progression to HSIL % and Progression to Cancer % in following
ASCUS :
LSIL:
HSIL :
Regression HSIL Cancer
ASCUS : 68% 7% 0.25%
LSIL: 47% 21% 0.15%
HSIL : 35% —- 1.4%
Given the associated hormonal status
0/10/90
0/90/10
20/80/0
100/0/0
0/10/90 : Estrogen effect
0/90/10 : Progesterone effect, New borns
20/80/0 : Androgen effect
100/0/0 : Atrophy, no estrogen
Parabasal/intermediate/sperficial
What defines the Pap as “ High risk” ?
Onset of sexual activity before 16
Multiple sexual partners (>5 in a lifetime)
Hx of STD, including HIV
Fewer then 3 neg paps in the last 7 years
Daughter of a women given DES
Abnormal pap in the last 3 years in a women of childbearing age
Whats the minimum number of cells in liquid Paps?
5000 cells
Whats the next step in management?
Unsat pap
If Unsat and HPV HR+
NILM but no EC/TZ
Unsat pap : Repeat in 2-4 months
Unsat and HPV HR+ : colpo
NILM but no EC/TZ : Routine screening
ASC-H will show a cin2 or worse on biopsy in what percentage of women?
40%
Gardasil covers what HPV types?
16,18,6,11
When should women start screening?
21
omen between the ages of 21 and 29 should have a Pap test every____ years
Women between the ages of 21 and 29 should have a Pap test every 3 years
For women 30-65 how often should they get pap test? What about HPV?
Women between the ages of 30 and 65 should have both a Pap test and an HPV test every 5 years. This is the preferred approach, but it is also OK to have a Pap test alone every 3 years.
When can women stop having paps?
At age 65, or hysterectomy for benign reasons
Can you stop if you get the Gardasil?
No, continue per recommendation of age group
How many cells are need per HPF for adequecy?
Thin prep
Surepath
Thin prep 3-4
Surepath 7-8
Match The following: 13mm, 20 mm, Vacuum, Centrifuge
Thin Prep
Surepath
Thin Prep 20 mm Vacuum filtration
Surepath 13mm Centrifuged
What type of virus is HPV
Nonenveloped DS DNA (Others in this group is the adenoviridae and the polyomaviridae)
