Gyn Pathology I

Question 1

What are indicated in classic white vulvar dermatoses?

Answer 1

Lichen simplex

Lichen sclerosis

Question 2

What is a hidradenoma?

Answer 2

benign labia neoplasm which may ulcerate (ectopic breast tissue)

Question 3

What are most cases of malignant vulvar diseases?

Answer 3

Squamous cell carcinoma

Question 4

What are most SCC’s of the vulva from? What is second most common?

Answer 4

Most common: HPV

Second: Chronic irritation from lichen stuff

Question 5

What other cancer non-squamous cancers can appear in the vulva?

Answer 5

Melanoma

Basal cell carcinoma

Question 6

What vulvar disease consists of malignant cells that may or may not be associated with breast cancer?

Answer 6

Extra-mammary paget’s disease

Question 7

What nodes do the vulvar carcinomas spread to?

Answer 7

Inguinal/femoral nodes

Question 8

When you have cancer in the vagina, usually what is it?

Answer 8

From other sources

Question 9

What embryonal cancer is unique to the vagina?

Answer 9

Embryonal rhabdomyosarcoma

Question 10

“grapelike”

Answer 10

rhabdomyosarcoma

Question 11

What are the most common gynocological cancers worldwide?

Answer 11

Cervical carcinoma
Ovarian
Endometrial

Question 12

How long does it take for the initial infection to become invasive CA for HPV?

Answer 12

15 years

Question 13

What other cancer, other than carcinoma, can be caused by HPV in the cervix?

Answer 13

Adenocarcinoma (glandular)

Question 14

Multinucleated cells on pap smear

Answer 14

Herpes

Question 15

Faint odd cells

Answer 15

Trichomonas

Question 16

Clue cells

Answer 16

Gardnerella

Question 17

What glandular cell abnormalities can you see on pap?

Answer 17

Atypical glandular cells of undetermined significance

Adenocarcinoma

Question 18

What are the two major concerns for abnormal uterine bleeding?

Answer 18

Anemia

Endometrial cancer

Question 19

What are indications for endometrial biopsy?

Answer 19

If older than 45 do it

If younger, unopposed estrogen exposure, failed med management, tamoxifen, lynch

Question 20

What are the main considerations for reproductive aged women?

Answer 20

Dysfunctional bleeding
Pregnancy
Anatomic lesions
Inherited or acquired hemostasis disorders

Question 21

What are the symptoms for PCOS?

Answer 21

Oligomenorrhea
Hyperandrogenism
Obesity
Insulin resistance

Question 22

What hormone often lacks in anovulation?

Answer 22

Progesterone

Question 23

What are the most common causes of postmenopausal vaginal bleeding?

Answer 23

Endometrial atrophy (59%)
Endometrial polyps (12%)
Endometrial hyperplasia (10%)
Endometrial carcinoma (10%)

Question 24

What is the average age at diagnosis for endometrial carcinoma?

Answer 24

61 yrs

Question 25

What is the most common type of endometrial cancer?

Answer 25

Type 1 carcinoma

Question 26

What hormone is implicated in causing type 1 carcinoma of the endometrium?

Answer 26

Estrogen

Question 27

What gene is often mutated in type 1 carcinoma of the endometrium?

Answer 27

PTEN

Question 28

What is type 2 endometrial carcinoma?

Answer 28

Serous/clear cell carcinoma

Question 29

What cancer is Type 2 EC like?

Answer 29

Ovarian cancer

Question 30

Which Endometrial carcinoma is worse?

Answer 30

Type 2 is much worse

Question 31

What long term effect must be thought of with Endometrial stromal neoplasia?

Answer 31

Decades later metastases (esp. lung)

Question 32

If endometrial cancer is in patients younger than 45, what genetic disorder must be assumed?

Answer 32

Lynch syndrome

Question 33

Where are most common sites for endometriosis?

Answer 33

Pelvis (tubes, ovaries, serosa)

Question 34

What are clinical symptoms of endometriosis?

Answer 34

Pelvic pain/dysmenorrhea with cyclic symptoms | Infertility

Question 35

How is diagnosis of endometriosis done?

Answer 35

Laparoscopy finding punctuate surface lesions, usually blue/black/brown

Question 36

How do you treat endometriosis?

Answer 36

Hormonal manipulation Lappy ablation Salpingooophrectomy/hysterectomy