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neuro > HY - female and male path > Flashcards

HY - female and male path Flashcards

1
Q

unilateral cystic lesion in vestibule

A

bartholin cyst

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2
Q

how do you determine if HPV infection is low or high grade?

A

DNA sequence b/c DNA virus - HR are 16, 18, 31, 33 with high risk of developing cancer

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3
Q

What do low risk HPV 6, 11 lead to?

A

condyloma

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4
Q

warty neoplasm with koilocytic change that rarely progresses to carcinoma

A

condyloma due to HPV 6 or 11

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5
Q

parchment-like vulvar skin in postmenopaulsal women

A

lichen sclerosis

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6
Q

white patch with thick, leathery vulvar skin

A

lichen simplex chronicus

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7
Q

hyperplasia due to chronic irritation of vulva

A

lichen simplex chronicus

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8
Q

patient has leukoplakia on vulva, what is your DDx?

A

lichen simplex chronicus, lichen sclerosis and vulvar carcinoma

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9
Q

what are two etiologies of vulvar carcinoma?

A

HPV related (16, 18, 31, 33) and non-HPV (lichen sclerosis, although rare)

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10
Q

erythematous, pruritic, ulcerated skin of vulva due to malignant epithelial cells in epidermis

A

extramammary paget disease

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11
Q

vulvar lesion that is PAS + keratin + and S100 -

A

paget cells, non-mamilly paget carcinoma

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12
Q

vulvar lesion that is PAS - keratin - and S100 +

A

melanoma of vulva

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13
Q

defining stain for melanoma

A

S100

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14
Q

keratin + means what type of cancer?

A

epithelial cells = carcinoma

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15
Q

when patient has paget’s disease of vulva, is there likely underlying malignancy?

A

no; this is unlike paget disease of nipple where there is certainly underlying malignancy

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16
Q

what is lower 1/3 vagina derived from

A

urogenital sinus

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17
Q

what is upper 2/3 vagina derived from

A

mullerian duct = columnar cells replaced by squamous cells of urogenital sinus

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18
Q

what do we call persistence of columnar cells in vagina?

A

adenosis; common in DES

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19
Q

what can adenosis lead to?

A

clear cell adenocarcinoma; associated with DES; malignant proliferation of glands with clear cytoplasm

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20
Q

embryonal rhabdomyosarcoma

A

bleeding grape-like mass protruding from vagina or penis of a child, usually child < 5 y/o

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21
Q

child with tumor protruding from vagina + cytoplasmic cross-striations on histo

A

rhabdomyoblast derived embryonal rhabdomyosarcoma

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22
Q

vaginal carcinoma in lower 1/3 will spread to what LN?

A

inguinal nodes

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23
Q

vaginal cancer that goes to iliac nodes is in what part of vagina?

A

upper 2/3

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24
Q

what does E6 of HPV do?

A

increases destruction of p53

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25
Q

what does E7 of HPV do?

A

increases destruction of Rb

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26
Q

what is key feature that differentiates dysplasia from carcinoma?

A

reversibility

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27
Q

middle-aged woman presenting with vaginal bleeding most likely has what

A

cervical carcinoma

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28
Q

risks of cervical carcinoma?

A

high risk HPV, smoking, immunodeficiency

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29
Q

what is an advanced finding of cervical carcinoma?

A

invasion through anterior wall into bladder with hydronephrosis

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30
Q

where must you take biopsy in pap?

A

transformation zone, where HPV is attracted to

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31
Q

is pap good for adenocarcinoma detection?

A

NO

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32
Q

what are you protecting against with quadrivalent HPV vaccination?

A

6, 11, 16, 18 - still need to do paps because could get disease from many others

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33
Q

loss of what hormone leads to shedding of endometrium

A

progesterone

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34
Q

uterus goes through 3 stages: growth, preparation, and shedding. which hormones are responsible for each phase?

A

growth = estrogen, preparation = progesterone, shedding = looss of progesterone

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35
Q

what can cause secondary amenorrhea due to loss of basalis and scarring?

A

over aggressive D&C; Asherman Syndrome

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36
Q

patient has bleeding from vagina and is taking tamoxifen, what should you be considering?

A

endometrial polyp

37
Q

what does endometriosis look like when it involves soft tissues?

A

gun powder lesions

38
Q

what is adenomyosis?

A

invovlement of uterine myometrium in endometriosis

39
Q

unopposed estrogen can lead to _______ ______

A

endometrial hyperplasia

40
Q

post-menopausal bleeding due to unopposed estrogen

A

endometrial hyperplasia or endometrial carcinoma

41
Q

what is the most important predictor of endometrial hyperplasia profression to carcinoma?

A

cellular atypia

42
Q

endometrioid histology

A

endometrial carcinoma from endometrial hyperplasia

43
Q

serous/pappliary serous histology

A

> 70 years old, sporadic pathway due to P53 mutations leading to endometrial carcinoma

44
Q

psammoma bodies

A

papillary carcinoma of thyroid, meningioma, papillary serous carcinoma, mesothelioma

45
Q

multiple white-whorled masses

A

leiomyoma, benign (if single more likely leioyomysomacroma)

46
Q

is a patient with leiomyoma more likely to be symptomatic or asymptomatic?

A

asymptomatic

47
Q

arises de novo + postmenopausal women + single lesions with necrosis and hemorrhage

A

leiomyosarcoma

48
Q

LH stimulates what cells?

A

theca

49
Q

under the influence of LH, ______ cells make androstenedione which is then converted by _______ cells to estradiol

A

Theca cells make androstenedione which is then converted by granuolsa cells to estradiol

50
Q

corpus luteum secretes ______ which prepares progesterone for implantation

A

progesterone prepares endometrium

51
Q

obese woman with infertility, oligomennorhea, hirsutism + insulin resistance with risk of T2DM + risk for endometrial carcinoma

A

PCOD

52
Q

PCOD is characterized by increased ____

A

luteinizing hormone, increases androgens

53
Q

what are the three cell-types that ovarian tumors can arise?

A

surface epithelium, ger cells, sex-cord stroma

54
Q

complex cysts of ovary with thick, shaggy lining

A

cystadenocarincoma; post menopausal women

55
Q

BRCA 1

A

breast, serous carcinoma of ovary and fallopian tube

56
Q

ovarian tumor with cells that resemble urothelium

A

brenner tumor

57
Q

how do ovarian epithelium cancers like to spread?

A

locally, for example omental caking

58
Q

useful serum marker to monitor tx response and screen for recurrence of epithelium ovarian tumor

A

CA 125

59
Q

ovarian tumor that usually occurs in women of reproductive age

A

germ cell tumor

60
Q

types of germ cell tumors

A

cystic teratoma, embryonal carcinoma, yolk sac tumor, dysgerminoma, choriocarcinoma

61
Q

whats the most common type of malignancy that arises in cystic teratoma?

A

squamous cell carcinoma fof skin cells

62
Q

dysgerminoma is the testicle is called _____

A

seminoma

63
Q

increased serum LDH can be seen in _______

A

dysgerminoma

64
Q

most common germ cell tumor in children

A

endodermal sinus tumor, malignang tumor that mimics yolk sac; serum AFP +

65
Q

glomeruloid-like structures/ schiller-duval bodies

A

endodermal sinus tumor

66
Q

reinke crystals are found in this ovarian tumor

A

sertoli-leydig tumor; reinke crystals found in leydig cells

67
Q

kruckenberg tumor

A

metastasis to ovaries from gastric CA; mucinous tumors

68
Q

how to differentiate between primary and secondary mucinous tumor of ovary?

A

if bilateral, likely metastasis from gastric carcinoma

69
Q

pseduomyxoma peritonei

A

mucinous primary tumor of appendix

70
Q

fibrinoid necrosis in vessels of placenta

A

pre-eclampsia, will go away with removal of placenta

71
Q

risk factors of SIDS

A

sleeping on stomach, smoking in household, prematurity

72
Q

age range of SIDS

A

1 month to 1 year

73
Q

complete hyaditiform mole

A

COMPLETELY empty, dad, and sacry (risk of choriocarcinoma)

74
Q

synciotrophoblasts produce ____

A

b-HCG

75
Q

breast-feeding + s aureus + warm, erythematous, nipple discharge

A

mastitis; give dicloxacillin

76
Q

smokers + subareolar mass + nipple retraction

A

periductal mastitis due to inflammation of subareolar ducts

77
Q

mammary duct ectasia

A

green-brown discharge of nipple + subaerolar mass due to inflammation and dilation of subaerolar duct

78
Q

fat necrosis of breast

A

trauma + mass or calcification + bipsy with necrotic fat, calcifications, and giant cells

79
Q

blue-domed appearance on gross exam of breast

A

fibrocystic chances of breast, “lumpy’ breast in RUQ

80
Q

bloody nipple discharge

A

papillary issue

81
Q

DCIS that extend up ducts to skin of nipple and almost always associated with an underlying carcinoma

A

paget disease of the nipple

82
Q

malignant cause of nipple retraction

A

invasive ductal carcinoma

83
Q

a patient suspected of acute mastitis but does not improve with dicloxacillin rx. what are you concerned about?

A

inflammatory carcinoma, decreased lymphatic drainage due to tumor in dermal lymphatics

84
Q

give rx for suspected acute mastitis. what is next step?

A

make sure to follow up 5 days later to mae sur resoled and eliminate concern for inlammatory carcinoma

85
Q

breast malignancy discovered incidentally and cells are determine dyscohesive and lacking e-cadherin

A

lobular carcinoma in situ

86
Q

LCIN risk factor for future invasive carcinoma so give patient ______

A

tamoxifen

87
Q

if breast CA is determined to express ER and PR, what rx to give?

A

tamoxifen

88
Q

if breast CA is Her2/neu +, what rx?

A

trastuzumab

neuro (34 decks)

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