infections of the female reproductive tract

Question 1

Cervical mucosa typically FIREY RED APPEARANCE

Answer 1

Trichomatas vaginalis: STRAWBERRY CERVIX

Question 2

Large flagellated ovoid protozoan

Answer 2

Gardnerrella vaginalis

Question 3

1. THIN GREEN-GREY MALODOROUS (fishy) vaginal discharge:
   
   1. Superficial/intermediate squamous cells covered with a shaggy coating coccobacilli
   2. Implicated in premature labor

Answer 3

Gardnerrella vaginalis

Question 4

Superficial/intermediate squamous cells covered with a shaggy coating coccobacilli

Answer 4

Gardnerrella vaginalis

Question 5

Account for some cases of vaginitis, cervicitis, implicated in chorioamniotitis and preterm labor

Answer 5

Ureaplasma Urealyticum + mycoplasma hominis

Question 6

Mainly takes the form of cervicitis, but infection may ascent to the uterus and fallopian tubes–> results in PID, endometritis, salpingitis

Answer 6

Chlamydia trachomatic

Question 7

Results in pelvic pain, adnexal tenderness , fever, vaginal discharge

Answer 7

PID: gonorrhea most common cause

Question 8

Post-birth, post-spontaneous abortions-

Answer 8

1. Post-birth, post-spontaneous abortions- important causes/PID
2. “Puerperal infections”: typically caused by staph, strep, coliforms and clostridium perfringens

Question 9

i. Ascending infections

Answer 9

i. They get to the “deeper layers” by traveling through the lymphatics and venous channels rather than mucosal surfaces

Question 10

Neisseria Gonococcal infection

1. is characterized by
2. Detected by
3. RNA/DNA
4. Endometrium is usually
5. Fallopian tubes

Answer 10

1. Neisseria Gonococcal infection characterized by marked actue inflammation of involved mucosal surfaces
2. Detected by RNA/DNA
3. Endometrium usually spared
4. Fallopian tubes targeted

Question 11

Nesseria Gonorrhea infections of the fallopian tubes and broad ligament

Answer 11

ACUTE SUPPURATIVE SALPINGITIS is the major one

SALPINGO-OOPHORITIS: Purulent exudate may leak from the fallopian tube into the abdomen causing SALPINGO-OOPHORITIS

TUBO-OVARIAN ABSCESSES or PYOSALPINX: Collections of pus abscess formation in ovary/tubes as TUBO-OVARIAN ABSCESSES or tubal lumen PYOSALPINX

CHRONIC SALPINGITIS: Scarring process leaves glandlike spaces referred to as CHRONIC SALPINGITIS

HYDROSALPING: Scarring of tube and fimbriae may prevent uptake of oocytes infertility HYDROSALPING develops as consequence of fusion of fimbriae + accumulation of tubal

Question 12

i. Morphology of non-N.G. infections (staph, strep, etc)

Answer 12

PID: less involvement of tube/mucosa

PID more DEEP layers: serosa, broad ligament, pelvic structures, peritoneum

Bactermia more frequent complication of strep/staph PID than N.G.

Question 13

PID: acute complications

Answer 13

PID: acute complications

Peritonitis

Bacteremia

a. Endocarditis

b. meningitis

c. suppurative arthritis

Question 14

PID: chronic complications

Answer 14

i. PID: chronic complications
1. Infertility
2. Tubal Obstruction
3. Ectopic pregnancy
4. Pelvic pain
5. Intestinal obstruction caused by adhesions between bowel and pelvic organs

Question 15

Answer 15

bartholin cysts

Question 16

Answer 16

sebaceous cysts

Question 17

Leukoplakia: causes

Answer 17

Leukoplakia: term for opaque white plaquelike thickening

May produce pruritus + scaling iii.

Caused by:

1. Inflammatory dermatoses (psoriasis, chronic dermatitis)
2. Lichen sclerosus+ squamous cell hyperplasia
3. Intraepithelial Neoplasia (VIN)
4. Paget disease
5. Invasive carcinoma
6. Neoplasias in general

Question 18

surface resembling porcelain or parchment

Answer 18

Lichen sclerosus

Smooth white plaques/macules that may enlarge/coalesce

Question 19

lichen sclerosis: what it causes, histology, most common age group effected, relationship to cancer.

Answer 19

1. Causes labia to become atrophic/agglutinated
2. Vaginal orifice constricts
3. Histo: Lesions characterized by marked thinning of epidermis, degeneration of basal cells, excessive keratinization (hyperkeratosis)
4. most commonly older women
5. no relationship to cancer. not a precursor to anything.
6. Not pre-malignant but may be present at margins of vulvar cancers

Question 20

benign exophytic lesions (BEL)

Answer 20

1. Condyloma acuminatum: HPV induced, called GENITAL WART
2. Condyloma latum: syphilitic (secondary syphilis)
3. Fibroepithelial polyps: skin tags, unknown etiology
4. Squamous papillomas

Question 21

Consist of papillary, exophytic treelike cores of stroma covered by squamous epithelium, shows “KILOCYTIC ATYPIA” and is NOT precancerous

Answer 21

condyloma acuminatum caused by HPV 6 and 11

Question 22

Answer 22

C. albicans

can appear as yeast, pseudohyphae, and less commonly as true hyphae, defined by the presence of septae.

Pseudohyphae is an important diagnostic clue. Pseudohyphae are a chain of budding yeast cells joined end to end at constrictions

Question 23

Answer 23

C. albicans

can appear as yeast, pseudohyphae, and, less commonly, true hyphae, defined by the presence of septae. Pseudohyphae, an important diagnostic clue, are a chain of budding yeast cells joined end to end at constrictions

Question 24

Answer 24

Genital Herpes

Question 25

Answer 25

Trichomonas vaginalis

Question 26

Answer 26

Trichomonas vaginalis: strawberry cervix

Frothy yellow vaginal discharge

Dyspareunia (painful intercourse)

On exam – fiery red vaginal and/or cervical mucosa (colpitis macularis) Characteristic “Strawberry cervix”

Question 27

Fitz-Hugh-Curtis syndrome

Answer 27

1. Fitz-Hugh-Curtis syndrome
2. Fitz-Hugh-Curtis syndrome is a rare disorder that occurs almost exclusively in women.
   
   1. characterized by peritonitis and peri hepatis.
   2. The diaphragm may also be affected.
3. Common symptoms include
   
   1. severe pain in the upper right area quadrant of the abdomen +/- referred pain
   2. fever, chills, headaches
   3. general feeling of poor health (malaise).