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Reproduction Two > Kaplan Path > Flashcards

Kaplan Path Flashcards

1
Q

Severe perimenstrual pain and nonfocal thickening of the myometrium. Ultrasound of pelvic organs shows nonfocal thickening of myometrium.

A

Adenomyosis

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2
Q

Characteristic histo of adenomyosis.

A

Characterizedby the presence of endometrial glands int he myometrium of the uterus.

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3
Q

What causes the pain and bleeding in adenomyosis?

A

Pain due to cyclic breaking down of glands and bleeding into the myometrium.

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4
Q

In a patient with amenorrhea, a very shallow vagina, and no obvious uterus and cervix, suspect ___ and look for ____ in the labia that might be abnormal testes?

A

Suspect testicular feminization (possibly due to presence of Mullerian Inhibitor Factor during early fetal life).
Look for palpable mass in labia that might be abnomral tests.

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5
Q

A 26 year old woman presents with hyperthyroid symptoms (normal TSH and inc T4)and a palpable abdominal mass. What does she have?

A

Monodermal teratoma form of mature teratoms of the ovary. This form (struma ovarii) produces abundant mature thyroid tissue, typically not under TSH control.

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6
Q

Most common form of mature teratoma?

A

Dermoid cyst

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7
Q

Suspects _____ in a breastfeeding pt who develops breast tenderness and swelling. Most likely etiology?

A

Acute mastoiditis. Staph aureus infection.

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8
Q

Suspect ___ in a pt with lower abdominal pain, vaginal discharge, adnexal tenderness, and tenderness with cervical motion.

A

PID

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9
Q

PID may be due to what four main infections?

A

N. gonorrhoeae, C. trachomatis, vaginal anaerobes, facultative gram(-) rods

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10
Q

Complications of PID.

A

Sterility, ectopic tubal pregnancy, bacteremia, peritonitis, intestinal obstruction.

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11
Q

In high grade dysplasia of the cervix, dysplastic cells show what?

A
  1. High nuclear:cytoplasmic ratio (big nucleus).
  2. Confined to epithelium
  3. Involve full thickness of surface epithelium
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12
Q

If a pt is lost to followup for 2 years following dx of high grade dysplasia of the cerivx, ___% persist and a small% possibly progress to ___.

A

60% persist and a small% possibly progress to invasive Ca.

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13
Q

Ca of breast that are positive for ER/PR have what prognosis and why? What do positive stains mainfest as?

A

Better because they may respond to tamoxifen - an ER antagonist.
(+)=brown stain

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14
Q
  • Grading of breast cancer is based on ____.
  • Staging is based on ____.
  • HER2 and ER/PR have what value?
A
  • Histologic features
  • Distribution of disease
  • Prognostic value (natural h of dz) and predictive value (response to therapy)
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15
Q

HER2 testing is done to decide whether pts will receive ___ therapy (and its MOA).

A

trastuzumab, a MOab (but they are aggressive tumors)

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16
Q

Name this: A patient presents with a whitish patch or plaque, lump, ulcer, or wart-like growth. Biopsy shows invasion of vulvar dermal-epidermal junction by disordered squamous epithelial cells.

A

Vulvar SCCa

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17
Q

Precursors to Vulvar SCCa

A

Vulvar intraepithelial neoplasia (VIN), condyloma, spontaneous

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18
Q

Most common predisposing factor for tubal pregnancy.

A

PID (also endometriosis, IUD, leiomyoma, and previous pelvic surgery)

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19
Q

Edema, HTN, proteinuria

A

Preeclampsia

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20
Q

What is HELLP?

A

Manifestation of severe Preeclampsia with: Hematuria, Elevated Liver enzymes, Low Platelets

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21
Q

Etiology of Preeclampsia

A

Develops secondary to placental ischemia.

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22
Q

A girl exhibits precocious sexual development. Suspect what?

A

Estrogen secreting tumor, like a Granulosa Cell tumor.

23
Q

Name the male-hormone secreting tumor of the ovary.

Name the hCG-secreting tumor of the ovary.

A
  • Sertoli-Leydig Cell Tumor

- Choriocarcinoma

24
Q

Name conditions that increase risk of breast carcinoma by (2x) and (5x)

A

2x - Sclerosing Adenosis and Hyperplasia WITHOUT Atypia

5x - Atypical Ductal or Lobular Hyperplasia

25
Q

Name this: An ulcerating lesion of or near the nipple with malignant glandular cells in the epidermis.

A

Paget Disease of the Breast

26
Q

Name this: Nipple trauma that leads to acute inflammation and necrosis.

A

Actue mastitis (…i think it’s fat necrosis)

27
Q

Name this: subareolar tumor in ducts that causes bloody or serous nipple dicharge.

A

Intraductal papilloma.

28
Q

Name this: poorly circumscribed, rubbery breast mass. Signet cells lined single file or in loose clusters.

A

Invasive Lobular Carcinoma

29
Q

Name this: tend to be benign, large, circumscribed, first breast mass, comprised of epithelial and stromal proliferation.

A

Phyllodes tumor

“leaf like”

30
Q

Increased risk associated with developing invasive breast carcinoma?

  • sclerosing adenosis
  • apocrine metaplasia
  • blue domed cysts
  • duct ectasia
  • fibroadenoma
A
  • sclerosing adenosis - yes

- rest: no

31
Q

What is this:
-Benign mass composed of whorls of smooth muscle cells. May cause abnormal uterine bleeding and anemia, more often in premenopausal women. May show immunoreactivity for smooth muscle actin.

A

Uterine leiomyomas

32
Q

Gastric mucinous adenocarcinomas that have met to (both) ovaries.

A

Krukenberg tumors

33
Q

What is this?
Resected ovarian tissue that shows numerous malignant cells containing cytoplasmic mucin droplets that push aside the nucleus of adenocarcinoma cell

A

Signet ring cells (Krukenberg tumors)

34
Q

Discrete mass with calcifications on mammography. Biopsy shows chronic/prominent multinucleated giant cells, lipid laden histiocytes, and calcification.

A

Fat necrosis

35
Q

Anovulatory cycles cause unopposed _____, leading to what?

A
  • unopposed estrogen stimulation

- leading to AUB and disordered proliferative endometrium

36
Q

Endometrial Ca develops in the background of ____, leading to malignant transformation of what?

A

unopposed estrogen –> endometrial hyperplasia and atypia –> malignant transformation –> endometrial Ca

37
Q

What is this and karyotype: Grapelike, multicystic villous, no fetal tissue, 2% risk fo choriocarcinoma development, extremely high hCG levels (N/V).

A

Complete mole, 46XX

38
Q

What is this and karyotype: wide range of villous sizes, often contain fetal tissue, no risk of choriocarcinoma , moderately high hCG levels (N/V).

A

Partial mole, 69XXY, 69XXX

39
Q

Solid, yellow ovarian mass that can produce estrogens, leading to precocious puberty in girls and endometrial hyperplasia and abnormal uterine bleeding in older women.

A

Granulosa cell tumor (—> COT to endometrial Ca dt estrogen)

40
Q

Suspect what? Ovarian mass (usually B9 fibroma), hydrothorax, and ascites

A

Meigs syndrome

41
Q

Type of teratoma: development of Ca in a mature teratoma

A

solid mature teratoma with malignant transformation

42
Q

Type of teratoma: almost always benign, cytstic, mature teratoma usually found in ovaries

A

dermoid cyst

43
Q

Type of teratoma: B9 tumor forming multiple adult like tissue found in ovaries (all ages) and testes (prepubertal males)

A

Solid mature teratomas

44
Q

Type of teratoma: contains tissue resembling embryonal tissues; considered to be potentially malignant

A

immature teratoma

45
Q

40-65 years, bilateral (2/3rds of pts). Surface derived ovarian tumor that is filled with clear fluid and lined by epthelial cells forming papillary fronds.

A

Serous cystadenocarcinoma

46
Q

Name this breast cancer: numerous small invasive glandular structures surrounded by desmoplastic stromal response

A

invasive ductal Ca

47
Q

Name this breast cancer: malignant cells with abundant mucin secretion

A

colloid (mucinous) Ca

48
Q

Name this breast cancer: single file distribution of invasive cancer cells

A

invasive lobular Ca

49
Q

Name this breast cancer: sheets of tumor cells surrounded by abundant lymphoplasmacytic reaction

A

Medullary Ca

50
Q

What is this infection: neonatal conjuctivitis in first 2 weeks of life, pneumonia (6wks-6mo), fever, tachypnea, crackles, wheezing, eosinophilia.

A

Chlamydia trachomatis/pneumonia - Sexually transmitted genital infection (mom to baby in vaginal canal)

51
Q

Characteristic vacuoles containing reticulate bodies seen in epithelial cells

A

Chlamydia trachomatis

52
Q

Women with complex hyperplasia with or without atypia have greater chance of developing endometrial Ca?

A

compelx hyeprplasia WITH ATYPIA have higher chance of developing endometrial Ca.
(high mitotic activity, disorganization, nuclear atypia)

53
Q

Tumor marker for epithelial-derived ovarian Ca (i.e. serous or cystadenomCa). Useful for monitoring what?

A

CA-125 useful for monitoring disease recurrence in pts who have been treated with surgery or chemo.

54
Q

A young woman with oligomenorrhea, infertility, and hirsutism. She has increased LH and low FSH.

A

Polycystic Ovarian Syndrome - multiple ovarial follicular cysts due to her hormone imbalance.

Reproduction Two (12 decks)

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