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PATHOLOGY EXAM 2 > lecture 2 part 2- female > Flashcards

lecture 2 part 2- female Flashcards

1
Q

-benign smooth muscle neoplasm
-fibroids
-may cause irregular bleeding(metrorrhagia)
-painful intercource (dyspareunia)

A

uterine leiomyoma

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2
Q

-glandular epithelium
-bleeding

A

proliferative lesions: endometrial hyperplasia and polyps

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3
Q

2 major diseases of the endometrium

A

endometriosis
adenocarcinoma

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4
Q

-endometrial tissue outside the uterine cavity
-Ectopic endometrial tissue influenced by hormonal change
-Recurring pelvic pain
-Symptoms depend on the site involved and worsen with the
menstrual cycle

A

endometriosis

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5
Q

“chocolate cyst”

A

endometriosis- ovary

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6
Q

risk factors for endometrial carcinoma

A
  1. age- most common in the 55 to 65 age group
  2. obesity- greater synthesis of estrogen in body fat
  3. infertility- women who are nulliparous are at increased risk of endometrial carcinoma
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7
Q

-Exfoliative cytologic screening for early detection (Papanicolau smear)
-squamo-columnar junction
-vaccination

A

cervical squamous cell carcinoma

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8
Q

cervical squamous cell carcinoma are mostly caused by

A

HPV sub types 16 and 18

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9
Q

sequence of events that may follow HPV infection

A
  1. sex
  2. HPV exposure
  3. low risk HPV[condyloma]
    or high risk HPV 16 and 18 [CIN->higher grade CIN-> invasive cancer->metastasis]
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10
Q

Cervical Intraepithelial Neoplasia (grades I, II, III)

A

LSIL- low-grade squamous intraepithelial lesion
HSIL- high-grade squamous intraepithelial lesion

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11
Q

A tumor containing tissues from all three germ layers

A

teratoma

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12
Q

Most tumors are derived from one

A

cell layer
(ectoderm, endoderm, mesoderm)

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13
Q

-Generally arise in gonadal tissues
-Most commonly seen in the ovary

A

teratoma

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14
Q

may contain a variety of tissues including hair, teeth, bone, cartillage,
thyroid, etc.

A

“Dermoid cyst” of the ovary – a benign cystic teratoma

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15
Q

-Pelvic inflammatory disease
-Tubal scarring
-Ectopic pregnancy

A

gonerrhea
(neisseria gonorrhea)

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16
Q

5 parts of breast

A

Glandular epithelium
Ducts
Lobules
Interstitial tissue
Lymphatics

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17
Q

-Enlargement of male breast may occur in response to estrogen
-Hyperestrinism in male

A

gynecomastia

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18
Q

gynecomastia
bilateral:
unilateral:

A

bilateral: rule out hormonal
unilateral: rule out tumor

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19
Q

Cirrhosis of liver – inability to metabolize estrogens
Klinefelter syndrome
Estrogen-secreting tumors
Estrogen therapy

A

factors of gynecomastia

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20
Q

-Most common benign neoplasm of breast
-Discrete, usually solitary, moveable nodule
-Young women (third decade)

A

fibroadenoma

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21
Q

Invasive lobular carcinoma

A

lobules

22
Q

Invasive ductal carcinoma

A

ducts

23
Q

-Genetic changes
-Hormonal influences
-Environmental variables

A

pathogenesis of breast cancer

24
Q

well-established risk factors in breast cancer (6)

A
  1. Age – uncommon < 30 y
  2. Genetics and family history - p53, BRCA1/2
    genes
  3. Menstrual history – early menarche (<12y),
    late menopause (>55y)
  4. Length of reproductive life
  5. Nulliparous – having children is protective
  6. Geographic variation
25
Q

other breast cancer risk factors

A
  1. Exogenous estrogens – postmenopausal hormone
    replacement therapy
  2. Oral contraceptives – newer formulations of balanced,
    low doses of estrogen and progestin safe
  3. Ionizing radiation during breast development
26
Q

Less well-established risk factors for breast cancer

A

alcohol
high fat diet
obesity
cigarette smoking

27
Q

Familial syndromes with breast cancer

A
  1. Li-Fraumeni Syndrome – germ-line mutations in p53
  2. Cowden Syndrome – germ-line mutations in PTEN
  3. Ataxia-telangiectasia gene –
    DNA repair genes
  4. BRCA1/BRCA2 – germ-line
    mutations
28
Q

-Epidermal growth factor
receptor
-Amplified in 30% of breast
cancers
-Overexpression associated with
poor prognosis
-Therapeutic intervention –
Herceptin (trastuzumab)

A

HER2/NEU proto-oncogene
with breast cancer

29
Q

Genetic changes continued:

Amplification of ____ and ____
(proto-oncogenes)

mutations on ___and ___(tumor suppressor genes)

estrogen receptor positivity-> therapeutic intervention:

progesterone receptor positive

A

RAS and MYC

Rb and p53

tamoxifen

30
Q

increased exposure to estrogen is a

A

risk factor for breast cancer

-long duration of reproductive life (more estrogen)
-nulliparity- having children is protective
-late age at birth of first child

31
Q

The more ______ the breasts are exposed to over a lifetime, the higher the risk of
breast cancer. During each monthly menstrual cycle, the breasts are exposed to
increased ______ levels, especially at the time of ovulation.

A

estrogen
estrogen

32
Q

Both early age at the start of menstrual cycles (menarche) and late menopause
increase breast cancer risk through increased exposure to estrogen during more
menstrual cycles.

T/F

A

true

33
Q

Late age for menarche and early age for menopause decrease breast cancer risk through

A

fewer menstrual cycles.

34
Q

increase breast cancer risk through
increased exposure to estrogen.

A

birth control pills and hormone replacement therapy

35
Q

The more alcohol consumed, the more impaired the liver becomes in its
ability to metabolize estrogen. Therefore, alcohol consumption

A

increases breast cancer.

36
Q

This is because adipose tissue produces small amounts of
estrogen.

A

obesity is risk for breast cancer

37
Q

most common breast cancer location

A

upper outer quadrant-50%
central portion- 20% next

38
Q
  1. have not penetrated the basement membrane
    -Ductal carcinoma in situ (DCIS, intraductal carcinoma)
    -Lobular carcinoma in situ (LCIS)
A

noninvasive classification of breast cancers

39
Q
  1. have penetrated the basement membrane (infiltrating)
    -Invasive ductal carcinoma – most common (scirrhous carcinoma)
    -Invasive lobular carcinoma
A

invasive classification of breast cancers

40
Q

-Precursor lesion to invasive carcinoma
-When invasive carcinoma develops in a woman with a previous diagnosis of DCIS, it is usually in the same
breast.
-treatment is surgery and radiation

A

ductal carinoma in situ

41
Q

antiestrogenic if estrogen receptor + (blocks estrogen receptor)

A

tamoxifen

42
Q

post-menopausal women (blocks estrogen formation)

A

aromatase inhibitors

43
Q

-Clinical variant of DCIS
-Extension of DCIS up to the lactiferous ducts and into the
contiguous skin of the nipple
-Crusting exudate over the nipple and areolar skin
-Underlying invasive carcinoma in 50%

A

paget’s disease of nipple

44
Q

-One-third of women with _____ develop invasive carcinoma
-The invasive carcinoma may arise in either breast
-_____ is a marker of increased risk for developing breast cancer
in either breast

A

LCIS
lobular carcinoma in situ

45
Q

Most breast carcinomas (70-80%)

Term used for all carcinomas that cannot be sub-classified into a specific
type (not discussed)

A

invasive ductal carcinoma

(Carcinoma of “no special type” or “not otherwise specified” (NOS) are
synonyms for invasive ductal carcinoma)

46
Q

3 clinical features common to all invasive carincomas

A
  1. Fixation secondary to adherence to pectoral muscles or deep
    fascia of chest wall
  2. Adherence to overlying skin with retraction or dimpling of the skin
    or nipple
  3. Lymphatic involvement may cause localized lymphedema with
    the skin thickened around exaggerated hair follicles (peau
    d’orange – orange peel appearance)
47
Q

TNM staging of breast cancer
Stage 1

A

tumor <2cm, without nodal involvement, no metastases

48
Q

TNM staging of breast cancer
Stage 2

A

tumor <5 cm with <3 nodes and no distant metastases (or
more than 5 cm without nodes)

49
Q

TNM staging of breast cancer
Stage 3

A
  • many categories, any cancer infiltration into skin and chest
    wall, with nodes, without disseminated metastases
50
Q

TNM staging of breast cancer
Stage 4

A

any cancer with disseminated metastases

51
Q

prognostic factors

A
  1. Size of primary carcinoma
  2. Lymph node involvement and number of
    nodes
  3. Distant metastases
  4. Histologic grade
  5. Histologic type
  6. Estrogen or progesterone receptor expression - Tamoxifen
  7. Proliferative rate
  8. Aneuploidy
  9. HER2/NEU overexpression - Herceptin
52
Q
A

PATHOLOGY EXAM 2 (6 decks)

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