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Pathology > Male and Female Reproductive Tract, TBP > Flashcards

Male and Female Reproductive Tract, TBP Flashcards

1
Q

Germ cells vs epithelial cells: Majority of testicular tumors derived from

A

Germ cells

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2
Q

Germ cells vs epithelial cells: Majority of ovarian tumours are derived from

A

Epithelial cells

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3
Q

T/F All masses of the testes are considered malignant unless proven otherwise

A

T

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4
Q

Seminomas vs nonseminomatous neoplasms: Remain localized in the testis for a longer period

A

Seminomas

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5
Q

Seminomas vs nonseminomatous neoplasms: Radiosensitive

A

Seminomas

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6
Q

Seminomas vs nonseminomatous neoplasms: Metastasize sooner

A

Nonseminomatous

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7
Q

Seminomas vs nonseminomatous neoplasms: Radioresistant

A

Nonseminomatous

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8
Q

Seminomas vs nonseminomatous neoplasms: Metastasize via lymphatic route

A

Seminomatous

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9
Q

Seminomas vs nonseminomatous neoplasms: Metastasize via hematogenous route

A

Nonseminomatous

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10
Q

Classic presentation of testicular cancer

A

Painless testicular mass

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11
Q

Sites of metastases from testicular neoplasms: Lymph nodes (3)

A

1) Para-aortic
2) Mediastinal
3) Supraclavicular

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12
Q

Sites of metastases from testicular neoplasms: Hematogenous

A

1) Lungs
2) Liver
3) Brain
4) Bone

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13
Q

Most common type of testicular neoplasm

A

Germ cell

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14
Q

Risk factors for development of testicular neoplasms (3)

A

1) Cryptorchidism
2) Syndromes with testicular dysgenesis such as Klinefelter syndrome
3) Family history and history of tumor in the collateral testis

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15
Q

Tumor with 1 histologic pattern vs Mixed germ cell tumor: More common

A

Mixed germ cell tumor

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16
Q

Non-seminomatous germ cell neoplasms (4)

A

CYTE

1) Choriocarcinoma
2) Yolk sac tumor
3) Teratoma
4) Emrbyonal carcinoma

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17
Q

Neoplasm-associated protein secreted: Seminoma

A

hCG

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18
Q

Neoplasm-associated protein secreted: Emrbyonal CA

A

hCG and AFP

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19
Q

Neoplasm-associated protein secreted: Yolk sac tumor

A

AFP

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20
Q

Neoplasm-associated protein secreted: Choriocarcinoma

A

hCG

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21
Q

Neoplasm-associated protein secreted: Teratoma

A

None

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22
Q

Preneoplastic proliferation of germ cells within seminiferous tubules

A

Intratubular germ cell neoplasia

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23
Q

Main risk factor for intratubular germ cell neoplasia

A

Cryptorchidism

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24
Q

Seminoma: Ovarian correlate

A

Dysgerminoma

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25
Q

Seminoma: 3 characteristic microscopic features

A

1) Large mononuclear cells with clear cytoplasm
2) Fibrous septae
3) Lymphocytes

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26
Q

Seminoma: Characteristic gross appearance

A

Homogeneous and tan

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27
Q

Seminoma: Cell component that secretes hCG

A

Syncytiotrophoblast

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28
Q

Seminoma: Prognosis

A

Excellent

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29
Q

Seminoma: Cure rate for Stage I and II disease

A

100%

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30
Q

Embryonal CA: Mostly pure vs part of mixed tumor

A

Mixed

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31
Q

Embryonal CA: Gross morphology

A

Hemorrhagic and necrotic

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32
Q

Embryonal CA: Microscopic

A

Ugly cells

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33
Q

Yolk sac tumor: Pure vs mixed in young males at about 3 y/o

A

Pure

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34
Q

Yolk sac tumor: Pure vs mixed in adults

A

Mixed

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35
Q

Yolk sac tumor: Characteristic microscopic feature

A

Schiller-Duval bodies

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36
Q

Yolk sac tumor: Description of Schiller Duval bodies

A

Core capillary surrounded by visceral and parietal layer

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37
Q

Schiller-Duval bodies resemble

A

Primitive glomerulus

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38
Q

Choriocarcinoma: Almost always pure vs mixed

A

Mixed

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39
Q

Choriocarcinoma: Primary route of metastasis

A

Hematogenous

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40
Q

Choriocarcinoma: Response to chemotherapy

A

Good

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41
Q

Choriocarcinoma: Prognosis

A

Good

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42
Q

Choriocarcinoma: Gross

A

Hemorrhagic mass

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43
Q

Choriocarcinoma: Microscopic

A

Syncytiotrophoblasts and cytotrophoblasts

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44
Q

Tumor derived from all 3 germ cell layers

A

Teratoma

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45
Q

T/F Teratomas are always benign

A

F

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46
Q

Pure teratomas: Young vs adult

A

Young

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47
Q

Teratoma part of a mixed germ cell tumor: Young vs adult

A

Adult

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48
Q

Mature teratoma: Benign vs malignant in adult

A

Assumed to be malignant

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49
Q

Mature teratoma: Benign vs malignant in young

A

Benign

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50
Q

T/F Immature teratomas are always malignant

A

T

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51
Q

Mature vs immature vs malignant transformation teratoma: Fully differentiated from all 3 germ lines

A

Mature

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52
Q

Mature vs immature vs malignant transformation teratoma: Areas of tumor have appearance of fetal or embryonic tissue

A

Immature

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53
Q

T/F Extragonadal (outside of testis) teratomas are common

A

F

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54
Q

Classic extragonadal presentation of a teratoma

A

1) Sacrococcygeal

2) Anterior mediastinal

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55
Q

Sacrococcygeal teratoma is more common in: Males vs females

A

Females

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56
Q

Most common testicular mass in men older than 60

A

Lymphoma

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57
Q

Testicular mass in men >60: Unilateral vs bilateral

A

Bilateral

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58
Q

Testicular mass in men >60: T/F Most have disseminated at diagnosis

A

T

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59
Q

Collection of fluid in the tunica vaginalis

A

Hydrocele

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60
Q

Hydrocele: Tender vs nontender

A

Nontender

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61
Q

Testicular varicocele is dilation of veins of

A

Pampiniform plexus

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62
Q

Testicular varicocele: Right vs left

A

Left

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63
Q

Testicular varicocele: Classic presentation

A

Testicular pain worse when standing

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64
Q

Testicular varicocele: Texture on palpation

A

Bag of worms

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65
Q

T/F If untreated, varicocele may cause infertility

A

T

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66
Q

Testicular torsion: Arterial vs venous

A

Venous

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67
Q

Testicular torsion: Type of infarct

A

Hemorrhagic

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68
Q

Testicular torsion: Classic presentation

A

Sudden excruciating testicular pain with tender, swollen high-riding testicle

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69
Q

SCC of penis: Circumcised vs uncircumcised male

A

Uncircumcised

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70
Q

SCC of penis: T/F associated with HPV infection

A

T

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71
Q

SCC of penis: Risk factors

A

1) Uncircumcised

2) HPV 16 and 18 infection

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72
Q

Carcinoma in situ of penile shaft

A

Bowen disease

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73
Q

Carcinoma in situ of penis presenting as erythematous patch on the glans

A

Erythroplasia of Queyrat

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74
Q

Causative agents of acute prostatitis in men older than 35 y/o

A

1) E. coli
2) Enterobacter
3) Other urinary tract pathogens

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75
Q

Causative agents of acute prostatitis in men younger than 35 y/o

A

1) N. gonorrheae

2) Chlamydia

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76
Q

Complication of acute prostatitis

A

1) Chronic prostatitis

2) Recurrent UTI

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77
Q

Important consideration in treatment of prostatitis

A

Antibiotics poorly penetrate the prostate

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78
Q

Acute prostatitis: PE of prostate

A

Boggy, tender

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79
Q

T/F PSA is commonly elevated in prostatitis

A

T

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80
Q

BPH: Usual location

A

Transitional zone (around urethra)

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81
Q

BPH: Results from action of

A

Androgens

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82
Q

BPH: Complication

A

Urinary obstruction

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83
Q

Prostatic CA: Location

A

Peripheral zone

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84
Q

Prostatic CA: Common site of metastasis

A

Osteoblasts in lumbar spine, proximal femur, and pelvis

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85
Q

Prostatic CA: Elevated in prostatic CA in addition to PSA secondary to common metastasis

A

ALP

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86
Q

Prostatic CA: Precursor lesion

A

High-grade prostatic intraepithelial neoplasia (PIN)

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87
Q

Prostatic CA: Grading system

A

Gleason

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88
Q

Prostatic CA: Prostatic PE

A

Nodular, hard

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89
Q

Prostatic CA: Microscopic

A

Small glands, back-to-back

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90
Q

PSA levels: Gray zone

A

4-10 ng/mL

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91
Q

PSA levels: Rarely cancer

A
92
Q

PSA levels: Most likely cancer

A

> 10 ng/mL

93
Q

PSA levels: Uncertain etiology

A

4-10 ng/mL

94
Q

Test done to evaluate patients with PSA level within 4-10 ng/mL

A

Free PSA

95
Q

Normal free PSA level

A
96
Q

Causes of elevated PSA besides prostatic CA (6)

A

1) BPH
2) Prostatitis
3) Prostate massage
4) Cystoscopy
5) TURP
6) Prostate biopsy

97
Q

PSA density is calculated by

A

PSA divided by weight of gland

98
Q

PSA density suggestive of CA

A

> 0.15

99
Q

PSA velocity suspicious for carcinoma

A

> 0.75 ng/mL/year

100
Q

Precursor lesion of clear cell adenoCA

A

Vaginal adenosis

101
Q

Dysplastic changes in cervical epithelium that are a precursor to malignancy (2)

A

1) CIN

2) SIL

102
Q

CIN grade: 1/3 from basement membrane to surface of cervical mucosa

A

I

103
Q

CIN grade: 2/3 from basement membrane to surface of cervical mucosa

A

II

104
Q

CIN grade: From basement membrane to surface of cervical mucosa

A

III

105
Q

SIL is based on

A

Appearance of ells in Papanicolaou smears

106
Q

Dramatically increases the risk of cervical cancer in women

A

HIV infection

107
Q

Risk factors for progression to squamous cell CA of cervix, low risk

A

1) Low-grade SIL
2) CIN I
3) HPV 6, 11, 42, 44

108
Q

Risk factors for progression to squamous cell CA of cervix, high risk

A

1) High-grade SIL
2) CIN II-III
3) HPV 16, 18, 31, 33

109
Q

Protein produced by HPV that induces degradation of p53

A

E6

110
Q

Protein produced by HPV that induces degradation of Rb

A

E7

111
Q

Viral change associated with CIN I found in the upper portion of the mucosa

A

Koilocytes

112
Q

Characteristic appearance of koilocytes

A

Raisinoid nucleus with clear halo

113
Q

Most common presenting symptom in cervical CA

A

Abnormal vaginal bleeding or postcoital spotting

114
Q

Most common cause of death in cervical CA

A

Uremia from ureteral obstruction

115
Q

T/F Papsmear is used to diagnose cervical CA

A

F

116
Q

Findings on colposcopic exam that indicate cervical CA (3)

A

1) Acetowhite change
2) Color change
3) Corkscrew and hairpin vessels

117
Q

Causative agents of PID in non postpartum or postabortion

A

1) Chlamydia

2) N. gonorrhea

118
Q

Causative agents of PID in postpartum or postabortion

A

1) Strep

2) Staph

119
Q

PID triad

A

1) Fever
2) Elevated WBC
3) Purulent cervical discharge

120
Q

Characteristic sign on IE indicative of PID

A

Chandelier sign (cervical motion tenderness)

121
Q

Syndrome associated with PID

A

Fitz-Hugh-Curtis

122
Q

Fitz-Hugh-Curtis syndrome is characterized by

A

RUQ pain in gonococcal or chlamydial perihepatitis

123
Q

Primary amenorrhea is defined as absence of menarche by the age of

A

16

124
Q

Secondary amenorrhea is defined as

A

Lack of menstrual period > 6 months after menarche has occurred

125
Q

Acquired syndrome associated with amenorrhea

A

Asherman syndrome

126
Q

What is Asherman syndrome

A

Adhesions in the uterus and/or cervix

127
Q

Most common cause of primary amenorrhea

A

Turner syndrome

128
Q

First step in evaluation of primary amenorrhea

A

Rule out pregnancy

129
Q

Most common cause of secondary amenorrhea

A

Pregnancy

130
Q

LH/FSH ratio suggestive of PCOD

A

> 2:1

131
Q

Progesterone challenge involves

A

Administering progestins for 7-10 days and awaiting withdrawal bleeding

132
Q

Progesterone challenge: Withdrawal bleeding indicates

A

Estrogen-primed endometrium and anovulatory but otherwise normal ovaries

133
Q

Progesterone challenge: Absence of withdrawal bleeding is followed up with

A

Combined estrogen and progesterone challenge

134
Q

Combined estrogen and progesterone challenge: Lack of withdrawal bleeding indicates

A

Anatomic obstruction to menstruation

135
Q

Combined estrogen and progesterone challenge: Withdrawal bleeding indicates

A

Low estrogen due to nonfunctional ovaries or dysfunctional HPO axis

136
Q

Microscopic finding in adenomyosis that indicates that it is NOT an invasive endometrial adenoCA

A

Presence of both glands and stroma

137
Q

Microscopic finding in endometrial adenoma that differentiates it from adenomyosis

A

Presence of glands only

138
Q

Acute infection of the endometrium caused by polymicrobial infection with vaginal flora

A

Acute endometritis

139
Q

Most common cause of postpartum fever in patients following CS

A

Acute endometritis

140
Q

Microscopic morphology of chronic endometritis

A

Plasma cells in endometrium

141
Q

Presence of normal endometrial tissue within the myometrium of the uterus

A

Adenomyosis

142
Q

Adenomyosis: Gross

A

Grossly enlarged uterus

143
Q

Leiomyoma: Gross

A

Nodularly enlarged uterus

144
Q

Endometrial tissue in abnormal location outside of uterus

A

Endometriosis

145
Q

Extrapelvic locations of endometriosis

A

1) Intestine

2) Lungs

146
Q

3 theories of mechanisms of endometriosis

A

1) Regurgutation into peritoneum
2) Metaplastic differentiation of coelomic epithelium
3) Vascular/lymphatic dissemination

147
Q

Endometriosis: Gross

A

Chocolate cyst

148
Q

Endometriosis: Microscopically, 2 of the following must be present

A

1) Endometrial glands
2) Endometrial tissue
3) Hemosiderin

149
Q

Profuse or prolonged bleeding during menstruation

A

Menorrhagia

150
Q

Profuse or prolonged bleeding between menstrual cycles

A

Metrorrhagia

151
Q

Encompasses menorrhagia and metrorrhagia

A

AUB

152
Q

Most common cause of AUB

A

Anovulation

153
Q

Mutation in endometrial hyperplasia

A

Inactivation of PTEN gene

154
Q

Outcome of PTEN inactivation in endometrial cells

A

More sensitive to oestrogen stimulation

155
Q

3 microscopic morphology of endometrial hyperplasia

A

1) Simple
2) Complex w/o atypia
3) Complex with atypia

156
Q

Endometrial hyperplasia: Cystic

A

Simple

157
Q

Endometrial hyperplasia: Crowded back to back glands, 50% of tissue is glands

A

Complex w/o atypia

158
Q

Endometrial hyperplasia: Crowded back to back glands with nuclear pleomorphism and mitotic figures

A

Complex with atypia

159
Q

Most common endometrial CA

A

Endometrial adenoCA

160
Q

Most common tumour of the uterus

A

Leiomyoma

161
Q

Most important risk factor for development of endomterial adenoCA

A

Increased estrogen levels

162
Q

Estrogen levels in OBESITY: Increased vs decreased

A

Increased

163
Q

How estrogen level is increased with obesity

A

Peripheral conversion of androstenedione to estrone via aromatase in adipose tissue

164
Q

Less commonly related to increased estrogen and hyperplasia: High-grade vs low-grade endometrial adenoCA

A

High-grade

165
Q

High-grade variants of endometrial adenoma (2)

A

1) Clear cell adenoma

2) Papillary serous adenoCA

166
Q

Associated with microsatellite instability or p53 mutation: High-grade vs low-grade endometrial adenoCA

A

High-grade

167
Q

Sites of endometrial adenoma metastases

A

1) Lungs
2) Liver
3) Bone

168
Q

Sentinel symptom of endometrial CA

A

Vaginal bleeding in postmenopausal women

169
Q

T/F Endometrial CA are usually diagnosed at an early stage

A

T

170
Q

Tumors that are uncommon causes of endometrial hyperplasia due to oestrogen secretion

A

Granulosa cell tumors

171
Q

Leiomyoma: Single vs multiple

A

Multiple

172
Q

T/F Leiomyoma commonly develops into leiomyosarcoma

A

F

173
Q

Most important risk factor for malignant degeneration of leiomyoma to leiomyosarcoma

A

Prior pelvic irradiation

174
Q

PCOD: AKA

A

Stein-Leventhal syndrome

175
Q

PCOD: Mechanism

A

Multiple cysts in ovary result in excessive production of estrogen and androgens that are converted to estrone. Estrone inhibits FSH.

176
Q

4 general categories of ovarian tumors

A

1) Surface epithelial
2) Germ cell
3) Sex cord-stromal
4) Metastatic

177
Q

5 categories of surface epithelial tumors

A

1) Serous
2) Mucinous
3) Brenner
4) Endometrioid
5) Clear cell

178
Q

Benign vs borderline vs malignant: MOST surface epithelial tumors

A

Benign

179
Q

T/F Benign ovarian tumors are more common in the younger age group and malignant ovarian tumours are more common in the older age group

A

T

180
Q

Most important tumour marker for ovarian CA

A

CA-125

181
Q

Most common type of all ovarian tumors

A

Serous

182
Q

Serous ovarian tumor: Unilocular vs multilocular

A

Unilocular

183
Q

Serous ovarian tumor: Bilateral vs unilateral

A

Bilateral

184
Q

Serous ovarian tumor: Microscopic

A

Fallopian tube-like epithelium

185
Q

Serous ovarian tumor: Characteristics that increase the chance that a malignant component is present (3)

A

1) Solid areas
2) Papillary projections
3) Friable tissue

186
Q

Mucinous tumors: MOST benign vs malignant

A

Benign

187
Q

Mucinous tumors: Unilocular vs multilocular

A

Multilocular

188
Q

Mucinous tumors: Unilateral vs bilateral

A

Unilateral

189
Q

Complication of mutinous tumour characterised by ascites, adhesions, and cystic peritoneal implants

A

Pseudomyxoma peritonei

190
Q

Mucinous tumors: Microscopic

A

Lined by glandular-like epithelium

191
Q

Brenner tumor: MOST benign vs malignant

A

Benign

192
Q

Ovarian tumor that microscopically appears like endometrial adenocarcinoma

A

Endometrioid tumor

193
Q

Mature cystic teratoma in females: Pure vs mixed

A

Pure

194
Q

A monodermal ovarian teratoma composed entirely of thyroid epithelium

A

Stroma ovarii

195
Q

Dysgerminoma is the female counterpart of male

A

Seminoma

196
Q

T/F All dysgerminomas are malignant

A

T

197
Q

Ovarian germ cell tumor associated with Meigs syndrome

A

Fibroma

198
Q

Triad of Meigs syndrome

A

1) Ovarian fibroma
2) Ascites
3) Hydrothorax

199
Q

Granulosa cell tumor: MOST benign vs malignant

A

Benign

200
Q

Granulosa cell tumor: Hormone production

A

Estrogen

201
Q

Granulosa cell tumor: Characteristic

A

Call-Exner

202
Q

Hormone produced by Call-Exner bodies

A

Inhibin

203
Q

Brenner tumor: Characteristic microscopic finding

A

Nest of transitional epithelium-like cells admixed with fibrous stroma

204
Q

Bilateral metastatic ovarian tumor composed of signet ring cells, usually GI in origin

A

Krukenberg tumor

205
Q

Most common organism associated with acute mastitis

A

S. aureus

206
Q

Fibroadenoma vs fibrocystic change: >35 y/o

A

Fibrocystic change

207
Q

Fibroadenoma vs fibrocystic change:

A

Fibroadenoma

208
Q

T/F Fibroadenoma carries a risk for development of CA

A

T

209
Q

Fibroadenoma: Characteristic PE

A

Painless, firm, movable, rubbery nodule

210
Q

Leafy architecture

A

Phyllodes tumor

211
Q

Important consideration in phyllodes tumor excision

A

Perform wide local excision to prevent recurrence

212
Q

Bloody nipple discharge

A

Intraductal papilloma

213
Q

2 types of carcinoma in situ of breast

A

1) DCIS

2) LCIS

214
Q

DCIS vs LCIS: Greatly increased risk for development of invasive ductal CA

A

DCIS

215
Q

T/F DCIS can be detected as a density on mammogram

A

F

216
Q

Characteristic microscopic morphology of high-grade DCIS

A

Comedo (has central necrosis)

217
Q

Erythematous eruption of the nipple with scaling and crust

A

Paget disease of the nipple

218
Q

Paget disease of the nipple: Location of neoplastic cells

A

Epidermis

219
Q

DCIS vs LCIS: Greatly increased risk for development of invasive breast CA, either lobular or ductal

A

LCIS

220
Q

DCIS vs LCIS: Marker of future risk of developing invasive CA

A

LCIS

221
Q

DCIS vs LCIS: May be associated with calcifications

A

DCIS

222
Q

Substance deficient in LCIS and lobular CA

A

e-cadherin

223
Q

T/F Majority of LCIS progress to invasive carcinoma

A

F

224
Q

Type of breast CA associated with peau d’orange

A

Inflammatory carcinoma

225
Q

Good vs bad prognosis: ER-positive, PR-positive

A

Good

226
Q

Good vs bad prognosis: Her2-neu +

A

Poor

227
Q

Her2-neu is what type of receptors

A

EGFR receptor

Pathology (16 decks)

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