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PATH 375 Female Reproductive System > PATH 375 Female Reproductive System > Flashcards

PATH 375 Female Reproductive System Flashcards

1
Q

Hermaphroditism

A

discordance between genotypic and phenotypic sex

a) True “: both male and female gonads
b) Male pseudo”: genotypically male
c) Female pseudo”:

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2
Q

STDs
3 common organisms
present (4)

A 
common (HSV, Chlamydia, HPV)
present with 
- vaginal discharge
- lesions
- pelvic pain 
- dyspareunia
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3
Q

Genital herpes (HSV2)

  • def
  • days
  • dormant
  • Dx impt
A

vesicles on genitalia that coalesce and ulcerate

  • 3-7 days after exposure (30% dev lesions)
  • dormant on nerves, recur
  • Dx impt, prevent vaginal delivery if active
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4
Q

HPV

  • condyloma (3 types)
  • assoc
A
  • labial, vaginal, and cervical warts (condyloma)
  • condyloma acuminatum: large vulvar wart (HPV 6, 11)
  • some types assoc with carcinoma
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5
Q

Chlamydia (trachomatis)

N. gonorrheae

A

urethritis or cervicitis with discharge, PID

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6
Q

Syphilis (T. pallidum)

A

vulvar ulcers

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7
Q

Bacterial vaginoses

A

Candida, Trichomonas, Gardnerella

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8
Q

PID

  • def
  • 2º to_
  • present
A
  • chronic, extensive infection of upper reprod tract
  • usu 2º to STD (Chlamydia, Gonorrhea)
  • salpingitis, tubo-ovarian abscess, peritonitis
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9
Q

PID complications (4)

A
  • chronic non-specific infection (fever, malaise, fatigue)
  • infertility (2º to fallopian tube scarring)
  • pelvis mass + pain
  • spread of infection
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10
Q

Endometrial hyperplasia

def

A

normal menstrual cycle req fn of hypothalamic-pituitary-ovarian axis

continued estrogen stimulation with inadequate progesterone => endometrial mucosa thickens

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11
Q

Endometrial hyperplasia

  • present
  • causes
  • complex vs simple hyperplasia
A

anovulatory cycles: no ovulation => no progesterone sec)

  • functional causes: puberty, anxiety, athlete
  • organic causes: excess estrogen (OCT, tumors)
  • atypical hyperplasia: incr risk of endometrial adenocarcinoma (from atypia)
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12
Q

Carcinoma of vulva

  • type
  • present (and colour)
  • Dx
  • Tx
A

squamous cell carcinoma

  • raised or ulcerated lesion
  • pre-neoplastic change present as white/red patch
  • Dx: biopsy
  • Tx: surgical +/- adjuvant Tx
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13
Q

Carcinoma of vagina (2 types)

A

squamous cell carcinoma

clear cell carcinoma: mother was on DES during pregnancy

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14
Q

Carcinoma of cervix

  • Dx
  • def
  • lack of _
  • loc
  • HPV types
  • grading
A 
Pap test (early Dx) reduced mortality
risk factors: sex early, multiple partners, HPV, other venereal diseases, env

squamous cell carcinoma: precursor lesion = dysplasia (cervical intra-epithelia neoplasia)
lack of normal maturation of squamous epith, occurs at transition zone
- cells shed into vagina (Pap smear)
- HPV types 16, 18, 33, 34, 35 assoc
- koilocytic change: characteristic changes due to HPV

graded mild (1/3), mod, severe

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15
Q

Leiomyoma (fibroid)

  • def
  • most common_
  • responds to_
  • symptoms
A

benign neoplasm der from smooth muscle in uterus wall

  • most common uterine neoplasm
  • responds to estrogen, arise dur reproductive age
  • usu asymptomatic
  • symptoms due to mass effects, bleeding
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16
Q

Leiomyosarcoma

A

malignant neoplasm der from smooth muscle

v rare

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17
Q

Endometrial adenocarcinoma

  • def
  • most common_
  • present
  • risk (6)
  • prognosis
  • Dx
  • Tx
A

malignant neoplasm der from epith cells in endometrium

  • most common malignant tumor of female reprod tract
  • elderly females, vaginal bleed (PMB)
  • risk related to incr estrogen (hyperestrinism): estrogen sec tumor, exogenous estrogen, obesity, nulliparous or early menarche, late menopause
  • prognosis: stage most impt, grade (low intermed, high)
  • Dx: endometrial biopsy, dilation and curettage
  • Tx: hysterectomy +/- adjuvant Tx
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18
Q

Ovarian cysts

  • def
  • arise from_
  • present
  • if large
A

fluid filled cavities lined by epith

  • arise from unruptured follicles (follicular cysts): may include cystic corpora lutea or inclusions of surface cells
  • usu small, solitary, asymptomatic
  • further investigation if large to rule out neoplasm
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19
Q

Polycystic ovary syndrome

  • def
  • cause
  • present
  • complications
A

multiple cysts in both ovaries

  • caused by complex hormal disturbances of hypothalamic-pituitary-ovarian-adrenal axis
  • menstrual irregularities
  • infertility
20
Q

Ovarian neoplasms

  • common_
  • mortality
  • 3 types classification by_
  • risk
A

second most common grp of tumors in female reprod tract

  • highest mortality of femal reprod tract tumors
  • 3 major grps based on histogenetics:
    1. surface epith tumors
    2. germ cell
    3. sex cord stromal

malignant ovarian tumors uncommon in young females
not linked to OCP
- risk: ovarian dysgenesis, BRCA1 and BRCA2 gene mutations

21
Q

Surface epith tumors

- histologic types

A

70% of ovarian neoplasms

- histologic types: serous, mucinous, endometrioid, clear cell, transitional cell

22
Q

Serous epith tumors

Mucinous

A

most common
usu cystic, filled with clear fluid (serous) or viscous (mucinous)

types: benign, borderline malignant, and malignant (histology)

bilateral in 25% benign, 50% malignant

23
Q

Germ cell tumors

A

20% ovarian tumors, occur in young females

teratoma: cystic, contain hair/seb material (dermoid cysts), teeth, bone, cartilage
- benign

immature teratoma: contains immature neural tissue
- may behave malignantly

24
Q

Fibroma

Thecoma

A

benign neoplasm

  • of fibroblasts
  • of spindle (theca) cells (firm and solid mass), prod extrogens
25
Q

Granulosa cell tumor

A

granulosa cells
benign or malignant
may prod estrogen

26
Q

Infertility (4 factors)

A

ovum-related
sperm-related
genital organ factors: PID, Asherman syndrome (endometrium scar and close)
systemic factors

27
Q

Ectopic pregnancy

  • loc
  • pathogenesis
A

implantation of fertilized ovume outside uterine cavity

usu fallopian tube
trophoblast cells (of placenta) invade wall of tube, enlarge, may rupture => surgical emergency
28
Q

Placenta accreta

A

abnormally deep penetration of placental villi into uterus wall

29
Q

Placenta previa

A

abnormal placental implantation site in lower uterine segment

30
Q

Toxemia of pregnancy

A

unknown pathogenesis

characteristic symptom complex in mother

31
Q

Preeclampsia

  • when
  • present
A

occurs in 3rd trimester
may progress to eclampsia
present with hypertension, edema, proteinuria

32
Q

Eclampsia

  • present
  • Tx
A

hypertension, edema, proteinuria, and seizures

life-threatening, must treat seizures
Tx: deliver baby asap

33
Q

Gestational trophblastic disease

A

abnormalities of placentation => tumor-like changes or malignant transform

34
Q

Hydatidiform mole

  • def
  • complete mole
  • incomplete mole
A

abnormal placenta dev
trophoblastic prolif, hydropic degen of chorionic vili
enlarged uterus with no fetal movt , high HCG

complete mole: no identifiable fetus, abnormal fertilization (all paternal 46XX)

incomplete mole: some fetal parts, abnormal fertilization (69 chromosomes)

35
Q

Choriocarinoma

A

rare
highly malignant tumor
placental origin
Tx: methotrexate

36
Q

Abortion

A

interruption of pregnancy prior ot fetal viability

<500g, 20wks

37
Q

Spont abortion

  • complete
  • incomplete
  • missed
  • threatened
A

1/3 all pregnancies, no identifiable cause

  • complete: fetus and placenta expelled, normal fn returns
  • incomplete: retain some fetal/placental mat
  • missed: death of fetus in utero, passed after several wks
  • threatened: cervical os closed, spotting of blood
38
Q

Endometriosis

  • def
  • loc
  • pathogenesis
  • present
A

endometrial tissue (uterine glands + stroma) loc outside uterus (usu. ovary, peritoneum)

  • common, may cause pain, infertility
  • benign
  • chocolate cyst of ovary

cycle in response to hormonal influences
- pathogenesis: retrograde flow, traumatic implantation

39
Q

Mastitis

  • def
  • pop
  • caused by
  • present
A

acute inflamm of breast

  • lactating female
  • B. infection
  • may dev abcess

chronic mastitis: unknown etiology, rare, may mimic BRCA

40
Q

Fibrocystic change

  • cause
  • present
A

various factors including hormones, age
cause benign changes in breast tissue

fibrosis of intralobular stroma
cystic dilation of epith ducts
epith hyperplasia

  • reprod age females
41
Q

Gyneomastia

A

incr prolif of male breast, various factors

42
Q

Fibroadenoma

A

benign neoplasm of breast epith and stroma

  • well circumscribed, mobile mass
  • young females
43
Q

Breast cancer

most common_
2nd most common_
influences (3)
risk (7)

A

most common cancer in females
2nd most common cause of cancer-related death in females

influences: hormonal, env, genetic (familiar BRCA-1, -2 are TSG, incr inc of other cancers)

risk:
female (100x males)
genetics
hormones (prolonged estrogen exposure- nulliparous, early menarche, late menopause)
other malignancies (contralateral breast carcinoma, endometrial carcinoma)
premalignant changes (carcinoma in situ, atypical hyperplasia)
age
race

44
Q

Infiltrating ductal carcinoma

  • most common_
  • type
  • present
  • pathogenesis
  • Dx
A
  • most common form of BRCA
  • adenocarcinoma
  • desmoplastic response of stroma
  • lymphatic spread (axillary nodes)
  • present as mass
  • early detection (self-exam, mammogram)
  • fine needle aspiration
  • incisional biopsy
45
Q

BRCA Tx (3)

A

surgical resection: lumpectomy, mastectomy, axillary dissection

radiation

chemo: tamoxifen, herceptin

46
Q

BRCA prognosis (4 factors)

A

staging most impt
histologic subtypes
histological grading
estrogen receptor status (ER +/-)

PATH 375 Female Reproductive System (1 decks)

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