PATH: Vulva, Vagina, and Cervix

Question 1

What condition has a characteristic thinned epidermis and a sclerotic and inflamed dermis?

Answer 1

lichen sclerosis

Question 2

What condition has a thickened epidermis and hyperkeratosis?

Answer 2

squamous cell hyperplasia

Question 3

What condition has an exophytic growth pattern and enlarged hyperchromatic nuclei with perinuclear halos?

Answer 3

condyloma acuminatum (HPV)

Question 4

What is the hyperchromatic nuclei with perinuclear halos seen with HPV cytopathic effect called?

Answer 4

koilocytic atypia

Question 5

What does normal uterine cervical squamous epithelium look like?

Answer 5

single cell layer of basal cells and cells get flatter with flatter nuclei (and abundant glycogen in cytoplasm) as you near the surface

Question 6

How do you gauge how bad uterine dysplasia is?

Answer 6

the higher in the epithelium the basaloid cells (darker with less clear glycogen), the worse the dysplasia

Question 7

What type of intraepithelial neoplasia correlates with LSIL?

Answer 7

CIN1

Question 8

What type of intraepithelial neoplasia correlates with HSIL?

Answer 8

CIN2 and CIN3 and CIS

Question 9

Will LSIL progress to carcinoma?

Answer 9

no! 10% progress to HSIL (which then may progress)

Question 10

Will HSIL progress to carcinoma?

Answer 10

yes, 10% will progress to carcinoma

Question 11

What is more likely to regress, LSIL or HSIL?

Answer 11

LSIL (60% regression) > HSIL (30% regression)

Question 12

What do the nuclei of koilocytes look like?

Answer 12

raisins

Question 13

How can you differentiate areas of abnormal cervical epithelium on physical examination?

Answer 13

brush with dilute acetic acid ans will turn area whitish

Question 14

If you see a cervix with nodular and bizarre vessels with areas of hemorrhage, what should you think?

Answer 14

invasive squamous cell carcinoma