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Repro Exam 2 > Path: Vulva, Vagina, Cervix > Flashcards

Path: Vulva, Vagina, Cervix Flashcards

1
Q

Top 3 most common sites of genital herpes infection.

A
  1. Cervix 2. Vagina 3. Vulva
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2
Q

Time it takes for lesions to appear after exposure to herpes.

A

3-7 days

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3
Q

Location of sequestered genital herpes viruses.

A

Lumbosacral dorsal root ganglia

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4
Q

If a herpetic lesion is active during labor and delivery, how should the delivery be handled?

A

C-section to prevent transmission to the newborn

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5
Q

What are 3 characteristics of cells of a pap smear when it is infected with Herpes?

A

Molding of nuclei

Margination of nucleoli

Multinucleation

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6
Q

Infectious agent of Molluscum Contaigiousum

A

Poxvirus

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7
Q

Most common population to develop Molluscum Contaigiosum.

A

Children between age 2 - 12

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8
Q

How does Molluscum Contaigiosum appear on microscopy?

A

The cells of the papules with be full of viruses and the nuclei are absent.

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9
Q

Patient presents with white clumpy vaginal discharge and complains of vulvar pruritis.

A

Candidiasis

-the image shows hyphae (or pseudospores) on papsmear

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10
Q

Patient complains of vaginal pain, speculum exam reveals bright red cervix. Pap smear reveals:

A

Trichomonas Vaginalis: protozoan infection

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11
Q

Patient presents with white/gray vaginal discharge with fish smell odor. Pap smear reveals

A

Bacterial Vaginosis caused by Garnerella vaginalis infection. The image shows clue cells.

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12
Q

Main causative agent of pelvic inflammatory disease (PID).

A

Chlamydia trachomatis

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13
Q

Why is PID caused by Chlamydia worse than PID caused by Gonorrhea?

A

Chlamydia takes longer to produce symptoms. Damage occurs before symptoms arise whereas Gonoccocal PID is treated earlier due to earlier symptoms.

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14
Q

Patient presents with persistent lower abdominal pain. Salpingo-oophorectomy reveals:

A

Tubo-ovarian abscess caused by Gonococcal infection.

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15
Q

Major complication of current or past PID.

A

Ectopic Pregnancy

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16
Q

Name the two major categories Non-neoplastic vulvar disorders.

A
  1. Lichen Sclerosis
    - thinning epidermis, hyperkeratosis, dermal fibrosis
  2. Squamous Cell Hyperplasia (Lichen Simplex Chronicus)
    - epithelial thickening, leukocytes infiltrate the dermis
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17
Q

Causative agent of Condyloma Acuminatum

A

HPV

(aka genital warts or syphilitic lesion)

18
Q

Infectious serotypes of agents that cause Condyloma Acuminatum that are oncogenic.

A

HPV 16 and 18

19
Q

Name the two types of Squamous Cell Carcinoma of the vulva.

A
  1. Basal and Warty Carcinoma
  2. Keratinizing Squamous Cell Carcinoma
20
Q

Major risk factor for developing Basal or Warty Carcinoma of the vulva.

A

Infection of HPV serotype 16 (18 and 31 are also possible but less common)

-usually sexually transmitted

21
Q

What does this biopsy of vulvar tissue indicate?

A

Indicates Basal or Warty carcinoma that is still in situ or intraepithelial (VIN). The basement membrane is still intact. The cell layers show a lack of maturation characteristic of neoplasia. The patient is HPV (+).

22
Q

What does this biopsy of vulvar tissue indicate?

A

Basal or Warty carcinoma that has invaded through the basement membrane.

23
Q

What is different about the risk of developing Keratinizing Squamous Cell Carcinoma vs. Basal or Warty Carcinomas?

A

Keratinizing Squamous cell is NOT associated with HPV infection.

It is mainly a result of individuals with long-standing Lichen Sclerosus or Squamous cell hyperplasia.

24
Q

What does this vulvar biopsy show?

A

Keratinizing Squamous Cell Carcinoma.

The dermis contains “nests and tongues” of squamous cells. This cell type is only supposed to be present in the EPIdermis.

25
Q

What is the prognosis for patients with a Keratizing Squamous Cell Carcinoma lesion 2cm or less vs. one that has entered lymph nodes?

A

2cm lesion: high survival (60-80% at 5 years)

Lymph node involvement: low survival (less than 10% at 5 years)

26
Q

What does this biopsy from a sharply circumscribed nodule of vulvar tissue indicate?

A

Papillary Hidradenoma: a glandular neoplastic lesion with intraductal papilloma projections

27
Q

A patient presents with a red, pruritic, crusted vulvar lesion. Biopsy reveals this:

A

Extra-mammary Pagets Disease

-large tumor cells in the epidermis with a “clear halo” separating them from other epithelial tissue

28
Q

Treatment for extramammary Paget Disease.

A

Surgical Excision

29
Q

What is vaginal adenosis?

A

Persistence of columnar epithelium in the upper 1/3 of the vagina. It should be stratified squamous cells.

30
Q

Major cause of vaginal adenosis.

A

Use of the medication Diethylstilbestrol by pregnant patients for estrogen replacement therapy. The adenosis would occur in the later in the life of the fetus of the pregnant patient.

31
Q

Major complication of vaginal adenosis.

A

Clear cell vaginal carcinoma

32
Q

Malnignant vaginal tumor in infants.

A

Sarcoma botryoides (embryologic rhabdomyosarcoma)

-grapelike

33
Q

How does Sarcoma Botyroides appear on histological examination?

A

Cambium Layer: tumor cells appear crowded beneath the vaginal epithelium

34
Q

Most common site of development of squamous cell carcinoma of the vagina.

A

At the junction of the upper vagina and ectocervix

35
Q

What maintains acidic pH in the vagina and cervix?

A

Lactobacilli sp.

-secrete acid keeping vaginal pH below 4.5

36
Q

What are endocervical polyps and how are they treated?

A

Cervical growths of fibromyxomatous stroma. Benign growths that can be removed with simple curettage or surgical excision.

37
Q

Major risk factor for developing cervical carcinoma.

A

Infection with HPV serotypes 16 and 18

-carcinomas form once the patient is in an immunocompromised state

38
Q

Cell type that HPV likes to infect.

A

Immature basal cells of squamous epithelium. Located at the squamocolumnar junction of the ectocervix and upper vagina.

39
Q

What is the main classification system used for PREcancerous cervical lesions?

A

A simplified two-tiered system

  1. Low Grade (LSIL or Lowgrade Squamous Intraepithelial Lesion): involves Cervical Intraepithelial Neoplasia (CIN) I, the atypical cells exapnd less than 1/3 the epithelial thickness
  2. High Grade (HSIL): invovles CIN II and CIN III, the atypical cells expand 2/3 of the epithelial thickness
40
Q

What does an exophytic lesion mean?

A

Tending to grow outward from its epithelial origin. Seen in a lot of squamous cell pathology.

41
Q

What is the treatment for most invasive cervical carcinomas?

A

Hysterectomy with lymph node dissection

+

Radiation

42
Q
A

Repro Exam 2 (17 decks)

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