Pathology

Question 1

You take a sample from a vaginal lesion and look at the cells under the microscope to find large nuclei with acidophilic inclusions and a ground glass appearance. what’s the most likely agent?

Answer 1

HSV

Question 2

An elderly woman on vulvar exam appears to have leukorrhea with parchment paper skin. How would you expect these features to look on histologic exam?

Answer 2

Hyperkaratosis, loss of rate ridges, acellular dermal zone.

Question 3

On PAP you notice a red granular patch on the vaginal mucosa of your 45 y/o patient, this finding is consistent with in utero exposure from her mother of a drug that does its damage at what week of embryologic development?

Answer 3

10th week when squamous epithelium replaces the glandular/columar epithelium in the upper vagina and exocervix.

DES exposure in utero can cause adenosis, or a persistence of columnar cells in the upper vagina.
It can also rarely progress to a clear cell adenocarcinoma

Question 4

Whats the most common general disease in the USA?

Answer 4

HPV

Question 5

What are the gross and microscopic differences between acute and chronic cervicitis and which is more common?

Answer 5

Acute
Gross-Red swollen and purulent
micro-infiltrate of polymorphonuclear leukocytes and stream edema

Chronic
Gross Red swollen, epithelial erosions
micro-mononuclear cells lymphocytes and plasma cells
More common

Question 6

According to the Bethesda system ASCUS and ASC-H mean what?

Answer 6

ASCUS 90% inflammation

ASC-H colposcopy to investigate