Pathology - Female Repro

Question 1

Koilocytic changes

Answer 1

HPV infection

Question 2

Vulvar carcinoma forms by what 2 pathways?

Answer 2

HPV-related (HPV-16, -18) or Non-HPV related (long-standing Lichen Sclerosis)

Question 3

40-50yo w/ Vulvar carcinoma what is the likely etiology?

Answer 3

HPV-related since it is seen years after peak sexual activity

Question 4

60-70yo w/ Vulvar carcinoma what is the likely etiology?

Answer 4

Non-HPV related (long-standing Lichen Sclerosis causing chronic inflammation & irritation)

Question 5

HPV infection risk factors

Answer 5

multiple partners & early age of intercourse

Question 6

Extramammary Paget’s Disease must be distinguished from

Answer 6

Melanoma

Question 7

Extramammary Paget’s Disease staining pattern

Answer 7

PAS+, keratin +, S100 - (malignant epithelial cells)

Question 8

Melanoma staining pattern

Answer 8

PAS -, Keratin -, S100 + (malignant melanocytes)

Question 9

Paget’s Disease of the Nipple we should assume

Answer 9

there is an underlying carcinoma

Question 10

Lower 1/3 of the vagina is derived from

Answer 10

Urogenital sinus -> non-keratinized stratified squamous epithelium

Question 11

Upper 2/3 of the vagina is derived from

Answer 11

Mullerian duct -> columnar epithelium

Question 12

During development of the vagina, stratified squamous epithelium grows upward to replace the columnar epithelium, if this fails to occur —>

Answer 12

Vaginal adenosis

Question 13

Vaginal adenosis risk factors

Answer 13

DES exposure in utero

Question 14

Vaginal adenosis complication

Answer 14

Clear Cell Adenocarcinoma

Question 15

Keratin + —–>

Answer 15

Epithelial Cell (Carcinoma)

Question 16

S100 + ———–>

Answer 16

Melanocytes (Melanoma)

Question 17

DES exposure increases the risk of _______ in the pregnant mothers

Answer 17

Breast cancer

Question 18

DES was used for

Answer 18

Used for pregnant females w/ Hx of premature labor, miscarriage

Question 19

Clear Cell Adenocarcinoma

Answer 19

proliferation of glands with clear cytoplasm

Question 20

5yo female with “grape-like” protruding mass from vagina

Answer 20

Embryonal Rhabdomyosarcoma

Question 21

Embryonal Rhabdomyosarcoma

Answer 21

mesenchymal malignancy of immature skeletal mm.

Question 22

Rhabdomyoblast exhibits

Answer 22

cytoplasmic cross-striations & Desmin+ Myogenin+

Question 23

Vaginal Carcinoma arises d/t

Answer 23

High-risk HPV (vaginal intraepithelial neoplasia)

Question 24

Vaginal Carcinoma in the upper 2/3 may spread to what lymph nodes?

Answer 24

Iliac nodes

Question 25

Vaginal Carcinoma in the lower 1/3 may spread to what lymph nodes?

Answer 25

Inguinal nodes

Question 26

Transformation Zone

Answer 26

junction b/w the exocervix (non-keratinized stratified squamous) & the endocervix (single columnar layer)

Question 27

High-risk HPV E6 proteins MOA

Answer 27

destruction of p53 (loss of tumor suppressor proteins)

Question 28

High-risk HPV E7 proteins MOA

Answer 28

destruction of Rb (loss of tumor suppressor proteins)

Question 29

p53 action

Answer 29

p53 stops progression into S phase by bringing in: BAX ----I BCL2 which causes -> cytochrome C release from now unstable mito membrane --> activates apoptosis

Question 30

BCL2 action

Answer 30

stabilizes mitochondria membrane

Question 31

Rb action

Answer 31

releases E2F after phosphorylation, E2F -> causes progression into S phase

Question 32

Risk factors for Cervical Carcinoma

Answer 32

high-risk HPV, smoking, immunodeficiency

Question 33

Smoking increases the risk of which cancers?

Answer 33

Oropharyngeal, esophageal, lung, kidney, urothelial, cervix, & pancreas

Question 34

Why is Cervical Carcinoma and AIDS-defining illness?

Answer 34

Infection & CIN 1/2 is often resolved by the immune system, therefore cervical carcinoma is an indication of low immunity

Question 35

CIN characteristics

Answer 35

koilocytic changes, nuclear atypia, high mitotic activity

Question 36

CIN 1

Answer 36

<1/3 of epithelium thickness

Question 37

CIN 2

Answer 37

<2/3 of epithelium thickness

Question 38

CIN 3

Answer 38

< entire epithelium thickness

Question 39

Carcinoma in situ

Answer 39

entire epithelium thickness

Question 40

"Chocolate cyst" on ovary

Answer 40

endometriosis involving the ovary

Question 41

"Gun-powder" nodules

Answer 41

endometriosis involving soft tissue

Question 42

Adenomyosis

Answer 42

endometriosis w/in the myometrium