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Pathology IV > Quiz 1 > Flashcards

Quiz 1 Flashcards

1
Q

The vulva is prone to skin infections due to:

A

constant exposure to secretions, moisture, and friction.

it is also sensitive to hormonal influences.

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2
Q

DNA poxvirus spread through direct contact or shared items like towels or clothing:

A

MCV - Molluscum contagiosum virus

4 types - MCV-1 is MC
high incidence in children
virus gone when lesions are gone

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3
Q

Waxing and waning inflammatory skin dz with scaling red plaques with silvery scales:

A

psoriasis

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4
Q

Histological findings of psoriasis:

A

marked elongation of rete pegs (hyper-proliferative)
marked hyperkeratosis
loss of granular layer
vascular dilatation

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5
Q

non-specific skin condition that is a consequence of chronic pruritus and scratching:

A

lichen simplex chronicus

may lead to leathery, brownish appearance of skin
mb treated with anti-anxiety meds to stop scratching

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6
Q

histology of lichen simplex chronicus:

A

thickened epidermis
leukocyte infiltration of the dermis
elongated/widened/thickened rete ridges

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7
Q

skin condition that causes irritation, ulceration, erythema, soreness, burning, and raw areas - on the limbs, trunk, mouth, and vulva:

A

lichen planus

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8
Q

histology of lichen planus:

A

degeneration of basal cell layer
thickening of granular cell layer
infiltration of inflammatory cells into sub-epithelial CT
saw-tooth appearance of rate ridges

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9
Q

thickening of the skin of the vulva and peri-anal area which appears pale or white in color:

A

lichen sclerosus

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10
Q

Which of these is associated with the greatest risk of vulvar cancer -
lichen planus
lichen sclerosis
lichen simplex chronicus

A

lichen sclerosus - up to 5% of pts

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11
Q

histology of lichen sclerosis:

A 
edematous degeneration of basal layer
atrophy of epidermis
disappearance of rete ridges
dermis replaced by CT
band-like lymphocyte infiltrates
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12
Q

Bartholin’s cysts are (common/rare), occur MC in the (young/old/all ages), and result from (hyperplasia/obstruction/atrophy) of the ducts.

A

common
all ages
obstruction

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13
Q

Bartholin’s cysts are lined by _________ epithelium or by epithelium that shows _________ __________. The predominant organism is:

A

transitional (normal)
squamous metaplasia
E. coli (infrequently gonococcal)

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14
Q

Bacterial STI’s:

A

Chalmydia (chl. trachomatis)
Gonorrhea (Neisseria gon.)
Syphilis (treponema pallidum)
Chancroid (haemophilus ducreyi)

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15
Q

Viral STI’s:

A 
HSV 1 & 2 (herpes simplex)
HIV 
HPV (human papilloma)
Heb B & C
MCV (molluscum contagiosum)
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16
Q

Fungal STI’s:

A

candidiasis

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17
Q

Parasitic STI’s:

A

lice (Pthirus pubis)

scabies (Sarcoptes scabieii)

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18
Q

Protozoal STI’s:

A

Trichomoniasis (Trichomonas vaginalis)

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19
Q

Smears from _______ lesions may reveal characteristic multinucleated giant cells.

A

Genital herpes (HSV)

the nuclei have a ground-glass appearance
mb nuclear inclusion bodies

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20
Q

gross appearance of MCV:

A

umbilicated erythematous papules

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21
Q

HPV strains responsible for 90% of genital warts:

A

6 & 11

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22
Q

HPV strains associated with 70% of cervical cancer:

A

16 & 18

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23
Q

Most easily recognizable sign of genital HPV infection:

A

genital warts
(condyloma acuminata)

most people who acquire HPV never develop sx

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24
Q

Histology of HPV:

A

acanthosis (diffuse epidermal hyperplasia)
hyperkeratosis
cytoplasmic vacuolation

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25
Q

spiral-shaped, gram neg highly mobile bacterium (assoc w/syphilis):

A

treponema pallidum

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26
Q

Syphilis infection may be characterized by a (painful/painless) (chancre/chankroid).

A

Painless

chancre

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27
Q

The 3 MC vaginal infections, accounting for 10M office visits per year:

A

bacterial vaginosis (BV)
trichomonas
candida

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28
Q

Vaginal infection characterized by no odor and low pH:

A

candida

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29
Q

Vaginal infection characterized by fishy odor and high pH:

A

BV

trichomonas

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30
Q

The discharge assoc w/candida has a characteristic ________ appearance.

A

cottage cheese

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31
Q

The discharge assoc w/trich has a ________ appearance.

A

frothy

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32
Q

Commonly, the only symptoms of BV are:

Histological findings:

A

discharge and odor

clue cells - epithelial cells coated with bacteria “shimmering”

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33
Q

Characteristic histo findings of trich:

A

flagellates

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34
Q

Signature characteristic of neisseria gonorrhea:

pathognomonic?

A

gram neg diplococci

NOT pathognomonic

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35
Q

Vulvar intraepithelial neoplasia (VIN) is characterized by:

A

the presence of hyper pigmented skin plaques
[varieties of colors - red, white, yellow, multi]

10-30% assoc w/a primary squamous neoplasm

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36
Q

More than 90% of all cases of VIN & assoc cancer contain DNA of which HPV strains?

A

16, 18, 31, 45

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37
Q

Vulvar carcinoma represents ___% of all genital cancers in women, the majority >____ yrs.

A

3%

>60yrs

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38
Q

85% of vulvar carcinomas are:

A

SCC

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39
Q

The less common 15% of vulvar carcinomas are:

A

basal cell carcinoma
melanoma
adenocarcinoma

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40
Q

Vulvar tumors (assoc w/cancer) often reveal accumulation of:

A

p53 protein

[noted in papillary serous carcinoma]

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41
Q

T/F: Well differentiated vulvar carcinoma is typically positive for the presence of HPV.

A

FALSE!

Poorly differentiated reflects greater dysplasia, and is assoc with HPV.

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42
Q

Distal metastases of vulvar carcinoma typically involve:

A

lungs and liver

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43
Q

Why did adenocarcinomas of the vagina receive special attention?

A

Because of increased frequency of clear cell adenocarcinoma in young women whose mothers had been treated with diethylstilbestrol (DES) during pregnancy.

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44
Q

Histology of clear cell adenocarcinoma:

A

vacuolated clusters of tumor cells

gland-like structures

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45
Q

5th most deadly cancer in women, worldwide:

A

cervical cancer (1st in developing countries)

[8th MC cancer of women in the US/2nd worldwide]

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46
Q

Cervical cancer risks:

A
  • early age of 1st intercourse
  • multiple sex partners
  • male partner w/multiple prior sex partners
  • persistent detection of high-risk HPV (high viral load)
  • presence of cancer-assoc HPV strains
  • exposure to OCP
  • tobacco use
  • history of STI
  • multiple births
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47
Q

CIN stands for:

and was developed to emphasize:

A

cervical intraepithelial neoplasia
the spectrum of cellular abnormalities in the development of cervical carcinoma; to standardize description, characterization, treatment

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48
Q

Mild dysplasia:

A 
CIN1
LSIL (low-grade squamous intraepithelial lesions)
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49
Q

Moderate dysplasia:

A

CIN2

HSIL

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50
Q

Severe dysplasia:

A

CIN3 (carcinoma in situ)

HSIL

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51
Q

Term to describe cellular changes - enlarged nuclei, stains with a halo-like appearance:

A

koilocytosis

characteristic of ASC-US
atypical squamous cells of undetermined significance

52
Q

Condition in which endometrial glands and stroma of the uterus are found and flourish outside the uterine cavity:

A

endometriosis

MC site - ovaries

53
Q

Common symptoms and sequelae of endometriosis:

A 
dysmenorrhea
chronic pelvic pain
dyspareunia
infertility
pelvic cysts
54
Q

What is a “chocolate cyst”?

A

endometrioma - an ovarian cyst formed due to ectopic endometrial tissue that bleeds within the ovary. rupture may lead to peritonitis.

55
Q

Ectopic endometrial tissue within the myometrium:

appearance:

A

adenomyosis

thick, spongy myometrial wall (muscular layer of uterus)
leads to uterine enlargement and irreg bleeding

56
Q

Inflammation or infection of the endometrium:

A

endometritis

57
Q

MC cause of endometritis:

A

childbirth related - d/t retained placental fragments or iatrogenic infx during delivery or abortion

non-childbirth related mb PID

58
Q

Acute endometritis is characterized by:

A

micro-abscesses or neutrophils within the endometrial glands

majority of cases are poly-microbial

59
Q

Gold standard for dx of endometritis:

A

endometrial biopsy

60
Q

Chronic endometritis is characterized by:

A

plasma cells in the stroma

[lymphs, eos, & lymphoid follicles mb seen]

61
Q

Etiology of chronic endometritis:

A

infx (typically w/PID)
intrauterine growths
foreign body
tissue damage d/t radiation

1/3 have no identifiable etiology

62
Q

Infx of the upper genital tract not assoc w/pregnancy or surgery:

A

PID - pelvic inflammatory dz

aka salpingitis - bc infx of oviducts is MC, and most sequalae result from destruction of tubal architecture.

63
Q

MC cause of PID infx:

A

BACTERIA

also mb viral, fungal, or parasitic

64
Q

rate of infertility 2° to PID:

A

1 in 4

also 6-10x greater risk of ectopic pregnancy

65
Q

MC GYN cancer in the US:

A 
endometrial cancer (adenocarcinoma)
35K diagnosed each year
66
Q

Risk factors for endometrial cancer:

A 
nulliparity
obesity (esp abd fat)
DM / hyperglycemia
HTN
peak age - 55-65
67
Q

Histology to differentiate endometrial adenocarcinoma from hyperplasia:

A

Glandular architecture is preserved but the tissue is confluent without intervening stroma

68
Q

Benign smooth muscle tumors of the uterus:

A

leiomyomas (fibroids)

found in the myometrium of the corpus

69
Q

Gross appearance of leiomyomas:

A 
discrete
well-circumscribed
round
firm
gray-white
vary in size
70
Q

Histology of leiomyomas:

A

whorled pattern - characteristic
uniform muscle cell size/shape
oval nuclei

71
Q

Histology of leiomyosarcoma:

A 
greater density of cells
more pleomorphism
hyperchromatic
some cells w/irreg nucleus
spindle-shaped cells
72
Q

T/F: leiomyosarcomas typically form from transition of leiomyomas.

A

FALSE

transition from the benign to the malignant is uncommon. leiomyosarcomas form independently.

73
Q

PCOS can develop when the ovaries are stimulated to produce what?

A

Excessive amounts of male hormones [esp testosterone] by releasing excess LH from ant pituitary.

One of the MC female endocrine d/o’s and causes of infertility.

74
Q

Sx of PCOS:

A 
hirsutism
acne
disrupted menses
infertility
insulin resistance
inc wt, cholesterol, trig, hyperglycemia
inc incidence of DM
75
Q

Hallmark lab finding of PCOS:

A

LH > FSH 3:1 or higher

76
Q

PCOS found in ___% of women presenting with anovulation.

A

5-10%

77
Q

Ultrasound finding in PCOS:

A

“string of pearls” sign

78
Q

Over 90% of ovarian cancers are classified as ________ and arise from __________________.

A

epithelial

the surface of the ovary (or mb fallopian tubes)

79
Q

Psammoma bodies are:

and are associated with:

A

small calcifications in the ovaries

ovarian serous cystadenocarcinomas (and other cancers)

80
Q

Ovarian germ cell tumors often called dermoid cysts:

A

ovarian teratomas

contain skin, hair, sebum, teeth

81
Q

The absence of one or both testes from the scrotum:

A

Cryptorchism

MC birth defect of male genitalia
3% full-term male births
30% premature males births
2/3 unilateral

82
Q

In ___% of cases of cryptorchism, an undescended testis can be palpated in the inguinal canal.

A

90%

the remaining minority - in abdomen or nonexistant

83
Q

2nd MC male birth defect, urethra that involves an abnormally placed urinary meatus:

A

hypospadias

ventral line
1st degree - cosmetic
1st/2nd degree - surgical repair
3rd degree - test hormones, endocrine, karyotype; intersex?

84
Q

Rare male birth defect involving urethral opening on the dorsum of the penis:

A

epispadius

also occurs in females
some of urethra extending beyond external tissue
possibly small or bifid phallus

85
Q

Condition where foreskin cannot be fully retracted over the glans:

A

phimosis

86
Q

Condition where foreskin becomes trapped behind the glans:

A

paraphimosis

87
Q

T/F: Both phimosis and paraphimosis are considered risk factor for development of penile cancer.

A

True

88
Q

An abnormal enlargement of the vein draining the testicles:

A

Varicocele

present in ~15% of adult male pop.
largely post-pubertal
incidence increases w/age

89
Q

98% of idiopathic varicoceles occur on the (left/right).

A

Left - due to testicular vein connecting to left renal vein at 90deg, vs right testicular vein draining directly into IVC at less than 90deg.

90
Q

Accumulation of fluids around a testicle caused by fluid secreted by the tunica vaginalis:

A

Hydrocele

91
Q

Etiology of hydrocele:

A 
trauma
hernia
orchitis
cancer
lymphatic impairement - via chronic infx, parasite
92
Q

PE to differentiate hydrocele from tumor:

A

transilluminate (hydrocele WILL transmit light)

93
Q

Condition that occurs when the spermatic cord twists, cutting off the blood supply to the testicle:

A

Testicular torsion

94
Q

MC underlying cause of testicular torsion:

A

congenital malformation know as “bell-clapper deformity”

typically surface rotates toward midline

95
Q

In testicular torsion, ischemia may lead to necrosis in ____ hrs.

A

5-6 hours from onset of pain

may decompress spontaneously
absence of cremasteric reflex

96
Q

Gonococcal urethritis is caused by:

A

Neisseria gonorrhoeae

GRAM-NEG DIPLOCOCCI!! :)
both intra- & extra-cellular

97
Q

Non-gonococcal urethritis (NGU) is MC caused by:

A

Chlamydia trachomatis

gram-neg obligate intra-cellular bacteria

98
Q

Triad of sx assoc w/reactive arthritis (Reiter’s syndrome):

A
  • inflammatory arthritis of large jts (SI, knees, back)
  • inflammation of the eyes (conjunctivitis, uveitis)
  • urethritis in men / cervicitis in women; mucocutaneous lesions
99
Q

T/F: Reactive arthritis is positive for rheumatoid factor.

A

False

seronegative for RF
positive for HLA-B27

100
Q

Reactive arthritis assoc. rash on the soles of feet:

A

keratoderma blennorrhagica

101
Q

80-20 rule for HSV:

A

HSV 1 - 80% oral / 20% genital

HSV 2 - 20% oral / 80% genital

102
Q

Approx US pop. positive for HSV 1 by 4th decade?

HSV 2?

A

1 - 65%

2 - 25%

103
Q

Characteristic histological finding in HSV:

Latent in:

A

Multinucleated giant cells

HSV 1 - trigeminal ganglia
HSV 2 - sacral ganglia

104
Q

Histopathology of syphilis:

A

Treponema pallidum spirochetes

Gross - keratotic lesions, granuloma

105
Q

Genital warts are caused by:

A

HPV - 6 & 11

106
Q

It is estimated that ____ new cases of HPV-assoc penile cancers are dx in the US each year.
95% are:

A

> 1000

SCC

107
Q

HPV prevalence in penile cancer:

Predominant strain:

A

40%

16 - 63%

108
Q

The MC solid tumor affecting males aged 20–35 yrs:

A

primary testicular cancer

showing a progressive inc over the past 2 decades

109
Q

Testicular cancer classifications/prevalence:

A

Seminoma - 35%
Embryonal carcinoma - 20%
Teratoma - 5%
Mixed cell types - 40%

110
Q

Avg age of dx of seminoma:

A

40 years old

MC - mass felt on self-exam / 10-14% have no palpable mass

111
Q

Blood tests in seminoma reveal:

A

PLAP (placental alk phosphatase) - 50%
hCG mb elevated

serum alphafetoprotein - not classically elevated

112
Q

Microscopic eval of seminoma usu reveals:

A 
sheet-like or lobular pattern of cells
fibrous stromal network
abundant clear to pink cytoplasm
abundant glycogen
prominent nuclei w/ 1 or 2 lg nucleoli
prominent nuclear membrane
113
Q

Germ cell tumor that occurs in the ovaries and the testes:

A

Embryonal carcinoma

Avg dx at 31 yrs
10% of testicular germ cell tumors
20-66% of pts have mets at dx

114
Q

Serology of embryonal carcinoma:

A

mb elevated hCG & AFP

115
Q

Histopathology of embryonal carcinoma:

A 
sheets of cells
primitive tubules
crowded, pleomorphic nuclei
primitive epithelial cells 
nuclear atypia, overlapping
prominent nucleoli
mitoses common
116
Q

Encapsulated tumor with tissue or organ components resembling normal derivatives of all three germ layers:

A

Teratoma

while tissue found is “normal” it is often present in an unexpected location

117
Q

Review three layers of germ cells:

A

Mesoderm: immature cartilage
Endoderm: G.I. lining cells/glands
Ectoderm: epidermis with keratin

118
Q

An inc in the # of prostatic stromal & epithelial cells, resulting in formation of lg, discrete nodules in the periurethral region of the prostate:

A

BPH

when sufficiently large, nodules compress urethral canal, causing obstruction

119
Q

T/F: Elevated PSA in BPH reveals an increased risk of cancer.

A

False.

BPH may elevate PSA levels, d/t organ volume, inflammation, and UTI, but does not increase cancer risk.

120
Q

A normal prostate is ___ cm in diameter:

A

3-4 cm

121
Q

BPH is extremely common in men over ____.

A

50

122
Q

Gross appearance of BPH:

A

enlarged prostate gland
multiple nodules of varying sizes
nodes vary from solid to cystic
partial to complete urethral obstruction

123
Q

Histopathology of BPH:

A

glandular > stromal tissue
glands well-differentiated
corpora amylacea - small laminated pink concretions

124
Q

Histopathology of prostatitis:

A

numerous small dark blue lymphocytes in stroma, btw glands

125
Q

T/F: Most prostate cancers are aggressive, fast growing, with lots of symptoms.

A

False. Although it is one of the most prevalent cancers in men, many remain asx, undergo no therapy, & die of other causes.
However, more aggressive prostate cancers acct for more cancer-related deaths in US men than any other cancer except lung.

126
Q

95% of prostate cancers are found to be:

A

adenocarcinoma

127
Q

T/F: prostatic hyperplasia is a premalignant lesion.

A

False

Pathology IV (6 decks)

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