Quiz 1 Flashcards
molluscum contagiosum
lesion appearance?
how it’s spread?
cause by?
characteristic lesion is pinpoint central umbilicus
spread via direct contact
caused by a DNA poxvirus
what are the histological findings of psoriasis?
marked hyperkeratosis
loss of granular layer
epidermal acanthosis and notable elongation of the rete ridges or pegs
vascular dilation
lichen simplex chronicus
histological findings?
scratch and itch cycle
thickened epidermis w leukocyte infiltration of the underlying dermis
widespread lichen simplex is often called what?
neurodermatitis
characteristic microscopic findings in lichen simplex chronicus are?
elongation, widening, and irregular thickening of rete ridges along with acanthosis, hyperkeratosis and chronic inflammation in the dermis
*same as psoriasis
would want to avoid what topical treatment to avoid further damage in lichen planus?
cortisol cream
the skin is inflamed and ulcerated and cortisol cream would further irritate the area
what is the microscopic appearance of lichen planus?
saw-tooth appearance of the rete pegs
gross appearance of lichen sclerosus?
the vulva and peri-anal area appear pale or white in color
which lichen condition is associated with an increased risk for vulva cancer?
lichen sclerosus
microscopic findings of lichen sclerosus reveal what?
flattening of the rete pegs
acellular zone beneath the epidermis (dense collagenous fibrous tissue)
describe the microscopic appearance of each of the lichen conditions and psoriasis
lichen simplex chronicus- thickening of rete pegs
psoriais - elongation of rete pegs
lichen planus - saw tooth rete pegs
lichen sclerosus - flattening of rete pegs
bartholin’s cyst usually related to what infection?
gonococcal infection
genital herpes
microscopic appearance
smears taken directly from the vesicle show characteristic multinucleated giant cells (due to abnormal division)
condyloma acuminata
aka
caused by
genital warts
HPV
HPV types __ and __ are responsible for 90% of all cases of genital warts
6, 11
which types of HPV cause the majority of cervical cancer?
16, 18
microscopic changes for condyloma acuminata?
acanthosis, hyperkeratosis, and cytoplasmic vacuolation
condyloma latum
underlying dz?
caused by?
underlying dz is syphilis
caused by treponema pallidum
treponema pallidum
morphology
gram neg or pos?
assoc with which condition?
morphology: spiral shaped gram neg highly mobile (flagellated) bacterium
assoc w: conyloma latum
chancre of syphilis painful or painless?
painless (hard to believe because it looks crazy painful gross)
compare BV, Trichomona and Candida in terms of odor and pH
BV and Trich have a high pH and a “fishy” odor while Candida doesn’t have an odor and has a low pH
on wet mount the presence of ____ is characteristic for BV?
clue cells
what is the most common STI worldwide?
chlamydia trachomatis
characteristics of Neiserria gonorrhea
gran neg diplococci
causes gonorrhea
in vulva intraepithelial neoplasia (VIN) the lesion may appear
variable in color
the plaques may be red, white, yellow, or multi-pigmented plaques
microscopic changes for condyloma acuminata?
marked thickening of epidermis (acanthosis) and cytoplasmic vacuolation
treponema pallidum
morphology
gram neg or pos?
assoc with which condition?
morphology: spiral shaped gram neg highly mobile (flagellated) bacterium
assoc w: condyloma latum
vulva intraepithelial neoplasia (VIN)
microscopically
looks like cancer!
diffuse cellular atypia, nuclear crowding, and increased mitotic index
More than 90% of all cases of VIN and associated cancers are found to contain DNA of the high risk strains of
HPV 16, 18, 31, and 45 (majority of cases are 16)
this is the same as for HPV
Approximately 85% of vulvar cancers are
squamous cell carcinoma
Children with mother’s who were treated with diestylbestrol (DES) during pregnancy show an increased incidence of what?
clear cell adenocarcinoma
Cervical cancer is directly tied to the presence of
HPV 16, 18, 31, and 45 (16 & 18 by far the most common)
what is the most recent classification of cervical cancer?
the Bethesda system
it has replaced the Cervical Intraepithelial Neoplasia classification (CIN)
Low-grade squamous intraepithelial lesions (LSIL) (corresponds to CIN1) and high-grade squamous intraepithelial lesions (HSIL) (corresponds to CIN2/3)
term used to describe cellular changes in which cells nuclei are enlarged and often stain with a halo-like appearance.(nuclei stain darker)
koilocytosis
characteristic of atypical squamous cells of undetermined significance (ASC-US). HPV infected cells.
what is the most common and most benign form of cervical intraepithelial neoplasia (carcinoma in situ)?
CIN 1
infertility is common in women with endometriosis and is thought to be due to
it’s also common in PID
scarring, adhesions, anatomical distortions of the involved ovary, Fallopian tubes or uterus.
Furthermore, inflammation due to endometriosis increases local release of cytokines that may interfere with conception, implantation or normal development of a fertilized ovum
endometrioma
aka
cause
chocolate cyst
ovarian cyst that is formed as a consequence of ectopic endometrial tissue that bleeds within the ovary
Adenomyosis generally refers to the presence of
ectopic endometrial tissue (glands and stroma) within the myometrium (the thick, muscular layer of the uterus)
appearance of glands where there shouldn’t be any
what’s the most common underlying cause of endometritis (inflammation of uterus due to infxn)?
usually due to retained placental fragments or iatrogenic infection during delivery or as a consequence of infection that develops following an abortion.
acute endometritis is characterized by the presence of what?
micro-abscesses or neutrophils within the endometrial glands
chronic endometritis is characterized by the presence of what?
plasma cells (nuclei that are off to the side of the cell- eccentric)
what is the most characteristic and common component of PID?
infxn of the oviducts
although an _______ is the most common cause of PID, many other routes of infection are possible, including _________
STI
lymphatic or hematogenous spread, postpartum or post-abortion infections and infection related to the presence of an intrauterine device (IUD).
atypical hyperplasia often presents with atypical bleeding due to
an estrogen dominant environment
endometrial cancer is the most common gynecological cancer. what type endometrial cancer is the most common?
adenocarcinoma
increased risk for developing endometrial cancer has been linked to:
nulliparity
obesity (peripheral conversion of estrogen)
DM (insulin has a GF like effect)
HTN
a far less common type of endometrial cancer than adenocarcinoma is
serous carcinoma of the ovary (papillary serious carcinoma)
microscopically papillary serous carcinoma is notable for
accumulation of nuclear p53 protein (aberrant p53)
leimomyomas,
aka
what are they
fibroids
benign smooth muscle tumors of the uterus
Leiomyomas usually present as
discrete, well-circumscribed tumors that are often round, firm and when sectioned appear gray-white in color.
These cells have a characteristic
whorled pattern of smooth muscle
leiomyoma sarcoma and sarcomas in general have a characteristic cell shape
“spindle shaped”, otherwise don’t appear to be aberrant
Benign epithelial tumors of the ovary is called
serious cystadenoma of the ovary
more than 90% of ovarian cancer are classified as _____ and arise from the ______
epithelial, surface of the ovary
why is ovarian cancer so hard to dx and why is it considered aggressive?
sx are often absent in the early course of the dz and when they do occur they are subtle (constipation, abdominal bloating, pelvic pain, difficulty eating and frequent urination
Ovarian serous cystadenocarcinomas may contain small calcifications which are referred to as
psammoma bodies.
cystic teratomas of the ovaries are a form of
ovarian germ cell tumor
When ovarian tertomas are mostly solid, they often contain less differentiated tissue. Such tumors are sometimes termed
“immature teratomas”
microscopically the teratoma has
cartilage and adipose tissue
most common birth defect of the male genitalia?
cryptorchidism (undescended testes)
2nd most common birth defect of the male genitalia?
hypospadias (urethral meatus on ventral side vs epispadias which is on dorsal side)
what’s the difference between phimosis and paraphimosis?
phimosis - foreskin can’t be retracted
paraphimosis - foreskin stuck in retracted position
an idiopathic (primary) varicocele is defined as? a secondary varicocele caused by?
- when valves within the veins along the spermatic cord don’t work properly
- compression of the vein causes engorgement (if just on R side, think mass! imaging!!!!)
what is the appropriate technique to dx a hydrocele?
transillumination (will light up. follow up with US)
what’s the most common underlying cause of testicular torsion?
what will happen with transillumination?
- a congenital malformation called “bell clapper deformity” (the testis is inadequately affixed to the spermatic cord)
- it will be opaque
Gonococcal urethritis is caused by:
The bacteria in question looks like:
Neisseria gonorrhea
gran negative diplococci
what causes non-gonococcal urethritis (NGU)?
The bacteria in question looks like:
Chlamydia trachomatis
it’s a gram negative obligate and with appropriate monoclonal staining you can see the inclusion bodies
reactive arthritis (Reither’s syndrome) is characterized by what sx
arthritis, conjunctivitis, and urinary tract infections, or urethritis and fourth major feature, ulcerations of the mouth and the skin (often of the feet).
a Tzanck smear of herpes simplex virus will show
a multinucleated giant cell
The chancres of syphilis are likely to be?
painless chancres (hard to beleive because they look like gaping fucking wounds)
what causes primary syphilis?
this bacterium looks like?
treponema pallidum
spirochete
secondary syphilis characterized by what sort of lesion? what does it mean?
circular lesions, represents active spirochete infection
condyloma acuminata (aka genital warts) is caused by
HPV strains, primarily 6 & 11
primary testicular cancer is the most common ______ malignant tumor in men between the ages ______ and _______
solid
20-35
______ prevalence in penile cancers is high at about 40%
______ is accountable for 63% of prostate cancers
HPV, HPV 16
what is the most common type of testicular cancer?
what are the other types of testicular cancer?
Seminoma (germ cell tumor)
embryonal
teratoma
mixed type
Blood tests may detect the presence of ______ or ________ in someone who has a seminoma tumor
placental alkaline phosphatase (PLAP)
Human chorionic gonadotropin (hCG)
microscopically seminoma tumor cells appear
Lobules of neoplastic cells have an intervening stroma with characteristic lymphoid infiltrates. The seminoma cells are large with vesicular nuclei and pale cytoplasm.
Blood tests may detect the presence of an elevation of______ and _______ in someone who has a embryonal carcinoma
human chorionic gonadotropin (hCG) alpha fetoprotein (AFP) - unique to this cancer
microscopically embryonal carcinoma appears
Sheets of cells are trying to form primitive tubules
a teratoma is an
encapsulated tumor
does benign prostatic hyperplasia (BPH) increase the risk of cancer?
Answer? NO! Although it does elevate PSA levels
microscopically benign prostatic hyperplasia appears
1) well-differentiated glands with tall columnar epithelial lining cells (normally there is one row of columnar cells and an outer layer of cuboidal to myoepithelial cells)
Approximately 95% of prostate cancer is found to be ________
adenocarcinoma
microscopically adenocarcinoma
greater density of glandular tissue
dissapearance of stoma
microscopically adenocarcinoma
greater density of glandular tissue
dissapearance of stroma
