Quiz 1, Genitalia SP2015 Flashcards
What is a DNA Poxvirus that looks similar to herpes?
Molluscum contagiosum
How does molluscum contagiosum present compared to herpes viruses?
MCV does not remain in the body after lesions heal. You can become reinfected though.
When psoriasis is present on the vulva, where does it usually occur? And what can it resemble?
Hear bearing portions.
Fungal infections
What term describes the epithelial extensions that project into the underlying connective tissue in both skin and mucous membranes?
Rete pegs
What is a non-specific skin condition that develops as a consequence of chronic pruritus and scratching?
Lichen simplex chronicus
Microscopic findings consist of elongation, widening and irregular thickenings of rete ridges, acanthosis, hyperkeratosis and chronic inflammation in dermis.
Lichen simplex chronicus
What skin condition that often happens in other regions of the body, can also occur around the vulva in women of childbearing age?
Lichen planus
What is the microscopic appearance of lichen planus?
Degeneration of the basal cell layer
Thickening of the granular cell layer
Infiltration of inflamm cells into the sub-epithelial layer of CT
“Saw-tooth” appearance of rete pegs
What vulvar skin condition is associated with vulvar cancer?
Lichen sclerosus
What are the histological characteristics of lichen sclerosus?
Edematous degeneration of basal layer
Atrophy of epidermis w/disappearance of the rete pegs
Underlying dermis is replaced by dense collagenous fibrous tissue
Infiltrates of band-like lymphocytes
Bartholin’s duct cysts are lined by either of what two types of cells?
Transitional epithelium of the normal duct, or
Epithelium that reveals squamous metaplasia
What STI reveals multinucleated giant cells on microscopy?
Herpes simplex
What STI is spread via skin-to-skin contact and is a sub-type of HPV?
Condyloma acuminata (genital warts)
Which two types of HPV are responsible for 90% of genital wart cases?
6 & 11
Which two types of HPV are responsible for 70% of cases of cervical cancer?
16 & 18
What are the histological findings of condyloma acuminata?
Acanthosis
Hyperkeratosis
Cytoplasmic vacuolation
What is the spirochete bacterium that causes syphilis?
Treponema pallidum
What lesions are typical of secondary syphilis?
Condyloma latum (flat warts)
Which two conditions are associated with a fishy odor and a high vaginal pH?
Bacterial vaginosis
Trichomonas vaginitis
(Candida has no odor and low pH)
What condition sometimes has a cottage cheese appearance?
Candida vaginitis
What are epithelial cells that are coated with bacteria and are associated with bacterial vaginosis?
Clue cells
What condition is characterized by the presence of hyperpigmented skin plaques?
Vulvar intraepithelial neoplasia
Vulvar intraepithelial neoplasia is associated with was condition in 10-30% of cases?
Primary squamous neoplasm in either the vagina or cervix.
What is the histologic appearance of HPV positive VIN?
Diffuse cellular atypia
Nuclear crowding
Increased mitotic index
~85% of vulvar cancers are of what type?
Squamous cell carcinoma
What factors are linked to metastatic spread of vulvar carcinoma?
Size of primary tumor
Depth of invasion
Involvement of lymphatic vessels
Adenocarcinoma of the vagina is rare, but associated with clear cell carcinoma in what population?
Young women whose mothers had been treated with diethylstilbestrol during pregnancy
Cervical Intraepithelial Neoplasia has three classification. What are they?
CIN1 (LSIL)- mild dysplasia
CIN2 (HSIL)- moderate dysplasia
CIN3 (HSIL)- severe dysplasia and carcinoma in situ
What term is used to describe cellular changes in which cells nuclei are enlarged and often stain with a halo-like appearance?
Koilocytosis
Koilocytosis is characteristic of what condition?
Atypical squamous cells of undetermined significance ASC-US
What are the histologic findings with endocervical cancer?
Cluster of endocervical cancer cells with enlarged round or oval nuclei, irregular chromatin distribution and prominent nucleoli
What characterizes stage 1 cervical cancer?
Carcinoma confined to the cervix
What characterizes stage 2 cervical cancer?
Carcinoma extends beyond the cervix but not onto the pelvic wall (vagina, but not lower 1/3)
What characterizes stage 3 cervical cancer?
Carcinoma extended to pelvic wall. No space b/t tumor and pelvic wall on DRE
What characterizes stage 4 cervical cancer?
Carcinoma beyond true pelvis or mucosa of bladder/rectum. Metastatic dissemination also.
What is the primary characteristic feature of endometriosis?
Cells from the endometrial lining of the uterus appear and flourish outside the uterine cavity
What is the most common site of implantation for ectopic endometrial cells?
Ovaries
How is endometrioma different from endometriosis?
(chocolate cyst) is an ovarian cyst formed from endometrial tissue that bleeds within the ovary
What is adenomyosis?
The presence of ectopic endometrial tissue within the myometrium. “adenomyometritis” is specific to the uterus.
What is characteristic of acute endometritis?
Micro-abscesses or neutrophils within the endometrial glands
What is characteristic of chronic endometritis?
The presence of plasma cells in the stroma
What type of gynecologic cancers are most common in the US?
Endometrial
What is the most common type of endometrial cancer?
Adenocarcinoma
What are the risk factors for endometrial cancers?
Age 55-65 Nulliparity Obesity Hyperglycemia/DM Hypertension
What distinguishes carcinoma from hyperplasia?
In well differentiated endometrial adenocarcinoma, the glandular architecture is preserved but the tissue is confluent without intervening stroma
What condition is notable for the accumulation of p53 protein?
Papillary serous carcinoma
What are benign smooth muscle tumors of the uterus, also known as fibroids?
Leiomyomas
What is the microscopic appearance of leiomyomas?
Muscle cells generally uniform in size and shape with oval nuclei. Characteristic whorled pattern of smooth muscle
How does a leiomyosarcoma compare to a leiomyoma?
Greater density of cells
More pleomorphic
More hyperchromatic
What condition is the most commonly diagnosed causes of female infertility and one of the most common endocrine disorders?
Polycystic ovary syndrome
Polycystic ovaries can develop when the ovaries are stimulated to produce what?
Excessive amounts of male hormones by the release of excessive LH from the anterior pituitary.
What are common concomitants with PCOS?
Insulin resistance weight gain high cholesterol hyperglycemia DM
What are the principal lab findings with PCOS?
LH > FSH 3:1 or greater
elevated testosterone
estrogen dominance
80% of epithelial tumors of the ovaries are what type?
Serous (benign)
Serous tumors of the ovary are characterized by what?
Proliferation of epithelium resembling that seen in the lining of the fallopian tubes
What is the histologic appearance of a serous cystadenoma of the ovary?
Single layer of cuboidal or epithelial cells with or without cilia
What histologic finding is commonly found in ovarian serous cystadenocarcinoma, among other neoplasms?
Psammoma bodies
What is the most common birth defect of the male genitalia?
Cryptorchidism
Differentiate phimosis and paraphimosis. For what condition are they both a risk factor?
Phimosis - foreskin cannot fully retract
Para- foreskin is trapped behind the glans
Penile cancer
What condition is caused by defective valves or compression of the veins that drain the testis?
Varicocele
Which side does 98% of idiopathic varicocele occur on and why?
Left because the left testicular vein connects to the renal vein at a 90 degree angle.
What causes hydrocele?
Accumulation of fluids around a testicle caused by fluid secreted by the tunica vaginalis. It is often the result of trauma, hernia, orchitis, or cancer.
What is the most common underlying cause of testicular torsion?
A congenital malformation known as bell-clapper deformity. The testis is inadequately affixed to the spermatic cord.
What is the most common cause of non-gonococcal urethritis (NGU)?
Chlamydia trachomatis
How do you differentiate gonococcal from non-specific urethritis (NSU) or NGU?
Gonococcal has a purulent d/c, while others have a clear d/c
What condition is characterized by the triad of urethritis(M)/cervicitis(F), inflammation of the eyes, and inflammatory arthritis of large joints?
Reactive arthritis or Reiter’s syndrome
What condition is characterized by shallow painless ulcers at meatus and glans penis?
Balanitis circinata
What histologic finding is characteristic of HSV?
Multinucleated giant cell
What bacteria is responsible for syphilis?
Treponema pallidum (a spirochete bacterium)
What is a soft, non-cancerous growth resulting from the tertiary stage of syphilis?
Gumma
Around 95% of penile cancers are what type?
Squamous cell carcinomas
What HPV strain if the leading cause of HPV positive tumors?
16
What is the most common solid malignant tumor in men aged 20-35?
Primary testicular tumors
What is the most common classification of testicular cancer?
Seminoma (~35%)
What are the blood test findings of a seminoma case?
+placental alkaline phosphatase
+hCG
-alpha-fetoprotein
What is the microscopic appearance of a seminoma?
(lymphoid stroma) Sheet-like or lobular pattern of cells with a fibrous stromal network
Abundant clear to pale pink cytoplasm containing abundant glycogen with prominent nuclei that usually contain 1 or 2 large nucleoli and have prominent nuclear membranes
What is a germ cell tumor that occurs in the ovaries and testes causing hCG and AFP to be increased?
Embryonal carcinoma
What tumor presents microscopically with nuclear atypia, prominent nucleoli, nuclei overlap and mitoses common?
Embryonal carcinoma
What is the second most common cause of cancer related death in men in the US?
Prostate cancer
95% of prostate cancers are of what type?
Adenocarcinoma
At high magnification what is the appearance of prostate adenocarcinoma?
Still appear as glands, but there is no intervening stroma and the nuclei are hyperchromatic. Enlarged nucleoli and mitotic figures.
