Quiz 5: Female genitalia Flashcards by joy nauman

What virus causes molluscum contagiosum

Molluscum contagiosum virus (MCV)

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viral infection of the skin caused by DNA poxvirus

Molluscum contagiosum

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Which strain of MCV is sexually transmitted and often seen in adults

MCV-2

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Where does psoriasis usually occur?

on the hair-bearing portion

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Inflammatory dz characterized by red scaling plaques covered with a dense, silvery scale

psoriasis

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What is occurrence of new psoriatic lesions at the site of skin injury

Koebner phenomenon

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Ring of peripheral blanching skin around a psoriatic plaque

Woronoff’s ring

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Presence of bleeding points seen upon lifting of a psoriatic scale

Auspitz’s sign

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Marked hyperkeratosis with parakeratosis; loss of granular layer; epidermal acanthosis and notable elongation of the rete ridges or pegs; vascular dilation

psoriasis

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non specific skin condition that develops as a consequence of chronic pruritis and scratching.

Lichen simplex chronicus

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edematous degeneration of basal layer, atrophy of epidermis with disappearance of the rete pegs, underlying dermis is replaced by dense collagenous fibrous tissue, infiltrates of band-like lymphocytes

lichen sclerosus

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elongation, widening, and irregular thickening of rete ridges along with acanthosis, hyperkeratosis and chronic inflammation in the dermis.

Lichen simplex chronicus

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degeneration of the basal cell layer, thickening of the granular cell layer, infiltration of inflammatory cells into the sub-epithelial layer of connective tissue & development of a “saw tooth” appearance of the rete pegs

Lichen planus

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What is the pathognomonic feature of lichen planus

development of a “saw-tooth” appearance of the rete pegs

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Result from the obstruction of the duct, usu as a consequence of infx

Bartholin’s cysts

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condition of unknown etiology (mb autoimmune) that results in a thickening of the skin of the vulva and peri-anal area and increases risk for vulvar cancer

lichen sclerosus

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Occurs more often in children bearing age

lichen planus

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Relatively common. Causes inflammation and sometimes ulceration.

Lichen planus

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What is the predominant organism in the contents of a Bartholin cyst?

E. coli

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Thickened epidermis with leukocyte infiltration of the underlying dermis

lichen simplex chronicus

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What lines the cyst in a Bartholin’s cyst?

transitional epithelium of the normal duct or epithelium that reveals squamous metaplasia

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Multinucleated giant cells. Nuclei with ground-glass appearance. Nuclear inclusion bodies may occasionally be visualized. Extra large epidermal cells with multiple nuclei

HSV-genital herpes

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(4) bacterial STIs

chlamydia, gonorrhea, syphilis, chancroid

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(5) viral STIs

HSV, HIV, HPV, Hep B and C, MCV

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Fungal STI

yeast infx

(2) parasitic STIs

Lice, scabies

Protozoal STI

Trichomoniasis

Extremely painful shallow ulcers.

HSV- genital herpes

Condyloma acuminata

genital warts caused by HPV

Which strains of HPV cause 90% of genital warts?

HPV 6 and 11

Which strains of HPV cause 70% of cervical cancers?

HPV 16 and 18

Caused by the spirochete bacterium

syphilis (treponema pallidium)

spiral-shaped, gm-, highly mobile bacterium

spirochete bacterium

How does secondary syphilis manifest clinically?

perineal condyloma latum or flat warts.

What are the 3 most common infxs in order of prevalence?

bacterial vaginosis, candida vaginitis, trichomonas vaginitis

Which STIs can be transmitted via vertical transmission?

Syphilis, gonorrhea

What 2 vaginal infxs are commonly associated with high pH and fishy odor?

BV and trich

What vaginal ifx is associated with low pH and no odor?

Candida

What bacterium causes chlamydia

chlamydia trachomatis

One of the most common sexually transmitted ifx worldwide

chlamydia

What organism causes gonorrhea?

neisseria gonorrhoeae

Characterized by the presence of hyperpigmented skin plaques

Vulvar intraepithelial neoplasia (VIN)

10-20% VIN found in association with what?

primary squamous neoplasm in either vagina or cervix

nuclear atypia within epithelial cells and nuclei show pattern of increased mitoses and often seen crowded together.

VIN

90% of all cases of VIN found to contain what?

DNA of high risk strains of HPV- 16, 18, 31, 45

Most vulvar cancers are what?

Squamous cell carcinoma

15% vulvar cancers are what? (3)

Basal cell carcinoma, melanoma, adenocarcinoma

2/3 vulvar carcinoma occur in women in what age group?

Over 60

What are the 2 categories of vulvar cancer?

HPV or lichen sclerosus, squamous cell hyperplasia or no risk factor

Poorly differentiated vulvar carcinoma is typically (pos/neg) for HPV

positive

well differentiated, keratinizing vulvar carcinoma is typically (pos/neg) for HPV

negative

Tumors of the vulva often contain what?

Notable accumulation of p53 protein

Metastatic spread of vulvar carcinoma depends on what?

size of the tumor, depth of invasion, involvement of the lymph vessels

Which lymph nodes are commonly involved in vulvar carcinoma?

inguinal, pelvic, iliam, periaortic

Distant mets from vulvar carcinoma travel where?

lungs and liver

Vacuolated tumor cells in clusters and gland-like structures

clear cell adenocarcinomas of the vagina

clear cell adenocarcinoma in young women is associated with what?

Mothers who had been treated with diethylstillbestrol (DES) during pregnancy

What are classic findings in invasive adenocarcinoma of the endocervix?

Prominent or macronucleoli and tumor diathesis

Term used to describe cellular changes in which cells nuclei are enlarged and often stain with a halo-like appearance

Koilocyctosis

Usually composed of intermediate and superficial squamous cells of the vaginal epithelium

Koilocyctolic atypia

Koilocytosis is characteristic of ...

ASC-US

Where can adenocarcinoma arise from?

endocervix, endometrium, extrauterine sites

cluster of cells with large round or oval nuclei, irregular chromatin and prominent nucleoli, cytoplasm is poorly defined and finely vacuolated.

Endocervical carcinoma

Condition in which cells from the endometrial lining of the uterus appear and flourish outside the uterine cavity.

Endometriosis

Most common site of implantation of ectopic endometrial cells

ovaries

ovarian cyst that is formed as a consequence of ectopic endometrial tissue that bleeds within the ovary.

endometrioma (chocolate cyst)

Thick, muscular layer of the uterus

myometrium

presence of ectopic endometrial tissue within the myometrium

adenomyosis

Most common underlying causes of endometritis

retained placental fragments during childbirth, iatrogenic ifx during delivery, ifx following abortion

Non childbirth related cases of endometritis

PID

micro-abcesses or neuts within the endometrial glands

acute endometritis

plasma cells in the stroma

chronic endometritis

Characteristic for chronic endometritis

plasma cells in the stroma

Gold standard of endometritis dx

endometrial biopsy

Most common ifx agent in PID

bacteria

Most common serious infx of women 16-25

PID

Most common gynecologic cancers in US

endometrial cancer

Most common type of endometrial cancer

adenocarcinoma

Peak incidence of endometrial cancer

55-65

3rd most common cause of gynecologic cancer death

endometrial carcinoma

20% of all endometrial cancers resemble ....

serous carcinoma of the ovary

benign, smooth muscle tumors of the uterus

leiomyomas (fibroids)

Where are leiomyomas (fibroids) usually found?

myometrium of the corpus

What are the 3 classifications of fibroids?

intramural, submucosal, subserol

discrete, well-circumscribed tumors that are often round, firm, and when sectioned appear grey-white in color

fibroids

characteristic whorled pattern of smooth muscle. Muscle cells are generally uniform in size and shape with oval nuclei, scarce mitotic activity.

Leiomyoma (fibroids)

relatively uncommon malignant neoplasms that arise from the myometrium or endometrial stroma that is undergoing smooth muscle differentiation.

Leiomyosarcomas

Usu contain muscle cells that become spindle shaped. Several cells with inc mitotic figures

leiomyosarcomas

Common benign ovarian tumor

ovarian serous cysstadenoma

Superficial resemblance to the most common type of ovarian cancer

ovarian serous cystadenoma

Most common type of ovarian cancer

serous carcinoma of the ovary

Most ovarian cancers are classified as...

epithelial

Most notable mutated genes in ovarian cancer

BRCA 1 and BRCA 2

Form of dystrophic calcification that can be seen in neoplasms

Psammoma bodies

Where are psammoma bodies commonly seen?

papillary thyroid carcinoma, papillary renal cell carcinoma, ovarian papillary serous cystadenocarcinoma, meningioma, mesothelioma, prolactinoma of the pituitary

Most common tissue element in the teratoma

skin

What type of teratomas are more worrisome because they are more aggresive

immature

Dermoid cysts

immature teratomas