Quiz 5: Female genitalia Flashcards
What virus causes molluscum contagiosum
Molluscum contagiosum virus (MCV)
viral infection of the skin caused by DNA poxvirus
Molluscum contagiosum
Which strain of MCV is sexually transmitted and often seen in adults
MCV-2
Where does psoriasis usually occur?
on the hair-bearing portion
Inflammatory dz characterized by red scaling plaques covered with a dense, silvery scale
psoriasis
What is occurrence of new psoriatic lesions at the site of skin injury
Koebner phenomenon
Ring of peripheral blanching skin around a psoriatic plaque
Woronoff’s ring
Presence of bleeding points seen upon lifting of a psoriatic scale
Auspitz’s sign
Marked hyperkeratosis with parakeratosis; loss of granular layer; epidermal acanthosis and notable elongation of the rete ridges or pegs; vascular dilation
psoriasis
non specific skin condition that develops as a consequence of chronic pruritis and scratching.
Lichen simplex chronicus
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
elongation, widening, and irregular thickening of rete ridges along with acanthosis, hyperkeratosis and chronic inflammation in the dermis.
Lichen simplex chronicus
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
What is the pathognomonic feature of lichen planus
development of a “saw-tooth” appearance of the rete pegs
Result from the obstruction of the duct, usu as a consequence of infx
Bartholin’s cysts
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
Occurs more often in children bearing age
lichen planus
Relatively common. Causes inflammation and sometimes ulceration.
Lichen planus
What is the predominant organism in the contents of a Bartholin cyst?
E. coli
Thickened epidermis with leukocyte infiltration of the underlying dermis
lichen simplex chronicus
What lines the cyst in a Bartholin’s cyst?
transitional epithelium of the normal duct or epithelium that reveals squamous metaplasia
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
(4) bacterial STIs
chlamydia, gonorrhea, syphilis, chancroid
(5) viral STIs
HSV, HIV, HPV, Hep B and C, MCV
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
