Repro Pathology Flashcards
(306 cards)
1
Q
How does an endometrial polyp presnt?
A
Abnormal uterine bleeding
2
Q
paget disease of the breast
A
Ductal carcinoma in situ that extendsup the ducts to involve the skin of the nipple
3
Q
How does a bartholin cyst present?
A
unilateral, painful cystic lesion at the lower vestibule adjacent to the vaginal canal
4
Q
Where does prostate adenocarcinoma metastizes to? What is the effect of this?
A
Spread to lumbar spine or pelvis; results in osteoblastic metastases that present as low back pain and increased serum alkaline phosphatase, PSA, and prostatic acid phosphatase (PAP)
5
Q
how does extramammmary paget disease present?
A
Erythematous, pruritic, ulcerated vulvar skin
6
Q
How do granulosa-theca cell tumors present?
A
With signs of estrogen excess
- Prior to puberty- precocious puberty
- Reproductive age- Menorrhagia or metrorrhagia
- Postmenopause- Endometrial hyperplasia with postmenopausal uterine bleeding
7
Q
How is ductal carcinoma in situ detected?
A
As calcification on mmamography
NOTE: mammographic calcifications can also be associated with benign conditions such as fibrocytstic changes (especially sclerosing adenosis) and fat necrosis
8
Q
Most common benign neoplasm of the breast
A
Fibroadenoma
9
Q
Histo of testicular yolk sac tumor
A
Schiller-Duval bodies
10
Q
How does lichen sclerosis present histologically?
A
Characterized by thinning of the epidermis and fibrosis of the dermis
11
Q
What are prostatic secretions in chronic prostatitis?
A
WBCs, but cultures are negative
12
Q
High levels of circulating estrone increases risk for _______.
A
Endometrial carcinoma
13
Q
Lymphogranuloma venerum
A
Necrotizing granulomatous inflammation of the inguinal lymphatics and lymph nodes
14
Q
Condyloma acuminatum
A
Benign warty growth on genital of skin
*Due to HPV type 6 or 11
15
Q
Possible complications of DES-associated vaginal adenosis
A
Clear cell adenocarcinoma
16
Q
Hydrocele
A
Fluid collection within the tunica vaginalis
17
Q
Causes of orchitis
A
- Chlamydia trachomatis (serotypes D-K) or Neisseria gonorrhoeae
- E. Coli and Pseudomonas
- Mumps virus
- Autoimmune orchitis
18
Q
What is the function of PSA?
A
made by prostatic glands and liquefies semen
19
Q
Growth of the endometrium is __________ driven.
A
Estrogen
*Proliferative phase
20
Q
Causes of spontaneous abortion
A
- Chromosomal anomalies (especially trisomy 16)
- Hypercoagulable states (antiphospholipid syndrome)
- Congenital infection
- Expsure to teratogens
21
Q
Demographic for leiomyosarcoma
A
Postmenopausal women
22
Q
Upper 2/3 of the vagina is derived from_______
A
Mullerian ducts
23
Q
Do patients with fibrosis, cysts or apocrine metaplasia of the breast have an increased risk for invasive carcinome?
A
No
24
Q
Phyllodes tumor
A
Fibroadenoma-like tumor with overgrowth of the fibrous component
25
Risk factors for hyperplastic endometrial carcinoma
Related to estrogen exposure
* early menarche/ late menopause
* Nulliparity
* Infertility with anovulatory cycles
* Obesity
26
Do patients with ductal hyperplasia or sclerosing adenosis of the breast have an increased risk for invasive carcinome?
Yes. 2X the risk
27
How is endometrial hyperplasia classified histologically?
Based on architectural growth pattern (simple or complex) and the presence or absence of cellular atypia
28
Two most common subtypes of surface epithelial tumors are _________ and \_\_\_\_\_\_\_\_. What are the characteristics of each?.
Serous: Full of watery fluid
Mucinous: Full of mucus-like fluid
\*Both are usually cystic
29
Trastuzumab
A designer antibody directed against the HER2 receptor; HER2/neu is a growth factor receptor present on the cell surface
30
How does endometrial hyperplasia present?
Postmenopausal uterine bleeding
31
What drugs can be used to treat prostate adenocarcinoma?
* Leuprolide (GnRH analog)
* Continuous GnRH analogs shut down the anterior pituitary gonadotrophs (LH and FSH are reduced)
* Flutamide
* Competitive inhibitor at the androgen receptor
32
Most common demographic for lichen sclerosis
Postmenopausal women; possible autoimmune etiology
33
Most likely cause of endometriosis
Retrograde menstruation with implantation at an ectopic site
34
Shedding occurs with loss of __________ support.
Progesterone
\*Menstrual phase
35
How do surface epithelial tumors usually present?
Late with vague abdominal symptoms (pain and fullness) or signs of compression (urinary frquency)
36
Composition of dysgerminoma
Large cells with clear cytoplasm and central nuclei
37
Ductal carcinoma in situ
Malignant proliferation of cells in ducts with no invasion of the nasement membrane
38
Classic presentation of polycystic ovarian disease
Obese young woman with infertility, oligomenorrhea, and hirsutism
**NOTE:** Some patients have insulin resistance and may develop type II diabeters mellitus 10-15 yrs later
39
Histo: hyperplastic endometrial carcinoma
Endometrioid (normal endometrium-like)
40
Malignant tumor composed of cytotrophoblasts and syncytiotrophoblasts
Choriocarcinoma
41
Demographic for mammary duct extasia
Multiparous postmenopausal women
42
Endocervix is lined by
A single layer of columnar cells
43
What is the testicular counterpart of a dysgerminoma?
Seminoma
44
How does placental abruption present?
Third-trimester bleeding and fetal insufficiency
45
Most common ovarian tumor
Surface epithelial tumor
46
What conditions are associated with sertoli-leydig cell tumors
Virilization and hirtsuitism
47
Biopsy of breast fat necrosis
Necrotic fat with associated calcifications and giant cells
48
Risk factors for squamous cell carcinoma of penis
High risk HPV
Lack of circumcision
* Foreskin acts as a nidus for inflammation and irritation if not properly maintained
49
Demographic for cervical carcinoma
Middle-aged women (40-50)
50
\_\_\_\_\_\_\_\_\_\_\_\_\_\_ is a metastatic tumor that involves both ovaries.
Krukenberg tumor
51
Endometrial glands and stroma outside of the uterine endometrial lining
Endometriosis
52
Biopsy of phyllodes tumor
"Leaf-like" projections
53
Teratogenic effects of alcohol
mental retardation
Facial abnormalities
Microcephaly
54
Acute mastitis is associated with \_\_\_\_\_\_\_\_\_.
Breast feeding
\*Fissures develop in the nipple providing a route of entry for microbes
55
Causes of galactorrhea
* Nipple stimulation
* Prolactinoma of the anterior pituitary
* Drugs
56
Histo: Leiomyosarcoma
Necrosis, mitotic activity, and cellular atypia
57
Gross view of leiomyoma
Multiple, well-defined, white, whorled masses that may distort the uterus and impinge on pelvic structures
58
\_\_\_\_\_\_\_\_\_ gland is present on each side of the vaginal canal and produces mucus-like fluid that drains via ducts into the lower vestibule.
Bartholin
59
prostate adenocarcinoma screening begins at the age of 50 with _______ and \_\_\_\_\_\_\_.
DRE; PSA
60
\_\_\_\_\_\_\_\_\_\_\_ is massive amounts of mucus in the peritoneum.
Psudomyxoma peritonei
61
Subtypes of surface epithelial tumors
Serous (common)
Mucinous (common)
Endometriod
Brenner tumor
62
Ultrasound of hydatidiform mole
Fetal heart sounds are absent, and a "snowstorm" appearance is classically seen on ultrasound
63
Where does does vaginal carcinoma go when spread to regional lymph nodes?
* Cancer from the lower 13 of vagina goes to the inguinal nodes
* Cancer from the upper 2/3 goes to regional iliac nodes
64
Which subtype of invasive ductal carcinoma has increased incidence in BRCA1 carriers?
medullar carcinoma
65
bowen disease
In situ carcinoma of the penile shaft or scrotum that presents as leukoplasia
66
Why are testicular tumors usually not biopsied? How are they removed?
Usually not biopsied due to risk of seeding the scrotum; removed via radical orchiectomy
67
Meigs syndrome
Fibroma of ovaries
Pleural Effusion
Ascites
68
What are most important predictive factors to response to treatment for breast cancer?
Estrogen receptor
Progesterone receptor
HER2/neu gene amplification
69
Tumors associated with BRCA2 mutatuons
Breast carcinoma in males
70
Characteristics of cystadenomas
* Composed of a single cyst with a simple, flat lining
* Most commonly arise in premenopausal women
71
Other than the ovary, where else does endometriosis occur and what are the presenting signs at each site?
* **Uterine ligaments:** Pelvic pain
* **Pouch of Douglas:** pain with defecation
* **Bladder wall:** Pain with urination
* **Bowel serosa:** Abdominal pain and adhesions
* **Fallopian tube mucosa:** Scarring increases risk for ectopic tubal pregnancy
\*Implants classically appear as yellow-brown 'gun powder' nodules
72
Placental abruption is a common cause of \_\_\_\_\_\_.
Still birth
73
How does a hydrocele present?
Scrotal swelling that can be transilluminated
74
Teratogenic effects of phenytoin
Digit hypoplasia and cleft lip/palate
75
Demographic for testicular germ cell tumors
15-40 yrs
76
Embryonal carcinoma of testicles
A malignant tumor comprised of immature, primitive cells that may produce glands
77
Placental abruption
Separation of placenta from the decidua prior to delivery of the fetus
78
Do patients with atypical hyperplasia of the breast have an increased risk for invasive carcinome?
Yes. 5X
79
What are some precursor in situ lesions for squamous cell carcinoma?
Bowen disease
Erythroplasia of queyrat
Bowenoid papulosis
80
Average age of presentation for hyperplastic endometrial carcinoma
60 yrs
81
True or false. Ductal carcinoma in situ produces a mass.
False
82
Demographic for germ cell tumors
Women of reproductive age
83
\_\_\_\_\_\_\_\_\_\_\_\_\_ cells are necessary for the diagnosis of chronic endometritis. Why?
Plasma cells given that lymphocytes are normally found in the endometrium
84
What serum markers may be elevated in embryonal carcinoma of testes?
AFP or B-hCG
85
Exocervix is lined by \_\_\_\_\_\_\_\_\_\_\_
Nonkeratinizing squamous epithelium
86
\_\_\_\_\_\_\_\_ is a useful serum market to monitor treatment response and screen for recurrence of surface epithelial tumors.
CA-125
87
Biopsy: Lobular carcinoma in situ
Dyscohesive cells lacking E-cadherin adhesion proteins. Often multifocal and bilateral
88
How does embryonal rhabdomyosarcoma?
Bleeding and a grape-like mass protruding from the vagina or penis of a child
89
Differentiate seminomas and nonseminomas
Seminomas
* Highly responsive to radiotherapy, metastasize late, and have an excellent prognosis
Nonseminoms
* Show variable response to treatment and often metastasize early
90
Fetal tissue, villous edema, trophoblastic proliferation, and risk for choriocarcinoma in _partial mole_
**Fetal tissue:** Present
**Villous edema:** Some villi are hydropic, and some are normal
**Trophoblastic proliferation:** Focal proliferation present around hydropic villi
**Risk for choriocarcinoma:** Minimal
91
\_\_\_\_\_\_\_ acts of theca cells to induce androgen production.
LH
92
Teratogenic effects of cigarette smoke
Intrauterine growth retardation
93
What serum marker may be elevated with a dysgerminoma?
LDH
94
Inflammation of the subareolar ducts
Periductal mastitis
95
Function of prostate
Secrete alkaline, milky fluid that is added to sperm and seminal vesicle fluid to make semen
96
How does a varicocele present?
Scrotal swelling with a "bag of worms" appearance
97
Functional unit of ovary
Follicle
98
Teratogenic effects of thalidomide
Limb defects
99
Biopsy: Invasive ductal carcinoma
Duct-like structures in a desmoplastic stroma
100
Epispadias
Opening of urethra on superior surface of penis
101
Gross appearance of embryonal carcinomas of the testicles
Hemorrhagic mass with necrosis
102
Location: BPH
Central periurethral zone of the prostate
103
Subtypes of invasive ductal carcinoma. What the characteristics of each?
* **Tubular carcinoma**
* Well-differentiated tubules that lake myoepithelial cells; relatively good prognosis
* **Mucinous carcinoma**
* Carcinoma with abundant extracellular mucin ("tumor cells floating in a mucus pool")
* Older women
* Relatively good prognosis
* **medullary carcinoma**
* ****large, high grade cells growing in sheets with associated lymphoctes and plasma cells
* Can mimic fibroadenoma
* Relatively good prognosis
* Increased incidence in BRCA1 carriers
* **Inflammatory carcinoma**
* ****Carcinoma in dermal lymphatics
* Poor prognosis
104
HER/neu amplification is associated with response to \_\_\_\_\_\_\_\_\_\_.
Trastuzumab (herceptin)
105
How is the comedo subtyoe of ductal carcinoma in situ characterized?
High-grade cells with necrosis and dystrophic calcification in the center of ducts
106
Treatment for lobular carcinoma in situ
Tamoxifen (to reduce the risk of subsequent carcinoma) and close follow
107
Complete mole
Empty ovum fertilized by two sperm (or one sperm that duplicates chromosomes); 46 chromosomes
108
How does acute mastitis present?
As an erythematous breast with purulent nipple discharge; may progress to abscess formation
109
Gross appearance of seminoma
Homogeneous mass with no hemorrhage or necrosis
110
Lichen sclerosis is beign, but associated with a slightly increased risk for \_\_\_\_\_\_\_\_\_\_.
Sqaumous cell carcinoma
111
Major complications of ectopic pregnancy
Bleeding into fallopian tube (hematosalpinx) and rupture
112
Benign tumor of fibroblasts
Fibroma
113
Histo of extramammary paget disease
Malignant epithelial cells in the epidermis of the vulva
114
Clinical features of BPH
* Problems starting and stopping urine stream
* Impaired bladder emptying with increased risk of infection and hydronephrosis
* Dribbling
* Hypertrophy of bladder wall smooth muscle; increased risk for bladder diverticula
* Microscopic hematuria may be present
* PSA is slightly elevated due to increased # of glands
115
How is intraductal papilloma differentiated papillary carcinoma?
Papillary carcinoma is characterized by fibrovascular projections lined by epithelial cells _without_ _underlying myoepithelial._ Papillary carcinoma is also seen most commonly in _post menopausal women_
116
Pathogenesis of BPH
1. Testosterone is converted to DHT by 5a-reductase in stromal cells
2. DHT acts on the androgen receptor of stromal and epithelial cells resulting in hyperplastic nodules
117
Hydrocele is associated with incomplete closure of the \_\_\_\_\_\_\_\_\_\_\_. What is the result of this?
Processus vaginalis; leads to communication with the peritoneal cavity (infants) or blockage of lymphatic drainage (adults)
118
How does endometrial carcinoma present?
Postmenopausal bleeding
119
Abnormal conception characterized by swollen and edematous villi with proliferation of trophoblasts
Hydatidiform mole
120
How does periductal mastitis present?
Subareolar mass with nipple retraction
121
Components of a follicle
Ooctye surrounded by granulosa and theca cells
122
partial mole
Normal ovum fertilized by two sperm (or one sperm that duplicates chromosomes); 69 chromosomes
123
Vulvar intraepithleial neoplasia
* Koilocytic change
* Disordered cellular maturation
* Nuclear atypia
* Increased mitotic activity
124
How does lichen simplex chronicus presnt?
Leukoplakia with thick, leathery vulvar skin
125
Another name doe leiomyoma
Fibroids
126
Tumors associated with BRCA1 mutatuons
Breast and ovarian carcinoma
127
How does fibrocystic change of the breast present?
Vague irregularity of the breast tissue, usually in the upper outer quadrant
128
Clinical feautures of hereditary breast cancer
* Multiple first-degree relatives with breast cancer
* Tumor at an early age
* Multiple tumors in a single patient
129
Eclampsia
Preeclampsia with seizures
130
Most common malignant germ cell tumor
Dysgerminoma
131
Erythroplasia of Queyrat
In situ carcinoma on the glans that presents as erythroplakia
132
Aside from treating BPH 5 a- reductase inhibitors have what use?
Treat male pattern baldness
133
Cervical intraepithelial neoplasia II
Involves \<2/3 of the thickness of the epithelium
134
Serum _______ is high in choriocarcinoma
B-hCG
135
Demographic for non HPV related vulvular carcinoma
Elderly women \>70
136
Histo: Endodermal sinus tumor
Schiller- Duval bodies (glomerulus-like structures)
137
An endometrial polyp can arise as a side effect of what drug?
Tamoxifen, which has anti-estrogenic effects on the breast but weak pro-estrogenic effects on the endometrium
138
What is the most important preictor for progression to carcinoma from endometrial hyperplasia?
The presence of atypia
139
Characteristics of cystadenocarcinomas
* Composed of complex cysts with a thick, shaggy lining
* Most commonly arise in postmenopausal women
140
Presence of estrogen and progesterone receptors is associated with response to \_\_\_\_\_\_\_\_\_\_.
Antiestrogenic agents (like tamoxifen)
141
Prognosis for seminomas
Good prognosis; responds to radiotherapy
142
Effects of orchitis due to Chlamydia or Gonorrhoea. Demographic
Seen in young adults. Increased risk of sterility, but libido is not affected because Leydig cells are spared
143
Cervical intraepithelial neoplasia is divided into grades based on...
The extent of epithelial involvement by immature dysplastic cells
144
Why are varicocele usually left sided?
Left testicular vein drains into the left renal vein, while the right testicular vein drains directly into the IVC.
\*Associated with RCC
145
Histo of embryonal rhabdomyosarcoma
Rhabdomyoblast exhibits cytoplasmic cross-striations and positive immunohistochemical staining for desmin and myogenin
146
Effects of orchitis due to E. Coli and Pseudomonas. Demographic?
Seen in older adults; urinary tract infection pathogens spread into the reproductive tract
147
\_\_\_\_\_\_\_\_ is a serous membrane that covers the testicle as well as the internal surface of the scrotum.
Tunica vaginalis
148
In what circumstances does estrogen go unopposed?
Obesity
Polycystic ovary syndrome
Estrogen replacement
149
How does chronic prostatitis present?
Dysuria with pelvic or low back pain
150
Coelomic epithelium embryologically produces the epithelial lining of which 3 structures?
Fallopian tube
Endometrium
Endocervix
151
Cause of pseudomyxoma peritonei
Due to mcinous tumor of the appendix, usually with metastasis to the ovary
152
Result of leydig cell tumor in males
Precocious puberty in children or gynecomastia in adults
**NOTE:** Characteristic Reinke crystals may be seen on histo
153
Gross of appearance of cyst in breast
Blue dome
154
Prognosis of choriocarcinoma
Poor response to chemotherapy
155
How does mammary duct ectasia present?
Periareolar mass with green-brown nipple discharge
**NOTE:** Chronic inflammation with plasma cells is seen on biopsy
156
How does invasive ductal carcinoma presnt?
As a mass detected by phyical exam or by mammography
157
Where is the highest density of breast tissue found?
Upper outer quadrant
158
Risk factors for leomyoma
Related to estrogen exposure
* Common in premenopausal women
* Often multiple
* Enlarge during pregnancy; shrink after menopause
159
Malignant proliferation of smooth muscle arising from the myometrium
Leiomyosarcoma
160
Risk factors for sudden infant death syndrome
Sleeping on stomach
Exposure to cigarette smoke
Prematurity
161
How does lichen sclerosis present?
White patch (leukoplakia) with parchment-like vulvar skin
162
How does acute prostatitis present?
Dysuria with fever and chills
163
After ovulation, the residual follicle becomes a \_\_\_\_\_\_\_\_, which primarily secretes \_\_\_\_\_\_.
Corpus luteum; progesterone
**NOTE:** This drives the secretory phase which prepares the endometrium for a possible pregnancy
164
Fetal tissue, villous edema, trophoblastic proliferation, and risk for choriocarcinoma in _complete mole_
**Fetal tissue:** Absent
**Villous edema:** Most villi are hydropic
**Trophoblastic proliferation:** Diffuse, circumferential proliferation present around hydropic villi
**Risk for choriocarcinoma:** 2-3%
165
Most common testicular tumor in children
Yolk sac (endodermal sinus) tumor
166
Autoimmune orchitis
Characterized by granulomas involving the seminiferous tubules
167
True of false. There is an increased risk of carcinoma at the site of endometriosis.
True. Especially at the ovary
168
\_\_\_\_\_\_\_\_\_ is a teratoma composed primarily of thyroid tissue.
Struma ovarii
169
Subtypes of germ cell tumors. What tissue type is mimiced by each?
* Cystic teratoma and embryonal carcinoma
* Fetal tissue
* Dysgerminoma
* Oocytes
* Endodermal sinus tumor
* Yolk sac
* Choriocarcinoma
* Placental tissue
170
Cause of preeclampsia
Due to abnormality of the maternal-fetal vascular interface in the placenta; resolves with delivery
171
Preparation of the endometrium for implantation is ________ driven.
Progesterone driven
\*secretory phase
172
HELLP
Preeclampsia with thrombotic microangiopathy involving the liver
* Hemolysis
* Elevated liver enzymes
* Low platelets
173
What bug causes lymphogranuloma venereum?
Chlamydia trachomatis (serotypes L1-L3)
174
Treatment for BPH
a1-antagonist
5a-reductase inhibitor
**NOTE:** a1A selective antagonists (tamsulosin) are used in normotensive individuals
175
Demographic of phyllodes tumor
Postmenopausal women
176
True or false. There is no increased risk of cancer in cases of benign prostatic hyperplasia.
True
177
Lower 1/3 of vagina is derived from \_\_\_\_\_\_\_\_\_\_\_.
Urogenital sinus
178
Intraductal papilloma
Papillary growth, usually into a large duct
179
How do testicular tumors presnt?
Firm, painless testicular mass that cannot be transilluminated
180
Focal persistence of columnar epitelium in the upper vagina
Adenosis
\*During development, squamous epithelium from the lower 1/3 of the vagina grows upward to replace the columar eputhelium lining of the upper 2/3 of the vagina
181
Preeclampsia
Pregnancy induced HTN, proteinuria, and edema, usually arising in the third trimester
**NOTE:** HTN may be severe, leading to headaches and visual abnormalties
182
Most common cause of krunkenberg tumor
Metastatic gastric carcinoma (diffuse type)
183
Increased incidence of adenosis in females who were exposed to ________ in utero.
Diethylstilbestrol (DES)
184
Components of prostate
* Glands and stroma
* Glands are composed of an inner layer of luminal cells and an outer layer of basal cells
**NOTE:** Glands and stroma are maintained by androgens
185
Average age of presentation for sporadic endometrial carcinoma
70
186
How does acute endometritis present?
Fever, abnormal uterine bleeding, and pelvic pain
187
How does a hydatidiform mole present?
Presents in second trimester as passage of grape-like masses through the vaginal canal
188
Junction between the exocervix and endocervix is called the \_\_\_\_\_\_\_\_\_\_\_\_\_.
Transformation zone
189
What two layers of epithelium line lobules and ducts in breast?
Luminal cell layer
* Inner cell layer lining the ducts and lobules; responsible for milk production in the lobules
Myoepithelial cell layer
* Outer layer lining ducts and lobules; contractile function propels milk towards the nipple
190
Failure of testicle to descend into the scrotal sac
Cryptorchidism
191
How does leiomyoma present?
Usually asymptomatic; when present, symptoms: abnormal uterine bleeding, infertility, and a pelvic mass
192
Fibroadenoma
Tumor of fibrous tissue and glands
193
Components of sertoli-leydig cell tumor
Composed of sertoli cells that form tubules and Leydig cells (between tubules) with characteristic Reinke crystals
194
invasive lobular carcinoma
Invasive carcinoma that characteristically grows in a single-file pattern; cells may exhibit signet-ring morphology
\*No ductal formation due to lack of E-cadherin
195
Prognosis of dysgerminoma
Good prognosis; responds to radiotherapy
196
Types of sex cord-stromal tumors
Granulosa-theca cell
Sertoli-Leydig cell
Fibroma
197
True or false. paget disease of the breast is almost never associated with an underlying carcinoma.
False. It's almost always associated with an underyling carcinoma
198
Malignant proliferation of endometril glands
Endometrial carcinoma
199
Effects of teratogens
* First 2 weeks of gestation- spontaneous abortion
* Weeks 3-8- Risk of organ malformation
* Months 3-9- risk of organ hypoplasia
200
Estradiol surge induces an LH surge, which leads to \_\_\_\_\_\_\_.
Ovulation
**NOTE:** This marks the beginning of the secretory phase of the endometrial cycle.
201
Bowenoid papilosis
* In situ carcinoma that presents with multiple reddish papules
* Seen in younger patients relative to Bowen disease and erythroplasia of Queyrat
* Does not progress to invasive carcinoma
202
How does endometriosis present?
Dysmenorrhea (pain during menstruation) and pelvic pain
\*May cause infertility
203
Risk factors for cervical carcinoma
High-risk HPV infection
Smoking
Immunodeficiency
\*Cervical carcinoma is an AIDS-defining illness
204
What are the two distinct pathways of endometrial carcinoma?
Hyperplasia (75%) and sporadic (25%)
205
Histo of chronic endometritis
Lymphocytes and plasma cells
206
Causes of acute prostatitis
Chlamydia and Gonorrheoeae- young adults
E. Coli and Pseudomonas- Older adults
207
Biopsy of prostate adenocarcinoma
Small, invasive glands with prominent nucleoli
208
Cause of acute endometritis
Usually due to retained products of conception; retained products act as a nidus for infection
209
Teratogenic effects of cocaine
Intrauterine growth retardation
Placental abruption
210
What may result from the elevated B-hCG seen in choriocarcinomas? Why?
Hyperthyroidism or gynecomastia (a-subunit of hCG is similar to that of FSH, LH, and TSH)
211
Cause of testicular torsion
Usually due to congenital failure of testes to attach to the inner lining of the scrotum (via the processus vaginalis)
212
What bug usually causes acute mastitis?
S. Aureus
213
Male breast cancer is associated with _______ and \_\_\_\_\_\_\_\_.
BRCA2 mutations and Klinefelter syndrome
214
Cervical intraepithelial neoplasia III
Involves slightly less than the entire thickness of the epithelium
215
Cervical intraepithelial neoplasia I
Involves \<1/3 of the thickness of the epithelium
216
Treatment for acute mastitis
Continued drainage (feeding)
Antibiotics (dicloxacillin)
217
Lobular carcinoma in situ
Malignant proliferation of cells in lobules with no invasion of the basement membrane
218
Most common cause of testicular mass in males \>60
lymphoma; often bilateral
\*Usually of diffuse large B- cell type
219
Vaginal carcinoma is usually related to _______ HPV.
High-risk
220
Regenerative layer of endometrium
Basalis
221
Embryonal rhabdomyosarcoma a.k.a \_\_\_\_\_\_\_\_\_\_\_.
Sarcoma botyroides
222
Serum _______ is often elevated in endodermal sinus tumors.
AFP
223
Demographic of fibroadenoma
Premenopausal women
\*Estrogen sensitive
224
Function of lobules in the breast
Make milk that drains via ducts to the mipple
225
Key risk factor for ectopic pregnancy
Scarring (secondary to pelvic inflammatory disease or endometriosis)
226
Teratogenic effects of isotretinoin
Spontaneous abortion
Hearing and visual impairment
227
Benign surface epithelial tumors
Cystadenomas
228
presentation of spontaneous abortion
Vaginal bleeding
Cramp-like pain
Passage of fetal tissues
229
presentation of intraductal papilloma
Bloody nipple discharge in a premenopausal woman
230
Most common site for endometriosis
Ovary, which commonly results in formation of a chocolate cyst
231
Where does prostate adenocarcinoma usually arise? What result does this have?
usually arises in the peripheral, posterior region of the prostate, and hence, does not produce urinary symptoms early on
232
What serum markers may be high with seminomas?
B-hCG
233
Prognosis for surface epithelial tumors?
Generally poor
234
Most common germ cell tumor in children
Endodermal sinus tumor
235
Brenner tumors
Composed of bladder-like epithelium and are usually benign
236
Result of lymphogranuloma venereum
Eventually heals with fibrosis; perianal involvement may result in rectal stricture
237
Cause of hypospadias
Failure of the urethral folds to close
238
Prognosis of embryonal carcinoma of testicles
* Aggressive with early hematogenous spread
* Chemotherapy may result in differentiation into another type of germ cell tumor
239
Demographic for HPV related vulvuvar carcinoma
Women of reproductive age
240
Hormonal characteristics of polycystic ovarian disease
Increased LH and low FSH
241
Hypospadias
Opening of urethra on inferior surface of penis
242
How does paget disease of the breast present?
Nipple ulceration and erythema
243
Presentation of ectopic pregnancy
Lower quadrant abdominal pain a few weeks after a missed period
244
bacterial infection of the breast
Acute mastitis
245
Varicocele
Dilation of the spermatic vein due to impaired drainage
246
Complications of cryptorchidism
Testicular atrophy with infertility and increased risk for seminoma
247
\_\_\_\_\_\_\_\_ stimulates granulosa cells to convert androgen to estradiol.
FSH
**NOTE:** This drives the proliferative phase of the endometrial cycle
248
Types of germ cell tumors
Seminoma and nonseminoma
249
How does placenta previa present?
Third-trimester bleeding
\*Oftern requires delivery of fetus by C section
250
Functional unit of the breast
Terminal duct lobular unit
251
Risk factors for breast cancer
Related to estrogen exposure
* Female gender
* Age
* Early menarche/ late menopause
* Obesity
* Atypical hyperplasia
* First-degree relative with breast cancer
252
How does chronic endometritis present?
Abnormal uterine bleeding, pain, and infertility
253
How does testicular torsion present?
Presents in adolescents with sudden testicular pain and absent cremasteric reflex
254
Most common histological subtype of breast cancer in males
Invasive ductal carcinoma
255
True or false. Leiomyosarcomas arise from leiomyomas
False
256
Causes of chronic endometritis?
* Retained products of conception
* Chronic pelvic inflammatory disease
* IUD
* TB
257
Risk factors for prostate adenocarcinoma
Age, race, and diet high in saturated fats
258
periductal mastitis is usually seen in \_\_\_\_\_\_\_. Why?
Smokers
* Relative vitamin A deficiency results in squamous metaplasia of lactiferous ducts, producing duct blockage and inflammation
259
placenta accreta
Improper implantation of placenta into the myometrium with little or no intrevening decidua
260
What conditions are associated with fibromas
Pleural effusions and ascites (Meigs syndrome)
261
Endometrial hyperplasia occurs as a consequence of..
Unpposed estrogen
262
malignant surface epithelial tumors
Cystadenocarcinoma
263
How does cervical carcinoma present?
Vaginal bleeding, especially postcoital bleeding, or cervical discharge
264
What is the result of an anovulatory cycle?
An estrogen-driven proliferative phase without a subsequent progesterone-drien secretory phase
* Proliferative glands break down and shed resulting in uterine bleeding
265
Benign neoplastic proliferation of smooth muscle arising from myometrium
Leiomyoma (fibroids)
266
How is high-grade dysplasia characterized on a pap smear?
By cells with hyperchromatic (dark\_ nuclei and high nuclear to cytoplasmic ratios
267
Testicular torsion
Twisting of the spermatic cord; thin-walled veins become obstructed leading to congestion and hemorrhagic infarction
268
How does placenta accreta present?
Difficult delivery of the placenta and postpartum bleeding
\*often requires a hysterectomy
269
True or false. Villi are absent in choriocarcinomas.
True
270
Effects of orchitis due to mumps Demographic
Teenage males. Increased risk for infertility
**NOTE:** testicular inflammation is usually not seen in children \<10 yrs old
271
Histo of intraductal papilloma
Characterized by fibrovascular projections lined by epithelial (luminal) and myoepithelial cells
272
Histo: Sporadic endometrial carcinoma
Serous and characterized by papillary structures with psammoma body formation
273
most common type of invasive carcinoma in the breast
invasive ductal carcinoma
274
Malignant tumor that mimics the yolk sac
Endodermal sinus tumor
275
Seminoma
Malignant tymor comprised of large cells with clear cytoplasm and central nuclei (resemble spermatogonia)
276
mammary duct extasia
Inflammation with dilaton of the subareolar ducts
277
Surface epithelial tumors are derived from __________ that lines the ovary.
Coelomic epithelium
278
Mucosa of the vagina is lined by \_\_\_\_\_\_\_\_\_\_
Non-keratinizing squamous epithelium
279
The vulva is lined by __________ epithelium.
Squamous
280
Placenta previa
Implantation of the placenta in the lower uterine segment; Placenta overlies cervical os
281
Gross exam: Leiomyosarcoma
Single lesion with areas of necrosis and hemorrhage
282
Pathogenesis of polycystic ovarian diseas
1. Increased LH induces excess androgen production resulting in hirsutism
2. Androgen is converted to estrone in adipose tissue
3. Estrone feedback decreases FSH resulting in cystic degeneration of follicles
283
Histology of lichen simplex chronicus
Hyperplasia of the vulvar squamous epithelium
284
precurosor lesion of vaginal carcinoma
Vaginal intraepithelial neoplasia
285
How does a fibroadenoma present?
Well-circumscribed, mobile marble-like mass
286
\_\_\_\_\_\_\_\_ is elevated in testicular yolk sac tumors.
AFP
287
Epispadias is associated with \_\_\_\_\_\_\_\_\_.
Bladder exstrophy
288
What are the prostatic secretions with acture prostatitits?
WBCs; culture reveals bacteria
289
What mutation is common with sporadic endometrial carcinoma
p53
290
Digital rectal exam: acute prostatitis
Tender and boggy
291
HPV-related vulvular carcinoma arrises from \_\_\_\_\_\_\_\_\_\_, while non HPV related vulvular carcinoma arises from \_\_\_\_\_\_\_\_\_\_\_.
Vulvular intraepithelial neoplasia; Lichen sclerosis
292
3 cell types of ovary
Surface epithelium
Germ cells
Sex cordstroma
293
Treatment of hydatidiform mole
Suction curettage
\*Subsequent B-hCG monitoring is important to ensure adequete mole removal and to screen for the development of choriocarcinoma
294
What indicats malignant potential in cystic teratomas
Presence of immature tissue or somatic malignancy (usually squamous cell carcinoma of skin)
295
How does inflammatory carcinoma (invasive ductal carcinoma) present?
Inflamed, swollen breast with no discete mass; can be mistaken for acute mastitis
* Tumor cells block drainage of lymphatics
296
\_\_\_\_\_\_\_\_\_\_\_mutation carriers have an increased risk for serous carcinoma of the ovary and fallopian tube.
BRCA1
297
Teratogenic effects of tetracycline
Discolored teeth
298
Side effects of 5a-reductase inhibitors
Gynecomastia and sexual dysfunction
299
How is extramammary paget disease differentiated from melanoma?
Paget: PAS +, keratin +, and S100-
Melanoma: PAS-, keratin-, and S100+
300
Cause of epispadias
Due to abnormal positioning of the genital tubercle
301
Asherman syndrome is the result of...
Overaggressive dilation and curettage
302
How does breast fat necrosis present?
Mass on physical exam or abnormal calcification on mammmography
303
Teratogenic effects of warfarin
Fetal bleeding
304
Risk factors for germ cell tumors of testes
Cryptorchidism and Klinefelter syndrome
305
Condolomas : histologically
Koilocytes
306
Asherman syndrome
Secondary amenorrhea due to loss of the basalis and scarring
