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OS5 > Repro Pathology > Flashcards

Repro Pathology Flashcards

1
Q

How does an endometrial polyp presnt?

A

Abnormal uterine bleeding

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2
Q

paget disease of the breast

A

Ductal carcinoma in situ that extendsup the ducts to involve the skin of the nipple

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3
Q

How does a bartholin cyst present?

A

unilateral, painful cystic lesion at the lower vestibule adjacent to the vaginal canal

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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)

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5
Q

how does extramammmary paget disease present?

A

Erythematous, pruritic, ulcerated vulvar skin

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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
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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

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8
Q

Most common benign neoplasm of the breast

A

Fibroadenoma

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9
Q

Histo of testicular yolk sac tumor

A

Schiller-Duval bodies

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10
Q

How does lichen sclerosis present histologically?

A

Characterized by thinning of the epidermis and fibrosis of the dermis

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11
Q

What are prostatic secretions in chronic prostatitis?

A

WBCs, but cultures are negative

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12
Q

High levels of circulating estrone increases risk for _______.

A

Endometrial carcinoma

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13
Q

Lymphogranuloma venerum

A

Necrotizing granulomatous inflammation of the inguinal lymphatics and lymph nodes

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14
Q

Condyloma acuminatum

A

Benign warty growth on genital of skin

*Due to HPV type 6 or 11

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15
Q

Possible complications of DES-associated vaginal adenosis

A

Clear cell adenocarcinoma

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16
Q

Hydrocele

A

Fluid collection within the tunica vaginalis

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17
Q

Causes of orchitis

A
  • Chlamydia trachomatis (serotypes D-K) or Neisseria gonorrhoeae
  • E. Coli and Pseudomonas
  • Mumps virus
  • Autoimmune orchitis
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18
Q

What is the function of PSA?

A

made by prostatic glands and liquefies semen

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19
Q

Growth of the endometrium is __________ driven.

A

Estrogen

*Proliferative phase

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20
Q

Causes of spontaneous abortion

A
  • Chromosomal anomalies (especially trisomy 16)
  • Hypercoagulable states (antiphospholipid syndrome)
  • Congenital infection
  • Expsure to teratogens
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21
Q

Demographic for leiomyosarcoma

A

Postmenopausal women

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22
Q

Upper 2/3 of the vagina is derived from_______

A

Mullerian ducts

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23
Q

Do patients with fibrosis, cysts or apocrine metaplasia of the breast have an increased risk for invasive carcinome?

A

No

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24
Q

Phyllodes tumor

A

Fibroadenoma-like tumor with overgrowth of the fibrous component

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25
Q

Risk factors for hyperplastic endometrial carcinoma

A

Related to estrogen exposure

  • early menarche/ late menopause
  • Nulliparity
  • Infertility with anovulatory cycles
  • Obesity
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26
Q

Do patients with ductal hyperplasia or sclerosing adenosis of the breast have an increased risk for invasive carcinome?

A

Yes. 2X the risk

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27
Q

How is endometrial hyperplasia classified histologically?

A

Based on architectural growth pattern (simple or complex) and the presence or absence of cellular atypia

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28
Q

Two most common subtypes of surface epithelial tumors are _________ and ________. What are the characteristics of each?.

A

Serous: Full of watery fluid

Mucinous: Full of mucus-like fluid

*Both are usually cystic

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29
Q

Trastuzumab

A

A designer antibody directed against the HER2 receptor; HER2/neu is a growth factor receptor present on the cell surface

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30
Q

How does endometrial hyperplasia present?

A

Postmenopausal uterine bleeding

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31
Q

What drugs can be used to treat prostate adenocarcinoma?

A
  • Leuprolide (GnRH analog)
    • Continuous GnRH analogs shut down the anterior pituitary gonadotrophs (LH and FSH are reduced)
  • Flutamide
    • Competitive inhibitor at the androgen receptor
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32
Q

Most common demographic for lichen sclerosis

A

Postmenopausal women; possible autoimmune etiology

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33
Q

Most likely cause of endometriosis

A

Retrograde menstruation with implantation at an ectopic site

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34
Q

Shedding occurs with loss of __________ support.

A

Progesterone

*Menstrual phase

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35
Q

How do surface epithelial tumors usually present?

A

Late with vague abdominal symptoms (pain and fullness) or signs of compression (urinary frquency)

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36
Q

Composition of dysgerminoma

A

Large cells with clear cytoplasm and central nuclei

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37
Q

Ductal carcinoma in situ

A

Malignant proliferation of cells in ducts with no invasion of the nasement membrane

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38
Q

Classic presentation of polycystic ovarian disease

A

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

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39
Q

Histo: hyperplastic endometrial carcinoma

A

Endometrioid (normal endometrium-like)

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40
Q

Malignant tumor composed of cytotrophoblasts and syncytiotrophoblasts

A

Choriocarcinoma

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41
Q

Demographic for mammary duct extasia

A

Multiparous postmenopausal women

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42
Q

Endocervix is lined by

A

A single layer of columnar cells

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43
Q

What is the testicular counterpart of a dysgerminoma?

A

Seminoma

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44
Q

How does placental abruption present?

A

Third-trimester bleeding and fetal insufficiency

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45
Q

Most common ovarian tumor

A

Surface epithelial tumor

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46
Q

What conditions are associated with sertoli-leydig cell tumors

A

Virilization and hirtsuitism

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47
Q

Biopsy of breast fat necrosis

A

Necrotic fat with associated calcifications and giant cells

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48
Q

Risk factors for squamous cell carcinoma of penis

A

High risk HPV

Lack of circumcision

  • Foreskin acts as a nidus for inflammation and irritation if not properly maintained
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49
Q

Demographic for cervical carcinoma

A

Middle-aged women (40-50)

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50
Q

______________ is a metastatic tumor that involves both ovaries.

A

Krukenberg tumor

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51
Q

Endometrial glands and stroma outside of the uterine endometrial lining

A

Endometriosis

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52
Q

Biopsy of phyllodes tumor

A

“Leaf-like” projections

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53
Q

Teratogenic effects of alcohol

A

mental retardation

Facial abnormalities

Microcephaly

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54
Q

Acute mastitis is associated with _________.

A

Breast feeding

*Fissures develop in the nipple providing a route of entry for microbes

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55
Q

Causes of galactorrhea

A
  • Nipple stimulation
  • Prolactinoma of the anterior pituitary
  • Drugs
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56
Q

Histo: Leiomyosarcoma

A

Necrosis, mitotic activity, and cellular atypia

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57
Q

Gross view of leiomyoma

A

Multiple, well-defined, white, whorled masses that may distort the uterus and impinge on pelvic structures

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58
Q

_________ gland is present on each side of the vaginal canal and produces mucus-like fluid that drains via ducts into the lower vestibule.

A

Bartholin

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59
Q

prostate adenocarcinoma screening begins at the age of 50 with _______ and _______.

A

DRE; PSA

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60
Q

___________ is massive amounts of mucus in the peritoneum.

A

Psudomyxoma peritonei

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61
Q

Subtypes of surface epithelial tumors

A

Serous (common)

Mucinous (common)

Endometriod

Brenner tumor

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62
Q

Ultrasound of hydatidiform mole

A

Fetal heart sounds are absent, and a “snowstorm” appearance is classically seen on ultrasound

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63
Q

Where does does vaginal carcinoma go when spread to regional lymph nodes?

A
  • Cancer from the lower 13 of vagina goes to the inguinal nodes
  • Cancer from the upper 2/3 goes to regional iliac nodes
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64
Q

Which subtype of invasive ductal carcinoma has increased incidence in BRCA1 carriers?

A

medullar carcinoma

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65
Q

bowen disease

A

In situ carcinoma of the penile shaft or scrotum that presents as leukoplasia

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66
Q

Why are testicular tumors usually not biopsied? How are they removed?

A

Usually not biopsied due to risk of seeding the scrotum; removed via radical orchiectomy

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67
Q

Meigs syndrome

A

Fibroma of ovaries

Pleural Effusion

Ascites

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68
Q

What are most important predictive factors to response to treatment for breast cancer?

A

Estrogen receptor

Progesterone receptor

HER2/neu gene amplification

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69
Q

Tumors associated with BRCA2 mutatuons

A

Breast carcinoma in males

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70
Q

Characteristics of cystadenomas

A
  • Composed of a single cyst with a simple, flat lining
  • Most commonly arise in premenopausal women
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71
Q

Other than the ovary, where else does endometriosis occur and what are the presenting signs at each site?

A
  • 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

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72
Q

Placental abruption is a common cause of ______.

A

Still birth

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73
Q

How does a hydrocele present?

A

Scrotal swelling that can be transilluminated

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74
Q

Teratogenic effects of phenytoin

A

Digit hypoplasia and cleft lip/palate

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75
Q

Demographic for testicular germ cell tumors

A

15-40 yrs

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76
Q

Embryonal carcinoma of testicles

A

A malignant tumor comprised of immature, primitive cells that may produce glands

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77
Q

Placental abruption

A

Separation of placenta from the decidua prior to delivery of the fetus

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78
Q

Do patients with atypical hyperplasia of the breast have an increased risk for invasive carcinome?

A

Yes. 5X

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79
Q

What are some precursor in situ lesions for squamous cell carcinoma?

A

Bowen disease

Erythroplasia of queyrat

Bowenoid papulosis

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80
Q

Average age of presentation for hyperplastic endometrial carcinoma

A

60 yrs

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81
Q

True or false. Ductal carcinoma in situ produces a mass.

A

False

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82
Q

Demographic for germ cell tumors

A

Women of reproductive age

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83
Q

_____________ cells are necessary for the diagnosis of chronic endometritis. Why?

A

Plasma cells given that lymphocytes are normally found in the endometrium

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84
Q

What serum markers may be elevated in embryonal carcinoma of testes?

A

AFP or B-hCG

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85
Q

Exocervix is lined by ___________

A

Nonkeratinizing squamous epithelium

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86
Q

________ is a useful serum market to monitor treatment response and screen for recurrence of surface epithelial tumors.

A

CA-125

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87
Q

Biopsy: Lobular carcinoma in situ

A

Dyscohesive cells lacking E-cadherin adhesion proteins. Often multifocal and bilateral

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88
Q

How does embryonal rhabdomyosarcoma?

A

Bleeding and a grape-like mass protruding from the vagina or penis of a child

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89
Q

Differentiate seminomas and nonseminomas

A

Seminomas

  • Highly responsive to radiotherapy, metastasize late, and have an excellent prognosis

Nonseminoms

  • Show variable response to treatment and often metastasize early
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90
Q

Fetal tissue, villous edema, trophoblastic proliferation, and risk for choriocarcinoma in partial mole

A

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

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91
Q

_______ acts of theca cells to induce androgen production.

A

LH

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92
Q

Teratogenic effects of cigarette smoke

A

Intrauterine growth retardation

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93
Q

What serum marker may be elevated with a dysgerminoma?

A

LDH

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94
Q

Inflammation of the subareolar ducts

A

Periductal mastitis

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95
Q

Function of prostate

A

Secrete alkaline, milky fluid that is added to sperm and seminal vesicle fluid to make semen

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96
Q

How does a varicocele present?

A

Scrotal swelling with a “bag of worms” appearance

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97
Q

Functional unit of ovary

A

Follicle

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98
Q

Teratogenic effects of thalidomide

A

Limb defects

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99
Q

Biopsy: Invasive ductal carcinoma

A

Duct-like structures in a desmoplastic stroma

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100
Q

Epispadias

A

Opening of urethra on superior surface of penis

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101
Q

Gross appearance of embryonal carcinomas of the testicles

A

Hemorrhagic mass with necrosis

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102
Q

Location: BPH

A

Central periurethral zone of the prostate

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103
Q

Subtypes of invasive ductal carcinoma. What the characteristics of each?

A
  • 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
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104
Q

HER/neu amplification is associated with response to __________.

A

Trastuzumab (herceptin)

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105
Q

How is the comedo subtyoe of ductal carcinoma in situ characterized?

A

High-grade cells with necrosis and dystrophic calcification in the center of ducts

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106
Q

Treatment for lobular carcinoma in situ

A

Tamoxifen (to reduce the risk of subsequent carcinoma) and close follow

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107
Q

Complete mole

A

Empty ovum fertilized by two sperm (or one sperm that duplicates chromosomes); 46 chromosomes

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108
Q

How does acute mastitis present?

A

As an erythematous breast with purulent nipple discharge; may progress to abscess formation

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109
Q

Gross appearance of seminoma

A

Homogeneous mass with no hemorrhage or necrosis

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110
Q

Lichen sclerosis is beign, but associated with a slightly increased risk for __________.

A

Sqaumous cell carcinoma

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111
Q

Major complications of ectopic pregnancy

A

Bleeding into fallopian tube (hematosalpinx) and rupture

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112
Q

Benign tumor of fibroblasts

A

Fibroma

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113
Q

Histo of extramammary paget disease

A

Malignant epithelial cells in the epidermis of the vulva

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114
Q

Clinical features of BPH

A
  • 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
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115
Q

How is intraductal papilloma differentiated papillary carcinoma?

A

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

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116
Q

Pathogenesis of BPH

A
  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
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117
Q

Hydrocele is associated with incomplete closure of the ___________. What is the result of this?

A

Processus vaginalis; leads to communication with the peritoneal cavity (infants) or blockage of lymphatic drainage (adults)

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118
Q

How does endometrial carcinoma present?

A

Postmenopausal bleeding

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119
Q

Abnormal conception characterized by swollen and edematous villi with proliferation of trophoblasts

A

Hydatidiform mole

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120
Q

How does periductal mastitis present?

A

Subareolar mass with nipple retraction

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121
Q

Components of a follicle

A

Ooctye surrounded by granulosa and theca cells

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122
Q

partial mole

A

Normal ovum fertilized by two sperm (or one sperm that duplicates chromosomes); 69 chromosomes

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123
Q

Vulvar intraepithleial neoplasia

A
  • Koilocytic change
  • Disordered cellular maturation
  • Nuclear atypia
  • Increased mitotic activity
124
Q

How does lichen simplex chronicus presnt?

A

Leukoplakia with thick, leathery vulvar skin

125
Q

Another name doe leiomyoma

A

Fibroids

126
Q

Tumors associated with BRCA1 mutatuons

A

Breast and ovarian carcinoma

127
Q

How does fibrocystic change of the breast present?

A

Vague irregularity of the breast tissue, usually in the upper outer quadrant

128
Q

Clinical feautures of hereditary breast cancer

A
  • Multiple first-degree relatives with breast cancer
  • Tumor at an early age
  • Multiple tumors in a single patient
129
Q

Eclampsia

A

Preeclampsia with seizures

130
Q

Most common malignant germ cell tumor

A

Dysgerminoma

131
Q

Erythroplasia of Queyrat

A

In situ carcinoma on the glans that presents as erythroplakia

132
Q

Aside from treating BPH 5 a- reductase inhibitors have what use?

A

Treat male pattern baldness

133
Q

Cervical intraepithelial neoplasia II

A

Involves <2/3 of the thickness of the epithelium

134
Q

Serum _______ is high in choriocarcinoma

A

B-hCG

135
Q

Demographic for non HPV related vulvular carcinoma

A

Elderly women >70

136
Q

Histo: Endodermal sinus tumor

A

Schiller- Duval bodies (glomerulus-like structures)

137
Q

An endometrial polyp can arise as a side effect of what drug?

A

Tamoxifen, which has anti-estrogenic effects on the breast but weak pro-estrogenic effects on the endometrium

138
Q

What is the most important preictor for progression to carcinoma from endometrial hyperplasia?

A

The presence of atypia

139
Q

Characteristics of cystadenocarcinomas

A
  • Composed of complex cysts with a thick, shaggy lining
  • Most commonly arise in postmenopausal women
140
Q

Presence of estrogen and progesterone receptors is associated with response to __________.

A

Antiestrogenic agents (like tamoxifen)

141
Q

Prognosis for seminomas

A

Good prognosis; responds to radiotherapy

142
Q

Effects of orchitis due to Chlamydia or Gonorrhoea. Demographic

A

Seen in young adults. Increased risk of sterility, but libido is not affected because Leydig cells are spared

143
Q

Cervical intraepithelial neoplasia is divided into grades based on…

A

The extent of epithelial involvement by immature dysplastic cells

144
Q

Why are varicocele usually left sided?

A

Left testicular vein drains into the left renal vein, while the right testicular vein drains directly into the IVC.

*Associated with RCC

145
Q

Histo of embryonal rhabdomyosarcoma

A

Rhabdomyoblast exhibits cytoplasmic cross-striations and positive immunohistochemical staining for desmin and myogenin

146
Q

Effects of orchitis due to E. Coli and Pseudomonas. Demographic?

A

Seen in older adults; urinary tract infection pathogens spread into the reproductive tract

147
Q

________ is a serous membrane that covers the testicle as well as the internal surface of the scrotum.

A

Tunica vaginalis

148
Q

In what circumstances does estrogen go unopposed?

A

Obesity

Polycystic ovary syndrome

Estrogen replacement

149
Q

How does chronic prostatitis present?

A

Dysuria with pelvic or low back pain

150
Q

Coelomic epithelium embryologically produces the epithelial lining of which 3 structures?

A

Fallopian tube

Endometrium

Endocervix

151
Q

Cause of pseudomyxoma peritonei

A

Due to mcinous tumor of the appendix, usually with metastasis to the ovary

152
Q

Result of leydig cell tumor in males

A

Precocious puberty in children or gynecomastia in adults

NOTE: Characteristic Reinke crystals may be seen on histo

153
Q

Gross of appearance of cyst in breast

A

Blue dome

154
Q

Prognosis of choriocarcinoma

A

Poor response to chemotherapy

155
Q

How does mammary duct ectasia present?

A

Periareolar mass with green-brown nipple discharge

NOTE: Chronic inflammation with plasma cells is seen on biopsy

156
Q

How does invasive ductal carcinoma presnt?

A

As a mass detected by phyical exam or by mammography

157
Q

Where is the highest density of breast tissue found?

A

Upper outer quadrant

158
Q

Risk factors for leomyoma

A

Related to estrogen exposure

  • Common in premenopausal women
  • Often multiple
  • Enlarge during pregnancy; shrink after menopause
159
Q

Malignant proliferation of smooth muscle arising from the myometrium

A

Leiomyosarcoma

160
Q

Risk factors for sudden infant death syndrome

A

Sleeping on stomach

Exposure to cigarette smoke

Prematurity

161
Q

How does lichen sclerosis present?

A

White patch (leukoplakia) with parchment-like vulvar skin

162
Q

How does acute prostatitis present?

A

Dysuria with fever and chills

163
Q

After ovulation, the residual follicle becomes a ________, which primarily secretes ______.

A

Corpus luteum; progesterone

NOTE: This drives the secretory phase which prepares the endometrium for a possible pregnancy

164
Q

Fetal tissue, villous edema, trophoblastic proliferation, and risk for choriocarcinoma in complete mole

A

Fetal tissue: Absent

Villous edema: Most villi are hydropic

Trophoblastic proliferation: Diffuse, circumferential proliferation present around hydropic villi

Risk for choriocarcinoma: 2-3%

165
Q

Most common testicular tumor in children

A

Yolk sac (endodermal sinus) tumor

166
Q

Autoimmune orchitis

A

Characterized by granulomas involving the seminiferous tubules

167
Q

True of false. There is an increased risk of carcinoma at the site of endometriosis.

A

True. Especially at the ovary

168
Q

_________ is a teratoma composed primarily of thyroid tissue.

A

Struma ovarii

169
Q

Subtypes of germ cell tumors. What tissue type is mimiced by each?

A
  • Cystic teratoma and embryonal carcinoma
    • Fetal tissue
  • Dysgerminoma
    • Oocytes
  • Endodermal sinus tumor
    • Yolk sac
  • Choriocarcinoma
    • Placental tissue
170
Q

Cause of preeclampsia

A

Due to abnormality of the maternal-fetal vascular interface in the placenta; resolves with delivery

171
Q

Preparation of the endometrium for implantation is ________ driven.

A

Progesterone driven

*secretory phase

172
Q

HELLP

A

Preeclampsia with thrombotic microangiopathy involving the liver

  • Hemolysis
  • Elevated liver enzymes
  • Low platelets
173
Q

What bug causes lymphogranuloma venereum?

A

Chlamydia trachomatis (serotypes L1-L3)

174
Q

Treatment for BPH

A

a1-antagonist

5a-reductase inhibitor

NOTE: a1A selective antagonists (tamsulosin) are used in normotensive individuals

175
Q

Demographic of phyllodes tumor

A

Postmenopausal women

176
Q

True or false. There is no increased risk of cancer in cases of benign prostatic hyperplasia.

A

True

177
Q

Lower 1/3 of vagina is derived from ___________.

A

Urogenital sinus

178
Q

Intraductal papilloma

A

Papillary growth, usually into a large duct

179
Q

How do testicular tumors presnt?

A

Firm, painless testicular mass that cannot be transilluminated

180
Q

Focal persistence of columnar epitelium in the upper vagina

A

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
Q

Preeclampsia

A

Pregnancy induced HTN, proteinuria, and edema, usually arising in the third trimester

NOTE: HTN may be severe, leading to headaches and visual abnormalties

182
Q

Most common cause of krunkenberg tumor

A

Metastatic gastric carcinoma (diffuse type)

183
Q

Increased incidence of adenosis in females who were exposed to ________ in utero.

A

Diethylstilbestrol (DES)

184
Q

Components of prostate

A
  • 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
Q

Average age of presentation for sporadic endometrial carcinoma

A

70

186
Q

How does acute endometritis present?

A

Fever, abnormal uterine bleeding, and pelvic pain

187
Q

How does a hydatidiform mole present?

A

Presents in second trimester as passage of grape-like masses through the vaginal canal

188
Q

Junction between the exocervix and endocervix is called the _____________.

A

Transformation zone

189
Q

What two layers of epithelium line lobules and ducts in breast?

A

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
Q

Failure of testicle to descend into the scrotal sac

A

Cryptorchidism

191
Q

How does leiomyoma present?

A

Usually asymptomatic; when present, symptoms: abnormal uterine bleeding, infertility, and a pelvic mass

192
Q

Fibroadenoma

A

Tumor of fibrous tissue and glands

193
Q

Components of sertoli-leydig cell tumor

A

Composed of sertoli cells that form tubules and Leydig cells (between tubules) with characteristic Reinke crystals

194
Q

invasive lobular carcinoma

A

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
Q

Prognosis of dysgerminoma

A

Good prognosis; responds to radiotherapy

196
Q

Types of sex cord-stromal tumors

A

Granulosa-theca cell

Sertoli-Leydig cell

Fibroma

197
Q

True or false. paget disease of the breast is almost never associated with an underlying carcinoma.

A

False. It’s almost always associated with an underyling carcinoma

198
Q

Malignant proliferation of endometril glands

A

Endometrial carcinoma

199
Q

Effects of teratogens

A
  • First 2 weeks of gestation- spontaneous abortion
  • Weeks 3-8- Risk of organ malformation
  • Months 3-9- risk of organ hypoplasia
200
Q

Estradiol surge induces an LH surge, which leads to _______.

A

Ovulation

NOTE: This marks the beginning of the secretory phase of the endometrial cycle.

201
Q

Bowenoid papilosis

A
  • 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
Q

How does endometriosis present?

A

Dysmenorrhea (pain during menstruation) and pelvic pain

*May cause infertility

203
Q

Risk factors for cervical carcinoma

A

High-risk HPV infection

Smoking

Immunodeficiency

*Cervical carcinoma is an AIDS-defining illness

204
Q

What are the two distinct pathways of endometrial carcinoma?

A

Hyperplasia (75%) and sporadic (25%)

205
Q

Histo of chronic endometritis

A

Lymphocytes and plasma cells

206
Q

Causes of acute prostatitis

A

Chlamydia and Gonorrheoeae- young adults

E. Coli and Pseudomonas- Older adults

207
Q

Biopsy of prostate adenocarcinoma

A

Small, invasive glands with prominent nucleoli

208
Q

Cause of acute endometritis

A

Usually due to retained products of conception; retained products act as a nidus for infection

209
Q

Teratogenic effects of cocaine

A

Intrauterine growth retardation

Placental abruption

210
Q

What may result from the elevated B-hCG seen in choriocarcinomas? Why?

A

Hyperthyroidism or gynecomastia (a-subunit of hCG is similar to that of FSH, LH, and TSH)

211
Q

Cause of testicular torsion

A

Usually due to congenital failure of testes to attach to the inner lining of the scrotum (via the processus vaginalis)

212
Q

What bug usually causes acute mastitis?

A

S. Aureus

213
Q

Male breast cancer is associated with _______ and ________.

A

BRCA2 mutations and Klinefelter syndrome

214
Q

Cervical intraepithelial neoplasia III

A

Involves slightly less than the entire thickness of the epithelium

215
Q

Cervical intraepithelial neoplasia I

A

Involves <1/3 of the thickness of the epithelium

216
Q

Treatment for acute mastitis

A

Continued drainage (feeding)

Antibiotics (dicloxacillin)

217
Q

Lobular carcinoma in situ

A

Malignant proliferation of cells in lobules with no invasion of the basement membrane

218
Q

Most common cause of testicular mass in males >60

A

lymphoma; often bilateral

*Usually of diffuse large B- cell type

219
Q

Vaginal carcinoma is usually related to _______ HPV.

A

High-risk

220
Q

Regenerative layer of endometrium

A

Basalis

221
Q

Embryonal rhabdomyosarcoma a.k.a ___________.

A

Sarcoma botyroides

222
Q

Serum _______ is often elevated in endodermal sinus tumors.

A

AFP

223
Q

Demographic of fibroadenoma

A

Premenopausal women

*Estrogen sensitive

224
Q

Function of lobules in the breast

A

Make milk that drains via ducts to the mipple

225
Q

Key risk factor for ectopic pregnancy

A

Scarring (secondary to pelvic inflammatory disease or endometriosis)

226
Q

Teratogenic effects of isotretinoin

A

Spontaneous abortion

Hearing and visual impairment

227
Q

Benign surface epithelial tumors

A

Cystadenomas

228
Q

presentation of spontaneous abortion

A

Vaginal bleeding

Cramp-like pain

Passage of fetal tissues

229
Q

presentation of intraductal papilloma

A

Bloody nipple discharge in a premenopausal woman

230
Q

Most common site for endometriosis

A

Ovary, which commonly results in formation of a chocolate cyst

231
Q

Where does prostate adenocarcinoma usually arise? What result does this have?

A

usually arises in the peripheral, posterior region of the prostate, and hence, does not produce urinary symptoms early on

232
Q

What serum markers may be high with seminomas?

A

B-hCG

233
Q

Prognosis for surface epithelial tumors?

A

Generally poor

234
Q

Most common germ cell tumor in children

A

Endodermal sinus tumor

235
Q

Brenner tumors

A

Composed of bladder-like epithelium and are usually benign

236
Q

Result of lymphogranuloma venereum

A

Eventually heals with fibrosis; perianal involvement may result in rectal stricture

237
Q

Cause of hypospadias

A

Failure of the urethral folds to close

238
Q

Prognosis of embryonal carcinoma of testicles

A
  • Aggressive with early hematogenous spread
  • Chemotherapy may result in differentiation into another type of germ cell tumor
239
Q

Demographic for HPV related vulvuvar carcinoma

A

Women of reproductive age

240
Q

Hormonal characteristics of polycystic ovarian disease

A

Increased LH and low FSH

241
Q

Hypospadias

A

Opening of urethra on inferior surface of penis

242
Q

How does paget disease of the breast present?

A

Nipple ulceration and erythema

243
Q

Presentation of ectopic pregnancy

A

Lower quadrant abdominal pain a few weeks after a missed period

244
Q

bacterial infection of the breast

A

Acute mastitis

245
Q

Varicocele

A

Dilation of the spermatic vein due to impaired drainage

246
Q

Complications of cryptorchidism

A

Testicular atrophy with infertility and increased risk for seminoma

247
Q

________ stimulates granulosa cells to convert androgen to estradiol.

A

FSH

NOTE: This drives the proliferative phase of the endometrial cycle

248
Q

Types of germ cell tumors

A

Seminoma and nonseminoma

249
Q

How does placenta previa present?

A

Third-trimester bleeding

*Oftern requires delivery of fetus by C section

250
Q

Functional unit of the breast

A

Terminal duct lobular unit

251
Q

Risk factors for breast cancer

A

Related to estrogen exposure

  • Female gender
  • Age
  • Early menarche/ late menopause
  • Obesity
  • Atypical hyperplasia
  • First-degree relative with breast cancer
252
Q

How does chronic endometritis present?

A

Abnormal uterine bleeding, pain, and infertility

253
Q

How does testicular torsion present?

A

Presents in adolescents with sudden testicular pain and absent cremasteric reflex

254
Q

Most common histological subtype of breast cancer in males

A

Invasive ductal carcinoma

255
Q

True or false. Leiomyosarcomas arise from leiomyomas

A

False

256
Q

Causes of chronic endometritis?

A
  • Retained products of conception
  • Chronic pelvic inflammatory disease
  • IUD
  • TB
257
Q

Risk factors for prostate adenocarcinoma

A

Age, race, and diet high in saturated fats

258
Q

periductal mastitis is usually seen in _______. Why?

A

Smokers

  • Relative vitamin A deficiency results in squamous metaplasia of lactiferous ducts, producing duct blockage and inflammation
259
Q

placenta accreta

A

Improper implantation of placenta into the myometrium with little or no intrevening decidua

260
Q

What conditions are associated with fibromas

A

Pleural effusions and ascites (Meigs syndrome)

261
Q

Endometrial hyperplasia occurs as a consequence of..

A

Unpposed estrogen

262
Q

malignant surface epithelial tumors

A

Cystadenocarcinoma

263
Q

How does cervical carcinoma present?

A

Vaginal bleeding, especially postcoital bleeding, or cervical discharge

264
Q

What is the result of an anovulatory cycle?

A

An estrogen-driven proliferative phase without a subsequent progesterone-drien secretory phase

  • Proliferative glands break down and shed resulting in uterine bleeding
265
Q

Benign neoplastic proliferation of smooth muscle arising from myometrium

A

Leiomyoma (fibroids)

266
Q

How is high-grade dysplasia characterized on a pap smear?

A

By cells with hyperchromatic (dark_ nuclei and high nuclear to cytoplasmic ratios

267
Q

Testicular torsion

A

Twisting of the spermatic cord; thin-walled veins become obstructed leading to congestion and hemorrhagic infarction

268
Q

How does placenta accreta present?

A

Difficult delivery of the placenta and postpartum bleeding

*often requires a hysterectomy

269
Q

True or false. Villi are absent in choriocarcinomas.

A

True

270
Q

Effects of orchitis due to mumps Demographic

A

Teenage males. Increased risk for infertility

NOTE: testicular inflammation is usually not seen in children <10 yrs old

271
Q

Histo of intraductal papilloma

A

Characterized by fibrovascular projections lined by epithelial (luminal) and myoepithelial cells

272
Q

Histo: Sporadic endometrial carcinoma

A

Serous and characterized by papillary structures with psammoma body formation

273
Q

most common type of invasive carcinoma in the breast

A

invasive ductal carcinoma

274
Q

Malignant tumor that mimics the yolk sac

A

Endodermal sinus tumor

275
Q

Seminoma

A

Malignant tymor comprised of large cells with clear cytoplasm and central nuclei (resemble spermatogonia)

276
Q

mammary duct extasia

A

Inflammation with dilaton of the subareolar ducts

277
Q

Surface epithelial tumors are derived from __________ that lines the ovary.

A

Coelomic epithelium

278
Q

Mucosa of the vagina is lined by __________

A

Non-keratinizing squamous epithelium

279
Q

The vulva is lined by __________ epithelium.

A

Squamous

280
Q

Placenta previa

A

Implantation of the placenta in the lower uterine segment; Placenta overlies cervical os

281
Q

Gross exam: Leiomyosarcoma

A

Single lesion with areas of necrosis and hemorrhage

282
Q

Pathogenesis of polycystic ovarian diseas

A
  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
Q

Histology of lichen simplex chronicus

A

Hyperplasia of the vulvar squamous epithelium

284
Q

precurosor lesion of vaginal carcinoma

A

Vaginal intraepithelial neoplasia

285
Q

How does a fibroadenoma present?

A

Well-circumscribed, mobile marble-like mass

286
Q

________ is elevated in testicular yolk sac tumors.

A

AFP

287
Q

Epispadias is associated with _________.

A

Bladder exstrophy

288
Q

What are the prostatic secretions with acture prostatitits?

A

WBCs; culture reveals bacteria

289
Q

What mutation is common with sporadic endometrial carcinoma

A

p53

290
Q

Digital rectal exam: acute prostatitis

A

Tender and boggy

291
Q

HPV-related vulvular carcinoma arrises from __________, while non HPV related vulvular carcinoma arises from ___________.

A

Vulvular intraepithelial neoplasia; Lichen sclerosis

292
Q

3 cell types of ovary

A

Surface epithelium

Germ cells

Sex cordstroma

293
Q

Treatment of hydatidiform mole

A

Suction curettage

*Subsequent B-hCG monitoring is important to ensure adequete mole removal and to screen for the development of choriocarcinoma

294
Q

What indicats malignant potential in cystic teratomas

A

Presence of immature tissue or somatic malignancy (usually squamous cell carcinoma of skin)

295
Q

How does inflammatory carcinoma (invasive ductal carcinoma) present?

A

Inflamed, swollen breast with no discete mass; can be mistaken for acute mastitis

  • Tumor cells block drainage of lymphatics
296
Q

___________mutation carriers have an increased risk for serous carcinoma of the ovary and fallopian tube.

A

BRCA1

297
Q

Teratogenic effects of tetracycline

A

Discolored teeth

298
Q

Side effects of 5a-reductase inhibitors

A

Gynecomastia and sexual dysfunction

299
Q

How is extramammary paget disease differentiated from melanoma?

A

Paget: PAS +, keratin +, and S100-

Melanoma: PAS-, keratin-, and S100+

300
Q

Cause of epispadias

A

Due to abnormal positioning of the genital tubercle

301
Q

Asherman syndrome is the result of…

A

Overaggressive dilation and curettage

302
Q

How does breast fat necrosis present?

A

Mass on physical exam or abnormal calcification on mammmography

303
Q

Teratogenic effects of warfarin

A

Fetal bleeding

304
Q

Risk factors for germ cell tumors of testes

A

Cryptorchidism and Klinefelter syndrome

305
Q

Condolomas : histologically

A

Koilocytes

306
Q

Asherman syndrome

A

Secondary amenorrhea due to loss of the basalis and scarring

OS5 (4 decks)

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