Reproduction Test 2: Fisch part 2

Question 1

Q9:

In Endometriosis, who is more likely to get it?

Answer 1

Higher incidence in women in higher socio-economic groups who tend to marry later in life.
- Women of reproductive life (30s-40s)

Question 2

Q9:

Does Endometriosis progress to cancer?

Answer 2

No, benign disease does not progress to cancer

Question 3

Q9:

List the four risk factors for endometrial carcinoma

Answer 3

1. Taking exogenous estrogen in the form of pills or injections
2. Have estrogen-producing tumors
3. Are obese and form estrogen at an increased rate by fat tissue conversion. DM and HTN are both known risk factors, both related to obesity.
4. are NULLIPAROUS ( woman who has never given birth) or have EARLY menarche and late menopause (related to longer exposure to estrogen)

Question 4

Q10:

Endometrial cancer is what type of cancer?

Answer 4

Adenocarcinoma (glandular) cancer.

Question 5

Q10:

What is the pathogenesis of endometrial cancer?

Answer 5

Increases in estrogen

Question 6

Q10:

Are thin or large people the major risk factor of endometrial cancer?

Answer 6

Large

Question 7

Q10:

Where does endometial cancer rank in GYN cancers?

Answer 7

MOST COMMON in number in GYN cancer.

- Most common malignant tumor of the female genital tract, accounting for approx. 50% of all GYN malignancies,

Question 8

Q10:

What are the most common complain for women w/ endometrial carcinomas (most common presenting symptom)?

Answer 8

Most common presenting symptom:
- Vaginal bleeding that may occur as spotting between two menstruations, or as prolonged pronounced menstral bleeding (menorrhagia)

Question 9

Q11*:

List the four risk factors of cervical carcinomas:

Answer 9

• Sexual intercourse at an early age
• Multiple sex partners (prostitutes)
• Evidence of HPV infection
• Other venereal diseases, such as Herpes or Syphilis (all point to environmental causes)

Question 10

Q12:

What are risk factors for ectopic pregnancy?

Answer 10

Most common pathologic condition leading to ectopics is CHRONIC SALPINGITIS (PID)
– Other factors include: Peritubal adhesions as from endometriosis, previous surgeries, and leiomyomas.

Question 11

Q13:

Would pregnancy test still be considered positive in an ectopic pregnancy and why?

Answer 11

Yes, because placenta still releases pregnancy hormones.

Question 12

Q13:

Where are the most common places for ectopic pregnancies to happen?

Answer 12

Fallopian tubes (95%)
Ovary
Abdominal cavity
Pouch of Douglas (Posterior Fornix)

Question 13

Q13:

What time frame would you seen in an ectopic pregnancy?

Answer 13

2-6 weeks after pregnancy.

Question 14

Q13:

What would you be aspirating from the posterior fornix or pouch of douglas if it ruptured?

Answer 14

fresh blood

Question 15

Q13:

What kind of pathologic condition would you have leading to ectopic pregnancy?
- If you have any structure adhesion in the fallopian tube, what is it called?

Answer 15

Chronic Salpingitis (aka pelvis inflammatory disease?)
- Chronic salpingitis

Question 16

Q13:

What would an endometrial biopsy show in an ectopic pregnancy.

Answer 16

Chorionic villi present in tube and not seen any in the uterus

Question 17

Q14:

In women, what three structures are squamous epithelium tissue and what is the name of the cancer of this area?

Answer 17

• Cervix, Vulva and Vagina (#1 cancer of Squamous cell carcinomas)
• Squamous cell carcinomas

Question 18

Q14:

In woman, what three structures are glandular epithelium tissue and what is the name of the cancer of this area?

Answer 18

• Fallopian tubes, ovaries and uterus (#1 cancer of adenocarcinomas)
• Adenocarcinomas

Question 19

Q15:

List four tumors that are derived from germ cell epithelium

Answer 19

• Benign Cystic Teratoma (Dermoid Cyst)
• Endodermal Sinus Tumor
• Dysgerminoma
• Choriocarcinoma

Question 20

Q15:

List four tumors that are derived from surface epithelium
- All tumors of surface epithelium are either what two things?

Answer 20

• Serous- Most common
• Mucinous
• Brenner
• Endometroid
• All tumors of surface epithelium are either adenomas or adenocarcinomas

Question 21

Q16:

What kind of tumor markers/hormones do surface epithelial tumors produce?

Answer 21

CA-125 (antibody to cancer antigen)

Question 22

Q16:

What kind of tumor markers/hormones do endodermal sinus tumors produce?

Answer 22

Alpha feto-protein (AFP)

Question 23

Q16:

What kind of tumor markers/hormones do choriocarcinomas produce?
- At time of diagnosis, choriocarcinomas can metastasize to where?

Answer 23

Beta HCG

- Metastasize widely from the bloodstream to the liver, lungs, and bones at time of diagnosis.

Question 24

Q16:

The following are all sex cord stromal tumors:
What kind of tumor markers/hormones do each produce?
- Thecomas tumors
- Granulosa cell tumors
- Sertoli- Leydig cell tumors

Answer 24

Thecomas = Estrogen
Granulosa cell tumors = Estrogen
Sertoli-Leydig cell tumors = Androgens aka testosterone

Question 25

Q16:

What kind of tumor markers/hormones do ovarian mass produce?

Answer 25

Alpha feto-protein (AFP)

Question 26

Q17:

What kind of tumor is a dermoid cyst?

Answer 26

Benign germ cell tumor

Question 27

Q17:

What is another name for a dermoid cyst?

Answer 27

Benign Cystic Teratoma

Question 28

Q18:

Give characteristics of a dermoid cyst and what can be found in a dermoid cysts?

Answer 28

Dermoid cyst is lined on the inside with hairy skin and the wall contains tissues such as teeth, bone, and cartilage along with skin appendages, such as sweat and sebaceous glands.

Question 29

Q19:

Common age for presence of dermoid cysts (benign cystic teratoma)?

Answer 29

Common ovarian tumor in women younger than 25 years old

Question 30

Q20:

List four locations that can harbor choriocarcinoma (where choriocarcinoma can come from)

Answer 30

Testes
Ovaries
Placenta
Endometrium