Reproductive System Pathology 1 Flashcards
What organism is most associated with toxic shock syndrome?
Staphylococcus aureus
How does gonorrhea usually present in males?
Urethritis, purulent discharge
What organism causes chancroid?
Haemophilus ducreyi
What organism is the commonest cause of epididymitis in men?
Chlamydia trachomatis
Which STD has a painful, ragged ulcer, and what organism causes it?
Chancroid, caused by Haemophilus ducreyi
What infection can be diagnosed with clue cells, and what organism causes it?
Bacterial vaginosis associated with Gardnerella vaginalis
How does gonorrhea present in females and what are the complications?
Usually asymptomatic, complications are PID/salpingitis and infertility
The hard chancre, a bull’s eye lesion, is associated with what disease?
Treponema pallidum infection (syphilis)
When is syphilis infectious?
Primary and secondary infections
The mucocutaneous lesion of syphilis is found in which phase?
Secondary
The gummas appear in what stage of syphilis?
Tertiary
What is Hutchinson’s triad and what is it caused by?
It is caused by congenital syphilis and has impaired vision, notched teeth and impaired hearing.
Condylomata lata are associated with what disease?
Secondary, mucocutaneous lesion of syphilis
In what stage is syphilis most infectious?
Secondary stage
What sexually transmitted organism requires cholesterol and urea?
Ureaplasma urealyticum
What sexually transmitted organism is associated with chronic conjunctivitis and blindness?
Chlamydia trachomatis
What organism causes lymphogranuloma venereum?
Chlamydia trachomatis serovars L1, L2, L3
What are the most common locations for HSV-2 outbreaks?
Genitals, anus, perineum. Versus HSV-1 is oral.
Besides skin lesions, what is common with the initial outbreak of HSV-2?
Inguinal lymph node inflammation
What is the name for genital warts?
Condylomata acuminata cauliflower warts from HPV. Condylomata lata are flat and wart-like lesions due to secondary syphilis.
Human papillomavirus (HPV) causes what conditions?
Warts (genital and common), cervical dysplasia and cancer, anorectal cancer, squamous cell carcinoma.
Anal, oral, or genital warts are typically caused by what serotypes of HPV?
HPV-6 and HPV-11
HPV-16, HPV-18 and HPV-31 are associated with what cancers?
Cervical
Penile
Anal
What routine test is used to detect early cervical dysplasia?
Pap smear
Does Trichomonas vaginalis form cysts?
No
What structure makes Trichomonas vaginalis motile?
Flagellum
Can Trichomonas vaginalis cause asymptomatic infections?
Yes, up to half of infections are believed to be asymptomatic.
Can Trichomonas vaginalis infect men?
Yes though less commonly than women.
What range of vaginal pH is most conducive to infection with Trichomonas vaginalis?
More basic than normal, roughly 5-6
What are the genetic characteristics of Turner’s syndrome?
Turner’s syndrome is a sex chromosome disorder in which there is an incomplete or partial chromosome 45, X genome (monosomy X), resulting in hypogonadism.
What conditions may cause vulvitis?
(1) Dermatological conditions, such as psoriasis, eczema, allergic dermatitis
(2) Staph or strep infection
Nonspecific vulvitis may result from what conditions?
Blood dyscrasias, such as leukemia, lymphoma
Uremia
Diabetes
Dystrophic skin lesions often present with what symptom?
Leukoplakia
What is condyloma acuminata?
These are venereal warts, a benign hyperplasia caused by HPV types 6 and 11.
What is the most common malignant tumor of the vulva?
Squamous cell carcinoma, which is associated with HPV infection from types 16 or 18.
What is a potential sequelae of vulval intraepithelial neoplasia?
Invasive carcinoma
What is the most common form of vaginitis?
Candidiasis, a yeast infection causing a white discharge and vaginal itching.
What type of organism causing vaginitis is transmitted sexually?
Trichomonas vaginalis
The vast majority of malignant tumors of the vagina are of what type?
Squamous cell carcinoma, comprising 95% of all malignant tumors of the vagina.
What may form from chronic cervicitis?
Nabothian cysts
What are some specific causes of cervicitis?
Gonorrhea, syphilis, trichomoniasis, and candidiasis
What screening test has been effective in reducing the death rate from carcinoma of the cervix?
Papanicolaou cytologic screening test (pap)
What is cervical carcinoma in situ?
Cervical dysplasia that reaches the basement membrane
Why is inflammation of the uterus not as common as cervicitis?
The endometrium and myometrium are resistant to disease.
What causes chronic endometritis?
Chronic PID
Intrauterine devices
Postpartum or post-abortion tissue retained
Tuberculosis
What is adenomyosis?
Endometrium invades the myometrium in the uterus, a benign condition.
What is endometriosis?
Non-neoplastic endometrial tissue found outside the uterus, often causing bleeding and cramping.
What are chocolate cysts?
Endometriosis in the ovaries creating blood-filled cysts
What are the two forms of dysmenorrhea?
(1) Primary form - no identifiable pathologic cause
(2) Secondary form - caused by other conditions, including chronic pelvic inflammatory disease, adenomyosis, endometriosis, fibroids
What are common causes of menorrhagia?
Endometriosis
Fibroids
Hormonal imbalances
What is the underlying problem in dysfunctional uterine bleeding (dub)?
Excessive unopposed estrogen
What are leiomyomas?
Benign neoplasms that are estrogen sensitive, often causing excessive bleeding.
When does atypical endometrial hyperplasia most commonly occur?
Near menopause. This is because ovulation ceases and thus progesterone production halts.
What are risk factors for endometrial cancer?
Obesity
Diabetes
Hypertension
History of anovulatory cycles
How does salpingitis most commonly present?
Acute abdomen
Of the two types of ovarian cysts, which are the most common?
Follicular cysts. The other type of cyst is of the corpus luteum.
Polycystic ovary syndrome (PCOS), also known as Stein-Leventhal syndrome, is associated with what signs and symptoms?
(1) Bilateral cystic ovaries
(2) Amenorrhea
(3) Acne
(4) Dysfunctional uterine bleeding
(5) Insulin insensitivity
(6) Hypertension
(7) Virilism
(8) Hirsutism
(9) Infertility
(10) Obesity
How are ovarian cancers classified?
By the site of origin:
(1) Surface
(2) Epithelial
(3) Germ cell
(4) Ovarian sex cord-stromal tumors
How common is congenital inversion of the nipple?
Very rare, but important to be aware of when assessing for breast cancer.
What are the four basic types of fibrocystic changes that affect the breast?
(1) Fibrosis form - extensive fibrous overgrowth, no epithelial hyperplasia or cysts
(2) Cystic form - large spaces lined by epithelium, filled with serous fluid, blood or secretions
(3) Sclerosing adenosis - firm lesions of proliferated small ducts or acini with increased stroma, no cysts
(4) Ductal epithelial hyperplasia - extensive multi-layered epithelium in ducts, no cysts; premalignant
What are the signs and symptoms of bacterial mastitis?
Bacterial mastitis is a painful inflammation of the breast seen early in lactation that creates cracks and fissures in the nipples. It is usually one-sided.
What may be detected on palpation of a breast with mammary duct ectasia?
A thickened, ropy feeling from dilated ducts filled with solidified secretions.
Because traumatic fat necrosis of the breast heals with scarring and a palpable mass, it is important to distinguish it from what condition?
Carcinoma
How does fibroadenoma present?
A firm, rubbery, painless well circumscribed lesion that increases and decreases in size with menses and pregnancy.
What are the predisposing factors for breast cancer?
(1) Long-term estrogen exposure due to age, late menopause, early menarche, or obesity
(2) No children or late birth of first child
(3) Previous history or family history of breast cancer
(4) Ductal epithelial hyperplasia
Where do most breast cancers develop?
In the ducts (90 percent)
What is intraductal carcinoma in situ (cis)?
Malignant tumor of the duct epithelium that is not invasive and confined to the basement membrane.
What is lobular carcinoma in situ?
Non-invasive mass of abnormal cells in duct terminals, associated with fibrocystic changes or intraductal cis.
How does Paget’s disease of the breast present clinically?
It affects the nipple and areola and resembles eczema of the nipple.
What two malformations may occur to the urethral meatus of the penis?
(1) Hypospadias - urethral meatus that opens on ventral surface of penis
(2) Epispadias - urethral meatus opens on the dorsal surface of the penis
What occurs with phimosis?
The foreskin of the penis cannot be retracted from the glans penis because of constriction. The constriction may be caused by inflammation or a congenitally narrow opening.
What inflammatory lesion of the penis is usually an acute emergency?
Paraphimosis, which blocks blood flow to the glans.
What is the most common malignant tumor of the penis?
Squamous cell carcinoma, which affects men 40 to 70 years of age and is rare in circumcised men.
What conditions are known to affect the tunica vaginalis of the scrotum?
(1) Hydrocele - serous fluid that fills and distends the tunica vaginalis
(2) Hematocele - blood that accumulates and distends the tunica vaginalis
(3) Chylocele - lymphatic fluid accumulation in the tunica vaginalis from elephantiasis
Cryptorchidism, the failure of the testes to descend into the scrotum, is associated with what complications?
(1) Testicular atrophy
(2) Sterility
(3) Increased risk of germ cell tumors
What is associated with testicular torison?
Compromised blood supply and a hematocele
What characteristics of the left testicular vein make it more likely for variocele development?
It is longer and drains into a smaller vein (the left renal vein) than the right testicular vein. The right testicular vein comes form the inferior vena cava while the left testicular vein comes from the renal artery.
How do seminomas, the most common malignant tumor of germ cell origin, present?
Present in the testes as a painless mass of neoplastic germ cells mixed with lymphocytes.
What organism is the most frequent cause of acute prostatitis?
E. coli
What are the symptoms of both acute and chronic prostatitis?
(1) Low back pain
(2) Dysuria
(3) Urgency (more common with acute prostatitis)
(4) Nocturia
What are the symptoms of benign prostatic hyperplasia (bph), also known as nodular hyperplasia?
(1) Frequency
(2) Nocturia
(3) Incomplete emptying of the bladder
(4) Hesitancy
What is the most common site of metastasis of prostate carcinoma?
Vertebrae, transported by blood and lymph
What are the stages of development of syphilis?
(1) Primary syphilis begins as a hard, painless chancre
(2) If untreated, it goes dormant to re-emerge with symptoms including a skin rash and condyloma lata in secondary syphilis
(3) If left untreated, it goes dormant again and re-emerges as tertiary syphilis with many serious complications
What are the symptoms of gonorrhea in males?
Inflammation and purulent discharge
What is the most common cause of nongonococcal urethritis?
Chlamydia
What are the symptoms of non-gonococcal urethritis?
Mild inflammation and clear discharge in males; cervicitis and clear discharge in females
How does trichomoniasis manifest in the male?
Asymptomatic; important to treat the partner so that re-infection does not occur
HPV may be associated with what types of cancers affecting males?
Penile and anal cancer
What is perimenopause?
The transition into menopause (occurring after reproductive years and before menopause). During this time, the ovaries gradually produce less estrogen (which leads to symptoms such as hot flashes and menses changes).
What is the definition of menopause?
Permanent cessation of menses (12 months of amenorrhea not due to pathological reasons). Ovaries have stopped releasing eggs. Menopause before age 40 is considered as primary ovarian insufficiency.
What is primary ovarian insufficiency (premature ovarian failure)?
Hypogonadism before 40 years old. This can present with similar symptoms of menopause.
