S. Reproductivo Mujer Flashcards
The Gram stain of vaginal fluid shows gram-negative intracellular diplococci – the pathogen responsible for a common sexually transmitted infection (STI).
Neisseria gonorrhoeae
This woman has invasive carcinoma of the breast. The diffuse erythema, edema, and pitting of the skin suggest peau d’orange (skin resembling an orange peel), which supports the diagnosis of inflammatory breast cancer. What is the explanation?
Obstruction of the dermal lymphatics by malignant tumor cells in inflammatory breast cancer results in localized lymphedema,
A 29-year-old woman comes to the physician because of a 3-day history of low-grade fever, muscle aches, and a rash. She has had 4 male sexual partners over the past year and uses condoms inconsistently. Examination shows a diffuse maculopapular rash that includes the palms and soles. The remainder of the skin examination shows no abnormalities. There are no lesions in the oral or genital mucosa. Testing for nonspecific anticardiolipin antibodies is positive. An antinuclear antibody test is negative. It is most appropriate for the physician to order which of the following tests at this time?
The fluorescent treponemal antibody absorption test (FTA-ABS) is a treponemal test (TT). The diagnosis of syphilis is confirmed using a serial testing strategy
This patient’s signs and symptoms of claudication with exertion and delayed femoral pulses are suggestive of aortic coarctation. Coarctation of the aorta, short stature, webbed neck (excess skin folds), and cubitus valgus (increased carrying angle) deformity are characteristic features of Turner syndrome. What other finding she might have?
Gonadal dysgenesis and subsequent streak ovaries are characteristic findings in Turner syndrome.
A 76-year-old woman comes to the physician for evaluation of a 3-month history of vulvar itching and pain. She was diagnosed with lichen sclerosus 4 years ago. She has smoked 1 pack of cigarettes daily for 35 years. Physical examination shows a 2.5-cm nodular, ulcerative lesion on the vaginal introitus and left labia minora with surrounding erythema. Punch biopsy shows squamous cell carcinoma. A CT scan of the chest, abdomen, and pelvis shows enlarged lymph nodes concerning for metastatic disease. Which of the following lymph node regions is the most likely primary site of metastasis?
The superficial inguinal nodes are the primary lymphatic draining site for the distal vagina and vulva
This 48-year-old woman has a rapidly growing 6-cm breast mass without any mastalgia, skin/nipple changes, or lymphadenopathy, indicating a benign condition. The mammogram also suggests a benign lesion (no spiculations or microcalcifications), and the biopsy confirms the diagnosis, showing a leaf-like microarchitecture.
Phyllodes tumor
A 27-year-old woman comes to the physician for a 1-week-history of painful urination and urinary frequency. She has no history of serious illness and takes no medications. She is sexually active with her boyfriend. Her temperature is 36.7°C (98.1°F). There is no costovertebral angle tenderness. Urine dipstick shows leukocyte esterase. A Gram stain does not show any organisms. Which of the following is the most likely causal pathogen?
This patient likely has Chlamydia trachomatis infection. Although most cases are asymptomatic, patients can present with urethritis and/or vulvovaginitis, as seen here. Chlamydiae do not gram stain well because they are obligate intracellular bacteria that lack muramic acid in their cell wall.
A 36-year-old woman comes to the physician for an annual pelvic examination and Pap smear. Her last Pap smear was 3 years ago. She has been sexually active with multiple male partners and takes an oral contraceptive. She has smoked one pack of cigarettes daily for 10 years. Pelvic examination shows no abnormalities. A photomicrograph of cervical cells from the Pap smear specimen is shown. Cells similar to the one indicated by the arrow (koilocytes) are most likely to be seen in which of the following conditions?
Koilocytes are pathognomonic of infection with human papillomavirus (HPV). Condylomata acuminata, like cervical dysplasia, are caused by an infection with HPV and can therefore present with koilocytes on histopathology. Condylomata acuminata are typically associated with HPV strains 6 and 11. Other manifestations of HPV infection include vulvar and vaginal intraepithelial neoplasia, as well as skin warts (verruca vulgaris) and plantar warts.
A 37-year-old nulliparous woman comes to the physician because of a 6-month history of heavy, prolonged bleeding with menstruation, dyspareunia, and cyclical abdominal pain. Menses previously occurred at regular 28-day intervals and lasted 4 days with normal flow. Pelvic examination shows an asymmetrically enlarged, nodular uterus consistent in size with a 10-week gestation. A urine pregnancy test is negative. Histopathologic examination shows smooth muscle bundles in a whorled pattern, which is characteristic of this condition. Another common pathologic feature is the presence of a pseudocapsule.
Which of the following is the most likely diagnosis?
Leiomyoma
Menorrhagia, dyspareunia, and dysmenorrhea in a nulliparous woman with an asymmetrically enlarged nodular uterus on examination is suggestive of uterine fibroids (leiomyomata), which are benign monoclonal smooth muscle tumors that arise in the myometrium.
The uterine artery, a branch of the internal iliac artery, supplies blood to the uterus. It runs through a structure located at the base of the broad ligament of the uterus.
The cardinal ligament (transverse cervical ligament) connects the cervix with the lateral pelvic wall, providing support to the uterus.
