Test 2 (Week 5) Flashcards
endometroid adenocarcinoma is associated with which specific gene mutation?
PTEN
Vulvar melanoma is mucin, PAS stain _____.
negative
Why does Prempro suck so bad that it’s trial got canceled?
increased risk of heart attacks, stroke, breast cancer, and blood clots
What’s Mifepristone (RU 486) used for?
abortifacient; combined w/ misoprostol
Brenner tumors have a predominant stromal component with island of _____.
transitional epithelium (look like bladder epithelium)
where do follicle cysts originate?
enraptured Graffian follicles
What is Chandelier sign?
cervix is tender (moving abscess) and painful to patient
What are the possible side effects of infertility treatment?
ovarian hyperstimulation, pulmonary complications (atelectasis and ARDS), CV complications (thrombosis and embolism)
abnormal vaginal discharge with strong “fishy” odor =
bacterial vaginosis
What causes bacterial vaginosis?
Replacement of lactobacilli and normal flora with overgrowth of anaerobic bacteria; this alters the normal vaginal environment
What’s the most common cause of bloody nipple discharge?
intraductal papilloma
extramammary Paget’s disease is mucin, PAS stain ____.
postive
What’s the only place you can cultivate pathogenic Treponema palladium?
rabbit testes.
What’s the major side effect of Diethylstilbestrol (DES)?
teratogenic; increased risk of child developing vaginal or cervical cancer if used in utero
Most common breast tumor in adolescent and young adults
fibroadenoma
What’s the most common causes of Salpingitis?
chlamydia or gonorrhea
How does serous “papillary” carcinoma spread?
–Spread through the fallopian tubes to the peritoneal cavity, thus worse prognosis –Lacks cell-surface adhesion molecules; spreads via exfoliation
What’s the causative agent of syphillis?
Treponema pallidum
Which cell type predominates in chronic endometritis ?
plasma cells
What’s the most common cause of anovulatory cycle?
obesity; peripheral fat makes estradiol
What is Fitz-Hughes-Curtis syndrome?
perihepatitis caused by chlamydia and gonorrhea on liver; can see “violin string” adhesions of parietal peritoneum to liver
What’s the shape of Treponema pallidum
corkscrew
What stain can you use to diagnose extramammary Paget’s disease?
mucin stain +
What is endometriosis?
Endometrial glands, stroma or both outside the uterine corpus.
The cause of chronic cervicitis is almost always ____.
Chlamydia
non-odorous white “cottage cheese” discharge =
candida albicans vulvovaginitis
What’s the most common cause of infertility and ectopic pregnancy?
pelvic inflammatory disease
What causes chronic endometritis?
gonorrhea, chlamydia, IUD (actinomyces) -not associated with pregnancy or retained products
What is a Jarisch-Herxheimer Reaction?
systemic reaction caused by the release of large numbers of killed syphilis organisms beginning 6-8 hours following treatment w/ effective antibiotic
What’s the treatment for syphilis?
penicillin G
Describe Sarcoma botryoides (including it’s effected patient population)
it’s a rare malignant skeletal muscle sarcoma on the anterior wall of the vagina.. shows rapid growing polypoid grape-lie mass; effects kid/infants under 5
How is Clomiphene effective in treating infertility?
it’s competitive inhibitor of estrogen receptors in the hypothalamus, so it prevents negative feedback = GnRH, FSH and LH levels increase
What is Danazol used for?
endometriosis and fibrocystic breast disease
extramammary Paget’s disease is S-100 protein _____.
negative
What organ is also removed in a patient with a mucinous cystadenoma of the ovary? Why?
the appendix is also removed; appendiceal tumor is the most common cause of pseudomyxoma pertonei (mucin throughout the abdomen)
In what tumor are Call-Exner bodies found?
granulosa cell tumor
Which cell type predominates in acute endometritis?
neutrophils
What are the more common progestins used in contraceptive meds?
Norgestrel Levonorgestrel Norethindrone Ethynodiol diacetate
What will characteristically be found in Leydig cells?
Reinke crystals
What’s the weird thing about Leiomyosarcoma?
Majority arise de novo, not out of pre-existing leiomyoma. **Leiomyomas are NOT a risk factor for leiomyosarcoma
How do you treat anovulatory cycle?
OCP’s
What’s Raloxifine used for?
postmenopausal osteoporosis; agonist of estrogen receptors in the bone
Clear cell tumors have the highest association with ____. They may also have associated ______.
pelvic endometriosis; hypercalcemia
Clear cell adenocarcinoma of the vagina is due to what?
intrauterine exposure to diethylstilbestrol (DES)
What are Call-Exner bodies?
small holes that are full of a pink secretion seen in granulosa cell tumors
What’s the MOA of Mifepristone (RU 486)?
competitive inhibitor of progestins at progesterone inhibitors
The pathogenicity of vaginal candida infections correlates with ability to adhere to tissues. What can increase its ability to attach?
estrogen
How do the chancre of chancroid differ from the chancre of syphilis?
chancroid= painful syphilis= painless
What is salpingitis?
inflammation of the fallopian tubes
What’s the vaginal pH with a candida infection?
normal (
What causes an anovulatory cycle?
Caused by excess estrogen (relative to progesterone) with proliferative “growth” until endometrial collapse on itself, spiral arteries rupture, and bleeding occurs.
Which proteins of high risk HPV disable two important tumor suppressor proteins that regulate the cell cycle? Which HPV protein goes with which tumor suppressor?
HPV proteins E6 and E7; E6 binds p53 and E7 binds to RB
What are the skin lesions that can appear in tertiary syphilis?
gummas- granulomatous dermal lesions
What’s the most common type of endometrial carcinoma?
endometroid adenocarcinoma
profuse, frothy, purulent vaginal discharge=
Trichomonas vaginalis
What hormonal imbalances accompany polycystic ovarian syndrome?
exces LH and androgens which lead to sxs of the disease
GI tract cancer that metastasizes to the ovaries is called what?
Krukenberg tumor
What are the 4 things you look at to make a diagnosis of bacterial vaginosis (you need 3 of em)?
1) homogenous white discharge 2) pH>4.5 3) “fishy” amine odor of vaginal fluid mixed with 10% KOH (whiff test) 4) clue cells
What stimulates growth of Leiomyomas ?
estrogen
what is Meigs syndrome?
hydrothorax and ascites caused by a thecoma
What’s the treatment for infertility when it is due to pituitary hypo function (women fail to ovulate)?
hMG/hCG or clomiphene
What cancer marker is detected in any ovarian cancer?
CA 125
What are some side effects of oral contraceptives ?
thrombotic events, MI, hypertension, cancer
What causes acute endometritis ?
Occurs after parturition or miscarriage, especially preterm birth. Due to retained products of conception with subsequent bacterial infection (Usually group B strep)
From what cells are Leiomyosarcomas derived from?
myometrial cells
How will secondary syphilis present?
painless lymphadenopathy with fever, malaise, headache, and a generalized skin rash (can be on soles and palms)
What’s the MOA of Tamoxifen?
it’s a competitive partial agonist of estrogen receptors. Antagonist at breast, agonist at bone and uterus.
What’s the vaginal pH with a bacterial vaginosis?
pH is elevated (4.7-5.5)
Yolk sac tumors are predominantly in young patients. What will be elevated in almost all cases?
AFP
What’s the MOA of Raloxifine ?
antagonist of estrogen receptors of breast and uterus and agonist of these same receptors in the bone
benign smooth muscle tumor
leiomyoma “fibroids”
What’s the most potent natural estrogen?
estradiol
100% of patients with Paget’s disease of the nipple have associated ____.
ductal carcinoma insitu
vaginitis with extensive inflammation and tissue erosion around the vagina =
Trichomonas vaginalis
Describe the histology features of invasive lobular carcinoma.
small uniform round or oval nuclei diffusely infiltrating the stroma in a single file pattern
Endometrial polyps are associated with the use of what breast chemotherapy med?
Tamoxifen
The progression to endometrial carcinoma is often due to mutations in which genes?
PTEN, KRAS
What type of necrosis is seen in ductal carcinoma in situ?
comedo necrosis
What’s Tamoxifen used for?
treat breast cancer (antagonist of estrogen receptors in breast)
Serous “papillary” carcinoma”is associated with which specific gene mutation?
p53
If a patient with pelvic inflammatory disease has RUQ pain, what do you need to be thinking of?
Fitz-Hughes-Curtis syndrome
What’s the only endometrial carcinoma associated with endometrial hyperplasia?
endometroid adenocarcinoma
Vulvar melanoma is S100 protein ____.
postive
What’s the vaginal pH with a Trichomonas vaginalis infection?
pH >5.0
What’s the MOA of Danazol?
synthetic androgen that acts as partial agonist at androgen receptors
What’s the name of the skin lesions in syphilis? are they painful?
chancre; not painful
