Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

medicine > The female genital tract > Flashcards

The female genital tract Flashcards

1
Q

What diseases are specific to the vulva?

A

1) bartholin cyst
2) lichen sclerosus
3) squamous cell hyperplasia or lichen simplex chronicus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What does lichen sclerosus look like?

A

smooth white plaques that in time coalesce

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What happens in lichen sclerosus when the entire vulva is affected?

A

the labia becomes atrophic and stiffened and the vaginal orifice is constricted

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What group of women does lichen sclerosus more commonly occur in?

A

post menopausal women

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What does lichen sclerosus look like on histology?

A

1) thinned epidermis with disappearance of rete pegs

2) dermal fibrosis with a scan perivascular mononuclear infiltrate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Is lichen sclerosus pre malignant?

A

NO!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the histology seen with squamous cell hyperplasia or lichen simplex chronicus?

A

1) marked epithelial thickening
2) expansion of the stratum granulosm
3) significant surface hyperkeratosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Does squamous cell hyperplase or lichen simplex chronicus increase your predisposition to cancer?

A

NO!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is a benign tumor of the vulva?

A

condyloma acuminatum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the malignant tumors of the vulva?

A

1) vulvar intraepithelial neoplasia and vulvar carcinoma
2) extra mammary paget disease
3) malignant melanoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the cause of condyloma cuminatum?

A

1) sexually transmitted

2) HPV 6 and 11

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the gross apperance of condyloma cuminatum?

A

1) verrocous
2) multifocal
3) looks like cauliflower and can be mistaken for laryngeal papiloma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the most common type of vulvar carcinoma?

A

squamous carcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What squamous cell carcinoma is most related to high risk HPV infections?

A

basolid and warty carcinomas

VIN —–> SCC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What squamous cell carcinoma is not related to HPV?

A

keratinizing SCC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What cells do HPV infect?

A

immature basal cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What cells does HPV replicate in?

A

1) squamous cells

2) results in a cytopathic effect “kolicytic atypia”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the progression of vulvar intraepithelial neoplasia (VIN) cause basaloid or warty carcinomas?

A

1) HPV infection
2) low grade dysplasia
3) moderate dysplasia
4) severe dysplasia (carcinoma in situ)
5) invasive squamous carcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What causes non-HPV related VIN and what does it lead to?

A

probably caused by chronic irritation in the elderly. leads to keratinizing squamous carcinomas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What does extramammary pagets disease look like clinically?

A

1) pruritic
2) red
3) crusted
4) sharply demarcated
5) on the labia majora

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What does extra mammary pagets disease look like on histology?

A

large tumor cells with a clear halo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What do patients with extra mammary pagets disease also have?

A

all have an underlying breast carcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What product caused benign vaginal lesions in some babies?

A

DES - diethylstilbestrol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are the tumors of the vagina?

A

1) vaginal intraepithelial neoplasia
2) squamous cell carcinoma
3) embryonal rhabdomyosarcoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is the most common malignant neoplasm of the vagina?

A

metastasis from the cervix

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is embryonal rhabdomyosarcoma also called and who does it occur in?

A

1) sarcoma botryoides

2) infants less than 5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What does embryonal rhabdomyosarcoma look like clinically?

A

1) polyploid, round bulk mass
2) protrudes out of vagina
3) bag of grapes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What does embryonal Rhabdomyosarcoma look like on histology?

A

1) small cells with oval nuclei
2) small protrusions of cytoplasm
3) striations within the cytoplasm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is the more recent terminology for cervical intraepithelial neoplasia?

A

1) CIN I - mild
2) CIN II - moderate
3) CIN III - severe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What terminology are clinical decisions based on for CIN?

A

1) CIN I - low grade

2) CIN II and III - high grade

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What are the characteristics of an SIL or squamous intraepithelial lesion?

A

1) nuclear atypia
2) enlargement
3) hyperchromasia (dark)
4) variation in nuclear size

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What is koliocytosis?

A

1) involves mature squamous cells

2) bi nucleation and cytoplasmic halos

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What are the differences in atypia found in the different stages of CIN?

A

1) CIN I - atypia in lower 1/3 of epithelium
2) CIN II - atypia 2/3 of epithelium
3) CIN III - full thickness atypia (Carcinoma in situ)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What is p16?

A

1) a gene that encodes for cyclin kinase inhibitor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What does cyclin kinase inhibitor do?

A

it is a cell cycle regulatory protein which inhibits the cell cycle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What is wrong with p16 in cells with HPV?

A

There is an over expression of p16 (cyclin kinase inhibitor)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What do ALL high grade squamous intraepithelial lesions have?

A

HPV 16 and HPV 18 infections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What are the recommendations for pap screening?

A

1) first pap - 21 y/o or within 3 years of onset of sexual activity and after on an anual basis
2) after age 30 - with 3 normal results - screened every 2-3 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What are the two types of cervical carcinoma and how common are they respectively?

A

1) squamous cell carcinoma - 80%

2) adenocarcinoma - 15%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What is an immediate precursor to squamous cell carcinoma?

A

CIN III (HSIL)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What is endometriosis?

A

presence of endometrial tissue outside the uterus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What are the most common sites of endometriosis?

A

1) ovaries
2) uterine ligaments
3) rectovaginal septum
4) cul de sac
5) pelvic peritoneum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What is the clinical presentation of endometriosis?

A

1) infertility
2) dysmenorrhea (painful menses)
3) pelvic pain
4) women of reproductive age

44
Q

What can endometriosis give rise to?

A

carcinoma

45
Q

What are the two theories on how endometriosis occurs?

A

1) metastatic theory

2) metaplastic theory

46
Q

What is the main thought behind metastatic theory and what is some proof behind it?

A

1) retrograde menstration

2) proof - shed of endometrium in peritoneal fluid, high incidence in women with retrograde flow

47
Q

What is the main thought behind metaplastic theory and what is some proof behind it?

A

1) endometrium could arise from epithelial lining of pelvic peritoneum or mullerian remnant tissue
2) proof - endometriosis in men and females with turner syndrome

48
Q

What two things are present on histological diagnosis of endometriosis?

A

1) endometrial glands

2) endometrial stroma

49
Q

What causes endometrial hyperplasia?

A

1) due to prolonged estrogen stimulation

2) increased number of glands

50
Q

What are the 4 categories of endometrial hyperplasia?

A

1) simple without atypia
2) simple with atypia
3) complex wtithout atypia
4) complex with atypia

51
Q

What category of endometrial hyperplasia is most likely to progress to carcinoma?

A

complex with atypia: 23-48%

52
Q

Who is most likely to get endometrial carcinoma?

A

1) post menopausal women (55-65)

2) post menopausal bleeding

53
Q

What have mutations of PTEN tumor supressor gene been associated with?

A

1) endometrioid carcinomas

2) endometrial hyperplasia

54
Q

What is the most common type of endometrial carcinoma?

A

endometrioid adenocarcinoma

55
Q

What are the associations with endometriod type carcinoma?

A

1) estrogen
2) age 55-65
3) hyperplasia

56
Q

What are the associations with non-endometrioid carcinoma?

A

1) older females: 65-75
2) p53 mutations
3) poor prognosis
4) not related to estrogen
5) includes serous, clear cell and mixed mullerian tumors

57
Q

What are the benign and malignant tumors of the myometrium?

A

1) benign - leiomyomas

2) malignant - leiomyosarcomas

58
Q

What is a leiomyoma?

A

1) most common benign tumor in women
2) originates from smooth muscle
3) most of the women are child bearing age

59
Q

What is the gross appearance of a leiomyoma?

A

1) sharply circumscribed
2) round
3) firm
4) gray-white

60
Q

What is the histological apperance of a leiomyoma?

A

1) bundles of smooth muscle cells
2) uniform in size and shape
3) rare mitotic figures

61
Q

Who is most susceptible to a leiomyosarcoma?

A

1) equally common before and after menopause

2) peak age 40-60

62
Q

What is the prognosis of leiomyosarcoma?

A

1) tendency to metastasize

2) 5 year survival of 40%

63
Q

What is the gross appearance of a leiomyosarcoma?

A

1) bulky, fleshy masses invading the uterine wall

2) polypoid masses that project into the uterine lumen

64
Q

What is the histology of a leiomyosarcoma?

A

1) bundles of smooth muscle cells with pleiomorphic and abundant mitotic figures
2) enlarged and irregular nucleus

65
Q

What are the non-neoplastic/functional cysts of the ovaries?

A

1) follicle and luteal cysts

2) polycystic ovaries and stromal hyperthecosis

66
Q

What are tumors of the ovaries?

A

1) surface epithelium tumors
2) sex cord stromal tumors
3) germ cell tumors
4) metastatic tumors

67
Q

How common are cystic follices in the ovaries?

A

so common they are basically normal

68
Q

What are cystic ovarian follicles?

A

1) originate in unruptured graafian follicles or in follicles that have ruptured and immediately sealed
2) usually multiple
2) up to 2cm in size

69
Q

What is polycystic ovaries and stromal hyperthecosis?

A

1) numerous cystic follicles often associated with oligomenorrhea
2) high levels of LH (anovulation, hyperandrogenism)
3) persistent amenorrhea, obesity, hirsutism and rarely virilism

70
Q

What is hirsutism?

A

presence of excessive terminal hair in androgen-dependent areas of a womans body

71
Q

Why is ovarian cancer so bad?

A

only 3% of all female cancer BUT detected when they have metastasized and account for a very high number of deaths

72
Q

What are 3 types of tumors of the surface epithelium of the ovary?

A

1) serous tumor
2) mucinous tumor
3) endometroid tumor

73
Q

What are risk factors for serous epithelial tumor of the ovary?

A

1) nulliparity
2) family history
3) mutations - BRACA1 and BRACA2

74
Q

What mutations are associated with malignant serous carcinoma of the ovary?

A

1) low grade - KRAS, BRAF

2) high grade (de novo) - p53, BRACA 1/2

75
Q

What are risk factors for mucinous epithelial ovarian tumors?

A

1) smoking

2) KRAS mutations

76
Q

What is the histology of mucinous epithelial ovarian tumors?

A

tall columnar epithelial cells with apical cilia

77
Q

What mutations are associated with endometriod tumors of the ovary?

A

1) PTEN tumor suppressor gene
2) KRAS and b-catenin oncogenes
3) micro satellite instability

78
Q

What is present in the serum of most patients with serous and endometrioid carcinomas and why is it not good for screening?

A

1) CA-125

2) can be elevated with non-specific irritation

79
Q

What is the most common germ cell tumor?

A

teratoma

80
Q

What are the contents of a teratoma?

A

1) wall of cyst - squamous epithelium with hair shafts and sebaceous glands
2) cyst contents - hair, bone, cartilage, brain

81
Q

What is dyserminoma and whatis its prognosis?

A

1) ovarian counterpart of seminoma of testis
2) large polyhedral tumor cells with central round nucleus, with surrounding lymphocytes
3) responsive to chemo - 80% survival

82
Q

What is an endodermal sinus (yolk sac) tumor?

A

1) rare
2) rich in alpha fetoprotein and alpha 1 antitrypsin
3) schiller-duval body - central blood vessel surrounded by germ cells

83
Q

What is a chriocarcinoma?

A

1) very aggressive but rare
2) exist mostly in combo with other germ cell tumors
3) identical to placental choriocarcinoma
4) high blood levels of hCG

84
Q

What happens with a granulosa theca cell tumors in young females vs adult females?

A

1) young females - precocious puberty

2) adult females - endometrial hyperplasia, cystic disease of the breast

85
Q

What are the characteristics of a granulosa theca cell tumors?

A

1) elevated inhibin serum levels
2) usually unilateral
3) yellow cut surface - lipids
4) call-exner body - gland like structure filled with central acidophilic

86
Q

What are fibromas, thecomas and fibrothecomas?

A

1) fibromas - tumors composed of fibroblast

2) thecomas - plump spindle cells with lipids

87
Q

What are the characteristics of fibroma, thecoma and fibrothecomas?

A

1) unilateral (90%)
2) majority are hormonally inactive and benign
3) pelvic mass + ascites + hydrothorax = meig’s syndrome

88
Q

What is a sertoli-leyding cell tumors (androblastomas)?

A

1) produce masculinization due to androgen production - atrophy of breasts, amenorrhea, sterility and loss of hair
2) progress to virilization (hirsutism) - male distribution of hair, hypertrophy of clitoris and voice changes

89
Q

What does a sertoli-leyding cell tumor look like grossly?

A

solid, golden yellow (lipid)

90
Q

What does a sertoli-leyding cell tumor look like on histology?

A

tubules composed of sertoli cells or leydig cells

91
Q

What are the gestational trophoblastic diseases?

A

1) hydatidiform mole
2) invasive mole
3) tumors
a) choriocarcinoma
b) placental site trophoblastic tumor

92
Q

What is a hydatidiform mole?

A

1) cystic swelling of the chorionic villi

93
Q

What age groups are hydatidiform moles most common?

A

1) teens

2) 40-50

94
Q

What is a complete hydatidiform mole?

A

1) fertilization of an egg that has lost its chromosomes - genetic material is parenterally derived
2) 46 XX (90%)
3) 10% fertilization of an egg by two sperm
4) not usually fetal parts
5) small risk of choriocarcinoma

95
Q

What is a partial hydatidiform mole?

A

1) fertilization of an egg with two sperm
2) triploid karyotype (69 XXY)
3) tetrapolyd (92, XXXY)
4) more often fetal parts
5) no risk of choriocarcinoma

96
Q

What does a complete mole show on histology?

A

1) show abnormalities that involve all or most of the villous tissue
2) enlarged chorionic villi and proliferation of trophoblast that involves the entire circumference of the villi

97
Q

What does a partial mole show on histology?

A

1) abnormalities involve only a portion of the villi

98
Q

What is p57KIP2?

A

a gene that is maternally transcribed but paternally imprinted and shows expression in maternal decidual tissue and cytotrophoblast and stromal cells when maternal genetic material is present

99
Q

Is p57 expressed in hydatidiform moles?

A

1) complete mole = negative p57

2) partial mole = positive p57 (has maternally derived tissue)

100
Q

What are the treatments for hydatidiform moles?

A

1) curettage

2) monitor serum concentrations of HCG (6 months to a year)

101
Q

What is an invasive mole?

A

1) mole that penetrates or perforates uterine wall
2) persistent elevated serum HCG
3) treat with chemotherapy

102
Q

What is a choriocarcinoma?

A

1) malignant neoplasm of trophoblastic cells derived from a previously normal or abnormal pregnancy

103
Q

Where do choriocarcinomas arise from?

A

1) 50% - hydatidiform moles
2) 25% - previous abortions
3) 22% - normal pregnancy

104
Q

What is seen on histology with choriocarcinomas?

A

1) does not contain chorionic villi - contains syncytiotrophoblast and cytotrophoblast
2) invades myometrium, has a rapid growth
3) metastasis to lung, vagina, brain, liver and kidney

105
Q

What is the treatment for choriocarcinoma?

A

1) chemotherapy - 100% remission

2) high cure rate

medicine (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions