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Unit 1 ID+LC > Vaginal diseases Post > Flashcards

Vaginal diseases Post Flashcards

1
Q

3 types of lymph node areas that drain the pelvic cavity

A
  1. Periaortic
  2. pelvic
    - uterine/ovarian cancers
  3. inguinal
    - vulvar neoplasms
  • which LN will you go after and how aggressive?
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2
Q

HSV will result in red painful lesions how many days after exposure?

A

3-7 days

Eosinophilic intranuclear inclusions
- pink

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3
Q

Molluscum contagiosum (pox virus) seen in which populations?

A

Adults
- genital (STD)

Children
- extremities via sharing towels (swimming)

Endophytic growth pattern

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4
Q

Condyloma acuminatum are seen with which HPV strain?

A

6, 11

White lesions

  • leaflike, papillae tips
  • Koilocytes (raisinoid nucleus with clear cytoplasm)
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5
Q 
flagellated protozoan,
frothy yellow d/c
foul smelling
dysuria/dyspareunia
"strawberry cervix" on colposcopy
A

Trichomonas

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6
Q

Nl, but can overgrow

Curdlike d/c and pruritis

A

candida

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7
Q

“sulfur granule” with clublike projection, non copper IUD

A

actinomyces

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8
Q

HPV associated SCC

  • population
  • HPV genes
  • precursor lesion
A

females

- takes a long time to develop

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9
Q

Infammatory associated SCC

  • population
  • HPV genes
  • precursor lesion
  • histology
A

female >70 yrs

HPV neg

Lichen sclerosus/ d-VIN

  • prominent keratin pearls in well differentiated carcinoma
  • resembles parchment, paperlike skin
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10
Q

Extramammary paget disease visual

A

red crusted sharply demarcated map-like area

  • histology: tumor cells with halo
  • in vulvar: not associated with carcinoma
  • in breast: is
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11
Q

Malignant melanoma in vulvar region

A

can look a lot like other cancers

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12
Q

Cancer we have to worry about for DES exposure

A

Clear cell carcinoma

  • “kissing lesion”
    anterior upper 1/3 of vagina with discontinuous areas
  • histology: tubulocystic pattern of growth with dense hyaline stroma. Clear cytoplasm with bland nuclei
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13
Q

Endocervical polyps found in which pop?

  • sx?
  • tx?
A

2-5% of adult women

can cause spotting

tx: curettage curative

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14
Q

staging of cervical cancers

A

based on clinical findings

*unlike endometrial cancers

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15
Q

histology of proliferative phase of menses.

- driven by what?

A
  1. straight tubular glands
  2. mitoses
  3. nuclear stratification
  • driven by E
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16
Q

Histology of secretory phase

- driven by what?

A

“S for secretory”

  1. S shaped tortuous, coiling glands, secretory activity
    - “piano keys”
  • driven by progesterone and E2 falling
17
Q

Menstrual phase

  • histology
  • drive by what?
A
  1. Stromal/glandular breakdown
  2. Inflammation
  3. Intravascular fibrin
  • driven by decrease in E2 and Progesterone
18
Q

Hormones driving pregnancy

- histology

A

Progesterone, hcG

  • histology: stromal decidualization
  • Arias-Stella Reaction
19
Q

Menopause

A
  • lack of E = everything kind of thins down
    1. >6 mo w/o menstruation
    2. Thin endometrium w/o mitoses
    3. Decrease cervical mucous and glycogenation
    4. cystic atrophy
20
Q

Polyps response to hormones

A

dont really respond

- out of phase with endometrial cycle

21
Q

Endometritis

A

clinicall PID
- acute: increase polyps in stroma and gland

  • chronic:
    plasma cells + infertility
22
Q

Diff betwen Adenomyosis and Endometriosis

A

Endometrial glands are not where they should be:

Adenomyosis
- w/in uterine wall

Endometriosis:
- outside of the uterus

  • same same
  • are hormonaly sensitive (unlike polyps)
23
Q

Most common uterine tumor

A

leiomyoma

  • WELL CIRCUMSCRIBED whorled bundleds of bland sm
  • menometrorrhagia, infertility, mass
  • hormonally responsive (unlike polyps)
24
Q

Tx of leiomyom

A
  1. surgery
  2. embolization
  3. GnRH agonist
  4. Nothing - not bothering her
25
Q

Most common uterine sarcoma

A

leiomyosarcoma

  • hemorrhage, necrosis
  • rapid increase in size (high mitotic activ)
  • mets to lungs
26
Q

Adenocarcinoma types

A 
Endometrioid adenocarcinoma (Type I)
- younger women + E dep w/ good prog
Serous adenocarcinoma (Type II)
- older women, higher grade histology w/ poorer prognosis
27
Q

Type I Endometrial cancer

  • age groups
  • risk factor
A

Premenopausal

risk: unopposed estrogen, genetics

28
Q

Hereditary nonpolyposis colon cancer (HNPCC) is a risk factor for which types of cancer? Why?

A

mutated mismatch repair genes –> microsatellite instability

genes that form heterodimers and are mismatch repair proteins: MLH1, MSH2

men: colon cancer
women: endometrial cancer

29
Q

Risk that simple hyperplasia can progress to cancer?

Treatment?

A

rarely progress to cancer

tx: progestins
(due to unopposed estrogen –> hyperplasia)

*comples hyperplasia 5-30% can progress to cancer

30
Q

Risk that complex hyperplasia can progress to cancer

A

5-30%

*simple hyperplasia rarely does

31
Q

Endometrial carcinoma (invaded beyond bm of glands)

  • symptoms
  • peak incid?
A

Usually asymptomatic

5th and 6th decade (50-60yrs old)

32
Q

Prognosis of endometrial carcinoma

- tx

A

stage I: 96% 5 yr survival

stage III: 23%

-tx: surgery - take uterus out

33
Q

Type II endometrial cancer

  • age group
  • aggressiveness?
  • % of endometrial cancers
A

Post menopausal

Agressive: think p53

10-20% endometrial cancers

34
Q

Most important lesions to remember in pts with abnl uterin bleeding (AUB)

A
  1. polyps
  2. adenomyosis
  3. leiomeyomas
  4. hyerplasia
  5. carcinoma
35
Q

grade vs stage

A

grade: degree of differentiation
stage: extent of spread

36
Q

which is type I and which is type II cancer? and name gene involved
Endometrial SEROUS carcinoma

Endometrial ENDOMETRIOID carcinoma

A

Endometrial SEROUS carcinoma

  • Type II
  • mut of p53

Endometrial ENDOMETRIOID carcinoma
- Type I
- mut in:
MLH-1, BRAF, B-catenin

Unit 1 ID+LC (32 decks)

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