Vaginal diseases Post Flashcards
3 types of lymph node areas that drain the pelvic cavity
- Periaortic
- pelvic
- uterine/ovarian cancers - inguinal
- vulvar neoplasms
- which LN will you go after and how aggressive?
HSV will result in red painful lesions how many days after exposure?
3-7 days
Eosinophilic intranuclear inclusions
- pink
Molluscum contagiosum (pox virus) seen in which populations?
Adults
- genital (STD)
Children
- extremities via sharing towels (swimming)
Endophytic growth pattern
Condyloma acuminatum are seen with which HPV strain?
6, 11
White lesions
- leaflike, papillae tips
- Koilocytes (raisinoid nucleus with clear cytoplasm)
flagellated protozoan, frothy yellow d/c foul smelling dysuria/dyspareunia "strawberry cervix" on colposcopy
Trichomonas
Nl, but can overgrow
Curdlike d/c and pruritis
candida
“sulfur granule” with clublike projection, non copper IUD
actinomyces
HPV associated SCC
- population
- HPV genes
- precursor lesion
females
- takes a long time to develop
Infammatory associated SCC
- population
- HPV genes
- precursor lesion
- histology
female >70 yrs
HPV neg
Lichen sclerosus/ d-VIN
- prominent keratin pearls in well differentiated carcinoma
- resembles parchment, paperlike skin
Extramammary paget disease visual
red crusted sharply demarcated map-like area
- histology: tumor cells with halo
- in vulvar: not associated with carcinoma
- in breast: is
Malignant melanoma in vulvar region
can look a lot like other cancers
Cancer we have to worry about for DES exposure
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
Endocervical polyps found in which pop?
- sx?
- tx?
2-5% of adult women
can cause spotting
tx: curettage curative
staging of cervical cancers
based on clinical findings
*unlike endometrial cancers
histology of proliferative phase of menses.
- driven by what?
- straight tubular glands
- mitoses
- nuclear stratification
- driven by E
Histology of secretory phase
- driven by what?
“S for secretory”
- S shaped tortuous, coiling glands, secretory activity
- “piano keys”
- driven by progesterone and E2 falling
Menstrual phase
- histology
- drive by what?
- Stromal/glandular breakdown
- Inflammation
- Intravascular fibrin
- driven by decrease in E2 and Progesterone
Hormones driving pregnancy
- histology
Progesterone, hcG
- histology: stromal decidualization
- Arias-Stella Reaction
Menopause
- 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
Polyps response to hormones
dont really respond
- out of phase with endometrial cycle
Endometritis
clinicall PID
- acute: increase polyps in stroma and gland
- chronic:
plasma cells + infertility
Diff betwen Adenomyosis and Endometriosis
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)
Most common uterine tumor
leiomyoma
- WELL CIRCUMSCRIBED whorled bundleds of bland sm
- menometrorrhagia, infertility, mass
- hormonally responsive (unlike polyps)
Tx of leiomyom
- surgery
- embolization
- GnRH agonist
- Nothing - not bothering her
