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Reproductive > Vulva Dx > Flashcards

Vulva Dx Flashcards

1
Q

Inflammatory disease of the vulva

A

Vulval condylomata
herpes Simplex
candidiasis

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2
Q

Pathogen causing condyloma acuminatum

A

HPV

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3
Q

Gross morphology of condyloma acuminatum

A

Exophytic benign papillomatous lesion on skin or mucous membrane

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4
Q

Main part of the reproductive system affected by condyloma acuminatum

A

Vulva
Perianal region perineum
vagina
cervix

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5
Q

Different presentation of condylomata

A 
Papules 
Plaques 
 nodules
 spiked or 
cauliflower like excrescences
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6
Q

Microscopic findings in condylomata

A

Striking papillomatous proliferation of squamous epithelium
Koilocyte- Epithelial cell with Perry nuclear hello and wrinkled nucleus containing HPV particles
Extensive Cytoplasmic destruct leading to koilocyte

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7
Q

Thank you Bashan period of herpes simplex

A

1-3 weeks

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8
Q

gross morphology of herpes simplex

A

Small vesicles and vulva which erode and become painful ulcers

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9
Q

Ganglia affected by genital herpes

A

Sacral ganglia

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10
Q

Can a newborn acquire fetal herpes infection through the birth canal from mother

A

Yes

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11
Q

If a mother has herpes virus what is an indication of C-section

A

Active herpetic lesions in the vagina at time of delivery

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12
Q

Percentage of women with asymptomatic fungi in vulva or vagina

A

10

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13
Q

Most common offender of candidiasis

A

Candida Albicans

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14
Q

Percentage of women that actually present with clinical apparent candidal vulvovaginitis

A

2%

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15
Q

Risk factors to candidiasis

A

Pregnancy
diabetes mellitus
oral contraceptives

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16
Q

Meaning presentation of infection candidiasis

A

Itching vulva

white discharge

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17
Q

Chris morphology of candidiasis

A

Firmly adherent Small white plaque on mucous membrane

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18
Q

Microscopy of candidiasis

A

Submucosal edema

chronic inflammation

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19
Q

What is the main diagnostic criteria of candidiasis

A

Characteristics spores and pseudohyphae in the wet mount preparation

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20
Q

Leukoplakia meaning

A

White pathches

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21
Q

Leukoplakia common areas

A

Vulva

Perineum

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22
Q

Types of leukoplakia

A

Squamous hyperplasia

Lischen sclerosis

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23
Q

Condylomata acuminata due tot which HPV strain

A

2
6
11

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24
Q

In coNdylomata acuminata , this phenomenon prominent in superficial keratinocytes

A

Koilocytosis

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25
Q

Name of sweat gland tumors presenting as local lump

A

Hidradenomas

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26
Q

Hudradenomas Micro morphology

A

Interlacing papillae lined with epithelium

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27
Q

Granular cell tumor morphology

A

Well circumscribed vulval lump

Uniform large cells , pink granular cytoplasm

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28
Q

Type of tumor seen on bartholins glands

A

Cysts abscess
Adenomas
Adenocarcinoma

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29
Q

Main population affected by carcinoma of vulva

A

6-7th decade

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30
Q

Main type of carcinoma of the vulva

A

squamous cell carcinoma

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31
Q

Lymph nodes to which carcinoma of the vulva spreads

A

Inguinal lymph node

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32
Q

Disease that leads to HPV related carcinoma

A

Vulval intraepithelial neoplasia Or Bowens disease

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33
Q

What can you compare extra memory Paget’s disease to in terms of manifestation

A

Paget’s disease of breast

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34
Q

Morphology of extra memory Paget’s disease

A

Prurituc red crusted sharply demarcated map like area on labia majora
Palpable submucosal thickening or tumor

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35
Q

Disease related to vagina discharge

A

Chronic cervicitis

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36
Q

Type of discharge in gonococcal infections

A

Frothy the vagina discharge

37
Q

Population of women affected by squamous cell carcinoma

A

Older woman

38
Q

Parts of the reproductive system at risk of fistula formation because of squamous cell carcinoma

A

Vagina bladder and rectum

39
Q

Which cancer is found in adolescent girls and is associated with administration of stillboestrol to the mothers in early pregnancy

A

Clear cell adencarcinoma

40
Q

Second name of embryonal rhabdomyosarcoma

A

Sarcoma botryoids

41
Q

Population at risk of embryonal rhabdomyosarcoma

A

Infants and children under five years old

42
Q

Morphology of embryonal rhabdomyosarcoma

A

Malignant Rhabdomyoblast
polypoid rounded bulky messages
sometimes fill and project out of vagina
Grape clusters - botyroides

43
Q

Elements causing death in embryonal rhabdomyosarcoma

A

Penetration of peritoneal cavity p

Obstruction of urinary tract

44
Q

Type of epithelium in ecto cervix

A

None keratinized stratified squamous epithelium

45
Q

Type of epithelium in endo cervix

A

Mucus secreting columnar epithelium with glands

46
Q

Noninfectious inflammatory disease of the cervix causes

A

Chemicals
tampons
pessaries

47
Q

Infectious causes of inflammatory disease of cervix

A

Bacteria -n. Gonorrhaea , strep, gardnerella vaginalis ,actinomyces Israeliii , tuberculosis

virus - HPV HSV

fungi- candida ,aspergillus

protozoa -T vaginalis she still small spaces

48
Q

What is cervicitis

A

Mild clinic information of cervix

49
Q

Structure that can undergo squamous metaplasia in chronic cervicitis

A

Endocervical glands

50
Q

Can you see dysplasia Of the squamous epitheliumin cervicitis

A

Yes

51
Q

Second name of cervical erosion

A

Cervical ectopy

52
Q

What is cervical erosion

A

Overgrowth of columnar epithelium replacing squamous epithelium around the cervical os

53
Q

Etiology of cervical erosion

A

Parturition
contraceptive pills
persistent condition normal in infancy
association with cervicitis

54
Q

What is cervical dysplasia

A

Disorderly but not neoplastic proliferation of cell with less in uniformity of individual cell and less of architectural orientation
may end up in Franck malignancy if not treated

55
Q

Different grades of cervical dysplasia

A

Mild
moderate
severe

56
Q

What are the stages of dysplasia in the three forms of cervical intraepithelial neoplasia and invasive carcinoma

A

CIN1- Mild dysplasia Less ,than 1/3
CIN2-Moderate dysplasia ,lower than 1/2 to 2/3
CIN3- Cynthia dysplasia -more than 90%

57
Q

symptoms of CIN

A

None

58
Q

What do you see in ascetic acid painting of cervix in the dysplastic epithelium

A

Aceto-whiteness

59
Q

What is carcinoma in situ of cervix

A

Complete loss of stratification in polarity variation in nuclear sizes of cells Mitotic figures at all levels

60
Q

Main area of carcinoma in situ development in cervix

A

squamocolumnar Junction

61
Q

Main age of carcinoma in situ of cervix

A

4th decade or earlier

62
Q

Is a screening test diagnostic for cervical cancer

A

No

63
Q

Which test is used to big dysplastic cells of cervic before they become malignant

A

Papaniculaou

64
Q

What is the Bethesda system

A

Adequacy of smear
presence or absence of dysplastic or malignant cells
background of smear

65
Q

Most common malignant tumor of the female genital tract

A

Carcinoma of the cervix

66
Q

Main type of carcinoma of the cervix

A

Squamous cell carcinoma

67
Q

High incidence Risk factors of carcinoma of cervix

A

Prostitute
early age of first coitus
multiple sexual partner lifetime
partners with previous multiple sex partner

68
Q

Low incidence risk factors in carcinoma of cervix

A 
Oral contraceptive
 cigarette smoking 
family history 
Genital infection 
lack of circumcision in male sexual partner
69
Q

Strains of HPV associated with squamous papilloma

A

1
2
4
7

70
Q

HPv associated with condylomata and cervical intra epithelial neoplasia 1 and 2

A

6

11

71
Q

HPV associated with cervical intraepithelial neoplasia 3 and invasive carcinoma

A

16, 18, 33

72
Q

If a cervical cancer is not associated with HPV which other risk factor might be associated to

A

HIV and cigarette smoking

73
Q

How do carcinoma of the cervix spread

A

Downward to the os and vagina
laterally to parametrium and ureters
Anteriorly and posteriorly to bladder the rectum and sacral nerveto the pelvic lymph nodes

74
Q

Percentage of endocervical adenocarcinoma in malignant cervical tumors

A

20

75
Q

Main morphology of invasive adénocarcinoma

A

Fungated or polyploid or papillary mass
If exophytic-> would have papillary pattern

if endophytic -> would have Glandular or tubular pattern

76
Q

Better survival for scc or invasive Adenocarcinoma

A

Scc

77
Q

How many stages in cervical carcinoma

A

5 from 0 to 4

78
Q

What is stage 0 cervical carcinoma

A

Carcinoma in situ at cervical intraepithelial neoplasia stage 3

79
Q

What is stage 1 cervical carcinoma

A

Carcinoma confined to cervix

80
Q

What is stage 2 cervical carcinoma

A

Carcinoma extending beyond cervix but not into pelvic wall

involves vagina not lower third

81
Q

What is stage 3 cervical carcinoma

A

Carcinoma extending into pelvic wall which involves lower third of vagina
no carcinoma free space between tumor and pelvic wall

82
Q

What is stage 4 cervical carcinoma

A

Carcinoma extend beyond true pelvis
can involved mucosa of bladder wall or rectum
distant metastasis

83
Q

5 yearSurvival rates for stage one cervical cancer

A

80 to 90%

84
Q

5 yearSurvival rates for stage 2 cervical cancer

A

75%

85
Q

5 yearSurvival rates for stage 3 cervical cancer

A

35 %

86
Q

5 yearSurvival rates for stage one cervical cancer

A

10 to 15%

87
Q

Main cause of death in stage 4 cervical cancer

A

Ureteral obstruction
Pyelonephritis
uremia

88
Q

Prevention of cervical carcinoma

A

Vaccination against HPV for girls and boys less than 15 years old
2 doses with 6 to 12 months interval

Gerdasil 9 vaccine to 27 to 45 years old

Gerdasil 3 vaccine for 11 and 12 yo

Cervical cancer screening Pap smear
Visual inspection using acetic acid

Reproductive (14 decks)

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