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Systems Pathology II Final > Vulva, Vagina, Cervix, Uterus > Flashcards

Vulva, Vagina, Cervix, Uterus Flashcards

1
Q

What is the most common condition involving the vulva?

A

Inflammation (neoplasia is rare)

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2
Q

What two general conditions can cause vulvitis?

A

1 allergic contact dermatitis (eczema)

2 infection

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3
Q

Obstruction of which female gland can result in a cyst and possible infection leading to the formation of an abscess?

A

Bartholin gland

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4
Q

Which female labial epithelial disorder results in epidermal thinning and atrophy?

A

Lichen sclerosus

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5
Q

Lichen sclerosus most commonly affects what population?

A

Elderly

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6
Q

Is there a cancer risk associated with lichen sclerosus?

A

Small (1-5% progress into SCC)

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7
Q

What is the hypothesized cause of lichen sclerosus?

A

Autoimmune

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8
Q

Which female labial epithelial disorder involves epithelial hyperplasia and hyperkeratosis from chronic irritation?

A

Lichen simplex chronicus

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9
Q

Which is NOT associated with a cancer risk at all: lichen sclerosus or lichen simplex chronicus?

A

Lichen simplex chronicus

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10
Q

Both lichen sclerosus and lichen simplex chronicus resemble what other condition?

A

Leukoplakia

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11
Q

What is most common type of vulvar carcinoma (although overall rare)?

A

Non-HPV-related SCC

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12
Q

Which type of vulvar carcinoma is associated with vulvar intraepithelial neoplasia (VIN)?

A

HPV-related SCC

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13
Q

What strains of HPV cause vulvar carcinoma?

A

HPV-16 and HPV-18

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14
Q

Which type of vulvar carcinoma is associated with older women? Middle-aged women?

A

Older women = Non-HPV-related SCC

Middle-aged = HPV-related SCC

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15
Q

What are the two types of vulvar carcinoma?

A

HPV-related SCC or non-HPV-related SCC

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16
Q

Lichen sclerosus can cause what type of vulvar carcinoma?

A

Non-HPV-related SCC

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17
Q

What infection produces green vaginal discharge?

A

Trichomonas vaginalis

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18
Q

Which fungal infection produces white vaginal discharge?

A

Candida albicans

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19
Q

What are the risk factors for vaginitis?

A

Diabetes, antibiotic therapy, immunodeficiency, pregnancy, recent abortion

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20
Q

What is the clinical term for white or yellow vaginal discharge?

A

Leukorrhea

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21
Q

What is the most common type of vaginal cancer?

A

Squamous cell carcinoma

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22
Q

What are risk factors for vaginal squamous cell carcinoma?

A

HPV, early intercourse, multiple partners

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23
Q

Which type of vaginal cancer presents as a risk for offspring whose mothers took diethylstilbestrol (DES)?

A

Clear cell adenocarcinoma

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24
Q

Which type of vaginal cancer presents with red/granular foci?

A

Clear cell adenocarcinoma

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25
What is unique about the location of a sarcoma botryoides?
Rhabdomyosarcoma that occurs in an area without skeletal muscle
26
Which type of vaginal cancer is a form of embryonal rhabdomyosarcoma?
Sarcoma botryoides
27
What is the clinical term for an inflamed cervix?
Cervicitis
28
What is the most common infectious cause of cervicitis?
Chlamydia (just under 50% of all cases)
29
What are non-infectious causes of cervicitis?
Acute: postpartum Chronic: reproductive age women (estrogen fluctuations, trauma)
30
What are risk factors for cervical cancer?
1 early first intercourse 2 multiple sex partners 3 male partner with several past partners 4 persistent infection with high-risk HPV
31
What is the average age in the U.S. for first sexual intercourse?
17 years
32
Do most HPV infections persist into cervical intraepithelial neoplasia (CIN)?
No
33
What is the precursor to invasive cervical carcinoma?
Cervical intraepithelial neoplasia (CIN)
34
What area of the cervix is the location where immature squamous cells are infected with HPV-16 or HPV-18 to develop into cervical cancer?
Transformation zone
35
Which oncogene involved with cervical cancer binds to TP53 and deactivates it? Which binds to Rb gene and deactivates it?
TP53 = E6 oncogene | Rb gene = E7 oncogene
36
What is known as the guardian of the genome?
TP53
37
What is known as the governor of the genome?
Rb gene
38
What type of cells make up the endocervix?
Columnar epithelial
39
What type of cells make up the exocervix?
Squamous epithelial
40
In what location of the cervix do both types of cervical epithelial (columnar and squamous) coexist?
Transformation zone
41
What is the most common age of diagnosis for cervical intraepithelial neoplasia (CIN)?
30 years
42
Although CIN is most commonly diagnosed at age 30, when does invasive cancer usually get diagnosed as a result of CIN?
15 years post diagnosis (aka around 45)
43
What are the two forms of CIN?
Low-grade (CIN I) and high-grade (CIN II-III)
44
What are the rates of progression and regression for both types of CIN?
``` CIN I (observation) = 60% regress, 10% progress to high-grade CIN II-III (excision) = 30% regress, 10% progress to cancer ```
45
What is the term for the collection of cellular changes caused from HPV?
Koilocytosis
46
What changes are seen in koilocytosis?
1 anaplasia/dysplasia 2 enlarged nuclei 3 irregular, wrinkled borders 4 darker staining (hyperchromasia)
47
What fraction of invasive cervical cancer cases are fatal?
1/3
48
Why is it important to do regular pap smear screening for neoplasia of the cervix?
CIN is asymptomatic
49
What is the most common type of invasive carcinoma of the cervix?
Squamous cell carcinoma (75%)
50
What age range is the most common time for diagnosis of cervical cancer?
Mid 40s
51
Are smaller or larger lesions of invasive cervical cancer associated with a better prognosis?
Smaller (metastasis occurs in 1% of those 3mm)
52
What population of women most commonly develop invasive cervical cancer?
Women without previous pap smear
53
What are the late stage symptoms of invasive cervical cancer (since it is asymptomatic early on)?
Leukorrhea, bleedings, dysuria, painful sex
54
What is the most common way those with cervical cancer die?
Local invasion (renal failure)
55
What is the treatment for invasive cervical cancer?
Hysterectomy and lymph node excision
56
Endometritis is associated with risks for what conditions?
1 ectopic pregnancy | 2 infertility
57
What is the clinical term for inflammation of the endometrium?
Endometritis
58
Endometritis is most commonly secondary to what disease?
Pelvic inflammatory disease (PID)
59
What infections can cause pelvic inflammatory disease?
N. gonorrhea, C. trachomatis, TB
60
What other things can cause endometritis besides PID?
Conception, abortion, intrauterine device
61
Female infertility results in what percentage of cases of endometriosis?
50%
62
Endometriosis affects 10% of what population?
All reproductive-age women
63
What is the method of injury of endometriosis?
Cyclic bleeding leading to fibrosis
64
What are the features of endometriosis?
Severe dysmenorrhea, dysuria, pelvis pain, sterility, painful BMs, painful intercourse
65
"Chocolate cyst" of the ovary is associated with what female condition?
Endometriosis
66
What is the clinical term for irregular, between periods (spotting)?
Metrorrhagia
67
What is the clinical term for profuse/prolonged menstruation?
Menorrhagia
68
When are anovulatory cycles most common?
At extremes of reproductive life (young and old)
69
What phase of the menstrual cycle is inadequate due to a retained endometrium leading to an anovulatory cycle and abnormal uterine bleeding?
Luteal
70
What are some causes of abnormal uterine bleeding?
``` 1 leiomyomas, leiomyosarcomas, endometrial carcinomas, endometritis 2 anovulatory cycle 3 idiopathic (dysfunctional uterine bleeding) ```
71
Elevated levels of what hormone can lead to endometrial hyperplasia? What conditions can cause this?
Estrogen; obesity and PCOD
72
What is the most common female genital tract cancer?
Endometrial carcinoma (NOT CERVICAL CANCER)
73
What is the most common type of endometrial carcinoma?
Endometrioid (80%)
74
What is the most common age range for endometrial carcinomas?
55-65 years
75
What is the unique symptoms seen in those that develop endometrial carcinoma and why?
Metrorrhagia (unique because the age range = 55-65)
76
What are the risk factors for endometrial carcinoma?
1 elevated estrogen (obesity) 2 infertility 3 hypertension 4 diabetes
77
What is the most common age range for the development of endometrial polyps?
Around menopause (40-50)
78
What is another term for a leiomyoma of the uterus?
Fibroids (benign tumors)
79
Which type of uterine smooth muscle tumor affects reproductive-age women? Post menopausal women?
``` Leiomyoma = reproductive-age women Leiomyosarcoma = postmenopausal ```
80
What race is more at risk for the development of uterine fibroids?
African Americans
81
When do uterine fibroids tend to shrink and why?
At menopause due to decreased levels of estrogen
82
Which type of uterine smooth muscle tumor is benign? Malignant?
``` Benign = leiomyoma Malignant = leiomyosarcoma ```
83
Which type of uterine smooth muscle tumor usually presents as a solitary, anapestic, hemorrhagic/necrotic mass?
Leiomyosarcoma
84
Which type of uterine smooth muscle tumor presents as multiple, well-circumscribed lesions?
Uterine fibroids (leiomyomas)
85
What is the most common location of metastasis for a uterine leiomyosarcoma?
Lungs
86
In what part of the uterus do smooth muscle tumors occur?
Myometrium

Systems Pathology II Final (8 decks)

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