Vulvar, Cervical, & Uterine Pathologies Flashcards
What is condyloma accuminatum?
Genital warts caused by HPV 6, 8, or 11
Most vulvar carcinomas are ____________________ in nature with a peak incidence at __________________ years of age?
Squamous cell; 60-70
A vulvar carcinoma in a young female is a ____________________________ also known as a ___________________________?
Rhabdomyosarcoma; sarcoma botryoides
What is acute cervicitis?
Inflammation of the cervix related to constant exposure to bacterial flora in the vagina
29 year old female patient presents to your office complaining of a discharge from her cervix. The cervix is grossly red and swollen. There is pus dripping from the external os. The fluid is aspirated and shows high amounts of neutrophils. What is the likely diagnosis?
Acute cervicitis
What form of cervicitis is the most common?
Chronic cervicitis
32 year old female patient presents to your office complaining of a discharge from her cervix. The cervical mucosa is hyperemia and shows erosions. A biopsy of the tissue shows high amounts of lymphocytes and plasma cells as well as a squamous metaplasia at the endocervical transformation zone. The patient is negative for an HPV infection. What is the likely diagnosis?
Chronic cervicitis
What are the most common cervical growths?
Endocervical polyps
31 year old female patient presents to your office complaining of vaginal bleeding and discharge. In the cervix there is a single, smooth mass that is lobular and 2.5 cm in diameter. What is the likely diagnosis?
Endocervical polyp
Most malignancies of the cervix are _____________________ carcinomas?
Squamous cell
What strands of HPV can cause cervical cancer?
HPV 16 and 18
22 year old female patient presents to your office complaining of lower right quadrant abdominal pain. She reports being sexually active. A CBC shows leukocytosis of 15,000 WBC and presence of human choriotropic gonadatropin (HCG) . She is positive for a pregnancy test. An ultrasound confirms the presence of a gestational sac in the region of pain. What is the likely diagnosis?
Ectopic pregnancy
What is the histological sign of a squamous cell carcinoma anywhere in the body?
Keratin pearl
What is the most common complaint in the early stages of a cervical carcinoma?
Vaginal bleeding after intercourse and/or painful intercourse
What is dyspareunia?
Painful intercourse
39 year old female patient presents to your office with the chief complaint of pain during intercourse associated with vaginal bleeding. Notable in the patient’s history is a 20 pack year smoking hx, an early pregnancy at age 15, and failure to use protection during intercourse. A biopsy of the cervix shows a keratin pearl appearance. What is the likely diagnosis?
Cervical carcinoma
What is metrorrhagia?
Increased bleeding between menstrual periods
What is menorrhagia?
Increased bleeding during menstruation
What is endometritis?
Inflammation of the endometrium due to ascending infection or IUD/PID
What can cause endometritis?
Ascending UTI
Intrauterine device
Pelvic inflammatory disease
What is pyometria?
Pus in the endometrial cavity
What gastrointestinal pathology is commonly associated with pyometria due to the reserve of bowel and uterine fistulas?
Crohn’s disease
27 year old female patients presents to your office complaining of a vaginal discharge. In the endometrial cavity a needle aspiration shows a purulent fluid that is high in neutrophils and proteins. Notable in the patients history is a past of intermittent irritable bowel symptoms usually presenting as right lower quadrant pain. What is the likely diagnosis based on this presentation?
Pyometria
What is adenomyosis?
Presence of endometrial glands and stroma within the myometrium
32 year old female patient presents to your office complaining of painful intercourse. When inquiring about her menstrual cycle she notes that she has been having very irregular periods that come every few months and are heavier than normal. Biopsy of the uterine tissue in the myometrium shows the presence of endometrial glands and stroma within the muscular layer of the uterus. What is the likely diagnosis?
Adenomyosis
What is the most common benign tumor of the uterus during reproductive age?
Leiomyoma
What is the common term for a leiomyoma of the uterus?
Uterine fibroid
What are the three types of leiomyomas of the uterus?
Submucous
Intramural
Subserous
What is/are the main symptom(s) present in a submucous leiomyoma of the uterus?
Increased bleeding including menorrhagia or metrorrhagia
23 year old female patient presents to your office complaining of vaginal bleeding. The patient says that the bleeding is the worst during menstruation but continues in between her periods. Ultrasound shows a hyperechoic mass protruding into the uterine cavity. A biopsy of the tissue shows a well-defined mass of smooth muscle. What is the likely diagnosis?
Submucous leiomyoma
What is/are the main symptom(s) present in an intramural leiomyoma of the uterus?
Often asymptomatic unless very large and can cause a myriad of symptoms including bowel, pain, and bleeding
23 year old female patient presents to your office complaining of bleeding and pain in the abdominopelvic region around her vagina. The patient reports the worst bleeding during menstruation but that it persists in the interim. An ultrasound shows a hyperechoic mass inside the wall of the uterus that is very large. What is the likely diagnosis?
Intramural leiomyoma
23 year old female patient presents to your office. For the past few weeks she has been progressively getting better for her chief complaint of low back pain. She is concerned however because her gynecologist discovered a hyperechoic mass in the wall of her uterus. She reports no change in symptoms. What is the likely diagnosis?
Intramural leiomyoma
What is/are the main symptom(s) present in a subserous leiomyoma of the uterus?
Pain and pencil thin stools
23 year old female patient presents to your office complaining of vaginal and pelvic pain. When inquiring about any changes in bowel or bladder habits. The patient reports less volume in her stool. An ultrasound shows a hyperechoic mass pushing on the peritoneum of the patient. What is the likely diagnosis?
Subserous leiomyoma
What causes endometrial hyperplasia?
Estrogenic stimulation
Endometrial hyperplasia can increase your risk for developing adenocarcinoma (TRUE/FALSE)?
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26 year old female patient presents to your office complaining of a heavy period that has persisted for a few months now. She presents to your office just after her last period. Her endometrial stripe is markedly thickened and should be thinnest following menstruation. The patient reports no other symptoms. A blood test shows a high level of estrogen. What is the likely diagnosis based on this information alone?
Endometrial hyperplasia
What is the most common gynecological cancer?
Endometrial adenocarcinoma
54 year old female patient presents to your office complaining of vaginal bleeding and pain. The patient is post-menopausal and overweight. She has no children. Her blood pressure is 141/94. A biopsy of her endometrial lining shows cells that are poorly differentiated and pleomorphic. What is the likely diagnosis?
Endometrial adenocarcinoma
What is endometriosis?
Growth of edometrial tissue (Ectopic) outside of the normal location
Where can ectopic endometrium present in the body?
Salpinx, ovary, bladder, rectum, shoulder, peritoneum
28 year old female patient presents to your office complaining of right shoulder pain. The pain has an odd pattern to it. The patient reports that the pain is the worst every 3 or 4 weeks during her period. The pain then subsides following her period. What pathology is this likely describing based on this information alone?
Endometriosis
What is salpingitis?
Inflammation of the uterine tubes
What is the main etiology of salpingitis?
Neisseria Gonorrheae, Escheria Coli, Chlamydia, and mycoplasma
What is hydrosalpinx?
Serous accumulation distal to stenosis from late-stage salpingitis
What is pyosalpinx?
Purulent exudate distal to stenosis from late-stage salpingitis
What is a tubo-ovarian abcess?
Abcess distal to the stenosis and ovary from late-stage salpingitis
Salpingitis may predispose an individual to ___________________?
Ectopic pregnancy
27 year old female patient presents to your office complaining of abdominopelvic pain. The patient performs a urine test which is positive for escheria coli. The cervix is unremarkable. A needle aspiration of the right uterine tube where the patient reports the most pain shows purulent exudate. What is the likely diagnosis?
Pyosalpinx
27 year old female patient presents to your office complaining of abdominopelvic pain on the left. The patient performs a urine test which is positive for neisseria gonorrhea. The cervix is unremarkable. A needle aspiration of the left Fallopian tube shows a straw-like fluid that has a few cells and high protein content. What is the likely diagnosis?
Hydrosalpinx
