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Endo/Repro: Week 5 > Witrak: Starred Slides > Flashcards

Witrak: Starred Slides Flashcards

1
Q

origin of most abnormal vaginal bleeding

A

> 90% endometrial

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2
Q

what causes dysfunctional uterine bleeding*?

A

disorders of ovulatory cycle (anovulation)

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3
Q

MCC of dysfuncitonal uterine bleeding

A

idiopathic*

PCOS

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4
Q

abnormal vaginal bleeding in POST menopausal women

A

endometrial atrophy*

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5
Q

endometrial ATOROPHY/ HYPERPLASIA/CARCINOMA*

OR

*structural disorders of the endometrium/myometrium:
endometrial POLYPS, leiomyomas, adenomyosis, endometriosis

all CAUSE:

A

abnormal vaginal bleeding

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6
Q

abnormal vaginal bleeding during gestation

A

abnormal gestation*

early trimester miscarriage
ectopic gestation
mid/late trimester bleeding

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7
Q

post menopausal vaginal bleeding is considered…

A

cancer until proven otherwise

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8
Q

adnexal mass

A

lump in adnexa of uterus (usually FT or ovary)

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9
Q

causes of NON-neoplastic ovarian/tubal disease

A

PID*
ectopic gestation
cysts: paratubal, ovarian follicle, corpus luteal
endometriosis

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10
Q

Most neoplastic adnexal diseases occur here

A

ovary

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11
Q

Primary ovarian neoplasms

A
  1. epithelial
  2. sex cord/stromal tumors
  3. germ cell> dermoid cyst
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12
Q

tumors that are metastatic to the ovary*

A

appendix
colon
breast
stomach

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13
Q

Common gestational disorders

A

early trimester miscarriage**

ectopic gestation

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14
Q

abnormal placental implantation

A

previa, abruption, accreta

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15
Q

what can occur peripartum/postpartum

A

hemorrhage*
infection
DIC

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16
Q

category?
hydatidiform mole
choriocarcinoma
placental site trophoblastic tumor

A

trophoblastic neoplasias

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17
Q

HSV transmission

A

can occur during ASYMPTOMATIC/SUBCLINICAL viral shedding (w/out lesions)

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18
Q

extragenital infections caused by HSV

A

aseptic MENINGITIS
distant SKIN LESIONS
urinary BLADDER RETENTION (d/t sacral ANS dysfunction)

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19
Q

dx HSV

A

swabs from UNROOFED vesicles or active ulcers

PCR* for HSV DNA vs. viral culture (50% sensitivity)

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20
Q

most useful for rapid dx of HSV

A

Tzank smear (can be used w/ pts w/ active genital ulcers in the vesical phase)

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21
Q

used in evaluating HSV to assess risk status for future infection or if pregnant pt is at risk to infect baby

A

serology

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22
Q

PAP smear test screening ideally samples form what zone

A

TRANSFORMATION ZONE

spatula/brush device rotates around cervical os than smeared on slide

*1941

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23
Q

what does PAP smear testing take advantage of

A

CIN disease exfoliates abnormal dysplastic cells for YEARS prior to onset of invasive carcinoma**

allows you to catch it early!

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24
Q

main considerations for abnormal vaginal bleeding in REPRODUCTIVE age women

A

dysfunctional uterine bleeding**

pregnancy disorders
anatomic lesions (fibroids, polyps, endometriosis)
inherited/acquired hemostasis disorders

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25
chief causes of vaginal bleeding in POST menopausal women
endometrial ATROPHY** endometrial POLYPS** endometrial hyperplasia endometrial carcinoma
26
percent of women w/ endometrial carcinoma that present w/ abnormal uterine bleeding
75-90%
27
enendometrial histoloogy grades 1-2
type I carcinoma
28
accounts for 80% of endometrial Ca and is usually limited to the UTERUS
type I carcinoma
29
chronic estrogen excess and precursor endometrial hyperplasia can lead to...
type I carcinoma *also associated w/ mutations in PTEN TSG
30
grade 3 endometriod w/ numerous rare subtypes: mucinous, squamous, undifferentiated
serous/clear cell carcinoma**
31
associated with ENDOMETRIAL ATROPHY and NO prior estrogen excess seen more in ELDERLY pts than type I
type 2 endometrial Ca
32
associated w/ mut in p53 TSG tends to be a tumor w/ a higher stage and poor prognosis
type 2 endometrial CA (5 yr survival is only 35%)
33
"endometrial intraepithelial carcinoma" and phenomena of extra uterine disease WITHOUT mymetrial invasion require...
FULL STAGING SURGERY
34
``` Pelvic pain dysmenorrhea deep dyspareunia (pain w/ intercourse) cyclical bowel/bladder sx infertility ```
endometriosis
35
how do you dx endometriosis
LAPAROSCOPY w/ finding of PUNCTUATE SURFACE LESIONS: usually BLACK/BLUE/BROWN
36
"chocolate cyst"
markedly enlarged and cystic ovaries seen w/ endometriosis
37
MC myometrial pathology
Leiomyomas** adenomyosis* leiomyosarcoma
38
an "internal endometriosis" when endometrial GLANDS and STROMA are present in the MYOmetrium in up to 20% of the uterus
adenomyosis leads to poorly circumscribed focal/nodular myometrial wall thickening
39
non-neoplastic source that when large (up to 2 cm) can simulate early cystic neoplasm
prominent follicle or corpus luteal cysts
40
oophoritis
secondary to PID
41
major non-neoplastic considerations when thinking about ovarian pathology
PCOS** oophoritis secondary to PID endometriosis/endometriotic cysts
42
Mentrual irregularity associated w/ oligo/anovulation and infertility + hyperandrogenism (hirsutism, acne, male pattern balding)
PCOS in 6-8% of women
43
PCOS is associated w/
enlarged ovaries w/ polycystic fxs (seen by transvaginal US) obesity insulin resistance/diabetes
44
bilateral epithelial ovarian tumor
serous
45
unilateral epithelial ovarian tumor
mucinous
46
benign
adenoma
47
malignant
carcinoma
48
"borderline" epithelial ovarian tumor
usually serous
49
accounts for 70% of ovarian neoplasias in F 10-30
ovarian germ cell tumors (GCT)
50
accounts for MAJORITY of germ cell tumors consists of SKIN/HAIR*, fat, brain, retina, bronchus, teeth, bone, cartilage, tissue
Mature cystic teratoma (dermoid cyst)** *rarely see monodermal differentiation
51
what percent of teratomas are benign
99%
52
how do teratomas usually present
ASYMPTOMATIC/INCIDENTAL FINDING ACUTE (torsion/infarction, cyst rupture, chemical peritonitis)
53
what percent of malignancies involving the ovary are from ADJACENT GYN CANCERS
5-10% from FT, endometrium, peritoneum
54
what are non-gyn primary cancers that may spread to the ovaries (often BILATERALLY)?
COLORECTUM* APPENDIX* stomach breast
55
signet ring cell adenocarcinoma from the stomach
Krukenberg tumor
56
mucinous peritoneal carcinomatosis (from appendiceal tumor)
pseudomyxoma peritonei
57
MC placental/maternal infection
Ascending** type
58
ascending infections of the placenta usually come from....and can occur with intact or ruptured membranes
vagina/cervix
59
ascending infection that is limited to fetal membranes
chorioamnionitis** | can also involve amniotic fluid, fetus, placental parenchyma
60
complication of placental infection
can cause PREMATURE membrane rupture (PROM) preterm delivery fetal sepsis endomyometritis
61
source of most ascending placental infections
Bacterial ``` Often polymicrobial: streptococcus e. coli ureaplasma fusobacterium anaerobes ```
62
transmission of hematogenous infections from mom to fetus occur
transplacentally
63
infections that spread transplacentally to fetus
``` Toxoplasmosis TB o Rubella hCv CMV Syphillis ``` also malaria, listeriosis, HBV
64
infection usually transmitted perinatally
HIV
65
MC congenital viral infection
CMV
66
fetal infection via birth canal passage if active ulceration is present
HSV
67
MC cause of life-threatening newborn ifnection
group B strep**
68
what percent of 3rd trimester women are carriers of group B strep
20%
69
Fetal infections that can occur via birth canal
HSV group B strep chlamydia gonococcus (newborn conjunctivitis)

Endo/Repro: Week 5 (6 decks)

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