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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
Q

chief causes of vaginal bleeding in POST menopausal women

A

endometrial ATROPHY**
endometrial POLYPS**
endometrial hyperplasia
endometrial carcinoma

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26
Q

percent of women w/ endometrial carcinoma that present w/ abnormal uterine bleeding

A

75-90%

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27
Q

enendometrial histoloogy grades 1-2

A

type I carcinoma

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28
Q

accounts for 80% of endometrial Ca and is usually limited to the UTERUS

A

type I carcinoma

29
Q

chronic estrogen excess and precursor endometrial hyperplasia can lead to…

A

type I carcinoma

*also associated w/ mutations in PTEN TSG

30
Q

grade 3 endometriod w/ numerous rare subtypes: mucinous, squamous, undifferentiated

A

serous/clear cell carcinoma**

31
Q

associated with ENDOMETRIAL ATROPHY and NO prior estrogen excess

seen more in ELDERLY pts than type I

A

type 2 endometrial Ca

32
Q

associated w/ mut in p53 TSG tends to be a tumor w/ a higher stage and poor prognosis

A

type 2 endometrial CA (5 yr survival is only 35%)

33
Q

“endometrial intraepithelial carcinoma” and phenomena of extra uterine disease WITHOUT mymetrial invasion require…

A

FULL STAGING SURGERY

34
Q 
Pelvic pain
dysmenorrhea
deep dyspareunia (pain w/ intercourse)
cyclical bowel/bladder sx
infertility
A

endometriosis

35
Q

how do you dx endometriosis

A

LAPAROSCOPY w/ finding of PUNCTUATE SURFACE LESIONS: usually BLACK/BLUE/BROWN

36
Q

“chocolate cyst”

A

markedly enlarged and cystic ovaries seen w/ endometriosis

37
Q

MC myometrial pathology

A

Leiomyomas**
adenomyosis*
leiomyosarcoma

38
Q

an “internal endometriosis” when endometrial GLANDS and STROMA are present in the MYOmetrium in up to 20% of the uterus

A

adenomyosis

leads to poorly circumscribed focal/nodular myometrial wall thickening

39
Q

non-neoplastic source that when large (up to 2 cm) can simulate early cystic neoplasm

A

prominent follicle or corpus luteal cysts

40
Q

oophoritis

A

secondary to PID

41
Q

major non-neoplastic considerations when thinking about ovarian pathology

A

PCOS**
oophoritis secondary to PID
endometriosis/endometriotic cysts

42
Q

Mentrual irregularity associated w/ oligo/anovulation and infertility
+
hyperandrogenism (hirsutism, acne, male pattern balding)

A

PCOS

in 6-8% of women

43
Q

PCOS is associated w/

A

enlarged ovaries w/ polycystic fxs (seen by transvaginal US)
obesity
insulin resistance/diabetes

44
Q

bilateral epithelial ovarian tumor

A

serous

45
Q

unilateral epithelial ovarian tumor

A

mucinous

46
Q

benign

A

adenoma

47
Q

malignant

A

carcinoma

48
Q

“borderline” epithelial ovarian tumor

A

usually serous

49
Q

accounts for 70% of ovarian neoplasias in F 10-30

A

ovarian germ cell tumors (GCT)

50
Q

accounts for MAJORITY of germ cell tumors

consists of SKIN/HAIR*, fat, brain, retina, bronchus, teeth, bone, cartilage, tissue

A

Mature cystic teratoma (dermoid cyst)**

*rarely see monodermal differentiation

51
Q

what percent of teratomas are benign

A

99%

52
Q

how do teratomas usually present

A

ASYMPTOMATIC/INCIDENTAL FINDING

ACUTE (torsion/infarction, cyst rupture, chemical peritonitis)

53
Q

what percent of malignancies involving the ovary are from ADJACENT GYN CANCERS

A

5-10%

from FT, endometrium, peritoneum

54
Q

what are non-gyn primary cancers that may spread to the ovaries (often BILATERALLY)?

A

COLORECTUM*
APPENDIX*
stomach
breast

55
Q

signet ring cell adenocarcinoma from the stomach

A

Krukenberg tumor

56
Q

mucinous peritoneal carcinomatosis (from appendiceal tumor)

A

pseudomyxoma peritonei

57
Q

MC placental/maternal infection

A

Ascending** type

58
Q

ascending infections of the placenta usually come from….and can occur with intact or ruptured membranes

A

vagina/cervix

59
Q

ascending infection that is limited to fetal membranes

A

chorioamnionitis**

can also involve amniotic fluid, fetus, placental parenchyma

60
Q

complication of placental infection

A

can cause PREMATURE membrane rupture (PROM)
preterm delivery
fetal sepsis
endomyometritis

61
Q

source of most ascending placental infections

A

Bacterial

Often polymicrobial:
streptococcus
e. coli
ureaplasma
fusobacterium
anaerobes
62
Q

transmission of hematogenous infections from mom to fetus occur

A

transplacentally

63
Q

infections that spread transplacentally to fetus

A 
Toxoplasmosis
TB
o
Rubella
hCv
CMV
Syphillis

also malaria, listeriosis, HBV

64
Q

infection usually transmitted perinatally

A

HIV

65
Q

MC congenital viral infection

A

CMV

66
Q

fetal infection via birth canal passage if active ulceration is present

A

HSV

67
Q

MC cause of life-threatening newborn ifnection

A

group B strep**

68
Q

what percent of 3rd trimester women are carriers of group B strep

A

20%

69
Q

Fetal infections that can occur via birth canal

A

HSV
group B strep
chlamydia
gonococcus (newborn conjunctivitis)

Endo/Repro: Week 5 (6 decks)

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