Women's Reproductive System - Carpenter Flashcards
1
Q
What is the epithelium of ectocervical mucosa
A
squamous
non-keratinizing
2
Q
What is the epithelium of endocervical mucosa
A
Columnar cells
- mucin
3
Q
Another name for cervis
A
transformation zone
4
Q
epithelium of cervix
A
squamocolumnar junction
5
Q
what are 2 layers of uterus
A
myometrium
endometirum
6
Q
histo for fallopian tubes
A
- columnar, both ciliated and non-ciliated
- intercalated cells (peg cells)
7
Q
what female structures does herpes simplex invade
A
vulva
vagina
cervix
8
Q
what does HSV look like
A
painful, red papules on vulva
- vesicles, ulcers
9
Q
For diagnosis what can detect HSV
A
NAA - nucleic acid amplification
Pap smear
detect anti-HSV antibodies
10
Q
what does herpes look like on pap smear
A
ground glass nuclei
11
Q
What is Molluscum contagiosum
A
pox virus
12
Q
what does Molluscum contagiosum impact
A
skin and mucous membranes
13
Q
What Molluscum Contagiosum is most prevalent
A
MCV1
14
Q
What Molluscum Contagiosum is sexually transmitted
A
MCV2
15
Q
Molluscum commonly occurs in who
A
young children 2-12
16
Q
how is Molluscum transmitted in children
A
1 direct contact
- inaminate objects
- lesion of trunk, arms, legs
17
Q
how is Molluscum transmitted in adults
A
sexually
18
Q
Clinical appearance of Molluscum
A
papules
dome-shaped
dimpled center
19
Q
what does Molluscum look like under microscope
A
Intracytoplasmic viral inclusions
20
Q
What is most common yeast infection
A
Candida
21
Q
What are risk factors for candida
A
pregnancy
diabetes
BCP
22
Q
symptoms of yeast infections ( candida)
A
itching
erythema
cottage cheese-like discharge
23
Q
What is used to diagnose yeast infection ( candida)
A
pap smear
wet preparation
culture and/or NAA
24
Q
What does Candida look like on pap smear
A
“spaghetti and meatballs”
25
clinical feature of Trichomonas vaginalis
fishy vaginal discharge with fishy odor
26
Trichomonas vaginalis can cause what
inflammatory response
27
what is the gross appearance of Trichomonas vaginalis
strawberry cervix
28
Trichomonas vaginalis increase susceptibility to what disease
HIV
29
What is the impact of Trichomonas vaginalis on pregnancy
- preterm deliver
| - low birth weight infants
30
What is the easiest method to diagnose trichomonas? other methods
wet prep ( easiest)
- pap smear
- liquid pap vial
31
What are characteristic of gardnerella
gram negative small bacillus
32
what CAN gardnerella be associated with?
bacterial vaginitis
33
on a wet prep or pap smear what do you seen for Gardnerella
epithelial cells covered with bacteria
| -- Clue cells
34
Chlamydia trachomatis causes what 3 diseases
1. follicular cervicitis
2. endometritis
3. salpho-oophoritis
35
what is follicular cervicitis
abundant lymphocytes seen infiltrating cervix
36
chlamydia trachomatis can cuase what
infertility
37
how is chlamydia trachomatis diagnosed
pap smear by NAA test
| urine specimen
38
Name 3 agents that can cause pelvic inflammatory disease
1. gonorrhea
2. chlamydia
3. enteric bacteria
39
what are 3 clinical features of pelvic inflammatory disease
1. pelvic pain
2. fever
3. vaginal discharge
40
When does PID occur
following: abortion, D&C, surgical procedure, normal delivery
41
what is puerperal infection
any bacterial infection of the female reproductive tract following childbirth or miscarriage.
42
initially what does PID cause
- acute suppurative salpingitis
- - acute inflammatory cells filling tubes
- - cause abscess formation
43
where does gonococcal PID usually begin? what anatomy does it involve? where can it spread and when does this happen? What layer does it involve
```
Bartholin glands
- cervix
2-7 days after exposure
- upward to tubes and ovaries
surface epithelium
```
44
How does non-gonococcal PID spread?
lymphvascular channels
45
What is the difference between gonococcal and non-gonococcal PID
non-gonococcal: inflammatory reaction deeper in layers
| gonococcal: surface epithelium
46
what are 3 complications of PID
1. peritonitis
2. bacteremia
3. intestinal obstruction
47
on what anatomical structure does leukoplakia occur
vulva
48
what does leukoplakia look like
"white plaque"
49
how is leukoplakia diagnosed
biopsy
50
what is lichen sclerosis
white patches with associated labial atrophy
- can be pruritic
- multiple areas
51
who is lichen sclerosis seen in?
post menopausal
52
what can cause lichen simplex chronicus
rubbing skin to relieve pruritis
53
what can lichen simplex chronicus present as
leukoplakia
54
What is the histo for lichen simplex chronicus and lichen sclerosis
lichen simplex chronicus: acanthosis, hyperkeratosis
| lichen sclerosis: thin epidermis, decrease glands
55
acanthosis
thickening of epidermis
56
what is condyloma acuminatum
venereal wart
| benign condition
57
Condyloma Acuminatum is associated with what other problem
HPV types 6 and 11 (low risk)
58
what is seen microscopically for Condyloma Acuminatum
kiolocyte (halo cell)
59
Majority of vulvar carcinomas are what type of carcinomas
squamous cell carcinomas
60
how are vulvar carcinomas categorized
HPV related
| non-HPV related
61
what is HPV related vulvar carcinoma called
Basaloid/Warty carcinioma
62
basaloid/warty carcinoma is associated with high risk of what
HPV
63
what is Basaloid/warty carcinoma preceded by
VIN
64
how can Basaloid warty carcinoma initially appear as
leukoplakia
65
what type of women get non-HPV related vulvar carcinoma
with long standing lichen sclerosis or squamous cell hyperplasia
66
what is histo for non-HPV vulvar carcinoma
keratinizing squamous cell cancers
67
what disease is vulvar squamous cell carcinoma associated with and precedes it
HPV
| VIN
68
grossly what does extra mammary paget disease look like
pruritic red crusted lesions
69
histo for extra mammary paget disease
large tumor cells surrounded by clear halos
70
where does paget disease originate from? where does the disease usually stay
stem cells or apocrine ducts
| epithelium
71
Breast Paget disease 100% associated with
adenocarcinoma
72
vaginal carcinomas are what type majority
squamous cell carcioma
73
vaginal carcinoma is associated with what disease
HPV
74
how does one usually get vaginal carcinoma
spread from cervical lesion
75
Why was Diethylstibesterol given to women
prevent preterm delivery
76
what is the problem with DES
problems with daughter
| not much problems with son
77
DES increases risk for what
- clear cell adenocarcinoma
- structural abnormalities of female genital tract
- infertility
78
how does vaginal adenosis from DES change epithelium
squamous epithelium replaced by glandular epithelium
79
who is embryonal rhabdomyosarcoma/sarcoma botryoides seen in
children less than 5 years
80
embryonal rhabdomyosarcoma/sarcoma botryoides gross appearance
grapelike clusters projecting from vagina
81
what is the process of cervix squamous metaplasia
1. increase estrogen increases glycgoen uptake by cervical/vaginal mucosa
2. glycogen provides substrate for bacteria
3. bacteria causes drop in vaginal pH
4. endocervix responds by proliferation of reserve cells
5. metaplasia
82
cervical squamous metaplasia is very susceptible to what infection
HPV
83
is squamous metaplasia normal
yes
84
is endocervical polyp begign
yes
85
what can cause endocervical polyp
vaginal discharge, bleeding
86
what is seen under microscope for endocervical polyp
mucinous columnar epithelium
| thick-walled vessels
87
cervical condyloma is associated with what
HPV 6, 11 (low risk)
88
cervical cancer is associated with what
HPV 16, 18
89
risk factors for cervical cancer
- early age intercourse
- multiple sex partners
- smoking
- OCP
- male with multiple partners
90
what type of HPV do adolescents get
HPV 16
91
if a women is negative for HPV, she has low risk for development of what
cervical cancer
92
CIN3 classification dysplaisa?
severe dysplasia/CIS
| high risk HPV
93
what area does HPV infect
immature squamous metaplastic cells, transformation zone
| - not mature squamous cells ( vagina, vulva)
94
can a virgin get HPV
yes
95
HPV encodes what viral proteins
E6/E7
96
E6/E7 interact with what
Rb
| p53
97
is cervical intraepithelial neoplasia cancerous? what is it
no,
| precancerous dysplasia
98
what is the dysplasia classification for CIN1
mild dysplasia
| - low grade
99
e dysplasia classification for CIN2
moderate dysplasia
100
what is seen under microscope for dysplasia
nuclear atypia
increased nuclear/cytoplasmic ratio
koilocytosis
101
CIN 1 where do changes occur
lower 1/3 of epidermis
102
where do CIN2 changes occur
lower 2/3 of epidermis
103
where do CIN 3 changes occur
entire layer
104
What are 3 types of cervical squamous cell carcinoma
fungating
ulcerating
infiltrative
105
cervical Adenocarcinoma comes from what layer
endocervical epithelium
