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