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D&T3 Exam 1 > Womens Repro-carpenter > Flashcards

Womens Repro-carpenter Flashcards

1
Q

Condyloma Acuminatum

Microscopic

A

Koilocyte (halo cell)

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2
Q

Extra Mammary Paget’s Disease

Where do you see proliferation?

A

See proliferation of large tumor cells at dermal-epidermal interface

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3
Q

HSV

Diagnosis

Anti-HSV antibodies

A

Primary acute phase: no abs

Pos abs: recurrent/latent infxn

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4
Q

Pap smear

Dysplasia

A

Big and dark

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5
Q

Ectocervical mucosa

A

Non keratinizing squamous

Nonstratified

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6
Q

PID

Can initially cause

A

Acute suppurations salpingitis

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7
Q

Trichomonas vaginalis

Common finding

A

Strawberry cervix

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8
Q

Molluscum contagiosum

Types

A

MCV1-4

MCV1: most prevalent

MCV2: sexually transmitted

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9
Q

Lichen simplex chronicus

Presentation

A

Leukoplakia

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10
Q

Endocervical polyp

Presentation

A

Benign

<3cm

Vaginal discharge, bleeding

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11
Q

Embryo all Rhabdomyosarcoma/Sarcoma Botryoides

Causes

A

Gonorrhea, chlamydia, mycoplasma, HSV

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12
Q

HSV

2 types

A

Hsv1- oropharyngeal infxn

Hsv 2-genital mucosa and skin

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13
Q

HPV association in cervical cancer

A

Ass with all cases

Condyloma- low risk 6,11

Cancer- high risk 16, 18

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14
Q

Chlamydia trachomatis

Can Cause

A

Follicular cervicitis

Endometritis

Sappho-oophoritis

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15
Q

Trichomonas vaginalis

Diagnosis

A

Wet prep (low sensitivity)

Pap smear

Molecular test (most sensitive)

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16
Q

Uterus

A

Composed of endometrium and myometrium

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17
Q

Cervical Intraepithelial Neoplasia (CIN)

A

Precancerous

Can spontaneously regress

May persist in noninvasive state

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18
Q

Vaginal Carcinoma

Common cause?

A

Spread from cervical lesion

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19
Q

HSV

Diagnosis

A

Exudate-culture

Detect with NAA

Pap smear (specific but not sensitive)

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20
Q

Candida

Sx

A

Itching

Erythema

Cottage cheese discharge

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21
Q

Acute and chronic cervicitis

Micro

A

Acute: neutrophils

Chronic: lymphocytes

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22
Q

Squamous metaplasia

Characteristics

A

Normal process (normal finding for pap)

Susceptible to HPV

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23
Q

Molluscum contagiosum

Cause

A

Pox virus- skin and mucous membranes

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24
Q

HSV

Lesions

A

Painful red papules on vulva: vesicles and ulcers

Contain high concentration of virus(=high transmission rate)

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25
Q

Dysplasia classification

CIN 2

A

Moderate, high grade, ass with high risk HPV, more likely to progress

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26
Q

Gardnerella

A

Gram neg small bacillu

Presence does not necessarily mean vaginitis

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27
Q

Leukoplakia

A

General term: white plaque

Biopsy for diagnosis

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28
Q

Dysplasia

Morphology

CIN 2

A

Changes in lower2/3 of epidermis

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29
Q

Lichen sclerosis

Histo

A

Sclerosis in dermis/stroma

Hydronic degeneration of basal layer

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30
Q

PID

Sx

A

Pelvic pain, fever, and vaginal discharge

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31
Q

Non-HPV related

Presentation

A

Keratinizing squamous cell cancers

Women with long standing lichen sclerosis or squamous hyperplasia (chronic irritation may lead to carcinoma)

Older women

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32
Q

HSV

Involves…

Transmission…

A

Vulva, vagina, cervix

STI

Begin 3-7 days after transmission

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33
Q

Lichen simplex chronicus

Pathogenesis

A

Non-specific condition occurs from rubbing skin to relieve pruritis

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34
Q

HPV

Factors ass. W/ pathogenesis

A

Immune status

Smoking

Nutrition

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35
Q

HPV

Who is most vulnerable?

A

Adolescents

Don’t test until 21

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36
Q

Acute sapingitis

Micro

A

Acute inflammatory cells

Mostly neutrophils

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37
Q

Adenocarcinoma

Arises from…

A

Endocervical epithelium

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38
Q

HSV

Healing

A

Lesions heal in 1-3 weeks

Can get latent infxn

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39
Q

Vaginal adenosis

Presentation

A

Red granular mucosa

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40
Q

Fungal infections

MC

A

Candida

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41
Q

Molluscum contagiosum

Clinical appearance

A

Papules

Dome-shaped

Dimpled center

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42
Q

Adenocarcinoma in DES exposure

A

Clear cell type

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43
Q

Molluscum contagiosum

Adults transmission and presentation

A

Sexually transmitted

Lesions on genitals, buttocks, inner thighs

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44
Q

Gardnerella

Microscopic

A

Clue cells

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45
Q

Dysplasia classification

CIN 1

A

Mild, low grade, ass with low risk HPV, spontaneously regress

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46
Q

HSV

Transmission to neonate

A

Occurs at birth

More likely with active infxn

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47
Q

Candida

Diagnosis

A

Seen on Pap smear

Wet prep

Culture

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48
Q

PID

Exposure and spread

A

2-7 days after exposure

May spread upward to tubes and ovaries

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49
Q

Diethylstibesterol (DES)

Ass. With risks in…

A

Daughters, not sons

50
Q

HPV related

Basaloid/Warty carcinoma

Associations

A

High risk HPV (16,18,31)

51
Q

PID

Aka

A

Puerperal infxn

Polymicrobial

52
Q

HPV vaccine

A

Gardasil 9 hits most

9-26 y/o

Only effective before exposure

53
Q

Dysplasia classification

CIN 3

A

Severe (CIS), ass with high risk HPV, more likely to progress to invasive carcinoma

54
Q

Condyloma Acuminatum

Ass. With…

A

Low risk HPV (6, 11)

55
Q

Dysplasia

Morphology

CIN 1

A

Changes in lower 1/3 of epidermis

56
Q

Adenocarcinoma

Ass.

A

HPV

57
Q

Vagina

Tissue

A

Non keratinizing squamous lined mucosa

58
Q

Dysplasia

Morphology

CIN 3

A

Changes involve entire layer of epidermis

59
Q

Vulvar carcinoma and dysplasia

2 groups

A

HPV related

Non-HPV related

60
Q

Cervical Squamous Cell Carcinoma

Peak incidence

A

30s-high grade dysplasia

40s-cervical cancer

61
Q

Diethylstibesterol (DES)

Risks

A

Inc risk for clear cell adenocarcinoma (late teens early 20s)

Inc risk for structural abnormalities of female genital tract (t shaped uterus)

62
Q

Candida

Risk factors

A

Pregnancy, diabetes

BCP

63
Q

Fallopian tubes

Histology

A

Composed of columnar cells, ciliated and nonciliated

Intercalated cells (peg cells)

64
Q

Adenocarcinoma

Precursor lesion

A

Adenocarcinoma in situ

65
Q

Vaginal Carcinoma

Ass.

A

HPV

66
Q

Embryo all Rhabdomyosarcoma/Sarcoma Botryoides

Presentation

A

Children <5yrs

Grapelike clusters projecting outside vagina

67
Q

Endocervical mucosa

A

Columnar

Contain mucin

Not a true gland

68
Q

Vulvar Squamous cell carcinoma

Presentation and prognosis

A

HPV ass- begin as VIN (warty cancer)

SCH-LS ass

Good prognosis

60-80% survival

69
Q

Cervical cancer

Risk factors

A

Early age 1st intercours; high parity

Multiple partners

Smoking

Oral contraceptives

Male partner with multiple previous partners

High risk HPV

70
Q

Endocervical polyp

Micro

A

Mucinous columnar epithelium

Thick walled vessels

71
Q

Dysplasia

Morphology

A

See inc development of nuclear atypia, inc nuclear/cytoplasmic ratio

Koilocytosis

72
Q

Molluscum contagiosum

Transmission in children

A

Direct contact

Can be fomites

73
Q

Vulvar carcinoma and dysplasia

MC

A

Squamous cell carcinomas (95%)

74
Q

PID

Acute suppurations salpingitis

Characteristics

A

Abundant acute inflammatory cells filling tubes

Can cause abscess formation

Can cause multiple adhesions

75
Q

HPV

Viral pathogenic factors

A

Proteins E6/E7 crucial for oncogenic effect
Interacts with tumor suppressors Rb and p53

Cancer-integrated into chromosome

Dysplasia-exists as free viral DNA as episome

76
Q

Lichen Sclerosis

Presentation

A

Presents as white patches with labial atrophy

Pruritic

Multiple areas

77
Q

HPV

16: ass.

A

60% cervical cancer

78
Q

PAP Smear

A

Increased detection of precancerous lesions

79
Q

HPV related

Basaloid/Warty carcinoma

Presentation

A

Young women

Preceded by precursor lesion (VIN)

Initially appear as leukoplakia

Multicentric and ass with lesion in vagina or cervix

80
Q

Trichomonas vaginalis

Can cause…

A

Inc susceptibility to HIV

Inc preterm delivery and low birth weight infants

81
Q

HPV

Mode of infection

A

Infects immature squamous metaplastic cells

Don’t need intercourse, skin to skin contact can spread

Transformation zone vulnerable but can infect mature squamous

82
Q

PID

Can be seen after…

A

D&C, abortion, surgical procedure

Following normal delivery

83
Q

Extra Mammary Paget’s Disease

Association

A

Not associated with underlying carcinoma

84
Q

Adenocarcinoma

Pap smear

A

Difficult to pick up

85
Q

HPV

After established infection

A

Replicates in mature squamous

Koilocytic cells

86
Q

PID

Causes

A

Gonorrhea

Chlamydia

Enteric bacteria

87
Q

PID

Non-Gonococcal

Spread

A

Spreads through lymphvascular channels

88
Q

Extra Mammary Paget’s Disease

Originates…

A

From stem cells or apocrine ducts (considered primary cutaneous adenocarcinoma)

89
Q

Endocervical polyp

Tx

A

Surgical excision

90
Q

PID

Gonococcal

Involves

A

Cervix

Involves surface epithelium (spares endometrium)

Frequently asymptomatic

91
Q

From squamous on ectrocervix to columnar in canal

A

Normal Chang in mucosa

Squamocolumnar junction (transformation zone)

92
Q

Vaginal dysplasia (VAIN)

Ass.

A

HPV

93
Q

PID

Gonococcal

Starts in

A

Bartholin glands

94
Q

Diethylstibesterol (DES) and Vaginal Adenosis

Epithelial change

A

Squamous replaced by glandular

35-90% exposed to DES

More likely than adenocarcinoma

95
Q

Extra Mammary Paget’s Disease

Spread

A

Stays confined to epidermis

96
Q

Condyloma Acuminatum

Characteristics

A

Venereal wart

Benign

Seen on vulva, vagina, cervix, perianal

97
Q

Lichen simplex chronicus

Histology

A

Thickening of the epidermis (acanthosis)

98
Q

HPV

18: ass.

A

10% cervical and ass. With endocervical adenocarcinoma

99
Q

PID

Non-Gonococcal

Common presentation

A

Not on surface

Inflammatory reaction in deeper layers

100
Q

Chlamydia trachomatis

Diagnosis

A

At time of Pap smear by molecular test

Urine specimen

101
Q

Extra Mammary Paget’s Disease

Presentation

A

Pruritis red crusted lesions

102
Q

Candida

Pap smear appearance

A

Spaghetti and meatballs

103
Q

Cervical Squamous Cell Carcinoma

3 forms

A

Fungating

Ulcerative

Infiltrative

Keratinizing or non-keratinizing

104
Q

Vulvar squamous cell carcinoma

Tx

A

Based on LN status, size and depth of invasion

Range from wide local excision to radical vulvectomy

105
Q

Vulvar Malignant Melanoma

Presentation

A

Pigmented lesion

6th-7th decades

Survival <32%

106
Q

HPV tests

A

Screening molecular tests (3 for DNA 1 for RNA)

Cut off for assay set at certain copy number of virus present

Therefore, neg HPV does not mean not exposed

107
Q

Chlamydia trachomatis

Can be a cause of…

A

Infertility

108
Q

HPV

Characteristics

A

4 of 5 women exposed by 50

Asymptomatic (most)

Transient infections

109
Q

Cervix

Process of squamous metaplasia (just read)

A

At menarche, inc estrogen causes inc glycogen uptake by cervical and vaginal mucosa

Glycogen provides substrate for bacteria

Bacteria cause drop in vaginal ph

Endocervix responds by proliferation of reserve cells

Leads to metaplasia

110
Q

PID

Complications

A

Peritonitis

Bacteremia

Interstitial obstruction

111
Q

Extra Mammary Paget’s Disease

Histology

A

Large tumor cells surrounded by clear halos

112
Q

Vaginal adenosis

Histology

A

Glands in vagina

113
Q

LS/LSC

A

Not considered precancerous

Slight inc risk of cancer development

114
Q

HSV

Transmission can occur when virus is…

A

Latent or active

115
Q

Vaginal Carcinoma

MC

A

Squamous cell carcinoma (95%)

116
Q

Molluscum contagiosum

Common Presentation and appearance

A

Common in children (2-12)

Lesion on trunk, arms, and legs

117
Q

Strawberry cervix

A

Trichomonas vaginalis

118
Q

HSV

Pap smear appearance

A

Ground glass nuclei

119
Q

Molluscum contagiosum

Microscopic

A

Intrcytoplasmic viral inclusions

120
Q

Trichomonas vaginalis

Presentation

A

Vaginal discharge and fishy odor

Marked inflammatory response

Protozoan with flagella

121
Q

Embryo all Rhabdomyosarcoma/Sarcoma Botryoides

Histology

A

Rhabdomyoblasts

Cross striations

Loose fibromyxoid stroma with tumor cells

D&T3 Exam 1 (19 decks)

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