Female genital system

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jaz_walker
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270903
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Female genital system
Updated:
2014-04-17 12:02:33
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pathology
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pathology
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pathology
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  1. 1. A 37 year old 24 week pregnant female develops hypertension, and suffers a PE.What would you check for and what complication endangers the foetus?
    Preeclampsia - Placental infarction
  2. 2. A 30 year old woman presents with positive hCG, but transplacental ultrasuond has an absence of heart sounds.What should you consider and what is the main complication of this?
    Tubal pregnancy - Rupture
  3. 3. A 49 year old woman is found to have bilateral ovarian masses.There are mucus-secreting signet ring cells.What should you be concerned about?
    Krukenberg tumour - GI malignancy
  4. 4. An 18 year old female presents with an abdominal mass.Excision shows a bulky mass, with areas of necrosis and bone, muscle.What is this?
    Immagure malignant teratoma
  5. 5. A 30 year old woman presents with positive hCG, but transplacental ultrasuond has an absence of heart sounds.At resection there is a voluminou smass of swollen, cystically dilated chorionic villi, appearing grossly as grapelike structures. The villi are 46, XX consisting of only paternal chromosomes.What is this?
    Complete hyditiform mole - Note these are benign.
  6. 6. A 36 year old female develops oedema and proteinuria in the third trimester of pregnancy. She goes on to develop seizures.What is this?
    Eclampsia
  7. 7. A 38 year old woman presents with a breast lump. There are microcalcifications on the mammogram.Histology shows an epithelial lining, clear cyst fluid and apocrine metaplasia on the cyst lining.What is this?
    A simple cyst.
  8. 8. A 42 year old woman with 1 child presents with nipple discharge.Biopsy shows the ducts are filled with granular debris. There is a lymphoplasmacytic infilcrate and granulomas in the periductal stroma.What is this?
    Pmammary duct ectasiia.
  9. 9. A 27 year old woman presents with a discrete, mobile breast mass.On biopsy, it is tan-white and uniform, with yellow-pink specks.What is this?
    Fibradenoma
  10. 10. A 34 year old woman presents with a bloody discharge.Biopsy shows a 5mm lesion, with multiple papillae on histology.What is this?
    Intraductal papilloma
  11. 11. A 31 year old woman gave birth 2 weeks ago. She complains of breast pain and cracked skin.What is this and what is the causative organism?
    Mastitis - staph aureus
  12. 12. A 34 year old woman presents with a large breast lump.On biopsy, it is biphasic. It has a cellular, abundant centre, with leaflike projections.What is this and what is prognosis?
    Phyllodes tumour - Prognosis is good, as it is usually benign.
  13. 13. A 36 year old female develops oedema and proteinuria in the third trimester of pregnancy.What is this and what is a common kidney/liver complication?
    Preeclampsia - HELLP
  14. 14. A 44 year old male presents with gynecomastiaWhat is the most commono cause of this?
    Cirrhosis of the livr
  15. 15. A 24 week pregnant 24 year old woman presents with vaginal itching.What infectious cause might you suspect?
    Candidiasis
  16. 16. An 81 year old caucasian woman presents with a breast lump in the upper outer quadrant.Mammogram shows calcifications.What are you concerned about?
    Ductal carcinoma
  17. 17. An 81 year old caucasian woman presents with eczema of the nipple and areolar skin, which is not improving with emollients.What are you concerned about?
    Paget's disease of the nipple
  18. 18. An 78 year old caucasian woman presents with multiple bilateral breast lumps.Mammogram shows calcifications.What are you concerned about?
    Lobular carcinoma
  19. 19. What are the main TORCH infections that can cause transplacental disease?
    Toxoplasmosis, other, rubella, cytomegalovirus, herpes
  20. 20. A 55 year old woman presents with a vulval wart.On examination you note some warty change in a single lesionWhat are you concerned about and what is a common risk factor?
    Vulval squamous cell carcinoma - HPV 16 + 17
  21. 21. A 55 year old woman presents with vulval irritationOn examination you note leukoplakia on the vulva, with some warty change.What are you concerned about and what is a common risk factor?
    Vulval squamous cell carcinoma - HPV 16 + 18
  22. 22. A 65 year old woman presents with vulval carcinomaWhat is the precursor of this and what is the major risk factor?
    VIN - HPV infection
  23. 23. A 42 year old woman presents with a vaginal lesionBiopsy shows red, granular appearing foci, which on histology are lined by mucus-secreting columnar cells.What is this, what is it a precursor for and what is the major risk factor?
    Vaginal adenosis - Clear cell adenocarcinoma (common in people whose mother during pregnancy took diethylstilbestrol)
  24. 24. A 35 year old woman presents with night sweats and a leukorrhoeaBiopsy of the endometrium shows granulomatous endometritis.What is the most common cause of this?
    Tuberculosis
  25. 25. A 34 year old woma is told she has cervical metaplasiaWhere is this most likely to be located?
    Transformation zone.
  26. 26. A 32 year old woman presents with infertilityShe has high TSH.What is the cause of her infertility.?
    Thyrotoxicosis causing anovulatory cycles.
  27. 27. What are the most common ovarian tumours?
    Surface epithelial tumours. - of which, serous tumours
  28. 28. A 31 year old woman is concerned about her risk of ovarian cancer, as her mother had ovarian cancer at an early ageShe is BRCA1 positive.What does this put her at risk for?
    Surface epithelial tumours.
  29. 29. A 24 year old woman presents with an unusual discharge.Swabs show infectionWhich 2 classes of infection are most common in acute cervicitis?
    Staphylococci and streptococci
  30. 30. A 36 year old woman presents with intermenstrual bleedingOn palpation, there is a barrel cervix. The cerix feels fixed and is not tender.What are you concerned about?
    Squamous cell cervical carcinoma
  31. 31. A 36 year old woman presents with intermenstrual bleedingWhat is the commonest - and second most common - types of cervical cancer?
    Squamous cell cervical carcinoma - second is adenocarcinoma
  32. 32. A 72 year old woman presents with bloatedness and symptoms of IBS.Ovarian histology shows bilateral tumours. There are nodular irregularities, and the tumours are multiloculated, with a clear serous fluid in them. There are papillary projections into the cysts. Psammoma bodies are present histologically.What is this?
    Serous cystadenocarcinoma
  33. 33. A 76 year old woman has new constipation and bloatedness. On examination there is an ovarian lumpHistology shows small tufts and papillae, with a lot of cytologic atypia.What is this?
    Serous carcinoma
  34. 34. A 35 year old woman is diagnosed with PID.What fallopian tube abnormality would you expect and what is the main complication of this?
    Salpingitis - ectopic tubal pregnancy
  35. 35. A 37 year old woman is diagnosed with infertility.Pelvic ultrasound shows enlarged ovaries, with a number of small cysts. Histology shows a thickened, fibrotic ovarian capsule with cystic folicles. There is an absence of corpus lutea in the ovary.What is this?
    Polycystic ovarian disease
  36. 36. A 31 year old woman presents with hirsutismHigh LH, low FSH.What is the likely cause?
    Polycystic ovarian disease
  37. 37. A 31 year old woman presents with abnormal discharge.You take a biopsy of endometrium. Which are you more concerned about, lymphocytes or plasma cells?
    Plasma cells - lymphocytes are normally present. Plasma cells show chronic endometritis
  38. 38. A 74 year old woman complains of vulval itchiness.Biopsy shows large tumour cells with abundant pale, finely granular cytoplasm. Periodic acid-Schiff stain is positive.What is this and from which cells does it originate?
    Paget disease of the vulva - Epidermal progenitor cells
  39. 39. A 39 year old woman is diagnosed with infertilityShe has high oestragen levels.What is the most likely cause?
    Ovarian cyst causing high oestragen causing anovulatory cycles
  40. 40. A 39 year old woman is diagnosed with infertility. You note she is obese.What is the most likely cause?
    Obesity causing anovulatory cycles
  41. 41. A 69 year old woman presents with postmenstrual bleedingOn laparoscopy, there is a multicystic lesion. The cysts are lined by mucin-producing epithelial cells. It is on one side only.What is this and what are the chances of malignancy?
    Mucinous cystadenocarcinoma - Low chance of malignancy
  42. 42. A 74 year old woman complains of vulval itchiness.On examination there is leukoplakia. Biopsy shows epithelial thickening and hyperkeratosis. There is increased mitotic activity in the basal and suprabasal layers. There is dermal inflammation.What is this?
    Lichen simplex
  43. 43. A 74 year old woman complains of vulval itchiness.Examination shows leukoplakia. Vaginal biopsy shows thinning of the epidermis, disappearance of rete pegs and hydropic degeneration of the basal cells. There is dermal fibrosis and a mononuclear infiltrate.What is this and what condition does it predispose to?
    Lichen sclerosus - Squamous cell carcinoma of the vulva.
  44. 44. A 37 year old woman complains of intermenstrual bleeding.Endoscopic biopsy shows a soft, haemorrhagic necrotic mass. There is tumour necrosis, cytologic atypia, and mitotic activity.What is this?
    Leiomyosarcoma
  45. 45. A 37 year old woman complains of intermenstrual bleeding.On endoscopy, there is a mass. It is sharply circumscribed, with a whorled cut surface. On histology there are bundles of smooth muscle cells.What is this?
    Leiomyoma
  46. 46. A 24 year old woman is BRCA1 positive and wants to know if oral contraceptives increase her change of beast cancer.Is this the case?
    No
  47. 47. What is the single greatest risk for this?
    HPV 16 + 18 infection
  48. 48. A 50 year old woman complains of intermenstrual bleeding.On examination the uterus is fixed and enlarged. Biopsy shows carcinoma.What is the most common type of endometrial carcinoma?
    Endometroid carcininoma
  49. 49. A 39 year old woman has dysmenorrhoea.Laporoscopy confirms chocolate cysts and lesions.What is this?
    Endometritis
  50. 50. Easter egg?
    Endometrioid tumours and Brenner tumours also exist.
  51. 51. Which 3 features of a lesion are required (2/3) to diagnose endometriosis?
    endometrial glands, endometrial stroma, hemosiderin pigment
  52. 52. A 50 year old woman complains of intermenstrual bleeding.Speculum shows a polypoid mass protruding from the endocervical mucosa. It Is soft, with a smooth, glistening surface.What is it and what kinds of cells does it contain?
    Endocervical polyp - Mucus secreting columnar cells
  53. 53. A 38 year old woman complains of vulval warts.On examination you see flat, moist, minimally elevated lesions.What is this and what condition causes it?
    Condylomata lata - secondary syphilis
  54. 54. A 38 year old woman complains of vulval warts.On examination, they are papillary and flat and rugose. There are several, which are red-pink. On histology, there is koilocytosis.What is this and what causes it?
    Condylomata acuminata - HPV 6 + 11
  55. 55. Which are the 2 greatest risk factors for progression?
    Cigarette smoking and immunosuppression (particularly HIV infection)
  56. 56. A 36 year old presents with a bloody, brownish discharge.b-hCG is rising. There is no uterine enlargement. Endoscopy and biopsy shows no chorionic villi. There are anaplastic cuboidal cytotrophoblasts and syncytiotrophoblasts.What is this?
    Choriocarcinoma
  57. 57. What is the most common cause of cervicitis?
    Chlamydia trachomatis
  58. 58. A 24 year old woman presents with cervicitis. Histology shows a neutrophilic infiltrate In the superficial endometrium.What is the most common cause of this?
    C. trachomatis, n. gonorrhoeae
  59. 59. A 25 year old woman presents with a bulge medial to her labia minora.The lesion is catheterised and disappears within the week.What is the most likely cause?
    Bartholin cyst.
  60. 60. Define Paget disease.
    An intraepidermal proliferation of malignant epithelial cells. - This can occur in the vulval skin or breast nipple
  61. 61. What is the underlying cause of endometrial hyperplasia?
    An excess of oestrogen relative to progestin.
  62. 62. A 38 year old woman presents with menorrhagiaBiopsy shows endometrial stroma deep in the myometrium. There is hypertrophy of the myometrium and a thickened uterine wallWhat is the most common cause of this?
    Adenomyosis
  63. 63. A 35 year old woman is told she has CIN III. How long on average would this take to progress to neoplasia without treatment?
    10 years.

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