shosh: female genital tract

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  1. Hydatidiform mole
    • Caused by fertilization of an egg with extra sperm
    • Can be complete (46XX) or partial (69XXY)
    • Increased hCG, abnormal vaginal bleeding
    • Precursor of choriocarcinoma
    • Partial moles present with fetal parts and snowstorm appearance on US
  2. Bicornate uterus
    • Results from incomplete fusion of paramesonephric ducts
    • Causes recurrent miscarriages in second trimester
  3. Eclampsia
    • Hypertension, proteinuria, edema ("preeclampsia") and seizures
    • Begins after GW 20
    • Caused by placental ischemia, due to impaired vasodilation of spiral arteries
    • Treat with Mg sulfate and diazepam, to prevent seizures
  4. Abruptio placenta
    • Premature detachment of placenta
    • Presents with painful bleeding in 3rd trimester
    • Associated with DIC, smoking, cocaine use
  5. Placenta accreta
    • Placenta is attached to myometrium
    • Massive bleeding after delivery
  6. Placenta previa
    • Placenta is attached to lower part of uterus
    • May obstruct os
    • Causes painless bleeding in any trimester
  7. Ectopic pregnancy
    • Most common site is ampulla of fallopian tube
    • Presents with adnexal mass, abdominal pain, and increased hCG
    • Can be mistaked for appendicitis
    • PID predisposes
  8. Polyhydramnios
    Esophageal or duodenal atresia
  9. Oligohydramnios
    • Placental insufficiency or renal agenesis
    • Can give rise to Potter's syndrome
  10. Cervical squamous cell carcinoma
    • Associated with HPV 16 or 18 infection
    • Can catch at early stages with koilocytes on Pap smear
    • Renal failure is the most common cause of death
  11. Endometriosis
    • Abnormal location of endometrial tissue, with cyclic bleeding from ectopic tissue
    • Bloody chocolate cysts, especially in ovaries
    • Chronic endometriosis is associated with IUD use and actinomyces infection
    • Acute endometriosis is associated with retained products of conception
  12. Adenomyosis
    Endometrial tissue found within myometrium
  13. Endometrial carcinoma
    • Most common gynecological malignancy
    • Presents at 55-65 y/o with vaginal bleeding
    • Associated with increased estrogen (obesity, PCO, granulosa cell tumor, nulliparity)
    • Diagnose on Pap smear
  14. Leiomyoma
    • Most common tumor in women
    • Benign SM tumor
    • Gives rise to circumscribed masses with a whorled pattern
    • Does NOT progress to leiomyosarcoma
  15. Leiomyosarcoma
    • Bulky and irregular shape
    • Hemorrhage and necrosis
    • Very aggressive, can recur
    • Spindle cells on histology
  16. PCO
    • Increased LH leads to anovulation
    • Ovaries are bilaterally enlarged and cystic
    • Amenorrhea, infertility, obesity, hirsutism
    • Increased risk of endometrial cancer
  17. Germinoma
    • Malignant ovarian tumor
    • Sheets of uniform cells
    • High hCG
  18. Choriocarcinoma
    • Can develop during pregnancy
    • Characterized by large, hyperchromatic, synctiotrophoblastic cells
    • Increased hCG
    • Associated with hydatidiform moles
  19. Yolk sac tumor
    • Aggressive childhood malignancy
    • Yellow, friable masses
    • Schiller-Duval bodies, look like glomeruli
    • Increased AFP
  20. Mature teratoma/dermoid cyst
    • Most common benign ovarian tumor
    • Younger patients
  21. Immature teratoma
    Aggressive behavior
  22. Struma ovarii
    • Ovarian tumor that contains thyroid tissue
    • Symptoms of hyperthyroidism
  23. CA-125
    Marker of ovarian cancer
  24. Cystadenomas (benign)
    • Serous--frequently bilateral
    • Mucinous--cysts, lined by mucus-secreting epithelium
  25. Cystadenocarcinomas (malignant)
    • Serous--bilateral, has psammoma bodies
    • Mucinous--associated with pseudomyxoma peritonei
  26. Pseudomyxoma peritonei
    Intrabdominal accumulation of mucinous material from an ovarian (mucinous cystadenocarcinoma) or appendiceal tumor
  27. Brenner tumor
    Composed of transitional epithelium (like bladder)
  28. Meig's syndrome
    • Triad of ovarian fibromas, ascites, and hydrothorax
    • Presents with a pulling sensation in the groin
  29. Granulosa cell tumor
    • Secretes estrogen, associated with precocious puberty and endometrial cancer
    • Call-Exner bodies (small, eosinophilic follicles)
    • Can cause abnormal uterine bleeding
  30. Krukenberg tumor
    • GI malignancy that metastasizes to ovaries
    • Characterized by mucin-secreting signet ring cells
  31. DES exposure in utero
    Vaginal clear cell adenocarcinoma
  32. Sarcoma botryoides
    • Affects young girls, presents as a grape-like mass
    • Spindle-shaped tumor cells are desmin +
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shosh: female genital tract
2011-05-15 10:13:10

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