shosh: female genital tract

• 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

• Results from incomplete fusion of paramesonephric ducts
• Causes recurrent miscarriages in second trimester

• 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

• Premature detachment of placenta
• Presents with painful bleeding in 3rd trimester
• Associated with DIC, smoking, cocaine use

• Placenta is attached to myometrium
• Massive bleeding after delivery

• Placenta is attached to lower part of uterus
• May obstruct os
• Causes painless bleeding in any trimester

• Most common site is ampulla of fallopian tube
• Presents with adnexal mass, abdominal pain, and increased hCG
• Can be mistaked for appendicitis
• PID predisposes

Esophageal or duodenal atresia

• Placental insufficiency or renal agenesis
• Can give rise to Potter's syndrome

• 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

• 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

Endometrial tissue found within myometrium

• 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

• Most common tumor in women
• Benign SM tumor
• Gives rise to circumscribed masses with a whorled pattern
• Does NOT progress to leiomyosarcoma

• Bulky and irregular shape
• Hemorrhage and necrosis
• Very aggressive, can recur
• Spindle cells on histology

• Increased LH leads to anovulation
• Ovaries are bilaterally enlarged and cystic
• Amenorrhea, infertility, obesity, hirsutism
• Increased risk of endometrial cancer

• Malignant ovarian tumor
• Sheets of uniform cells
• High hCG

• Can develop during pregnancy
• Characterized by large, hyperchromatic, synctiotrophoblastic cells
• Increased hCG
• Associated with hydatidiform moles

• Aggressive childhood malignancy
• Yellow, friable masses
• Schiller-Duval bodies, look like glomeruli
• Increased AFP

• Most common benign ovarian tumor
• Younger patients

Aggressive behavior

• Ovarian tumor that contains thyroid tissue
• Symptoms of hyperthyroidism

Marker of ovarian cancer

• Serous--frequently bilateral
• Mucinous--cysts, lined by mucus-secreting epithelium

• Serous--bilateral, has psammoma bodies
• Mucinous--associated with pseudomyxoma peritonei

Intrabdominal accumulation of mucinous material from an ovarian (mucinous cystadenocarcinoma) or appendiceal tumor

Composed of transitional epithelium (like bladder)

• Triad of ovarian fibromas, ascites, and hydrothorax
• Presents with a pulling sensation in the groin

• Secretes estrogen, associated with precocious puberty and endometrial cancer
• Call-Exner bodies (small, eosinophilic follicles)
• Can cause abnormal uterine bleeding

• GI malignancy that metastasizes to ovaries
• Characterized by mucin-secreting signet ring cells

Vaginal clear cell adenocarcinoma

• Affects young girls, presents as a grape-like mass
• Spindle-shaped tumor cells are desmin +