Female GU Path

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Female GU Path
2011-07-17 16:24:21
female GU

for path exam
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  1. curdy white discharge
    candida albicans vaginitis
  2. copious gray green discharge
    trichonomas vaginalis vaginitis
  3. organisms causing purulent vaginal discharge in cervicitis
    Chlamydia, trich, candida, HPV and HSV
  4. organism causing acute nonspecific form of cervicitis
    staph or strep
  5. most common population in acute cervicitis
    post partum women
  6. Chronic inflammatory obstruction of the cervical glands occuring over time
    Nabothian cyst
  7. Soft masses that are few cm in diameter that protude from the cervix and may bleed
    Endocervical polyps
  8. What is the prognosis of endocervical polyps?
    No malignant potential
  9. Pap smears have dramatically lowered the incidence of what type of cancer?
  10. Most invasive cervical SCC arise from?
  11. Pronosis of CIN
    Some progress to invasive CA, some don't
  12. Describe CIN I
    mild dysplasia, generally involving lower 1/3 of cervical epithelium
  13. Describe CIN II
    Moderate dysplasia, generally involving the lower 2/4 of the cervical epitheilium
  14. Describe CIN III
    severe dysplasia and carcinoma in situ, involving the entire thickness of the epithelium
  15. What is the peak ageo f CIN?
    30 years
  16. Peak age of invasive Ca?
    45 years
  17. What are risk factors for CIN?
    Early age at first intercourse, multiple sexual partners, or a male partner with multiple previous sexual partners
  18. Most common organism in precancerous cervical lesions and invasive neoplasms
    HPV (85-90%)
  19. Which HPV types are associated with precancerous lesinos and invasive neoplasms?
    16, 18, 31, 33
  20. Which HPV types are associated with benign condylomas?
    6, 11, 42, 44
  21. Most invasive carcinomas of the cervix are of what type?
  22. Cauliflower like mass which may encircle the cervical os
    fungating form of invasive carcinoma of the cervix
  23. Sloughing of central surfce of the tumor
    ulcerative form of invasive carcinoma of the cervix
  24. Carcinoma grows downward into the underlying stroma
    infiltrative invasive carcinoma of the cervix
  25. Advanced lesions of invasive carcinomas of the cervix may extend into where?
    LN, rectu, bladder, ureters
  26. circulated lesion, beefy red
    Advance invasive carcinoma of the cervix
  27. What are the sx of carcinoma in situ?
    They are usually asx
  28. What are the sx of invasive carcinoma?
    irregular bleeding, dysuria, burning, vaginal discharge
  29. Mortality from invasive cervical carcinomas are usually from what?
    local effects (obstruction of ureters, or penetration into the bladder or rectum)
  30. How much time elapses in between the insitu and invasive stages of cervical carcinoma?
    10 yeras
  31. Soft polypoid masses occring in infants and children under 5 years that may occur in bladder and bile ducts also
    sarcoma botyroides
  32. Soft polypoid masses, coming from the vaginal orifice, that are large and grape like and can be aggressive
    Sarcoma botyroides
  33. Sessile lesions, 0.5-3.0 cm in diameter
    Endometrial polyps
  34. What are endometrial polyps made of?
    They are covered with columnar cells and adenomatous stroma
  35. What is the prognosis of endometrial polyps?
    They may produce abnormal uterine bleeding, and may in rare cases give rise to cancer
  36. Which type of female GU polyps don't have any malignant potential?
    endocervical polyps
  37. Causes of DUB
    • Any dysfunction of the hypothalamus, pituitary gland, thyroid
    • Ovarian lesion
    • Malnutrition (absence of building blocks needed to produce secretory phase)
    • Obesity (makes more estrogen)
    • Stress
  38. What causes endometrial hyperplasia?
    • excess of estrogen relative to progestin
    • Excess estrogen can be caused by ovarian tumors or steroids
  39. What cancer is associated with endometrial hyperplasia?
    endometrial carcinoma
  40. women in late teens whose mothers were exposed to DES
    Vaginal clear cell adenoma
  41. Glandular differentiation with cells with relatively clear cytoplasm, not forming normal glands, that are clumped
    Vaginal clear cell adenoma
  42. What are the differences btewen adenomyosis and endometriosis?
    • Tissue type: adenomyosis is glandular tissue, endometriosis is endometrium tissue
    • Deposit location: adenomysis is muscle (myometrium), endometriosis is outside the uterus
    • Cyclic bleeding: unusual in adenomyosis, common in endometriosis
  43. What are common areas for endometriosis?
    Ovaries, pouch of douglas, uterine ligaments, rectovaginal septum
  44. Red blue to yellow-brown nodule or implants that can markedly vary in size
  45. blood filled cysts in the ovaries which may rupture and lead to fibrosis of pelvic structures
    chocolate cysts, associated with endometriosis
  46. growth of endometrial basal layer into the myometrium
  47. Bilateral ovarian tumors
    • SESTs-serous, mucinous
    • GCTs-teratomas
  48. unilateral ovarian tumors
    • SESTs-Brenner tumor
    • GCT-dysgerminoma
    • SXSCT-Granulosa thecal cell, fibroma-thecoma, Sertoli leydig cell tumors
  49. Which ovarian tumors may have a borderline, malignant, benign counterpart/subtype?
    surfce epithelial stromal tumors (all types)
  50. Serous ovarian tumors are usually (B/L or U/L?)
    30-50% are B/L
  51. Mucinous ovarian tumors are usually (B/L or U/L?)
    10-20% B/L
  52. Mostly multiloculated cysts containing mucinous material
    mucinous tumors
  53. Honey comb type of appearance, filled with thicker mucinous material
    pseudomyxoma peritonei: implant on peritoneal structures, associated with mucinous ovarian tumors
  54. What hormones do dysgernimonas produce?
    Increase levels of gonadotrophin
  55. What hormones do yolk sac tumors and endodermal sinus tumors produce?
    increase levels of afp and A1AT
  56. What hormones do granulosa tumors produce?
  57. What hormones do fibroma-thecomas produce?
    may secrete estrogen
  58. What homrones do sertoli-leydig cells produce?
    may have estrogenic effects
  59. Gestational trophoblastic dz produces what hormone?
  60. What are risk factors for ectopic pregnancies?
  61. Which moles are triploid?
    Partial hydatidiform
  62. Which moles are diploid?
    complete hydatidiform mole
  63. Which moles have fetal parts?
    partial hydatidiform moles
  64. Which moles don't have fetal parts?
    complete hydatidiform
  65. Which moles are invasive?
    • invasive mole (but not true metastasis)
    • Choriocarcinomas (vascular invasion common)
  66. Proliferative endometrium collapses and bleeds
  67. Most common benign tumor in females
  68. what stimulates the growth of leiomyomas?
  69. Well circumscribed gray white masses
  70. Whils of smooth muscles (circular loops of smooth muscle)
  71. Uterine tumor that can result in abdominal enlargement
  72. May become hemorrhagic or calcified
  73. Solitary, infiltrating polypoid or discrete tumors
  74. Frequent mitoses, cellular, atypia
  75. Difference in gross appearance between leiomyomas and leiomyosarcomas
    • Leiomyomas are small to very large, and may be multiple
    • Leiomyosarcomas have a more loose appearance, are more hemorrhagic, and are often solitary
  76. Age range affected by benign ovarian tumors
    20-45 yo
  77. Age range affected by malignant ovarian tumors
    40-65 yo
  78. Predisposing factors for ovarian cancer
    nulliparity, FH, heritable mutations, gonadal dysgenesis, BRCA-1, BRCA-2, mutationsin p53
  79. What decreases the incidence for ovarian cancer?
  80. What is the most common type of ovarian cancer?
    serous cystadenocarcinomas, arising from surface epithelium
  81. Her2/neu oncogene
    Associated with a poor prognosis in adenocarcinomas, present in 30%
  82. cystic spaces with papillary formations filled with clear fluid
    serous ovarian tumor
  83. multi loculated containing mucinous material
    mucinous ovarian tumor
  84. Large cystic mass with solide areas
    Endometrioid tumors
  85. Cystic nests of cells resembling transitional cells with grooved nuclei
    Brenner tumor
  86. Cyst wall wrinkled and gray
  87. Mature teratoma
  88. Bulky with smooth external surface; solid with necrosis and hemorrhage
    Immature teratoma
  89. solid, soft, fleshy, yellow white
  90. Composed of large vesciular cells with clear cytoplasm, well defined borders, and a centrally located nucleus
  91. Lymphocytic infiltrate
  92. prognosis of dysgerminomas
    All are malignant, but only 1/3 are aggressive and overall survival is good
  93. Schiller duval body
    Yolk sac tumor
  94. Glomerulus structure with central blood vessel enveloped by germ cells within a space lined by germ cells
  95. Schiller duval body, associated with yolk sac tumors
  96. Call exner bodies
    Granulosa-Theca cell tumors
  97. Hemorrhagic tumor masses with vascular invasion
  98. Tetraploid mole
    partial hydatidiform(only some though)
  99. Bunch of grapes that distend the uterus
    Complete hydatidiform mole
  100. No identifiable embryo
    Complete hydatidiform mole
  101. Results from fertilziation of an egg that has lost its chromosomes by either one or two sperm
    Complete hydatidiform mole
  102. Complete mole in which the villi penetrate the myometrium of its vessels
    invasive mole