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Path 22 Female Gens
Path
| Question | Answer |
|---|---|
| Painful genital ulcerations on cervix, vag/vulv d/t DNA viruses (1 is oropharyngeal, 2 is genital mucosa/skin). Initial lesions, red papule->vesicle->ulcer w fever, malaise, tender inguinal nodes at 3-7 days. heal 1-3 wks, virus migrates to lumbosacral | Herpes Simplex Virus 2 (HSV-2) |
| Poxvirus skin/mucous memb infx (4 types: 1 is most prevalent [kids, infx on trunk, arms, legs]; 2 is most often sex transmit [adult, infx on gens, low abdomen, butt, inner thigh]). Pearly, dome shaped papules w dimpled center and viral inclusions. | Molluscum contagiosum |
| DM, antibiotics, preg, immunosuppress predispose to vulvovag pruritis, erythema, swelling, curd-like discharge. | Candida |
| Large, flagellated ovoid protozoan has yellow, frothy vaginal discharge, vulvovag discomfort, dysuria, dyspareunia. Fiery red vaginal and cervical mucosa (strawberry cervix) | Trichomonas vaginalis |
| Gram neg bacillus is main cause of bacterial vaginosis (vaginitis). thin, green-gray, fishy vaginal discharge. can cause premature labor | Gardnerella vaginalis |
| Gram neg diplococcus. Endocervix initially involved, spreads to fallopian tubes along the mucosal surface-> salpingo-oophoritis, tubo-ovarian abscess, pyosalpinx-> hydrosalpinx. PID and infertility. | Gonococcus |
| causes cervicitis and PID (sequelae of PID include infertility, tubal obstruction, ectopic preg, pelvic pain, intestinal obstruct from adhesions b/w bowel and pelvic organs) | Chlamydia trachomatis |
| THIN epidermis and disappearance of rete pegs, hydropic degen of basal cells, superficial hyperkeratosis, dermal fibrosis w scant perivasc mononuc inflamm cell infiltrate. smooth, white plaques. Labia can become atrophic and stiff. postmenopause | Lichen sclerosus |
| nonspecific condition resulting from rubbing/scratching of skin to relieve pruritis. THICK epithel expansion of stratum granulosum and hyperkeratosis. area of leukoplakia. | Squamous cell Hyperplasia |
| benign lesions w verrucous gross appearance and branching, treelike cores of stroma w viral cytopathic changes (Koilocytic Atypia). D/t low risk HPV (types 6 and 11) | Condyloma Acuminatum |
| Most common vulvar cancer. warty, from VIN (HPV 16), are related to high oncogenic HPV, keratinizing (70%) are not related to HPV | Squamous cell carcinoma - HPV 16->Vulvar Intraepithelial Neoplasia-> Vulvar CA - Lichen Sclerosus/Squamous Cell Hyperplasia-> Differentiated VIN-> Keratinizing Squamous Cell Carcinoma |
| Sharply circumscribed nodule on labia majora or interlabial folds, tendency to ulcerate. Identical in appearance to intraductal papillomas of the breast. Columnar secretory epithel and underlying Myoepithel | Papillary Hidradenoma |
| Pruritic, red, crusted, sharply demarcated, maplike area, on labia majora. Large tumor cells lying singly or in small clusters w/in the epidermis, distinguished from the surrounding epithel by a halo | Extramammary Paget Disease - reacts to anti-cytokeratin - has mucopolysaccharides |
| Septate vagina (w Uterus Didelphys) arises from ... | failure of total fusion of mullerian ducts |
| Gartner duct cysts are derived from ... | Wolffian (Mesonephric) duct rests |
| <5 y/o tumors grow as polypoid, rounded, bulky masses that sometimes fill and project out of the vagina. Grapelike clusters | Embryonal Rhabdomyosarcoma (Sarcoma Botryoides) |
| Risk factors for Cervical Cancer | 1. Multi sex partners 2. Male partner w previous multi sex partners 3. Young age at first intercourse 4. High parity 5. Infx w high onco risk HPV (16, 18) 6. Immunosuppression 7. Some HLA subtypes 8. Oral Contraceptives 9. Nicotine |
| Most common cause of dysfunctional uterine bleeding, results in excessive and prolonged estrogenic stimulation w/o counteractive effect of progestational phase | Anovulatory Cycle |
| Bacterial infx after delivery or miscarriage. often group A strep and staph | Acute Endometritis |
| Presence of endometrial tissue outside the uterus, frequently ovaries. causes infertility, dysmenorrhea, pelvic pain. High levels of PGE2, IL1Beta, TNF, IL6, estrogen upregulated by high aromatase. red-blue/yellow-brown nodules and chocolate cysts. | Endometriosis |
| Endometrial nests w/in myometrium-> hemorrhagic cysts w/in the uterine wall and menometrorrhagia, colicky dysmenorrhea, dyspareunia, pelvic pain | Adenomyosis |
| Exophytic masses that project into the endometrial cavity, can ulcerate and undergo necrosis and cause abnorm bleeding. glands are hyperplastic or atrophic. assoc w tamoxifen and rearrangements of HMGIY gene | Endometrial Polyps |
| Inc prolif of endometrial glands relative to the stroma d/t prolonged estrogen stim from anovulation, inc endog or exog estrogen (obesity, menopause, polycystic ovarian disease, ERT). asso w endometrial carcinoma and inactive PTEN (can cause Cowden synd) | Endometrial Hyperplasia - Simple w/o atyp: various size glands, irreg shapes w cystic dilation - Simple w atyp: uncommon, loss of polarity, vesicular nuclei, prominent nucleoli - Complex w/o atyp: inc number, size of glands->crowding - Complex w a |
| Most common invasive cancer of female gen tract, usually in postmenopausals (cause postmenopausal bleeding). | Endometrial Carcinoma |
| Most common type of endomet carc, typically from endomet hyperplasia (asso w obesity, diabetes, HTN, infertility, unopposed estrogen stim; also PTEN mut). | Type 1 endomet carcinoma - and most of these are Endometrioid Adenocarcinoma |
| Type of Endomet Carc that arises 10 yrs later and in the setting of endomet atrophy. Poorly differentiated (grade 3) tumors. p53 mut. precursor is Endomet Intraepithel Carcinoma (EIC). | Type 2 endomet carcinoma - most common of these is Serous Carcinoma: large, bulky tumor, deeply invasive into myometrium |
| Endometrial Adenocarcinomas w malignant changes in stroma. Fleshy, bulky, polypoid, can protrude through cervical os. | Malignant Mixed Mullerian Tumor |
| Large broad-based endomet polypoid growths that may prolapse through cervical os. has malignant stroma w benign but abnorm shaped endomet glands. 30-40 y/o. | Adenosarcomas |
| Most common tumor in women, benign smooth muscle neoplasms, multiple. Whorled pattern of smooth muscle bundles. | Leiomyoma |
| Bulky fleshy masses that invade uterine wall or Polypoid masses that project into uterine lumen. w nuclear atypia, mitotic index, zonal necrosis | Leiomyosarcoma |
| Most common cause of suppurative salpingitis | Gonnococcus |
| Cystic follicles w oligomenorrhea, persistent anovulation, obesity, hirsutism, virilism. ovaries are double sized w smooth, gray-white outer cortex studded w subcortical cysts | Polycystic Ovarian Disease (PCOD) - Stromal hyperthecosis: uniform enlargement of ovaries w white-tan cut section. heavy virilization |
| Most common malignant ovarian tumor. lined by tall, columnar, ciliated and nonciliated epithel cells, filled w clear fluid | Serous Ovary Tumors - Low-grade: KRAS and BRAF muts - High-grade: p53 muts |
| less common ovarian tumor, larger cystic masses w rarity of surface involvement, filled w sticky, gel fluid rich in glycoprots. asso w smoking and KRAS muts. | Mucinous Ovary Tumors |
| Ovarian tumors w presence of tubular glands bearing close resemblance to benign or malignant endometrium. can coexist w endometriosis. asso w PTEN, KRAS, Beta-catenin, p53 muts and microsatellite instability. | Endometrioid Ovary Tumors (Endometrioid Adenofibromas) |
| Large epithel cells w abundant clear cytoplasm in the ovaries | Clear Cell Adenocarcinoma |
| Adenofibromas in which epithel component consists of nests of transitional-type Ovarian epithel cells resembling those lining bladder, nests of epithel cells resembling UT epithel. usually unilateral | Brenner Tumors |
| HPV 16 and HPV 18 Viral E6 affects ... Viral E7 affects ... | most important (esp HPV 16) for cervical oncogenesis E6 binds to and degrades p53 and upregulates telomerase E7 binds to RB and upregulates cyclin E |
| cysts containing hair, teeth, areas of calcification, mixtures of tissues, and cheesy sebaceous material. | Teratoma - Most are benign (mature). 46 XX - Struma ovarii is all mature thyroid tissue->hyperthyroidism - Malignant (immature) resemble embryonal and immature fetal tissue, like primitive neuroepithel |
| Most common malignant germ cell tumor of ovary, ovarian counterpart of testicular seminoma. composed of large vesicular cells having a clear cytoplasm, defined borders, and central regular nuclei. Teens and 20s. Express Oct3, Oct4, Nanog, cKIT. | Dysgerminoma - responds to chemo, 1/3 are aggressive, >80% survival |
| Tumor is rich in Alpha-fetoprotein and Alpha1-antitrypsin. Glomerulus-like central blood vessel enveloped by germ cells w/in space lined by germ cells (Schiller-Duval body). Children/young women w ab pain and rapidly developing pelvic mass. | Endodermal Sinus (Yolk Sac) Tumor |
| yellow coloration to cut surface d/t intracell lipids, tumor cells are arranged in sheets punctuated by small follicle-like structures (Call-Exner bods). can elaborate large amounts of estrogen and elevate inhibin, asso w precocious puberty, endomet CA. | Granulosa-Theca cell Tumors |
| Ovarian Tumor, Hydrothorax, Ascites = | Meigs syndrome - Fibromas, Thecomas, Fibrothecomas |
| Most common site of ectopic preg ... Most important predisposing condition ... Presentation of ectopic preg ... | Fallopian tubes PID -> Fallopian tube scarring Severe ab pain, pelvic hemorrhage->shock |
| HTN, edema, proteinuria = ? + convulsions = ? 10% develop HELLP = ? | Preeclampsia (usually in last trimester) Eclampsia Hemolysis, Elevated Liver enzymes, Low Platelets |
| Cystic swelling of chorionic villi w vaiable trophoblastic prolif. inc risk of choriocarcinoma. HCG levels far exceeding normal pregnancy (higher in Choriocarcinoma) | Hydatidaform Mole - Complete: fertilization of an egg w/o genetic material, most are 46XX (duplication of sperm genes). Enlarged scallop shaped villi w cisterns and extensive trophoblast prolif involving entire circumference of villi - Partial: has p5 |
Created by:
Jakphooey
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