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Vagina, Vulva, Cervi
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| Question | Answer |
|---|---|
| Clear cell carcinoma (vaginal) | unlike ovarian this arises in young women whose mothers used DES (glands of clear cells that HOBNOB (nucleus protrudes out)) |
| Embryonal Rhabdomyosarcoma | sarcoma of primitive skeletal muscle cells in children |
| Rhabdomyosarcoma botryoid | tends to occur in vagina and bladder (grape like) protrudes from the vagina with cambian growth patter (treelike) 50% 5year |
| Endocervical Polyp | BENIGN cervical lesion from the os can cause post coital bleeding (endothelium over thich walled blood vessel |
| Adenocarcinoma in situ | Premalignant cervical lesion- in transformation zone associated with HPV, nuclear enlargement with loss of cytoplasm |
| what is the main difference between low and high risk HPV | high risk inserts itself into the genome |
| high risk HPV? low | high 16,18, 31,33 Low 8 and 11 |
| What CIN gradings are high grade | CIN 2 and CIN 3 |
| what percent of untreated high grade dysplasias progress to SCC | 70% |
| two mechanisms of high risk HPV cancer causing | insert and inactivate p53 or activate retinoblastoma (uncontrolled DNA proliferation) |
| what is the histiological apperance of chlamydia | follicular cervicitis |
| what are two complications of chlamydia | endometritis (40%) and salpingitis (11%) |
| Post chlamydia sequelae | PID, Tubal infertility, neonate pneumonia |
| HSV2 | a virus that causes non-painful vesicles and shallow excruciatign ulcerations |
| what are the three Ms seen in late Herpes Infections | Multinucleation, Margination(clear around nucleus) and Molding (push against each other) |
| what happens if herpes is passes onto the child during birth | encephalitis, neurological damage, mental retardation |
| Non-infectious cervicitis can be caused by? | chemical, mechanical damage but is often asymptomatic with infiltrate and squamous metaplasia |
| Vulvular cysts Bartholin's Gland | hard to palpitation hiding behind the labia minora may mimick malignancy |
| Lichensclerosis et Atrophicus | common cause of white changes in the vulva most often in post menopausal women may be painful Parchment paper like lesions |
| what is the NON HPV squamous cell carcinoma | Lichen sclerosis et atrophicus |
| Padget's disease | red eczematous with irregular borders in older women this is an intraepithelial proliferation of Malignant gland like cells that rarely invade below stroma thought to be sebaceous gland |
| prognosis of padget's disease | slow progression with surgical removal being challenging due to irregular borders 15% of other women have malignancy elsewhere |
| Melanoma | padgetoid spread of nest cells (10% of vulvar malignancies) |
| survival of melanoma patients is based on | degree of invasion less than 1.5 mm great prognosis, more = 5% 5yr |
| what is micro invasive scqamous cell carcinoma | SCC of less than 3 mm this is important because there is a decreased risk of spread and excellent prognosis |