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PATH 375 > 11 - Female Reproductive System, Breast and Skin > Flashcards

11 - Female Reproductive System, Breast and Skin Flashcards

1
Q

Three examples of developmental abnormalities of female reproductive system?

A
  1. agenesis of vagina
  2. agenesis of uterus
  3. abnormality of uterus
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2
Q

Define the difference btwn true hermaphroditism, male and female pseudohermaphroditism

A

True: person has both male and female gonads (hormone makers)
Male pseudo: genotypically male, phenotypically female
Female pseudo: genotypically female, phenotypically male

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3
Q

What are the 2 pathogenic and 5 anatomic classifications

A

Pathogenic:
1. descending infections (TB, hematogenouos)
2. Ascending infection (STI)

Anatomic classification:
1. salpingitis: fallopian tube
2. endometritis: endometrium
3. cervicitis: cervix
4. vaginitis: vagina
5. vulvitis: vulva

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4
Q

What are the main characteristics of diseases caused by genital herpes (3)? Why is it important?

A
  • majority are asymptomatic
  • vesicle rupture can lead to ulcerations
  • no cure, virus remains dormant in neural ganglion

Important because don’t want vaginal delivery if active lesions

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5
Q

What are the main characteristics of diseases caused by HPV (3)?

A
  • labial, vaginal, and cervical warts (condyloma)
  • certain types associated with carcinoma
  • condyloma acuminatum: anogenital warts, usually caused by HPV 6,11 and transmitted through skin contact
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6
Q

Describe bacteria and diseases caused by chlamydia, gonorrhea, and syphilis

A

Chlamydia:
- chlamydia trachomatis
- causes urethritis, cervicitis with discharge, and PID

Gonorrhea:
- neisseria gonorrheae
- causes urethritis, cervicitis with discharge, and PID

Syphilis:
- treponema pallidum
- causes vulvar ulcers

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7
Q

Characteristics of PID? What are 3 other diseases it can cause and 3 complications?

A
  • infection of reproductive tract, usually secondary to an ascending infection of STI

Causes: salpingitis, tubo-ovarian abscess, peritonitis

Complications: infertility, ectopic pregnancy, spread of infection

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8
Q

What are the three main infectious and non-infectious causes of vaginitis

A

Infectious:
1. bacterial vaginosis (bacteria, not STI)
2. candidiasis (fungus, not STI)
3. Trichomonas (trichomonas vaginalis, STI)

Non-infectious:
1. atrophic vaginitis
2. foreign body
3. allergen or irritant

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9
Q

What is endometriosis characterized by (2)? Pathogenesis? What’s a specific example

A

Characterized by:
- when endometrial tissue, which is normally lines the inside of the uterus, is found on the outside of the uterus
- benign condition that may cause pain and infertility

Pathogenesis:
- retrograde menstrual flow theory
- traumatic implantation
- embryonic rests (part of embryonic tissue remains after embryonic development period)

Example: **Ovarian endometriosis **-> ovarian cyst

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10
Q

What is endometrial hyperplasia?

A

thickening of endometrial mucosa due to hormonal imbalances

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11
Q

What are the 5 main steps of the anovulatory cycle? What are the functional and organic causes? What disease is this cycle relevant to?

A
  1. no ovulation
  2. no progesterone secretion
  3. unopposed estrogenic stimulation
  4. proliferation
  5. endometrial hyperplasia

Functional: puberty, anorexia, anxiety, nervosa, bulima, athletes
Organic: excess estrogen

Endometrial Hyperplasia

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12
Q

Describe characteristics of vulva (4) carcinoma and vaginal carcinoma (2)

A

Vulva
- squamous cell carcinoma
- raised wart-like or ulcerated regions
- may result in leukoplakia or erythroplakia
- biopsy to assess, surgical excision w/ or w/o adjuvant therapy to treat

Vagina
- squamous cell carcinoma
- clear cell carcinoma due to women born to mothers on DES during pregnancy

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13
Q

What are 4 characteristics of carcinoma of cervix?

A
  1. cause is unknown
  2. most commonly squamous cell carcinoma
  3. occurs at transition zone of exocervic and endocervix
  4. cells may shed into vagina (hence pap test)
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14
Q

What are 2 risk factors of carcinoma of cervix?

A
  1. sexual intercourse at young age/multiple partners/HPV infections type 16 and 18
  2. Environmental factors (tobacco)
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15
Q

What type of neoplasm is cervical intra-epithelial neoplasia (CIN) associated with? What does CIN I, II, III mean in terms of severity?

A

Carcinoma of cervix

CIN I = mild
CIN II = moderate
CIN III = severe

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16
Q

Describe leiomyoma (3) and leiomyeosarcoma (2)

A

Leiomyoma:
- benign neoplasm of uterus derived from smooth muscle of uterus wall
- response to estrogen, usually asymptomatic
- may produce symptoms due to bleeding

Leiomyosarcoma:
- malignant neoplasm derived from smooth muscle in uterus wall
- very rare

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17
Q

What is endometrial adenocarcinoma? What is a risk factor? Diagnosis and treatment?

A

Malignant neoplasm derived from epithelial cells in endometrium

Risk factors are related to increased estrogen

Diagnosis: endometrial biopsy, dilation, curettage

Treatment: hysterectomy (surgical removal of uterus) with or without adjuvant therapy

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18
Q

Name an example of a disease with ovarian cysts and state 4 characteristics

A

Polycystic ovary syndrome
1. multiple cysts in both ovaries
2. presents with menstrual irregularities
3. patients don’t ovulate
4. cause of infertility

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19
Q

What are the three major ovarian neoplasm groups? Pathogenesis (3)?

A

Three Major Groups:
1. surface epithelial tumors
2. Germ cell tumors
3. Sex Cord stromal tumors

Pathogenesis
1. after ovulation, ovarian surface epithelium ruptures
2. heals by proliferation
3. proliferative surface epithelial cells have increased risk of transformation

20
Q

What are the three main surface epithelial tumors? Describe their characteristics and whether they’re generally benign or malignant

A

Serous epithelial tumors
- typically cystic and filled with clear fluid
- 30% benign 60% malignant

Mucinous epithelial tumors
- typically cystic and filled with vicsous fluid
- more likely to be benign compared to serous

Endometriod epithelial tumors
- typically solid
- usually malignant

21
Q

Characteristics of teratoma (4)?

A
  • aka dermoid cyst, often cystic and contains hair + sebaceous material
  • may contain teeth and bone cartilage
  • benign but should be resected to avoid malignant transformation
  • immature teratomas contain immature neural tissue and may behave malignantly
22
Q

What disease is a risk of excess estrogen

A

Endometrial carcinoma

23
Q

Where do ovarian sex cord neoplasms originate from? What are the 4 types?

A

Originates from ovarian stromal cells

  1. Fibroma: benign neoplasm of fibroblasts
  2. thecoma: benign neoplasm of theca cells, can produce estrogen
  3. Granulosa cell tumor: benign or malignant neoplasm of granulosa cell, can produce estrogen
  4. Sertoli-leydig cell tumor: secretes androgens -> virilization
24
Q

What are 4 factors leading to infertile pregancies?

A

Ovum related:
- immature ovum, incomplete meiotic division

Sperm related:
- azospermia (no sperm)
- oligospermia (low sperm)
- immotile sperm

Genital organ factors:
- PID
- Asherman’s syndrome: scar tissue in uterus or cervix

Systemic Factors:
- immune mechanisms

25
Q

Describe ectopic pregnancy and why it’s dangerous (3)?

A
  • implantation of fertilzied ovum outside of uterine cavity, usually in the fallopian tube
  • adhesions prevent normal passage of zygote so it implants and penetrates in the fallopian tube
  • may erode through wall and rupture, leading to massive blood loss
26
Q

Difference btwn placenta accreta and previa?

A

Accreta:
- abnormally deep peneration of placental villi into uterus wall
- risk of retaining placenta after delivery and post-partum hemorrhage

Previa:
- abnormal placental implantation site in lower uterine segment
- prone to bleeding and risk of premature delivery

27
Q

What is the difference btwn complete, incomplete, missed, threatened, and inevitable abortion?

A

Complete: fetus and placenta expelled, normal function
Incomplete: retention of some fetal and placental material
Missed: death of fetus in uterus, expelled weaks later
Threatened: cervix closed, spotting blood, fetus still in uterus
Inevitable: cervix is dilated, but products of conception not expeleld

28
Q

What are gestational trophoblastic diseases? What are the two cell types? Name a benign and malignant GTD.

A

Group of abnormalities of placentation resulting in tumor-like changes or malignant transformation

Cytotrophoblasts and synctiotrophoblasts which proliferate in GTD

Benign: hydatid mole
Malignant: choriocarcinoma

29
Q

What are some characteristics of hydatid form moles? Difference btwn complete and incomplete moles?

A
  • trophoblastic proliferation, degeneration of chorionic villi
  • features enlarged uterus with no fetal movement, looks like cluster of grapes on ultrasound

Complete mole:
- more common, no fetus (empty ovum), abnormal fertilization (all chromosomes from one parent, but normal amount)

Incomplete mole:
- some fetal parts in ovum, abnormal fertilization (abnormal number of chromosomes)

30
Q

Characteristics of choriocarcinoma?

A

rare highly malignant tumor of gestational trophoblasts, arises from pre-existing complete mole

31
Q

What is the difference btwn preeclampsia and eclampsia? What disease do they describe?

A

Preeclampsia:
- triad: HTN, edema, proteinuria
- typically occurs in third trimester
- can lead to eclampsia

Eclampsia:
- triad + seizure, life threatning to both mother and baby
- requires treatment of seizure before delivering baby

Toxemia of pregnancy

32
Q

What is mastitis? Difference btwn acute and chronic mastitis?

A

Mastitis = inflammation of breast

Acute:
- warm, red, edema, painful
- bacterial infection through milk ducts and breastfeeding
- may develop abscess
Chronic: mimics breast cancer, requires biopsy

33
Q

Describe fibrocystic change. What are some clinical features? Pathological findings?

A

Benign change in bobs due to hormones and age

Clinical findings: pain, nodularity, sensitivity on palpation

Pathological findings:
- fibrosis on intralobular stroma
- cystic dilation of epithelial ducts
- epithelial hyperplasia

34
Q

Describe gynecomastia

A

Increased proliferation of excretory ducts and stroma, leading to enlarged man breasts, usually due to hormonal changes

35
Q

Name a benign breast neoplasm and what causes it to occur

A

Fibroadenema
- Proliferation of stromal elements (fibro) and epithelial elements (adenoma)
- Believed to be abnormal exaggerated response of breast to hormones (puberty, pregnancy)

36
Q

Name a malignant breast neoplasm and what causes it to occur

A

Breast cancer, most common type is ductal carcinoma
- hormonal, environmental, and genetic influences (e.g. familial breast cancers = mutation in BRCA-1 and BRCA-2 tumor suppressor genes)

37
Q

What are some non-modifiable and modifiable risk factors of breast cancer?

A

Non-modifiable:
- age, race, female sex
- genetic predisposition, personal history
- hormones
- dense breasts

Modifiable:
- alcohol intake
- smoking
- maintaining healthy body weight
- breastfeeding
- hormone replacement therapy
- radiation exposure (unnecessary)

38
Q

Describe the three types of external skin injuries

A

Mechanical:
- blunt force
- sharp force

Electrical:
- inadequately isolated electrical wiring/lightening
- can cause burns
- can interfere with heart conduction

Radiation injury
- non-ionizing (UV)
- ionizing

39
Q

Describe the 4 degrees of burn

A

First degree: epidermis only, erythema, swelling, pain
Second degree: involves dermis, superficial or deep partial thickness, blisters/pain
Third degree: full thickness dermis, charred and black, no pain
Fourth degree: underlying soft tissue, muscle and bone

40
Q

Describe eczema and urticaria

A

Eczema
- chronic inflammatory disorder characterized by red, dry, scaly. itchy skin
- type I HSR
- often associated with asthma and allergic rhinitis

Urticaria (hives, welts, wheals)
- acute, transient, intensely itchy red raised plaques
- mast cell degranulation
- allerigic triggers (meds, food, bite) and non-allergic triggers (infections, cold temperature)

41
Q

What is seborrheic dermatitis

A
  • chronic relapsing mild dermatitis
  • infants -> cradle cap
  • severity varies
42
Q

What is psoriasis

A

Papules and patches covered by scale extensor surfaces (elbows, knees)

43
Q

What are the 4 types of skin neoplasms?

A
  1. epithelial (basal cell carcinoma, squamous cell carcinoma)
  2. melanocytic (nevus/mole, melanoma)
  3. dermal connective tissue
  4. metastasis
44
Q

Describe basal and squamous cell carcinoma

A

Basal:
- good prognosis, doesn’t metastasize
- nodule with red thread-like veins

Squamous:
- good prognosis, <2% metastasize
- firm, scaly nodules

45
Q

Describe nevus and melanoma

A

Nevus: benign neoplasm of melanocyte

Melanoma: malignant neoplasm of melanocyte
- refer to the ABC’s:
- Asymmetry
- Border irregularity
- Colour irregularity
- Diameter > 6 mm
- Evolution (shape, colour, size, etc.)

PATH 375 (6 decks)

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