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GU > vulva, vagina, cervix > Flashcards

vulva, vagina, cervix Flashcards

Describe endocervical polyps Describe common diagnostic methods for cervicitis Define the T-zone and its impact on cervical pathology Describe PAP smears (how they work and what selected diagnoses look like) Describe HPV and its role in squamous dysplasia \ carcinoma (Applies to vulva and vagina as well) Describe lichen sclerosis and lichen simplex chronicus as it presents in the vulva Describe Paget’s disease and vulvar melanoma as they present in the vulva, and ways to tell them apart D

1
Q

non-neoplastic growth from the endocervix

A

endocervical polyp

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2
Q

why endocervical polyps are clinically importanr

A

can mimic malinancy and cause postcoital bleeding

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3
Q

how to diagnose acute cervicitis

A

DNA probe tests for gonorrhea or chlamydia, wet mount for trichomonas

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4
Q

how to diagnose chronic cervixitis

A

biopsy shows lymphoid follicles

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5
Q

normal cause of chronic cervicitis

A

chlamydia

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6
Q

“transformation zone” def

A

area where new squamous and mucinous epithelium in the cervix comes from

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7
Q

why the T-zone is important

A

comminly infected by HPV, giving rise to dysplasia

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8
Q

cause of all squamous dysplasia in the cervix

A

HPV

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9
Q

risk factors for cervical dysplasia

A

same as STD (early sex, multiple partners, early pre, smoking, immunosupression, OCP, vit deficiencies)

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10
Q

low risk HPV serotype

A

6,11

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11
Q

high risk HPV type

A

16,18

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12
Q

big risk for vulvar, vaginal, penile, anal cancaers

A

HPV 16,18

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13
Q

HPV E4 gene does what

A

encodes for protein that binds and disrupts cytokeratin network

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14
Q

HPV E6/E& genes do what

A

disable tumor supressors - leading to cell immortality

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15
Q

E6 binds to

A

p53

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16
Q

E7 binds to

A

RB

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17
Q

proteins in the 16,18 HPV

A

E6, E7

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18
Q

“raisin” cells

A

kolilcytes - low grade squamous epithelial lesion (LGSIL)

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19
Q

small cells with enlarged dark nucleus and scant cytoplasm

A

high grade squamous intraepithelial lesions

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20
Q

important about the appearance of high grade lesions

A

if they are in a pap smear they have reached the top of the cervical epithelium

21
Q

atypical mitotic figures, nuclear crowding, near or total lack of maturation

A

HGSIL CIN III

22
Q

marked nuclear pleomorphism, dirthy backround, orange keratin cells

A

squamous cell carcinoma

23
Q

histological definition of cervical SCC

A

when cells invade stroma

24
Q

nests of keratin under the cervical surface

A

invasive carcinoma of the cervix

25
Q

cause of 90% of invasive cervical cancers

A

HPV

26
Q

most often kind of invasive cervcal cancer

A

SCC

27
Q

smooth white “cigarrette paper” plaques,strophic stiff labia, constriction of vaginal orifice

A

lichen sclerosis

28
Q

cause of lichen simplex chronicus

A

itch-scratch cycle

29
Q

causes of lichen simplex chronicus

A

dermatitis, infectious processes, other inflammatory

30
Q

histological charicteristics of lichen simplex chronicus

A

hyperkeratosis, hypergranulosis, acanthosis

31
Q

cause of condyloma acuminatum

A

HPV 6 and 11

32
Q

branching architecture, koilcytosis, hyper/parakeratosis, aconthosis

A

condyloma acuminatum

33
Q

big player in high grade vulvar lesions

A

HPV 16

34
Q

def of high grade vulvar intraepithelial neoplasia

A

SC dysplasia of the vulva affecting most layers of epithelium, but w/o stromal invasion

35
Q

most common site of extramammary paget’s

A

vulva

36
Q

solitary or multiple well demarcated foci of red crusted areas

A

extramammary paget’s

37
Q

why extramammary paget’s is hard to excise

A

microscopically extends past grossly evident lesion

38
Q

histologic dx of extramammary paget’s

A

mucin stain

39
Q

large pleomorphic cells surrounded by abundant pale cytoplasm

A

extramammary paget’s

40
Q

ddx of extramammary paget’s

A

vulvar melanoma

41
Q

s-100 protein

A

vulvar melanoma

42
Q

prognosis of vulvar melanoma

A

poor

43
Q

why vulvar melanoma has poor outomes

A

often lesion is non-pigmented

44
Q

HPV strain causing vaginal cancer

A

HPV 16

45
Q

risk group for vaginal cancer

A

over 60

46
Q

most cases of vaginal cancer are from

A

cervical cancer

47
Q

“cluster of grapes”, mostly in kids

A

sarcoma botryoides

48
Q

DES chemical =

A

risk for clear cell adenocarcinoma

GU (12 decks)

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