B8-032 Uterine, Cervical, and Vulvar Pathophysiology

Question 1

progressive inflammatory vulvar disease characterized by porcelain-white plaques

Answer 1

lichen sclerosus

Question 2

lichen sclerosus slightly increases the chance of

Answer 2

SCC

keratinizing

Question 3

vulvar pathology that causes thinning of epithelium on path, loss of rete pegs, and inflammatory infiltrate

Answer 3

lichen sclerosus

Question 4

vulvar pathology that causes thickening of epithelium and increased mitotic activity on path

Answer 4

classic vulvar intraepithelial neoplasia (VIN)

Question 5

how can classic vulvar intraepithelial neoplasia (VIN) be distinguished from differentiated VIN?

Answer 5

classic is HPV dependent

differentiated is HPV independent

Question 6

vulvar carcinoma characterized by peripheral palisading and deep basophilic staining pattern

Answer 6

basaloid and warty squamous cell carcinoma

Question 7

vulvar carcinoma associated with HPV

Answer 7

basaloid and warty squamous cell carcinoma

Question 8

vulvar carcinoma occurring most commonly in women with long standing-lichen sclerosus

Answer 8

keratinizing SCC

(unrelated to HPV)

Question 9

vulvar carcinoma characterized by keratin pearls

Answer 9

keratinizing SCC

Question 10

ectocervix is lined by

Answer 10

stratified squamous epithelium

Question 11

endocervix is lined by

Answer 11

columnar mucinous epithelium

Question 12

HPV independent endocervical adenocarcinoma

Answer 12

gastric type

Question 13

type of cervical adenocarcinoma associated with Peutz-Jeghers syndrome

Answer 13

gastric type

HPV independent

Question 14

[proliferative/secretory phase]

tubular glands
monomorphic stroma

Answer 14

proliferative

Question 15

[proliferative/secretory phase]

coiled glands
edematous stroma

Answer 15

secretory

Question 16

associated with infertility/recurrent implantation failure

antibiotic therapy can improve outcomes

Answer 16

chronic endometritis

Question 17

identification of […] cells is most important criterion for the diagnosis of chronic endometritis

Answer 17

plasma

Question 18

presence of endometrial glands within the myometrium

Answer 18

adenomyosis

Question 19

adenomyosis is made up of the […] layer of the endometrium

endometriosis is composed of the […] layers of the endometrium

Answer 19

adenomyosis is made up of the [basal] layer of the endometrium (non-functional)

endometriosis is composed of the [functional] layers of the endometrium

Question 20

may be a precursor to endometrioid and clear cell carcinoma

Answer 20

endometriosis

Question 21

frequent precursor to endometrial carcinoma

associated with prolonged estrogenic stimulation

Answer 21

endometrial hyperplasia

Question 22

increased gland-to-stroma ratio when compared to normal proliferative endometrium

Answer 22

endometrial hyperplasia

Question 23

endometrial hyperplasia often shows inactivation of […] gene

Answer 23

PTEN

(PI3K/AKT pathway)

Question 24

[Type 1 vs Type 2 endometrial carcinoma]

55-65 years

Answer 24

type I

Question 25

[Type 1 vs Type 2 endometrial carcinoma] 65-75 years

Answer 25

type II

Question 26

[Type 1 vs Type 2 endometrial carcinoma] linked to unopposed estrogen, obesity, HTN, diabetes

Answer 26

type 1

Question 27

[Type 1 vs Type 2 endometrial carcinoma] linked to atrophy and thin physique

Answer 27

type 2

Question 28

[Type 1 vs Type 2 endometrial carcinoma] morphology is endometrioid

Answer 28

type 1

Question 29

[Type 1 vs Type 2 endometrial carcinoma] morphology is serous, clear cell, or mixed mullerian

Answer 29

type 2

Question 30

[Type 1 vs Type 2 endometrial carcinoma] precursor is hyperplasia

Answer 30

type 1

Question 31

[Type 1 vs Type 2 endometrial carcinoma] precursor is serous endometrial intraepithelial carcinoma

Answer 31

type 2

Question 32

[Type 1 vs Type 2 endometrial carcinoma] mutated gene is PTEN

Answer 32

type 1

Question 33

[Type 1 vs Type 2 endometrial carcinoma] mutated gene is p53

Answer 33

type 2

Question 34

[Type 1 vs Type 2 endometrial carcinoma] indolent spreads via lymphatics

Answer 34

type 1

Question 35

[Type 1 vs Type 2 endometrial carcinoma] aggressive intraperitoneal and lymphatic spread

Answer 35

type 2

Question 36

endometrial adenocarcinomas with malignant mesenchymal component mesenchymal component can take many forms

Answer 36

mixed mullerian tumors (type 2 endometrial carcinoma)

Question 37

squamous cell carcinoma of the vagina is usually secondary to

Answer 37

cervical SCC (primary vaginal carcinoma is rare)

Question 38

arises from vaginal adenosis found in females who had exposure to DES in utero

Answer 38

clear cell adenocarcinoma | type 2 endometrial carcinoma

Question 39

presence of endometrial tissue in the myometrium

Answer 39

adenomyosis

Question 40

presence of endometrial tissue outside uterus

Answer 40

endometriosis

Question 41

abnormal endometrial gland proliferation often caused by unopposed estrogen

Answer 41

endometrial hyperplasia

Question 42

presents with uterine bleeding/dysmenorrhea diffusely enlarged "globular", soft "boggy" uterus on exam

Answer 42

adenomyosis **endometriosis presents with normal sized uterus on exam**

Question 43

yellow brown "powder-burn" lesions chocolate cysts

Answer 43

endometriosis

Question 44

presents with uterine bleeding/dysmenorrhea normal sized uterus on exam

Answer 44

endometriosis **vs. adenomyosis: "globular" and "boggy" uterus on exam**

Question 45

inflammation of the endometrium usually occurs after delivery due to innoculation of uterine cavity by vaginal microbiota

Answer 45

endometritis (**IUDs** also a risk factor)

Question 46

fever, purulent lochia, and uterine tenderness

Answer 46

endometritis

Question 47

c-section is the most important risk factor for

Answer 47

endometritis

Question 48

benign tumor of myometrium most common GYN tumor

Answer 48

leiomyoma

Question 49

tumor size is estrogen sensitive; increases with pregnancy and decreases with menopause

Answer 49

leiomyoma

Question 50

whorled pattern of smooth muscle bundles and well-demarcated borders

Answer 50

leiomyoma

Question 51

subtype of endometrial carcinoma heavily associated with unopposed estrogen

Answer 51

endometrioid carcinoma | type 1

Question 52

confluent endometrial glands without intervening stoma on biopsy

Answer 52

endometrial carcinoma | more specifically, type 1 i think

Question 53

are endometrial polyps associated with endometriosis?

Answer 53

no

Question 54

predominant hormone in the secretory phase

Answer 54

progesterone

Question 55

predominant hormone in the proliferative phase

Answer 55

estrogen

Question 56

cystically dilated glands fibrous stroma thick walled vessels

Answer 56

endometrial polyps

Question 57

increased gland-to-stroma ratio with irregular architecture

Answer 57

endometrial hyperplasia

Question 58

# [type 1 vs type 2 endometrial carcinoma] back-to-back endometrial glands admixed with solid areas

Answer 58

type I endometrial carcinoma

Question 59

endometrial carcinoma with papillary architecture, cytologic atypia and numerous mitoses may have psammoma bodies

Answer 59

type II (serous) endometrial carcinoma

Question 60

what components of a MMMT tumor are malignant?

Answer 60

both the epithelial and mesenchymal

Question 61

does cervical intraepithelial neoplasia cause dysfunctional uterine bleeding?

Answer 61

no

Question 62

[classical/differentiated] vulvar intraepithelial neoplasia is a precursor of keratinizing SCC

Answer 62

differentiated

Question 63

[classical/differentiated] vulvar intraepithelial neoplasia is a precursor of basaloid/warty SCC

Answer 63

classical

Question 64

[classical/differentiated] vulvar intraepithelial neoplasia is associated with HPV infections

Answer 64

classical