Cervix, vulva, vagina, cervix, fallopian tubes, ovaries

Question 0

bacterial std

Answer 0

neisseria
treponema
haemophilia
calymmatpbacterium donovani

Question 1

viral std

Answer 1

HIV 1,2
HSV 1,2
chlamydia,mycoplasma
chlamydia trachomatis (L), lymphogranuloma venereum
c.trachomatis, ureaplasma
urelyticum

Question 2

other stds

Answer 2

trichomonas

arthropod

Question 3

oropharyngeal herpes serotype

Answer 3

HSV 1

Question 4

genital, mucosal, skin HSV serotype

Answer 4

HSV2

Question 5

herpes simplex gross

Answer 5

red papules ➡️ vesicles, pustules, ulcers

Question 6

herpes simplex histo

Answer 6

multinucleation
molding-kissing nuclei
margination
inclusion bodies
ground glass nuclei or perinculear halo

Question 7

genital herpes s/sx

Answer 7

fever
malaise

cervical and vaginal:
pelvic pain
purulent discharge

Question 8

complications of genital herpes simplex

Answer 8

latent infection 2/3 recurrences

neonatal transmission

Question 9

genital herpes simplex diagnosis

Answer 9

immunologic
serology
biopsy

Question 10

treatment for latent HSV

Answer 10

noooone

Question 11

may shorten the length of the initial and recurrent assymptomatic phase

Answer 11

Acyclovir

Fancyclovir

Question 12

lymphogranuloma venereum agent

Answer 12

Chlamydia trachomatis serotypes L1,2,3

Question 13

lymphogranuloma venereum causes

Answer 13

cervisitis

Question 14

cervitis by lymphogranuloma lesion

Answer 14

1. painless genital ulcer
2. swelling of inguinal lymph nodes - stellate abscesses surrounded by epitheloid cells
3. scarring in chronic cases- elephantiasis of the vulva

Question 15

lymphogranuloma venereum diagnosis

Answer 15

Frei test - chlamydial antigen

Question 16

cause of vulvar condyloma acumintatum

Answer 16

HPV

Question 17

low risk HPV types

Answer 17

6, 11

42, 44

Question 18

high risk HPV

Answer 18

16, 18

31, 33

Question 19

gross HPV

Answer 19

papillary or cauliflower outgrowth

Question 20

HPV histo

Answer 20

papillary overgrowth
hyperkeratosis
acanthosis
parakeratosis
hyperkeratosis
koilocytic
vacuolization

Question 21

raisinoid nuclei and nuclear halo is seen in

Answer 21

HPV

Question 22

cytopathic changes in pap smear of HPV inf

Answer 22

nuclear atypia
perinuclear halo
exfoliated squamous cells

Question 23

vulvar chancre is caused by

Answer 23

Treponema pallidum

Question 24

vulvar chancre gross

Answer 24

painless shallow ulcer

Question 25

histo vulvar chancre

Answer 25

ulceration chronic inflammation vasculitis

Question 26

diagnosis of vulvar chancre

Answer 26

darkfield microscopy fluorescence silver stain serology

Question 27

granuloma inguinale is caused by

Answer 27

Calymmatobcterium granulomatis

Question 28

gross granuloma inguinale

Answer 28

painless ulcers with rolled borders and friable base- coalesce

Question 29

granuloma inguinale histo

Answer 29

nonspecific granulomatous rxn with no caseation Donovan bodies

Question 30

donovan bodies invade

Answer 30

cytoplasm of histiocytes

Question 31

trichomoniasis agent

Answer 31

Trichomoniasis vaginalis

Question 32

trichomoniasis lasts for

Answer 32

4 days to 14 weeks

Question 33

trichomoniasis gross

Answer 33

copious purulent yellow frothy discharge strawberry appearance severe dilatation of mucosal vessels

Question 34

strawberry cervix is seen in

Answer 34

trichomoniasis

Question 47

crab louse infection

Answer 47

pediculosis pubis

Question 48

main causative agent of bacterial vaginosis

Answer 48

Gardnerella vaginalis

Question 49

Gardnerella vaginalis is a

Answer 49

G- coccobacilli

Question 50

vaginitis or vaginosis s/sx

Answer 50

thin, gray fishy odor vaginal discharge

Question 51

inflammation of the placenta caused by G. vaginalis

Answer 51

chorioamnionitis

Question 52

G. vaginalis histo

Answer 52

clue cells | - individual sq cells covered by a layer of coccobacilli along the margin

Question 53

pruritus, curdlike vaginal discharge caused by disturbance in vaginal microbial system

Answer 53

candidiasis

Question 54

which disease is not considered an STD?

Answer 54

candidiasis

Question 55

diagnosis of candida albicans

Answer 55

wet KOH mount | papsmear

Question 56

candida albicans histo

Answer 56

nonseptated pseudopores or filamentous fungal hyphae in wet KOH

Question 57

balls and spaghetti in microscopy is seen in

Answer 57

Candida albicans infection

Question 58

ascending type of infection | most serious complication of gonorrhea in women

Answer 58

pelvic inflammatory disease

Question 59

PID s/sx

Answer 59

pelvic pain fever adnexal tenderness

Question 60

causative agents of PID

Answer 60

Gonococcus Chlamydia trachomatis Puerperal infections

Question 61

GC in PID starts to appear

Answer 61

2-7 days after inoculation

Question 62

puerperal infection microbes

Answer 62

``` Strep Staph Coliform Clostridium perfingens Enteric ```

Question 63

most common site of Gonococcal infection

Answer 63

endocervix

Question 64

involvement of tubo-ovaria regions in PID leads to

Answer 64

tubo-ovarian abscess

Question 65

non GC caused PID spread

Answer 65

uterus➡️lymphatics➡️venous channels

Question 66

complications of PID

Answer 66

peritonitis intestinal obstruction dt adhesions infertility, ectopic pregnancy bacteremia

Question 67

non neoplastic epithelial disorders

Answer 67

bartholin duct cyst | vulvar dystrophy

Question 68

Bartholin duct cysts s/sx

Answer 68

``` adenitis abscess cystic dilatation at the posterior aspecr of labium majus pain discomfort ```

Question 69

management of bartholin duct cust

Answer 69

marsupialization- open permanently | excision

Question 70

bartholin glands are analogous to

Answer 70

Cowper's gland

Question 71

bartholin glands aka

Answer 71

greater vestibular glands

Question 72

nonspecific inflammation characterized by white, scaly, plaquelike mucosal thickenings (leukoplakia)

Answer 72

vulvar dystrophy

Question 73

2 categories of vulvar dystrophy

Answer 73

lichen sclerosis | squamous cell hyperplasia

Question 74

lichen sclerosis histo (6)

Answer 74

``` thinning of epidermis disappearance of rete pegs hydropic regeneration of basal cells superficial hyperkeratosis dermal fibrosis scant perivascular mononuclear infiltrate ```

Question 75

lichen sclerosis occurs

Answer 75

anywheeeere

Question 76

lichen sclerosis is common in

Answer 76

menopausal women

Question 77

clinical manifestation of lichen sclerosis

Answer 77

pale gray, parchment like appearance atrophied labia introitus narrowed

Question 78

pathogenesis of lichen sclerosis

Answer 78

unknown

Question 79

results from rubbing or scratching from skin due to pruritus associated with cancer

Answer 79

squamous cell hyperplasia

Question 80

squamous cell hyperplasia histo

Answer 80

hyperplasia of vulvar squamous epithelium | hyperkeratosis

Question 81

indicated in all vulvar lesions

Answer 81

BIOPSY

Question 82

neoplastic tumors of the vulva- glandular neoplastic lesion

Answer 82

papillary hidradinoma | extramammary paget's disease

Question 83

neoplastic tumors of the vulva- benign vulvar tumors

Answer 83

condyloma acuminatum fibroepithelial polyp squamous papilloma papillary hidradenoma

Question 84

neoplastic tumors of the vulva- malignant vulvar tumors

Answer 84

``` vulvar intraepithelial neoplasia VIN vulvar carcinoma vulvar scca invasive scca malignant melanoma ```

Question 85

papillary hidradinoma involves

Answer 85

labia majora more than labia minora

Question 86

papillary hidradinoma gross

Answer 86

small, well circumscribed nodules covered by normal skin | ulceration that may mimic carcinoma

Question 87

papillary hidradinoma histo

Answer 87

similar to intraductal papilloma of the breast - apocrine sweat glands tubulopapillary glands lined by columnar cells and surrounded by myoepithelial cells

Question 88

extramammary Paget's disease gross

Answer 88

red sharply demarcated lesion on labia majora epidermis, hair follicles, sweat glands micropolysaccharide cells

Question 89

prognosis of extramammary Paget's disease

Answer 89

good!

Question 90

not considered a precancerous lesion

Answer 90

condyloma acuminatum

Question 91

Cancer cells are confined within the basement membrane of the entire thickness of the epithelium

Answer 91

VIN

Question 92

VIN is multicentric meaning

Answer 92

may involve both majora and minora

Question 93

VIN I

Answer 93

mild dysplasia | atypical proliferation <1/3

Question 94

VIN II

Answer 94

Moderate dysplasia | <2/3 of thickness

Question 95

VIN III

Answer 95

sever dysplasia in situ | entire thickness

Question 96

uncommon, 3% of female genital cancers that occurs mostly in women of 60

Answer 96

carcinoma of the vulva

Question 97

majority of vulva carcinoma are

Answer 97

SCCA

Question 98

15% of vulva carcinoma

Answer 98

melanoma adenoca basal cell ca

Question 99

prognosis of vulva ca

Answer 99

poor | 65% have metastasized at time of dx

Question 100

80% survival rate at lesions

Answer 100

<2cm

Question 101

1st group or basaloid or warty vulvar scca is associated with

Answer 101

HPV infection of high oncogenic risk, 16,18/31

Question 102

1st group or basaloid or warty vulvar scca is almost always preceded by

Answer 102

classic VIN

Question 103

1st group or basaloid or warty vulvar scca occurs in

Answer 103

reproductive age women

Question 104

vulvar intraepithelial lesion, Bowen's dse is characterized by

Answer 104

nuclear atypia increased mitoses lack of cellular maturation

Question 105

classic VIN is analogous to

Answer 105

cervical squamous intraepithelial lesions

Question 106

second group or keratinizing scca is associated with

Answer 106

vulvar dystrophy- sq cell hyperplasia

Question 107

second group or keratinizing scca is preceded by

Answer 107

Differentiated VIN

Question 108

differentiated VIN is characterized by

Answer 108

marked atypia of basal layer | normal maturation and diff of superficial layers

Question 109

more common group of vulvar scca

Answer 109

second group or keratinizing scca 70%

Question 110

mean age for second group or keratinizing scca

Answer 110

76 y/o

Question 111

gene features in second group or keratinizing scca

Answer 111

p53 mutations

Question 112

vulvar scca with worse prognosis

Answer 112

second group or keratinizing scca

Question 113

second group or keratinizing scca histo

Answer 113

keratin pearls | tonguelike masses of malignant cells infiltrating the stroma

Question 114

invasive scca gross

Answer 114

exophytic fungating mass | endophytic ulcerating lesion

Question 115

invasive scca histo

Answer 115

keratin pearls intercellular bridges frank stromal invasion

Question 116

incidence of malignant melanoma of vulva

Answer 116

5% of vulvar cancers, rare

Question 117

peak incidence of malignant melanoma of the vulva

Answer 117

60-70

Question 118

malignant melanoma of the vulva histo

Answer 118

round, ovoid to spindly with large nuclei hyperpigmentation intracytoplasmic

Question 119

immunostain specific for melanomas

Answer 119

HMB. 45

Question 120

congenital vagina anomalies

Answer 120

Garthner's duct cysts Mucous cyst Vaginal atresia Double vagina

Question 121

Garthner's duct cysts are found in

Answer 121

anterooateral wall of vagina following mesonephric or Wolfian duct

Question 122

Garthner's duct cysts histo

Answer 122

low cuboidal non mucin secreting cells devoid of cytoplasmic mucicarmine or PAS + material

Question 123

which vaginal congenital anomaly is common?

Answer 123

Garthner's duct cysts

Question 124

cyst derived from Mullerian epithelium

Answer 124

Mucous cyst

Question 125

total absence of vagina

Answer 125

vaginal atresia

Question 126

failure or total closure of the Mullerian ducts

Answer 126

double vagina

Question 127

Vaginal intraepithelial neoplasia or VaIN gross

Answer 127

white reddish patch | raised

Question 128

VaIN histo

Answer 128

loss of maturation nuclear atypia normal and abnormal mitotic figures

Question 129

primary carcinoma of the vagina is

Answer 129

extremely uncommon

Question 130

SCCA of vagina arises from vaginal intraepithelial neoplasia which is analogous to

Answer 130

cervical squamous intraepithelial lesions

Question 131

SCCA of vagina most commonly found in

Answer 131

inv upper posterior | proximal 3rd

Question 132

most common malignancy of vagina is

Answer 132

secondary to cervical or vulvar ca

Question 133

vaginal ca gross

Answer 133

polypoid fungating indurated ulcerated lesions

Question 134

vaginal CA histo

Answer 134

``` intercellular bridges central pearl formation pigmenting stratification waxy cytoplasm ```

Question 135

occurence of vaginal adenoca

Answer 135

raaaare

Question 136

increased frequency of vaginal adenoca in

Answer 136

young women whose mothers were treated with DES

Question 137

possible precursor of vaginal adenoca

Answer 137

vaginal adenosis

Question 138

prognosis of vaginal adenoca

Answer 138

good upon surgery and radiation

Question 139

vaginal adeno ca histo

Answer 139

clear cells of vacuolated, glycogen containing cells

Question 140

very uncommon vaginal tumor seen in infants and children under 5

Answer 140

embryonal rhabdomyosarcoma or | sarcoma botryoides

Question 141

sarcoma botryoides gross

Answer 141

soft, gray, tan, nodular tumors | polypoid lesions like a bunch of grapes

Question 142

sarcoma botryoides histo

Answer 142

small round to spindle cells with cytoplasmic extensions from one end (tennis racket) abundant pink cytoplasms

Question 143

subepithelial dense zone in sarcoma botryoides

Answer 143

cambium layer

Question 144

most cervical lesions are

Answer 144

benign

Question 145

site where most cervical lesions arise

Answer 145

SCJ

Question 146

acute and chronic cervicitis is common in

Answer 146

multiparous and nulliparous women

Question 147

pathogenesis of acute and chronic cervicitis

Answer 147

glucogenated sq cells provide a substrate for endo bacteria causing acidic pH

Question 148

lactobacilli produce

Answer 148

lactic acid to make pH of vagina less than 4.5 | h2o2- bacteriotoxic

Question 149

clinical manifestations of cervicitis

Answer 149

thick purulent discharge fishy odor itching discomfort

Question 150

diagnosis of cervicitis

Answer 150

clinical evaluation culture pap smear

Question 151

replacement of mucus endocervical glands by stratified sq epithelium

Answer 151

squamous metaplasia of the endocervix

Question 152

squamous epithelium in metaplasia of endocervix may also arise directly from

Answer 152

basal nerve cells of the endocervical mucosa

Question 153

cystic dilatation of endocervical glands or ducts with accumulation of secretory material within the cervical stroma

Answer 153

Nabothian cysts

Question 154

more common form of Nabothian cysts

Answer 154

multiple

Question 155

inflammatory, benign, nonneoplastic growth within the endocervical canal up to 5 cm

Answer 155

endocervical polyp

Question 156

symptom of endocervical polyp

Answer 156

vaginal bleeding or spotting

Question 157

management of endocervical polyp

Answer 157

simple curretage or excision

Question 158

endocervical polyp histo

Answer 158

soft, almost mucoid composed of loose fibromyxomatous stroma harboring dilated, mucus secreting endocervical glands often with inflammation

Question 159

HPV associated premalignant change in cervix

Answer 159

cervical intraepithelial neoplasia or CIN

Question 160

3 different classification systems for CIN

Answer 160

dysplasia- mild, mod, sev CIN- 1-3 SIL or bethesda classification- LSIL, HSIL

Question 161

CIN 1

Answer 161

mild dysplasia | basal third of epithelium

Question 162

CIN 2

Answer 162

moderate dysplasia | lower and middle 3rd

Question 163

CIN 3

Answer 163

severe dysplasia and CIS | all layers

Question 164

CIN 1 renamed

Answer 164

LSIL

Question 165

CIN 2 and 3 renamed to

Answer 165

HSIL

Question 166

risk factors for cervical cancer

Answer 166

``` persistent HPV 16,18 HPV 6, 11 : condylomas early age at first intercourse multiple sexual partners high risk male sexual partners cigarette smoking parity-multigravid ```

Question 167

cervical CA cocarcinogens

Answer 167

HLA subtypes oral contraceptives nicotine

Question 168

CIN begins at the

Answer 168

SCJ

Question 169

peak incidence for CIN is

Answer 169

30 years old

Question 170

CIN diagnosis

Answer 170

Schiller test papsmear colposcopy

Question 171

CIN is transient and can be cleared within

Answer 171

8 months to 2 years

Question 172

susceptible to CIN

Answer 172

immature basal cells | metaplastic squamous cells

Question 173

HPV inactivates

Answer 173

p53 | RB

Question 174

nuclear alterations and perinuclear halo are termed

Answer 174

koilocytic atypia

Question 175

invasive cervical ca that spreads via direct extension or lymphatics

Answer 175

SCCA. of cervix

Question 176

most common complaint in SCCA. of cervix

Answer 176

postcoital bleed

Question 177

SCCA. of cervix complication

Answer 177

``` obstruction infection ureteral compression hydronephrosis renal failure ```

Question 178

SCCA. of cervix gross

Answer 178

large fungating mass from posterior wall of cervix expanding laterally going inside transformation zone palabas

Question 179

histologic grade of scca cervical

Answer 179

large keratinizing large nonkeratinizing small cell

Question 180

large keratinizing aka

Answer 180

invasive scca, large cell keratinizing

Question 181

most common histologic grade of cervical ca

Answer 181

large keratinizing

Question 182

large keratinizing histo

Answer 182

keratin pearls dyskeratosis well differentiated

Question 183

large cell nonkeratinizing histo

Answer 183

no intercellular bridges seen | moderately differentiated

Question 184

most aggressive grade of Cervical CA

Answer 184

small cell

Question 185

morphologically cannot diff from undifferentiated neuroendocrine ca with no keratin

Answer 185

small cell CA of cervix

Question 186

resembles endocervical mucinous glandular epithelium with atypia, pleomorphism, mitoses, invasion

Answer 186

cervical adenoca

Question 187

arrangement of cervical adenoca

Answer 187

gland tubules papillae

Question 188

cervical adenoca histo

Answer 188

tall columnar glands with basally oriented nuclei and apical cytoplasmic mucin

Question 189

cervical cancer stage 0

Answer 189

carcinoma in situ

Question 190

cervical cancer stage 1

Answer 190

confined to cervix

Question 191

stage 1A

Answer 191

microinvasive cancer | >5 mm in depth

Question 192

stage 1b

Answer 192

invasive cancer > 5mm in depth

Question 193

cervical cancer stage 2

Answer 193

extends beyond cervix into upper 1/3 of vagina | but not onto pelvic wall

Question 194

cervical cancer stage 3

Answer 194

extends to pelvic wall on lower 1/3 of vagina

Question 195

cervical cancer stage 4

Answer 195

extends beyond pelvis into bladder or rectum with distant metastases

Question 196

prognosis of cervical ca

Answer 196

5 year survival 60%

Question 197

cervical cancer screening and prevention

Answer 197

cytologic screening histologic dx HP vaccination program

Question 198

indications for CONE biopsy

Answer 198

lesions which are high in the endocervical canal inconclusive or failed colposcopy ca in situ on punch or coposcopic biopsy

Question 199

types of biopsy procedures

Answer 199

colposcopic directed biopsy punch biopsy cone biopsy

Question 200

most common disorder of the fallopian tubes

Answer 200

inflammations

Question 201

accounts for more than 60% of suppurative salphingitis | -usually more than one ha

Answer 201

Gonococcus

Question 202

almost always a part of PID

Answer 202

suppurative salphingitis

Question 203

important sequelae of suppurative salphingitis

Answer 203

infertility | ectopic pregnancy

Question 204

infection in fallopian tubes that is part of a systemic disease and is common in third world countries

Answer 204

tuberculous salphingitis

Question 205

bleeding due to ectopic pregnancy usually occurs

Answer 205

6 weeks after a menstrual period

Question 206

ectopic pregnancy gross

Answer 206

edema congestion fetus surrounded by blood clot

Question 207

occurs as a small round ovoid cyst attached by a pedicle to the fimbriated end of the tube

Answer 207

paratubal cyst | Cyst of Morgagni

Question 208

wall of paratubal cyst

Answer 208

paper thin | contain clear serous fluids

Question 209

paratubal cysts microscopy

Answer 209

lined by flat to ciliated columnar cells

Question 210

paraovarian cysts are lined by

Answer 210

flattened cuboidal epithelium

Question 211

which is more common, primary or secondary malignancy in fallopian tubes?

Answer 211

secondary

Question 212

secondary tumors are mistaken for lesions of

Answer 212

chronic salphingitis | pyosalpinx

Question 213

benign tumors of the fallopian tube are of what origin

Answer 213

mesoderm

Question 214

most frequent type of benign tubal tumor

Answer 214

adenomatoid tumor or benign mesothelioma

Question 215

adenomatoid tumor gross

Answer 215

nodular swelling beneath the tubal serosa or within the tubal wall 1-2 cm in diameter grayish white or yellow in color

Question 216

adenomatoid tumor histo

Answer 216

multiple, slitlike or ovoid spaces | lined by single layer of low cuboidal or flattened epithelial cells

Question 217

adenomatoid tumor clinical sx

Answer 217

asymptomatic

Question 218

common malignant tumor of the fallopian tube

Answer 218

papillary adenoca

Question 219

fallopian malignant tumor are common in

Answer 219

post menopausal | 60-70

Question 220

papillary adeno ca of the fallopian tube gross

Answer 220

enlarged, swollen | lumen is filled and dilated by papillary or solid tumor mass

Question 221

malignant tumor of fallopian tube histo

Answer 221

composed of fine branching papillae covered by one or more epith enlarged pleomorphic hyperchromatic nuclei

Question 222

primary tumor carcinoma of fallopian tube gross

Answer 222

main tumor is in the tube | ovary is intact and normal looking

Question 223

primary tubal carcinoma of the fallopian tube histo

Answer 223

mucosa invasion | papillary pattern

Question 224

tubal carcinoma may cause

Answer 224

paraneoplastic syndrome

Question 225

may prove useful in tx of malignancy of the fallopian tube

Answer 225

Ca-125 antigenic determination

Question 226

adenoca of the fallopian tube stage 0

Answer 226

carcinoma in situ

Question 227

adenoca of the fallopian tube stage 1

Answer 227

tumor extends into submucosa or muscularis, not serosa

Question 228

adenoca of the fallopian tube stage 2

Answer 228

tumor extends to serosa

Question 229

adenoca of the fallopian tube stage 3

Answer 229

tumor extends to ovary and/or endometrium

Question 230

adenoca of the fallopian tube stage 4

Answer 230

tumor extends beyond repro organs

Question 231

non neoplastic ovarian cyst

Answer 231

``` inclusion (germinal cyst) follicle cysts/ cystic follicle lutein cyst/ corpus luteum cyst polycystic (sclerocystic) ovary para-ovarian cyst endometrial cyst ```

Question 232

usual location of inclusion cyst

Answer 232

surface or cortex

Question 233

inclusion cyst is filled with

Answer 233

serous or blood tinged fluid

Question 234

inclusion cyst lining

Answer 234

cuboidal or columnar of mullerian origin

Question 235

histogenesis of inclusion cyst

Answer 235

trapping of surface epithelium due to repeated ovulation and fibrosis

Question 236

incusion cyst histogenesis of cancer

Answer 236

serous cystadenoma mucinous tumors etc

Question 237

follicle cyst

Answer 237

abnormal cyst >2.5 cm granulosa-theca lining cells

Question 238

cystic follicle

Answer 238

physiologic cyst <2.5 cm granulosa theca-lining cells

Question 239

follicle cyst/cystic follicle occurence

Answer 239

common | considered normal

Question 240

histiogenesis of follicle cyst/cystic follicle

Answer 240

unruptured graafian follicle or ruptured follicle that immediately sealed

Question 241

follicle cyst/cystic follicle gross

Answer 241

single or multiple filled with clear serous fluid transparent gray membrane

Question 242

cells that secrete estrogen to stimulate the development of the follicle

Answer 242

granulosa cells

Question 243

granulosa cells histo

Answer 243

cuboidal with large centrally placed hyperchromatic nuclei | scanty cytoplasm

Question 244

theca cells nuclei

Answer 244

oval rather than round

Question 245

theca cells cytoplasm

Answer 245

pale | abundant

Question 246

usual diameter of corpus luteum cyst

Answer 246

>2.5 cm

Question 247

occurence of corpus luteum cyst

Answer 247

very common

Question 248

corpus luteum cyst gross

Answer 248

bright yellow orange rim

Question 249

corpus luteum histo

Answer 249

granulosa lutein cells luteinized theca cells innermost layer of CT - foci of hemorrhage

Question 250

clinical significance of corpus luteum cyst

Answer 250

occasionally ruptures leading to intraperitoneal bleeding causing abdominal pain

Question 251

corpus luteum cyst rupture can mimic

Answer 251

appendicitis | pancreatitis

Question 252

extremely yellow cyst of a premenopausal ovary is regarded as

Answer 252

luteal in origin

Question 253

large follicular, bilateral, thin-walled cysts marked with luteinization of the theca interna layer

Answer 253

theca lutein cyst

Question 254

theca lutein cyst is associated with

Answer 254

high levels of HCG - H. mole - chorioCA - fetal hydrops - multiple gestation

Question 255

also known as Stein Leventhal syndrome

Answer 255

polycystic ovarian dse

Question 256

prevalence of polycystic ovarian dse

Answer 256

3-6% | young women

Question 257

associated syndromes of PCOD

Answer 257

``` AUB with hyperestrenism oligomenorrhea anovulation obesity hirsutism infertility virilism- rare ```

Question 258

mechanism of PCOD

Answer 258

loss of hypothalamic control➡️unbalanced or asynchronous release of LH by pituitary gland increased secretion of LH➡️stimulation of theca lutein cells of follicles➡️excess androgen➡️increase conversion to ESTRONE➡️inc ESTROGEN neg feedback on FSH release

Question 259

PCOD gross

Answer 259

2x bigger than normal ovary thick pearly white capsule superficial cortex fibrotic and thickened

Question 260

PCOD histo

Answer 260

hyperplasia and luteinization of theca and granulosa cells -follicular hyperthecosis absent corpora albicantia endometrial hyperplasia

Question 261

also known as chocolate cyst

Answer 261

endometriotic cyst

Question 262

endometriotic cysts are developed from

Answer 262

abnormal implants of endometrial gland and stroma in the ovary

Question 263

endometriotic cyst histo

Answer 263

old lesions with hemosiderin macrophages and fibrosis

Question 264

most common site of endometriosis

Answer 264

ovaries ``` broad ligament peritoneum large bowel umbilicus fallopian tubes laparatomy scars ```

Question 265

endometrial glands and stroma are within uterus- myometriumc

Answer 265

adenomyosis

Question 266

ectopic glands response to cyclical hormone in endometriosis

Answer 266

cyclical abdomina pain or pelvinc pain

Question 267

infertility caused by endometriosis is due to

Answer 267

serosal fibrosis of the fallopian tubes | anovulation of unknown etiology

Question 268

lining of endometriotic cyst wall

Answer 268

tall columnar endometrial cells

Question 269

incidence of cancer

Answer 269

endometrium>cervix>ovary

Question 270

ovarian cancer prevalence

Answer 270

6% in women excluding the skin

Question 271

80% of ovarian CA are benign, usually occur

Answer 271

25-45

Question 272

20% of ovarian ca are malignant, occuring between

Answer 272

45-65 years

Question 273

ovarian tumor symptoms secondary to the mass effect of the tumor

Answer 273

abdominal pain mass distention urinary or GI symptoms vaginal bleeding

Question 274

cause of up to 50% cancer deaths of FGT because discovered late

Answer 274

ovarian tumors

Question 275

ovarian tumor markers

Answer 275

CA-125 | osteopontin

Question 276

CA-125 is unspecific because it is high in benign ovarian condition but is negative in

Answer 276

mucinous ovarian cancer

Question 277

tumor marker better in screening ovaria ca

Answer 277

osteopontin

Question 278

ovarian ca risk factors

Answer 278

nulliparity family history genetic (hereditary) and host genes

Question 279

associated with breast cancer located at ch17q21

Answer 279

BRCA1&2

Question 280

high levels of HER2/neu oncogene means

Answer 280

poor prognosis

Question 281

K-ras protein is overexpressed in ovarian ca by

Answer 281

30%

Question 282

50% of carcinomas show mutations of this gene

Answer 282

p53 suppressor gene

Question 283

general classification of ovarian tumor

Answer 283

surface epithelial germ cell sex-cord stroma metastatic tumors

Question 284

most frequent ovarian tumor

Answer 284

surface or mullerian epithelial tumor

Question 285

greatest proportion ovarian tumor

Answer 285

90%

Question 286

sex cord stroma ovarian ca age group

Answer 286

all ages

Question 287

surface epithelium cancer age group

Answer 287

20+

Question 288

surface epithelial tumors arises from

Answer 288

surface, coelomic germinal, mullerian epithelium

Question 289

mullerian tumors differentiate into

Answer 289

serous (tubal) endometrioid(endometrium) mucinous (endocervix)

Question 290

comprises 2/3 of ovarian tumors | comprises 90% of all ovarian cancers

Answer 290

mullerian epithelial tumor

Question 291

pathogenesis of mullerian epithelial tumor

Answer 291

``` arises de novo adeno ca sequence surface epithelial dysplasias endometrioses incessant ovulation hypothesis ```

Question 292

incessant ovulation hypothesis

Answer 292

cortical inclusion cysts in which epithelial tumors can develop

Question 293

surface epithelial tumor classification

Answer 293

``` serous mucinous endometrioid clear (mesonephroid) cell transitional or Brenner mixed, squamous ```

Question 294

surface epithelial tumor: | recapitulate tubal mucosa (columnar ciliated)

Answer 294

serous

Question 295

surface epithelial tumor: | recapitulate endocervical enteric type of epithelial cells, tall columar mucus secreting

Answer 295

mucinous

Question 296

surface epithelial tumor: | recapitulate endometrial glands

Answer 296

endometrioid

Question 297

surface epithelial tumor: | mullerian

Answer 297

clear (mesonephroid) cell

Question 298

surface epithelial tumor: | cells are similar to the cells lining your urinary tract

Answer 298

transitional/ Brenner

Question 299

tumor is cystic and the lining epithelium differentiates into serous

Answer 299

serous cyst

Question 300

benign serous cyst

Answer 300

serous cystic adenoma

Question 301

parameter of classification of surface epithelial tumors

Answer 301

cell type pattern amt of fibrous stroma atypia and invasiveness

Question 302

BENIGN surface epithelial tumor

Answer 302

single layer, nonpapillary uniform,nonstratified no stromal invasion

Question 303

BORDERLINE surface epithelial tumor

Answer 303

papillary architecture ❤️cell atypia no stromal invasion

Question 304

MALIGNANT surface epithelial tumor

Answer 304

complex papillary, solid marked cell atypia ❤️stromal invasion

Question 305

most widely accepted theory for the derivation of mullerian epithelial tumors

Answer 305

transformation of coelomic epithelium

Question 306

benign surface epithelial tumors are further classified based on components: cystic areas

Answer 306

cystadenoma

Question 307

benign surface epithelial tumors are further classified based on components: cystic, fibrous

Answer 307

cystadenofibroma

Question 308

benign surface epithelial tumors are further classified based on components: predominantly fibrous

Answer 308

adenofibroma

Question 309

30% of ovarian tumors

Answer 309

serous tumors

Question 310

70% of serous tumors are

Answer 310

benign and borderline

Question 311

most common ovarian cancer

Answer 311

serous tumors

Question 312

histologic classification of serous tumors

Answer 312

benign serous tumors serous tumors of borderline malignancy or APST malignant serous tumors

Question 313

benign serous tumors

Answer 313

cystadenoma, papillary cystadenoma surface papilloma adenoma, cystadenofibroma

Question 314

APST

Answer 314

cystic and papillary cystic surface papillary carcinoma adenoca-fibroma/ cystadenocarcinofibroma

Question 315

malignant serous tumors

Answer 315

papillary cystadenocarcinoma surface papillary carcinoma adenocarcinoma-fibroma/ cystadenocarcinofibroma

Question 316

serous tumors general histo

Answer 316

lined by tall, columnar, ciliated and nonciliated epithelial cells -tubal like epithelium filled with clear serous fluid

Question 317

major group that arises in association with serous borderline tumors mutations are in KRAS or BRAF oncogenes with mutation in p53

Answer 317

low grade serous ovarian CA (well differentiated)

Question 341

trichonomiasis s/sx

Answer 341

discomfort dyspareunia dysuria

Question 342

trichomoniasis diagnosis

Answer 342

wet mounts of vaginal discharge | pap smear

Question 343

Trichomona vaginalis microscopy

Answer 343

eccentrically located nuclei flagellated, ovoid, pear shaped cyanophilic 15-30 nm in size

Question 344

DNA poxvirus infection | common self-limiting viral dse of skin spread by direct contact

Answer 344

molluscum contagiosum

Question 345

most prevalent MCV

Answer 345

MCV 1

Question 346

sexually transmitted MCv

Answer 346

MCV 2

Question 347

direct contact infection of MCV is common in

Answer 347

children 2-12 y/o

Question 348

sexually transmitted MCV is common in

Answer 348

adults

Question 349

average incubation period of MCV

Answer 349

6 weeks

Question 350

molluscum contagiosum gross

Answer 350

pearly dome shaped papules with a dimpled center

Question 351

MCV lesions usually at the

Answer 351

trunk anogenital abdominal face

Question 352

molluscum contagiosum histo

Answer 352

cup-like verrucous epidermal hyperplasia | eosinophilic intracytoplasmic inclusions

Question 636

major group that arise de novo without recognizable precursor lesion has mutations in p53 but lacks mutations in KRAS or BRAF

Answer 636

high grade ovarian CA (poorly differentiated)

Question 637

benign serous ovarian tumor histo

Answer 637

``` single, ciliated, flattened to cuboidal cells- reminiscent of TUBAL epithelium fibrous stroma no epithelial thickening may contain focal papilae Psamomma bodies in 15% ```

Question 638

benign serous ovarian tumor gross

Answer 638

``` 5-10 cm diameter or larger 30-40cm smooth glistening outer membrane paper thin wall prominent BV tensed tumor- filled with fluid *small nodules or projections ```

Question 639

borderline malignancy or APST is common in

Answer 639

older patients

Question 640

borderline malignancy or APST histo

Answer 640

complex exophytic papillary projections stratification: >1 cell layer but <3 layers cellular atypia of columnar ciliated serous cells -hyperchromasia NO stromal invasion

Question 641

borderline malignancy or APST gross

Answer 641

multiple nodular growths protruding within the cyst wall LARGE POPCORN on the surface of the inner cyst wall irregularly thickened wall clear serous fluid: blood-tinged

Question 642

(+) stromal invasion with 3 layers of cell

Answer 642

Serous cystadenoma

Question 643

(-) stromal invasion (+) cell atypia

Answer 643

APST or borderline malignancy

Question 644

borderline malignancy prognosis

Answer 644

5yr survival rate: 95-99%

Question 645

``` (+) stromal invasion extreme stratification >3 layers pleomorphism nuclear atypia mitoses ❤️PSAMOMMA bodies ```

Answer 645

malignant (serous cystadenoCA)

Question 646

Psamomma bodies are more common (not specific though) in benign serous or malignant serous?

Answer 646

malignant (serous cystadenoCA)

Question 647

malignant (serous cystadenoCA) gross

Answer 647

cystic lesion papillary epithelium is contained within few fibrous walled cysts (intracystic) large nodular yellow brown masses extension of the tumor outside the capsule

Question 648

malignant (serous cystadenoCA) histo

Answer 648

cysts lined by columnar epithelium more complex and branched hyperchromasia PSAMOMMA bodies

Question 649

mucinous tumors histologic class

Answer 649

mucinous cystadenoma borderline mucinous tumor or APMT mucinous cystadenoCA

Question 650

mucinous tumor histogenesis

Answer 650

surface epith with ENDOCERVICAL or panneth differentiation

Question 651

mucinous tumors are --- of ovarian tumors

Answer 651

25%

Question 652

80% of mucinous tumors are

Answer 652

benign or borderline

Question 653

which tumors are less likely to be malignant? | serous or mucinous

Answer 653

mucinous

Question 654

mucinous or serous tumors are common in

Answer 654

older patients

Question 655

mucinous or serous? | larger

Answer 655

mucinous

Question 656

mucinous or serous? | sticky gelatinous material

Answer 656

mucinous

Question 657

mucinous or serous? | clear, straw colored

Answer 657

serous

Question 658

mucinous or serous? | tubal-like epithelium

Answer 658

serous

Question 659

after ovulation the ovarian follicles will transform into

Answer 659

corpus luteum

Question 660

without implantation of fertilized ovum in the uterus, corpus luteum will regress into

Answer 660

corpus albicans

Question 661

part of the ovary relatively free of developing follicles | rich in ct and bv

Answer 661

medulla

Question 662

gonadal differentiation that break up into a single layer of mesothelial follicular cells surrounding each germ cell

Answer 662

cortical sex cords

Question 663

differentiate to oogonia and undergo mitosis to increase their numbers

Answer 663

primordial germ cells

Question 664

connective tissue stroma for follicular support

Answer 664

mesenchym

Question 665

before birthm the oogonia enter

Answer 665

meiosis I prophase

Question 666

during meisois prophase the ovaries separate from the

Answer 666

mesonephros

Question 667

lost during meiosis prophase I

Answer 667

peritoneal covering of the ovary