Chapter 18 Flashcards
(205 cards)
1
Q
What is the most common condition in the Vulva?
A
Inflammation
2
Q
Is neoplasia common or rare in the vulva?
A
Rare
3
Q
What type of vulvitis is assorted with erythema, itching, oozing, and are caused by soaps lotions, detergents?
A
Allergic contact dermatitis
4
Q
What are causes of infectious vulvitis?
A
Condylomata acuminata, HSV, preponema pallidum, N. Gonorrhoeae, C. Albicans
5
Q
What condition associated with the vulva is an obstruction/dilation of the Bartholin gland?
A
Bartholin cyst
6
Q
Is a Bartholin cyst painful or painless and how long does it take to develop?
A
Can be painless or painful, develops in days.
7
Q
What condition of the vulva may possibly have a co-infection which my lead to an abscess?
A
Bartholin cyst
8
Q
What condition is associated with epidermal thinning, with smooth white lesions near labia minor?
A
Lichen sclerosus
9
Q
What is the cause of lichen sclerosus?
A
Idiopathic/autoimmune
10
Q
Who is most common affected by lichen sclerosus and what is a risk factor?
A
Bimodal (old and young) cancer Risk (5% –>SCC)
11
Q
What condition is associated epithelial hyperplasia and hyperkeratosis?
A
Lichen simplex chronicus
12
Q
Does lichen sclerosus or lichen simplex chronicus has a cancer risk?
A
Lichen sclerosus
13
Q
Is lichen simplex chronicus a thickening or thinning of epidermis ??
A
Thickening
14
Q
What condyloma is associated with secondary syphilis and are flat, moist, painless?
A
Condylomata Alta
15
Q
Are vulvar carcinomas rare or common?
A
Rare
16
Q
In what age group are vulvar carcinomas most commonly seen?
A
> 60 (late mets)
17
Q
What is the most common vulvar carcinoma?
A
Non-HPV-related SCC
18
Q
What vulvar carcinoma is associated with vulvar intraepithelial neoplasia?
A
HPV-Related Squamous cell carcinoma (SCC)
19
Q
Who as at risk for a HPV related (vulvar carcinoma) squamous cell carcinoma?
A
Middle aged, smokers, immunodeficiency
20
Q
Who is at risk for a non-HPV-related (vulvar carcinoma) squamous cell carcinoma. ?
A
Older woman, isolated, lichen sclerosus.
21
Q
What causes a white vaginal infection?
A
C. Albicans
22
Q
What causes a green vaginal discharge in the vagina?
A
Trichomonoas vaginalis
23
Q
What are risks for infections in the vagina?
A
Diabetes, immunodeficiency, antibiotics
24
Q
Are congenital malformations of the vagina common or rare?
A
Rare
25
Leukorrhea (discharge), pain, and itching, that is most common benign and transient is associated with what condition?
Vaginitis
26
What form of vaginal cancer is most commonly seen in elderly (>60) ?
Squamous cell carcinoma
27
What form of vaginal cancer has a risk factor of HPV (early intercourse, multiple partners) and informs from a precancerous vaginal intraepithelial neoplasia.?
Squamous cell carcinoma
28
What form of vaginal cancer is usually seen in children less than 5 years old?
Sarcoma Botryoides
29
What vaginal cancer is from an ADR because their mothers took Diethylsthilbestrol (DES) ?
Clear cell adenocarcinoma
30
What form of vaginal cancer is is rare with red/granular forci?
Clear cell adenocarcinoma
31
Mothers who took DES this increases their child's chances by________%of getting what form of vaginal cancer?
Clear cell adenocarcinoma
32
Embryonal Rhabdomyosacrcoma is associated with what vaginal cancer?
Sarcoma Botryoides
33
Where in the body is rhabdomyosarcoma commonly seen?
Areas with little skeletal muscle (head neck 40%, genitourinary 25%, extremities 20%, truck 7%)
34
What is the most common pediatric soft tissue sarcoma ?
Rhabdomyosarcoma
35
What percent of patients with rhabdomyosarcoma are cured?
2/3
36
Is cervicitis most commonly benign or malignant ?
Benign
37
What is the most common causes of infectious cervicitis ?
Chlamydia ( 40% of cases
38
What is the causes of acute non infections cervicitis?
Postpartum
39
What is the cause of chronic non infectious cervicitis?
Estrogen fluctuations or trauma ( reproductive aged woman)
40
What are 4 risk factors of neoplasia of the cervix?
Early 1st intercourse, multiple sex partners, male partner with several past partners, High risk HPV infection.
41
What HPV's are involved with neoplasia of the cervix?
HPV16 and HPV18
42
Most HPV infections are______?
transient (months)
43
do most HPV infections persist to Cervical intraepithelial neoplasia?
No
44
what is the most common location for HPV?
transformation zone
45
Endocervix = what kind of epithelium ?
columnar
46
exocervix = what kind of epithelium?
squamous
47
What is eversion during puberty?
Columnar cells undergo squamous metaplasia
48
What is the most common pathology of the vulva?
Inflammation
49
What are causes of allergic vulvitis?
Contact dermatitis (eczema)
50
What are causes of infectious vulvitis?
HPV, HSV, preponderance pallium, gonorrheae
51
What is a Bartholin cyst?
Obstruction of the Bartholin gland (vulva)
52
Are Bartholin cysts painful?
May or may not be
53
What are two non neoplasticism epithelial disorders?
Lichen sclerosus, lichen simplex chronicus
54
What is thinning of the epidermis due to atrophy ?
Lichen sclerosus
55
What is a benign white lesion most common in the elderly near labia minor?
Lichen sclerosus
56
What is epithelial hyperplasia and hyperkeratosis?
Lichen simplex chronicus
57
What epithelial disorder is benign and caused by chronic irritation (leukocytes)
Lichens simplex chronicus
58
What is most likely though rare to have change of Turning into cancer?
Lichen sclerosus
59
What are 2 neoplasms of the vulva?
Condyloma, vulvar carcinoma
60
When do you see condylomata lata?
Secondary syphilis
61
When do you see condylomata culminate?>
Genital warts (HPV)
62
90% of vulvar carcinomas are what kind?
Squamous cell carcinoma
63
HPV related SCC are associated with what?
Vulvar intraepithelia neoplasia (VIN), HPV 16 and 18
64
What vulvar carcinoma is most common?
Non-HPV-related SCC
65
Non HPV related SCC are associated with what?
Older women, isolated, lichen sclerosis, NO VIN
66
Vaginitis is most commonly.....?
Benign and transient
67
What are common symptoms of vaginitis ?
Leukorrhea (discharge), pain.
68
Is vaginitis has a white discharge it is probably caused by what organism ?
C. Albicans
69
If vaginitis has a green discharge it is most commonly caused by what organism?
Trichamonas vaginalis
70
What vaginal cancer is most common in age 60 or older?
Squamous cell carcinoma
71
What are risk factors for squamous cell carcinoma?
HPV, VIN
72
Diethylstilbestrol (DES) is also acted with what vaginal cancer and what is the increased risk?
Clear cell adenocarcinoma, 40 times the risk
73
What vaginal cancer is most common in woman less that 5 years old??
Sarcoma botryoides
74
Sarcoma Botryoides is a type of what?
Embryonal rhabdomyosarcoma
75
Cervicitis is most commonly....?
Benign And has leukorrhea
76
What is the most common pediatric soft tissue sarcoma?
Rhabdomyosarcoma
77
Infectious cervicitis is most commonly caused by what?
Chlamydia
78
Acute (rare) Non infectious cervicitis is most common when?
Postpartum
79
Chronic (more common) cervicitis is most common in who? Due to?
Reproductive age woman due to estrogen fluctuations, trauma
80
If HPV persists what does it Turn into?
Cervical intraepithelial neoplasia (CIN)
81
What are high risks for cervical neoplasms?
HPV 16 and 18
82
Where does most of HPV take place?
Transformation zone
83
Eversion at puberty is what?
Changing from columnar cells to squamous metaplasia
84
Cervical intraepithelial neoplasia (CIN) is associated with what 2 things? ?
HPV and dysplasia
85
Cervical intraepithelial neoplasia (CIN) is most common in who?
30 year old, takes 15 years
86
With low grade CIN what happens?
Observation ---60% regress, 10% progress to high grade
87
With high grade CIN what happens?
Excision- 30% regress, 10% get cancer
88
What is cellular changes from HPV?
Kilocytosis
89
What are characteristics of Koilocytosis ?
Enlarged nucleus, anaplaia, wrinkled boarders, dark
90
Is CIN asymptomatic or no?
Yes
91
What do we screen for CIN?
Pap smear
92
Invasive carcinoma or the cervix is almost always (70%) what?
Squamous cell carcinoma (SSC)
93
When is invasive carcinoma of the cervix diagnosed ?
Mid 40s
94
Where does invasive carcinomas of the cervix happen?
Transformation zone
95
Once invasive carcinomas get bigger than______ there is a higher likely hood of mets
Bigger than or equal to 3
96
What is associated with cervical cancer ? (Cause of death)
Renal failure (due to local invasion which is most common)
97
What kind of cells do you see in acute endometritis?
Neutrophils
98
What kind of cells do you see with chronic endometritis?
Plasma cells
99
Endomitritis is most common following what?
Pelvic inflammatory disease (from STDS, TB)
100
Endometritis can happen (not common) following ?
Retained products (conception, abortion, IUD)
101
Extrauterine endometrial tissue is associated with what?
Endometriosis
102
Where does endometriosis develop?
Ovaries, peritoneum, pouch of Douglass, uterine lig, Fallopian tubes, does, Hearst, lung
103
What is associated with 50% of all female infertility?
Endometriosis
104
A chocolate cyst is associated with what?
Endometriosis
105
What is the cause of endometrial hyperplasia ?
Increased estrogens
106
What is the most common female genital tract cancer?
Endometrial carcinoma?
107
When is someone diagnosed with endometrial carcinoma ?
55-65 years old
108
What type of endometrial carcinoma is most common?
Endometriod (80%)
109
What type of endometrial carcinoma occurs perimenopausal, causes infertility?>
Endometroid
110
What type of endometrial carcinoma is endometrial atrophy, that is aggressive and POST-menopausal ?
Serous
111
When are endometrial polyps most common?
Menopause
112
What is a benign smooth muscle tumor?
Leiomyoma
113
When are leiomyomas found?
Reproductive age
114
What is a malignant smooth muscle tumor ?
Leiomyosarcoma
115
When do we see leiomyosarcoms?
Postmenapause
116
Leiomyosarcoms could possible met to where?
Lung (40% 5 year survival rate)
117
What is inflammation of the Fallopian tubes called?
Salpingitis
118
Salpingitis can contribute to what?
Possible ectopic pregnancy, sterility.
119
What is the most common Fallopian tube carcinoma?
Adenocarcinoma
120
Where in the Fallopian tube do we see adenocarcinomas most?
Fimbriae
121
Fallopian tube adenocarcinomas are associated with what mutation
BRCA1 and BRCA2
122
Ovarian cysts are what size?
1-4 cm
123
Ovarian cysts are from what?
Graafian or ruptured follicles
124
In polycystic ovarian disease (PCOD), the ovaries enlarge to what side?
2x the normal size
125
What hormones are increased for polycystic ovarian disease?
Androgens, estrogen, LH. (FSH is decreased)
126
Are ovarian cysts or POCD familial?
Both are q
127
Talcum powder can increase you risk of ovarian cancer by what?
30%
128
What are risks for tumors of the ovary?
Nulliparity, BRCA1/2 gene,
129
Ovarian cancer is the _____mc cancer in us woman and is the _____mc cause of cancer related death?
8th, 5th
130
90% of ovarian cancers are what?
Surface epithelial tumors
131
What is the most common surface epithelial tumors ?
Serous
132
Are most serous epithelial tumors benign or malignant?
Benign (60%)
133
What is the most common malignant surface epithelial tumor?
Endometrioid
134
What mutation is associated with Serous Surface epithelial tumors?
TP53
135
______serous epithelial tumors are found in 30-40 Year olds, _______ are found in 45-65.
Benign, malignant
136
What surface epithelial tumor is more likely to be bilateral?
Endometrioid
137
Is a cystic or solid surface epithelial tumor have a higher cancer risk?
Solid
138
What is cancer of the GI tract that has spread to the ovaries?
Krukenberg tumors
139
What cells are associated with a Krukenberg tumor?
Signet-ring cells
140
Are most krukenberg tumors unilateral or bilateral ?
Bilateral (80%)
141
What is a tumor that Arises from all 3 germ layers?
Ovarian teratomas
142
Are most ovarian teratomas being on cancerous ?
Benign ( 90% )
143
When are ovarian teratomas most common?
In the first two decades
144
What does BEAT stand for for ovarian cancer?
Bloated, Difficulty eating, Abdominal pain, Trouble with GI.
145
What placental infection is most common?
Ascending
146
Transplacental infections are assoacited with what?
Torch (toxoplasmosis, rubella, CMV, HSV, TB syphilis, hiv
147
Where is the most common ectopic pregnancy?
Fallopian tube (90%)
148
How common is ectopic pregnancy?
1%
149
An acute rupture of an ectopic pregnancy happens when?
1st tri
150
What is associated with a rupture of and ectopic pregnancy?
Hypovolemic shock
151
What is a benign grape like cystic mass?
Hydatidiform mole
152
What is a complete hydatiform mole?
2 sperm, no fetal parts, ( risk for invasive mole)
153
What is a partial hydatidifrom mole?
1 egg + 2 sperm, early fetal parts
154
And invasive mole is from what?
Complete hydatidiform mole
155
Are invasive moles benign?
Yes (but locally invasive). If they rupture they're life threatening
156
What are choriocarcinoma form??
Complete mole(50%) or after pregnancy
157
Extreme high hCG is assoacited with what?
Choriocarcinoma
158
What is the treatment for choriocarcinoma?
Chemotherapy (100% cured)
159
What most commonly when it metastasizes goes to the lung and is called a cannon ball metastasis?
Choriocarcinoma
160
What are the 3 things associated with preeclampsia?
HTN, proteinuria, edema in the face or periphery
161
When is preeclampsia diagnosed and most common?
3rd trimester, 1st pregnancy
162
What is maternal endothelial dysfunction assoacited with ?
Preeclampsia ( 5-10% all pregnancy)
163
What is eclampsia?
Seizures and coma after preeclampsia
164
HEELP syndrome is assoacited with what?
Eclampsia
165
What are symptoms of eclampsia?
Elevated BP, maternal end organ failure
166
What are the treatments for Eclampsia ?
Delivery >37 weeks, magnesium sulfate
167
What are 3 minor breast abnormalities?
Supernumerary nipple, inverted nipple (MC congenital), galactocele
168
When do you see galactocele?
Later stages of nursing, self limiting inflammation.
169
Are more break lesions benign or malignant?
Benign
170
Is breast cancer commonly painful?
Nooooooo
171
What is the number one most common female cancer? Number 2 in deaths?
Breast cancer
172
Most breast lumps and caused by what?
Fibrocystic changes
173
Fibrocystic changes occur when?
Premenopausal (reproductive age)
174
Where do most fibrocystic changes occur?
Superolateral quadrant
175
What type of fibrocystic changes are most common?
Nonproliferative
176
Proliferative fibrocytic changes are associated with what
An additional cellular layer
177
Mild proliferative fibrocytic changes =?
Orderly hyperplasia
178
Atypical proliferative fibrocystic changes are a risk factor for what?
Breast cancer q
179
What is plasma cell mastitis?
Mammary duct ectasia
180
What is assoacited with a non bacterial chronic inflammation of the breast, that is diagnosed around 40-60 and there may be possible nipple retraction?
Mammary duct ectasia
181
What is the most common benign breast lesion?
Fibroadenoma
182
What breast tumor is asp acted with leaf like projects and rapid rapid growth?
Phyllodes tumor
183
How lethal is breast cancer?
40k a year die(20%), 200k diagnosed
184
What is the lifetime risk for breast cancer?
1:8
185
Most breast cancer happens after what age?
50
186
In what area do most breast cancers occur on the body?
Superolateral (4% bilateral)
187
What breast lesion is rarely palpable, calcific, with mixed cells and has a great prognosis (97%) ?
Ducati carcinoma in Situ
188
What breast lesion has uniform cells, mucin vacuoles, rarely calcific. ?>
Lobular carcinoma in situ
189
What breast lesion adheres to pectorals, dimples the skin, nipple inversion?
Invasive carcinoma
190
Is DCIS or LCIS more likely to be bilateral?
LCIS (DCIS unilateral)
191
What invasive breast cancer makes up the majority (70-80%) of all breast cancer?
Invasive ducal carcinoma
192
What invasive breast cancer has aggressive growth, occult, and may met to CSF ?
Invasive lobular carcinoma
193
Medullary carcinoma is assoacited with what gene?
BRCA1
194
What invasive breast cancer is "triple negative:
Medullary carcinoma
195
Is invasive breast cancer mobile or fixed?
Mobile
196
If invasive breast cancer is lateral and central (MC) met via what?
Axillary nodes
197
If the invasive breast cancer is more medial it will met via what?
Internal mammary arteries
198
What is gene amplification that has to do with breast cancer?
HER2/neu
199
What receptors if both present get the best response (80%)
Estrogen (ER+) and progesterone (PR+)
200
Is gynecomastia unilateral or bilateral?
Bilateral
201
Gynecomastia is normally due to what what?
Ducati hyperplasia
202
Carcinoma is the male breast rapidly invades what?
The thorax (50% mets)
203
A button like appearance of the areola is associated with what?
Gynecomastia
204
What are things that give breast cancer a poor prognosis?
Anaplaia, increased size, invasion, distant mets.
205
What are some things that give breast cancer a better prognosis ?
Estrogen/progesterone receptors
