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Flashcards in Chapter 18 Deck (205):
1

What is the most common condition in the Vulva?

Inflammation

2

Is neoplasia common or rare in the vulva?

Rare

3

What type of vulvitis is assorted with erythema, itching, oozing, and are caused by soaps lotions, detergents?

Allergic contact dermatitis

4

What are causes of infectious vulvitis?

Condylomata acuminata, HSV, preponema pallidum, N. Gonorrhoeae, C. Albicans

5

What condition associated with the vulva is an obstruction/dilation of the Bartholin gland?

Bartholin cyst

6

Is a Bartholin cyst painful or painless and how long does it take to develop?

Can be painless or painful, develops in days.

7

What condition of the vulva may possibly have a co-infection which my lead to an abscess?

Bartholin cyst

8

What condition is associated with epidermal thinning, with smooth white lesions near labia minor?

Lichen sclerosus

9

What is the cause of lichen sclerosus?

Idiopathic/autoimmune

10

Who is most common affected by lichen sclerosus and what is a risk factor?

Bimodal (old and young) cancer Risk (5% -->SCC)

11

What condition is associated epithelial hyperplasia and hyperkeratosis?

Lichen simplex chronicus

12

Does lichen sclerosus or lichen simplex chronicus has a cancer risk?

Lichen sclerosus

13

Is lichen simplex chronicus a thickening or thinning of epidermis ??

Thickening

14

What condyloma is associated with secondary syphilis and are flat, moist, painless?

Condylomata Alta

15

Are vulvar carcinomas rare or common?

Rare

16

In what age group are vulvar carcinomas most commonly seen?

>60 (late mets)

17

What is the most common vulvar carcinoma?

Non-HPV-related SCC

18

What vulvar carcinoma is associated with vulvar intraepithelial neoplasia?

HPV-Related Squamous cell carcinoma (SCC)

19

Who as at risk for a HPV related (vulvar carcinoma) squamous cell carcinoma?

Middle aged, smokers, immunodeficiency

20

Who is at risk for a non-HPV-related (vulvar carcinoma) squamous cell carcinoma. ?

Older woman, isolated, lichen sclerosus.

21

What causes a white vaginal infection?

C. Albicans

22

What causes a green vaginal discharge in the vagina?

Trichomonoas vaginalis

23

What are risks for infections in the vagina?

Diabetes, immunodeficiency, antibiotics

24

Are congenital malformations of the vagina common or rare?

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