Exam 2 Flashcards
(104 cards)
1
Q
MC condition of the vulva
A
Inflammation (vulvitis)
2
Q
Two general causes of vulvitis
A
- allergic contact dermatitis
- infection
3
Q
These infections can cause??
HPV HSV-2 N. Gonorrhoeae C. Albicans Treponema pallidum (Syphylis)
A
Vulvitis
4
Q
Erythema, oozing/crusting and itching of vulva that may be caused by soaps, lotions, detergents, deoderants and urine
A
Allergic contact dermatitis
5
Q
Obstruction/dilation of a barthholin gland
A
Bartholin cyst
6
Q
Infection of a bartholin cyst is now called
A
Bartholin abscess
7
Q
Characteristics of bartholin cyst
A
Develops quickly (days)
Can be painless or painful
8
Q
When does a bartholin cyst become a bartholin abscess
A
During infection
9
Q
What is an epithelial disorder that involves hyperplasia and hyperkeratosis anywhere external outside the vaginal canal (vulva) due to chronic irritation
A
Lichen simplex chronicus
10
Q
Does lichen simplex chronicus have any CA risk
A
Nope
11
Q
Does lichen sclerosus have any CA risk
A
Yes - SCC develops in 5%
12
Q
What autoimmune condition causes atrophy and a smooth, white appearance near minora along with dermal fibrosis and vaginal constriction
A
Lichen sclerosus
13
Q
Who is most likely to get lichen sclerosus
A
Females aged 8 and 60 (bimodal)
14
Q
Name for wart like structure
A
Condyloma
15
Q
What causes condylomata acuminata
A
HPV 6 and 11
16
Q
What causes condylomata lata
A
Secondary syphilis
17
Q
Who is most likely to get vulvar carcinoma and what type of CA
A
Women >60 years old
90% squamous cell carcinoma (lymphatic Mets)
18
Q
What is the pre-cancerous legion associated with HPV 16 and 18 related SCC (vulvar carcinoma)
A
Vulvar intraepithelial neoplasia (VIN)
19
Q
What HPV infections is HPV related SCC (vulvar carcinoma) associated with
A
16 and 18
20
Q
Who is most likely to get non-HPV related SCC (vulvar carcinoma)
A
Older women with lichen sclerosus
21
Q
What is MC?
HPV related SCC or non-HPV related SCC
A
Non HPV related SCC
22
Q
What are different types of malformation of the vagina
A
Agenesis
Atresia (narrowing)
Septate vagina (double barrel vagina)
23
Q
Vaginal inflammation
A
Vaginitis
24
Q
Examples of benign and transient vaginitis
A
Candida albicans
Trichomonas vaginalis
25
Risk factors for vaginal infections
Diabetes
Immunodeficiency
Antibiotics
26
Symptoms of vaginitis
Leukorrhea (white discharge)
Pain
Itching
27
3 types of vaginal cancer
Squamous cell carcinoma
Clear cell adenocarcinoma
Sarcoma botryoides
28
Vaginal cancer that is rare, but MC in elderly and related to HPV
Squamous cell carcinoma
29
Regarding vaginal squamous cell cancer, what is VAIN
Vaginal intraepithelial neoplasia
30
Which vaginal cancer is associated with the drug, diethylstilbestrol (DES) in 1971
Clear cell adenocarcinoma
31
Which vaginal cancer is rare and has red/granular foci appearance and associated with mothers who took DES drug
Clear cell adenocarcinoma
32
Which vaginal cancer is rare, has soft/polyploid masses and occurs in young girls
Sarcoma botryoides
33
Which type of vaginal cancer is a form of rhabdomyosarcoma
Sarcoma botryoides
34
Inflammation of the cervix
Cervicitis
35
Examples of infectious cervicitis
```
Chlamydia (MC)
Trichomoniasis
Candidiasis
Gonorrhea
Genital herpes
HPV
```
36
Non infectious examples of cervicitis (acute/chronic)
Acute = postpartum
Chronic = fluctuating estrogen levels in reproductive aged women
37
Main risk factor for CA of the cervix
HPV exposure!
38
70% of cervical CAs develop from what type of HPV
HPV 16 or 18
39
4 risks of HPV exposure / cervical CA
- early intercourse
- multiple sex partners
- male partner with several past partners
- high risk HPVs (16 and 18)
40
What does CIN stand for regarding CA of the cervix and persisting HPV infections
Cervical intraepithelial neoplasia
41
What precancerous lesion is associated with persisting HPV infections
Cervical intraepithelial neoplasia (CIN)
42
What are the characteristics of koilocytosis regarding CIN
Anaplasia/dysplasia
Enlarged nuclei
Irregular/wrinkled borders
Darker staining (hyperchromasia)
43
What is precancerous CIN
HPV —> dysplasia
44
CIN is MC at age
30
45
What happens about 15 years after someone gets CIN
Cervical CA
~age 45
46
What is the trt plan for CIN I (low grade)
Observation
60% regress and 10% progress
47
What is the Tx for CN II and III (high grade)
Excision
30% regress and 10% —> CA
48
What is LEEP
Loop electro surgical excision procedure
49
Why do women get Pap smears
To look for CIN because it is asymptomatic
50
Vaccinations for cervix neoplasia
HPV 6, 11, 16, 18
51
Invasive carcinoma of the cervix originates from
HPV infection
52
Invasive carcinoma of the cervix usually occurs to women around the age of
45
53
MC—>LC invasive carcinomas of the cervix
SCC !!!! = 75%
Adenocarcinoma = 20%
Carcinoid = 5%
54
What occurs in the transformation zone of cervical cancer
Asymptomatic early
Advanced cases = Leukorrhea, bleeding, dysuria, painful sex
55
Mets % criteria for cervical cancer
1% Mets if <3mm
10% Mets if >/= 3mm
56
Who is cervical cancer MC in
Women who lack screening
57
MC cause of death regarding cervical cancer
Invasion leading to renal failure
58
Tx for cervical cancer
Hysterectomy and lymph node excision
If a smaller lesion = cone biopsy or LEEP
59
“Barrel cervix” is associated with
Invasive cervical cancer
60
Endometritis
Endometrial inflammation
61
Symptoms of endometritis
Fever, abdominal pain
Menstrual abnormalities
Infertility or ectopic pregnancy
62
Where does endometritis occur
Where endometrium should be
| Compared to endometriosis that involves endometrium growing in abnormal places
63
PID (pelvic inflammatory disease) is caused by
What is main symptom
Gonorrhea, chlamydia, TB
Endometritis
64
Other than PID what else can cause endometritis
Retained products
- contraception
- abortion
- IUD
Tx = removal
65
Extrauterine endometrium
Endometriosis
66
Consequences of endometriosis
Dysmenorrhea
Dysuria
Pelvic pain
Sterility
Painful bowel movements and intercourse
67
Prevalence of endometriosis
10% of reproductive aged women
68
What causes half of all female infertility / sterility
Endometriosis
69
Endometriosis causes
Multiple masses 1-2 cm of extrauterine endometrium
Can lead to bleeding and fibrosis
70
Common sites of endometriosis
```
Ovaries
Peritoneum
Pouch of Douglas
Uterine ligaments
Fallopian tubes
```
71
Rare sites of endometriosis
Nodes
Heart
Lungs
Bone
72
What is a “chocolate cyst”
Endometriosis related mass on ovary
73
What is menorrhagia
Profuse/prolonged menstruation
74
What is metrorrhagia
Irregular bleeding between periods (spotting)
75
Potential causes of abnormal uterine bleeding
Leiomyomas
Leiomyosarcomas
Endometritis
Endometrial hyperplasia
Endometrial carcinoma
Anovulatory cycle
Dysfunctional uterine bleeding
76
What is anovulatory cycle and what may it cause
When does it occur
Inadequate luteal phase
Causing a retained endometrium which is prone to breakdown/bleeding
Occurs at extremes of reproductive life (12-14 ——> 50)
77
What does hyperplasia mean
Increased # of cells
78
What is endometrial hyperplasia
Overgrowth of endometrial cells
79
Symptoms of endometrial hyperplasia
Increased estrogen (obesity, PCOS, HRT)
Failed ovulation
80
What is endometrial hyperplasia a major risk factor for
Endometrial CA
3-50% —> carcinoma
Detected via “atypia” serial biopsies
81
MC female genital tract CA
Endometrial carcinoma
82
Who does endometrial carcinoma affect
Women aged 55-65 (post menopausal)
83
Symptoms of endometrial carcinoma
Enlarged uterus
Leukorrhea (abnormal discharge)
Metrorrhagia
84
How doe endometrial carcinoma metastasize
Lymphatics
Usually late so good prognosis
85
2 types of endometrial carcinoma
Endometrioid (MC)
Serous
86
Characteristics of endometrioid endometrial carcinoma
Endometrial hyperplasia
Perimenopausal
```
Increased estrogens
Diabetes
Lynch syndrome
Infertility
HTN
```
MC type!!
87
Characteristics of serous endometrial carcinoma
```
Endometrial atrophy
(Occurs much later on in life)
```
TP53 gene mutations
aggressive!
88
Two general categories of proiferative lesions of the uterus
Endometrial polyps
Smooth muscle tumors
89
Characteristics of endometrial polyps
MC perimenopausal
Abnormal uterine bleeding
Small CA risk
90
Two types of smooth muscle tumors of the uterus
Leiomyoma
Leiomyosarcoma
91
Characteristics of leiomyomas
AKA uterine fibroids
Benign
Usually have multiple
Effects reproductive aged African American women
Increased estrogens
92
Characteristics of leiomyosarcoma
Malignant smooth muscle tumor of the uterus
Usually only have one (solitary)
Effect post menopausal women (why an older woman randomly start bleeding again)
Mets—>lungs (MC)
Commonly recur
93
MC asymptomatic menorrhagia
Leiomyoma
94
What is salpingitis
Inflammation of the Fallopian tubes
95
Symptoms of salpingitis
Fever
Abdomen pain
Pelvic mass
96
Salpingitis is a risk for
Ectopic pregnancy or sterility
97
Microbial causes for salpingitis
Chlamydia
Gonorrhea
Strep
Staph
PID or sepsis
98
Characteristics of Fallopian tube carcinoma
Adenocarcinoma
MC on fimbriae
99
What genes are associated with Fallopian tube carcinoma
TP53
BRCA1
BRCA2
100
If Fallopian tube carcinoma is Dx late where does it commonly invade
Peritoneal cavity
101
2 types of ovarian cysts
Follicular cysts
| Luteal cysts
102
What are ovarian cysts
Serous filled cysts 1-4 cm
103
What causes ovarian cysts
Graafian or ruptured follicles
May be normal if they are small
104
Symptoms of ovarian cysts
Increased size = increased complications
Bleeding
Pelvic mass
Pain
Acute abdomen
