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Flashcards in Exam 2 - Female Deck (175):
1

When is breast cancer common and uncommon

Uncommon <40, MC when >50

2

What are some of the causes of breast cancer

Hormonal, genetic, environmental

3

Who is most likely to get breast cancer

>50, white, family Hx, geography

4

Why would someone <30 have breast cancer

Nulliparous or chest irradiation

5

What are hormonal, and genetic risks for breast cancer

Increased estrogen, BRCA1/2, benign lesion

6

When breast cancer penetrates the BM what is it called

Invasive, infiltrating

7

When breast cancer does not invade the BM what is it called

In situ

8

Where is breast cancer most commonly located

In superolateral quadrant

9

What form of breast cancer is characterized by small “mixed” cells with necrosis and calcification

Ductal carcinoma in situ (DCIS)

10

If left untreated what would happen to a patient with DCIS

1/3 turn into invasive CA

11

If a female that was diagnosed with DCIS (underlying cancer) comes in showing manifests on skin near the areola that looks like eczema what is the disease

Paget disease of the nipple

12

A women comes in with a form of breast cancer with uniform cells, mucin vacuoles, and you incidentally diagnosed that left untreated would turn into CA on both breasts

Lobular carcinoma in situ

13

Patient comes in with breast cancer that has invaded and adhered to the pectorals what is it

Invasive (infiltrating) carcinoma

14

What type of breast cancer has possible lymphedema and lymphatic mets that shows as dimpling of skin and nipple inversion after it invaded/adheres to the pectorals

Invasive/infiltrating carcinoma

15

What type of breast cancer extends from DCIS making up 75% of all breast CA with heterogenous cells, irregular borders that also has firm/ fibrotic and palpable lumps

Invasive ductal carcinoma

16

What breast CA is from LCIS that has multiple masses that are palpable and when aggressivecan mets to GI, ovary, uterus, CSF, marrow

Invasive lobular carcinoma

17

What type of breast cancers lack 3 main receptors (ER,PR,HER2) and are linked to mutations on BRCA1/2

Triple negative breast Ca’s

18

What type of pathology report deals with estrogen receptors and progesterone receptors where if both + indicates 80%. Response

Hormone receptors

19

HER2 breast cancer pathology report indicates from what and is 30% of all breast Ca’s

Gene amplification

20

What breast cancer has solitary painless mass detected during palpation

Invasive breast cancer

21

Where is invasive breast cancer usually mets to

Lymphatic

22

What does the location of invasive breast cancer more lateral/central indicate

Route through axillary nodes

23

What does the location of invasive breast cancer more medial

Internal mammary arteries

24

What brings on poorer prognosis of invasive breast cancer

Anaplasia, increase in size, invasion or distant mets, overexpression of HER2/neu

25

What brings about better prognosis of invasive breast cancer

Estrogen receptors, and progesterone receptors

26

Patient comes in with enlarged male breast tissue that is non cancerous, you notice increased estrogen and going through puberty

Gynecomastia

27

Who is most likely to get male breast cancer

Mc in elderly

28

Where is male breast cancer likely to go to

Rapidly invades thorax, 50% mets at dx

29

Patient comes in with bilateral button like subareolar swelling what is it

Gynecomastia

30

Patiet has increase connective tissue, ductal hyperplasia, and is not lobule

Gynecomastia

31

What type of vulvitis produces erythema, oozing/crust, itching commonly caused form soaps, lotions and other things

Allergic contact dermatitis vulvitis

32

What type of vulvitis is caused by HPV/HSV, trep pallidum, gonorrheae, c albicans

Infectious vulvitis

33

Patient comes in and is dx with an obstruction/dilation of a bartholin gland what is the condition

Bartholin cyst

34

What is a co-infecx with a barhtolin cyst

Bartholin abscess

35

What condition is produced from hyperplasia/hyperkeratosis of epithelium due to chronic irritation

Lichen simplex chronicus

36

What epithelial disorder is from atrophy due to an AI whitening near the minora

Lichen sclerosus

37

Patient age 8 and patient age 60 comes in with dermal fibrosis around the minora what do you suspect is the cause

Lichen sclerosus

38

What type of CA is produced from lichen sclerosus

5% SCC

39

What do lichen simplex chronicus and lichen sclerosus resemble

Leukoplakia

40

What type of condyloma is a causitive of secondary syphilis

Condylomata lata

41

What type of condyloma is caused by HPV 6/11 (genital warts)

Condylomata acuminata

42

What type of neoplasia usually impacts >60 years, 90% SCC and has late lymph mets

Vulvar carcinoma

43

What hpv-related SCC deals with precancerous lesion of the vulva

Vulvar intraepithelial neoplasia

44

What type of vulvar carcinoma is the mc type and impacts older women with symptoms of lichen sclerosus (no VIN)

Non-HPV related SCC

45

What is the cause usually for vaginitis

Infections = fungi, protozoan (C.albicans, trichomonas)

46

What are risks of vaginitis

Diabetes,immunodeficiency, antibiotics

47

What of the vagina is benign/transient and has leukorrhea, pain, itching

Vaginitis

48

What type of vaginal cancer is rare, but mc in the elderly

Squamos cell carcinoma

49

What vaginal cancer is a pre-cancerous vaginal intraepithleial neoplasia

Squamos cell carcinoma

50

What are the risks of squamos cell carcinoma vaginal cancer

HPV, early intercourse, multiple partners

51

What type of vaginal cacer has symptoms of rare red/granular foci

Clear cell adenocarcinoma

52

What vaginal cancer is a 40x risk from mothers who took DES

Clear cell carcinoma

53

What type of vaginal cancer is rare but is characterized by embryonal rhabdomyosarcoma

Sarcoma botryoides

54

What type of vaginal cancer is mc <5 years, soft/polypoid mass

Sarcoma botryoides

55

What skeletal muscle tumor usually affects the head and neck and is mc pediatric soft tissue sarcoma

Rhabdomyosarcoma

56

Is cervicitis benign or malignant

Benign

57

What prompts a pelvic exam due to leukorrhea, pain, itching, bleeding, fever

Cervicitis

58

What is the mc cause of cervicitis

Infectious = chlamydia

59

What are the 2 types of non infectious cervicitis

Acute and chronic

60

Chronic cervicitis is common in who

Reproductive age women due to estrogen fluctuations or trauma

61

What type of cervicitis deals with postpartum

Non infectious acute cervicitis

62

Most cases of cancer in the cervix are from what

HPV 16 - 18

63

Most hpv infections last months and if they persist they can become what

Cervical intraepithelial neoplasia

64

What cervical neoplasia has columnar cells undergoing squamos metaplasia

Puberty = eversion

65

What darker stain indicates cervical intraepithelial neoplasia

Koilocytosis

66

What neoplasia of the cervix starts as HPV producing dysplasia and eventually precancerous

Cervical intraepithelial neoplasia

67

When is CIN most commonly diagnosed

Age 30 and peaks 15 years later

68

What CIN needs observation

Low grade CIN 1

69

What CIN needs excision

CIN 2/3

70

Why do we do screenings for CIN

It is asymptomatic

71

What neoplasia is dx in mid 40’s and is usually SCC from HPV infection

Invasive carcinoma of the cervix

72

Where is cervical cancer located

Transformation zone

73

What size determines cervical cancer mets

1% if <3 mm, 10% if >3mm

74

Who is most likely going to get cervical cancer

Mc in women who lack screening

75

Invasion of cervical cancer results in what mc cause of death

Renal failure = mc cause of death

76

What is associated with barrel cervix

Invasive cervical cancer

77

What is endometrial inflammation in its normal location

Endometritis

78

What can endometritis left untreated from gonorrhea, chlamydia, TB produce

Pelvic inflammatory disease (PID)

79

What type of enometritis needs a removal of an item for resolutin

Retained products

80

What is a chocolate cyst associated with

Endometriosus

81

What is extrauterine endometrial tissue with multiple masses causing bleeding and fibrosis

Endometriosus

82

What is the cause of half of female infertility

Endometriosus

83

What abnormal uterine bleeding is profuse/prolonged menstruation

Menorrhagia

84

What abnormal uterine bleeding is irregular, between periods

Metorrhagia

85

What is an inadequate luteal phase

Anovulatory cycle

86

What can cause an anovuluntary cycle

Retained endometrium = prone to breakdown/bleeding

87

What is an overgrowth of endometrial cells due to increased estrogen or failed ovulation

Endometrial hyperplasia

88

What is the most common female genital tract cancer

Endometrial carcinoma

89

Who is most impacted by endometrial carcinoma

Age 55-65

90

What are symptoms of endometrial carcinoma

Enlarged uterus, leukorrhea, metorrhagia

91

How does endometrial carcinoma mets

Late lymphatic mets

92

What type of endometrial carcinoma is mc and deals with endometrial hyperplasia, increased estrogens, diabteses HTN

Endometrioid

93

What type of endometrial carcinoma deals with endometrial atrophy, post menopausal and is aggressive

Serous

94

What type of proliferative lesions is mc around menopause and causes bleeding, cancer risk

Enometrial polyps

95

What smooth muscle tumore is bening, multiple, reproductive age women, and is fibroid

Leiomyoma

96

Who is likely to get leiomyoma

Repro age women, increased estrogens, african americans

97

What smooth muscle tumore is malgnant, solitary

Leiomyosarcoma

98

What smooth muscle tumor is postmenopausal and mets to lungs mc

Leiomyosarcoma

99

What is a microbial infection of the fallopian tubes

Salpingitis

100

What else can cause salpingitis

Ectopic pregnancy, endometriosis, tumor

101

What is an adenocarcinoma mc on fimbriae

Fallopian tube carcinoma

102

What does fallopian tube carcinoma invade

Peritoneal cavity

103

What are risks of fallopian tube carcinoma

BRCA 1/2

104

What are ovarian cysts from

Graffian or ruptured follicles

105

How big are ovarian cysts

Serous filled cysts 1-4 cm

106

Patient comes in with multiple cystic follicles enlarged to 2x size

Polycystic ovarian disease

107

Why does PCOD cause hirsutism and obesity

Increased androgens, estorgens, LH and decrease FSH

108

Both PCOD and ovarian cysts are what genetically

Familial

109

Increase the size of ovarian cyst increases the what

Complications

110

What is the fifth mc cause of CA related death

Ovarian tumors

111

What are risks of ovarian tumors

>20 years, nulliparity, family hx, BRCA 1/2

112

What can decrease the risk of ovarian tumors

Oral contraception

113

Surface epithelial tumors of ovarian tumors are benign or malig

Benign

114

What is 90% of ovarian cancers

Surface epithelial tumors

115

Ovulation creates what in surface epithelial tumors

Metaplasia

116

What are the mc surface epithelial tumors

Serous tumores

117

95% of surface epithelial tumors have what

Mutated TP53

118

When are most serous tumors benign

30-40 years old

119

When are most surface epithelial tumors malignant

45-65 years old

120

What are characteristics of serous tumors

Large = 40cm, 25% bilateral

121

What type of surface epithelial tumor is malignant

Endometrioid tumors

122

What are enometrioid tumors associated with

Endometrial CA and endometriosus

123

Wha type of endometrioid tumor increases CA risk

Solid no cystic

124

What is cancer of the GI tract that has spread to the ovaries with signet ring cells

Krukenburg tumore

125

What type of mets goes with krukenburg tumor

Lymphatic

126

Who is most likley to get krukenburg tumor

45 years old

127

What is signet ring cells originally a characteristic of before spread to ovaries

Gastric adenocarcinoma

128

Is ovarian teratomas benign or malignant

Benign, younger = increased cancer risk

129

What disease of pregnancy is mc

Ascending

130

What disease of pregnancy is from premature ruptrue of membranes sending neutrophils and edema there to combat mc bacteria

Ascending

131

What type of disease of pregnancy has the acronym TORCH

Transplacental

132

What is TORCH stand for

Toxoplasmosis, other, rubella, CMV, HSV

133

Where do most ectopic pregnancies take place

Most are tubal

134

When can ectopic pregnancies rupture

During 1st trimester

135

Why would ectopic pregnancy have acute abdominal pain

Salpingitis

136

What is a group of tumors resulting from abnormal fertilization

Gestational trophoblastic disease

137

What can mimic early pregnancy and increases hCG

Gestational trophoblastic disease

138

What is a benign tumor cystic mass that is grape like gestiational trophoblastic disease

Hydatidiform mole

139

When is there a risk for invasive hatidiform mole

Complete 2 sperm

140

What type of gestational trophoblastic disease is benign but locally invasive, from complete moles and can have possible life threatening hemorrhage

Invasive mole

141

What type of gestational trophoblastic disease is malignant, from complete mole, causing severe uterine bleeding extreme hCG increase (blood/urine

Choriocarcinoma

142

Choriocarcinoma commonly mets to where and is called what

Mc to the lungs, aka “cannonball metastasis”

143

What other cancers may produce a “cannonball” appearance

Testicular choriocarcinoma, renal cell carcinoma, prostatic adenocarcinoma

144

What is preeclampsia

Toxemia of pregnancy

145

What are symptoms of preeclampsia

HTN (>20 wks gestation), proteinuria, edema in face or periphery

146

What happens in preeclampsia around 3rd tirmester that can result in organ damage and placental hypoxia

Maternal endothelial dysfunx

147

Who is at risk for preeclampsia

1st pregnancy, material age> 35 years old

148

After preeclampsia what can develop due to endothelial damage that leads to clotting

DIC

149

What are the main issues with eclampsia

Onset of seizures and possible coma

150

What are the symptoms of eclampsia

Continued BP elevation, HA, diplopia, epigastric pain

151

How does eclampsia affect the kidneys and liver

Maternal end organ failure

152

What do 10% of cases of eclampsia develop (hint: what syndrome can develop)

HELLP syndrome

153

What does HELLP syndrome stand for

Hemolysis, elevated liver enzymes, low platelets

154

What type of minor abnormalities can happen in the breast

Supernumerary nipple, inverted nippled, galactocele

155

What takes place in the later stages of nursing and can produce a possible cyst due to an obstructed mammary gland duct

Galactocele

156

What can be common in the breast due to menstrual hormonal fluctuations

Fibrocystic changes

157

Who is most likely to have fibrocystic changes

Reproductive age females

158

Patient comes in with a fibrotic, cystic mass in the superolateral quadrant of the breast, what do you think it is

Fibrocystic changes

159

How does oral contraceptive impact fibrocystic changes

Decreases the risk

160

What are the categories of fibrocystic changes and which is mc

Nonproliferative (MC) and proliferative

161

What type of fibrocystic change has dilated ducts, multiple/bilateral cysts (<5cm), and has fibrotic/calcific densities

Non proliferative fibrocystic changes

162

What type of fibrocystic changes deals with ductal epithelial hyperplasia

Proliferative

163

Where does ductal epithelial hyperplasia of proliferative fibrocystic changes take place

Extra layer of cells in ducts/lobules (>2 cell layers)

164

What are the two types of proliferative fibrocystic changes and how are they categorized

Mild = orderly hyperplasia, atypical = dysplastic hyperplasia

165

Which type of fibrocystic change has an increased risk of breast CA

Atypical = 5x risk

166

What inflammatory breast lesion is indicated by small, chalky white painful mass

Fat necrosis

167

What is fat necrosis inflammatory breast lesion most likely caused by

Alcoholism/trauma= pancreatitis

168

What inflamm breast lesion is mc a S. Aureus infx in the ducts due to early nursing

Acute mastitis

169

Patient comes in age 40-60 wiith a non bacterial inflamm breast lesion with nipple retraction, what is it

Mammary duct ectasia

170

What inflamm breast lesion has chronic inflamm due to lymphocytes and plasma cells and is caused by ductal dehydration

Mammary duct ectasia

171

What are tumors of the breast mc from

Epithleia (fibrotic and glandular)

172

What is the mc benign breast tumor

Fibroadenoma

173

Who is likely to get fibroadenoma tumor of the breast

Younger women 20-30

174

What tumor of the breast is mostly bening but still has rapid growth with late mets

Phyllodes tumor

175

What tumor of the breast has a leaf like appearance

Phyllodes tumor