Female Genital/Breast

Question 1

pap smear credited with reduction of which cancer?

Answer 1

cervical carcinoma

Question 2

most important agent in cervical oncogenesis

Answer 2

HPV

Question 3

low risk HPV serotypes

Answer 3

6,11

Question 4

high risk HPV serotypes

Answer 4

16,18

Question 5

HPV interferes with which tumor suppressor gene?

Answer 5

p53

Question 6

which quadrivalent vaccine confers immunity to HPV types 16 & 18 (70% of cervical cancer) and 6 & 11 (90% of condyloma acuminatum)

Answer 6

gardasil

Question 7

cervical carcinoma preceded by precancerous (dysplastic) lesion

Answer 7

cervical intraepithelial neoplasia

Question 8

peak incidence of cervical carcinoma

Answer 8

40-45 years

Question 9

“genital warts”, sexually transmitted and benign, multiple, HPV types 6 & 11

Answer 9

condyloma acuminatum

Question 10

STD caused by the spirochete treponema pallidum; main diagnostic tests: VDRL and RPR

Answer 10

syphilis

Question 11

presence of a chancre at the site of initial inoculation; small papule which enlarges into a painless ulcer with well-defined margins and clean moist base

Answer 11

primary syphilis

Question 12

generalized lymphadenopathy and a variety of mucocutaneous lesions; lesions can be maculopapular, scaly or pustular; involvement of palms and soles common; typically within 2 months of resolution of the chancre

Answer 12

secondary syphilis

Question 13

usually after a latent period of 5 yrs or more; 3 categories: cardiovascular, neuro, benign; gummas are focal granulomatous lesions that can occur in multiple organs

Answer 13

tertiary syphilis

Question 14

common STD, purulent cervicitis typically develops 2-7 days after exposure; vaginal discharge, painful intercourse, dysuria; easily treated with antibiotics

Answer 14

gonorrhea

Question 15

nongonococcal cervicitis; most commonly reported bacterial STD; caused by a small G-

Answer 15

chlamydia (c. trachomatis)

Question 16

most common cause of abnormal vaginal discharge; thin, milky vaginal discharge, foul fishy odour; gardenella vaginalis

Answer 16

bacterial vaginosis

Question 17

eukaryotic organism, parasitic protozoa, STD, burning, itching, malodorous vaginal discharge, can usually be seen on PAP smear

Answer 17

trichomonas vaginalis

Question 18

most common vaginal and cervical fungal infection; predominantly as yeast buds and forms pseudohyphae

Answer 18

candida

Question 19

most common in patients using intrauterine contraceptive devices

Answer 19

actinomyces

Question 20

ground glass nuclei, eosinophilic intranuclear inclusions

Answer 20

herpes

Question 21

both intranuclear (basophilic) and cytoplasmic inclusions

Answer 21

cytomegalovirus

Question 22

pelvic pain, adnexal tenderness, fever, vaginal discharge, may induce formation of tubo-ovarian abscess/pyosalpinx; oophoritis, salpingitis; gonococci and chlamydia

Answer 22

pelvic inflammatory disease

Question 23

also called Stein-Leventhal syndrome; numerous cystic follicles; enlarged ovaries twice their normal size

Answer 23

polycystic ovarian disease

Question 24

the presence of glands or endometrial stroma in an abnormal location outside uterus; a disorder of reproductive years; responds to hormonal stimulation

Answer 24

endometriosis

Question 25

common cause of abnormal bleeding; linked to prolonged estrogen stimulation

Answer 25

endometrial hyperplasia

Question 26

most common invasive carcinoma of the female genital tract; predominately a disease of postmenopausal women; "post-menopausal bleeding"

Answer 26

endometrial carcinoma

Question 27

tumor of smooth muscle; common during reproductive years; may induce spontaneous aportion

Answer 27

leiomyoma

Question 28

malignant counterpart of leiomyoma with necrosis

Answer 28

leiomyosarcoma

Question 29

second most common cancer of the female genital tract: 3 % of all cancers in women

Answer 29

ovarian cancer

Question 30

account for a disproportionate number of fatal cancers due to presentation at late stage; often asymptomatic until late stages; elevations in CA-125

Answer 30

ovarian cancer

Question 31

surface epithelial tumor; cystic filled with clear fluid; can be benign

Answer 31

serous tumors

Question 32

malignant serous tumor

Answer 32

serous cystadenocarcinoma

Question 33

surface epithelial tumor: closely resemble serous counterparts; 80% are benign

Answer 33

mucinous tumors

Question 34

germ cell tumors: "dermoid cyst"; mature and immature; may contain elements of all 3 germ layers

Answer 34

teratoma

Question 35

developmental disorder: may result in supernumerary nipples

Answer 35

milkline remnants

Question 36

developmental disorder: implications in breast carcinoma

Answer 36

accessory axillary breast tissue

Question 37

developmental disorder: may be clinically confused with inversion resulting from carcinoma and/or inflammation

Answer 37

congenital inversion of nipple

Question 38

suspicious findings in mammography

Answer 38

densities, calcifications, nipple-inversion

Question 39

associated with lactation; breast vulnerable due to fissures induced by nursing; staph and strep species; confusion with inflammatory carcinoma

Answer 39

acute mastitis

Question 40

erythema, pain, fever, infiltration by neutrophils, necrosis possible

Answer 40

acute mastitis

Question 41

history of trauma or surgery; presents as painless palpable mass; possible confusion with breast carcinoma

Answer 41

fat necrosis

Question 42

stromal tumor: most common benign tumor of female breast; occur in reproductive period; size can fluctuate through menstrual cycle; abnormal density and occasionally calcified

Answer 42

fibroadenoma

Question 43

stromal tumor: "leaf-like"; occur in older age group; most present as palpable masses; high grade lesions behave in malignant manner

Answer 43

phyllodes tumor

Question 44

benign, non-proliferative changes NOT associated with increased risk of carcinoma

Answer 44

fibrocystic change

Question 45

most common malignancy in women; 2nd leading cause of cancer death in women

Answer 45

carcinoma of the breast

Question 46

1/4 of familial breast cancers attributed to mutations in ...

Answer 46

BRCA1 and BRCA2

Question 47

major risk factor of sporadic breast cancer

Answer 47

hormone exposure (estrogen)

Question 48

all carcinomas are thought to arise from ...

Answer 48

the terminal duct lobular unit

Question 49

1/2 of mammographically detected cancers; malignant cells limited to ducts and lobules by basement membrane

Answer 49

ductal carcinoma in situ

Question 50

does not produce mammographic findings; most cases will proceed to infiltrating carcinoma; loss of E-cadherin expression

Answer 50

lobular carcinoma in situ

Question 51

large tumors may be fixed to chest wall; lymphatic blockage may induce "peau d'orange" appearance; by the time carcinoma is palpable 1/2 of patients will have axillary lymph node involvement

Answer 51

infiltrating carcinoma

Question 52

involvement of dermal lymphatics =

Answer 52

inflammatory carcinoma

Question 53

drug that inhibits estrogen receptor; for ER, PR positive; used as adjuvant therapy in estrogen receptor positive tumors

Answer 53

tamoxifen

Question 54

drug for Her2 positive cancers; Her2/neu: member of the epidermal growth factor receptor family; overexpression of Her2/neu seen in some breast and ovarian cancers

Answer 54

trastuzamab