Female Genital (phathology) Flashcards
(118 cards)
0
Q
unfused proxima duct
A
Fallopian tubes
1
Q
mullarian duct
A
para-mesonephric duct –> fallopian tubes
2
Q
fused caudal part
A
uterine body
cervix
upper vagina
3
Q
UROGENITAL SINUS FORMS?
A
lower vagina
vestibule
4
Q
ovary contains?
A
follicle (germ cells) –> endodermal, from yolk sac (4th week)
outer epithelium/stroma –> mesodermal from urogenital ridge
5
Q
When does ovulation occurs?
A
14 days before LMP = secretory phase
6
Q
pregnancy mantainance hormone?
A
progestorone
7
Q
disfunctional uterine bleeding cause?
A
unknown (MC)
fibroids
ovarian cycles
8
Q
disfuncional uterine bleeding pathogenesis?
DUB
A
anovulatory
menorrhegia –> 3-5days
>80mL blood loss
9
Q
ovary size?
A
4x3x2
cortex - graafian follicles
medulla - wolffian duct remnants (rete ovarii, hilus cells) - can form cysts
10
Q
whats are the cysts formed by Wolffian duct remnants?
A
Gardner’s duct cysts
11
Q
length of fallopian tubes?
A
10 cm in length
site of fertilization
ectopic preg can occur
C - rupture, obstruction
12
Q
uterus anatomy?
A
9x6x3 50g 1. corpus/body 2. lower uterine segment 3. uterine cervix (endo/ecto)
13
Q
histology of vagina?
A
no glands
striatified squamous epitheilum
14
Q
uterus histology?
A
endo - columnar
ecto - stratified squamous
15
Q
where do cancers form?
A
ecto-endo junction (precancerous)
16
Q
fallopian tube histology?
A
columnar
cuboidal
17
Q
What can you tell about the glands in endometrium?
A
if they are compact 1. proliferative early - glands tubes late - telescope glands 2. secretory early - edema, corkscrew glands late -
18
Q
rule of 10?
A
10 days (within menstral cycle) except - Tb endometruritis -> 2* infertility F
19
Q
pelvic inflammatory disease is characterize by?
A
- adnexal tenderness (tubes + ovary)
2. vaginal discharge
20
Q
causes of PID?
A
pregnant - post partum
non-preg - sex
21
Q
PUD complications?
A
peritonitis
intestinal obstruction
infertility long standing chronic PID
22
Q
Tx for PID?
A
gonorrhea - Ceftriaxone
chlamydia - azythromicin (tetracyclines)
23
Q
surgery for PID?
A
bilateral salpingo ooherectomy - entirely removed
24
vulva diseases?
```
folluculitits - inflm hair
intertrigo - irritant derm
tinea - fungal infect.
psoriasis -
herpes - HSV-2, painful ulcers (no vaginal delivery)
```
25
what can happen to baby with herpes vaginal delivery?
HSV 2 - encephalitis
26
atrophy of vulva?
due to estrogen deprivation, pathological when remove ovaries in young age
27
leukoplakia in vulva?
cancer risk
28
circulatory disorders in vulva?
varicose veins
angioneurotic edema
elephantiasis
29
diabetic vulvitis?
```
beefy red
fungal growth (candida)
```
30
secretion for candidiasis?
```
thick discharge
severe itching (pruritis)
```
preg
diabetes
Oralcontraceptives
Dx; 10% KOH
31
gonorrhea infection site?
columnar epitelium
32
gonorrhea infection in children?
sexual abuse
| vulvo-vaginitis
33
syphilis in vulva?
painless chancre can be missed if in vaginal folds
34
bartholin cysts results from ?
obstruction of Bartholin duct
35
inclusion cysts
after reparative operation of perineal laceration
36
benign conditions
condylomata acuminatum - venereal warts - cauliflower like growth
37
vulva intraepithelial neoplasia VIN
HPV 16, 18
38
malignancies in vulva?
1. carcinoma (SCC), from VIN lesions
| 2. Paget dis (extra-mammary)
39
where do you see paget dis?
bone
vulva
nipple (100% malignant)
40
confirm paget's?
basal layer - cells are big with mucin
| "Paget cells"
41
Paget's of bone?
infection by paramyxo virus
forming/breaking bones
"mosaic pattern"
"change hat size"
42
Malignant melanoma?
60-70s
looks like Paget but S100+
Melan A
Mucin (--)
43
double vagina
mullarian ducts developed
not fused
septum divides
one bigger than the other
44
hematocolpos
blood in vagina
45
hematosalpinx
blood in tubal isthmus
46
fistulaes
vesico-vagina (++infections)
| recto-vaginal (++delivery)
47
herniations?
cystocele - bladder pushed forward, down
rectocele - has to pull all vagina
cystocele will always be there too
48
Trichomona presentation?
edema
red vagina (strawberry)
green-yellow discharge + small bubles
severe burning/itching
49
gardnerella vaginalis?
clue cells
50
dystocia
difficulty delivery
| Caused by Gartner's cysts
51
dyspareunia
pain during sex
| Caused by Gartner's cysts
52
inclusion cysts in vagina
episiotomy incision if you don't close it properly
53
endometriosis
ectopic endometrial tissue
MC site - ovaries
Infertility
54
benign in vagina
1. condylomata accuminata - HPV 6,11
| 2. fibroma (MEIG syndrome)
55
adenocarcinoma of vagina
"clear cells"
even with no glands
young
mom used med during pregnancy to prevent abortion - DiEthylStilbesterol
mom - endometrial carcinoma
56
sarcoma botryoides
embryonal rhabdomyosarcoma
"tennis racket" cells
infancy/childhood (rare)
57
metastases MC site?
vagina --> cervix
58
cervicitis?
inflammation of cervix
acute - rare, postpartem
chronic non-specific - lymphocyte, obstructed dialated gland (Nebothian cyst)
59
benign neoplasm in cervix
endo-cervical polyps
| columnar lining
60
premalignant neoplasms in cervix?
CIN (cervical intraepithelial neoplasm)
61
CIN I
CIN II
CIN III
Koilocytic change?
I - superficial, maturation
II - superfiial, parabasal
III - and basal layer, no maturation
62
classification for CIN?
"squamous intraepithelial lesions"
```
low grade (I, II)
high grade (III)
then stain them with iodine (colorless areas --> cone biopsy)
```
63
risk factors for premalignant cervical cancers?
1-first sexual intercourse at young age
2-multiple sex partners
3-HPV
Co-factors
HSV2
HIV
64
malignant cervix conditions?
SCC (75%)
adenocarcinoma (25%)
large cell non-keratinized (RT good)
keratinized (RT-not good, Surgery-good)
65
staging for cervical carcinoma?
```
0 - 100% cure (15 yrs to develop to 1)
1 - limit to cervix (95%)
2 - extended beyond cervix but not wall (65%)
3 - into wall or lower vagina (35%)
4 - metastasis (15%)
```
66
Endometritis
chronic inflammation
associated with PID
TB - endometrial biopsy in late secretory phase
67
Adenomyosis
endometrial tissue is in myometrium
68
Endometriosis
outside the uterus endometrial tissue
| endometrial glands
endometrial stroma
hemosedirin latent macrophages
need 2/3
69
endometrial hyperplasia
"pathological hyperplasia"
causes - hyperestrogenemia
```
ovarian tumors(endometroid, granulo seca)
Tamoxifen (breast cancer Tx)
```
70
types of endometrial hyperpasia?
low grade - absent atypia
high grade - atypia
PTEN gene - suppressor gene
71
MC endometrial cancer
adenocarcinoma
72
Stroma tumors of endometrium
Stromal tumor with benign glands (adenosarcoma)
| stromal tumors
stroma nodule
stroma sarcoma
73
Risk factors for uterine malignancy?
```
obesity
DM
HTN
infertility
prolonged estrogen exposure
```
74
presentation of uterine malignancies
abnormal (post-menopausal) bleeding = 6 mons after
75
myometrial tumors
leiomyoma
| Leiomyosarcoma (mitosis visible)
76
Fibroids
MC histological type of uterine neoplasms
grows really fast in reproductive period
77
Change in fibroids specialy during pregnancy
red degeneration
78
Presentation of fibroids?
hanging = "submucosal"
| increase surface area --> heavier, infertility, torsion
79
diagnose leiomyosarcoma?
10 mitosis/10 HPF +,- atypia
| 5-10 mitosis/10 HPF + cell atypia
80
salpingitis
inflammation of fallopian tubes
81
chronic salpingitis?
Tb
tube is aplastic
nonmotile
lead to infertility
82
ectopic pregnancy
risk - rupture
"30s female, HX amenorrhea 6-8wks
sudden severe a. abd pain"
++B-hCG levels
```
US (best)
endometrial biopsy (decidual change)
```
83
tumors in FT?
rare
| MC adenocarcioma
84
ovarian cystic lesions
non-neoplastic
| noplastic
85
non-neoplastic
follicular/leuteal cysts - common
if big then they can cause problems
86
Stein-Leventhal syndrome
```
young female
oligomennorhea/amenorrhea
obese
hirsutism
infertility
```
++androgens
-- pituitary
87
primary surface epithelial tumors
surface of epithelial cells
MC
20s
88
germ cell tumors of ovaries
same as male
teratoma
dysgeminoma
endodermal sinus
choriocarcimoma
89
sex-cord stroma tumors
all ages
| granuloma - theca cells
90
teratoma (mature cystic)
dermoid cysts
91
stroma ovaries
teratoma with thyroid
92
dysgeminoma
same as seminoma
93
serous cyst adenoma
MC ovarian tumor
cuboidal
watery secretions
CA-125 tumor marker
60% benign
malignant if bilateral
94
mucinous tumors
tall ciliated columnar
spread to other ovary
largest ovarian tumor with pseudomyxoma peritonei
95
endometroid
malignant
secrete estrogens
bilateral 50%
1/3 pt have endometrium carcinoma
96
bilateral tumors?
100 krukenberg
50 primary ovarian
20 benign tumors
97
Brener's
benign
yellow mass
cells - nests of transitional epithelium
98
clinical features of surface epithelial tumors
abd distention
lower abd pain
GIT/urinary symptoms
99
diagnosis for primary epithelial tumors
CT
US
Biopsy
100
Treatmet
surgery
| Combined Rx
101
Prognosis
poor if malignant (due to early metastasis and peritoneal spread)
102
germ cell neoplastic transformation
```
mature
embryonal (dont differentiate)
```
103
germ cell tumors arrise frome?
totipotential cells
104
dys\germinoma
like seminoma
teens/20s
malignant
radiosensitive
105
teratoma
3 germs layers
106
yolk sac carcinoma what you see in histology?
schiller duval body
endodermal sinuses
107
sex-cord stroma tumor
granulosa-theca
fibroma
sertoli
108
granuloma-theca
granulosa
theca
post-mena
produce estrogens
109
fibroma in ovaries
MEIG's syndrome
110
sertoli-leydig cell tumors
masculanization
| look like seminiferous tubules
111
secondary/metastasis
bilateral ovarian from GIT/breast
krukenberg
gastric carcinoma
112
placental infection
ascending and bacterial
113
hydatidiform mole features
+bhCG
complete/partial
hydrophilic villi
114
invasive mole features
++BhCG
villi present
invade uterine wall (no metast)
Rx - chemotherapy
115
complete mole
**diploid**
large uterus
++vaginal bleeding
fetal parts = very rare
116
partial mole
```
triploid
small uterus
+ vaginal bleeding
fetal parts = common
no choriocarcinoma
```
117
choriocarcinoma (gestational)
```
+++BhCG
no villi
metast --> lungs
Hx - preganancy, abortions
Rx - chemotherapy (methotrexate)
```
