Female Repro Path

Question 1

ulcerative lesions of the vulva

Answer 1

HSV, molluscum contagiosum (paxvirus), carcinoma

Question 2

ulcer is biopsied and shows viral inclusions in multinucleate squamous cells that have ground glass cytoplasm what is the etiologic agent

Answer 2

HSV

Question 3

infection common in young children 2-12 or adults, presents as pearly dome shaped papules with dimpled center

Answer 3

molluscum contagiosum

Question 4

curdlike vaginal discharge

Answer 4

candida

Question 5

yellow frothy discharge

Answer 5

trichomonas vaginalis

Question 6

fiery red cervix

Answer 6

trichomonas vaginalis

Question 7

thin green gray discharge and gram neg bacillus

Answer 7

gardnerella vaginalis

Question 8

comon cause of PID

Answer 8

chlamydia, niserria gonorrhea

Question 9

how does neisseria spread upwards in PID

Answer 9

mucosal surfaces to involve fallopian tubes and ovaries

Question 10

how do non neisseria infections spread upwards in PID

Answer 10

lymph channels or veins

Question 11

lichen sclerosus occurs more in women with other autoimmune conditions and increases risk of what

Answer 11

squamous cell carcinoma of vulva

Question 12

name for genital wart caused by HPV infection, and which strains cause it

Answer 12

condyloma acuminatum (HPV 6 and 11)

Question 13

genital wart caused by syphilitic infection

Answer 13

condyloma latum

Question 14

this is a characteristic of HPV infection and results in nuclear enlargement, hyperchromasia, perinuclear halo

Answer 14

koilocytic atypia (no cancer risk)

Question 15

age of woman with vulvar carcinoma

Answer 15

60

Question 16

where and how does vulvar carcinoma spread

Answer 16

via lymph to lungs liver

Question 17

pt presents with red itchy crusty area on labia major what is it, biopsied and discovered to express cytokeratin 7

Answer 17

extramammory pagets disease

Question 18

describe growth of extramammory pagets disease

Answer 18

lateral spread through epidermis

Question 19

we get septate or double vagina / double uterus when the ___ fails to fuse

Answer 19

mullerian duct

Question 20

exposure to diethylstilbestrol DES in utero increases chance of developing what

Answer 20

clear cell carcinoma

Question 21

persistence of glandular epithelium in the vagina

Answer 21

vaginal adenosis

Question 22

fluid filled cysts in vagina, remnant of wolffian duct

Answer 22

gartner duct cyst

Question 23

most common vaginal location for invasive quamous cell carcinoma

Answer 23

upper vag, posterior wall

Question 24

child under 5 with grape like clusters protruding from nuclei

Answer 24

embryonal rhabdomyosarcoma / sarcoma botryoides

Question 25

HPV's favorite spot to infect

Answer 25

transformation zone, squamocolumnar junction

Question 26

3rd most common cancer in women

Answer 26

cervical carcinoma

Question 27

low risk HPVs ___ cause ___

Answer 27

6, 11, warts

Question 28

high risk HPVs ___ cause ___

Answer 28

16, 18, carcinoma

Question 29

HPV protein E6 does what

Answer 29

promotes degradation of p53

Question 30

HPV protein E7 does what

Answer 30

promotes degradation of RB

Question 31

whats the mechanism for low risk HPVs to dysregulate growth and survival of cells

Answer 31

disrupt Notch signalling, bind RB with low affinity

Question 32

average age for woman with cervical squamous cell carcinoma

Answer 32

45

Question 33

what do we use to treat endometriosis

Answer 33

aromatase inh (stops estrogen production)

Question 34

endometriosis increases risk of what cancers

Answer 34

endometrioid, clear cell

Question 35

what is a chocolate cyst

Answer 35

an endometrioma: endometriosis in ovary, large cystic mass

Question 36

endometrial polyps are responsive to estrogen and associated with what medication

Answer 36

tamoxifen

Question 37

what are risk factors for endometriosis (things causing high estrogen)

Answer 37

obesity, menopause, PCOS, granulosa cell tumor, anovulation, exogenous estrogen

Question 38

what is cowden syndrome

Answer 38

germline PTEN mutation, predisposes to endometrial hyperplasia and carcinoma

Question 39

now that cervical cancer is detected early, whats the most common invasive cancer of female genital tract

Answer 39

endometrial carcinoma

Question 40

african american women more commonly get what kind of endometrial carcinoma

Answer 40

type II, p53 mutant, serous subtype

Question 41

most stromal tumors are benign in the enodmetrium, what translocation is present in many of the malignant sarcomas

Answer 41

JAZf1 - SUZ12

Question 42

mutation unique to uterine SM tumors

Answer 42

MED12

Question 43

which ovarian tumors/findings are found bilaterally

Answer 43

PCOS, metastatic cancer, serous carcinoma of the ovary, endometrioid ovarian tumors

Question 44

this is the most common malignancy of ovaries in childbearing age women (increased risk for nulliparity, family hx, BRCA mutations)

Answer 44

serous cystic carcinoma

Question 45

serous carcinomas in the ovary tend to metastasize where and cause what

Answer 45

peritoneal surfaces, omentum, ascites

Question 46

most mutinous carcinomas of the ovary are unilateral and share what mutation

Answer 46

KRAS

Question 47

if we have pt with pseudomyxoma peritonea (mutinous ascites) and suspect bilateral mutinous carcinoma in ovaries what needs to be ruled out

Answer 47

nonovarian origin: usually appendicieal source

Question 48

serum marker used to detect recurrence/progression in those with ovarian tumors

Answer 48

CA125

Question 49

specialized teratomas can be functional and secrete what kind of hormones

Answer 49

5HT (carcinoid syndrome) or thyroid hormone (hyperthyroid)

Question 50

small gland like structures with acidohillic material "call exner bodies" are found in what condition

Answer 50

granulosa cell tumor

Question 51

what is the marker for a granulosa cell tumor

Answer 51

inhibin

Question 52

what is meigs syndrome

Answer 52

ascites, hydrothorax, and ovarian tumor

Question 53

bilateral metastasis of a mucin producing sgnet ring cell cancer in both ovaries

Answer 53

krukenberg tumor (GI metastesis)

Question 54

HELLP syndrome (occurs in 10% of moms with preeclempsia)

Answer 54

hypercoagulable, elevated liver enzymes, low platelets

Question 55

clue cells would indicate what kind of infection

Answer 55

garderella

Question 56

most common cause of cervicitis

Answer 56

chlamydia

Question 57

brca1 mutations most commonly lead to which form of breast cancer

Answer 57

medullary