GYN

Question 1

Which syndrome is Peutz Jeghers associated with in the gyn?

Answer 1

Adenoma Malignum

Ovarian Sex cord tumor with annular tubules

Question 2

Peutz-Jeghers is due to Mutation in what gene? Chromosome?

Answer 2

STK11/LKB1

Chromosome 19p

Question 3

In lynch syndrome:

_______% lifetime risk of endometrial cancer; often in the _________

_______% risk of ovarian cancer; often _______

Answer 3

___50_% lifetime risk of endometrial cancer; often in the lower uterine segment

___10____% risk of ovarian cancer; often clear cell type

Question 4

What genes are associated with hereditary breast/ovary cancer (HBOC)?

Answer 4

BRCA1 and 2

Question 5

What is the precursor lesion seen in hereditary breast/ovary cancer (HBOC) in the Fallopian tube?

Answer 5

Serous tubal intraepithelial carcinoma

Question 6

What chromosome is BRACA 1?

Answer 6

17q21

Question 7

What chromosome is BRACA 2?

Answer 7

13q12-13

Question 8

High risk HPV

Answer 8

16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68, 73, 82

Question 9

Infections that result in benign processes usually have _________ viral DNA

Answer 9

Episomal

Question 10

How is mutated BRCA expressed?

Answer 10

AD with high penetrance

Question 11

E6 gene product act through inhibition of what tumor suppressor gene?

Answer 11

p53

Question 12

E7 gene product act through inhibition of what tumor suppressor gene? Which causes?

Answer 12

Retinoblastoma Over expression of p16

Question 13

Is lichen sclerosis a precancerous lesion?

Answer 13

No

Question 14

Does lichen sclerosis have a greater risk of carcinoma?

Answer 14

Yes; 1-4%

Question 15

Lichen simplex chronicus: histologic

Answer 15

Hyperkeratosis with acanthosis

Collagenization of the superficial dermis with underlying chronic inflammatory infiltrate

Question 16

DES is associated with alteration of what gene?

Answer 16

P63

Question 17

Serous carcinoma IHC

Answer 17

p53 and p16 diffusekt positive

p53 maybe completely negative

Question 18

Ovarian tumors with esteogenic effect

Answer 18

Granulosa cell tumor
Thecomas
Stromal luteoma

Question 19

Ovarian tumors with androgenic effect

Answer 19

Sertoli leydig
Leydig/Hilus cell tumor
Steroid cell tumor

Question 20

Ovarian tumor of the young <30

Answer 20

Sertoli leydig (retifrom variant seen ~15)
Juvenile granulosa
Sclerosing stromal tumor
Sex cord stromal tumor with annular tubules

Question 21

Ovarian tumors of perimenopausal age

Answer 21

Fibromas

Question 22

Ovarian tumors of post menopausal age

Answer 22

Adult granulosa
Thecomas
Leydig
Stromal luteoma

Question 23

What is the maximum number of slides a tech can screen? What’s the calculation?

Answer 23

100 in 24 hours (in no less than 8 hours)

Number of hours * 100 /8

Question 24

Whats the gene product of HPV that’s used in vaccines?

Answer 24

L1

Question 25

Give the risk of developing HSIL or worse in the following scenarios... Neg Pap and Neg HPV Neg Pap and Positive Pooled HPV Neg pap and Positive for HPV 16 ASCUS and Positive HPV

Answer 25

Neg Pap and Neg HPV : <2% Neg Pap and Positive Pooled HPV: 3-5% Neg pap and Positive for HPV 16: 20% ASCUS and Positive HPV : 25-30%

Question 26

Give the Regression %, Progression to HSIL % and Progression to Cancer % in following ASCUS : LSIL: HSIL :

Answer 26

Regression HSIL Cancer ASCUS : 68% 7% 0.25% LSIL: 47% 21% 0.15% HSIL : 35% ---- 1.4%

Question 27

Given the associated hormonal status 0/10/90 0/90/10 20/80/0 100/0/0

Answer 27

0/10/90 : Estrogen effect 0/90/10 : Progesterone effect, New borns 20/80/0 : Androgen effect 100/0/0 : Atrophy, no estrogen Parabasal/intermediate/sperficial

Question 28

What defines the Pap as " High risk" ?

Answer 28

Onset of sexual activity before 16 Multiple sexual partners (>5 in a lifetime) Hx of STD, including HIV Fewer then 3 neg paps in the last 7 years Daughter of a women given DES Abnormal pap in the last 3 years in a women of childbearing age

Question 29

Whats the minimum number of cells in liquid Paps?

Answer 29

5000 cells

Question 30

Whats the next step in management? Unsat pap If Unsat and HPV HR+ NILM but no EC/TZ

Answer 30

Unsat pap : Repeat in 2-4 months Unsat and HPV HR+ : colpo NILM but no EC/TZ : Routine screening

Question 31

ASC-H will show a cin2 or worse on biopsy in what percentage of women?

Answer 31

40%

Question 32

Gardasil covers what HPV types?

Answer 32

16,18,6,11

Question 33

When should women start screening?

Answer 33

21

Question 34

omen between the ages of 21 and 29 should have a Pap test every____ years

Answer 34

Women between the ages of 21 and 29 should have a Pap test every 3 years

Question 35

For women 30-65 how often should they get pap test? What about HPV?

Answer 35

Women between the ages of 30 and 65 should have both a Pap test and an HPV test every 5 years. This is the preferred approach, but it is also OK to have a Pap test alone every 3 years.

Question 36

When can women stop having paps?

Answer 36

At age 65, or hysterectomy for benign reasons

Question 37

Can you stop if you get the Gardasil?

Answer 37

No, continue per recommendation of age group

Question 38

How many cells are need per HPF for adequecy? Thin prep Surepath

Answer 38

Thin prep 3-4 | Surepath 7-8

Question 39

Match The following: 13mm, 20 mm, Vacuum, Centrifuge Thin Prep Surepath

Answer 39

Thin Prep 20 mm Vacuum filtration | Surepath 13mm Centrifuged

Question 40

What type of virus is HPV

Answer 40

Nonenveloped DS DNA (Others in this group is the adenoviridae and the polyomaviridae)