MOD 2 Flashcards by Anisha Narayan

benign follicular cyst

distended follicle, lined by granulosa cells and filled with clear fluid, can cause pain/rupture

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Hemorrhagic corpus luteum cysts

from CL that fills with blood/fluid, can cause pain/bleeding, look like diffusely large ovary

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Ectopic preg
path
what is elev?

usu in fallopian tube but CAN be in ovary, can have pain/bleeding, rupture is surgical emergency and inv hemorr
B-HCG elev!

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which ovarian tumors are usu bilateral/ occur in women >45?

malig ovarian tumors

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risk factors for ovarian tumors?

protective factors?

nullparity, older age, turners (ovarian dysgenesis) etc

-protective factors preg and OCP

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genetics of ovarian tumors

BRCA, lynch syndrome (usu endometrial with MMR issue), HER-2, early p53 etc

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what are the 3 major compartments where ovarian tumors can arise?

Surface epithelium
Stroma
Germ cells

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Serous tumors type 1 and 2

type 1 progress from benign thru borderline to get to low grade carc
type 2 mostly due to p53 mut, high grade

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Serous tumors
Benign
Borderline
Malig/ marker?

benign serious (cystadenoma)- singler layer of cil epith prod yellow/clear fluid, can bey cystic or papillary or solid

borderline serious: fingerlike prolif, can have compl like bowel obstr, px good if stays in ovary, NO prolif/invazn
malig serious: (cystadenocarcinoma), similar to borderline but have invasion, can spread to perit, usu bilateral, have marker CA125! (low grade is KRAS/BRAF/HER2 and high grade is p53/BRCA)

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Mucinous tumor/ marker
Benign
Borderline
malig

Marker: CEA! kras mut assoc, ascites, etc

benign: similar to serous but single layer of col mucin-secr epith (similar to intest epith), assoc with fcystic teratomas
borderline: prolif of epith but no invazn
malig: stromal invazn, likely bilateral, usu metastatic from GI/pancr/breast

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Endometrioid tumor

malig carc, assoc with endometriosis thru PTEN mut

-cx by atypical hyperplasia, can diff into carc and sarc forming MMMT (malig mixed mullerian tumor)

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Clear cell carc

aggro, postmeno women, assoc with endometr

-histo: hobnail cells (enlarged nucl bulges into cyto), and vacuolated clear cyto

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Brenner tumor

microscopic calc, elongated nuclei (coffee bean nuclei aka grooved nuclei), usu benign but can invade

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Germ cell tumor types

Mature cystic teratoma (dermoid cyst)
Immature teratoma
Dysgerminoma
Yolk sac / endodermal sinus tumor

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Mature cystic teratoma (dermoid cyst)

tissue from all 3 gemr layers, ectoderm usu, cystic cavity filled with fat and hair (or tooth) and can have irreg calcs, can rupture or cause hemolytic anemia

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Immature teratoma

infrequent but can be malig, immature neural tissue, primitive mesenchyma cells, maybe some cartilage etc

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dysgerminoma
px
pop
histo
gross
markers

radiosens, excellent px

histo: pale clear cells, PAS + clear cyto with intervening stroma/lymphos/plasma cells
appear in adolescence and assoc with gonadal dysgen like streak ovaries
gross: solid, lobulated, gray-white
PAS + and CD117+

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Endodermal sinus tumor 
(yolk sac tumor) 
pop
histo
elev

v malig, young kids
schiller-duval bodies, necr/hem
AFP+

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Sex cord-stroma tumors

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Fibroma/thecoma, granulosa/theca cell tumor, sertoli-leydig cell tumor (androblastoma)

Metastatic tumor to ovaries example

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Krukenberg tumor

fibroma/thecoma

gross, assoc

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postmeno women, vaginal bleeding

fibroma is white and thecoma is yellow//fatty
assoc with Meig’s syndrome (ascites and pleural effusion and basal cell nevus skin/nerv/bone syndrome)

granulosa-theca cell tumor

-histo, elev

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makes estrogens leading to precocious puberty, bleeding, carc etc
-histo has call-exner bodies (EMPTY CYTOPLASM), coffee bean nuclei, and inhibin A/B markers

Sertoli-Leydig (androblastoma)

histo

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androgenic tumor with masc

-Reinke crystals (eosinophillic)

Krukenberg tumor

histo etc

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metastatic from GI tract, has mucin and signet ring cells, usu bilat

What does the chorion do and what is it made of

transfers nutrients to fetus, has villi, has cytotrophoblast and syncytiotrophoblast (which secretes hcg from villi into maternal circulation, preg tests measure this)

chronic follicular salpingitis?

scarring of salping (fallopian tube) after PID, commonly causes ectopic preg

Cornual vs Tubal pregnancy (from chronic follicular salpingitis)

cornual- ectopic preg in intrauterine part of fall tube | tubul- tubal preg thru fimbriated end into abd cavity

Most common cause of hematosalpinx | -when does it occur?

Tubal pregnancy! causes blood in fall tube (know this!), gest sac thins tube and causes rupture causing intraperitoneal hemm -severe abdominal pain at 6 weeks after period

If monochorionic and monoamniotic past day 13 may mean?

conjoined twins

Gestational Trophoblastic Disease examples

Hyatidform or invasive mole, or chiorcarcinoma, placental site trophoblastic tumors

Which tumors produce HpL (human placental lactogen)

Placental-site trophoblastic tumors

Molar pregancy types and what they are

- Complete hyatidiform mole- fert of empty ovum and have only paternal chrom (more common) - Partial- triploid gestiations-- 2 sperm 1 ovum 2:1 ration of chrom - Early complete, and - Invasive molar preg-- penetrates musc water of uterus

Placenta previa

placenta overlies exit of cervical canal and req C section for delivery

Preeclampsia and what is it assoc with

need both HTN and proteinuria (severe is this with one of other stuff like oliguria, CNS, pulm , RUQ pain, hepatocell, thrombo, growth restr, etc) assoc with hypercoag state

What is NOT preecplamsia?

new onset HTN without proteinuria after 20 wk gestation (if before with new onset then is)

Eclampsia

new onset seizures during preg

abruptio placentae - what is it - what is it assoc with - what must you watch out for

placenta separates from uterus, causing retroperiot hemorr, (hallmark is painful vaginal bleeding in 3rd trim), uterine issues, fetal distress - assoc with maternal trauma or alc or coke or delv of 1st twin or amniocentesis needle - underlying htn - watch out for DIC

Kleihauer-Betke test | and what happens when its not done

acid elution test that measures amount of fetal hb in mothers blood - impt for Rh- mothers bc determines amt of chemical to inhib Rh ab's/Rh disease in future - hydrops erythroblastosis if not done when needed

What indicates intrauterine growth retardation?

measured by large head circumference (head bigger than body is long)

Chrioamnionitis

amniotic fluid infxn, placental infxn is leading cause of premature delviery at <32 wk, nonfatal, usu ascending route

TORCH infections

Toxo, Other (syphilis and viruses), Rubella, CMV, HSV | -titers incl testing for IgG or IgM ab's (more than one)

does amnion or chorion split first

Amnion! so can be diamnionic monochrionic monozygotic twins

most common time to find ectopic tubal preg

6 wks

When does preeclampsia commonly manifest?

34 weeks of gestation (but earlier in women who have hyatidform mole)

Gestational choriocarcinoma lacks...?

villi

MOD 2 Flashcards

(45 cards)