Genital herpes (HSV2) - def - days - dormant - Dx impt

vesicles on genitalia that coalesce and ulcerate - 3-7 days after exposure (30% dev lesions) - dormant on nerves, recur - Dx impt, prevent vaginal delivery if active

HPV - condyloma (3 types) - assoc

- labial, vaginal, and cervical warts (condyloma) - condyloma acuminatum: large vulvar wart (HPV 6, 11) - some types assoc with carcinoma

PID - def - 2º to_ - present

- chronic, extensive infection of upper reprod tract - usu 2º to STD (Chlamydia, Gonorrhea) - salpingitis, tubo-ovarian abscess, peritonitis

Endometrial hyperplasia - present - causes - complex vs simple hyperplasia

anovulatory cycles: no ovulation => no progesterone sec) - functional causes: puberty, anxiety, athlete - organic causes: excess estrogen (OCT, tumors) - atypical hyperplasia: incr risk of endometrial adenocarcinoma (from atypia)

Carcinoma of vulva - type - present (and colour) - Dx - Tx

squamous cell carcinoma - raised or ulcerated lesion - pre-neoplastic change present as white/red patch - Dx: biopsy - Tx: surgical +/- adjuvant Tx

Leiomyoma (fibroid) - def - most common_ - responds to_ - symptoms

benign neoplasm der from smooth muscle in uterus wall - most common uterine neoplasm - responds to estrogen, arise dur reproductive age - usu asymptomatic - symptoms due to mass effects, bleeding

Endometrial adenocarcinoma - def - most common_ - present - risk (6) - prognosis - Dx - Tx

malignant neoplasm der from epith cells in endometrium - most common malignant tumor of female reprod tract - elderly females, vaginal bleed (PMB) - risk related to incr estrogen (hyperestrinism): estrogen sec tumor, exogenous estrogen, obesity, nulliparous or early menarche, late menopause - prognosis: stage most impt, grade (low intermed, high) - Dx: endometrial biopsy, dilation and curettage - Tx: hysterectomy +/- adjuvant Tx

Ovarian cysts - def - arise from_ - present - if large

fluid filled cavities lined by epith - arise from unruptured follicles (follicular cysts): may include cystic corpora lutea or inclusions of surface cells - usu small, solitary, asymptomatic - further investigation if large to rule out neoplasm

Polycystic ovary syndrome - def - cause - present - complications

multiple cysts in both ovaries - caused by complex hormal disturbances of hypothalamic-pituitary-ovarian-adrenal axis - menstrual irregularities - infertility

PATH 375 Female Reproductive System Flashcards by Cecilia T

Hermaphroditism

discordance between genotypic and phenotypic sex

a) True “: both male and female gonads
b) Male pseudo”: genotypically male
c) Female pseudo”:

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STDs
3 common organisms
present (4)

common (HSV, Chlamydia, HPV)
present with 
- vaginal discharge
- lesions
- pelvic pain 
- dyspareunia

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Genital herpes (HSV2)

def
days
dormant
Dx impt

vesicles on genitalia that coalesce and ulcerate

3-7 days after exposure (30% dev lesions)
dormant on nerves, recur
Dx impt, prevent vaginal delivery if active

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HPV

condyloma (3 types)
assoc

labial, vaginal, and cervical warts (condyloma)
condyloma acuminatum: large vulvar wart (HPV 6, 11)
some types assoc with carcinoma

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Chlamydia (trachomatis)

N. gonorrheae

urethritis or cervicitis with discharge, PID

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Syphilis (T. pallidum)

vulvar ulcers

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Bacterial vaginoses

Candida, Trichomonas, Gardnerella

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PID

def
2º to_
present

chronic, extensive infection of upper reprod tract
usu 2º to STD (Chlamydia, Gonorrhea)
salpingitis, tubo-ovarian abscess, peritonitis

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PID complications (4)

chronic non-specific infection (fever, malaise, fatigue)
infertility (2º to fallopian tube scarring)
pelvis mass + pain
spread of infection

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Endometrial hyperplasia

def

normal menstrual cycle req fn of hypothalamic-pituitary-ovarian axis

continued estrogen stimulation with inadequate progesterone => endometrial mucosa thickens

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Endometrial hyperplasia

present
causes
complex vs simple hyperplasia

anovulatory cycles: no ovulation => no progesterone sec)

functional causes: puberty, anxiety, athlete
organic causes: excess estrogen (OCT, tumors)
atypical hyperplasia: incr risk of endometrial adenocarcinoma (from atypia)

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Carcinoma of vulva

type
present (and colour)
Dx
Tx

squamous cell carcinoma

raised or ulcerated lesion
pre-neoplastic change present as white/red patch
Dx: biopsy
Tx: surgical +/- adjuvant Tx

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Carcinoma of vagina (2 types)

squamous cell carcinoma

clear cell carcinoma: mother was on DES during pregnancy

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Carcinoma of cervix

Dx
def
lack of _
loc
HPV types
grading

Pap test (early Dx) reduced mortality
risk factors: sex early, multiple partners, HPV, other venereal diseases, env

squamous cell carcinoma: precursor lesion = dysplasia (cervical intra-epithelia neoplasia)
lack of normal maturation of squamous epith, occurs at transition zone
- cells shed into vagina (Pap smear)
- HPV types 16, 18, 33, 34, 35 assoc
- koilocytic change: characteristic changes due to HPV

graded mild (1/3), mod, severe

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Leiomyoma (fibroid)

def
most common_
responds to_
symptoms

benign neoplasm der from smooth muscle in uterus wall

most common uterine neoplasm
responds to estrogen, arise dur reproductive age
usu asymptomatic
symptoms due to mass effects, bleeding

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Leiomyosarcoma

malignant neoplasm der from smooth muscle

v rare

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Endometrial adenocarcinoma

def
most common_
present
risk (6)
prognosis
Dx
Tx

malignant neoplasm der from epith cells in endometrium

most common malignant tumor of female reprod tract
elderly females, vaginal bleed (PMB)
risk related to incr estrogen (hyperestrinism): estrogen sec tumor, exogenous estrogen, obesity, nulliparous or early menarche, late menopause
prognosis: stage most impt, grade (low intermed, high)
Dx: endometrial biopsy, dilation and curettage
Tx: hysterectomy +/- adjuvant Tx

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Ovarian cysts

def
arise from_
present
if large

fluid filled cavities lined by epith

arise from unruptured follicles (follicular cysts): may include cystic corpora lutea or inclusions of surface cells
usu small, solitary, asymptomatic
further investigation if large to rule out neoplasm

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Polycystic ovary syndrome

def
cause
present
complications

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multiple cysts in both ovaries

caused by complex hormal disturbances of hypothalamic-pituitary-ovarian-adrenal axis
menstrual irregularities
infertility

Ovarian neoplasms

common_
mortality
3 types classification by_
risk

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second most common grp of tumors in female reprod tract

highest mortality of femal reprod tract tumors
3 major grps based on histogenetics:
1. surface epith tumors
2. germ cell
3. sex cord stromal

malignant ovarian tumors uncommon in young females
not linked to OCP
- risk: ovarian dysgenesis, BRCA1 and BRCA2 gene mutations

Surface epith tumors

- histologic types

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70% of ovarian neoplasms

- histologic types: serous, mucinous, endometrioid, clear cell, transitional cell

Serous epith tumors

Mucinous

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most common
usu cystic, filled with clear fluid (serous) or viscous (mucinous)

types: benign, borderline malignant, and malignant (histology)

bilateral in 25% benign, 50% malignant

Germ cell tumors

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20% ovarian tumors, occur in young females

teratoma: cystic, contain hair/seb material (dermoid cysts), teeth, bone, cartilage
- benign

immature teratoma: contains immature neural tissue
- may behave malignantly

Fibroma

Thecoma

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benign neoplasm

of fibroblasts
of spindle (theca) cells (firm and solid mass), prod extrogens

Granulosa cell tumor

granulosa cells benign or malignant may prod estrogen

Infertility (4 factors)

ovum-related sperm-related genital organ factors: PID, Asherman syndrome (endometrium scar and close) systemic factors

Ectopic pregnancy - loc - pathogenesis

implantation of fertilized ovume outside uterine cavity ``` usu fallopian tube trophoblast cells (of placenta) invade wall of tube, enlarge, may rupture => surgical emergency ```

Placenta accreta

abnormally deep penetration of placental villi into uterus wall

Placenta previa

abnormal placental implantation site in lower uterine segment

Toxemia of pregnancy

unknown pathogenesis | characteristic symptom complex in mother

Preeclampsia - when - present

occurs in 3rd trimester may progress to eclampsia present with hypertension, edema, proteinuria

Eclampsia - present - Tx

hypertension, edema, proteinuria, and seizures life-threatening, must treat seizures Tx: deliver baby asap

Gestational trophblastic disease

abnormalities of placentation => tumor-like changes or malignant transform

Hydatidiform mole - def - complete mole - incomplete mole

abnormal placenta dev trophoblastic prolif, hydropic degen of chorionic vili enlarged uterus with no fetal movt , high HCG complete mole: no identifiable fetus, abnormal fertilization (all paternal 46XX) incomplete mole: some fetal parts, abnormal fertilization (69 chromosomes)

Choriocarinoma

rare highly malignant tumor placental origin Tx: methotrexate

Abortion

interruption of pregnancy prior ot fetal viability | <500g, 20wks

Spont abortion - complete - incomplete - missed - threatened

1/3 all pregnancies, no identifiable cause - complete: fetus and placenta expelled, normal fn returns - incomplete: retain some fetal/placental mat - missed: death of fetus in utero, passed after several wks - threatened: cervical os closed, spotting of blood

Endometriosis - def - loc - pathogenesis - present

endometrial tissue (uterine glands + stroma) loc outside uterus (usu. ovary, peritoneum) - common, may cause pain, infertility - benign - chocolate cyst of ovary cycle in response to hormonal influences - pathogenesis: retrograde flow, traumatic implantation

Mastitis - def - pop - caused by - present

acute inflamm of breast - lactating female - B. infection - may dev abcess chronic mastitis: unknown etiology, rare, may mimic BRCA

Fibrocystic change - cause - present

various factors including hormones, age cause benign changes in breast tissue fibrosis of intralobular stroma cystic dilation of epith ducts epith hyperplasia - reprod age females

Gyneomastia

incr prolif of male breast, various factors

Fibroadenoma

benign neoplasm of breast epith and stroma - well circumscribed, mobile mass - young females

Breast cancer most common_ 2nd most common_ influences (3) risk (7)

most common cancer in females 2nd most common cause of cancer-related death in females influences: hormonal, env, genetic (familiar BRCA-1, -2 are TSG, incr inc of other cancers) risk: female (100x males) genetics hormones (prolonged estrogen exposure- nulliparous, early menarche, late menopause) other malignancies (contralateral breast carcinoma, endometrial carcinoma) premalignant changes (carcinoma in situ, atypical hyperplasia) age race

Infiltrating ductal carcinoma - most common_ - type - present - pathogenesis - Dx

- most common form of BRCA - adenocarcinoma - desmoplastic response of stroma - lymphatic spread (axillary nodes) - present as mass - early detection (self-exam, mammogram) - fine needle aspiration - incisional biopsy

BRCA Tx (3)

surgical resection: lumpectomy, mastectomy, axillary dissection radiation chemo: tamoxifen, herceptin

BRCA prognosis (4 factors)

staging most impt histologic subtypes histological grading estrogen receptor status (ER +/-)

PATH 375 Female Reproductive System Flashcards

(46 cards)