Path Flashcards Preview

Reproductive > Path > Flashcards

Flashcards in Path Deck (84):
1

fetal growth restriction due to fetal abnormalities

SYMMETRIC
caused by: chromosomal disorders, congenital anomalies, congenital infections (TORCH)

2

TORCH

group of infections (transplacental)
toxoplasmosis (cat litter), rubella, CMV, herpesvirus, other viruses and bacteria (syphilis and listeria)

3

fetal growth restriction due to placental abnormalities

ASYMMETRIC
spares brain
caused by: UTEROPLACENTAL INSUFFICIENCY: umbilical-placental vascular anomalies, plactena abruption, placenta previa, placental thrombosis/infarction, placental infection, multiple gestations

4

What is a third trimester loss usually due to?

placental insufficiency

5

fetal growth restriction due to maternal abnormalities

maternal conditions that result in decreased placental blood flow
caused by: vascular disease: PREECMAPSIA, CHRONIC HTN

6

spontaneous abortion

pregnancy loss before 20 weeks gestation
causes
1. fetal chromosomal anomalies (50% of early loss)
2. maternal endocrine factors
3. physical defects of uterus
4. systemic disorders affecting the maternal vasculature
5. ascending infection

7

How does an maternal infection cause a fetal inflammatory response?

inflammation of umbilical vessels (vasculitis) and cord substance (funisitis)

8

Twin-twin transfusion

MONOCHORIONIC
ARTERIOVENOUS SHUNT increases blood flow to one twin

9

monochorionic

twin placentas have vascular anastomoses that connect the twins' circulation

10

decidua

endometrium of uterus in a pregnant woman

11

Homeobox genes (HLX and DLX3)

expressed in trophoblast and its blood vessels
dysfunctional in preeclampsia

12

amnion nodosum

nodules seen in placentas effected by oligohydramnios
associated with: stratified squamous metaplasia
due to: renal agenesis

13

IHC: p57

neg. has relationship to hydatidiform moles

14

Choriocarcinoma: gross appearance

soft, fleshy, yellow-white tumor with large areas of necrosis and extensive hemorrhage

15

complications of pre-maturity

1. neonatal distress syndrome, hyaline membrane disease
2. necrotizing enterocolitis
3. sepsis
4. intraventricular and germinal matrix hemorrhage

16

pathology of hyaline membrane disease

1. reduced surfactant (increase tension)
2. atelectasis (uneven perfusion, hypoventilation)
3. hypoxemia and CO2 retention (acidosis, pulmonary vasoconstriction and hypoperfusion)
4. endothelial and epithelial damage
5. plasma leak into alveoli: fibrin and necrotic cells increase diffusion gradient

17

fetal hydrops

accumulation of edema fluid in the fetus during intrauterine growth
caused by: CV, chromosomal, fetal anemia (immune (Rh, ABO), ParvoB19, homozygous alpha thalassemia), twin-twin

18

triple risk model of SIDS

1. vulnerable infant
2. critical developmental period in homeostatic control
3. exogenous stressor (smoking, cockroach, sleeping on belly, overweight, sleep with parents)

19

progesterone withdrawal test

pos. for bleeding: PCOS
neg. for bleeding: premature ovarian failure

20

When will the majority of breast cancers metastasize?

by the time you can palpate them: 2-3cm

21

Most common presentation of breast CA

abnormal mammogram

22

fibrocystic changes: radial scar

proliferative type: increased risk for invasive carcinoma

23

lymphocytic mastitis

type of breast inflammation
due to: DM, autoimmune

24

granulomatous mastitis

type of breast inflammation

25

Genetic profile of breast CA
1. luminal A
2. luminal B
3. HER2 positive
4. Basal type

1. ER pos.; HER2 neg.
2. ER pos.; HER2 overexpressed
3. ER neg.; HER2 overexpressed
4. ER and HER2 neg.

26

Characteristics of breast CA linked to inherited mutations

more likely to be/have
1. bilateral
2. other CA (ovarian)
3. Family Hx
4. CA before menopause
5. certain ethnicity

27

BRCA mutation

tumor suppressor genes
breast CA (BOTH alleles must be inactivated)
more common in Ashkenazi Jew
most carriers develop CA by 70

28

Li-Fraumeni

p53 mutation
Breast CA

29

Cowden

PTEN mutation
breast CA

30

ataxia-telangiectasia carriers

breast CA

31

BRCA1

AD: breast CA, serous ovarian and fallopian tube CA
may interact with p53
strongest predictors :TRIPLE NEG. breast CA, CA before 50 yrs
prophylaxis: mastectomy or follow closely, tamoxifen
increased risk of recurrence after breast conserving Sx
does not affect death rates, but is associated with resistance to certain chemo drugs
MEDUALLARY, DCIS

32

BRCA2

Breast CA
usually CA by 50
higher risk of CA of: OVARY (serous), bone, pharynx, prostate, pancreas
more frequent in blacks than whites
INVASIVE DUCTAL CA, DCIS

33

Types of DCIS

1. solid
2. comedo
3. cribiform
4. papillary
5. micropapillary

34

Tx options for DCIS

1. lumpectomy
2. radiation
3. anti-estrogs (tamoxifen and aromatase)

35

E-cadherin

lost in LCIS and INVASIVE LOBULAR CA
GASTRIC SIGNET RING CELL CA

36

Tx options for LCIS

1. chemo
2. close follow up

37

What type of breast tumor lacks the myoepithelial cell layer?

invasive ductal carcinoma

38

CDH1

gene encoding E-cadherin
LOBULAR CA and LCIS
heterozygous germline mutation: increased risk of GASTRIC SIGNET RING CELL CA

39

Causes of gynecomastia
1. pathologic
2. physiologic

1. cirrhosis, anabolic steroids, Klinefelter syndrome, drugs
2. puberty, old age

40

HSV-2 migrates to where in latent phase?

regional lumbosacral ganglia

41

What typically causes death in cervical CA?

local tumor invasion (urethral obstruction, pyelonephritis, uremia)

42

What does E7 inhibit?

RB
p21, p27 (cyclin dependent kinase inhibitors)

43

Low grade squamous intraepithelial lesion (LSIL)

CIN I (mild dysplasia)

44

High grade squamous intraepithelial lesion (HSIL)

CIN II, III (mod. severe dysplasia (carcinoma in situ)
high risk for progression to carcinoma

45

At what size does the risk of metastasis of cervical carcinoma increase to 10%

3 MM

46

PTEN inactivation

endometrial hyperplasia and carcinoma (hyperplasia pathway not sporadic)
breast CA (Cowden)

47

Classification of endometrial hyperplasia

simple vs. complex
with or without atypia
atypia: endometrioid intraepithelial neoplasia

48

MSI mutation

endometrial hyperplasia and carcinoma (hyperplasia pathway not sporadic)

49

What defect in cellular repair predisposes to endometrial carcinoma?

DNA mismatch repair

50

HNPCC

hereditary nonpolyposis colorectal carcinoma
LYNCH syndrome: COLON CA
ENDOMETRIAL carcinomas

51

p53 mutations

sporadic endometrial carcinoma

52

Where do serous ovarian carcinomas arise?

fallopian tube

53

Common pathologies of the fallopian tubes

1. infection: Gonococcus, Chlamydiae, TB
2. benign paratubal cysts
Tumors are UNCOMMON

54

Two pathways of epithelial ovarian tumors

1. cystadenoma/endometriosis to borderline tumor to low grade serous, endometrioid, mucinous
2. fallopian tube to inclusion cyst to high grade serous

55

KRAS mutation

mucinous ovarian cystadenoma/adenocarcinoma

56

Where do most metastatic tumors of the ovary come from?

mullerian origin: uterus, fallopian tube, contralateral ovary, pelvic peritoneum
other: breast, GI, appendix

57

IHC: inhibin

granulosa tumor

58

Meigs syndrome

ovarian tumor (fibrothecoma), hydrothorax, ascites

59

basal cell nevus syndrome

fibrothecoma ovarian tumor

60

Categories of ovarian teratoma

1. mature (benign)
2. immature (malignant)
3. monodermal (highly specialized)

61

C-KIT (CD117)

receptor tyrosine kinase
activating mutation in DYSGERMINOMA

62

alpha fetoprotein

Yolk sac

63

Hypospadia associations

inguinal hernia
undescended testis

64

balanoposthitis

inflammation of prepuce overlying the glans penis

65

Agents that cause balanitis and balanoposthitis
Most cases are caused by?

Candida
anaerobic bacteria
Gardnerella
pyogenic bacteria
caused by: poor hygiene in uncircumcised male

66

phimosis

prepuce cannot be retracted over glans penis

67

orchiopexy

reduces risk of sterility and CA in those with cryptorchidism

68

Where in the testis is an inflammatory lesion most likely to occur?
Causes of inflammatory lesion of testis?

epididymis
causes: sexually transmitted, nonspecific epididymitis and orchitis, MUMPS, TUBERCULOSIS

69

orchitis: mumps histology

lymphoplasmacytic

70

orchitis: TB histo

granulomatous
caseous necrosis

71

neonatal testicular torsion

in utero or shortly after birth
NO associated anatomic defect

72

adult testicular torsion

due to bilateral anatomic defect with increased mobility

73

1. Most common cell type of testicular neoplasm? more likely benign or malignant?
2. Less common?
3. Are whites or blacks more likely to have testicular CA?

1. most common: Germ cell: malignant
2. less common: Sertoli or Leydig (sex cord): benign
3. White

74

obstructive lesion of the ureters
1. intrinsic
2. extrinsic
3. complications

1. calculi, strictures, tumors, blood clots, neurogenic
2. pregnancy, periureteral inflammation, endometriosis, tumors
3. hydroureter, hydronephrosis, pyelonephritis

75

vesicoureteral reflux

most common and serious bladder congenital anomaly
backwards flow of urine from bladder into kidneys
complications: renal infection, scarring

76

urachal anomalies
1. totally patent
2. other

urachus (fetal canal connecting bladder to allantois in umbilical cord)
1. fistulous urinary tract: connect bladder to umbilicus
2. urachal cyst (adenoCA can arise from the cyst)

77

racemase stain

red
prostate CA

78

Which bladder neoplasms
1. recur
2. have coexisting invasion
3. progress
4. cause death

1. PUNLMP, LGUC, HGUC
2. HGUC, sometimes LGUC
3. LGUC and HGUC
4. LGUC and HGUC

79

Types of bladder neoplasms

papilloma
PUNLMP: papillary urothelial neoplasm of low malignant potential
LGUC: low grade urothelial carcinoma
HGUC: high grade urothelial carcinoma

80

primary syphilis

chancre

81

secondary syphilis

palmar rash
lymphadenopathy
condyloma latum

82

tertiary syphilis

neuro
aortitis
gummas (irregular, firm mass of necrosis surrounded by connective tissue): hepar lobatum, skin, bone

83

congenital syphilis

1. late abortion, stillbirth
2. infant: rash, osteochondritis, periostitis, liver and lung fibrosis
3. child: interstitial keratitis, hutchinson teeth, deaf

84

PLAP

DYSGERMINOMA