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PATH FEMALE GU Flashcards

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1
Q

24 year old patient presenting to the ED with vaginal spotting, history of PID, and increased hCG. There is suspicious mass in the fallopian tube. Where in the tube is the mass most likely located?

A

Ampulla

Ectopic pregnancies most commonly occur in the ampulla

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2
Q

What kind of cancer are females whose mothers were exposed to DES (diethylstilbestrol) predisposed to?

A

Vaginal Clear Cell Adenocarcinoma

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3
Q

What is FALSE about Lichen Sclerosis Heteroplasm?

A

That it is never seen in women under 30

It is more common in postmenopausal women, but it can happen at any age

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4
Q

What is TRUE about Molluscum Contageosum?

A

It is caused by Pox Virus

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5
Q

A biopsy diagnosis says, “Bowen’s Disease with mild dysplasia showing VIN I.” What is wrong with this?

A

Bowen’s disease is VIN III by definition (Squamous Cell Carcinoma in-situ)
It is a high-grade dysplasia

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6
Q

What is the immunohistochemical stain of Paget’s of the vulva?

A

CEA+ Cytokeratin+

p53- and S100-

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7
Q

What Immunohistochemical stains are positive in malignant melanoma?

A

S100+ and Melan-a+ (MART1 or melanin a)

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8
Q

What cells compose a Gartner’s duct cyst?

A

Wolffian (aka mesonephric) duct rests

These are vestigial remnants of the mesonephric duct

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9
Q

What is TRUE about Embryonal Rhabdomyosarcoma?

A
  1. AKA Sarcoma botryoides (refers to grape cluster appearance)
  2. Histological features include a Cambian Layer (rhabdomyoblasts in fibromyxomatous storm)
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10
Q

You have a biopsy of cervical small cell carcinoma with neuroendocrine features. Which is FALSE?

A

CD45/LCA Not positive (I don’t know if this means that it is positive or if the double negative is intentional. I believe that these tumors are CD45 negative)

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11
Q

What is TRUE about cervical CIN I?

A

It’s a low grade intraepithelial dysplasia

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12
Q

Which of the following is NOT a subtype of Cervical Squamous Cell Carcinoma?

A

Serous Papillary (I believe that these are Adenocarcinomas)

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13
Q

What staining pattern would be seen in grade 2-3 endometrial adenocarcinoma?

A

Vimetin+ and ERPR+

CEA- and P16-

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14
Q

What is the characteristic histological feature of early secretory endometrium (day 17)?

A

Sub-nuclear vacuoles are lined up

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15
Q

An endometrial biopsy shows areas of Stella (Arias-Stella) phenomenon. What is this condition associated with?

A 
Ectopic Pregnancy
(This is the presence of benign changes that used to be mistaken for malignancy)
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16
Q

What is TRUE about Serous cancer of the endometrium?

A

It is an aggressive tumor associated with intraperitoneal spread.

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17
Q

What is TRUE about malignancy mixed mesodermal tumor (MMMT) carcinosarcoma?

A

Looks like de-differentiated endometrial cancer and has a fulminant clinical course

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18
Q

What is TRUE about pt3b endometrial cancer?

A

Tumor extends into vaginal parametrium (T3 is aggressive)

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19
Q

What Immunohistochemical stain is positive in Endometrial Stromal sarcoma?

A

CD10

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20
Q

What is TRUE about Polycystic Ovarian Disease?

A

It is also called Stein Leventhal Syndrome

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21
Q

A 27 year old presents with dysfunctional uterine bleeding and endometrial hyperplasia without atypia. What is TRUE?

A

It is a Low-grade hyper plastic process that is initially treated with progesterone therapy

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22
Q

You have a path report of a Clear Cell Vaginal carcinoma. What is TRUE?

A

Diethylstilbesterol (DES) exposure in the patients mother could be associated with this lesion

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23
Q

What WHO stage is a serous cyst adenocarcinoma that is confined to the pelvis with positive pleural effusion?

A

Stage 4

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24
Q

What is TRUE regarding serous cyst adenomas?

A

Serous borderline tumors with micro invasion have similar prognosis

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25
What is wrong with the statement, "Mature Teratoma Primi Ovari"?
Not a mature teratoma
26
What is true about Endometrial Granulosis cell tumors of the adult type?
Estrogenic tumor effect
27
What is true about Sex Cord stroll tumors with annular tubules?
They're associated with Peutz-Jegher Syndrome
28
Adnexal tumor of the Wolffian duct... What is TRUE?
Mesonephric Origin
29
What is True about small cell cancer of the hypercalcemic type?
All of the above...
30
What is TRUE about Sertoli-Leydig tumors?
It is a masculinizing/androgenizing cell tumor
31
What is TRUE about mucinous adenocarcinoma of the endometrium?
It's a low grade tumor
32
What is NOT TRUE about endometrial sinus tumors?
It is not a seminoma (again, not sure if this is an intentional double negative)
33
When would you see Reinke crystals?
Leydig cell tumor
34
What is true about serous borderline tumors?
Low malignant potential
35
What are completely conjoined twins?
Monozygotic and monoamnoitic
36
What is the karyotype of a complete hydatidiform mole?
46XX or XY (all parental)
37
What is true about a placental floor infarction?
All of the above
38
What are tested for with TORCH?
Too, Rubella, CMV, HSV, syphilis, TB, listeria
39
What is true about a complete hydatidiform mole?
Moles occur in 1/1000 pregnancies
40
What is the karyotype of a partial hydatidiform mole?
Triploid
41
What is true about invasive moles?
All of the above
42
What is true about the uterine contents of gestational choriocarcinomas?
50% occur after molar disease
43
What is associated with placental site trophoblastic tumors?
Distinct membranous glomerulonephropathy
44
What is placenta accretia?
Complete adherence of the decidua to the muscle wall.
45
What is true about placental floor infarctions?
that is a misnomer | It's really a fibrin deposition, not an infarction
46
What is true about acute chorioamnionitis and acute funisitis?
Idk... All of the above?
47
What is true about endometrial hyperplasia without atypia?
Low grade and low rate of progression
48
What does it mean if you do a biopsy on day 23 (should be secretory), but it shows glandular and stromal breakdown?
Anovulatory cycle dysfunctional uterine bleeding
49
What is the stage of an endometrial tumor that extends outside the uterus by not into the true pelvis?
Stage 3
50
What is true about granulosa cell tumors?
They have Call-Exner bodies and produce estrogen
51
What is it called when the placenta is implanted over the cervix?
Placenta previa
52
What are the high risk types of HPV?
16, 18, 31, 33
53
What is meconium a sign of?
fetal stress
54
What is a stage 1 ovarian tumor?
Ovarian capsule is intact
55
What stage is an ovarian tumor that has spread to the capsule of the liver?
Stage 3
56
What stage is an ovarian tumor that has spread to the liver parenchyma?
Stage 4
57
What is true about Serous cystadenocarcinoma of low malignant potential borderline tumor?
There is an absence of destructive invasion
58
What are symptoms of malignant surface epithelial tumors?
Abdominal pain, increased girth, ascites
59
What is true of Ovarian surface tumors of borderline malignant potential?
They have peritoneal implants but no destructive invasion
60
What immunohistochemical finding is constant with mesothelial lesions in the peritoneum?
Calretinin+
61
When are embryonic rhabdomyosarcomas bad?
Adults (they aren't too bad in kids)
62
What is Fitz-Hugh-Curtis syndrome?
Complication of PID (Chlamydia or Gonorrhea) that results in liver capsule inflammation and adhesions
63
What is a gram negative diplococcus?
Neisseria gonorrhea
64
What is seen in the endometrium on day 23?
rim of decidual chance around arterioles, stroll edema, and looks very white
65
Where does fertilization occur?
Ampulla
66
When does implantation take place?
6-7 days after fertilization (day 21 of the cycle)
67
What can cause vaginal bleeding in a neonate?
menstruation due to sudden drop of Estrogen and progesterone from mom
68
What is the most common site for adenomyosis?
Rectal pouch of douglas
69
When might you see a plasma cell infiltrate?
Chronic endometritis

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