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Flashcards in Pathology - Nichols Deck (62):
1

Mucosa

lining (membrane) of body passages and cavities that communicate directly or indirectly with the exterior (commonly containing mucin-secreting glands)

2

Serosa

outermost layer (covering) of an organ in a serosal cavity (peritoneal, pleura or pericardial) consisting of fibroelastic tissue covering by mesothelium continuous with the lining of the cavity

3

Basement Membrane

acellular fibrous (collagenous) membrane separating the organized cellular elements of a tissue from the interstitium (space b/w organized cellular element of a tissue)

4

Epithelium

purely cellular avascular layer covering and lining all the external and internal surfaces of the body and associated glands

5

Stroma

supportive connective tissue around the parenchyma

6

Parenchyma

-functional tissue of an organ, which performs the function of the organ

7

Menstrual Endometrium

-fragmented glands and stroma, and degenerating blood

8

Why does menstruation occur?

to slough infection

9

What role does estrogen play in menstruation?

lack of it allows it to occure

10

What role does progesterone play in menstruation?

being insufficent

11

What role do the arteries play?

vasoconstrict, vasospasm, cut off blood supply causing ischemic necrosis

12

Proliferative Endometrium (early)

-straight glands lined with pseudostratified epithelium and stroma with spindle-shaped cells

13

Early Secretory Endometrium

-prominent basal cytoplasmic vaculoes (begin 36-48 hrs post-ovulation and are evidence that it has occurred)

14

Secretory Endometrium

-tortuous dilated glands containing secretions

15

Granulasa cells produce?

growth factors

16

FSH stimulates?

-themselves to convert androgens from thecal cells to estradiol by aromatase during the proliferative phase

17

What happens to granulosa cells after ovulation?

-the turn into granulosa lutein cells that produce progesterone

18

How would a granulosa cell tumor manifest clinically in a child?

percuosis puberty

19

How would a granulosa cell tumor manifest clinically in an adult?

abnormal uterine bleeding
-hirscitism

20

Would a granulosa cell tumor manifest differently after menopause?

new bleeding

21

What happens to the corpus luteum if fertilization of the ovum occurs?

-gets big
-keeps producing hormones, progesterone is key

22

What happens to corpus luteum if NO fertilization of the egg occurs?

it involutes

23

Ovary Serosa

-single cell layer of modified peritoneal mesothelial cells, overlying stroma of spindle-shaped cells

24

# of ovarian tumors from serosal surface?

-70%
-90% of malignant ones

25

Histology of Fallopian Tube

-papillary epithelium and muscular wall
-lined by ciliated epithelium

26

Histology of Uterus

-endometrium
-myometrium composed of smooth muscle

27

Uterine Cervix

-transition from stratified squamous epithelium (exocervix) to columnar epithelium of cells with abundant cytoplasmic mucin (endocervix)

28

Metaplastic squamous cells

-in cervical transformation zone
-prone to infection with HPV, which can progress to squamous cell carcinoma
-prevented by Pap smear to detect dysplasia before it becomes carcinoma

29

Breast Duct lining?

-two-cell layer of inner epithelial and outer myoepithelial cells, surrounded by basement membrane

30

Breast Duct?

-epithelial cells
-myoepithelial cells
-stromal cells
-wavy collagen
-blood vessel

31

90% or breast cancers are?

-ductal
-in situ before they are invasive, and in situ carcinoma can look very much like hyperplasia, but hyperplasia will leave the layer of myoepithelia cells in place

32

What do prolonged high levels of progesterone do?

-produced by corpus luteum
-transform spindle-shaped stromal cells of proliferative endometrial stroma into enlarged rounded cells with abundant smooth pink cytoplasm in a process called decidualization

33

Decidualized Endometrium

-large, rounded stromal cells
-abundant smooth eosinophilic cytoplasm

34

Diseases of Vulva?

-inflammation, non-noeplastic epithelial disorders, dysplasia, tumors

35

Diseases of Vagina?

-inflammation, dysplasia, tumors

36

Diseases of Cervix?

-inflammation, dysplasia, tumors

37

Diseases fo Corpus?

-menstrual cycle, inflammation, adenomyosis, abnormal bleeding, endometrial hyperplasia, tumors

38

Diseases of Tubes?

-inflammation & ectopic pregnancy

39

Diseases of Ovary

-cysts, tumors

40

HSV

STD, commonly affects vulva
-sexually transmitted (HSV I or II)
-common in young age
-painful papules progressing to vesicles & ulcers on vulva, vagina, cervix
-nuclear inclusions, multi-nucleation
-transmitted during neonate delivery

41

Molluscum contagiosum

STD, vulva

42

HPV

STD, gential wart, intraepithelial dysplasia, invasive carcinoma

43

Clamydia Trachomatis

STD, cervicitis, endometritis, salpingo-oophoritis

44

Neisseria gonorrhoeae

STD, Skene gland adenitis, cervicitis, endometritis, salpingitis

45

Candidia

endogenous, vulvovaginitis
-about 10% of women
-predisposition: DM, pregnancy, oral contraceptives
-white mucosal surface w/curdy white vaginal discharge, discomfort, itching

46

Trichomonas

STD, cervivovaginitis
-caused by flagellated protozoa
-sexually transmitted (must treat partner)
-15% of women
-heavy, foamy, gray-green vaginal discharge, mucosal irritation & itching
-"strawberry" cervix
-feed on squamous cells

47

Pelvic Inflammatory Disease (PID)

-caused by Gonococcus, Chlamydia, Mycoplasm, enteric bacteria (in postpartum)-streptococci, staphlococci
-presents with vaginal discharge, pelvic pain, fever, adnexal tenderness
-vulva, vagina, cervix, endometrium, & adnexa re involved

48

Pathology of Gonorrheal PID

-spread: ascending from vestibular glands to vagina-cervix-corpus & adnexa
-acute suppurative salpingitis
-salpingo-oophoritis
-tubo-ovarian abscess
-pyosalpinx (resolved: hydrosalpinx)

49

Complications of Gonorrheal PID

-infertility (from tube closure)
-sepsis (endocarditis, bacteria in blood)
-peritonitis
-suppurative arthritis

50

Ectopic Pregnancy

-abnormal implantation site of the fetus
-most common: fallopian tubes
-sudden abdominal pain, acute abdomen, shock-like presentation about six to twelve weeks following a previous menstrual period
-early diagnosis is critical

51

Endometrial Histology: Proliferative Phase

-estrogen effect
-straight glands with pseudo-stratified epithelium
-negative for mucin production
-stroma is composed of spindle cells with scant cytoplasm, high mitotic rate

52

Endometrial Histology: Secretory Phase

-progesterone effect
-postovulation: basal secretory vacuoles decreasing mitotic activity, simple epithelial layer
-late phase: tortuous, dilated glands, prominent secretory activity, prominent stromal spiral arteries, decidulization

53

Endometrial Histology: Menstrual Phase

-progressively decreasing estrogen and progesterone levels
-extravasation of red blood cells into the stroma
-leukocytic infiltration of stroma
-fibrin thrombi
-disintegrating glands & stroma

54

Postmenopausal (atrophic) Endometrium

-inactive, simple or cystic glands
-no evidence of proliferation or secretion
-dense, inactive stroma
-can be reversed by exogenous hormones/or tumor producing hormones
"swiss cheese"

55

Endometrial Hyperplasia Etiology

-prolonged, abnormally high estrogenic stimulation without progesterone effect

56

Endometrial Hyperplasia Conditions

-Stein-Leventhal syndrome
-Perimenopause
-Estrogen producing tumors
-Obestiy

57

Endometrial Hyperplasia Foms

-simple with/without atypia
-complex with/without atypia

58

Molecular Pathology of Hyperplasia & Carcinoma

-inactivation of PTEN tumor suppressor gene through deletion and/or inactivation
-normally unopposed estrogen increases PTEN production
-PTEN inactivation increases the gland sensitivity to estrogen

59

Simple Endometrial Hyperplasia

-glandular crowing, irregularly shaped glands with stroma

60

Complex Endometrial Hyperplasia

-complex glandular architecture with stroma

61

Complex Endometrial Atypical Hyperplasia

-glands are crowded with almost total exclusions of stroma b/w them
-cytological atypia is present

62

Simple Endometrial Atypical Hyperplasia

-nuclei are rounded with prominent nucleoli