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Flashcards in Quiz 1 Deck (119)
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1
Q

What is the defining characteristic of molluscum contagiosum lesions?

A

umbilicated vesicles filled with hard waxy stuff

2
Q

What does psoriasis look like histologically?

A
hyperkeratosis with parakeratosis
loss of granular layer
epidermal acanthosis
elongation of rete ridges
vascular dilation
3
Q

What does lichen simplex chronicus look like histologically?

A
thickened epidermis with leukocyte infiltration of dermis
elongation/widening of rete ridges
hyperkeratosis
acanthosis
dermal inflammation
4
Q

What do we think of with lichen simplex chronicus?

A

scratch-itch cycle

5
Q

Who is at most risk for lichen planus?

A

women of child bearing age

6
Q

In what condition is the saw tooth appearance of rete ridges pathognomonic?

A

Lichen planus

7
Q

Which of the “lichen” are most likely to cause cancer?

A

Lichen sclerosus

8
Q

What is the gross appearance of Lichen sclerosus?

A

thickening of skin

pale/white/variation in color

9
Q

What does lichen sclerosus look like under the microscope?

A

edematous degeneration of the basal layer
epidermal atrophy/no rete ridges
dense CT replaces dermis
band-like lymphocytes

10
Q

T/F. Bartholin’s duct cysts are a certain indicator of a STD

A

False

11
Q

What types of cells line Bartholin’s duct cysts?

A

transitional epithelium or squamous metaplasia

12
Q

Name 4 bacterial causes of a STI

A

chlamydia
gonorrhea
syphilis
chancroid

13
Q

Name 5 viral causes of a STI (4 of 5 start with H)

A
HSV
HIV
HPV
Hep B/C
MSV
14
Q

What is the histological appearance of HSV?

A

multi-nucleated giant cells

15
Q

What infection is implied with Condyloma acuminata?

A

HPV

16
Q

What is another name for condyloma acuminata?

A

genital warts

17
Q

Which two HPV types are responsible for 90% of genital warts cases?

A

6 and 11

18
Q

T/F. Most people who acquire HPV never develop warts or any other sxs

A

True

19
Q

Which two HPV types account for 70% of all cervical cancer?

A

16 and 18

20
Q

What are three microscopic changes seen with HPV?

A

acanthosis
hyperkeratosis
cytoplasmic vacuolation

21
Q

Treponema pallidum causes what STI?

A

syphilis

22
Q

What what three characteristics classify Treponema pallidum?

A

Gm-
spiral shaped
mobile

23
Q

T/F. Both genital warts and syphilis cause painless lesions.

A

true

24
Q

Characterize the d/c of BV, Trich, Candida.

A

BV: fishy, thicker
Trich: foamy, thin coating
Candida: cottage cheese

25
Q

Clue cells are an indicator of what kind of infection?

A

BV

26
Q

What kind of bacteria is Neisseria gonorrhoeae?

A

gram negative diplococci

27
Q

The presences of ______________________ characterizes Vulvar intraepithelial neoplasia (VIN).

A

hyperpigmented skin plaques

28
Q

What is VIN associated with?

A

primary squamous neoplasm in vagina or cervix

29
Q

What does VIN look like histologically?

A

diffuse cellular atypia
nuclear crowding
increased mitotic index

30
Q

What kind of DNA is found in over 90% of VIN cases?

A

DNA of high risk HPV (16, 18, 31, 45)

31
Q

What increases the risk of VIN progressing to invasive cancer?

A

age

immunosuppression

32
Q

What is the most common vulvar cancer?

A

squamous cell cancer

33
Q

After squamous cell cancer, what are the 3 most likely forms of vulvar CA?

A

basal cell
melanoma
adenocarcinoma

34
Q

What are the two main categories of vulvar carcinoma?

A

HPV

Non-HPV (caused by lichen sclerosus, squamous cell hyperplasia, idiopathic)

35
Q

What does tissue look like microscopically when vulvar carcinoma is caused by HPV.

A

poorly differentiated

36
Q

When the microscope reveals well differentiated, keratinized cells, what kind of vulvar carcinoma are you thinking?

A

HPV negative

37
Q

Which LNs are usually involved with vulvar carcinoma?

A

inguinal
pelvic
iliac
periaortic

38
Q

Where does vulvar carcinoma usually metastasize?

A

lung

liver

39
Q

What drug is associated with clear cell adenocarcinoma?

A

Diethylstilbestrol (DES)

40
Q

Which HPV strains are implicated in cervical cancer?

A

16, 18, 31, 45

41
Q

What gene is associated with cervical cancer?

A

HLA-B7

42
Q

Name some cervical cancer risk factors

A
many sexual partners
tobacco
OCP
HPV
multiple births
43
Q

Koilocytosis is associated with what Bethesda scale rating?

A

Low grade SIL

44
Q

What is Koilocytosis characteristic of?

A

ASC-US (atypical squamous cells of undetermined significance)

45
Q

What are typical features of koilocytes?

A
enlarges nuclei (2-3x normal size)
darkly staining
46
Q

What does CIN1 look like histologically?

A

koilocytotic atypia

perinuclear halos

47
Q

What type of DNA is most abundant in koilocytes and what color does it stain?

A

HPV

blue

48
Q

Up-regulation of __________ characterizes high risk HPV, histologically

A

p16ink4 (a tumor suppressor gene)

looks like intense immunostaining

49
Q

Define Stage 1 cervical cancer.

A

carcinoma confined to the cervix

50
Q

Define Stage II cervical cancer.

A

Carcinoma extends beyond cervix but not into pelvic wall.

involves the vagina but not the lower 1/3

51
Q

Define Stage III cervical cancer.

A

carcinoma extended onto pelvic wall

no cancer free space between the tumor and the pelvic wall

52
Q

Define Stage IV cervical cancer.

A

carcinoma has extended beyond the true pelvic or has involved the mucosa of the bladder or rectum.
all metastatic cases fall under this category.

53
Q

What is the most common site of implantation of ectopic endometrial cells?

A

ovaries

54
Q

t/f. ectopic endometrial cells are influenced by hormonal changes and respond like glands and stroma within the uterus.

A

true

55
Q

What is an endometrioma?

A

aka chocolate cyst

ovarian cyst formed due to ectopic endometrial tissue that bleeds and builds up within the ovary

56
Q

Where is ectopic endometrial tissue found in the case of adenomyosis?

A

within the myometrium

57
Q

What do you call adenomyosis that specifically involves the uterus?

A

adenomyometritis

58
Q

What does adenomyosis look like grossly?

A

thickened and spongy myometrial wall

59
Q

What are the most common causes of endometritis?

A

childbirth related:
retained placental fragments
iatrogenic infection from delivery or abortion

60
Q

When might endometritis occur not related to childbirth?

A

PID

61
Q

What characterizes acute endometritis?

A

micro-abscesses or neutrophils within the endometrial glands

62
Q

What characterizes chronic endometritis?

A

plasma cells in the stroma

63
Q

PID increases the risk of ectopic pregnancy by how many times?

A

6-10x

64
Q

What is the most common gyn CA in the US?

A

endometrial CA

65
Q

What is the most common endometrial ca?

A

adenocarcinoma

66
Q

When does adenocarcinoma of the endometrium usually present?

A

age 55-65yo

uncommon <40yo

67
Q

What distinguishes carcinoma from hyperplasia?

A

glandular architecture is preserved but the tissue is confluent without intervening stroma

68
Q

What percentage of endometrial cancers resemble serous carcinoma of the ovary (papillary serous carcinoma)?

A

20%

69
Q

If a specialized immunohistochemistry stain reveals accumulation of nuclear p53 protein, what kind of cancer is likely?

A

papillary serous carcinoma

70
Q

What do you call a benign smooth muscle tumor of the uterus (or anywhere) and where are they found?

A

leiomyoma

myometrium of the corpus

71
Q

What does a leiomyoma look like grossly and microscopically?

A

gross: well-circumscribed, round, firm, gray-white
microscopic: uniform muscle cells, oval nuclei, whorled pattern

72
Q

Histology report reports spindle shaped muscle cells with increased mitotic figures. What might this be?

A

Sarcoma (leiomyosarcoma)

73
Q

What is the most common cause of female infertility?

A

PCOS

74
Q

What is the most common form of ovarian cancer?

A

epithelial (arising from the surface of the ovary)

75
Q

Which type of ovarian cancer has more pronounced papillary growth and more hyperchromatic cells seen in a biopsy?

A

serous cystadenocarcinoma

76
Q

What do you call the small calcifications as seen with ovarian serous cystadenocarcinoma?

A

psammoma bodies

77
Q

What is another name for a teratoma?

A

dermoid cyst

78
Q

Define cryptorchism

A

absence of one or both testes in the scrotum

79
Q

What is the most common birth defect of the male genitalia?

A

cryptochidism

80
Q

T/F. 80% of cryptorchid testes descend by the first year of life.

A

true

81
Q

In what percentage of cases can undescended testes be palpated in the inguinal canal?

A

90%

82
Q

What does cryptorchidism increase the risk of?

A

infertility, germ cell tumors, testicular torsion, infarction, inguinal hernias

83
Q

What do you call the surgery to correct cryptorchidism?

A

orchioplexy

84
Q

What aspect of the penis does hypospadias affect?

A

ventral

85
Q

What aspect of the penis does epispadias affect?

A

dorsal

86
Q

What do you call the condition where the foreskin cannot be fully retracted over the glans?

A

phimosis

87
Q

What do you call the condition where the foreskin becomes trapped behind the glans?

A

paraphimosis

88
Q

What is the difference between the cause of a primary and secondary varicocele?

A

primary: defective valves or compression of the vein by a nearby structure
secondary: compression of the venous drainage of the testicle

89
Q

Is the right of left testicle more likely to be affected by a varicocele?

A

left 85-90%

90
Q

Is the right of left testicle more likely to be affected by a varicocele?

A

left 85-90%

91
Q

Where does the fluid come from in the case of a hydrocele?

A

tunica vaginalis

92
Q

T/F. A hydrocele will tranilluminate

A

true

93
Q

What is the malformation called that often is the cause of testicular torsion?

A

bell clapper deformity

94
Q

What are the two types of urethritis and their causes?

A

gonococcal urethritis: Neisseria gonorrhoeae

non-gonococcal urethritis: Chlamydia trachomatis (most commonly)

95
Q

What is the characteristic bacteria type of Neisseria gonorrhoeae?

A

gram-negative diplococci

96
Q

What is the triad of reactive arthritis/reiter’s?

A

inflammatory arthritis of large joints
inflammation of the eyes
urethritis in men with mucocutaneous lesions

97
Q

What does Chlamydia trachomatis look like histologically?

A

granulated cytoplasmic inclusions

immunostaining needed usually

98
Q

What type of cell is characteristic of herpes simplex?

A

multinucleated giant cell

99
Q

What do you call the soft, non-cancerous growth associated with tertiary syphilis?

A

gumma

100
Q

What are condyloma acuminata?

A

genital warts due to HPV (mostly strains 6 and 11)

101
Q

What virus is high associated with penile cancer?

A

HPV

102
Q

What is the most common form of penile CA?

A

squamous cell carcinoma

103
Q

What HPV strain is associated with 63% of HPV positive tumors?

A

HPV 16

104
Q

What is the most common solid malignant tumor in men aged 20-35?

A

primary testicular tumors

105
Q

What is the most common classification of testicular cancer?

A

seminoma 35%

106
Q

What makes the affected age group different with seminomas compared with other germ cell tumor of the testes?

A

average dx is at age 40 (10-15 years older)

107
Q

What is detectable in serum tests with 50% of seminoma cases?

A

placental alkaline phosphatase (PLAP)

108
Q

T/F. Serum alpha fetoprotein is elevated with seminoma

A

false

109
Q

What does a seminoma look like histologically?

A

sheet-like or lobular pattern of cells with fibrous stromal network (nests)
clear/pink cytoplasm with glycogen
prominent nuclei with 1-2 large nucleoli and nuclear membranes

110
Q

What is the average age of dx for embryonal carcinoma?

A

31yo

111
Q

t/f. pure embryonal carcinoma is rare but this tumor type is present in a majority of non-seminoma germ cells tumors.

A

true

112
Q

What two serum values are elevated with embryonal carcinoma?

A

AFP, hCG

113
Q

What does embryonal carcinoma look like histologically?

A

sheets of cells trying to form primitive tubules

crowded pleomorphic nuclei

114
Q

Is BPH a result of hypertrophy or hyperplasia of cells?

A

hyperplasia

115
Q

What is the consistency of the prostate with BPH?

A

rubbery

nodular

116
Q

In BPH, what do you call the pink concretions within the glandular lumens as seen under the microscope?

A

corpora amylacea

117
Q

What percentage of prostate cancers are slow growing?

A

66%

118
Q

What is the most common form of prostate cancer?

A

adenocarcinoma

119
Q

What is the characteristic histological appearance of prostatic adenocarcinoma?

A
small, crowded glands
no intervening stroma
nuclei are hyperchromic
enlarged nucleoli
mitotic figures