Repro 7 - Vaginal And Cervial Pathologies

Question 1

What ligaments support the cervix?

Answer 1

The cardinal ligaments (3 and 9 o’clock; connect the cervix to the side wall, contain the uterine vessels). Uterosacral ligaments (5 and 7 o’clock; curve around from the back of the cervix and connect to the sacral bone). Round ligaments. Infundibulopelvic ligament (AKA IP ligament, connects ovary all the way to the aorta and vena cava).

Question 2

What would be the three Pelvic organ prolapse?

Answer 2

Cystocele (Bladder). Rectocele (colon). Enterocele (Small intestine). Caused by tear in the fascia.

Question 3

What are the six causes of vaginal pain?

Answer 3

Trauma. Infection. Muscular spasm. Mucosal allodynia (pain from stimuli that normally does not provoke) or hyperalgesia (increased sensitivity to pain). Vaginismus (spasms at the base of vagina). Vestibulitis (burning sensation of the bartholin glands).

Question 4

What is Koilocytosis?

Answer 4

Squamous cell w/ perinuclear cytoplasmic clearing.

Question 5

What is the cause of vulvar intraepithelial neoplasia (VIN)?

Answer 5

Associated with HPV (especially 16, 18, and 31). Precursor to vulvar carcinoma.

Question 6

Which gene products act together to immortalize cells and lead to cancer?

Answer 6

E6 and E7 gene products. E6 causes degradation of p53 (the negative regulator of the cell cycle). E7 inhibits Rb; allows cell growth to go unchecked).

Question 7

What is clear cell adenocarcinoma?

Answer 7

Associated w/ diethylstillbestrol (DES) exposure in utero. The daughter will have deformed genitalia and will develop this cancer in adulthood.

Question 8

What is Sarcoma botryoides? What is seen in the histology?

Answer 8

It is a Rhabdomyosarcoma that arises from wall of bladder or vagina. Seen in girls younger than 4 years of age. Causes a grape-like gross appearance of the tumor. Causes Spindle-shaped cells and a (+) Desmin stain.

Question 9

Describe the squamocolumnar junction of the cervix.

Answer 9

Where the ectocervix with stratified squamous epithelium meets the endocervix that has simple columnar epithelium.

Question 10

What would be the most common type of cancer in the cervix?

Answer 10

90% is squamous cell carcinoma, 10% may be adenocarcinoma.

Question 11

How does cervical cancer spread and what can it cause when it has been growing for some time?

Answer 11

Spreads locally. Clinically staged. Lateral invasion can block ureters, leading to renal failure.

Question 12

RFF: Dysplastic cervical cells, with enlarged, dark nuclei.

Answer 12

Koilocytes (HPV infection).