Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Path 4 > Vulva, vagina, cervix > Flashcards

Vulva, vagina, cervix Flashcards

1
Q

vulvitis

A

reactive inflammation d/t irritation (urine, soap, detergent) or allergic rxn (perfume, soap, clothing dye)
erythematous weeping and crusting papules and plaques

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

candida vulvovaginitis

A

very common, d/t yeast fungus
risk factor: DM, pregnancy, abx, immunocompromised states
causes pruritic rash, dyspareunia, thick discharge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

genital herpes

A

HSV usually type 2
dormant w reactivation d/t stress, trauma, UV radiation
can be transmitted in latent or active phase
causes papules -> painful vesicles -> ulcers
histo: intranuclear inclusions and giant cells
*systemic herpes in immunocompromised (AIDS, neonates)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Bartholin cyst

A

usually d/t obstruction of duct following infection
lined by transitional or squamous metaplastic epithelium
tx: excise or marsupialise (open permanently)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

epidermal inclusion cyst

A

similar to cyst in other hair-bearing skin

lined by keratinized squamous epithelium - can smell bad if keratin rots

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

lichen sclerosus etiology and gross appearance

A

aka chronic atrophic vulvitis
inflammatory dz of unknown cause, sometimes a/w AI dz
m/c post-menopause
skin is atrophic, pale gray, scarring, pruritic
*not pre-malignant, but inc risk carcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

lichen sclerosus histo

A

epidermis: hyperkeratosis, atrophic w loss of rete pegs, hydropic degeneration of basal cells
dermis: dense collagenous infiltrate, perivascular T cell infiltrate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

squamous cell hyperplasia

A

aka hyperplastic dystrophy or lichen simplex chronicus
result of rubbing/scratching
presents as leukoplakia
not premalignant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

squamous cell hyperplasia histo

A

acanthosis (epidermal thickening) and hyperkeratosis
stratum granulosum thickened, inc basal and suprabasal mitoses, NO cellular atypia
dermal inflammatory infiltrate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

HPV vulvar disease - types

A

condylomata acuminata
classic vulvar intraepithelial neoplasia (VIN) - precursor to…
squamous cell carcinoma: basaloid and warty types

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

condylomata acuminata

A

sexually transmitted “venereal warts”
d/t HPV 6, 11
verrucous proliferation of stratified squamous epithelium - acanthosis w hyperkeratosis, parakeratosis, koilocytic atypia (raisinoid nuclei w perinuclear vacuoles)
*not pre-malignant, may regress

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

classic vulvar intraepithelial neoplasia

A

precursor to poorly differentiated basaloid and warty squamous cell carcinomas
90% a/w HPV 16, 18
in middle-aged females, smokes
multifocal erythematous plaque with scaling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

classic VIN histo

A

acanthosis, hyperkeratosis, parakeratosis
nuclear atypia, mitoses, lack of maturation from base extending superficially
3 grades; VIN 3 = squamous carc in situ

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

differentiated VIN

A

aka VIN simplex
tP53 mutations
histo: basal cell atypia and superficial differentiation
precursor to well-differentiated keratinizing squamous cell carcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

keratinizing squamous cell carcinoma

A

common in 80s, esp w lichen sclerosus or squamous cell hyperplasia
dev from diff VIN
*good prognosis if caught early (less than 2cm lesion = 90% 5 yr survival), but LN involvement = less than 10%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Paget’s disease of vulva

A

aka extramammary Paget’s
looks like breast Paget’s but not a/w invasive cancer, confined to epidermis
red, scaling lesion
single or small groups of neoplastic cells in epidermis surrounded by halo, granular PAS+ cytoplasmic mucin (diff from melanoma)

17
Q

vaginal epithelial atrophy

A

nonkeratinizing stratified squamous mucosa becomes glycogenated w estrogen
post-menopause lack of estrogen -> atrophy of epithelium -> dyspareunia and infection

18
Q

vaginitis cause

A

usually d/t disruption of normal flora by abx, pregnancy, or DM -> commensals become pathogenic

19
Q

3 main types of vaginitis and clinical features

A

1) yeast - Candida albicans (thick white discharge)
2) bacterial - Gardnerella (thin grey milky), Chlamydia
3) protozoan - Trichomonas (thin green frothy)

20
Q

vaginal malignancies

A

rare: primary squamous cell carcinoma, d/t HPV and VAIN
very rare: clear cell adenocarcinoma, embryonal rhabdomyosarcoma, melanoma
*m/c is invasion by adjacent organs (uterus, rectum, bladder)

21
Q

vaginal clear cell adenocarcinoma

A

15-20 yo whose mothers were treated with DES in pregnancy (prevent miscarriage)
have adenosis (glandular columnar epithelium) as precursor that may rarely transform
upper 1/3rd of anterior vaginal wall
good prognosis

22
Q

embryonal rhabdomyosarcoma

A

aka sarcoma botryoides

infants/ kids

23
Q

Nabothian cyst

A

forms when gland openings in cervix are obstructed, may be d/t squamous metaplasia

24
Q

cervicitis

A

common, presents w discharge

acute: usually post-partum, rare (staph, strep)
chronic: STDs (m/c Chlamydia)

25
Q

cervical verruca

A

benign condylomata d/t HPV 6, 11, 42, 44

26
Q

endocervical polyps

A

present w bleeding
loose fibromyxomatous stroma w dilated glands and inflammatory cells
may undergo squamous metaplasia or ulcerate
*no malignant potential

27
Q

cervical dysplasia

A

arises in transformation zone, m/c cause: HPV 16, 18 - integrates into host DNA (E6 p53 and E7 Rb)
precursor to invasive squamous carcinoma - higher grade = greater cancer risk, less time to develop

28
Q

grading of cervical dysplasia

A

biopsy for CIN
CIN1/LSIL: koilocytic change in basal 1/3; 60% regress
CIN2/HSIL: pleomorphism and mitoses in middle 1/3 - treat
CIN3/CIS: full thickness
Pap smear - LSIL or HSIL

29
Q

cervical cancer

A

m/c: squamous cell, other types (adeno) may also be HPV-related
d/t HPV 16, 18, 31, 33, 58
mutation in LKB1 (Peutz-Jeghers syndrome) in over 20% tumors
usually mid-older women
tx: cone biopsy or hysterectomy

30
Q

stages of cervical cancer

A

0 - CIS/CIN3
1 - confined to cervix
2 - beyond cervix but not to pelvic wall or lower 1/3rd vagina
3 - extends into pelvic wall and/or lower 1/3rd vagina
4 - extends beyond true pelvis, involves bladder or rectal mucosa, mets
*death d/t local invasion

Path 4 (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions