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Systems Pathology II Final COPY > Vulva, Vagina, Cervix, Uterus > Flashcards

Vulva, Vagina, Cervix, Uterus Flashcards

1
Q

What is the most common condition involving the vulva?

A

Inflammation (neoplasia is rare)

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2
Q

What two general conditions can cause vulvitis?

A

1 allergic contact dermatitis (eczema)

2 infection

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3
Q

Obstruction of which female gland can result in a cyst and possible infection leading to the formation of an abscess?

A

Bartholin gland

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4
Q

Which female labial epithelial disorder results in epidermal thinning and atrophy?

A

Lichen sclerosus

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5
Q

Lichen sclerosus most commonly affects what population?

A

Elderly

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6
Q

Is there a cancer risk associated with lichen sclerosus?

A

Small (1-5% progress into SCC)

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7
Q

What is the hypothesized cause of lichen sclerosus?

A

Autoimmune

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8
Q

Which female labial epithelial disorder involves epithelial hyperplasia and hyperkeratosis from chronic irritation?

A

Lichen simplex chronicus

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9
Q

Which is NOT associated with a cancer risk at all: lichen sclerosus or lichen simplex chronicus?

A

Lichen simplex chronicus

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10
Q

Both lichen sclerosus and lichen simplex chronicus resemble what other condition?

A

Leukoplakia

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11
Q

What is most common type of vulvar carcinoma (although overall rare)?

A

Non-HPV-related SCC

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12
Q

Which type of vulvar carcinoma is associated with vulvar intraepithelial neoplasia (VIN)?

A

HPV-related SCC

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13
Q

What strains of HPV cause vulvar carcinoma?

A

HPV-16 and HPV-18

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14
Q

Which type of vulvar carcinoma is associated with older women? Middle-aged women?

A

Older women = Non-HPV-related SCC

Middle-aged = HPV-related SCC

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15
Q

What are the two types of vulvar carcinoma?

A

HPV-related SCC or non-HPV-related SCC

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16
Q

Lichen sclerosus can cause what type of vulvar carcinoma?

A

Non-HPV-related SCC

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17
Q

What infection produces green vaginal discharge?

A

Trichomonas vaginalis

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18
Q

Which fungal infection produces white vaginal discharge?

A

Candida albicans

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19
Q

What are the risk factors for vaginitis?

A

Diabetes, antibiotic therapy, immunodeficiency, pregnancy, recent abortion

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20
Q

What is the clinical term for white or yellow vaginal discharge?

A

Leukorrhea

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21
Q

What is the most common type of vaginal cancer?

A

Squamous cell carcinoma

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22
Q

What are risk factors for vaginal squamous cell carcinoma?

A

HPV, early intercourse, multiple partners

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23
Q

Which type of vaginal cancer presents as a risk for offspring whose mothers took diethylstilbestrol (DES)?

A

Clear cell adenocarcinoma

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24
Q

Which type of vaginal cancer presents with red/granular foci?

A

Clear cell adenocarcinoma

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25
Q

What is unique about the location of a sarcoma botryoides?

A

Rhabdomyosarcoma that occurs in an area without skeletal muscle

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26
Q

Which type of vaginal cancer is a form of embryonal rhabdomyosarcoma?

A

Sarcoma botryoides

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27
Q

What is the clinical term for an inflamed cervix?

A

Cervicitis

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28
Q

What is the most common infectious cause of cervicitis?

A

Chlamydia (just under 50% of all cases)

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29
Q

What are non-infectious causes of cervicitis?

A

Acute: postpartum
Chronic: reproductive age women (estrogen fluctuations, trauma)

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30
Q

What are risk factors for cervical cancer?

A

1 early first intercourse
2 multiple sex partners
3 male partner with several past partners
4 persistent infection with high-risk HPV

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31
Q

What is the average age in the U.S. for first sexual intercourse?

A

17 years

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32
Q

Do most HPV infections persist into cervical intraepithelial neoplasia (CIN)?

A

No

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33
Q

What is the precursor to invasive cervical carcinoma?

A

Cervical intraepithelial neoplasia (CIN)

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34
Q

What area of the cervix is the location where immature squamous cells are infected with HPV-16 or HPV-18 to develop into cervical cancer?

A

Transformation zone

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35
Q

Which oncogene involved with cervical cancer binds to TP53 and deactivates it? Which binds to Rb gene and deactivates it?

A

TP53 = E6 oncogene

Rb gene = E7 oncogene

36
Q

What is known as the guardian of the genome?

A

TP53

37
Q

What is known as the governor of the genome?

A

Rb gene

38
Q

What type of cells make up the endocervix?

A

Columnar epithelial

39
Q

What type of cells make up the exocervix?

A

Squamous epithelial

40
Q

In what location of the cervix do both types of cervical epithelial (columnar and squamous) coexist?

A

Transformation zone

41
Q

What is the most common age of diagnosis for cervical intraepithelial neoplasia (CIN)?

A

30 years

42
Q

Although CIN is most commonly diagnosed at age 30, when does invasive cancer usually get diagnosed as a result of CIN?

A

15 years post diagnosis (aka around 45)

43
Q

What are the two forms of CIN?

A

Low-grade (CIN I) and high-grade (CIN II-III)

44
Q

What are the rates of progression and regression for both types of CIN?

A 
CIN I (observation) = 60% regress, 10% progress to high-grade
CIN II-III (excision) = 30% regress, 10% progress to cancer
45
Q

What is the term for the collection of cellular changes caused from HPV?

A

Koilocytosis

46
Q

What changes are seen in koilocytosis?

A

1 anaplasia/dysplasia
2 enlarged nuclei
3 irregular, wrinkled borders
4 darker staining (hyperchromasia)

47
Q

What fraction of invasive cervical cancer cases are fatal?

A

1/3

48
Q

Why is it important to do regular pap smear screening for neoplasia of the cervix?

A

CIN is asymptomatic

49
Q

What is the most common type of invasive carcinoma of the cervix?

A

Squamous cell carcinoma (75%)

50
Q

What age range is the most common time for diagnosis of cervical cancer?

A

Mid 40s

51
Q

Are smaller or larger lesions of invasive cervical cancer associated with a better prognosis?

A

Smaller (metastasis occurs in 1% of those 3mm)

52
Q

What population of women most commonly develop invasive cervical cancer?

A

Women without previous pap smear

53
Q

What are the late stage symptoms of invasive cervical cancer (since it is asymptomatic early on)?

A

Leukorrhea, bleedings, dysuria, painful sex

54
Q

What is the most common way those with cervical cancer die?

A

Local invasion (renal failure)

55
Q

What is the treatment for invasive cervical cancer?

A

Hysterectomy and lymph node excision

56
Q

Endometritis is associated with risks for what conditions?

A

1 ectopic pregnancy

2 infertility

57
Q

What is the clinical term for inflammation of the endometrium?

A

Endometritis

58
Q

Endometritis is most commonly secondary to what disease?

A

Pelvic inflammatory disease (PID)

59
Q

What infections can cause pelvic inflammatory disease?

A

N. gonorrhea, C. trachomatis, TB

60
Q

What other things can cause endometritis besides PID?

A

Conception, abortion, intrauterine device

61
Q

Female infertility results in what percentage of cases of endometriosis?

A

50%

62
Q

Endometriosis affects 10% of what population?

A

All reproductive-age women

63
Q

What is the method of injury of endometriosis?

A

Cyclic bleeding leading to fibrosis

64
Q

What are the features of endometriosis?

A

Severe dysmenorrhea, dysuria, pelvis pain, sterility, painful BMs, painful intercourse

65
Q

“Chocolate cyst” of the ovary is associated with what female condition?

A

Endometriosis

66
Q

What is the clinical term for irregular, between periods (spotting)?

A

Metrorrhagia

67
Q

What is the clinical term for profuse/prolonged menstruation?

A

Menorrhagia

68
Q

When are anovulatory cycles most common?

A

At extremes of reproductive life (young and old)

69
Q

What phase of the menstrual cycle is inadequate due to a retained endometrium leading to an anovulatory cycle and abnormal uterine bleeding?

A

Luteal

70
Q

What are some causes of abnormal uterine bleeding?

A 
1 leiomyomas, leiomyosarcomas, endometrial carcinomas, endometritis
2 anovulatory cycle
3 idiopathic (dysfunctional uterine bleeding)
71
Q

Elevated levels of what hormone can lead to endometrial hyperplasia? What conditions can cause this?

A

Estrogen; obesity and PCOD

72
Q

What is the most common female genital tract cancer?

A

Endometrial carcinoma (NOT CERVICAL CANCER)

73
Q

What is the most common type of endometrial carcinoma?

A

Endometrioid (80%)

74
Q

What is the most common age range for endometrial carcinomas?

A

55-65 years

75
Q

What is the unique symptoms seen in those that develop endometrial carcinoma and why?

A

Metrorrhagia (unique because the age range = 55-65)

76
Q

What are the risk factors for endometrial carcinoma?

A

1 elevated estrogen (obesity)
2 infertility
3 hypertension
4 diabetes

77
Q

What is the most common age range for the development of endometrial polyps?

A

Around menopause (40-50)

78
Q

What is another term for a leiomyoma of the uterus?

A

Fibroids (benign tumors)

79
Q

Which type of uterine smooth muscle tumor affects reproductive-age women? Post menopausal women?

A 
Leiomyoma = reproductive-age women
Leiomyosarcoma = postmenopausal
80
Q

What race is more at risk for the development of uterine fibroids?

A

African Americans

81
Q

When do uterine fibroids tend to shrink and why?

A

At menopause due to decreased levels of estrogen

82
Q

Which type of uterine smooth muscle tumor is benign? Malignant?

A 
Benign = leiomyoma
Malignant = leiomyosarcoma
83
Q

Which type of uterine smooth muscle tumor usually presents as a solitary, anapestic, hemorrhagic/necrotic mass?

A

Leiomyosarcoma

84
Q

Which type of uterine smooth muscle tumor presents as multiple, well-circumscribed lesions?

A

Uterine fibroids (leiomyomas)

85
Q

What is the most common location of metastasis for a uterine leiomyosarcoma?

A

Lungs

86
Q

In what part of the uterus do smooth muscle tumors occur?

A

Myometrium

Systems Pathology II Final COPY (9 decks)

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