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D&T 4 exam 1 > Women's Reproductive System - Carpenter > Flashcards

Women's Reproductive System - Carpenter Flashcards

1
Q

What is the epithelium of ectocervical mucosa

A

squamous

non-keratinizing

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2
Q

What is the epithelium of endocervical mucosa

A

Columnar cells

- mucin

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3
Q

Another name for cervis

A

transformation zone

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4
Q

epithelium of cervix

A

squamocolumnar junction

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5
Q

what are 2 layers of uterus

A

myometrium

endometirum

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6
Q

histo for fallopian tubes

A
  • columnar, both ciliated and non-ciliated

- intercalated cells (peg cells)

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7
Q

what female structures does herpes simplex invade

A

vulva
vagina
cervix

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8
Q

what does HSV look like

A

painful, red papules on vulva

- vesicles, ulcers

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9
Q

For diagnosis what can detect HSV

A

NAA - nucleic acid amplification
Pap smear
detect anti-HSV antibodies

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10
Q

what does herpes look like on pap smear

A

ground glass nuclei

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11
Q

What is Molluscum contagiosum

A

pox virus

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12
Q

what does Molluscum contagiosum impact

A

skin and mucous membranes

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13
Q

What Molluscum Contagiosum is most prevalent

A

MCV1

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14
Q

What Molluscum Contagiosum is sexually transmitted

A

MCV2

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15
Q

Molluscum commonly occurs in who

A

young children 2-12

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16
Q

how is Molluscum transmitted in children

A

1 direct contact

  1. inaminate objects
  2. lesion of trunk, arms, legs
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17
Q

how is Molluscum transmitted in adults

A

sexually

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18
Q

Clinical appearance of Molluscum

A

papules
dome-shaped
dimpled center

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19
Q

what does Molluscum look like under microscope

A

Intracytoplasmic viral inclusions

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20
Q

What is most common yeast infection

A

Candida

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21
Q

What are risk factors for candida

A

pregnancy
diabetes
BCP

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22
Q

symptoms of yeast infections ( candida)

A

itching
erythema
cottage cheese-like discharge

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23
Q

What is used to diagnose yeast infection ( candida)

A

pap smear
wet preparation
culture and/or NAA

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24
Q

What does Candida look like on pap smear

A

“spaghetti and meatballs”

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25
Q

clinical feature of Trichomonas vaginalis

A

fishy vaginal discharge with fishy odor

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26
Q

Trichomonas vaginalis can cause what

A

inflammatory response

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27
Q

what is the gross appearance of Trichomonas vaginalis

A

strawberry cervix

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28
Q

Trichomonas vaginalis increase susceptibility to what disease

A

HIV

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29
Q

What is the impact of Trichomonas vaginalis on pregnancy

A
  • preterm deliver

- low birth weight infants

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30
Q

What is the easiest method to diagnose trichomonas? other methods

A

wet prep ( easiest)

  • pap smear
  • liquid pap vial
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31
Q

What are characteristic of gardnerella

A

gram negative small bacillus

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32
Q

what CAN gardnerella be associated with?

A

bacterial vaginitis

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33
Q

on a wet prep or pap smear what do you seen for Gardnerella

A

epithelial cells covered with bacteria

– Clue cells

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34
Q

Chlamydia trachomatis causes what 3 diseases

A
  1. follicular cervicitis
  2. endometritis
  3. salpho-oophoritis
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35
Q

what is follicular cervicitis

A

abundant lymphocytes seen infiltrating cervix

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36
Q

chlamydia trachomatis can cuase what

A

infertility

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37
Q

how is chlamydia trachomatis diagnosed

A

pap smear by NAA test

urine specimen

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38
Q

Name 3 agents that can cause pelvic inflammatory disease

A
  1. gonorrhea
  2. chlamydia
  3. enteric bacteria
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39
Q

what are 3 clinical features of pelvic inflammatory disease

A
  1. pelvic pain
  2. fever
  3. vaginal discharge
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40
Q

When does PID occur

A

following: abortion, D&C, surgical procedure, normal delivery

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41
Q

what is puerperal infection

A

any bacterial infection of the female reproductive tract following childbirth or miscarriage.

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42
Q

initially what does PID cause

A
  • acute suppurative salpingitis
    • acute inflammatory cells filling tubes
    • cause abscess formation
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43
Q

where does gonococcal PID usually begin? what anatomy does it involve? where can it spread and when does this happen? What layer does it involve

A 
Bartholin glands 
- cervix 
2-7 days after exposure
- upward to tubes and ovaries 
surface epithelium
44
Q

How does non-gonococcal PID spread?

A

lymphvascular channels

45
Q

What is the difference between gonococcal and non-gonococcal PID

A

non-gonococcal: inflammatory reaction deeper in layers

gonococcal: surface epithelium

46
Q

what are 3 complications of PID

A
  1. peritonitis
  2. bacteremia
  3. intestinal obstruction
47
Q

on what anatomical structure does leukoplakia occur

A

vulva

48
Q

what does leukoplakia look like

A

“white plaque”

49
Q

how is leukoplakia diagnosed

A

biopsy

50
Q

what is lichen sclerosis

A

white patches with associated labial atrophy

  • can be pruritic
  • multiple areas
51
Q

who is lichen sclerosis seen in?

A

post menopausal

52
Q

what can cause lichen simplex chronicus

A

rubbing skin to relieve pruritis

53
Q

what can lichen simplex chronicus present as

A

leukoplakia

54
Q

What is the histo for lichen simplex chronicus and lichen sclerosis

A

lichen simplex chronicus: acanthosis, hyperkeratosis

lichen sclerosis: thin epidermis, decrease glands

55
Q

acanthosis

A

thickening of epidermis

56
Q

what is condyloma acuminatum

A

venereal wart

benign condition

57
Q

Condyloma Acuminatum is associated with what other problem

A

HPV types 6 and 11 (low risk)

58
Q

what is seen microscopically for Condyloma Acuminatum

A

kiolocyte (halo cell)

59
Q

Majority of vulvar carcinomas are what type of carcinomas

A

squamous cell carcinomas

60
Q

how are vulvar carcinomas categorized

A

HPV related

non-HPV related

61
Q

what is HPV related vulvar carcinoma called

A

Basaloid/Warty carcinioma

62
Q

basaloid/warty carcinoma is associated with high risk of what

A

HPV

63
Q

what is Basaloid/warty carcinoma preceded by

A

VIN

64
Q

how can Basaloid warty carcinoma initially appear as

A

leukoplakia

65
Q

what type of women get non-HPV related vulvar carcinoma

A

with long standing lichen sclerosis or squamous cell hyperplasia

66
Q

what is histo for non-HPV vulvar carcinoma

A

keratinizing squamous cell cancers

67
Q

what disease is vulvar squamous cell carcinoma associated with and precedes it

A

HPV

VIN

68
Q

grossly what does extra mammary paget disease look like

A

pruritic red crusted lesions

69
Q

histo for extra mammary paget disease

A

large tumor cells surrounded by clear halos

70
Q

where does paget disease originate from? where does the disease usually stay

A

stem cells or apocrine ducts

epithelium

71
Q

Breast Paget disease 100% associated with

A

adenocarcinoma

72
Q

vaginal carcinomas are what type majority

A

squamous cell carcioma

73
Q

vaginal carcinoma is associated with what disease

A

HPV

74
Q

how does one usually get vaginal carcinoma

A

spread from cervical lesion

75
Q

Why was Diethylstibesterol given to women

A

prevent preterm delivery

76
Q

what is the problem with DES

A

problems with daughter

not much problems with son

77
Q

DES increases risk for what

A
  • clear cell adenocarcinoma
  • structural abnormalities of female genital tract
  • infertility
78
Q

how does vaginal adenosis from DES change epithelium

A

squamous epithelium replaced by glandular epithelium

79
Q

who is embryonal rhabdomyosarcoma/sarcoma botryoides seen in

A

children less than 5 years

80
Q

embryonal rhabdomyosarcoma/sarcoma botryoides gross appearance

A

grapelike clusters projecting from vagina

81
Q

what is the process of cervix squamous metaplasia

A
  1. increase estrogen increases glycgoen uptake by cervical/vaginal mucosa
  2. glycogen provides substrate for bacteria
  3. bacteria causes drop in vaginal pH
  4. endocervix responds by proliferation of reserve cells
  5. metaplasia
82
Q

cervical squamous metaplasia is very susceptible to what infection

A

HPV

83
Q

is squamous metaplasia normal

A

yes

84
Q

is endocervical polyp begign

A

yes

85
Q

what can cause endocervical polyp

A

vaginal discharge, bleeding

86
Q

what is seen under microscope for endocervical polyp

A

mucinous columnar epithelium

thick-walled vessels

87
Q

cervical condyloma is associated with what

A

HPV 6, 11 (low risk)

88
Q

cervical cancer is associated with what

A

HPV 16, 18

89
Q

risk factors for cervical cancer

A
  • early age intercourse
  • multiple sex partners
  • smoking
  • OCP
  • male with multiple partners
90
Q

what type of HPV do adolescents get

A

HPV 16

91
Q

if a women is negative for HPV, she has low risk for development of what

A

cervical cancer

92
Q

CIN3 classification dysplaisa?

A

severe dysplasia/CIS

high risk HPV

93
Q

what area does HPV infect

A

immature squamous metaplastic cells, transformation zone

- not mature squamous cells ( vagina, vulva)

94
Q

can a virgin get HPV

A

yes

95
Q

HPV encodes what viral proteins

A

E6/E7

96
Q

E6/E7 interact with what

A

Rb

p53

97
Q

is cervical intraepithelial neoplasia cancerous? what is it

A

no,

precancerous dysplasia

98
Q

what is the dysplasia classification for CIN1

A

mild dysplasia

- low grade

99
Q

e dysplasia classification for CIN2

A

moderate dysplasia

100
Q

what is seen under microscope for dysplasia

A

nuclear atypia
increased nuclear/cytoplasmic ratio
koilocytosis

101
Q

CIN 1 where do changes occur

A

lower 1/3 of epidermis

102
Q

where do CIN2 changes occur

A

lower 2/3 of epidermis

103
Q

where do CIN 3 changes occur

A

entire layer

104
Q

What are 3 types of cervical squamous cell carcinoma

A

fungating
ulcerating
infiltrative

105
Q

cervical Adenocarcinoma comes from what layer

A

endocervical epithelium

D&T 4 exam 1 (17 decks)

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