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56 Cards in this Set
- Front
- Back
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Endometrail hyperplasia is due to what?
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estrogen overstimulation
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#1 invasive cancer of the female genital tract is?
& develops from? |
Carcinoma
hyperplasia |
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CIN- typical place it is found and assoc w?
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squamocolumnar junction
HPV 16 & 18 |
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CIN 1-
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mild dysplasia and only upper layer of epithelium
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CIN 2
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severe dysplasia throughout the entire epithelial thickness
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CIN 3
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carcinoma in situ-entire cervical epithelial layer is replaced by neoplastic cells but no invasion beyond the underlying basement membrane
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PCOS
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chronic anovulation due to androgen excess along w/ obesity
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Presentation of PCOS
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infertility
amenorrhea oligomenorrhea acne hissutism |
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endometriosis
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proliferation of non-neoplastic endometrial tissue outside the uterine cavity.
#1 site is the ovary "chocolate cysts" presents w 1-dysmenorrhea 2-dyschezia 3- dyspareunia |
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Uterine leiomyoma
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fibroid of benign smooth muscle
#1 uterine tumor and over tumor in women estrogen sensitive BLACKS in reproductive years "whorrled pattern" common complaint-inpaired fertility abortion and postpartum hemorrhage |
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complete hydatiform mole
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sperm fert an ovum that has lost its genetic material
grape like cysts HIGH RISK FOR CHORIOCARCINOMA |
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incomplete hydatiform mole
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1 ovum with 2 or more sperm giving a triploidy or more.
zona pellucida let too many sperm in grape like cysts |
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hydatiform mole
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VERY high beta hCG-bc produced so much placental tissue
grape like cysts abnormal ovum fertilizaiton that casues excessive trophoblastic dev in the form of grape like cysts |
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Choriocarcinoma
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frequent and early mets-diagnose too late for intervention :(
Malig neoplasm of throphoblastic cells VERY high beta hCG late findings off irregular spotting of brown bloody foul smelling fluid |
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placenta previa
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placenta over or near the internal os
PAINLESS vag bleeding. most freq bt 27-32 weeks-may recoccur at anytime and cause profuse dangerous bleeding |
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placental abruptia
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premature seperation of placenta from uterus
LIFE THREATENING vag bleeding sharp tearing PAIN fetal distress anytime from 20 weeks on |
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placenta accreta
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abnormally deep attachement of the placenta into the uterine wall
increase risk for post partum hemorrhae and may require hysterectomy after |
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ectopic preg
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outside the uterine cavity usually in the fallopian tube. Bc placenta is not well supported or supplied
Low hCG bc diminished placental health |
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breast fibrocystic change
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multiple
lumpy bumpy flactulate in size and tenderness with period bening |
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breast cancer
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solitary
unilateral non tender early NOT flactuate with period |
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benign breast tumors
3 |
1-fibroadenoma-<30 single, sharp circumzided, mobile, marble shape and size
2-phylloides tumor-huge, log shaped tumor 3-intraductal papilloma-nipple discharge-freequent bloody and serous |
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breast cancers
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1-ductal
2-lobular 3-padgets 4-other |
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most common breast cancer
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invasive ductal carcinoma-scirrhous (hard)
may see peau d orange, nipple retraction, dimpling, may palpate a fixed mass |
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Padgets Dz of the nipple
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a form of DCIS actually extends from the nipple into the nipple skin and areola
fissured, ulcerated, oozing, hyperemic, edematous nipple-like chapped lips |
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invasive ductal or tubular look like what on mammogram
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"spiculated density"-star burst
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acute erosive gastritis
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focal damage
alcohol nsaids cancer drugs smoking |
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Chronic type A
A= Autoimmune |
glandular destruction and mucosal atrophy
fundus autoimmune-Ab against gastric glands, parietal cells, and intrinsic factor assoc w/-Hashimoto, Addisons, Vitiligo-bc also autoimmune |
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Chronic type B
B=bacteria |
H. pylori
affects antrum-lower part of stomach eventual mucoscal atrophy and then eventual carcinoma |
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Menetrier's
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mucosal hyperplasia- concomitant with atrophy of glands
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5 type of intestinal polpys
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1-hyperplastic
2-harartomatous 3-inflammatory 4-lymphoid 5-adenomatous |
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Hyperplastic
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most common-90%
decreased epi cell turnover = accum of cells on the surface little malig risk |
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Hamartomatous
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malformation of glands and stroma of the epi causing overgrowth of mature tissue natural to the area
little malig risk can be in assoc w/ Peutz-Jegers Syndrome |
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Inflammatory
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IBD- "psuedopolyps"
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Lymphoid
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large but normal variants of intramucosal lymphoid tissue
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Adenomatous
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NEOPLASTIC-pre malig for invasive colorectal carcinoma
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3 subtypes of adenomatous polyps
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1-tubular
2-villous-finger like projections HIGHEST RISK FOR MALIG 3-tubulovillous-both tubular and villous features |
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Peutz-Jeghers
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Auto Dominant
hamartomatous polyp disorder that is familial polyposis syndrome of the whole bowel polpyps+spotted melanin hyperpigmentation of lips,palms and soles BUT polyps have very low cancer risk |
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Familial adenomatous polyposis FAP
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AD
loss of tumor suppressor gene APC almost 100% chance of colon cancer dev :( |
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Gardner's
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FAP variant- classlic FAP + benign mandible and skull tumors + epidermal cysts + high risk for abnormal dentitiion
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Turcot
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FAP variant +malignant brain tumors
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Hereditary Nonpolyposis Colorectal Cancer HNPCC or Lynch syndrome
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AD
defective DNA mismatch repair genes assoc w/ microsatellites increase risk-colon cancer and multiple other BUT cancer dev tends NOT to arise from adenmatous polyps |
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colon cancer
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most arise from adenomas
arise: APC (tumor suppressor) becomes inactivated or k-RAS (oncogene) is mutated and p53 (tumor suppressor) is inactiveated- sp we turn off good and start up the bad risk factors-high calories, high carbs, red mead, low fiber diet NSAIDS and aspirin are protective :) |
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Who must be worked up for colon cancer?
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ANYONE over 50 with an iron def anemia must be to rule out colon carcinoma
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1st places colon cancer mets?
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Liver & Lungs
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Diverticulosis
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occurs in area of weakness, normally where vessel inserts
most in SIGMOID colong painless bleeding DX-colonoscopy, barium enema, and X ray |
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Diverticulitis
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inflammation of diverticuli
LLQ pain, fever, elevated neutrophils and diarrhea but NO BLOOD abcess formation or bowel perforation and sepsis so could be life threatening Must CT-NOT barium or colonoscopy treat-Ciprofloxacin and Metronidazole |
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IBS-
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recurremt, unpredictable bowel habits plus cramping
worsened by emotional stress dysregulation of enteric nervous system-says hey i'm doing what i want |
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Crohn's Dz
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Mouth to anus with rectum spared
ileum #1 site "skip lesions" transmural granulomas (non caseating) +string sign more PAIN less bleeding |
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Ulcerative colitis
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Begins at rectum
continuous lesions mucosa and submucosa only pseudopolyps lead pipe colon HIGH RISK: colon CA and toxic megacolon more BLEEDING less pain |
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Celiac Sprue
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small intestines-find flat vili
anti-gliadin, gluten,endomysial and reticulum Caucasians some dev- dermatitis herpatiformis increased risk for MALT |
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Tropical Sprue
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diarrhea, steatorrhea, weight loss
natives of tropical regions-Caribbean |
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Whipple's Dz
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ANY organ but primarily intestine, CNS and joints
steatorrhea,arthralgia and fever caused by: Tropheryma whippeli and Actinomyces MOST IMPORTANT- 4-6 months to a year of Ceftriaxone or Pen G |
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Choletlihiasis
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gallstones
usually asymp labs normal MUST treat Native Americans |
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Cholecystitis
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gallbladder infection
Fever, RUQ pain, Murpheys Sign, N/V NO JAUNDICE |
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Choledocholithiasis
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obstruction of common bile duct
RUQ pain, janudice, clay colored stools, tea colored urine, elevated alk phos and conjugated bilirubin NO FEVER |
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Ascending Cholangitis
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complication of choledocholithiasis
Charcots Triad : FEVER, JAUNDICA, RUQ pain elevated alk phos and conjugated bilirubin quickly ascend to reach liver and cause life threatening sepsis |
