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45 Cards in this Set
- Front
- Back
What are hydatid cysts of Morgagni?
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Cysts located at the fimbriated end of the fallopian tube
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What are ovarian follicular and leuteal cysts?
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Follicular: a cyst due to distention of unruptured graffian follicle
Leutal: from hemorrhage into a persistant corpus luteum that is assoc with menstrual irregularity. |
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VIP
What is polycystic ovary syndrome? |
A syndrome affecting young women, exhibiting numerous cystic follicles that can cause amenorrhea, obesity, and hirsuitism.
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What is one potential cause of polycystic ovary syndrome?
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Disturbance of the hypothalamus' pituitary secretion leading to an asychronous release of LH.
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Are most ovarian tumors benign or malignant?
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Benign
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VIP
What is the name and derivation of each of the 3 classes of ovarian neoplasms? |
1. Surface epithelial origin (70%)
2. Germ cell orgin (20%) 3. Sex-cord stromal tumor origin (5%) |
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What are 3 signs of ovarian tumors?
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1. abdominal pain
2. bloating 3. increased abdominal girth |
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What is the only general screening test for tumor?
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Regular pelvic exam.
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What is the most important prognostic indicator in ovarian tumors?
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STAGE
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What are the stages of ovarian tumors?
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Stage 1 - tumor limited to ovary
Stage 2 -involves one or both ovaries with pelvic extension Stage 3 - involves one or both ovaries with peritoneal mets Stage 4 - outside pelvis |
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What are the types of surface epithelial malignant ovarian tumors?
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1. serous (50%)
2. mucinous (10%) 3. endometriod (15%) 4. clear cell (6%) SMEC (He SMEC'ed me) with a clear mucus hand |
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What is a common benign ovarian tumor of surface epithelium?
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Cystadenofibroma (or cystadenoma)
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What are ovarian germ cell tumors characteristics (3)?
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1. 15-20% of all tumors
2. children and young adults most commonly effected 3. 90% are benign (mature cystic teratoma) |
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What are the most common ovarian benign tumors?
What age group is most commonly effected? |
Mature cystic teratoma (Dermoid cysts)
10-20yo |
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What is the ovarian counterpart to the testicular seminoma?
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Dysgerminoma
-childhood, 20-30yo -gonadal dysgenesis is a predisposing factor - radiosensitive |
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Describe the proliferative phase that is ended by ovulation:
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There is a rapid growth of both glands and stroma. Formation of straight tubular glands. Mitoses occurs
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What hormone increases in secretory phase?
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Progesterone
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What stromal changes occur in the secretory phase?
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Edema and spiral arterioles are seen.
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What is the most common cause of dysfunctional endometrial bleeding?
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Anovulatory cycle (excessive and prolonged estrogenic stimulation without the development of the progestional phase that normally follows ovulation -- ovulation tells cells to stop)
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What are the two age groups that are most likely to have an anovulatory cycle?
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1. adolescence
2. peri-menopausal |
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Most common cause of acute endoMETRITIS?
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Bacterial infection after delivery or miscarriage
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Most common cause of chronic endoMETRITIS
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Pelvic inflammatory disease
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Endometrial pathology: VIP
1. Adenomyosis 2. Endometriosis |
1. Adenomyosis = presence of endometrial glands and surrounding stroma with in myometrium
2. Endometriosis: presence of endometrial and stroma in abnormal locations outside of the uterus |
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What percentage of women are effected by endometriosis?
Causes? (4) |
10%
Causes: 1. severs dysmenorrhea 2. dyspareunia (painful sex) 3. menstrual irreg 4. infertility (30-40%) |
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What are endometrial polyps and how are they treated?
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Polyps:
Benign masses of variable size projecting into endometrial cavity. May cause abnL bleeding, (>40yo) Treatment: since they respond to estrogen (increase in size), treat with Tamoxifen. |
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What are the two types of endometrial hyperplasia? And their associations.
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1. Low grade = caused by anovulatory cycle
2. High grade = caused by PTEN gene mutation that causes proliferation of endometrial glands and cytologic atypia (premalig) |
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To diagnose endometrial intraepithelial neoplasia (EIN) what must be confirmed?
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Must confirm the loss of PTEN gene expression.
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What does PTEN gene do?
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PTEN is a tumor suppressor gene that makes a protein expressed by benign endometrial glands during proliferative phase.
Unopposed estrogen stimulation leads to an increase in PTEN protein. PTEN-absent endometrial glands are more sensitive to estrogen stimulation, which eventually leads to hyperplasia and CA |
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Compare age of onset of endometrial tumors and ovarian tumors:
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Endometrial = postmenopausal
Ovarian = 10-30yo |
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What are four risk factors for endometrial carcinomas?
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1. obesity
2. diabetes 3. hypertension 4. inferility |
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What is the most curable female cancer?
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Endometrial CA
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What is stage II endometrial CA mean?
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CA has spread out of uterus (Stage 1) into cervix but not further.
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What is a DDx for postmenopausal bleeding?
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1. malignant endometrial tumor
2. EIN (PTEN) 3. Clear cell tumor 4. Serous papillary CA 5 Carcinosarcoma (malignant mixed mullarian tumor) |
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Describe the features of a Serous Papillary CA (endometriod CA)
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It is highly aggressive and 40-70% of pt having deep myometrial invasion.
Mneumo: Serous Papillary is a "serious" dz of endometrioid |
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What are clear cell carcinoma of the endometrium?
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Nonendometrioid type tumor in postmenopausal women.
Shows glycogen accumulation within cytoplasm. Poor prognosis |
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How are endometrial tumors graded?
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Based on their architecture and severity of nuclear features.
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What is the most common benign mesenchymal tumor in the female repro system?
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Leiomyomas (smooth cell tumor) aka fibroids.
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What age do you get fibroids (leiomyomas)?
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75% of reproductive age
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Are leiomyomas estrogen responsive?
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Yes
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Describe the gross characteristics of leiomyomas:
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Well circumscribed, round, firm nodules. They are tan-white (more common in AA)
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What is the histologic appearance of leiomyomas?
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Whorled bundles of smooth muscle cells
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What three clinical symptoms can patients with leiomyomas present with?
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1. sudden pain
2. infertility 3. bladder compression |
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What is the five year survival rate of a leiomyosarcoma?
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40% (10-15% if highgrade)
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Who is most commonly effected by stromal sarcomas (myometrial)?
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Middle aged women
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Describe the gross appearance of stromal sarcoma:
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Multiple tan-yellow masses with permeation involving irregular tongues and worm-like plugs in myometrial veins.
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