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57 Cards in this Set

  • Front
  • Back
urogenital sinus
vestibule of the external genitalia and the lower vagina
unfused mullerian ducts
fallopian tubes
fused mullerian ducts
uterus and upper vagina
mesonephric (wolffian ducts) regress...
in females and male remnants may persist. in the cervix and vagina, they become cystic (gartner duct cyst)
candida albicans
most common vaginitis; infection in 10% of women; assoc w/ diabetes, OCP, pregnancy, antibiotics, and immunosuppression.
appearance of candida albicans
small white superficial patches in cervix or vagina; leukorrhea and pruritis.
micro: hyphae and spores--hockey sticks and pucks; special stain w/ GMS and PAS
trichomonas vaginalis
large flagellated ovoid protozoan; wet mounts; purulent discharge and discomfort; strawberry cervix; frothy vaginal discharge
gardnerella vaginitis
caused by gardnerella vaginalis; sexually transmitted; dx cell is the "clue" cell on PAP smear-- epithelial cells w/ dot like organisms that stick to surface of the squamous cell
N.gonorrhea; PID, urethritis, paraurethral and bartholin's glands, skene ducts; extra genital manifestations: pharyngitis, proctitis, purulent monoarticular arthritis, and ophthalmia neonatorum.
chlamydia cervicitis serotype D through K; MOST COMMON STD- causes PID, mostly asymp.
lymphogranuloma venereum: C trachomatis L1, L2, or L3 serotype-- ulcer leading to fibrosis; also infection of eye-- can lead to blindness
primary syphilis
chancre; firm painless ulcer; spirochetes under darkfield
secondary syphilis
grey flattened wart like lesion called condyloma lata; might also see palmar rash
ocngenital syphilis
fetal malformations: saddle nose deformity, hutchinson teeth, and saber shin
granuloma inguinale
calymmatobacterium donovani, a gram neg rod; DONOVAN bodies-- multiple organisms filling large histiocytes; papule or ulcers fuse to form large genital ulcers or inguinal ulcers, sometimes w/ lymphatic obstruction or genital distortion
H. ducreyi; soft, painful ulcerated lesion. key difference b/w chancre is that it is painful.
vulva, vag, and cervix; sx in 1/3; neonate can get infected; tzanck smear; micro: see multinucleated cell w/ nuclear molding, ground glass chromatin, and intranuclear inclusions (cowdry bodies);
gonococcal infection--spreads upward via mucosa; non gonococcal--spreads via blood and lymphatics
complications of PID
peritonitis, intestinal obstruction due to adhesions, bacteremia leading to endocarditis, meningitis, or suppurative arthritis; and infertility due to chronic PID
exotoxin produced by S. aureus; dx by culture of vaginal/cervical secretion
lichen sclerosis (know pic)
after menopause; not precancerous, but 1-4% can turn to carcinoma; thinning of epidermis and replacement of dermis by dense collagenous fibrous tissue
lichen simplex chronicus (know pic)
nonspecific due to chronic rubbing or scratching; thickening of skin; acanthosis w/ hyperkeratosis; epithelium very thick w/ increased mitoses. sometiems assoc w/ cancer, but not a precancerous lesion.
condyloma acuminatum
Sexually transmitted benign tumors caused by HPV types 6 and 11. often multiple; branching tree like pattern of stratified squamous epithelium supported by fibrous stroma; KOILOCYTES (nuclear vacuolization)
squamous cell carcinoma
most common malignant tumor of vulva; older women; mets; tx w/ vulvectomy; preceded by VIN 1-3.
paget disease of vulva
most common extramammary site of pagets; assoc w/ underlying adenocarcinoma;
gross: pruritic red, crusted, sharply demarcated--on labia majora; might see submucosal thickening;
micro: large tumor cells lying singly or in clusters w/in epidermis--cells w/ clear halo.
gartner duct cyst
found in lateral wall of vagina; derived from wolffian duct rests; 1-2 cm filled cysts
SCC of vagina
primary SCC is rare; usually assoc w/ cervical SCC and HPV. lesions of lower 2/3 met to inguinal nodes; and upper 1/3 met to iliac nodes.
vaginal adenosis
benign condition where glandular columnar epithelium of mullerian type either appears beneath the squamous epithelium or replaces it; daughters of women exposed to DES.
Clear cell adenocarcinoma
rare; daughters of women exposed to DES; clear cell adenocarcinoma w/ vacuolated tumor cells in clusters and glands; malignant.
embryonal rhabdosarcoma
sarcoma botryoides (grape like); rare; infants and kids <5 yrs; polypoid rounded mass filling and projecting out vagina; tumor cells are small, w/ oval nuclei and cytoplasmic protrusions that look like tennis rackets; cambium layer of crowded cells beneath epithelium; deep region lies in loose fibromyxomatous stroma
area where most dysplasia and carcinomas originate
transition zone-- squamo-columnar junction
nabothian cyst
multiple small mucinous cysts on endocervix that result from blockage of endocervical glands by overlying squamous metaplastic epithelium
endocervical polyps
inflammatory; not true tumors; produce vaginal spotting or bleeding; small and sessile to large and protruding; polypoid, covered w/ epithelial lining, and contain loose fibromyxoid stroma w/ dilated gland and thick walled vessels
HPV and cervical cancer
high risk HPV types assoc w/ cancer are 16, 18, 31, and 33. 16 and 18 acct for 85%. E6 and p53. E7 and RB and p16INK4. VACCINES.
carcinoma of cervix
usually ectocervix; 40-45 yrs; exophytic, ulcerative, and infiltrative; involves contiguous structures, esp ureters leading to hydronephrosis and hydroureter. 95% are large cell either keratinized or non keratinized
uterine lesions present w/...
abnormal vaginal bleeding
anovulatory cycle
most common; due to prolonged estrogenic stimulation w/o development of the progestational phase; biopsy shows proliferative endometrium.
inadequate luteal phase
inadequate corpus luteum function w/ low progesterone output; chronology and appeareance of endometrium dont correlate
irregular shedding
prolonged functioning of CL and continued progesterone production reuslts in prolonged heavy bleeding. mix of secretory and proliferative appearance
endometrial changes b/c of oral contraceptives
inactive glands amid a decidualized stroma. glands that look like estrogen phase and stroma that looks like progesterone phase.
endometrial glands and stroma in abnormal location outside uterus. ovaries are most common; also uterine ligaments, rectovag septum, belly button, etc... present w/ infertility, pelvic pain. red-blue to yellow brown nodules just below serosa; chocolate cysts of ovaries; powder burns on serosal surface;
endometrial tissue in uterine wall myometrium. hemorrhage w/in adenomyotic nests cause menorrhagia, colicky dysmenorrhea, dyspareunia, and pelvic pain. ill defined
endometrial polyp
benign sessile lesion; asx or may cause AUB if they ulcerate; assoc w/ tamoxifen (antiestrogen to tx breast ca)
endometrial hyperplasia
increased gland to stromal ratio; presents w/ AUB and may progress to carcinoma; assoc w/ prolonged estrogen stimulation (anovulatory or increased secretion). seen w/ menopause, polycystic ovarian disease, estrogen secreting ovarian tumors, estrogen replacement therapy. inactivation of PTEN; risk for carcinoma varies w/ degree of cellular atypia
endometrial carcinoma
increasing incidence; ages 55-65; asx or irregular vaginal bleeding; most 85% are endometrial adenocarcinomas;
endometrial carcinoma associations
diabetes, obesity, HTN, infertility, breast cancer
malignant mixed mullerian tumor (MMMT); variety of malignant mesodermal components; post menopausal; fleshy bulky polypoid tumor protruding from os;
uterine leiomyoma
aka fibroids; most common uterine tumor; most common of all tumors in women; african lineage; benign neoplasm, malignant transformation is rare. estrogen dependent or sensitive.
malignant; rare; 40-60 yrs; recur; met via blood; tumor arises de novo; best way to differentiate from leiomyoma is by plieomorphism and number of mitoses;
assoc w/ PID; 60% by gonococcus; also caused by trauma; complications are pyosalpinx and hydrosalpinx and tubo-ovarian abscess.
paratuberal: small translucent filled w/ clear serous fluid; hydatid of morgani- cysts near fimbriated end and appear to be remnants of mullerian duct and of little clinical significance;
adenomatoid tumors or mesotheliomas
most common benign tumor of FT and are located subserosally
adenocarcinoma of FT
primary tumors are rare; probably from ovaries or endometrium
follicular cyst
distension of unruptured graffian follicle that is >2 cm; inner lining of granulosa cells that secrete estrogen; inner thecal lining w/ increased cytoplasm and pale appearance.
corpus luteum cyst
hemorrhage into persistent mature CL; assoc w/ menstrual irregularities and occasional peritoneal hemorrhage if it ruptures
theca lutein cyst
results from gonadrotropin stimulation; can be assoc w/ choriocarcinoma and hydatidiform mole. multiple and bilateral and lined by luteinized thecal cells
chocolate cyst
blood containing cyst from ovarian endometriosis