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25 Cards in this Set
- Front
- Back
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What is the difference between endometrial polyps and endometrial hyperplasia?
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polyps - benign, often asymptomatic, estrogen sensitive
hyperplasia - pre-malignant, hi estrogen OR low progesterone due to estrogen overstim |
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What is the difference between CIN1, 2, 3, and invasive cervical carcinoma?
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1 - mild dysplasia of upper layer of cervical epithelium
2 - more severe dysplasia, various cells effected throughout the entire epithelial thickness 3 - carcinoma in situ, entire cervical epithelial layer is replaced entirely by neoplastic cells, no invasion beyond basement membrane ICC - neoplastic development of cervical epithelium with invasion through underlying BM |
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What is PCOS?
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Chronic anovulation with symptoms of androgen excess along with obesity.
Due to excess LH by anterior pituitary excess LH - androstenedione (from theca) - causes acne, hirsutism - androgen converted to estrone in adipose - negative feedback of estrone to decrease FSH reduced FSH leads to decreased follicular development, preventing the formation of an ovum - anovulatory infertile, amenorrhea or oligomenorrhea, acne, hirsutism |
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What is the diagnosis when "chocolate cysts" are seen?
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endometriosis
presence and proliferation of non-neoplastic endometrial tissue outside uterine cavity - #1 site is ovary dysmenorrhea, dyschezia, dyspareunia |
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What is the difference between a complete and incomplete hydatidiform mole?
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incomplete - fomred from the fertilization of 1 nucleated ovum with 2 or more sperm, yielding triploidy, tetraploidy, etc.
complete - 2 X-chromosome-containing sperm that have fertilized 1 enucleated ovum - usually an older female >35 |
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What is the difference between fibrocystic change and breast tumors?
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FC - multiple, bilateral nodes - lumpy bumpy breast. fluctuates in size depending on menstrual cycle. benign
BT - one solitary nodule, unilateral. Non-tender in early stages and does not fluctuate with menstrual cycles |
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What are the benign breast tumors?
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Fibroadenoma - fibrous and glandular tissue - stromal tumor - single, circumscribed, mobile, marble shaped
Phylloides - stromal tumor, usually >70 yo. grows quickly - huge, log-shaped tumor Intraductal Papilloma - epithelial tumor - ductal epithelial cells - bloody or sero us nipple discharge |
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What is the difference between ductal carcinoma in situ and invasive ductal carcinoma?
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DCIS - non invasive - does not cross basement membrane. neoplasm of ductal epithelial cells.
IDC - neoplasm of ductal epithelium that penetrates the basement membrane. May see peau d'orange, nipple retraction, dimpling, fixed mass |
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What is Paget' disease of the nipple?
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a form of DCIS that extends from the nipple ducts into the contiguous nipple skin and areola. Fissured, ulcerated, oozing hyeremic, edematous nipple
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What breast cancer is commonly associated with BRCA1 gene mutation?
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medullary carcinoma
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What are the most common sites for breast cancer metastasis?
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lungs, bone, liver, adrenals, brain, meninges
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What are the important oncogenes and tumor suppressors that deal with breast cancer?
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oncogene - c-erb-B2 (HER-2/neu)
TSG - BRCA1/2, p53 |
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Which gastritis effects the fundus? antrum?
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fundus - Chronic type A - glandular destruction and mucosal atrophy - destroys parietal cells and decrease intrinsic factor - results in pernicious anemia and achlorhydria. Associated with Hashimotos, Addisons, or vitiligo
Antrum - chronic type B due to H. Pylori. Leads to eventual mucosal atrophy and metaplasia and eventual carcinoma |
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What is the most common intestinal polyp?
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hyperplastic polyp - most common in pts 50s and 60s due to decreased epithelial cell turnover in the bowl. Accumulation of mature cells on the surface. Little to no risk for malignancy
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What are adenomatous polyps?
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adenomas
neoplastic precursor for inasive colorectal carcinoma. All arise from proliferative dysplasia of epithelial cells lining the colon 3 types: tubular adenoma - tubular epithelial glands villous adenoma - villous projections. >4cm are at highest risk for malignancy. most common to rectum and rectosigmoid colon - gross rectal bleeding, hypoK, hypoproteinemia tubulovillous adenoma - both villous and tubular features |
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What causes familial adenomatous polyposis?
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loss of tumor suppressor gene, APC
almost 100% chance of colon cancer development develops 500-2500 polyps autosomal dominant |
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What is Lynch Syndrome?
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hereditary nonpolyposis colorectal cancer
autosomal dominant - due to defective DNA mismatch repair genes; associated with microsatellites. increased cancer risk but cancer tends to NOT rise from the polyps. malignancies occur in multiple sites and are not typically formed within or associated with adenomas |
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What is the difference between right and lift sided colonic cancers?
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R - cause iron deficiency anemia (with fatigue and weakness) and (+) hemoccult stool; no stool changes are noted
L - (+) hemoccult stool, change in bowel habits, and crampy left lower quadrant discomfort or tenesmus; pencil stools may also be produced |
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What are the 2 types of diverticular disease?
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1) diverticulosis - diverticuli present - diagnosed by barium enema and xray OR with colonoscopy - painless - gross bleeding - + hemoccult
2) diverticulitis - inflammation of diverticuli - complication of diverticulosis - blocks the diverticulum orifice which traps bacteria causing infection - LLQ pain, fever, increase neutrophils, diarrhea but - hemoccult. Diagnose by CT scan |
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What is IBS?
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irritable bowel syndrome
recurrent, unpredictable bowel habits (diarrhea and/or constipation) plus abdominal cramping exacerbated by stress |
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What is the difference between Crohn's disease and Ulcerative colitis
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CD - mouth to anus - spares rectum. Contains skip lesions - entire wall thickness. non caseating granulomas. Has strictures, fissures, and fistulas. (+) string sign. More Pain, Less Bleeding
UC -begins at rectum and moves proximally to ileocecal junction. Continuous lesions in mucosa/submucosa only. nongranulomatous lesions. Pseudopolyps. Lead pipe colon. More Bleeding than Pain. |
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What is the gold standard test to detect malabsorption?
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Stool fat analysis - high amounts in stool indicate malabsorption
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What is seen on a biopsy on a patient with Celiac Sprue?
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flat villi in the duodenum.
immune complexes form, deposits MAC - decapitates the villi heads |
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What are the different types of gallstones?
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cholesterol - high cholesterol
mixed - cholesterol and bilirubin pigment - excess bilirubin |
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What is the difference between cholecystitis and choledocholithiasis?
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itis - gallbladder infection - bacteria trapped in gallbladder by a stone
lithiasis - obstruction of a common bile duct |
