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96 Cards in this Set

  • Front
  • Back
Follicular cyst
location
pathophys
complications
ovary
distention of unrupture graafian follicles, can be assoc w hyperestrinism and endometrial hyperplasia
can rupture --> peritonitis
Pathophys of corpus luteum cyst
results from hemorrhage into eristent mature corpus luteum
assoc with menstrual irreg and sometimes intraperitoneal hemorrhage
Pathophys of theca-lutein cyst
disease association
morph
gonadtropin stimulation
also assoc with choriocarcinoma and hydatidiform mole
multiple and bilateral cysts, lined by luteinized theca cells
Pathophys of PCOS
excess LH and androgens
Relationship between DM adn PCOS
there is increased insulin R and increased risk of DM
hyperinsulinemia --> increased ovarian androgen production --> increased LH
morphology of PCOS (cell types?)
markedly thickened ovarian capsule
multiple small follicular cysts containing granulosa cell alyer and luetinized theca interna
cortical stromal fibrosis, with islands of focal leutinization
What are the different classes of ovarian tumors
sumors of surface epi origin
tumors of germ cell origin
tumors o fovarian sex cord-stromal origins
mets to ovary
what are the different types of ovarian tumors of surface epi origins?
serous tumors
mucinous tumors
endometrioid tumors
clear cell tumors
Brenner tumros
demographics of surface epi tumors of ovaries
women older than 20 yo
these tumors are 75% of all tumors
what are the different types of serous tumor s
serous cystadenoma (benign)
serous cystadenocarcinoma (malig)
morph of serous cystadenoma
lined with cells sim to fallophian tube epi
usually bilat
which cancer accounts for 50% of ovarian carcinomas?
serous cystadenoma
types of mucinous tumors
mucinous cystadenoma (benign)
mucinous cystadenocarcinoma (malig)
morph of mucinous cystadenoma
multilocular cysts lined by mucous secreting columnar epi filled with mucinous material
consequence of mucinous cystadenocarcinoma
pseudomyxoma peritonei --> production of intraperitoneal muncinous material
causes of pseudomyxoma peritoei
mucinous cystadenocarcino (most common cause)
mucinous cystadenoma
carcinomatous mucocele of appendix
are endometrioid tumors benign or malig?
clear cell tumors?
Brenner tumors?
malig
malig
benign
morph of brenner tumors
small islands of epi cells resembling bladder transitional epi interspersed w/i fibrous stroma
tumor in women analagous to testiular seminoma? benign/malig?
dysgerminoma (malig, but good prog)
morphology of endodermal sinus tumor?
biochem markers?
resembles extraembryonic yolk sac
produces AFP
types of teratomas (behaviour)
immature teratoma (aggressive, malignant)
mature teratoma (benign)
monodermal (benign?)
pathophys of dermoid
reduplication of meiotic maternal chromosomes --> 46XX cells of maternal origin
most common type of monodermal teratoma
struma ovarii (consists of thyroid tissue --> hyperthyroidism)
What are the tumors of ovarian sex cord-stromal origin
thecoma-fibroma
thecoma
granulosa cell tumor
sertoli-leydig cell tumor
morph of ovarian fibroma?
association?
consists of bundles of spindle shaped fibroblasts
meig's syndrome (triad of ovarian fibroma, ascites, and hydrothorax)
morph of thecoma
biology of thecoma
round lipid containing cells in addition to fibroblasts
secretes estrogen (occassionally)
what do theca cells normally do?
GC?
produce testosterone and androstenedione (test diffuses to nearby granulosa cells and converts testosterone into 17B estradiol)
granulosa lutein cells make progesterone
pre-ovulatory GC converts testosterone to 17B estradiol via aromatase (and stim by FSH)
activity of granulosa cell tumor
association?
secretes estrogen --> precocious puberty
associated with endometrial hyperplasia or endometrial carcinoma
morph of GC tumor? what helps wiht dx?
small cuboidal deeply staining granulosa cells arranged in anastomotic cords
Call-Exner odies are small follicles filled with eosinophilic secretion (used to dx)
activity of Sertoli-Leydig cell tumor
androgen secreting tumor associated with virilism
Krukenberg tumor
ovaries are replaced bilaterally by mucin=secreting signet ring cells from mets of carcinoma of the stomach
what is abruptio placentae
premature separation of placenta
associed with DIC
what is placenta accreta
causes
presentation
attachment of placenta directly to myometrium, defective decidual layer
predisposed by endometrial inflammation and old scars from prior cesarian sections/other surgeries
impaired placental separation after delivery, sometimes w massive hemorrhage
placenta previa: definition
clinical presentation
attachment of placenta to lower uterine segmnet, partially or completely covering cervical os
can co-exist with placental accreta
manifest by bleeding
predisposition ofo ectopic pregnancy
chronic salpingtis (often gonorrheal)
endometriosis
post-op adhesions
some occur in normal ppl
what does ectopic pregnancy cause
hematosalpinx
tubal rupture --> acute abdomen/shock
when does toxemia of preganancy normally occur?
1st preg
3rd trimester
types of toxemia of pregnancy
pre-ecampsia
eclampsia
clinical presentation of pre-eclampsia
HTN
albuminuria
edema

HELLP syndrome is variant (hemolysis, elevated liver enzymes, low platelets)
clinicla presentation of eclampsia
DIC and convulions
reverses rapidly on termination of pregnancy, but can be fatal
cause of amniotic fluid embolism
presentatioin
progression
tear in placental membranes and rupture of maternal veins
peripartal respiratory difficulty --> chock and death
--> DIC
morph of amniotic fluid emobolism
masses of debris adn epi squamous cells in maternal pulm microcirculation
what is amniotic fluid aspiration syndrome
morph
inability to expel amniotic fluid at birth (prob of neonate)
assoc with prematurity
squamous epithelial cells of amniotic origin in fetal terminal air spaces and larger bronchi
chorioamnionitis
follows premature ROM
caused by ascending infection from vagina or cervix
morph of hydatidiform mole
enlarged edematous placental villi in loose stroma, resemblingn a bunch of grapes
biochem marker of hydatidiform mole
sig increase in hcg
when does hydatidiform mole occur?
what cna it progress to?
clincal presentation
early in regnancy
choriocarcinoma
vaginal bleeding and rapdi increase in uterine size.. can be mistaken for a normal pregnancy, but uterus too large for supposed state of gestation
what are the different types of hydatidiform mole?
complete (no embryo present, 46XX karyotype of paternal derivation)
partial: (embryo present, triploidy and rarely tetrapoidy can occur- thought to be d/t fertilization of ovum by 2+ spermatozoa, usually 2 sets of chromosomes from dad, 1 set from mom)
biochem dx of gestational choriocarcinoma
biology of tumor (whwere does it spread to?)
demographics
increased serum hCG
early hematogenous spreaed to lungs
responsive to chemo
asia/african
what can precede gestational choriocarcinoma
hydatifidiform mole
abortion of ectopic pregnancy
normal-term preg
clinical presentation of gestational choriocarcinoma
vaginal bleeding
which is the most common d/o of breast
clinical presentation
fibrocystic dz
palpable breast mass in pts between 25-50 yo
lumpy breast with midcycle tenderness
usually bilateral
which types of fibrocystic breast disease are associated with increased risk of breast cancer?
epithelial hyperplasia (w atypia)
sclerosing adenosis
any time hyperplastic epi has atypia
which fibrocystic dz of breast are not associated with increased risk of breast ca
stromal fibrosis
cyst frmation
morph of fibrocystic dz
fibrosis
cysts
epi lining may be flattened, show apocrine metaplasia or be hyperplastic
in adenosis: small ducts and myoepithelial cells (in adenosis w fibrosis = sclerosing adenosis)
what is the most common breast tumor in women younger than 25 yo
benign/malig
morph
fibroadenoma
benign
rubbery, firm, painless, well-circumscribed
well demarcated from adjacent breast tissue
stromal cells are neoplastic and ductal epi cells are reactive
types of fibroadenomas
intracanalicular fibroadenoma (stroma compresses and distrots glands into slitlike spaces)
pericanalicular (gland maintains round shape)
Phyllodes tumor
morph
large, bulky
variable malig
has ulceration of overlying skin
cystic spaces contain leaf-like projections from cyst walls and myxoid contents are characteristic
presentation of adenoma of nipple
tumor presents with serous or bloody discharge and palpable mass
can be mistaken for malignancy
presentation of intraductal papilloma
serous or bloody discharge
(benign tumor of major lactiferous ducts that must be disting from carcinoma)
another name for intraductal carcinoma in situ
characteristics
tumr cells fill ducts
tumor cell necrosis --> cheese like consistancy
most common form of breast carcinoma
morph
invasive ductal carcinoma (scirrhous carcinoma)
tumor cells arrangd in cords, islands, and glands, embedded in dense fibrous stroma
abundant fibrous tissue --> firm consistency
morph of Paget dz of breast
eczematoid lesion of nipple or areola
neoplastic Paget cells (large cells surrounded by clear halo-like area) invade epidermis
underlying ductal carcinoma always present
morph of lobular carcinoma in situ
clusters of neoplastic cells fill intralobular ductules and acini
--> invasive carcinoma in same/contralateral breast
morph of medullary carcinoma
cellular with scant stroma
soft, fleshy consistency
lymphocytic infiltrate
good prognosis compared to invasive ductal carcinoma
morph of mucinous carcinoma
prognosis
pools of extracellular mucous surrounding clusters of tumor cells
gelatinous consteny
good prognosis
morph of inflammatory carcinoma
lymphatic involvment of skin by underlying carcinoma
--> red swollen hot skin
POOR PROGSNOSI S
which genetics are associated with a poor prognosis for breast carcinoma
c-erB2 (Her2/Neu)
Gross appearance of cervicitis?
red cervix
#1 cause of cervicitis in sexually active women
chlamydia trachomatis
discharge from candidiasis?
scant, curdlike, milky
discharge from trichomonas
frothy, yellow/green
discharge from garnerella
fishy, thin
gross appearance of uterus in adenomyosis
2-4x bigger, from myometrial thickening
enlargement is symmetrical
no focal masses/lesions
gross appearance of uterus in leiomyoma
asymmetrical
does endometrial hyperplasia lead to increased uterus size
no
when does endometrila hyperplasia usually occcur?
association with other dzs?
during menopuase (also associated with germ line ovarian tumors)
25% --> endometrial carcinoma
pathology of pre-eclampsia
decidual arterioles show acute atherosis and fibrinoid necrosis
what does a decrease in estriol in a pregnant woman indicate
incipient abortion
biochem markers for NTD
high AChE and MSAFP
which gene has association with ovarian ca
brca 1
how do GC-theca cell tumors --> endometrial hyperplasia
they produce estrogens
Clinical presentation of embryonic rhabdomyosarcoma
vaginal bleeding and grape like protrusion from vagina of a child
Histology of endometriosis
red/blue brown .3 cm implants on uterine serosa
how to treat cin 1?
no tx necessary
causes of salpingitis
chlamydia
gonorrhea
mycolplasma
Presentation of choriocarcinoma
bloody, brown vaginal discharge
masses in lungs --> SOB
mass in vagina
synctiotrophoblasts
hihg hCG from synctiotrophoblasts
clue cells found when?
Pap smear of pt with Garnerella vaginosis
pathophys of gardnerella
loss of normal vaginal lactobacilli --> overgrowth of anaerobes --> superficial polymicrobial infection
What bacteria are associated with Bartholin cysts?
N. gonorrheae
Staph
both grow after Bartholin ducts are obstructed
histo forms of vulvar dystrophies
lichen sclerosus/hyperplastic dystrophy (both benign )
atypical hyperplastic dystrophy (malig)
clinical features of vulvar dystrophy
pruritis
leukoplakia
most common causes of PID
gonorrhea
chlamydia
enteric bacteria
which STD causes opthalmia neonatorum
gonorrhea
what causes lymphogranuloma venereum?
sx?
C. trachomatis
small papule or ulcer followed by superficial ulcers and enlarged lymph nodes that can get matted together --> rectal stricture from scarring and inflammation
cellular changes associated with cervical erosion
columnar epi replacing stratified squamous epi --> erythematous area