Er: Female Repro Path

Front 1

what is the chance of a female developing breast cancer by fraction.

Back 1

1 in 8

Front 2

what percentage of women that present with chief complaints of :
-palpable mass
-inflammatory lesions
-nipple secretions/mammo abnormality
-pain
actually have to undergo a biopsy?

Back 2

10%

Front 3

what is the chief complaint has the highest incidence that pans out to be verified cancer?

Back 3

palpable masses

Front 4

the rare inflammation of the breast called ____ most commonly presents with _____ _____ and ______.

Back 4

mastitis
erythematous
swollen
painful

Front 5

acute mastitis is most often due to the bacterial agent _____ occurring during what natural proscess?

Back 5

Staph. aureus
lactation --> breast feeding

Front 6

what type of histological changes in the breast are the primary breast problem?

Back 6

fibrocystic changes

Front 7

what are the most frequently diagnosed lesions of a palpable mass?

Back 7

carcinoma (33%)
fibroadenoma (23%)
Cysts (10%)

Front 8

what are the most frequently diagnosed lesions of a mammographic lesion?

Back 8

carcinoma (23%)
cysts (22%)
fibroadenoma (20%)

Front 9

what is the most common benign tumor of the breast?

Back 9

fibroadenoma (fibroblastic CT / glandular tissue)

Front 10

if one palpates a well demarcated, marble-like, smooth lesion in the breast....it may suggest the presence of?

Back 10

fibroadenoma

Front 11

what are the 3 types of benign lesions observed in the breasts?

Back 11

1) Non-proliferative ( no hyperplasia)
2) Proliferative breast disease (hyperplasia)
3) Atypical hyperplasia (dysplasia)

Front 12

what percentage of women undergo some sort of fibrocystic changes?

Back 12

60%

Front 13

ADH and ALH are examples of what?

Back 13

Benign - Proliferative breast disease with Atypia: thus lacking sufficient qualitative or quantitative features for a diagnosis of carcinoma in situ

Front 14

ADH (atypical ductal hyperplasia) and ALH (lobular) exhibit a ___ relative risk for developing invasive carcinoma in situ?

Back 14

4-5 x

Front 15

Lobular or Ductal carcinoma in situ exhibit a ____ relative risk for developing invasive carcinoma in situ?

Back 15

8-10x

Front 16

what type of carcinoma in situ exhibits IPSILATERAL display on breast?

Back 16

Ductal carcinoma in situ

Front 17

what drug is given to patients with carcinoma in situ?

Back 17

tamoxifen

Front 18

what percentage of women With breast cancer are expected to die?

Back 18

20%

Front 19

what is the most common location for invasive breast cancer to appear?

Back 19

upper outer quadrant(50%)
20% = nipple
10% = other quadrants

Front 20

what are 3 common sites for distant metastases of breast cancer reach by the hematogenous route?

Back 20

lung
liver
brain

Front 21

what in regards to menopause is a risk factor (20%) for developing breast cancer?

Back 21

early menses
late menopause

Front 22

women with a full term pregnancy prior to age ____ or over ____ are half as likely to the risk of nulliparous (never have children) due to lobular differentiation that is resistant to given carcinogens

Back 22

20
35

Front 23

first degree relatives will increase the risk for breast cancer of pt.? (T/F)

Back 23

true

Front 24

African American women have a (increased/decreased) incidence of breast cancer after the age of 40, and present at a more (early/advanced) stage

Back 24

decreased
advanced

Front 25

which of the following are NOT minor risk factors for breast cancer development?
1) Estrogen Exposure (HRT)
2) Radiation Exposure
3) Carcinoma in Ipsilateral Breast or Endometrium
4) Demography/Geography
5) breast feeding

Back 25

3) Carcinoma in CONTRALATERAL breast or Endometrium

Front 26

which of the following are NOT minor risk factors for breast cancer development?
1) Diet: alcohol/fat
2) Obesity
3) Exercise
4) Smoking
5) Antibiotic use
6) Enviromental Toxins

Back 26

5) antibiotic use

Front 27

what is more likely a hereditary risk factor for development of breast cancer:
1) multiple relatives affected
2) first-degree relatives affected
3) father's relatives affect

Back 27

2) first degree relatives

Front 28

the 2 higly penetrant autosomal-dominant genes associated with BC?

Back 28

BRCA1/BRCA2

Front 29

almost all breast cancers are _____ in classification?

Back 29

adenocarcinomas

Front 30

What is the most common type of In Situ Carcinoma?

Back 30

Ductal Carcinoma in situ

Front 31

What is the most common of the 2 main categories of breast cancer?

Back 31

Invasive Carcinoma @ 70-85%

Front 32

what are the 2 most common types of Invasive Carcinoma?

Back 32

Ductal type carcinoma
Lobular carcinoma

Front 33

what is the most important prognostic factor for invasive carcinoma in the absence of distant metastases?

Back 33

axillary lymph node involvement:

1-3 nodes = 35-40% 10 yr disease free
>10 nodes = 10-15% 10 yr disease free

Front 34

what is the second most important prognostic factor independent of axillary nodes?

Back 34

tumor size

Front 35

Locally advanced disease(adjacent muscle..)

and

Inflammatory carcinoma are examples of (major or minor) prognostic factors for breast carcinoma?

Back 35

major

Front 36

which of the following are NOT examples of MINOR prognostic factors for breast carcinoma?
1) histological subtypes
2) tumor grade
3) estrogen / progesterone receptors
4) nodal morphology

Back 36

4) nodal morphology

Front 37

which of the following are NOT examples of MINOR prognostic factors for breast carcinoma?
1) Human epidermal growth factor receptor
2) Leu-65
3) c-erb B2
4) neu 5
5) lympovascular invasion
6) proliferative rate
7) DNA content

Back 37

2) Leu-65

Front 38

what are 3 very common infection of the female genital tract?

Back 38

1) Candida
2) Gardnerella
3) Trichomoniasis

Front 39

what are 2 major infectious agents causing female infertility by pelvic inflammatory disease by stricture of fallopian tubes?

Back 39

1) Gonorrhea
2) Chlamydia

Front 40

what is an infectious agent responsible for spontaneous abortions?

Back 40

Mycoplasma

Front 41

an infectious agent linked to cervical cancer?

Back 41

HPV

Front 42

what are the common 3 culprits of Pelvic Inflammatory Disease (PID) and which of these are most common?

Back 42

1) Gonocci (most common)
2) chlamydiae (second)
3) enteric bacteria

Front 43

inflammation of the fallopian/ uterine tubes?

Back 43

salpingitis

Front 44

salpingitis can often begin where?

Back 44

endometrium

Front 45

complications of PID include:
1) _____
2) infertility
3) Intestinal obstruction = adhesions
4) ______
5) tubo-ovarian abscesses/cysts

Back 45

1) peritonitis
4) bacteremia

Front 46

Cervical Carcinoma is the ____ leading cause of cancer death of which is reduced due to the ____

Back 46

8th
pap smear

Front 47

changes within the epithelium that can range from mild dysplasia - carcinoma in situ

Back 47

squamous intra-epithelial lesions

Front 48

CIN =

Back 48

cervical inter-epithelial neoplasia

Front 49

which of the following is NOT a risk factor for cervical cancer?
1) early age intercourse
2) multiple sex partners
3) UTIs
4) increased parity

Back 49

3) UTIs

Front 50

Which of the following is NOT a risk factor for cervical cancer?
1) Presence of cancer-associated HPV
2) Persistent detection of high risk HPV

3) HLA and viral subtypes
4) Tamoxifen drug use
5) exposure to nictotine/oral contraceptives
6) genital infections (chlamydia)

Back 50

4) Tamoxifen drug use

Front 51

what type of vaccines have been manufactured to prevent precancerous infections?

Back 51

HPV

Front 52

what is the epithelial type of the vaginal wall?

Back 52

stratified squamous epithelium

Front 53

what is the epithelial type of the uterus ?

Back 53

tall columnar (glandular in origin)

Front 54

HPV can lead to what 2 types of cervical carcinoma?

Back 54

1) invasive sqamous carcinoma
2) invasive adenocarcinoma

Front 55

invasive SCC of the cervix most often develops in women between what ages?

Back 55

40-45

Front 56

SCC of cervix spreads most commonly by ___ and _____?

Back 56

direct expansion
lymphatics

Front 57

what is the most common early complaint of SCC of the cervix?

Back 57

vaginal bleeding

Front 58

what may be used for resection of very early microinvasive tumors

Back 58

cone biopsy

Front 59

SCC of the cervix that has lymph node involve what means of dissection?

Back 59

hysterectomy

Front 60

what is used for treatment of advanced cases of SCC of the cervix?

Back 60

hysterectomy / radiotherapy

Front 61

what is the most invasive cancer of the female genital tract for females btwn 55-60 yrs?

Back 61

endometrial carcinoma

Front 62

endometrial carcinoma is associated mainly with what 2 conditions?

Back 62

1) prolonged estrogen stimulation (HRT, infertility)

2) endometrial hyperplasia

Front 63

endometiral glands within myometrium/muscles of uterus = ?

Back 63

adenomyosis

Front 64

what is the most common site of enodmetriosis?

Back 64

ovaries

Front 65

teh presence of bengn endometiral glands and stroma in a location outside of the uterus?

Back 65

endometriosis

Front 66

what % of women are affected by endometriosis?

Back 66

10%

Front 67

what are the 4 means of spread of endometriosis?

Back 67

1) regurgitation thru fallopian tubes
2) lymphatic
3) hematogenous ( liver and lungs)
4) coelomic (fluid-filled)

Front 68

early signs of endometriosis appear as ____ nodules on implanted surfaces?

Back 68

reddish/blue

Front 69

ectopic glands bleed during menstrual cycle ---> hemosiderin deposition ---> fibrosis---> repeated hemorrhage leading to?

Back 69

chocolate cysts

Front 70

pain upon menses?

Back 70

dysmenorrhea

Front 71

what is the primary complaint in 1/3 of endometriosis patients?

Back 71

infertility

Front 72

benign tumors of smooth muscle of the uterus and possibly the most common tumor of humans?

Back 72

Fibroids = Uterine Leiomyoma

Front 73

what % of women over 30 may have fibroids (including small tumors)?

Back 73

75%

Front 74

which of the following is NOT a feature of leiomyoma?
1) firm
2) pale-gray
3) well demarcated
4) encapsulation
5) whorled masses
6) large = 30 cm = 10-11 inches

Back 74

4) they are NOT encapsulated

Front 75

fibroids may found in uterine tissue:
1) intramural
2) ______
3) subserosal
4) _______

Back 75

2) submucosal
4) peunclated (w/in uterus body)

Front 76

typically fibroids are slow growing except during ____?

Back 76

pregnancy

Front 77

large fibroids are removed by _____
small fibroids are removed by _____

Back 77

myomectomy
hysterectomy

Front 78

the average female has ____ fibroids?

Back 78

6.5

Front 79

what are the 2 most common lesions of the ovaries?

Back 79

cysts
tumors

Front 80

formerly called Stein-Leventhal Syndrome

Back 80

Polycystic Ovarian Disease

Front 81

pt. presents with:
-numerous follicle cysts on ovary
-oligo-menorrhea
-persistent anovulation
-obesity
-hirsutism
-virilism

Back 81

PCOD (polycystic ovarian disease)

Front 82

what is uncommon for PCOD?
1) infertility
2) endometrial hyperplasia
3) adenocarcinoma
4) cervical SCC
5) prolonged HRT

Back 82

4) cervical SCC

Front 83

what is the tx for PCOD?

Back 83

hormonal tx to interrupt excessive androgen production

Front 84

occurs when an ovary twists upon itself leading to infarction and necrosis?

Back 84

ovarian torsion

Front 85

80% of ovarian neoplasms are (malignant or benign)?

Back 85

benign

Front 86

what is the 3rd most common gynecologic malignancy with a high mortality rate?

Back 86

ovarian cancer

Front 87

which of the following are not risk factors for ovarian cancer?
1) oral contraception
2) BRCA 1/2 mutations
3) family history
4) gonadal dysgenesis
5) undergone tubal ligation
6) nullparity

Back 87

1)
5)

Front 88

what is a metastatic tumor from the GI tract (usually colon) to the ovaries?

Back 88

Krukenberg tumor

Front 89

what are the most frequent cell origin of ovarian tumors?

Back 89

surface epithelial cells (65-70%)

Front 90

ovarian teratoma is an example of what cell origin type of ovarian tumor?

Back 90

germ cell

Front 91

what are the malignant type of teratomas?

Back 91

immature

Front 92

Cystadenofibromas are _____ in nature?

Back 92

malignant

Front 93

Apart from Suface Epthelial / Germ cell derived ovarian tumors...the other 2 origins are ___ and ___

Back 93

1) sex cord stroma
2) metastases from non-ovarian primary tumor

Front 94

what origin type of ovarian tumors usually affect those over 20 yrs. old?

Back 94

Surface Epithelial cells

Front 95

the 3 categories of teratomas are:
1) mature
2) _____
3) _____

Back 95

2) immature (malignant)
3) monodermal

Front 96

most benign teratomas are referred to as _______

Back 96

dermoid cysts

Front 97

what % of teratomas undergo malignant change?

Back 97

1%

Front 98

what is the % of teratomas that are more common in women and present bilaterally?

Back 98

10-15%

Front 99

thyroid tissue in ovary?

Back 99

sturma ovarii

Front 100

carcinoid is a monodermal teratoma that secretes ____

Back 100

serotonin (5HT)

Front 101

what is the % of recognized pregnancies resulting in spontaneous abortions?

Back 101

10-15%

Front 102

what is the main reason for spontaneous abortions?

Back 102

lack of vascular supply to fetus

Front 103

where doe most ectopic pregnancies occur ____ % due to ____ as the most common predisposing factor?

Back 103

90%
PID (pelvic inflammatory disease)

Front 104

what is the concern for early detection of ectopic pregnancy?

Back 104

shock

Front 105

characterized by hypertension, proteinuria, and edema (preeclampsia) during pregnancy?

Back 105

Toxemia of pregnancy

Front 106

wha tsi teh main concern for those involving eclempsia during pregnancy?

Back 106

DIC
seizing

Front 107

what 2 courses are the only definitive tx for toxemia?

Back 107

balanced diet
antihypertensives

Front 108

what disease is characterized by :
1) hydatidiform moles
2) invasive moles
3) choriocarcinoma

Back 108

Gestational Trophoblastic Disease

Front 109

a cystic swelling of the choionic villi with some vairable trophoblastic proliferation?

Back 109

hydatidiform moles

Front 110

what are 2 types of hydatidiform moles?

Back 110

complete
partial

Front 111

a mole with swelling of villi and some feal parts are present?

Back 111

partial hydatidiform mole

Front 112

a malignant epithelial neoplasm of trophoblastic cells derived fro any form of previous pregnancy

Back 112

choriocarcinoma

Front 113

abnormal pregnancy due to presence of hydatidiform mole or anomalous growth with non-viable embryo?

Back 113

molar pregnancy

Front 114

what type of mole contains all chromosomes from father?

Back 114

complete

Front 115

what type of mole contains a triploid karyotype with 69 chromosomes?

Back 115

69

Front 116

2% of these moles become choriocarcinoma?

Back 116

complete

Front 117

what type of moles have:
trophoblastic prolif = focal / slight
Atypia = absent
HCG = not so elevated?

Back 117

parial