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58 Cards in this Set
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CIN-I |
few atypia Cytoplasmic holos in lower epithelial cells |
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CIN-II |
Progressive atypia Immature cell above lower third |
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CIN-III |
Diffuse atypia loss of maturation Immature basal cells upto epithelial surface |
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LSILs Characteristics |
Productive HPV infection No disruption of cell cycle Regresses spontaneously |
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HSILs Characteristics |
Cell cycle deregulation Non productive HPV infection Progresses to invasive carcinoma |
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Stage 0 |
Carcinoma in situ |
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Stage I |
Carcinoma confined to the cervix |
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Stage Ia |
Preclinical carcinoma Diagnosis only by microscope |
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Stage Ia1 |
Stromal invasion No greater than 3mm No wider than 7mm |
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Stage Ia1 |
Microinvasive carcinoma |
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Stage Ia2 |
Maximum depth of invasion greater than 3 mm,width not more than 7mm |
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Stage Ib |
Greater than Ia2 |
Maximum depth of invasion greater than 3 mm,width not more than 7mm |
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Stage II |
Extends beyond the cervix but not to the pelvic wall. Involves the vagina but not the lower third |
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Stage III |
Extends onto pelvic wall Involves the lower third |
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Stage IV |
Extends beyond true pelvis |
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Risk factors for CIN |
1. High risk HPV 16 or 18 2. Multiple sexual partners 3. Young age at first intercourse |
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Low risk HPV |
Type 6,11 |
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High risk HPV |
Type 16 and 18 and above |
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High risk HPV pathogenesis |
E6,E7 > suppression of p53 and RB > Carcinoma in situ |
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Peak incidence of cervical carcinoma |
45 years in women |
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Morphology of SCC |
Nests of malignant squamous epithelium keratinized or non keratinized |
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Diagnosis of CIN |
1. Visual inspection by acetic acid 2. Cytological screening PAP test 3. Cervical biopsy and histopathology 4. HPV DNA testing 5. Colposcopy when PAP test is abnormal |
5 tests |
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PAP smear |
Cytological preparation of exfoliated cellls |
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PAP smear stained |
Stained with Papanicolaou method |
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Schedule for PAP test |
First smear at 21 years or within 3 years of onset of sexual activity then annually. After age 30 with 3 consecutive normal results test in every 2 or 3 years |
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Papanicolaou grading |
Group I normal Group II atypical cell not malignant Group III suspension of malignancy Group IV few malignant cells Group V large number of malignant cells |
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Endometriosis |
Presence of ectopic endometrial tissue outside the uterus |
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Sites of endometriosis |
Ovaries Uterine ligaments Rectovaginal septum Laparotomy scars Cul de sac Pelvic peritoneum Intestine Appendix Mucosa of cervix Vagina Felopian tube |
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Endometriosis age group |
Age groups in active reproductive life,most often in 3rd and 4th decades |
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Pathogenesis of endometriosis |
Regurgitation theory Benign metastasis theory Metaplastic theory Progenitor cell theory |
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Regurgitation theory |
Retrograde mensuration |
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Clinical features of endometriosis |
Severe dysmenorrhoea Dysperunia Pelvic pain Pain on defecation Dysuria |
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Chocolate cyst |
In endometriosis,Distorted,cystic ovaries filled with brown fluid due to previous haemorrhage |
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Adenomyosis |
Presence of endometrial tissue within the uterine wall |
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Adenomyosis |
Menometrorrhagia |
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Leiomyoma/Fibroids |
Benign smooth muscle neoplasms of the uterus |
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Leiomyoma gross |
Intramural Submucosal Subserosal |
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Leiomyoma microscopic |
Whorled bundles of smooth muscle cells |
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Leiomyoma complications |
Abnormal uterine bleeding Urinary frequency Impaired fertility In pregnancy Spontaneous abortion Fetal malpresentation PPH |
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Ovarian tumors classification |
Surface epithelial stromal tumors Sex cord stromal tumors Germ cell tumors Metastatic from other sites |
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Surface epithelial stromal tumors |
Serous Mucinous Endometroid Clear cell Transitional cell (Brenner's) Epithelial stromal (adenosarcoma,MMM)
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SMECTE , benign borderline malignant |
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Sex cord stromal tumors |
Granulosa tumors Fibroma thecoma Thecoma FibrothecomaThecomaSertoli-Leydig cell tumorsSteroid tumors Sertoli-Leydig cell tumors Steroid tumors |
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Germ cell tumors |
Teratoma Immature Mature Solid Cystic Monodermal Dysgerminoma Yolk sac tumors Mixed germ cell tumors |
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Metastatic cancer from other sites |
Colonic,appendiceal Gastric icobiliary PancreaticobiliaryBreast Breast |
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Hormone producing tumors of ovary |
Granulosa theca cell- estrogen Sertoli-Leydig cell - androgen Choriocarcinoma - HCG |
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Causes of cystic mass in ovary |
Follicular and luteal cysts Polycystic ovary Serous cystadenoma Dermoid cyst |
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Polycystic ovaries |
Hyperandrogenism Menstrual abnormalities Polycystic ovaries Chronic anovulation Decreased fertility |
AMPAI |
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Polycystic ovaries |
Stein Leventhal Syndrome |
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Polycystic ovaries Risk factors |
Obesity Type II DM Premature atherosclerosis |
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Polycystic ovaries Pathophysiology |
Dysregulation of androgen biosynthesis Excessive androgen production |
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Benign cystic teratoma |
Germ cell tumors |
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Benign cystic teratoma |
Opaque gray White epidermis Hair shafts,tooth, calcification |
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Ovarian counterpart of seminoma of testis |
Dysgerminoma of ovary |
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Dysgerminoma |
Sheets and cords containing lymphocytes |
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Krukenberg tumors |
Metastatic gastrointestinal neoplasms to the ovaries |
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Krukenberg tumors |
Bilateral metastasis composed of mucin producing signet ring cancer cells |
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Meigs syndrome |
Ovarian tumors+hydrothorax+ascitis Fibrothecoma |
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Ovarian tumors markers |
Epithelial-CA125,CA72-4,CA19-9,CEA Germ cell - AFP,BETA HCG Sex cord stromal - Estradiol,Inhibin |
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