• Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off
Reading...
Front

How to study your flashcards.

Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key

Up/Down arrow keys: Flip the card between the front and back.down keyup key

H key: Show hint (3rd side).h key

A key: Read text to speech.a key

image

Play button

image

Play button

image

Progress

1/127

Click to flip

127 Cards in this Set

  • Front
  • Back
this is epithelium invaginates and fuses to form bilateral Mullerian ducts
Coelmoic epithelium
Coelomic epithelium gives rise to what structures
endometrium
fallopian tube mucosa
ovarian surface epithelium
When the distal portions of the Mullerian ducts fuse they become what structures
Uterus and upper portion of the vagina
Coelomic epithelium is derived from which germ layer
mesoderm
germ cell are derived from what germ layer
endoderm
where are germ cells originally located in the fetus
yolk sac
all fetuses start off with what reproductive structure
Mullerian duct - need MIS to digress this process
three common organisms associated with PID
Neisseria gonorrhoeae (#1)
chlamydia
actinomyces
an ascending infection of the female genital tract characterized by: pain, tenderness, fever, vaginal discharge
PID
what two things can PID result in
female infertility
ectopic pregnancy
cysts in these glands located on the medial aspect of the labia minora
Bartholin gland cyst
sexually transmitted infection with squamous epithelial proliferation (exophytic) that is non pre-malignant and has koilocytosis (perinuclear cavitation)
condyloma accuminatum
which HPV subtypes are associated with condyloma accuminatum
HPV 6 and 11
most common malignant neoplasm of the vulva
squamous carcinoma
precursor lesions associated with development into squamous carcinoma of the vulva
vulvar intraepithelial neoplasia (VIN)
premalignant epithelial changes associated with HPV 16 and 18 and smoking in young women
VIN
known as carcinoma in-situ of the vulva
Bowen's disease
what are two vulvar epithelial changes seen in older women that are pre-malignant
lichen sclerosus
squamous hyperplasia
associated with atrophy of the over epidermis and underlying chronic inflammation of the vulva in an older woman
lichen sclerosus
associated with hyperkeratosis and mild inflammation of the dermis in an older woman
squamous hyperplasia
invasive squamous cell carcinoma of the vulva associated with a large fungating mass that does not metastasize
verrucous carcinoma
vulva seen with red, elevated, crusted lesions
extramammary Paget disease
what is different about the Paget's disease of the vulva than the breast
Paget's disease in the vulva is only 30% associated with underlying invasive adenocarcinoma
what do the tumor cells of Paget's disease stain positive for
Mucin
this lesion is associated with women whose mothers took diethystilbesterol during pregnancy
adenosis (vagina)
what is adenosis associated with
increased risk for adenocarcinoma of the vagina
fibroepithelial poly in the vagina
squamous epithelium overlying edematous myxois stroma with bizarre nuclei
what are most squamous cell carcinomas of the vagina associated with
HPV infection
what part of the vagina does SCC most commonly affect
upper 1/3 of the vagina
what must be checked before diagnosis of primary vaginal carcinoma is made
cervical carcinoma must be excluded first
what is adenocarcinoma of the vagina associated with
diethylstilbeserol (DES) exposure
most common malignant vaginal tumor in children
sarcoma botryoides (embryonal rhabdomyosarcoma)
child presents with benign epithelium of the vagina with closely packed spindle-shaped cells underneath that stain positive for desmin
sarcoma botryoides
most common location cervical carcinomas develop
squamocolumnar junction
endocervix - columnar cells
ectocervix - squamous cell
what is microglandular hyperplasia of the cervix associated with
birth control pills - progesterone
obstructed endocervical glands
nabothian cysts
risk factors for squamous neoplasia of the cervix
multiple sex partners
HPV infection
smoking
differentiate what HPV 16, 18, and 31 are associated with
16 - precancerous lesions of vulva, vagina, and cervix
18 - adenocarcinoma and small cell carcinomas of the cervix
31 - cervical neoplasia
associated with koiocytoic atypia
squamous cell HPV infection
accounts for approximately 90% of cervical carcinomas
invasive carcinoma
precancerous lesions of the cervix
cervical intraepithelial neoplasia
I - mild dysplasia
II - moderate
III - severe dysplasia known as carcinoma in-situ
three invasive carcinomas of the cervix
large cell nonkeratinizing
large cell keratinizing
small cell carcinoma
most common invasive squamous carcinoma of the cervix
large cell nonkeratinizing
how do invasive squamous cell carcinomas spread
lymphatics
what is cervical adenocarcinoma associated with
HPV 18
what cells are seen in Pap smear
squamous cells (superficial, intermediate, parabasal)
endocervical
endometrial
when should endometrial cells not be seen on Pap smear
after day 12 of cycle
what else is Pap smear useful for detecting besides cervical dysplasia
disturbances of endocrine function or assessing effecting of hormonal therapy - best site to sample is lateral vaginal wall
best site to sample for hormone function during Pap smear
lateral vaginal wall
differentiate low and high grade squamous intraepithelial lesions (SIL) on Pap smear
low grade - associated with mild dysplasia or CIN (I), low risk HPV subtypes
high grade - contain significant parabasal atypia
differentiate ASCUS and AGCUS
ASCUS - atypically squamous cells - most of these are low grade and don't meet criteria for SIL
AGCUS - atypical glandular cells - most have SIL, endometrial, or endocervical lesions
functionalis and basalis of the endometrium
functionalis - upper 2/3 that slough with hormonal variations
basalis - lower 1/3 in which regeneration occurs following menstruation
which hormones are involved with proliferation and differentiation of endometrial cycle
estrogen - proliferation
progesterone - differentiation (gland secretion and stromal predecidualization)
part of the endometrial cycle in which the glands become complex with pseudostratified epithelium
proliferative phase - under estrogen stimulation
what day of the cycle is associated with subnuclear vacuoles and evidence that ovulation has occurred
day 17
what day of the cycle does menstrual phase begin
day 28
Arias-Stella reaction (gestational endometrium)
bizarre hypersecretory changes with nuclear hyperchromatism and pleomorphism
prolonged unopposed administration of what hormone may result in glandular hyperplasia of the endometrium
estrogen
taking this substance results in prominent stromal precedidual changes
oral contraceptives
endometrial infection associated with group A streptococi
acute endometritis
associated with plasma cells in the endometrium
chronic endometritis
4 causes of chronic endometritis
1. chronic PID
2. TB
3. retained placental fragments
4. IUD
most common cause of dysfunctional uterine bleeding
anovulatory cycles - found near menarche and menopause
common cause of postmenopausal uterine bleeding
endometrial polyps
endometrial glands and stroma occurring outside the uterus
endometriosus
3 common locations of endometriosus
1. ovaries
2. pelvic peritoneum
3. appendix
what should you think of in women with dysmenorrhea, pelvic pain, that is infertile
endometriosus
general cause for endometrial hyperplasia
prolonged estrogen levels with decreased/absent progesterone activity
causes of endometrial hyperplasia
1. functioning granulosa and theca cell tumors of ovary
2. exogenous estrogen use
3. abnormalities of adrenal cortical function
% risk of adenocarcinoma in complex hyperplasia with atypia of the endometrium
30%
postmenopausal carcinoma associated with increased estrogen (DM, obesity, HTN, infertility, late menopause)
endometrioid adenocarcinoma
what other metaplasia is common in endometrioid carcinomas
squamous metaplasia - adenosquamous carcinoma
tumor with mixture of carcinoma and sarcoma in endometrium
mixed Mullerian tumor
differentiate homologous and heterolgous Mixed Mullerian tumors
homologous- sarcoma are tissues normally found in uterus - leiomyosarcoma
heterologous - sarcoma tissues are not normally found in uterus (osteosarcoma, chondrosarcoma, rhabdomyosarcoma)
what does prognosis of esdometrial adenocarcinomas depend on
both grade and stage
endometrial stroma is present within multiple vascular spaces in the myometrium
stromal sarcoma
presence of benign endometrial glands and stroma within myometrium
adenomyosis
patients present with pelvic pain, abnormal menstrual bleeding, and dysmenorrhea; enalarged uterus found on exam due to smooth muscle hyperplasia
adenomyosis
most common tumor of the uterus
leiomyoma
Do leiomyosarcomas tend to arise from preexisting leiomyomas
No, arise de novo
acute salpingitis
fallopian tube infection with chlamydia or gonorrhoeae
what is chronic salpingitis associated with
infertility
ectopic pregnancy
IUDs are associated with increased risk of PID via what organisms
actinomyces
woman presents with amenorrhea, vaginal bleeding, and pelvic pain; what test should be done
B-hCG to look for ectopic pregnancy
inflammation of the uterus, fallopian tubes, and/or ovaries
PID
ovarian cyst associated with invagination of surface (coelomic) epithelium
inclusion cyst
ovarian cysts linked by granulosa cells
follicular cells
ovarian cysts lined by luteinized cells that occasionally rupture causing Mittelschmerz
luteal cysts
associated with the triad of obesity, hirsutism, and secondary amenorrhea
polycystic ovaries
ovarian nodule associated with being yellow and large; mild virilization may be present
luteoma of pregnancy
three main groups of ovarian tumors
1. surface epithelial tumors (#1)
2. sex cord-stromal tumors
3. germ cell tumors
differentiate serous and mucinous tumors of the ovary
serous - more common, epithelium of oviduct (columnar), bilateral, psammoma bodies, serous fluid
mucinous - endocervical mucosa (mucinous), may be much larger, less commonly bilateral
what is associated with pseudomyxoma peritonei
mucinous tumors with borderline histology
endometriois tumors of the ovary are associated with what
20-30% of patients have co-existent carcinoma of the endometrium
what is thought to cause pseudomyxoma peritonei
appendix is primary tumor, then metastasizes to ovary and peritoneum
Brenner tumor of ovary
epithelial nests surrounded by fibrous stroma
most common functioning tumors in the ovary
sex cord-stromal tumors
this ovarian tumor is associated with producing estrogen and having numerous Call-Exner bodies resembling small follicles
granulosa cell tumor
Mieg's syndrome
triad of:
ovarian fibroma
ascites
right-sided pleural effusion
solid yellow ovarian tumor that produces estrogen
thecoma
ovarian tumor with spindle cells of stromal origin predominating
fibroma
most common ovarian cancers in children
germ cell tumors
germ cell tumor associated with children, nests of germ cells (proliferation of ova), and lymphocytes
dysgerminoma
most common germ cell tumor
mature teratoma
these germ cell tumors contain all three germ cell layers
mature teratoma
ovarian tumor associated with secretion of thryoid hormones
struma ovarii
immature teratoma
malignant neoplasm composed of wide variety of tissue elements that tends to metastasize early
ovarian tumor associated with a-FP and Schiller-Duval body
endodermal sinus tumor
ovarian tumor that resembles tissues of the yolk sac microscopically
endodermal sinus tumor
these ovarian tumors secrete high levels of hCG
embryonal choriocarcinoma
massive enlargement of the ovaries bilaterally with signet ring that stain positive for mucin
Krukenberg tumor
common sites that metastisize to the ovary
breast
GI (Krukenberg)
inflammation of the fetal membranes
chorio-amnionitis
infection of the umbilical cord, often accompanied by what
funisitis
chorioamnionitis usually precedes
Dizygotic twins always have separate placentas
**
monochorionic is associated with what
monozygotic twins
abnormal adherence of the placenta to the uterine wall due to absence of decidua basalis
placenta accreta
invasion of the myometrium by placental villi
placenta increta
implantation of the placenta overlying the cervix, may cause serious bleeding
placenta previa
premature separation of the normally situated placenta
abruptio placentae
differentiate complete and partial hydatidiform mole
complete - No embryo present, two parental chromosomes (46XX)
partial - fertilization of an egg by two sperm (69 XXX,XXY)
neoplasm of both cytotrophoblast and synctialtrophoblast with no chorionic villi present; hematogenous metastases occur early and are widespread
choriocarcinoma
associated with triad of HTN, proteinuria, and edema
preeclampsia
associated with HTN, proteinuria, edema, convulsions, and DIC
eclampsia
when does preeclampsia typically occur
during third trimester of first pregnancy
initiating event for preeclampsia
placenta ischemia resulting in arterial constriction
treatment for severe cases of preeclampsia
delivery