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180 Cards in this Set
- Front
- Back
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A 21-year-old female presents complaining of a gray, flattened, wart-like lesion on the vulva. She states that her ex-boyfriend was treated for syphilis
What is the most likely diagnosis? |
Condyloma lata
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Thinning of the epidermis with superficial hyperkeratosis (like cigarette paper)
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Lichen sclerosus
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Eipthelial thickening with significant hyperkeratosis
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Lichen simplex chronicus
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thin, flat, and moist Condyloma
Associated with secondary syphilis |
Condylomata lata
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condylomas are NOT precancerous but may coexist with VIN grade I
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Vulvular condylomas
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is present in 75%-90% of vulvar Carcinoma cases
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HPV 16
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Often appear as areas of leukoplakia in any regions of the vulva or adjacent skin
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Vulvar Tumors
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Vulvar Tumor often associated with underlying adenocarcinoma of the apocrine sweat glands.
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Paget disease of the vulva
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Accounts for approximately <10% of malignant tumors of the vulva
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Malignant melanoma
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What pathogen produces a curdy white vaginal discharge and is present in 5% of normal adult women AND is the MOST COMMON FORM of vaginitis?
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Candida albicans
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thin, homogenous vaginal discharge with a malodorous, fishy amine odor, especially with 10% KOH (potassium hydroxide) and clue cells
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Gardnerella vaginalis
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second most common type of vaginitis
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Trichomonas vaginalis
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Mothers who took ethylstilbestrol (DES) during pregnancy where at risk for what type of cancer
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Vaginal Intraepithelial Neoplasia
Vaginal clear cell adenocarcinoma |
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5 y/o presenting features include multiple polypoid masses resembling a “bunch of grapes” often protruding out of the vagina
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Sarcoma Botryoides
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A rare variant of rhabdomyosarcoma
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Sarcoma Botryoides
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Associated with mucopurulent or purulent vaginal discharge, usually
noted as leukorrhea, and not a precancerous lesion |
Cervicitis
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What is the MOST COMMON sexually transmitted pathogen responsible for acute cervicitis?
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Chlamydia trachomatis
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50 years ago was the most frequent form of cancer in women and a major cause of cancer-related deaths worldwide
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Cervical carcinoma
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Cervical precancerous changes are graded How?
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CIN I: Mild dysplasia-Low-Grade SIL
CIN II: Mod dysplasia-High-Grade SIL CIN III: Severe dysplasia-High-Grade SIL CIS: Carcinoma in situ-High-Grade SIL |
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Often due to extension of SCC of the cervix, Vagina is rarely the primary site
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Vaginal Squamous cell carcinoma
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list some Risk factors for CIN and Invasive Carcinoma
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- Early age at first intercourse
- Multiple sexual partners - A male partner with multiple previous sexual partners - Persistent infection by “high-risk” papillomavirus |
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what are the 2 most types of High-Risk HPV and were implicated in neoplasms of the penis
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16, 18
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what are the 2 most types of Low-Risk HPV
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6, 11
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what is the most likley type of Invasive Carcinoma of the Cervix
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squamous cell carcinomas
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Peak incidences of CIN and invasive carcinoma are at what ages
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30 years
45 years |
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Growth of the basal layer of the endometrium down into the myometrium, uterine wall becomes thickened w/ reactive hypertrophy of the myometrium, and clinically may present w/ menorrhagia menorrhalgia or primary dysmenorrhea
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Adenomyosis
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excessive bleeding at the time of the menstrual period
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Menorrhagia
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painful menstruation or pelvic pain accompanying menstruation, sometime a symptom of endometriosis
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Menorrhalgia
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pain present just prior to or at the onset of menstruation
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Primary dysmenorrhea
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irregular bleeding between the periods
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Metrorrhagia
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Usually caused by an excess of estrogen relative to progestin and In time, may give rise to carcinoma of the endometrium
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Endometrial Hyperplasia
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What is the term used to describe irregular uterine bleeding between the periods (normal menstrual cycles)?
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Metrorrhagia
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While performing a GYN exam on a 35-y/o BF when you note that the uterus appears to be asymmetrically enlarged on your bimanual examination of the uterus.What test would you perform? MOST LIKELY diagnosis? What's your major concern
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Pregnancy test
Leiomyoma Leiomyosarcoma |
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Infection of the Uterus, usually limited to bacterial, arising after delivery, miscarriage. retained products of conception are the usual predisposing influence
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Acute Endometritis
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Infection of the Uterus, associated with, Chronic gonorrheal pelvic disease, tuberculosis, retained gestational tissue, and (IUDs)
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Chronic Endometritis
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The MOST FREQUENT CANCER of the female genital tract in the US, appears between 55 and 65 years and frequently arises from endometrial hyperplasia
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Endometrial Carcinoma
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Most common benign uterine tumors in females often referred to as “fibroids” and Commonly found as multiple masses
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Leiomyoma
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Uterine tumors that arise from myometrium NOT leiomyomas,
usually always solitary lesions recurrence is common, 40% 5-year survival rate |
Leiomyosarcoma
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List the risk factors for ovarian cancer
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Family history
Nulliparity High fat diets Anovulation Some reduction of risk with estrogen use |
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What is the pathological process that increases the risk of an ectopic pregnancy and infertility in women following pelvic inflammatory disease (PID)?
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ascending infection from the genital tract
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Inflammation of the fallopian tubes nearly always bacterial in origin
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Salpingitis
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What is the most common pathogen associated with (PID), infertility and ectopic pregnancy
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Chlamydia
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What are the pathogens associated with Postpartum Salpingitis
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Streptococci
Staphylococci |
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What pathology of the fallopian tube occurs, leading to a significant cause of infertility and ectopic pregnancy
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scarring and blockage
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Elevated levels of _________ have been found in 70%-90% of women with surface epithelial tumors also used in monitoring response to therapy
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CA 125
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A23-y/o pregnant F at approx 12 weeks into perform a vaginal ultrasound to confirm an intrauterine pregnancy. The ultrasound discovers the presence of the fetus, but there is no cardiac activity. What type of spontaneous abortion does this represent?
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Missed Abortion
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fetus and placenta are completely expulsed and woman resumes normal menses
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Complete Abortion
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cervical dilation and expulsion of some fetal parts with some being retained
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Incomplete Abortion
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death of a fetus which remains in utero
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Missed Abortion
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cervical bleeding but the cervix does not dilate and pregnancy may continue uneventfully
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Threatened Abortion
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Occurs as a result of an abnormally functioning placenta or abnormal materno-placental interaction
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Toxemia of Pregnancy
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which type of Toxemia of Pregnancy is it if no seizures occur
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preeclampsia
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which type of Toxemia of Pregnancy is it if seizures occur (potentially fatal)
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eclampsia
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which type of Toxemia of Pregnancy may lead to disseminated intravascular coagulation (DIC)
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Full blown eclampsia
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congenital absence of the breast
No breast tissue, nipple, or aureola |
Amastia
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development of more than 2 breasts
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Polymastia
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breast tissue without nipple (occasionally found in the axilla)
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Accessory breast
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additional breast along the milk line (as in cats and dogs)
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Supernumerary breasts
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supernumerary nipples without glands
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Polythelia
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most common inflammatory disease of the breast, usually occurs during lactation
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Acute Mastitis
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Diffuse or localized edema and/or erythema, pain, tenderness to palpation, possible purulent discharge from the nipple
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Acute Mastitis
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What are the most common pathogens of Acute Mastitis
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Staph and Strep
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Which of the following is the most common pathogen responsible for acute mastitis
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Staphylococcus aureus
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The most common benign tumor of the female breast, increased estrogen activity is thought to play the primary role, usually the third decade of life
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Fibroadenoma
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Breast mass that is freely moveable nodules, 1–10 cm in diameter, may enlarge late in the menstrual cycle and during pregnancy
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Fibroadenoma
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Breast mass that is usually 3-4 cm, but most grow large to massive in size ‘leaf-like’ tumors usually benign, may become malignant and less common than fibroadenomas
About 15% of the malignant tumors tend to metastasize to different sites |
Phyllodes Tumor
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neoplastic papillary growth within a duct, usually lactiferous ducts or sinuses, serous or bloody nipple discharge, rarely nipple retraction
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Intraductal Papilloma
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second only to lung cancer as the leading cause of cancer death in women
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Breast Carcinoma
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Cirrhosis of the liver, with inability of the liver to metabolize estrogens
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hyperestrinism
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Enlargement of the male breast, may result from estrogen excess, most important cause of hyperestrinism
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Gynecomastia
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Typically, cancer affects the _______breast slightly more than the _______
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Left more than Right
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Tumors within the breast are more prevalent where
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Upper outer quadrant 45%-50%
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What is believed to be a high-risk factor for breast carcinoma?
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Jewish ethnicity
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list some higher Risks factors for breast Breast Cancer
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- Female gender
- > 30 years of age - Caucasions (especially of Jewish ethnicity) - Nulliparity - Late age first pregnancy |
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Nearly all tend to become adherent to the pectoral muscles or deep fascia of the chest wall as well as adherence to the skin, Causing retraction or dimpling of the skin or nipple
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Breast Carcinoma
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skin thickens around exaggerated hair follicles
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Peau d’orange
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Breast Cancer metastasize Most via which lymphatics
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axillary lymph nodes
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Breast Carcinomas are Mostly
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Invasive Ductal Carcinomas
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Men with _______ or ________ gene mutations have been associated with increased risk of breast cancer and prostate cancer
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BRCA1 or BRCA2
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Oversecretion of GH in a child leads to elongation of the long bones. This thereby causes the child to be very tall. What is the type of tumor responsible for this pathology? What is this condition known as?
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Somatotrophic adenoma
Giantism |
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Symptoms of polyuria, polydipsia, and a positive water deprivation test
Treatment with substitution therapy with ADH is effective |
diabetes insipidus
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an autoimmune response to TSH receptors on the gland associated with thyroid storm
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Graves Disease
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heart palpitations, tachycardia, nervousness, tremors, and HEAT INTOLERANCE and exophthalmos
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Hyperthyroidism
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What disease is characterized by hyperfunction of thyroid, exophthalmos, and pretibial myxedema
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Grave’s Disease
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What are the primary features seen in a patient with Graves Disease?
Skin? Muscle mass and weight? Gender Prevalence? Cardiac? |
Warm, moist, pretibial myxedema
Decrease Female Tachycardia, palpitations |
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most common cause of hypothyroidism in the US
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Hashimoto’s thyroiditis
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An autoimmune disorder, commonly associated with other autoimmune diseases (Sjogren’s Syndrome, myasthenia gravis)
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Hashimoto’s thyroiditis
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Disease associated with a Greatly increased free T4 and greatly reduced TSH
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Grave’s Disease
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sensitivity to cold, fatigue, constipation, chronic sleepiness, difficulty thinking/concentrating, hair loss, dry skin, myxedema, decreased cardiac stroke volume
,Bradycardia |
Hypothyroidism
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Most common form of thyroid Cancer. most commonly caused by radiation exposure or genetic
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Papillary carcinoma
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what are the Four Interesting Facts of the Parathyroid Glands
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4 glands
4th (and 3rd) branchial arch 40 mg in weight 4 mm in diameter |
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what is the most common cause of Hyperparathyroidism
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parathyroid adenoma
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Hyperparathyroidism results in what electrolyte imbalance
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Hypercalcemia and hypophosphatemia
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what is the most common cause of Hypoparathyroidism
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accidental removal during thyroidectomy
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Which of the following would be MORE LIKELY to develop nephrolithiasis (Kidney stones)?
Hyperparathyroidism Hypoparathyroidism |
Hyperparathyroidism
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Severe or prolonged Hyperparathyroidism can result in what skeletal or renal pathology
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loss of calcium from bones
formation of stones in kidneys |
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truncal obesity, “moon” facies, and “buffalo hump”
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Hypercortisolism (Cushing Syndrome)
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Chronic Adrenocortical Insufficiency
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Addison’s Disease
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Hyperpigmentation of the skin Hyperkalemia, hyponatremia, volume depletion, and HYPOTENSION
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Adrenocortical Insufficiency (Addison’s Disease)
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Which of the following are associated with hypertension, weight gain, and development of abdominal striae?
Cushing’s syndrome Addison’s disease |
Cushing's Syndrome
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most common extracranial solid tumor of childhood Occurs during first 5 years of life, and Most arise from the adrenal medulla
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Neuroblastoma
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An acquired autoimmune disorder of neuromuscular junction characterized by muscle weakness where antibodies are directed against the acetylcholine receptors.
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Myasthenia Gravis
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Characterized by eyelids often show ptosis (drooping) Facial muscle weakness produces a bland expression
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Myasthenia Gravis
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Which skeletal muscles disease is a X-linked recessive disorder that affects young boys between the ages of 3-5 years of age?
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Duchenne-Type Muscular Dystrophy
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mild form of Duchenne’s MD
A X-linked recessive disorder Onset is later, typically 5-10 years of age Not necessarily associated with mental retardation |
Becker’s Muscular Dystrophy
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Severe wasting of skeletal muscles leads to severe deformities Usually associated with mental retardation, appears in preschool (ages 3-5), By age of 10-12 the boys are usually confined to a wheelchair
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Duchenne-Type Muscular Dystrophy
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The The second most common genetic muscle disease
Autosomal dominant disease, Symptoms usually appear in adulthood (10-30 years) |
Myotonic Muscular Dystrophy
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Facial muscle weakness with “hatchet face” appearance
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Myotonic Muscular Dystrophy
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lateral curvature of the spine
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Scoliosis
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exaggerated forward curvature of the thoracic spine
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Kyphosis
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brittle bone” disease
Group of hereditary conditions characterized by abnormal development of type I collagen (Most are autosomal dominant disorders) |
Osteogenesis imperfecta
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“marble bone disease”
Caused by deficient osteoclastic activity Both autosomal recessive and dominant forms |
Osteopetrosis
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impaired maturation of cartilage in the developing growth plate.
Major cause of dwarfism and most common disorder for growth plates |
Achondroplasia
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Which of the previously covered diseases is a result of a hereditary condition characterized by abnormal development of type I collagen?
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Osteogenesis imperfecta
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A bacterial infection of bones
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Osteomyelitis
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Osteomyelitis most often originates in the
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metaphysis
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Osteomyelitis In children , the infection is most often associated with
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bacteremia
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Osteomyelitis In adults, the infection often occurs as a
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complication of bone fractures or bone surgery
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skeletal disorder characterized by low bone mass and micro-architectural deterioration.Is the most common bone disorder seen in clinic, occurs in elderly, mainly women.
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Osteoporosis
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““softening of the bones” due to inadequate mineralization of the bone matrix of growing bones is known as Rickets
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Osteomalacia
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benign lesions of the bone
Most common in the head and neck Are not invasive but may cause cosmetic or mechanical problems (expanding nature not invasive |
Osteoma
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benign lesions of fibroblasts
The problems arise from the expansive nature of the tumors Compress surrounding tissues causing pain or neurologic symptoms |
Nonossifying fibroma
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Which of the following types of tumors is the second most common type of malignant bone tumors in children?
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`
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Where does Ewing’s sarcomas typically arise
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`
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Which type of tumors is the MOST COMMON type of malignant bone tumors in children?
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`
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AKA: Degenerative Joint Disease (DJD)
Most common form of joint disease |
Osteoarthritis
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Slow progression of the erosion of the articular cartilage of the weight bearing joints and fingers
Initial changes are seen in the articular cartilage |
Osteoarthritis
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Chronic SYSTEMIC Iinflammation of joint disease
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Rheumatoid Arthritis
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Does osteoarthritis typically involve the joint of the elbow?
Does rheumatoid arthritis? |
No
Yes |
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accumulation of blood between the skull and the dura
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Epidural hematoma
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Which of the following intracranial hemorrhages are usually a result of damage to the middle meningeal artery from a temporal bone fracture?
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Epidural
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Which of the following intracranial hemorrhages may continue to develop for days to weeks after an accident?
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Subdural
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Which of the following intracranial hemorrhages is often associated with an immediate loss of consciousness followed by a interval of consciousness, then may rapidly deteriorate
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Epidural
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affects the entire brain due to lack of perfusion often during shock
Infarct size depends on time without adequate blood supply |
Global Ischemia
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usually caused by a thrombosis in a cerebral artery. More commonly called a stroke or a cerebrovascular accident (CVA)
Most common site at the trifurcation of the middle cerebral artery |
Regional Ischemia
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A 67-year-old male is presented to the Emergency Department due to a sudden inability to talk or move any of the muscles on the left side of his body. What type of event does this represent?
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Regional
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infection of CSF between the pia mater and arachnoid usually caused by hematogenous spread
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Leptomeningitis
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infection of the dura mater usually due to contiguous infection of the sinus or mastoids
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Pachymeningitis
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Blunt trauma from front or back or when skull hits fixed object (windshield) is typical cause
Repeated trauma has a cumulative effect (Boxers |
Subdural Hematoma
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Accumulation of blood between the dura and the arachnoid
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Subdural Hematoma
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Venous blood is lower pressure so will clot faster (**clotting continues increasing size of mass)
Gradual signs of cerebral compression occurring hours to days over even weeks after head injury. |
Subdural Hematoma
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Bleeding between the arachnoid membrane and the pia (surface of the brain)
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Subarachnoid Hemorrhage
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Ruptured congenital ‘berry’ aneurysms of the circle of Willis are another significant cause
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Subarachnoid Hemorrhage
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swan-neck deviation
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Rheumatoid Arthritis
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caused byLyme Disease caused by
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Borrelia burgdorferi
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Most common presentation is of acute gout is painful swelling where
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of the 1st MTP joint
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benign, well circumscribed tumor consisting of well differentiated adipocytes
If seen, are subcutaneous on upper trunk, neck, upper extremities Treat by leaving alone, or by local excision |
Lipoma
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Most commonly affected areas of Rhabdomyosarcoma are
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the arms and legs
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Benign lesion that present as well-defined mobile nodules in the dermis or subcutaneous tissue
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Lipoma
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Which of cancer forms from striated muscle and is most commonly found in children?
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Rhabdomyosarcoma
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second most common sarcoma of adulthood
Composed of malignant fat cells |
Liposarcoma
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small aneurysms at the base of the brain in the Circle of Willis
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Berry aneurysms
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Usually the vertebral, basilar, and internal carotid arteries, Usually confined to larger cerebral arteries
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Atherosclerotic Aneurysms
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Contusion of the cortex of the brain with bleeding from the ruptured intracerebral vessels, A common complication of nearly all forms of head trauma, May be a complication of hypertension
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Intracerebral Hemorrhage
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Essentially a hemorrhagic ‘stroke
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Intracerebral Hemorrhage
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Third most common cause of death in the US, Most important manifestation is stroke
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Cerebrovascular Disease
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Cerebrovascular Disease result due to
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atherosclerosis of the cerebral arteries
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Most important cause of Meninges in neonates
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Group B streptococci and Escherichia coli
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Forms as a result of deposits of beta amyloid which form plaques in the cerebral cortex
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Alzheimer’s Disease
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Most important in older children, adolescents, and young adults
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Neisseria meningitides
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A 23-year-old male present with fever, chills, headache, and nuchal rigidity. You suspect that he may have bacterial meningitis. Which of the following CSF findings would support you
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Cloudy CSF, low glucose, elevated protein
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Characteristics of Multiple Sclerosis:
More common in males or females? Common presenting sign? What part of the brain is typically affected? |
Females
Loss of touch with paresthesias White matter |
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Which of the following neurodegenerative diseases is characterized by a loss of pigmented neurons in the substantia nigra of the midbrain?
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Parkinson’s Disease
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An autosomal dominant neurodegenerative disorder, Primarily affecting striatal neurons and the cerebral cortex
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Huntington’s Disease
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Cogwheel rigidity is found on physical exam
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Parkinson’s Disease
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Characteristic “pill-rolling” tremor
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Parkinson’s Disease
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Leading cause of preventable blindness worldwide
Etiology: Chlamydia trachomatis |
trachoma
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nearsightedness
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myopia
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Farsightedness of Old Age
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Presbyopia
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farsightness
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hyperopia
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an infection of a hair follicle or sweat gland in the eyelid
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Hordeolum (stye)
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blockage of a gland in the eyelid
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chalazion
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most often found in children suffering from atopic dermatitis
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Allergic otitis externa
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External Ear Tumors of the elderly are most commonly on the
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auricle
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A 5-year-old male is seen in your clinic for concerns about decreased hearing is the child’s left ear. Upon physical examination, you note what appears to be a small 2-3 mm nodule in the TM. Based on this physical finding, you suspect that the problem is:
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Cholesteatoma
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Bone deposits on both sides of the oval window, The new bone encompasses the bones of the inner ear preventing movement
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Otosclerosis
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A 5-year-old male is seen in your clinic for concerns about decreased hearing is the child’s left ear. you note what appears to be a small 2-3 mm nodule in the TM. Based on this physical finding, you suspect that his hearing loss ___________ in nature.
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Conductive:
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Disease is associated with hydrops of the endolymphatic system of the cochlea
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Meniere’s Disease
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Type of hearing loss resulting from cochlear abnormalities Caused by repetitive noise trauma
Some medication may cause |
Sensory
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Type of hearing loss resulting from a lesions of the cranial nerve (least common form of hearing loss)May be from a neuroma of cranial nerve VIII, multiple sclerosis, or cerebrovascular accidents
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Neural
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