Pathology - Exam 3 - Uterus, Fallopian Tubes, Gonads, & Prostate

Front 1

A woman's endometrium is increasing in thickness and volume. You suspect she is in what phase of the menstrual cycle?

Back 1

proliferative phase

Front 2

A woman's endometrium is increasing in thickness and volume. What is the endometrium responding to?

Back 2

increasing serum estrogen levels

Front 3

During the proliferative phase of the menstrual cycle, the pituitary is secreting what hormone?

Back 3

FSH

Front 4

The LH surge which occurs mid menstrual cycle produces what?

Back 4

ovulation

Front 5

Ovulation, produced by the LH surge in mid menstrual cycle, initiates what phase of the menstrual cycle?

Back 5

secretory phase

Front 6

Progesterone induced glandular secretions and pre-decidual changes of the uterine stroma are characteristic of what stage of the menstrual cycle?

Back 6

secretory phase

Front 7

The secretory phase of the menstrual cycle produces changes in the uterus in anticipation of what?

Back 7

implantation of a fertilized ovum

Front 8

Necrosis and sloughing of the endometrium down to the basal layer occurs because of what hormonal changes?

Back 8

declining progesterone and estrogen levels

*this happens when a fertilized ovum does not implant

Front 9

Cervical mucus is air-dried on a glass slide. It has a crystalline or "ferning" pattern. This indicates what?

Back 9

estrogen predominance

Front 10

Cervical mucus is air-dried on a glass slide. It has an amorphous appearance. This indicates what?

Back 10

progesterone predominance

Front 11

The character of cervical mucus can be used to do what?

Back 11

differentiate between the 2 major causes of amenorrhea (pregnancy vs anovulation)

*amenorrhea = absence of menstrual periods

Front 12

Pregnancy causes amenorrhea because of...

Back 12

increased progesterone

*amenorrhea = absence of menstrual periods

Front 13

Anovulation causes amenorrhea because of....

Back 13

increased estrogen

*amenorrhea = absence of menstrual periods

Front 14

The vast majority of cervical malignancies are

Back 14

squamous cell carcinoma

Front 15

WORLDWIDE, the most common malignancy of the female genital tract is

Back 15

invasive squamous cell carcinoma of the cervix

**WORLDWIDE capitalized because there is a different one in the syllabus for US >:{

Front 16

True or False: Cervical neoplasia is 100% curable if detected early.

Back 16

True.

Front 17

What are the 3 bottom line risk factors for cervical malignancies?

Back 17

-early onset of sexual activity
-number of sexual partners
-promiscuity of sexual partner

Front 18

In actuality, cervical cancer is

Back 18

an infectious STD

Front 19

What are the 2 agents felt to be responsible for cervical cancer?

Back 19

human papilloma virus (HPV)

herpes virus (HSV II) <-less common

Front 20

What is considered a premalignant precursor lesion to cervical cancer?

Back 20

dysplasia

Front 21

Dysplasia/neoplasia (related to cervical carcinoma) virtually always begins where?

Back 21

at the boundary between the squamous epithelium of the cervix and the columnar epithelium of the endocervical canal

Front 22

Growth of invasive squamous cell carcinoma of the cervix, by local extension, can involve what 4 things?

Back 22

bladder
ureter
rectum
vagina

Front 23

Metastases of invasive squamous cell carcinoma of the cervix occur primarily via

Back 23

lymphatics

Front 24

Death caused by invasive squamous cell carcinoma of the cervix usually results from what?

Back 24

renal failure due to obstruction of the ureter(s)

(*because the neoplasm can grow and involve the ureters)

Front 25

The presence of functional endometrial tissue outside of the uterus is called

Back 25

endometriosis

Front 26

The most common location of ectopic functional endometrial tissue is

Back 26

in the ovary and scattered throughout the peritoneal cavity

Front 27

Red-blue to yellow-brown nodules located on peritoneal surfaces of involved tissues describes the appearance of what condition

Back 27

endometriosis

(nodules are ectopic functional endometrial tissue)

Front 28

Cyclic bleeding associated with endometriosis induces what

Back 28

reactive fibrous adhesions with consequent problems of pelvic visceral distortion

Front 29

You overhear a doctor describing large "chocolate" cysts in a patient's ovaries. You know that this woman has what condition?

Back 29

endometriosis

Front 30

The 2 most frequent symptoms associated with endometriosis are

Back 30

abdominal pain (freq around time of menses)

infertility

Front 31

Pelvic pain and dysmenorrhea due to periuterine adhesions are associated with with condition

Back 31

endometriosis

Front 32

When are most endometrial polyps identified?

Back 32

during the postmenopausal period

(can occur at any age)

Front 33

Endometrial hyperplasia refers to what

Back 33

increased proliferation of the endometrium with a resulting increase in endometrial volume

Front 34

Clinically, endometrial hyperplasia causes what?

Back 34

abnormal or excessive bleeding (spotting or menorrhagia)

Front 35

Endometrial hyperplasia is associated with

Back 35

prolonged or excessive estrogen stimulation

*this was BOLDED in the syllabus!

(so estrogen secreting ovarian tumors and exogenous estrogen administration can cause it!)

Front 36

How can endometrial hyperplasia be treated?

Back 36

periodic interruption of estrogen stimulation of the endometrium with progesterone

Front 37

IN THE US, the most commonly occurring female genital malignancy is

Back 37

endometrial carcinoma


*IN THE US capitalized because there is another listed for worldwide >:{

Front 38

95% of endometrial carcinoma cases occur when?

Back 38

after menopause

Front 39

The most common symptom of endometrial carcinoma is

Back 39

postmenopausal uterine bleeding

*this is bolded in the syllabus!

Front 40

The etiology of endometrial carcinoma is

Back 40

prolonged or excessive estrogen stimulation

Front 41

Obesity, diabetes, hypertension, and infertility are all risk factors for

Back 41

endometrial carcinoma

Front 42

The most common tumor in females, which is estimated to affect 25% of women during their reproductive life, is

Back 42

leiomyoma (benign smooth muscle tumor)

Front 43

Circumscribed, discrete, tan-white, rubbery spheroids with whorled cut surfaces are

Back 43

leiomyomas (benign smooth muscle tumors) of the myometrium

Front 44

Leiomyomas tend to ____ (increase or decrease?) in size after menopause. Why?

Back 44

decrease
decreased estrogen

**rarely disappear completely though

Front 45

Although many are asymptomatic, symptoms that may occur with a leiomyoma of the myometrium include... (3)

Back 45

abnormal menstrual bleeding
size of the tumor
pain

Front 46

Salpingitis is usually due to either of what 2 things

Back 46

either gonococcal or chlamydia infections

Front 47

A patient has a fever and abdominal tenderness. Her symptoms appear to correlate with those of acute appendicitis however the patient has no appendix. You suspect what?

Back 47

salpingitis caused by gonococcal infection

*salpingitis caused by chlamydia infection are usually asymptomatic

Front 48

90% of ectopic pregnancies occur where?

Back 48

fallopian tube

Front 49

True or False: The majority of ectopic pregnancies have an underlying pathology.

Back 49

False.

in ~50% of ectopic pregnancies there is no underlying pathology identified

Front 50

Chronic salpingitis, peritubal adhesions, and tubular cysts or tumors are all predisposing factors for...

Back 50

ectopic pregnancy

Front 51

The most common cause of hematosalpinx is what?

why?

Back 51

ectopic pregnancy

because developing placental tissue is poorly anchored to the wall of the fallopian tube which results in hemorrhage

Front 52

A pregnant female patient presents with severe abdominal pain. She goes into shock and dies. You suspect...

Back 52

her pregnancy was ectopic and the placenta ruptured

Front 53

Rupture of the placenta in an ectopic pregnancy usually occurs when?

Back 53

2-6 weeks after pregnancy ensues

Front 54

In regard to the ovary, non-neoplastic masses are generally caused by...

Back 54

the development of cysts

Front 55

Ovarian cysts may be asymptomatic or they may present with...

Back 55

abdominal pain and/or abnormal menstrual cycles

Front 56

_____ cysts are extremely common and consist of one or more cysts up to 2 cm in diameter and are usually of no clinical significance

Back 56

follicle cysts

(of the ovary)

Front 57

What type of ovarian cyst is often due to excessive hemorrhage?

Back 57

corpus luteum

(hemorrhage is into a normal corpus luteum and can bleed into peritoneal cavity causing abdominal pain)

Front 58

The only true cyst of the testes is a...

Back 58

spermatocele - a cystic dilatation of epididymal ducts containing semen

Front 59

What is a hydrocele?

Back 59

a (testicular) "cyst" that contains serous fluid
can be result of trauma, infection, systemic edema, etc.

Front 60

______ are (testicular) cysts containing blood as the result of trauma or hemorrhagic diathesis

Back 60

hematoceles

Front 61

____ are (testicular) cysts containing lymphatic fluid (as result of lymphatic obstruction by tumor, parasites, etc.)

Back 61

chyloceles

Front 62

What are the 3 basic cell types native to the gonads?

Back 62

surface epithelial cells
sex cord/stromal cells
germ cells

Front 63

The third most frequent (do we really need to know 3rd? ugh) female genital tract malignancy is

Back 63

ovarian carcinoma

Front 64

Abdominal pain and distension, GI or urinary tract compression or invasion, and abdominal bleeding are all symptoms of

Back 64

ovarian neoplasms

*symptoms are due to size of tumor. unless endocrinologically active, ovarian tumors are otherwise asymptomatic

Front 65

Ovarian neoplasms tend to be most prominent when? And malignant forms tend to occur when?

Back 65

most prominent during reproductive years
malignant forms tend to occur pre or perimenopausally

Front 66

True or False: Family history of ovarian tumors does not appear to increase risk of ovarian neoplasia.

Back 66

False.

The risk of ovarian neoplasia appears to be increased in women with a family history of ovarian tumors

Front 67

True or False: Women who have borne children are more at risk for ovarian neoplasia than those who have not.

Back 67

False

Women who have not borne children are at higher risk for ovarian neoplasia

Front 68

True or False: Estrogen does not appear to play a role in ovarian neoplasia.

Back 68

True.

Front 69

Painless enlargement of the testis is caused by..

Back 69

testicular neoplasms

Front 70

In the 15-34 year age group, the most common neoplasm of males are...

Back 70

testicular tumors

(*14% of all cancer deaths)

Front 71

Failure of a testis to descend into the scrotum from its embryologic position in the abdominal cavity is called...

Back 71

cryptorchidism

Front 72

Ovarian neoplasms most commonly derive from what cell type?

Back 72

surface epithelial cells

Front 73

Low abdominal pain and distension that is complicated by GI and urinary symptoms characterize...

Back 73

surface epithelial tumors of the ovary

Front 74

Malignant surface epithelial ovarian neoplasms grow ___ (slowly/fastly?) and are often not recognized until they

Back 74

grow slowly
often not recognized until they have already spread

Front 75

Peritoneal seeding of surface epithelial ovarian neoplasms may cause..

Back 75

massive ascites

Front 76

Which type of gonadal tumor have the potential of endocrine function?

Back 76

those that are derived from sex cord/stromal cells of the gonad

Front 77

Tumors derived from sex cord/stromal cells of the gonads may produce ...

Back 77

androgens or estrogens

Front 78

Ovarian tumors that are derived from sex cord/stromal cells tend to be ____ (benign/malignant?)

Back 78

malignant

Front 79

Testicular tumors that are derived from sex cord/stromal cells tend to be ____ (benign/malignant?)

Back 79

benign

Front 80

98% of testicular neoplasms are derived from what cell type?

Back 80

germ cell

Front 81

Ovarian tumors that are derived from germ cells tend to be ____ (benign/malignant?)

Back 81

benign

(except in young girls)

Front 82

Testicular tumors that are derived from germ cells tend to be ____ (benign/malignant?)

Back 82

malignant

Front 83

_____ is the most common testicular tumor (50%) and is most prevalent in the 4th and 5th decade

Back 83

seminoma

Front 84

Bulky, firm, lobulated, tan-yellow tumors without necrosis or hemorrhage are...

Back 84

seminomas

Front 85

95% of germ cell tumors in the ovary are

Back 85

mature cystic teratomas (dermoid cysts)

Front 86

What does this describe? "They most often arise in young adults, are unilateral, and usually less than 10 cm. in size. They may be found as an asymptomatic adnexal mass on routine pelvic exam or patients may complain of irregular periods. Since they are prone to torsion and infarction, patients may also present with abdominal pain"

Back 86

mature cystic teratomas (dermoid tumors)

Front 87

A metastatic tumor in the ovary that arose from a primary site (classically the GI tract but also the breast or pelvic organs) is referred to as

Back 87

Krukenberg tumor

Front 88

A male presents with low back pain. He describes symptoms similar to urinary tract infections. He probably has...

Back 88

prostatitis

*which can also be asymptomatic

Front 89

A relative imbalance between androgens and estrogens due to increasing estrogen levels that occur with increasing age can lead to what condition

Back 89

benign prostatic hyperplasia

**excess estrogen sensitizes the prostatic tissue to effects of testosterone

Front 90

What tissue is most susceptible to benign prostatic hyperplasia?

Back 90

periurethral tissue

Front 91

Spongy, nodular enlargement of the periurethral tissue which causes symptoms related to partial urinary obstruction or urine retention characterizes what condition

Back 91

benign prostatic hyperplasia

Front 92

True or False: There does not appear to be a causal relationship between benign prostatic hyperplasia and subsequent development of prostatic cancer.

Back 92

True.

Front 93

True or False: If a male is going to get prostatic carcinoma, it is likely to occur before the age of 50.

Back 93

False.

Unusual before the age of 50, prostatic carcinoma increases in frequency with advancing age so that prostatic cancer occurs in up to 70% of men by the age of 80

Front 94

The most common malignancy in males is

Back 94

prostatic carcinoma

Front 95

On rectal examination, you palpate a hard irregular nodularity. The patient has reported urinary obstruction. You suspect...

Back 95

prostate cancer

**urinary obstruction usually doesn't occur til late in the course of the disease