Pathology - Female Gu - Uterus And Ovary

Front 1

What is the MCC of dynsfunctional uterine bleeding?

Back 1

an Anovulatory cycle

Front 2

how does an anovulatory cycle cause DUB?

Back 2

the lack of ovulation means a progesterone-secreting corpus luteum is not produced. +++ estrogen means the endometrium keeps growing until it just can't anymore so some of it breaks down. Remember, progesterone is what changes it from proliferative to secretory then sloughing offf

Front 3

postmenopausal change of endometrium?

Back 3

cystic dilation of glands and atrophy

Front 4

acute endometritis from?

Back 4

retained pregnancy products

Front 5

chronic endometritis from?

Back 5

PID/IUDs, see lyphocytes and plasma cells

Front 6

Most important causes of non-neoplastic disorders?

Back 6

adenomyosis and endometriosis

Front 7

most common finding in women w endometriosis?

Back 7

infertility

Front 8

Etiology of endometriosis?

Back 8

retrograde mesntruation/metastasis

Front 9

What is adenomyosis?

Back 9

endometrial strom that has ectopically entered myometrium, causing focal hemorrhage during menstruation

Front 10

endocrine abnormalities in woman with endometriosis?

Back 10

upregulated estrogen production

Front 11

Neoplastic/premalignant endometrial conditions?

Back 11

polyps and hyperplasia

Front 12

Associated with tamoxifen and antiestrogen therapy?

Back 12

endometrial polyps

Front 13

treatment of endometrial polyps?

Back 13

estrogen

Front 14

associated with high, prolonged level of estrogen stimulation in endometrium?

Back 14

endometrial hyperplasia

Front 15

molecular alteration of endometrial hyperplasia?

Back 15

PTEN tumor suppressor inactivation

Front 16

What is cowden syndrome?

Back 16

mutation of PTEN gene causing harmatomas and visceral cancers. AD

Front 17

estrogen related endometrial carcinoma?

Back 17

type I, PTEN and PIK3CA gene mutations implicated

Front 18

proliferative endometrium like appearance in endometrial carcinoma?

Back 18

Type I

Front 19

carcinoma associated with endometrial hyperplasia?

Back 19

endometrial carcinoma Type I

Front 20

arises on an atrophic endometrial background?

Back 20

endometrial carcinoma Type II

Front 21

genetic implication of the most common Type II endometrial carcinoma subtype

Back 21

serous carcinoma - p53 mutation

Front 22

menopausal status of type I vs tyoe II endometrial carcinoma?

Back 22

type 1 - pre/perimenopaulsa, type 2 - postmenopausal

compare contrast pg 109

Front 23

which carcinoma has a higher tumor grade?

Back 23

Type 2, serous and clear cell

Front 24

polypoid, exophytic, bulky, fleshy mass that pay protrude through cervical OS is made of what elements?

Back 24

malignant mixed mullerian tumor: epithelial and stromal elements derived from ONE CELL

Front 25

80 yr old woman with vaginal bleeding and mass protruding from cervical OS?

Back 25

malignant mixed mullerian tumor, highly malignant

Front 26

malignant endometrial stroma with benign glands?

Back 26

adenocarcinoma

Front 27

tumor with cells resembling endometrial stroma?

Back 27

stromal tumor

Front 28

assocuated with t(7:17)?

Back 28

stromal sarcoma, high grade in endometrium

Front 29

most common tumor in women?

Back 29

leiomyoma of myopetrium.

Front 30

metastasis of leiomyomas are called?

Back 30

benign metastasizing leiomyom or disseminated peritoneal leiomyomatosis if there are multiple small nodules in peritoneum.

Front 31

what is STUMP?

Back 31

smooth muscle Tumors of Uncertain Malignant Potential

Front 32

which variant of leiomyoma is seen in young or pregnant woman?

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mitotically active leiomyoma

Front 33

40% of leiomyomas are associated with?

Back 33

chromosomal abnormality

Front 34

leiomyosarcoma percursor?

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they generally arise DE NOVO, must treast with hysterectomy

Front 35

most common non-neoplastic lesion of the fallopian tube?

Back 35

ectopic pregnancy

Front 36

#1 killer among female genital malignancies?

Back 36

ovarian cancer in US

Front 37

Most common lesions of ovaries?

Back 37

functional cysts and neoplasms

Front 38

functional cysts include?

Back 38

follicular cysts and luteal cysts

Front 39

symptoms associated with ovarian pathology?

Back 39

bleeding and pelvic masses

Front 40

Oophoritis can be from?

Back 40

infection like PID or autoimmune

Front 41

what are follicular and luteal cysts?

Back 41

unruptured graafian follicles or ruptured ones that seal immediately

Front 42

What is POS?

Back 42

polycystic ovarian syndrome

Front 43

Pathophys of POS?

Back 43

increased LH causes ovaries to overproduce testosterone which is converted by aromatase to estradiol and estrone

Front 44

What is a high risk factor for POS?

Back 44

obesity because it means increased FAT and aromatase to convert testosterone and estradiol

Front 45

What is a follicular cysts?

Back 45

distention of an unruptured fraafian follicle

Front 46

Hemorrhage into a persistent corpus luteum?

Back 46

corpus luteum cyst, will regress spontaneously

Front 47

theca-lutein cyst due to?

Back 47

gonadotropin stimulation from chroiocarcinomas and moles (therefore often bilateral and multiple)

Front 48

what is a chocolate cyst?

Back 48

ovarian blood containing cyst from endometriosis which varies with menstural cycle

Front 49

Woman presents with amenorrhea, hirsutism, obesity, and hirsutism. What is the appearance of her ovaries and how old is she?

Back 49

2x normal ovary size with cyst-like string of pearls, she is postmenopausal (this is POS)

Front 50

mutation of what gene increase susceptibility to ovarian cancers? age distribution?

Back 50

BRCA1 less than 70 yrs and BRCA2, and Lynch syndrome

Front 51

what is lunch syndrome?

Back 51

HNPPC inherited mismatch repair defect

Front 52

Classification of ovarian tumors?

Back 52

based upon most probably cell of origin: endometrial )surface coelomic epithelium), germ, or ovarian stroma.

Front 53

Which ovarial tumors are bilateral?

Back 53

Me, Tara, and E (metastatic and epithelial

Front 54

Which ovarian tumors are unilateral?

Back 54

STROGER (Stroma and Germ cell tumors)

Front 55

Ovary: columnar epithelium with cilia and no nuclear stratification?

Back 55

benign epithelial tumor

Front 56

ovary: papillae, few mitotic figures, no stromal infasion?

Back 56

PAPILLAE think borderline epithelial tumor

Front 57

ovary: multifocal, with stromal invastion and nuclear atypia and psammoma bodies?

Back 57

malignant epithelial tumor

Front 58

Most common ovarian cancer?s

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1) epithelial (30%)
2) mucinous (25%) and endometriod (20%).

less common ar clear cell and brenner tumors

Front 59

epithelial cells w abundant clear cell cytoplasm arranged in sheets, tubules or cysts... assocaited with what other cancer?

Back 59

endometriosis and endometrioid carcinoma (this is clear cell adenocarcinoma)

Front 60

Rare, UNILATERAL (90%) adenofibromas. Histo?

Back 60

urothelium with coffee bean nuclei: this is a brenner tumor

Front 61

CA-125?

Back 61

elevated in serous and endometrioid cancers of ovary

Front 62

markers for ovarian cancers?

Back 62

COPS: CA-125, Osteopontin, Preoteomics

These are all plasma cell markers

Front 63

Patient with BRCA mutations standarly undergo what procedure?

Back 63

prophylactic oophorectomy

Front 64

Types of ovarian neoplasms and prevalence?

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1) epithelial
2) Germ cell
3) stromal

Front 65

Most germ cell tumors of ovary are?

Back 65

Benign cystic teratomas aka dermoid cysts BILATERAL

Front 66

ovary: papillae, few mitotic figures, no stromal infasion?

Back 66

PAPILLAE think borderline epithelial tumor

Front 67

ovary: multifocal, with stromal invastion and nuclear atypia and psammoma bodies?

Back 67

malignant epithelial tumor

Front 68

Most common ovarian cancer?s

Back 68

1) epithelial (30%)
2) mucinous (25%) and endometriod (20%).

less common ar clear cell and brenner tumors

Front 69

epithelial cells w abundant clear cell cytoplasm arranged in sheets, tubules or cysts... assocaited with what other cancer?

Back 69

endometriosis and endometrioid carcinoma (this is clear cell adenocarcinoma)

Front 70

Rare, UNILATERAL (90%) adenofibromas. Histo?

Back 70

urothelium with coffee bean nuclei: this is a brenner tumor

Front 71

CA-125?

Back 71

elevated in serous and endometrioid cancers of ovary

Front 72

markers for ovarian cancers?

Back 72

COPS: CA-125, Osteopontin, Preoteomics

These are all plasma cell markers

Front 73

Patient with BRCA mutations standarly undergo what procedure?

Back 73

prophylactic oophorectomy

Front 74

Types of ovarian neoplasms and prevalence?

Back 74

1) epithelial
2) Germ cell
3) stromal

Front 75

Most germ cell tumors of ovary are?

Back 75

Benign cystic teratomas aka dermoid cysts BILATERAL

Front 76

What are monodermal germ cell tumors?

Back 76

ovarian tumors that have undergone specialization so they do weird ectopic things

Front 77

Types of monodermal neoplsms of ovary?

Back 77

struma ovarii, carcinoid, or both.

Front 78

What is struma ovarii?

Back 78

mature thyroid tissue

Front 79

What monodermal neoplsm is usually bilateral?

Back 79

metastatic intestinal carcinoid.

Front 80

Solid and cystic with hemorrhage and necrosis in prepubertal and yong women?

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immare monodermal neoplasm (teratomas are common in women in reproductive years)

key word is solid and age. Teratomas are cystic

Front 81

Which germ cell neoplasms are benign?

Back 81

teratomas and monodermal (except immature which is malignent)

Front 82

Most common malignant germ cell tumors?

Back 82

dysgerminoma then yolk sac tumors

Front 83

Dysgerminomas are simliar to what in males?

Back 83

seminomas

Front 84

Radiosensitive, no HCG production, solid mass?

Back 84

dysgerminoma

Front 85

rapidly developing pelvic mass with alpha feto protein and alpha natitrypsin. Histology?

Back 85

schiller duval bodies with hyaline droplets

Front 86

High HCg, often mixed w other tumors in ovary and unresponsive to chemotherapy. What age commonly?

Back 86

under 10, this is choriocarcinoma.

Front 87

What is a gonadoblastoma?

Back 87

germ cell + sex-cord stromal derivative. Usually with Y chromosome or associated with Turner's

Front 88

tumor with sertoli, leydig, granulosa, and theca structures?

Back 88

sexcord-stromal tumor which can be feminizing or masculinizing

Front 89

Coffee bean nuclei with granulose and theca cells post menopause?

Back 89

granulosa-theca cell tumors

Front 90

Call-exner bodies?

Back 90

small glandlike structures that are pink material surrounded by granulosa cells. Seen in gRanulosa-thecal cell tumors

Front 91

Thecomas assocaited with what other neoplasm?

Back 91

because they elaborate lost of estrogen: endometrial hyperplasia or carcinoma

Front 92

elevated serum levels of inhibin?

Back 92

granulosa cell tumor or another sex cord stromal tumor

Front 93

Juvenile granulosa cell numor presents w?

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precocious sex dvelopment because of ++ estrogen

Front 94

What is meigs syndrome?

Back 94

asciates, right sided hydrothorx, and ovarian tumor > 6cm

Front 95

fibroblasts and plump spindle cells with lipid?

Back 95

tibroma-thecoma from ovarian stroma

Front 96

presentation of fibroma thecoma?

Back 96

LARGE MASS with pain in uterus, usually unilateral. Benign.

Front 97

Reinke crystalloids. What is elevated?

Back 97

this is a leydic cell tumor, elevated 17-ketosteroids

Front 98

Krukenberg tumor?

Back 98

bilateral metastases of gastric carcinoma (see signet ring cells)

Front 99

metastasis to ovary is usually waht distribution?

Back 99

bilateral