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58 Cards in this Set
- Front
- Back
Diagnosis?
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Hairy leukoplakia
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What is hairy leukoplakia associated with?
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HIV infection or other immunocompromised states. It is caused by EBV infection.
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What is the distinctive microscopic appearance of hairy leukoplakia?
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Hyperparakeratosis and acanthosis with "balloon cells" in the upper spinous layer.
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Diagnosis?
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Leukoplakia with invasive SCC
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What is the definition of leukoplakia?
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A white patch or plaque that cannot be scraped off and cannot be characterized clinically or pathologically as any other disease.
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What are patients with leukoplakia at risk for developing?
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Leukoplakia is precancerous and these patients are at risk for developing SCC.
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Diagnosis?
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Mucocele
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Describe the histology of mucocele.
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Cystic spaces filled with mucin and inflammatory cells such as macrophages.
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What is a ranula?
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Histologically, it is identical to a mucocele, but specifically refers to a mucocele when the duct of the sublingual gland is damaged.
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Diagnosis?
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Ranula
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Describe the epidemiology of nasopharyngeal carcinoma.
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a) Most common malignant tumor of the nasopharynx
b) Male dominant c) Increased incidence in China (adult) and Africa (children) |
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What is the cause of nasopharyngeal carcinoma?
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EBV
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What are the pathological findings associated with nasopharyngeal carcinoma?
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SCC or undifferentiated cancer that metastasizes to cervical lymph nodes.
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What is Candida albicans associated with in the female genital tract?
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It is a normal part of the vaginal microbiota and is a common cause of vaginitis. Risk factors include diabetes, antibiotics, pergnancy, and OCPs.
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What is Trichomonas vaginalis associated with?
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It is a flagellated protozoan that produces vaginitis, cervicitis, and urethritis.
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What is Treponema pallidum associated with?
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It is a gram negative spirochete that causes syphilis.
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What are the three types of syphilis?
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Primary: solitary painless indurated chancre.
Secondary: maculopapular rash on trunk, palms, soles. Tertiary: Neurosyphilis, aortitis, gummas |
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What is HSV-2 associated with?
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It is a virus that remains latent in sensory ganglia. It causes recurrent vesicles that ulcerate.
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How can HSV-2 be diagnosed?
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Tzanck preparation: Scrapings from base of ulcer yield multinucleated squamous cells with eosinophilic intranuclear inclusions.
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What non-cervical lesion is HPV associated with?
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Types 6 and 11 are associated with genital warts (condyloma acuminata).
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What are some obvious microscopic changes seen with HPV infection of the skin?
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Koilocytic changes in squamous epithelium.
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What are five different vulvular tumors?
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1) Papillary hidradenoma
2) Vulvar intraepithelial neoplasia 3) Squamous cell carcinoma 4) Extramammary paget's disease 5) Malignant melanoma |
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This is a biopsy from a red crusted vulvar lesion. What is the diagnosis?
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Extramammary Paget's disease forming intraepithlial adenocarcinoma. The malignant Paget's cells contain mucin (PAS +).
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Which vulvar carcinomas is HPV associated with?
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VIN which may then develop into SCC.
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How can malignant melanoma be distinguished from extramammary Paget's disease?
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MM is PAS negative.
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Describe the clinical picture of a patient with sarcoma botryoides.
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Also known as embryonal rhabdomyosarcoma, this is a grape-like mass protruding from the vagina of girls < 5 y/o.
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A patient whose mother was treated with DES for attempted abortion presents with vaginal adenosis. What is she at risk for developing?
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Clear cell adenocarcinoma.
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What does DES do?
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It inhibits mullerian differentiation leading to the persistence of remnants. This leads to vaginal adenosis which is a precursor lesion for clear cell adenocarcinoma.
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This is a vaginal biopsy, what is the diagnosis?
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Clear cell adenocarcinoma
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What is the transformation zone?
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The region in the cervix where the pH changes and the squamous metaplasia occurs. This are is particularly susceptible to dysplasia.
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What is the diagnosis?
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Normal cervical tissue
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What is the diagnosis?
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CIN II
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What is the diagnosis?
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CIN I
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What is the diagnosis?
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CIN III
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What is the diagnosis?
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Normal Pap smear
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What is the diagnosis?
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HSIL: CIN II
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What is the diagnosis?
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HSIL: CIN III
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What is the diagnosis?
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LSIL: CIN I
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What is the most common cause of death in cervical cancer?
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Renal failure due to cancer causing obstruction of the ureters.
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What is the most common cause of dysfunctional uterine bleeding?
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An anovulatory cycle.
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How does an anovulatory cycle cause dysfunctional uterine bleeding?
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Failure of ovulation results in prolonged, excessive, endometrial stimulation by estrogens with an absence of the progestational phase.
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What is the diagnosis?
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Endometriosis of the colon.
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Diagnosis?
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Endometriosis of the colon.
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What is adenoacanthoma?
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Endometrial carcinoma which contains glands as well as foci of squamous elements. (20% of endometrial carcinoma)
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What is the most common form of endometrial carcinoma?
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Adenocarcinoma.
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What are the two types of endometrial carcinoma and what are they associated with?
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Type I: increased estrogens, PTEN protein absent, well-differentiated, good prognosis.
Type II: endometrial atrophy, papillary serous Ca, poorly differentiated, poor prognosis. |
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What is a leiomyoma?
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A benign smooth muscle tumor that is relatively common, usually in multiples (fibroids), and respond to estrogen.
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What is a leiomyosarcoma?
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An uncommon, de novo tumor of the uterus. Malignancy depends on number of mitotic figures per field (> 5), tumors metastasize and poor prognosis.
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What may mucinous tumors of the ovary cause?
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They resemble endocervix or intestinal tissue, and due to secretion of mucin into the peritoneum, cause pseudomyxoma peritonei (jelly belly).
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Where do mucinous tumors of the ovary usually arise from?
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They usually arise from spread of pancreatic mucinous tumors.
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What is a teratoma?
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A dermoid cyst containing hair, tooth, cheesy material, thyroid tissue, and bone. Usually benign and contains at least 2 types of tissue.
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List the four types of germ cell tumors.
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Teratoma, choriocarcinoma, dysgerminoma, endodermal sinus tumor (yolk sac tumor)
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What markers do all germ cell tumors express?
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alpha-fetal protein, hCG, alpha1-antitrypsin
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What are some important findings in granulosa-theca cell tumors?
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Call-Exner bodies (follicles with coffee-bean nuclei), estrogen production, and Inhibin and Calretinin expression.
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How do complete hydatidiform moles develop.
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Loss of genetic material in ovum and either fertilization with a single sperm that undergoes chromosomal duplication or dispermy.
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How do partial hydatidiform moles develop?
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Fertilization of normal ovum with two sperm yielding triploidy.
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What are the critical abnormalities that occur in preeclampsia?
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Diffuse endothelial dysfunction, vasoconstriction (leading to HTN), and increased vascular permeability (resulting in proteinuria and edema).
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If preeclampsia develops to eclampsia, what may happen?
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HELLP syndrome. Hemolysis, Elevated Liver enzymes, and Low Platelet
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