Term
| Vulvitis can be many forms of vulvar infection caused by __________ or related to infection caused by _________ |
|
Definition
|
|
Term
| Is candida albicans a STD? What causes it? Describe the associated d/c. What predisposes a female? How is the dx made? |
|
Definition
-no, its caused by a common fungal organism
-thick, white d/c with pruritis
-pregnancy, oral contraceptives, abx, DM, immunosuppression
-Dx: visual exam, pap smear, wet mounts |
|
|
Term
| What is the most common sexually transmitted virus? |
|
Definition
|
|
Term
|
Definition
| dysplastic changes in mucosal epithelium that may be benign, premalignant, or malignant |
|
|
Term
| What are the low risk types of HPV? High risk? what are the vaccines? |
|
Definition
-6 and 11 (cause condylomata acumunata-- anogenital warts)
-16 and 18 (cause premalignant lesions and CA in cervix)
-Gardasil (6,11,16,18), cervarix (16 and 18) |
|
|
Term
| Does HPV go away on its own? |
|
Definition
| Yes, 90% will clear it in 10 years |
|
|
Term
| Which STD is characterized by painful red vesicles on vulva, vagina, cervix accompanied by fever, malaise, and tender inguinal lymph nodes? |
|
Definition
|
|
Term
| Why is HSV dangerous for pregnant women? |
|
Definition
| neonatal herpes infection is lethal in about 60% of affected infants |
|
|
Term
| Which mentioned STD is caused by a gram-negative bacteria? |
|
Definition
| gonorrhea (neisseria gonorrhoeae) |
|
|
Term
| Gonorrhea causes suppurative infxn of ______________/_________ |
|
Definition
vulvovaginal glands
(skene's and bartholin's) |
|
|
Term
| What are the most common sites of infxn of gonorrhea? |
|
Definition
|
|
Term
| What are some symptoms of gonorrhea? what can it lead to? |
|
Definition
-vaginal d/c, dysuria, intermenstrual bleeding
-may lead to tubal scarring and infertility |
|
|
Term
| about 1/2 of all women with gonorrhea also have __________ |
|
Definition
|
|
Term
| Which STD is caused by a spirochete bacteria? |
|
Definition
| syphilis (treponema pallidum) |
|
|
Term
| Characterize primary, secondary, and tertiary syphilis. |
|
Definition
-primary: painless sores (chancres) on genitals, rectum, tongue or lips
-secondary: skin rash and mucous membrane lesions
-tertiary: damage to many internal organs |
|
|
Term
| How is syphilis diagnosed? |
|
Definition
| by bacteria with lesions, serology, and PCR |
|
|
Term
| Why is syphilis so dangerous in pregnant women? |
|
Definition
| maternal transmission causes congeintal syphilis- still birth or serious tissue injury bc it can cross the placenta |
|
|
Term
| What is lichen sclerosis? What type of reaction can cause it? What does it put the pt at increased risk for? What population generally affected? |
|
Definition
-an atrophic epithelium with dermal fibrosis
-an autoimmune reaction may be involved
-increased risk of SCC
-usually older women |
|
|
Term
| What is lichen simplex chronicus? does it cause increased risk of SCC? |
|
Definition
-end stage of many inflammatory dermatoses
-epithelial thickening, expansion of stratum granulosum and surface hyperkeratosis
-usually no increased predisposition to CA |
|
|
Term
| Only 3% of all genital system cancers in women are carcinoma of the __________ |
|
Definition
|
|
Term
| 90% of the vulvar carcinomas are __________ and 90% of these are __________ related |
|
Definition
|
|
Term
| Non-HPV related vulvar SCC's occur in __________ women. They are well __________ and uni-__________. What are they often associated with? |
|
Definition
older
differentiated
focal
lichen sclerosis or other inflammatory conditions |
|
|
Term
| What type of carcinoma is paget dz of the vulva? how common is it? who does it usually effect? |
|
Definition
-a form of intraepithelial carcinoma
-rare, 5% of all genital CA
-usually 65-75 yoa |
|
|
Term
| WHat does paget dz of the vulva look like? How is it different from paget dz of the breast? |
|
Definition
-red, scaly, crusted plaque
-there is no invasion of the underlying dermis |
|
|
Term
| The vagina is seldom the site of __________ disease |
|
Definition
primary
-usually secondarily involved in spread of CA or infection arising in cervix, vulva, bladder, or rectum |
|
|
Term
| What is vaginitis? What are three things that cause it? |
|
Definition
-not serious inflammation of the vagina usually producing a vaginal d/c (leukorrhea)
-bacterial vaginosis: most common vaginal infection in women of childbearing age (gardenerella vaginalis)
-candida albicans
-trichomonas vaginalis (protozoan parasite that causes trichomoniasis, most common curable STD) |
|
|
Term
| What is the most common site of dz in the female genital tract? |
|
Definition
|
|
Term
| Most lesions in the cervix are caused by __________ and not serious. however the cervix is also the site of __________ |
|
Definition
|
|
Term
| 40% of cervicitis cases are caused by what microorganism? what is it often the cause of? what can it lead to if untreated? |
|
Definition
-chlamydia trachomatis
-most common bacterial std
-causes PID
-can lead to infertility |
|
|
Term
| What is premalignant dysplastic changes in epithelium that are not yet CA , but a precursor to carcinoma? |
|
Definition
-cervical intraepithelial neoplasia (CIN)
-almost all carcinomas arise in CIN, but not all cases of CIN progress to carcinoma |
|
|
Term
| What do the grades of CIN mean? |
|
Definition
| the higher the grade, the more likely the lesion will progress to carcinoma |
|
|
Term
| What is the main RF for cervical carcinoma? |
|
Definition
| infection by high risk HPV (16 and 18) |
|
|
Term
| 75% of cervical cancers are __________ arising from __________ |
|
Definition
|
|
Term
Mortality of cervical carcinoma is related to __________.
Why is it now not even in the top 10 causes of cancer death? |
|
Definition
|
|
Term
|
Definition
| when the foci of endometrium is found outside of the uterus. usually located on ovaries and peritoneum, ectopic implants respond to hormones and undergo cyclical bleeding which can cause scarring, pain, and sometimes sterility |
|
|
Term
| What is the regurgitation theory of endometriosis? |
|
Definition
| -menstrual back flow through fallopian tubes --> subsequent implantations at other sites |
|
|
Term
| What is endometrial hyperplasia? is it preneoplastic? what causes it? |
|
Definition
excessive endometrial proliferation
can be preneoplastic
caused by excessive estrogen, either endo- or exogenous |
|
|
Term
| what are some RF for endometrial hyperplasia? |
|
Definition
| anovulatory cycles, obesity, estrogen producing ovarian tumors, exogenous hormone use |
|
|
Term
| What are the three categories of endometrial hyperplasia? |
|
Definition
|
|
Term
| the more sever the hyperplasia, the greater the chance that it will evolve into __________ |
|
Definition
|
|
Term
| What are the two types of uterine tumors? |
|
Definition
-myometrial tumors (leiomyoma: benign and common; leiomyosarcoma: malignant, rare)
-endometrial tumors (carcinoma: malignant, common) |
|
|
Term
| What is a leiomyoma? another name for it? Tx? What are the sx? |
|
Definition
-benign tumor of smooth muscle
-uterine fibroids
-estrogen responsive
-may be asymptomatic OR: abnormal bleeding, impaired fertility, bladder compression, spontaneous abortion |
|
|
Term
| What is the most invasive cancer of the female genital system? |
|
Definition
|
|
Term
| Where do endometrial carcinomas typically arise? |
|
Definition
| in endometrial hyperplasia |
|
|
Term
| what are the RFs for endometrial carcinoma? |
|
Definition
| obesity, diabetes, HTN, infertility |
|
|
Term
| what are the symptoms of endometrial carcinoma? |
|
Definition
| leukorrhea, regularly irregular bleeding |
|
|
Term
| do endometrial carcinomas metastasize? |
|
Definition
| if they do it is often late |
|
|
Term
| What is a malignant smooth muscle tumor that is uncommon? |
|
Definition
|
|
Term
| What happens after leiomyosarcomas are removed oftentimes? Where do they metastasize? |
|
Definition
|
|
Term
| What type of cysts are ovarian cysts oftentimes? What are some sx if they rupture? |
|
Definition
follicular and luteal
intraperitoneal bleeding and acute abd symptoms |
|
|
Term
| What is another name for polycystic ovarian syndrome (PCOS)? |
|
Definition
|
|
Term
| what is the most common hormonal disorder in reproductive aged women? |
|
Definition
|
|
Term
| What do the ovaries look like in PCOS? |
|
Definition
| twice the normal size, gray-white cortex, with multiple subcortical cysts |
|
|
Term
| Excessive production of ___________ by the cysts causes oligomenorrhea, hirsutism, infertility, and sometimes obesity |
|
Definition
|
|
Term
| Most ovarian tumors are slow growing, benign, and rarely symptomatic, what are three examples? |
|
Definition
-benign cystic teratomas (dermoid cysts): derived from all 3 germ cell layers, but consist mainly of ectodermal tissue
-fibromas: usually <7 cm in diam
-cystadenomas: most commonly serous or mucinous |
|
|
Term
| What is the 5th leading cause of cancer-related deaths in the US? |
|
Definition
|
|
Term
| Why are ovarian cancers often fatal? |
|
Definition
-they are asymptomatic in the early stages and nonspecific in advanced stages
-usually advanced when they are diagnosed |
|
|
Term
| WHat are the two biggest risk factors for ovarian CA? |
|
Definition
nulliparity
family hx of endometrial, breast, or colon CA |
|
|
Term
| what decreases the risk for ovarian cancer? |
|
Definition
|
|
Term
| 5-10% of ovarian cancers are related to mutations in what genes? |
|
Definition
|
|
Term
| What is the name for the implantation of the fertilized ovum in any site other than the normal uterine location? |
|
Definition
|
|
Term
| What factors predispose to an ectopic pregnancy? |
|
Definition
| any factor that retards the passage of an ovum from oviduct to uterus predisposes to ectopic pregnancy (PID, tumors, endometriosis) |
|
|
Term
| Rupture of an ectopic pregnancy is a ___________/___________ |
|
Definition
|
|
Term
| What is pre-eclampsia characterized by? |
|
Definition
| new-onset HTN, proteinuria, and edema after 20 weeks of gestation |
|
|
Term
| What causes pre-eclampsia? |
|
Definition
| poorly developed uterine placental spiral arterioles, which decreases maternal blood flow to the placenta |
|
|
Term
|
Definition
generalized seizures in patient with preeclampsia
-usually fatal if untreated (but rare because of early recognition and treatment of preeclampsia) |
|
|
Term
| What are exaggerations of distortions of the cyclic breast changes that occur normally in the menstrual cycle? |
|
Definition
| fibrocystic changes in the breast |
|
|
Term
| What are non-proliferative and proliferative changes in the breast? |
|
Definition
-nonproliferative: cysts and fibrosis- most common change; dilation of ducts with formations of C's and F's (little to no increased risk for carcinoma)
-proliferative: atypical hyperplasia of ductular or lobular epithelium associated with a five-fold increase in breast carcinoma |
|
|
Term
| What is the most common benign neoplasm of the breast? |
|
Definition
|
|
Term
| what contributes to the development of fibroadenomas? when do they enlarge? when do they regress? are they cancerous? |
|
Definition
-increase estrogen activity
-late in the menstrual cycle and during pregnancy
-regress and calcify after menopause
-almost never become malignant |
|
|
Term
| WHat is the leading cause of cancer death in women between the ages of 15 and 54? |
|
Definition
|
|
Term
| When does the first sign of great cancer usually show up? |
|
Definition
| on a woman's mammogram before it can be felt or any other symptoms are present |
|
|
Term
| 96% of women who find and treat breast cancer early will be cancer free after ___________ years |
|
Definition
|
|
Term
| A woman's risk for development of breast cancer is increased up to 3-fold if one ___________-___________ relative is affected, and it is 10-fold if more than one is affected, and even more if its onset is in a person 40 yoa or younger |
|
Definition
|
|
Term
| Approx 20% of breast cancer cases have a polygenic or ___________ mode of inheritance |
|
Definition
|
|
Term
| 80% of breast CA's occur in the ___________, 10-15% in the ___________ |
|
Definition
|
|
Term
| SPread of breast cancers occur through ___________ and ___________routes |
|
Definition
|
|
Term
| when cancer presents as a palpable mass, ___________/___________ metastases in 40% of cases, when found on mammography less than 15% |
|
Definition
|
|
Term
| Prognosis of breast cancer is influenced by many things, but over expression of the ___________ proto-oncogene is one example |
|
Definition
|
|
Term
| Hereditary breast and ovarian cancers are due to mutations in what two genes? |
|
Definition
|
|
Term
| BRCA 1 and BRCA 2 are what type of genes? |
|
Definition
|
|
Term
| what is the inheritance for BRCA 1 and BRCA 2? |
|
Definition
| autosomal dominant (inherit one mutant copy and you need another mutation in the non-mutant to develop CA) |
|
|
Term
| BRCA1 and BRCA2 encode ubiquitously expressed nuclear proteins that are believed to maintain ___________/___________ by regulating DNA repair, transcriptional transactivation, and the cell cycle |
|
Definition
|
|
Term
| Tumor formation follows the _______-_______ hypothesis, that is, in order for tumors to form in patients who have inherited one germline mutant allele of BRCA1 and BRCA2, there must be somatic loss of function of the second normal allele |
|
Definition
|
|
Term
| Despite their ubiquitous expression, mutations in BRCA 1 and BRCA 2 predisposes predominantly to neoplasia of the _________ and ___________ |
|
Definition
|
|
Term
| Unlike some other TSGs (like APC), which have a major involvement in both familial and sporadic forms of cancer, BRCA1 and BRCA2 are mutated at a _____ frequency in sporadic breast cancer |
|
Definition
|
|
Term
| BRCA1 germline mutations in males have an increased risk for what? |
|
Definition
|
|
Term
| BRCA2 have an increased risk for CA's in males? What other CA's besides great and ovarian in both sexes? |
|
Definition
-breast and prostate
-pancreatic, bile duct, and GB CA |
|
|
Term
| For female carriers of BRCA 1 or BRCA 2 germ line mutation, the overall penetrance is higher for which mutation? |
|
Definition
BRCA1 (50-80%)
BRCA2 is only 10-40% |
|
|
Term
| Total bilateral mastectomy or bilateral salpingo-oophorectomy may reduce the risk of cancer, but does it totally ablosh it in a female with w/ a BRCA 1 or 2 germ line mutaion? |
|
Definition
| no because some tissue may still remain |
|
|
Term
| Children of a patient with a BRCA 1 or 2 germ line mutation have a _____% risk of inheriting the mutation |
|
Definition
|
|
