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73 Cards in this Set
- Front
- Back
Infection associated with OCP and pregnancy? What else is it associated with?
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Candida, also associated with DM
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Mycoplasma implicated in what GU pathologic processes?
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spontaneous abortion and chorioamnionitis
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Low risk HPVs
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6 and 11
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High risk HPVs
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16 and 18
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How does high risk HPV cause disease?
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viral genes code for E6 and E7 proteins which ubiquinates p53 for destruction and binds Rb
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What is p53 genee responsible for?
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stimulates apoptosis when DNA repair is impossible (p53 goes POW and binding by bax) by binding bax synthesis
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What does Rb gene control?
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Rb Regualtes cell cycle ( tumor suppressor) so immature cells dont enter S phase
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what is the bcl-2 gene responsible for?
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inhibition of apoptosis (BCL-2 goes BLOCK) by preventing cytochrome C release from mitochondria and binding Apaf-1 (pro apoptotic factor)
located on CH 18 and implicated in follicular lymphonas |
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koilocyes are seen. What disese?
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HPV, these are vacuolated epithelial cells
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villous papillary stroma with hyperkeratosis and acanthosis?
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HPV
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Herpesvirus structure?
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linear dsDNA, enveloped
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subgroups of herpes?
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alpha beta gamma.
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alpha group of herpes
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HSV 1, 2, and VZV
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beta group of herpes
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CMV, HSV6and HSV7.
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Gamma group of herpes?
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EBV, HHV8
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where is beta herpes group latent?
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CMV in marrow progenitors, HSV 6 and 7 in T cells
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Where is gamma group latent?
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EBV in B cells (EBV is Epithelial and B cell Virus)
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Major cause of corneal blindness in US?
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HSV1, also mcc of fatal sporadic encephalitis and gingivostomatitis
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Large, pink to purple intranuclear inclusions?
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Cowdry A in herpes (INTRAnuclear),
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Common cause of genital ulcer in Africa and SE asia, painful. Symptoms?
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H. ducreyi, papule that presents on genitalia a week after inoculation that erodes, may be multiple and accompanied by inguinal node enlargement.
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H ducreyi morphology?
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gram negative coccobacilli (Hemophilus are coccobuddies! with pseudomonas which is bacillus)
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gram negative rod that causes a painless mass
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klebsiella granulomatis, lymph nodes SPARED
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K granulomatis presentation?
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painless ulcerating lesion that spares regional lymph nodes
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pseudoepitheliomatus hyperplasia with exudate. Dx tool and what occurs if left unterated?
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dx w giemsa stain to ID organism. if left untreated, elephantitasis of external genitalia
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Hw to visualize syphilis?
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Silver Syphilis Stain Spirochetes STD.
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Describe primary syphilis.
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nontender chancre 3 weeks after contact that heals after 3 weeks.
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Secondary syphilis?
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2 months after chancre heals and cause diffuse macropapular lesions alll over
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condyloma latum
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secondary syphilis
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Prognosis after secondary syphilis?
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1/3 go onto tertiary which involve CV, neurologic, and gummas.
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Which syphilitic test has many false positives? why?
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VDRL because it is anti cardiolipin which can cross react
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which test turns positive the earliest and remains positive the longest?
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FTA-ABS (fast! turns + the quickest!)
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MCC of fungal infections?
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Candida albicans, its normal flora that breaches skin/mucosal barriers
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incidence of infection of Candida in women increases with?
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diabetes, pregnancy, OCP
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What is MCV-2?
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the most common Molluscum Contagiosum Virus, (2 is genitaaals, STD) a poxvirus
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purulent vaginal discharge 4 weeks after sex. What is it and how does it present?
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tichomonas vaginalis, a flagellated protozoan. Patient has strawberry cervix due to vasodilation.
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Fishy vaginal discharge. What does this predispose to
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Gardnerella vaginalis, predisposes to premature labor
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most common cause of bacterial vaginitis?
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gardnerella vaginitis, gram - bacillus (most down there are Gm - bacilli! like e coli too)
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MCC of PID
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gonorrhea and chlamydia, then enteric bacteria
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S/P of PID?
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spontaneous or induced abortions
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gonococcal vs non G PID infection?
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non-G involve lyph and vein spread which meands deeper layers of organs!
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Adhesions and fibrosis from PID complications can lead to?
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bowel obstruction, tubal obstruction, and ectopic pregnancy, and infertility
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Marsupialization is the treatment for?
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bartholin cyst
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two non-neoplastic vulvular lesions?
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think SKIN on vulva: lichen sclerosus and squamous cell hyperplasia (one is thinning and one is thickening)
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Which non-neoplastic vulvular lesions has increased change of developing SCC?
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lichen sclerosus
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What is lichen sclerosis?
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atrophy of epidermis and sclerosis of SUBepidermis with degeneration of basal cells
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What is lichen simplex chronicus?
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epithelial thickeing of vulva due to rubbing
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Often present at margins of vulvular cancer?
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lichen simplex chronicus (squamous cell hyperplasia)
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ectopic breast?
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papillary hidradenoma with columnar and mypoepithelial cells (duct cells!)
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precursor to SCC of vulva?
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VIN, vulvar intraepithelial neoplasia, associated with HPV 16
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most common malignant vulvular tumor?
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squamous cell carcinoma, presents w pain, discomfort, pruritis
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pruritic, red, crusted, demarcated gladular malignancy?
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extramammary paget disease confined to epidermis and adnex
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Congential anomalies associated with?
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in utero DES exposure (diethylbestrol)
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non-neoplastic disorders of the vaginal?
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mesonephric duct persistence = gartner duct systs,
also endometriosis |
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premalignant lesions of vagina and what do they develop into?
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VAIN into SCC and Adenosis into adenocarcinoma
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what is adenosis?
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endocervical epithelium making its way into upper vag, related to DES exposure in utero
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SCC arises where and from what?
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posterior vaginoectocervical junction, either HPV related or spread from cervix or vulva
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most common tumor in vagina. Where?
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metastatic carcinoma at the cervix
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Posterior vaginal malignancy?
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SCC ( ADENO is ANTERIOR)
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polypid, grapelike mass in vagina under 5?
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sarcoma botryoides aka embroyonal rhabdomyosarcoma
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Implicated in cervical oncogenesis, how common is the virus and common prognosis?
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very common, 90% of infections are cleared within 2 years by the immune system
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types of cervical CIN?
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LSIL and HGIL (low and high grade squamous intraepithelial lesion
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what is HGSIL
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CIS with progressive deregulation of cell cycle, 100% have koilocytes
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premalignant, atypical, inner 1/3 pleomorphism?
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LGSIL
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CIN1, loss of polarity, increased mitotic figures in cervix?
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HGSIL, will be CIN2 if there is full thickness involvement
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Ki-67
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markedly increased in HGSIL CIN3 (proliferative index)
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most common cervical cancer? second?
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squamous cell carcinoma, then adenocarcinoma
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nests/tongues of malignant squamous epithelium underlying cervical stroma with keratin pearls?
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SCC of cervix
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proliferation of glandular epithelium with depletion of mucin?
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adenocarcinoma
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what is neuroendocrine carcinoma?
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like HPV + small cell carcinoma
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PAP smear recommendations?
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21 or 3 years of onset of sex
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if PAP is abnormal...
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follow w colposcopy
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HPV vaccine is to which types?
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6, 11, 16, 18.
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At what stageis cervical carcinoma confined to cervix? clinically visible?
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Ib
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