Female Lower Genital Tract Pathology Physiology

Lichen simplex chronicus former name

Squamous hyperplasia.

Lichen simplex chronicus risk factors

Rubbing, chronic irritation, psoriasis, and atopic dermatitis.

Lichen simplex chronicus pathogenesis

Increased mitotic activity in the vulvar epidermis.

Lichen simplex chronicus presentation

Leukoplakia or hyperpigmentation accompanied by pruritus and dyspareunia.

Lichen simplex chronicus biopsy findings

Epidermal thickening, hyperkeratosis, basal mitotic activity, and dermal leukocyte infiltration without atypia.

Condyloma acuminata common term

Anogenital warts.

Non-oncogenic HPV strains in Condyloma acuminata

HPV serotypes 6 and 11.

Oncogenic HPV strains in Condyloma acuminata

HPV serotypes 16 and 18.

Condyloma acuminata characteristic biopsy feature

Koilocytosis.

Medical management options for Condyloma acuminata

Podophyllin, trichloroacetic acid, or intralesional alpha interferon.

Most common histological type of vulvar cancer

Squamous cell carcinoma (90% of cases).

VIN full name

Vulvar intraepithelial neoplasia.

HPV serotypes in VIN and vulvar CA

HPV serotypes 16 and 18 (present in 90% of cases).

Vulvar carcinoma developmental sequence

VIN (carcinoma in situ) progressing to invasive carcinoma.

Histologic differentiation of HPV-positive vulvar tumors

Poorly differentiated.

Histologic differentiation of HPV-negative vulvar tumors

Well differentiated.

Congenital anomalies of the vagina

Total vaginal agenesis and septate ("double") vagina.

Major risk factor for vaginitis

Systemic antibiotic use altering normal flora.

Primary presentation of vaginitis

Leukorrhea (vaginal discharge).

Candida albicans discharge characteristic

Cheesy white vaginal discharge.

3-day antimycotic treatments for Candida vaginitis

Clotrimazole, miconazole, butaconazole, or terconazole.

6-day antimycotic treatments for Candida vaginitis

Ketoconazole or nystatin.

Trichomonas vaginalis pathogen type

Protozoan parasite.

Trichomonas vaginalis discharge characteristic

Malodorous, watery, copious gray-green discharge.

Conditions triggering pathogenic growth of commensal vaginal flora

Diabetes mellitus, systemic antibiotics, and immunocompromised status.

Vaginitis mucosal complication

Atrophy and thinning of the squamous vaginal mucosa.

Vaginal cancer associated with in utero DES exposure

Clear cell adenocarcinoma.

Risk population for clear cell adenocarcinoma from DES

Daughters of women treated with diethylstilbestrol during pregnancy.

Diethylstilbestrol (DES) chemical class

Non-steroidal estrogen.

Current medical indication for diethylstilbestrol

Treatment of prostate cancer in men.

Most common type of female cervical cancer

Squamous cell carcinoma (SCC).

Nabothian cyst anatomical site

Transformation zone of the cervix.

Pathogenesis of a Nabothian cyst

Squamous epithelium blocks endocervical gland orifices, trapping mucus.

Epithelial lining of Nabothian cysts

Mucus-secreting epithelium.

Timing of acute cervicitis occurrence

Essentially limited to the postpartum period.

Causative organisms of acute cervicitis

Staphylococci and Streptococci.

Presentation of acute cervicitis

Mucopurulent vaginal discharge.

Antibiotic regimen for acute cervicitis

Dicloxacillin 250 mg QID.

Primary etiology of chronic cervicitis

Sexually transmitted infections (STDs).

Physical examination findings in chronic cervicitis

Erythema, swelling, and granularity around cervical margins.

Most common single cause of chronic cervicitis

Chlamydia trachomatis (40% of cases).

Organisms causing chronic cervicitis

Chlamydia, Trichomonas, Ureaplasma urealyticum, Candida, Gonorrhea, HSV II, HPV.

Infiltrate character in chronic cervicitis histology

Predominantly mononuclear inflammatory infiltrate.

CIN full name

Cervical intraepithelial neoplasia.

Percentage of cervical cancers linked to HPV

90% (primarily serotypes 16 and 18).

Screening tool that reduced invasive cervical cancer incidence

Pap smear.

Cervical region first affected by CIN

Transformation zone.

Peak age of incidence for CIN

30 years old.

Behavioral risk factors for cervical carcinoma

Early coitus, multiple partners, promiscuous male partner, and smoking.

Mechanism of HPV oncogenicity

Viral proteins inactivate host tumor suppressor genes p53 and Rb.

High-risk oncogenic HPV serotypes in cervical neoplasia

Serotypes 16, 18, 31, and 33.

CIN I classification

Mild dysplasia.

Regression rate of CIN I lesions

50% regression rate.

Progression rate of CIN I to CIN II

30% progress to CIN II.

Depth of atypical cells in CIN I

Lower 1/3 to 1/4 of the epithelium.

Cytological feature seen in upper epithelial layers of CIN I

Koilocytic changes.

CIN II classification

Moderate dysplasia.

Depth of atypical cells in CIN II

Lower 1/2 of the epithelium.

CIN III classification

Severe dysplasia and carcinoma in situ (CIS).

Mitotic findings in CIN III

Both normal and abnormal mitoses across epithelial layers.

Surgical/management options for CIN

Ablation or cone biopsy.

Histological distribution of invasive cervical carcinoma

90% squamous cell carcinoma, 10% adenocarcinoma.

Peak incidence age for invasive cervical carcinoma

45 years old.

Three morphological patterns of invasive cervical cancer

Fungating (cauliflower-like), ulcerative, and infiltrative.

Colposcopic appearance of cervical precancer after acetic acid

Pale (acetowhite) areas.