Pathology Exam 3: Female Reproductive System

What are the main structures of the female reproductive system?

Ovaries, uterus, fallopian tubes, vagina, and vulva.

What are the two main divisions of the ovary?

Cortex (outer, follicle-producing) and medulla (inner, vascular).

What are the main divisions of the uterus?

Cervix, corpus (body), and fundus.

What are the two parts of the cervix?

The vaginal portion and the endocervix.

What is the main function of the uterus?

To house and nourish the developing fetus.

What happens in the first half of the menstrual cycle?

Endometrial glands and stroma proliferate under estrogen from the ovarian follicle.

What occurs at midcycle during ovulation?

The follicle releases an ovum and becomes a corpus luteum that produces estrogen and progesterone.

What does progesterone do in the menstrual cycle?

Converts the proliferative endometrium into secretory endometrium to prepare for implantation.

What happens if no pregnancy occurs?

The corpus luteum degenerates, estrogen and progesterone levels fall, and the endometrium is shed as menses.

What happens hormonally when the corpus luteum breaks down?

Estrogen and progesterone drop, signaling the hypothalamus to start a new FSH/LH cycle.

What is vaginitis?

Inflammation of the vagina causing discharge, itching, and irritation.

What organisms commonly cause vaginitis?

Candida albicans, Trichomonas vaginalis, and Gardnerella vaginalis with anaerobes.

What is cervicitis?

Mild chronic inflammation of the cervix, often in women who have had children.

What organisms cause severe cervicitis?

Gonococci and Chlamydia trachomatis.

What is salpingitis?

Inflammation of the fallopian tubes, usually from ascending infection.

What is pelvic inflammatory disease (PID)?

Infection involving the fallopian tubes and ovaries, causing lower abdominal pain, fever, and possible sterility.

What are long-term complications of PID?

Tubal scarring, ectopic pregnancy, and infertility.

What are condylomas?

Venereal warts caused by human papillomavirus (HPV).

Where are condylomas commonly found?

Cervix, vagina, vulva, and around the anus.

How are condylomas treated?

Destruction by chemicals, electrocoagulation, freezing, or surgical excision.

What is toxic shock syndrome?

An acute illness caused by Staphylococcus aureus toxin entering the bloodstream.

What situations commonly cause TSS?

Tampon use or staph infections of skin, bone, or kidneys.

What are the symptoms of TSS?

Fever, vomiting, diarrhea, muscle aches, and a sunburn-like rash that later peels.

What is the treatment for TSS?

Supportive care until toxin effects wear off; antibiotics do not shorten the course.

What is vulvar dystrophy?

Thickened white patches (leukoplakia) on vulvar skin causing itching and discomfort.

How is vulvar dystrophy treated?

Local therapy; monitored for progression to carcinoma.

What is carcinoma of the vulva?

Malignancy often arising from preexisting dystrophy; treated by vulvectomy and lymph node removal.

What are cervical polyps?

Benign growths from the cervix that may bleed and are treated by surgical removal.

What is cervical dysplasia?

Abnormal maturation of squamous epithelial cells of the cervix.

What are mild causes of cervical dysplasia?

Chronic cervical inflammation that may regress spontaneously.

What can severe cervical dysplasia progress to?

Carcinoma in situ or invasive cervical cancer.

What does CIN represent?

A spectrum of epithelial abnormalities from mild dysplasia to carcinoma in situ.

How is CIN graded?

Grade I = mild, Grade II = moderate, Grade III = severe dysplasia.

What virus is most strongly associated with CIN and cervical cancer?

Human papillomavirus (HPV).

Which HPV strains are considered high-risk and carcinogenic?

Types 16 and 18.

Which HPV strains cause most genital warts?

Types 6 and 11.

How is CIN diagnosed?

Pap smear, HPV testing, colposcopy, and biopsy confirmation.

What is the first HPV vaccine called and what does it protect against?

Gardasil (2006), protects against types 6, 11, 16, and 18.

What percentage of cervical cancer cases are caused by HPV types 16 and 18?

About 70%.

What percentage of genital warts are caused by HPV types 6 and 11?

About 90%.

What is the main benefit of HPV vaccination?

Prevents infection with carcinogenic HPV strains, reducing risk of dysplasia and cancer.

Where do most cervical abnormalities occur?

At the squamocolumnar junction (transition zone) of the cervix.

What diagnostic tests are used for cervical cancer screening?

Pap smear and colposcopy with biopsy.

What are treatment options for cervical dysplasia or carcinoma in situ?

Cryotherapy, surgical excision, or hysterectomy.

What are treatment options for invasive cervical carcinoma?

Radiation therapy or radical hysterectomy.

How is the prognosis for early cervical carcinoma?

Excellent when detected early; poor in advanced stages.

What are uterine leiomyomas?

Benign smooth muscle tumors of the uterus (fibroids).

What is uterine adenocarcinoma?

Malignant glandular tumor of the endometrium due to prolonged estrogen exposure.

What is dysfunctional uterine bleeding (DUB)?

Irregular bleeding due to anovulatory cycles (no corpus luteum formation).

What causes dysfunctional bleeding?

Continuous estrogen stimulation without progesterone leading to irregular shedding.

What other conditions can cause uterine bleeding?

Endometrial hyperplasia, endometrial or cervical polyps, myomas, and carcinoma.

What is benign endometrial hyperplasia?

Overgrowth of endometrial glands causing irregular uterine bleeding.

What are endometrial polyps?

Benign growths that may bleed if the surface erodes.

What is endometrial adenocarcinoma?

Malignant tumor often associated with unopposed estrogen use.

What is the most common symptom of endometrial carcinoma?

Irregular or postmenopausal bleeding.

What is endometriosis?

Presence of endometrial tissue outside the uterine cavity.

Where can endometriosis occur?

Uterine wall, ovaries, peritoneum, rectum, or appendix.

How does ectopic endometrium respond to hormones?

It bleeds cyclically, causing inflammation, scarring, and adhesions.

What are symptoms of endometriosis?

Pelvic pain, dysmenorrhea, dyspareunia, and infertility.

How is endometriosis diagnosed?

By laparoscopy to visualize and biopsy lesions.

How is endometriosis treated?

Hormonal suppression (progesterone, oral contraceptives, GnRH analogs) or surgical excision.

What is primary dysmenorrhea?

Painful menses due to prostaglandin-induced uterine contractions, with no pelvic disease.

When does primary dysmenorrhea usually begin?

After ovulatory cycles start (about 2 years after menarche).

What is secondary dysmenorrhea?

Menstrual pain due to pelvic pathology such as endometriosis.

How is dysmenorrhea treated?

NSAIDs and oral contraceptives to inhibit prostaglandin production.

What are ovarian cysts?

Fluid-filled sacs from follicles or corpora lutea that fail to regress normally.

What are functional cysts?

Follicular or corpus luteum cysts that develop from deranged maturation and involution.

What are endometrial cysts?

Cysts formed by endometriosis within the ovary, filled with old blood ("chocolate cysts").

What is polycystic ovary syndrome (PCOS)?

Condition with multiple ovarian cysts, hyperandrogenism, irregular menses, and infertility.

What is a benign cystic teratoma (dermoid cyst)?

Benign ovarian tumor arising from unfertilized ova containing tissues like hair, teeth, and bone.

What is a malignant teratoma?

Rare ovarian tumor composed of malignant embryonic tissues.

What are the main types of ovarian tumors?

Serous, mucinous, endometrioid, fibroma, granulosa-theca cell, and androgen-producing tumors.

What is a serous tumor?

Tumor resembling fallopian tube epithelium; may be benign (cystadenoma) or malignant (cystadenocarcinoma).

What is a mucinous tumor?

Tumor resembling endocervical epithelium; can be cystadenoma or cystadenocarcinoma.

What is an endometrioid tumor?

Tumor resembling endometrial tissue; can become endometrioid carcinoma.

What is a fibroma?

Benign tumor of fibrous connective tissue in the ovary.

What is a granulosa-theca cell tumor?

Estrogen-producing ovarian tumor that causes endometrial hyperplasia or carcinoma.

What are male-hormone-producing ovarian tumors?

Tumors that secrete androgens and cause masculinization.

What is natural family planning?

Avoiding intercourse during ovulation.

What are barrier methods of contraception?

Diaphragms and condoms; effective with no systemic side effects.

How do oral contraceptives work?

Suppress ovulation and stabilize hormone levels.

What are side effects of oral contraceptives?

Increased risk of thromboembolism and hypertension, especially in smokers.

How do intrauterine devices (IUDs) prevent pregnancy?

Prevent implantation of the fertilized egg.

What are risks of IUD use?

Increased risk of tubal infections and ectopic pregnancy.

What is emergency contraception?

High-dose hormones to prevent pregnancy after unprotected intercourse.

How does emergency contraception work?

Delays ovulation, interferes with fertilization or implantation.

When is emergency contraception most effective?

Within 12 hours of intercourse (<1% risk of pregnancy); effective up to 5 days.