Quiz On Pathology Female Genital Tract

1. A woman presents with amenorrhea, vomiting and positive for pregnancy test. Three to four months later, she has vaginal bleeding with grape like structures present. There are also fetal parts present. The most likely chromosome for her mole is:

69 XXY

46 XX

46 XY

None of the above

All of the above

The correct answer is 69 XXY. This is because the presentation of vaginal bleeding with grape-like structures and fetal parts is indicative of a molar pregnancy, specifically a complete hydatidiform mole. Complete moles are characterized by the absence of fetal tissue and the presence of a complete set of paternal chromosomes. In this case, the presence of an additional X chromosome (XXY) suggests that the mole is a result of fertilization of an empty egg by two sperm.

Explanation

The correct answer is 69 XXY. This is because the presentation of vaginal bleeding with grape-like structures and fetal parts is indicative of a molar pregnancy, specifically a complete hydatidiform mole. Complete moles are characterized by the absence of fetal tissue and the presence of a complete set of paternal chromosomes. In this case, the presence of an additional X chromosome (XXY) suggests that the mole is a result of fertilization of an empty egg by two sperm.

2. All of the following are predisposing factors for pre-eclampsia except?

Primagravida, over 35 years

Multiple pregnancies, hydramnios

Preexisting hypertension

Hyadatiform mole

All are predisposing factors

Pre-eclampsia is a condition that typically occurs during pregnancy and is characterized by high blood pressure and damage to organs, such as the liver and kidneys. Predisposing factors are conditions or characteristics that increase the likelihood of developing pre-eclampsia. The correct answer states that all of the options listed are predisposing factors for pre-eclampsia. This means that each of the options, including primagravida (first pregnancy), being over 35 years old, having multiple pregnancies or hydramnios (excess amniotic fluid), having preexisting hypertension, and having a hydatidiform mole (a type of abnormal pregnancy), can increase the risk of developing pre-eclampsia.

Explanation

Pre-eclampsia is a condition that typically occurs during pregnancy and is characterized by high blood pressure and damage to organs, such as the liver and kidneys. Predisposing factors are conditions or characteristics that increase the likelihood of developing pre-eclampsia. The correct answer states that all of the options listed are predisposing factors for pre-eclampsia. This means that each of the options, including primagravida (first pregnancy), being over 35 years old, having multiple pregnancies or hydramnios (excess amniotic fluid), having preexisting hypertension, and having a hydatidiform mole (a type of abnormal pregnancy), can increase the risk of developing pre-eclampsia.

3. A woman from Asia has increased levels of bHCG. She recently had a pregnancy and it was a mole. The structure was hemorrhagic and friable, with no chronionic villi. Which of the following are key features of her disease?

Malignant cytotrophoblasts

Malignant syncitiotrophoblasts

Cured with chemotherapy

Extensive metastasis

All of the above

The key features of the woman's disease include malignant cytotrophoblasts, malignant syncitiotrophoblasts, extensive metastasis, and the ability to be cured with chemotherapy. This suggests that the woman has gestational trophoblastic disease, specifically a mole, which is characterized by abnormal growth of the placental tissue. The presence of malignant cytotrophoblasts and syncitiotrophoblasts indicates the potential for cancerous spread and metastasis. However, the disease can be effectively treated with chemotherapy, leading to a favorable prognosis.

Explanation

The key features of the woman's disease include malignant cytotrophoblasts, malignant syncitiotrophoblasts, extensive metastasis, and the ability to be cured with chemotherapy. This suggests that the woman has gestational trophoblastic disease, specifically a mole, which is characterized by abnormal growth of the placental tissue. The presence of malignant cytotrophoblasts and syncitiotrophoblasts indicates the potential for cancerous spread and metastasis. However, the disease can be effectively treated with chemotherapy, leading to a favorable prognosis.

4. Absence of a plane of separation between villi and myometrium, with severe post partum hemorrhage and a hysterectomy, all indicate_

The absence of a plane of separation between the villi (tiny finger-like projections) of the placenta and the myometrium (muscle layer of the uterus), along with severe postpartum hemorrhage and the need for a hysterectomy, are all characteristic features of placenta accreta. Placenta accreta is a condition in which the placenta attaches too deeply into the uterine wall, making it difficult to remove after delivery and causing excessive bleeding.

Explanation

The absence of a plane of separation between the villi (tiny finger-like projections) of the placenta and the myometrium (muscle layer of the uterus), along with severe postpartum hemorrhage and the need for a hysterectomy, are all characteristic features of placenta accreta. Placenta accreta is a condition in which the placenta attaches too deeply into the uterine wall, making it difficult to remove after delivery and causing excessive bleeding.

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5. Patient presents with decreased levels of estrogen and progesterone. She has excessive bleeding due to breaking down of her endometrium. Her uterus is small compared to her amenorrhea. The bHCG levels are also low, indicating the death of an embryo. What is the most likely cause of her pregnancy?

PID

Endometriosis

PID or endometriosis

None of the above

It is a hydatiform mole

The most likely cause of the patient's pregnancy is PID or endometriosis. PID (Pelvic Inflammatory Disease) is an infection of the female reproductive organs that can lead to scarring and damage, which may result in infertility or difficulty getting pregnant. Endometriosis is a condition where the tissue that normally lines the uterus grows outside of it, causing pain and potentially affecting fertility. Both PID and endometriosis can cause hormonal imbalances and abnormal bleeding, which align with the symptoms described in the question.

Explanation

The most likely cause of the patient's pregnancy is PID or endometriosis. PID (Pelvic Inflammatory Disease) is an infection of the female reproductive organs that can lead to scarring and damage, which may result in infertility or difficulty getting pregnant. Endometriosis is a condition where the tissue that normally lines the uterus grows outside of it, causing pain and potentially affecting fertility. Both PID and endometriosis can cause hormonal imbalances and abnormal bleeding, which align with the symptoms described in the question.

6. A patient presenting with gestational edema, proteinuria, and hypertension, not before pregnancy, is diagnosed with _.

Pre-eclampsia is a condition characterized by high blood pressure, proteinuria (presence of excess protein in urine), and edema (swelling) during pregnancy. It typically occurs after 20 weeks of gestation and resolves after delivery. These symptoms indicate impaired kidney function and vascular changes, which can lead to complications for both the mother and the fetus. Therefore, pre-eclampsia is the most likely diagnosis for a patient presenting with gestational edema, proteinuria, and hypertension.

Explanation

Pre-eclampsia is a condition characterized by high blood pressure, proteinuria (presence of excess protein in urine), and edema (swelling) during pregnancy. It typically occurs after 20 weeks of gestation and resolves after delivery. These symptoms indicate impaired kidney function and vascular changes, which can lead to complications for both the mother and the fetus. Therefore, pre-eclampsia is the most likely diagnosis for a patient presenting with gestational edema, proteinuria, and hypertension.

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7. A patient presents with papillomatous warts on her cervix. Blood tests reveal that she has an STD infection, from HPV. Histology reveals koilocytes (which is not indicative of malignancy). The mechanism of her lesions occurs by activation of _.

P53

Rb gene

Cyclin E

All of the above are activated

None of the above

The correct answer is cyclin E. Activation of cyclin E can lead to the development of papillomatous warts on the cervix. This activation can occur due to an STD infection, specifically from HPV. The presence of koilocytes in the histology indicates the presence of HPV infection, but it is not indicative of malignancy. Activation of p53 and rb gene are not associated with the development of papillomatous warts in this case.

Explanation

The correct answer is cyclin E. Activation of cyclin E can lead to the development of papillomatous warts on the cervix. This activation can occur due to an STD infection, specifically from HPV. The presence of koilocytes in the histology indicates the presence of HPV infection, but it is not indicative of malignancy. Activation of p53 and rb gene are not associated with the development of papillomatous warts in this case.

8. Postcoital bleeding is associated with _

Postcoital bleeding refers to vaginal bleeding that occurs after sexual intercourse. It is associated with various conditions, but one of the most common causes is squamous carcinoma of the cervix. Squamous carcinoma is a type of cervical cancer that arises from the squamous cells lining the cervix. This type of cancer can cause bleeding, especially after sexual activity, due to the fragile nature of the tumor tissue. Therefore, postcoital bleeding should raise suspicion for squamous carcinoma of the cervix and prompt further evaluation and medical attention.

Explanation

Postcoital bleeding refers to vaginal bleeding that occurs after sexual intercourse. It is associated with various conditions, but one of the most common causes is squamous carcinoma of the cervix. Squamous carcinoma is a type of cervical cancer that arises from the squamous cells lining the cervix. This type of cancer can cause bleeding, especially after sexual activity, due to the fragile nature of the tumor tissue. Therefore, postcoital bleeding should raise suspicion for squamous carcinoma of the cervix and prompt further evaluation and medical attention.

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9. Sarcoma botryoides is an embryonal rhabdomyosarcoma seen in less than five years old kids, which looks like a bunch of grapes hanging in the vagina, and is highly _.

Sarcoma botryoides is a type of embryonal rhabdomyosarcoma that typically occurs in children under five years old. It is characterized by a tumor that resembles a bunch of grapes hanging in the vagina. This tumor is highly aggressive and has a malignant nature, meaning it has the potential to spread and invade surrounding tissues.

Explanation

Sarcoma botryoides is a type of embryonal rhabdomyosarcoma that typically occurs in children under five years old. It is characterized by a tumor that resembles a bunch of grapes hanging in the vagina. This tumor is highly aggressive and has a malignant nature, meaning it has the potential to spread and invade surrounding tissues.

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