Flashcards in XIX - Female Genital System and the Breast Deck (173)
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151
Most important risk factors of breast cancer
Estrogenic stimulation and age(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 1057
152
Most common molecular subtype of invasive breast cancer
ER-positive, HER2-negative, low proliferation(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 1060
153
Histologic hallmark: presence of discohesive infiltrating tumor cells, often including signet-ring cell containing mucin droplets.
Lobular carcinoma of the breast(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1065
154
Most important prognostic factor for invasive carcinoma of the breast in the absence of lymph node status.
Axillary lymph node status(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 1066
155
A 44 year old G3P3 has a routine Pap smear, which reported "LSIL." A colposcopy showed a reddish area in the posterior cervix. Biopsy showed an intact squamous epithelium with some cells showing dark, angulated nuclei surrounded by a clear cytoplasm. The biopsy will be read as (A) normal (B) CIN I (C) CIN II (D) CIN III
CIN I (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 718-719
156
A 38 year old G2P2 presents with dysmenorrhea and menorrhagia. Ultrasound shows a symmetrically enlarged uterus, with a 4 cm thick myometrium, and endometrium with normal thickness. She opts to have a hysterectomy. The histopathology showed nests of endometrial glands and stroma in the myometrium between the muscle bundles. The endometrium is described as "proliferative." She has (A) a leiomyoma (B) adenomyosis (C) endometrial stromal sarcoma (D) endometrial carcinoma
Adenomyosis(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 721
157
A 42 year old G4P4 has had a 20 year history of dysmenorrhea. An ultrasound shows a right adnexal cyst. She undergoes a right salpingoophorectomy. The right ovary has been converted to a 10 cm diameter brown cystic mass, filled with dark brown fluid. The internal surface is shaggy. Microscopic examination shows hemorrhage and hemosiderin deposits, and occasional endometrial glands and stroma. This lesion (A) contains nonfunctioning endometrium (B) probably originated from retrograde implantation of menstrual endometrium (C) is malignant (D) all of the above
probably originated from retrograde implantation of menstrual endometrium (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 722
158
Which of the following is associated with endometrial hyperplasia? (A) Stein-Leventhal syndrome (B) granulosa-theca cell tumors (C) obesity (D) all of the above
all of the above (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 723
159
Which of the following has the highest risk of developing endometrial carcinoma? (A) cystically dilated endometrial glands, with single layer of endometrial cells (B) crowded branched endometrial glands, with tall, columnar epithelium exhibiting stratification and nuclear atypia (C) nests of closely packed glands with single layer of endometrial cells (D) regularly spaced endometrial glands, with epithelium exhibiting supranuclear vacuoles, and stromal edema
crowded branched endometrial glands, with tall, columnar epithelium exhibiting stratification and nuclear atypia (complex hyperplasia with atypia) (A- disordered endometrium; C - hyperplasia without atypia; D - secretory endometrium) (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 723-724
160
A 48 year old G0P0 woman has menorrhagia. Ultrasound shows multiple sharply circumscribed myometrial and submucosal masses. She undergoes hysterectomy. Histopathology showed whorled bundles of smooth muscle cells, with rare mitoses, and no necrosis. These masses (A) commonly transform into sarcomas (B) may shrink postmenopausally (C) are polyclonal (D) all of the above are true
may shrink postmenopausally (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 724
161
Which of the following is a risk factor for endometrial carcinoma? (A) obesity (B) diabetes mellitus (C) hypertension (D) all of the above
all of the above (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 725
162
In endometrial carcinomas, which histologic pattern is associated with p53 mutations, arises in a background of endometrial atrophy, and has a poor prognosis? (A) serous (B) mucinous (C) endometrioid (D) adenosquamous
serous (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 726
163
A 22 year old presents with signs of acute abdomen. On history, she has been amenorrheic for 8 weeks. Pelvic examination showed a tender right adnexal mass. She undergoes emergency laparotomy with right salpingectomy. At histopathology, the fallopian tube is dilated with a point of rupture. The lumen is filled with blood clots. Which of the following histopathologic findings proves tubal pregnancy? (A) decidualized tubal epithelium (B) infiltrates of neutrophilic agreggates and necrosis (C) diffuse hemorrhage and fibrin deposition (D) chorionic villi
chorionic villi (TOPNOTCH) (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 734
164
Which of the following statements on ovarian cancer is true? (A) the risk is higher in BRCA 2 mutations than in BRCA1 (B) multiparity is a risk factor (C) oral contraceptives somewhat reduces the risk (D) all of the above
oral contraceptives somewhat reduces the risk (A - higher in BRCA1, B - nulliparity is a risk) (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 729
165
Epithelial tumors of the ovary can be benign, borderline, or malignant. Which histologic type is more likely to be malignant than benign? (A) serous (B) mucinous (C) endometrioid
endometrioid (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 731
166
A 17 year old female presents with a 10 cm left ovarian cyst and undergoes oophorectomy. On histopathology, the cyst is filled with sebum and hair. There is a solid area with a gritty cut surface. Which of the following histologic findings characterizes the tumor as immature? (A) islands of cartilage and bone (B) nests of pseudostratified epithelium (C) sheets of round cells with scant cytoplasm, some forming rosettes (D) foci of glial cells admixed with neuropil
sheets of round cells with scant cytoplasm, some forming rosettes (neuroepithelial differentiation) (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 733
167
Which of the following ovarian tumors can produce virilizing signs and symptoms? (A) granulosa cell tumor (B) thecoma (C) sertoli-leydig tumor (D) dysgerminoma
Sertoli-Leydig cell tumor(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 732
168
Which of the following trophoblastic lesions has a triploid karyotype? (A) complete mole (B) partial mole (C) invasive mole (D) placental site trophoblastic tumor
Partial mole(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 735-736
169
Which of the following tumors is most responsive to chemotherapy? (A) gonadal choriocarcinoma (B) gestational choriocarcinoma (C) placental site trophoblastic tumor
gestational choriocarcinoma (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 737
170
A 32 year old female presents with a 5 year history of a right breast lump. A core needle biopsy is performed. Which of the following findings represents a lesion that can progress to ductal carcinoma? (A) small and large cysts with cuboidal to columnar epithelium and surrounding fibrous stroma (B) lymphocytes and plasma cells infiltrating the periductal stroma (C) loose fibroblastic stroma with compressed, slit-like epithelium lined spaces (D) expanded ducts with proliferating monomorphic epithelial cells, with rigid, round fenestrations
expanded ducts with proliferating monomorphic epithelial cells, with rigid, round fenestrations (atypical ductal hyperplasia) (A - fibrocystic changes; B - chronic mastitis; (C) - fibroadenoma) (TOPNOTCH) Robbins Basic Pathology, 8th ed., pp 739-743
171
A 39 year old female presents with bloody discharge from the right nipple. A subareolar lump is palpated. It is excised and submitted to histopathology, which showed multiple papillae with connective tissue cores and lined by an outer cuboidal epithelial layer, and an inner myoepithelial layer. This lesion (A) is also known as cystosarcoma phyllodes (B) is malignant (C) usually arises in a lactiferous duct (D) all of the above
usually arises in a lactiferous duct (intraductal papilloma) (TOPNOTCH) Robbins Basic Pathology, 8th ed., p743
172
A 45 year old female presents with a right breast lump. An excision is performed, showing an ill-defined firm mass. Histopathology shows cells invading individually into the stroma, some forming aligned strands or chains. Other cells encircle normal-appearing ducts, forming a bull's eye pattern. This carcinoma (A) is almost always associated with HER2/NEU overexpression (B) frequently metastasizes into CSF, serosal surfaces and gastrointestinal tract (C) consists more than 80% of breast carcinomas (D) all of the above are true
frequently metastasizes into CSF, serosal surfaces and gastrointestinal tract (invasive lobular carcinoma) (A - Her2/Neu overexpression very rare; C - uncommon type,
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