Deck 18: Female Genital System and Breast

Question 1

This biopsy specimen was taken from an excoriated and oozing nipple of a 50-year-old woman. These histologic findings are most consistent with the diagnosis of

A) eczema
B) psoriasis
C) Paget disease of the breast
D) medullary carcinoma of the breast
E) fibrocystic change of the breast

Answer 1

Paget disease of the breast

Question 2

This uterus was removed from a 58-year-old woman who complained of metrorrhagia. Most likely this lesion is pathogenetically related to

A) herpesvirus infection
B) human papillomavirus infection
C) hyperestrinism
D) multiparity
E) endometriosis

Answer 2

hyperestrinism

Question 3

Comedocarcinoma of the breast is a type of which of the following carcinomas?

A) Ductal carcinoma in situ
B) Medullary carcinoma
C) Invasive ductal carcinoma
D) Invasive lobular carcinoma
E) Tubular carcinoma

Answer 3

Ductal carcinoma in situ

Question 4

The solitary nodular lesion in this uterus removed from a 55-year-old woman is most likely composed of

A) benign endometrial glandular cells
B) malignant endometrial glandular cells
C) benign smooth muscle cells
D) malignant smooth muscle cells
E) foci of adenomyosis

Question 5

Which of the following nonneoplastic breast lesions is associated with the highest risk of mammary cancer?

A) Apocrine cysts
B) Sclerosing adenosis
C) Complex sclerosing lesion
D) Small duct papillomas
E) Atypical ductal hyperplasia

Question 6

A 25-year-old woman had a workup for infertility. During the laparoscopic examination, the gynecologist found foci of endometriosis. Such foci are most often seen on which of the following sites?

A) Ovary
B) Uterine ligaments
C) Rectovaginal septum
D) Pelvic peritoneum
E) Appendix

Question 7

A 55-year-old woman who has diabetes mellitus complains of genital itching. Examination shows whitish plaques on the mucosa of the vulva and vagina. Which of the following infectious agents most likely caused these changes?

A) Human papillomavirus
B) Herpes simplex virus type 2
C) Trichomonas vaginalis
D) Gardnerella vaginalis
E) Candida albicans

Question 8

A 50-year-old woman sees her physician because she has noticed a bloody discharge from the left nipple. Upon physical examination, there are no palpable masses in the breast. Which of the following is the most likely cause of this discharge?

A) Solitary cyst
B) Fibrocystic change
C) Acute mastitis
D) Intraductal papilloma
E) Carcinoma

Question 9

Assuming that a vaccination will be discovered for the human papillomavirus in women, it is expected that the vaccination will reduce the incidence of carcinoma at which of the following sites?

A) Clitoris
B) Vagina
C) Cervix
D) Endometrium
E) Ovary

Question 10

BRCA1 and BRCA2 genes that are mutated in 25% of all women who have familial breast cancer encode proteins. Which of the following functions do these proteins serve?

A) Cell surface receptors for growth factors
B) Growth factors
C) Cytoplasmic signaling molecules
D) DNA repair enzymes
E) Nuclear hormone receptors

Question 11

This breast tumor was removed from a 60-year-old woman. On gross examination, the tumor was found to be

A) rubbery and yellow
B) white and gritty
C) calcified
D) necrotic and caseous
E) soft and gelatinous

Question 12

Which of the following genital lesions is associated with a greater than expected risk of carcinoma of the vulva?

A) Condyloma acuminatum
B) Condyloma latum
C) Lichen simplex chronicus
D) Lichen sclerosus
E) Papillary hydradenoma

Question 13

A high level of expression of the tumor suppressor gene PTEN will most likely be found in which of the following?

A) Normal proliferative phase endometrium
B) Uterine ligaments
C) Complex atypical endometrial hyperplasia
D) Endometrial intraepithelial neoplasia
E) Adenocarcinoma of the endometrium

Question 14

This pelvic tumor most likely originated from the

A) prostate
B) rectum
C) urinary bladder
D) ovary
E) uterus

Question 15

These ovaries were removed from an infertile, obese, slightly hirsute 30-year-old woman with persistent menstrual irregularities. The cystic spaces seen in the ovaries represent

A) foci of endometriosis
B) foci of endosalpingiosis
C) corpora lutea
D) corpora albicantia
E) dilated follicles filled with fluid

Question 16

Elevated 17-ketosteroid excretion, masculinization, and hirsutism are found in a woman who has a tumor of the ovary. The tumor is composed of polygonal cells with abundant eosinophilic cytoplasm and occasional Reinke crystals. Which of the following is the most likely classification of this tumor?

A) Thecoma
B) Granulosa cell tumor
C) Hilar tumor of the ovary
D) Sertoli-Leydig cell tumor
E) Brenner tumor

Question 17

A physical examination of a 5-year-old girl shows a grape-like polypoid mass protruding from the vagina. Histologic examination reveals that the mass has a myxoid stroma that contains small oval-shaped cells. Some of these cells have pink cytoplasm and resemble tennis rackets. These cells reacted positively upon immunohistochemical staining with the antibodies to desmin. Which of the following is the most likely diagnosis?

A) Squamous cell carcinoma
B) Clear cell adenocarcinoma of the cervix
C) Leiomyosarcoma
D) Rhabdomyosarcoma
E) Malignant melanoma