WBR0465

Author	[[PageAuthor::Rim Halaby, M.D. [1]]]
Exam Type	ExamType::USMLE Step 1
Main Category	MainCategory::Microbiology
Sub Category	SubCategory::Genitourinary
Prompt	[[Prompt::A 60 year old female patient presents to her physician’s office for post-coital bleeding. Following appropriate work-up, the pathology identified in this patient is similar to the image shown below. Which of the following characteristics appropriately describes the etiology of the patient's condition? ]]
Answer A	AnswerA::Sexual activity
Answer A Explanation	AnswerAExp::Sexual activity predisposes to HPV infection. “Multiple sexual partners” is the most important risk factor for HPV infection that causes genital warts and cervical cancer.
Answer B	AnswerB::Smoking
Answer B Explanation	AnswerBExp::Smoking is an important risk factor for many cancers and chronic diseases. It is in fact also a risk factor for cervical cancer.
Answer C	AnswerC::Polycycstic overian syndrome (PCOS)
Answer C Explanation	AnswerCExp::Polycycstic overian syndrome (PCOS) is a risk factor for endometrial cancer.
Answer D	AnswerD::Exposure to aniline dye
Answer D Explanation	AnswerDExp::Exposure to aniline dye is a risk factor for transitional cell carcinoma.
Answer E	AnswerE::Family history
Answer E Explanation	AnswerEExp::Family history is an important risk factor for many cancers and chronic diseases. It is in fact the most important risk factor for ovarian cancer.
Right Answer	RightAnswer::A
Explanation	[[Explanation::The patient is presenting with genital warts or condyloma accuminatum caused by human papilloma virus (HPV). The image shown above shows a normal cervical cell on the left, and a koilocyte defined as an HPV-infected cell, on the right side that is characterized by large nuclei with perinuclear halo. HPV infection is a sexually transmitted infection (STI). Among the most important HPV types are HPV types 16, 18, 31, 33, and 45 which predispose to cervical cancer; and 6, 11, 42, 43, and 44 which cause genital warts. Educational Objective: Koilocytes, defined as enlarged nuclei with perinuclear halo, are infected cells with HPV. HPV is a sexually transmitted virus that has at least a 100 types described, some of which predispose to cervical cancer and some cause genital warts. Educational Objective: References: ]]
Approved	Approved::No
Keyword	WBRKeyword::condyloma, WBRKeyword::accuminata, WBRKeyword::condyloma accuminata, WBRKeyword::HPV, WBRKeyword::human, WBRKeyword::papilloma, WBRKeyword::virus, WBRKeyword::human papilloma virus, WBRKeyword::genital, WBRKeyword::warts, WBRKeyword::genital warts, WBRKeyword::cervical, WBRKeyword::cancer, WBRKeyword::risk, WBRKeyword::factor, WBRKeyword::sexual, WBRKeyword::partner, WBRKeyword::multiple
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