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 40 year old female patient presents to her physician’s office for a lesion in her urogenital area. The pathology identified similar to the patient is shown in the image below. What is the most important risk factor that predisposed the patient to develop the lesion? ]]
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, 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
Linked Question	Linked::
Order in Linked Questions	LinkedOrder::