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Reproduction Week 1 2018/19 > 9: Pathology of the uterus > Flashcards

9: Pathology of the uterus Flashcards

1
Q

Which hormone causes the endometrium to proliferate?

A

Oestrogen

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2
Q

Which hormone maintains the endometrium during the luteal phase and encourages uterine secretions?

A

Progesterone

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3
Q

What term is used to describe the appearance of the endometrium when the egg cell is fertilised?

A

Decidualised

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4
Q

Which hormones are involved in the uterine cycle if the egg is cell is actually fertilised?

A

hCG

Progesterone

if not, corpus luteum degenerates and these aren’t produced

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5
Q

What are the elements of the proliferative endometrium which you can see on histology?

A

Columnar epithelium

Stromal cells

Glands

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6
Q

In the proliferative phase of the uterine cycle, which aspects of the endometrium grow?

A

Stroma

Glands

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7
Q

What is the corpus luteum?

A

Remnant of leading follicle left when egg is released

Produces progesterone to maintain endometrium

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8
Q

In the event of no fertilisation, what does the corpus luteum degenerate to form?

A

Corpus albicans

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9
Q

What phase of the uterine cycle starts when ovulation occurs?

A

Secretory phase

because progesterone is being produced

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10
Q

How does the endometrium change in the secretory phase?

A

Glands become torturous - wiggly

Glands fill with secretions

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11
Q

If no fertilisation occurs, what happens to the endometrium?

A

Loss of blood supply

Sloughing > Menstruation

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12
Q

What is a genetically inherited syndrome which causes GI polyposis and increases a woman’s chances of developing endometrial cancer?

A

Lynch syndrome / HNPCC

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13
Q

What is the difference between abnormal and dysfunctional uterine bleeding?

A

Abnormal bleeding - organic cause: infection, tumour, miscarriage, ectopic/molar pregnancy

Dysfunctional bleeding - no abnormal cause: pathology is hormonal or idiopathic

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14
Q

What is the most common cause of dysfunctional uterine bleeding?

A

Anovulation

common at extremes of age

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15
Q

How does anovulation cause dysfunctional uterine bleeding?

A

No ovulation > no corpus luteum to produce progesterone

Prolonged oestrogen production > Prolonged proliferation of endometrium

Eventually sloughs due to loss of blood supply > Heavy bleeding

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16
Q

Which tumours can cause abnormal uterine bleeding?

A

Endometrial polyps

Leiomyomas (fibroids)

17
Q

What are endometriosis and adenomyosis?

A

Growth of endometrium / glands outwith the uterus

Grow in response to oestrogen

Cause pain

18
Q

What inflammatory condition causes abnormal uterine bleeding?

A

Endometritis

19
Q

What drugs used to control menopausal symptoms can cause abnormal uterine bleeding?

A

HRT

Tamoxifen

20
Q

An endometrial thickness of over ___ mm is an indication for biopsy.

A

4 mm

21
Q

What investigation is used to assess endometrial thickness?

A

Transvaginal ultrasound

22
Q

Which investigation is used to view the endometrium?

A

Hysteroscopy

23
Q

What are two methods of taking an endometrial biopsy?

A

Pipelle biopsy

Dilatation and curettage

24
Q

What is a disadvantage of using a pipelle over D&C for taking an endometrial biopsy?

A

You can’t see the endometrium while taking the sample

25
Q

Between pipelle biopsy and D&C, what is the preferred method for taking endometrial samples?

A

D&C

Because you can see the endometrium while you’re doing it

26
Q

During which phase of the uterine cycle are endometrial biopsies not particularly useful?

A

Menstrual phase

because glands and stroma are falling apart

27
Q

If endometrial glands grow for months e.g anovulation, what can they form?

A

Cysts

28
Q

Despite being in the muscle layer, how do leiomyomas cause abnormal uterine bleeding?

A

Contraction stretches blood vessels, stroma and glands

29
Q

Endometritis is inflammation of the endometrium which can be either infectious or non-infectious.

What symptom can it cause?

How do you recognise it on histology?

A

Abnormal uterine bleeding

Inflammatory cells (shouldn’t be there; chronic - plasma cells, acute - neutrophils & macrophages)

30
Q

What type of endometritis does tuberculosis cause?

A

Granulomatous endometritis

big closed off rings of inflammatory cells

31
Q

Endometrial polyps are usually (benign / malignant).

A

benign

32
Q

Some endometrial polyps progress to form ___.

A

carcinomas

33
Q

When do women tend to develop endometrial polyps?

A

Menopause

34
Q

What structures, belonging to the foetus, are seen on histology of a miscarriage sample?

A

Chorionic villi

Foetal red blood cells

35
Q

How can you tell foetal RBCs apart from maternal RBCs on histology?

A

Foetal RBCs are nucleated

Maternal RBCs aren’t

Reproduction Week 1 2018/19 (9 decks)

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