Clinically important hyperplasias and metaplasias

Question 1

def endometrial hyperplasia

Answer 1

incr. proliferation of edno glands compared to surrounding stroma

Question 2

cause of endometrial hyperplasia

Answer 2

excessive, prolonged, unoppposed E

Question 3

4 features of endometrial hyperplasia

Answer 3

1. common
2. irreg. vag bleeding
3. oft. obese/infertile
4. physcial exam normal

Question 4

pathological effects of endometrial hyperplasia (2)

Answer 4

1. abnormal bleeding

2. increased risk of CA with increased risk from simple, complex and atypical

Question 5

treatment of endometrial hyperplasia

Answer 5

1. treat cause
2. prog. therapy (pill)
3. hyterectomy (choice and atypical)

Question 6

def. prostatic hyperplasia

Answer 6

prlif of prostatic epithelium and stomal cells in urethra

Question 7

cause of prostatic hyperplasia

Answer 7

hormonal changes with age, esp DHT

Question 8

presentation of prostatic hyperplasia

Answer 8

1. common
2. many asymptomatic
3. bladder outlet obstruction
4. symettrical, rubbery prostate

Question 9

effect on PT of prostatic hyperplasia

Answer 9

1. bladder outlet obstruciton

2. no incr. risk of CA ( not actual proliferation, just lack of death)

Question 10

treatment of prostatic hyperplasia

Answer 10

1. decrease fluid
2. 5 A reductase inhib.
3. TURP

Question 11

def squamous metaplasia of the cervix

Answer 11

PHYSIOLOGIC example of metaplasia

Question 12

cause of squamous metaplasia of the cervix

Answer 12

exposure of columnar epithelium to the acid of vag at menarche

Question 13

clinical features of squamous metaplasia of the cervix (3)

Answer 13

1. ALL women
2. asymptomatic
3. cannot be prevented

Question 14

pathological effects of squamous metaplasia of the cervix

Answer 14

increased risk of dysplasia and CA esp with HPV

Question 15

treatment of squamous metaplasia of the cervix

Answer 15

1. pap tests
2. ID and treat dyplasia
3. HPV vaccine

Question 16

def. barrett’ esophagous

Answer 16

pathologic metaplasia of squamous epi thelium in lower esoph

Question 17

cause of barrett’ esophagous

Answer 17

gastric reflux

Question 18

4 clinical features of barrett’ esophagous

Answer 18

1. Sx associated with GERD
2. most GERD mild and managed
3. severe GERD requires investigation
4. on OGD - islands of velvety red mucosa

Question 19

path effect of barrett’ esophagous on PT

Answer 19

incr risk of dysplasia and CA

Question 20

treatment of barrett’ esophagous

Answer 20

1. treat GERD
2. screen for dysplasia
3. treat dysplasia and CA

Question 21

def intestinal metaplasia of the stomach

Answer 21

pathlogic metaplasi of gastric columnar epithelium

Question 22

cause of intestinal metaplasia of the stomach

Answer 22

chronic h. pylori infection

Question 23

4 clinical features of intestinal metaplasia of the stomach

Answer 23

1. h pylori
2. may be asymptomitc
3. Sx of chronic gastritis
4. gastroscopy and biopsy required

Question 24

path effects of intestinal metaplasia of the stomach

Answer 24

1. loss of parietal cells and hypoclorhydria
2. H. pylori infeciton predisposes to ulcers
3. incr risk of dysplasia and CA

Question 25

treatment of intestinal metaplasia of the stomach

Answer 25

1. treat h pylori

2. screen for dysplasia and treat