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Clinical Pathology > Diseases of the female genital system part 2 > Flashcards

Diseases of the female genital system part 2 Flashcards

1
Q

What is Endometriosis?

A

Ectopic Endometrium which causes bleeding into tissues and fibrosis.
It affects 30-40yr olds.

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2
Q

What are the symptoms, investigations, treatments and links to other conditions of endometriosis?

A

Symptoms:

  • Dysmenorrhoea (painful menstrual cramps.)
  • Dyspareunia (pain during sex)
  • pelvic pain
  • subfertility
  • pain passing stool
  • dysuria (pain during urination)

Investigation:
-Laparoscopy

Treatment:

  • Medical (Progesterone antagonists, COCP, GnRH agonist/anagonists)
  • Surgical

links to:

  • Ectopic pregnancy
  • Ovarian cancer
  • IBD
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3
Q

What is Endometritis?

What are the causes of acute vs. chronic endometritis?

A

Inflammation of the endometrium.
Acute - Retained placenta. (neutrophils causes inflammation)
Chronic - endometrial TB, chlamydial infection. (histology = lymphocytes / plasma cells)

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4
Q

What are the symptoms, investigations and treatments of Endometritis?

A

Symptoms:

  • Abdo/pelvic pain,
  • Pyrexia (fever)
  • discharge
  • dysuria (pain when urinating)
  • abnormal vaginal bleeding

Investigation:
-Biochemistry/microbiology test

Treatment:

  • Analgesia
  • remove cause
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5
Q

What are the symptoms of endometrial polyps?

A

They are often asymptomatic, however the following can occur:

  • Intermenstrual bleeding
  • post menopausal bleeding
  • menorrhagia (heavy period)
  • dysmenorrhoea (painful cramps)
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6
Q

What investigations and treatments are done for endometrial polyps?

A 
Investigation : 
-Hysteroscopy
Treatment : 
-Medical (P4/GnRH agonists)
-surgical removal
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7
Q

What is a leiomyomata?

A

It is a uterine fibroid.

A benign myometrial tumour with eostrogen and progesterone dependant growth.

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8
Q

What are the risk factors of leiomyomata?

A
  • Genetics
  • nulliparity (no child birth)
  • obesity
  • PCOS
  • hypertension
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9
Q

What are the symptoms pf leiomyomata?

A
  • Often Asymptomatic
  • Menometrorrhagia (excessive uterine bleeding)
  • subfertility
  • urinary problems during pressure on the bladder
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10
Q

What are the investigations and treatments for leiomyomata?

What is the prognosis after treatment?

A

Investigations:

  • Bimanual examination
  • USS (ultrasound scan)

Treatment:

  • IUS (intra uterine system contraception)
  • NSAIDs,
  • OCP (oral contraceptive pill)
  • P4 (progesterone)
  • Iron

Prognosis:

  • menopausal regression
  • malignancy risk 0.01%
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11
Q

What is endometrial hyperplasia?

A

excessibe endometrial proliferation due to increased oestrogen and decreased progesterone.

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12
Q

What are the risk factors of endometrial hperplasia?

A
  • obesity
  • exogenous eostrogen
  • PCOS (poly cystic ovary syndrome)
  • tamoxifen (breast cancer drug)
  • Oestrogen producing tumours.
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13
Q

What are the different types of endometrial hyperplasia?

A

Typical Hyperplasia (only 1-3% progess to malignancy)

Atypical Hyperplasia (23 - 48% are carcinoma on hysterectomy)

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14
Q

What are the symptoms / complications of endometrial hyperplasia?

A

-Abnormal bleeding

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15
Q

What investigations are done for endometrial hyperplasia?

A
  • Ultrasound scab
  • Hysteroscopy
  • biopsy
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16
Q

What are the treatments for endometrial hyperplasia?

A
  • Intra Uterine System (contraception)
  • Progesterone
  • surgical (Total abdominal hysterectomy)
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17
Q

What is the prognosis of endometrial hyperplasia?

A

If left untreated it can develop into endometrial adenocarcinoma.

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18
Q

How does endometrial hyperplasia progress?

A

1) Normal
2) Non Atypical Hyperplasia
3) Atypical Hyperplasia
4) Endometroid Carcinoma

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19
Q

What are the 2 types of endometrial adenocarcinoma?

A

1) Endometroid :
- Arises from endomtrial intraepithelial neoplasia.
- caused by unopposed oestrogen stimulation.
- Usually affects young women.
- HAS PTEN MUTATION, (no P53 Mutation)

2) Non-endometroid or Serous:
- Arises from inactive or atrophic endometrium.
- It is not associated with oestrogen.
- HAS P53 MUTATION but NO PTEN MUTATION.
- affects elderly women. has a poor prognosis.

20
Q

What are the symptoms / complications of Endometrial Carcinoma?

A
  • Post menopausal Bleeding

- Inter menstrual bleeding

21
Q

What investigations are done for Endometrial Carcinoma?

A
  • Ultrasound scan
  • biopsy
  • hysteroscopy
22
Q

What are the treatments for endometrial carcinoma?

A
  • Progesterone

- Total abdominal hysterectomy.

23
Q

What is Polycystic Ovary Syndrome?

A

Endocrine disorder that has 3 characteristics:

1) Hyperandrogenism (increased testosterone)
2) Menstrual abnormalities
3) Polycystic ovaries

24
Q

What are the investigations done for PCOS?

A
  • Ultrasound scan
  • biochemical screen (decreased FSH, Increased LH, Increased testosterone, Increased DHEAS).
  • glucose tolerance test.
25
Q

What are the treatments for PCOS?

A

Lifestyle:
-Weightloss

Medical:

  • Metformin
  • Oral Contraceptive Pill.

Surgical:
Ovarian drilling

26
Q

What are the complications and other conditions linked to PCOS?

A
  • Infertility

- Endometrial Hyperplasis&raquo_space;>Adenocarcinoma

27
Q

What are the causes of HYPERgonadotrophic hypogonadism (primary failure of gonads)?

A

Congenital:

  • Turner Syndrome
  • Klinefelter’s Syndrome (XXY)

Acquired:

  • Infection
  • Surgery
  • Chemo/radiotherapy
  • toxins/drugs
28
Q

What are the causes of HYPOgonadotrophic hypogonadism (hypothalamic/pituitary failure&raquo_space;» secondary failure of gonads)

A
  • Sheehan’s Syndrome
  • Pituitary Tumours
  • Brain Injury
  • Empty Sella syndrome
  • PCOS
29
Q

How does HYPOgonadotrophic hypogonadism (secondary failure of gonads) present?

A
  • Amenorrhoea (absent menarche)
  • delayed puberty
  • decreased sex hormones
30
Q

What investigations are done for HYPOgonadotrophic hypogonadism?

A
  • Hormone profiling

- Karyotyping

31
Q

what are the 3 origins of ovarian neoplasms?

A

1) Sex cord - stromal
2) Epithelial
3) Germ cell

32
Q

What are Dysgerminomas?

A

it is a rare malignant ovarian germ cell tumour.

33
Q

What are teratomas?

A

A tumour of the ovary that contains all three germ cell layers : ectoderm, endoderm and mesoderm.

34
Q

Distinguish between mature and immature teratomas.

A

Mature :

  • benign,
  • cystic
  • contain hair, teeth

Immature:

  • Malignant
  • embryonal / fetal tissue
35
Q

What is a yolk sac tumour?

A

A highly malignant tumour.

  • cystic
  • solid
  • harmorrhagic
36
Q

What are choriocarcinomas?

A

Malignant , unresponsive tumour of the placenta.

37
Q

What is a Thecoma?

A

Thecoma is a common sex cord stromal tumour. It is a benign tumour of the ovarian stroma.

It is made of spindle cells and has a lot of fat and so is associated with Oestrogen production.

38
Q

What is Meig’s Syndrome?

A

It is a triad of :

1) Ascites (fluid in peritioneal cavity)
2) Pleural Effusion
3) Ovarian tumour

39
Q

what are Granulosa cell tumours?

A

They are low grade malignant tumours that are associated with Oestrogen production.

40
Q

What are sertoli-leydig cell tumours?

A

It is a rare tumour composed of variable cell types normally seen in the testis. They produce ANDROGENS and can be malignant.

41
Q

What are the risk factors of ovarian cancer?

A
  • Family history
  • increased age
  • Breast cancer
  • smoking
  • Oestrogen only receptors.
  • obesity
42
Q

What are the protective factors of Ovarian cancer?

A
  • Oral contraceptive pill
  • breastfeeding
  • hysterectomy
43
Q

What are the symptoms of ovarian cancer?

A
  • pain
  • bloating
  • weight loss
  • bleeding
  • urinary frequency
44
Q

What are the treatments for ovarian cancer?

A
  • total abdominal hysterectomy (for stage 1 cancer)

- chemo

45
Q

What is a mullerian tumour?

A

It is a malignant neoplasm found in the uterus, ovaries and fallopian tubes/ It contains both epithelial and connective tissue.

Clinical Pathology (59 decks)

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