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Reproductive > Endometrial Dx > Flashcards

Endometrial Dx Flashcards

1
Q

What is acute endometritis

A

Presence of polymorphonuclear leukocytes in endometrium

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2
Q

Main causes of acute endometritis

A

Ascending infections from cervix caused by abortion, delivery, or medical instrumentation

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3
Q

What procedure helps with diagnosis and cure of acute endometritis

A

Curettage by removing necrotic tissues

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4
Q

What is chronic Endometritis

A

Rare condition following complicate acute Endometritis

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5
Q

What do you see in the stroma of Chronic a Endometritis

A

Infiltrated stroma by plasma cells

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6
Q

Chronic Endometritis is associated with

A

Intrauterine contraceptive devices
Pelvic inflammatory disease
Product retention of conception after abortion or delivery

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7
Q

Main clinical manifestation of chronic endometritis

A

Bleeding

pelvic pain or both

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8
Q

Is Chronic Endometritis self-limiting or not

A

Self-lim

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9
Q

What is tuberculosis Endometritis

A

Endometritis due to tuberculosis

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10
Q

What are the main characteristics of tuberculous Endometritis

A

Extension from fallopian tubes
amenorrhea
Caseated necrosis
granulomatous inflammation with langhans giant cells

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11
Q

What is pyometra

A

Pus in the endometrial cavity

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12
Q

What gross anatomy defects are associated with pyometra

A

Fistulous Tracts between bowel and uterine cavity
bulky or perforating malignancies
cervical stenosis

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13
Q

What are the two forms of endometrial hyperplasia

A

Simple

complex

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14
Q

What are the two forms of complex endometrial hyperplasia

A

Atypia

Without atypia

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15
Q

What is complex hyperplasia

A

High Glandular crowding

increased gland to stromal ratio

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16
Q

What are atypical glands in complex hyperplasia

A

increased mitotic figures

dysplastic cells line glands

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17
Q

Between typic and atypic complex hyperplasia k which is considered a premalignant condition

A

Atypic

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18
Q

Two types of endometrial carcinoma

A

Endometrioid cancers

non endometrioid types

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19
Q

What are Endometrioid cancer

A

 Associated with endometrial intraepithelial neoplasia Precursors
Slow clinical course
prior estrogen exposure

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20
Q

Non Endometrioid types characteristics

A

No warning
Seen in older woman
higher fatality rates

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21
Q

3/4 of women with endometrial cancer or in which phase of their life

A

Postmenopausal

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22
Q

Median age of diagnosis of endometrial cancer

A

63 years old

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23
Q

Major form of endometrial cancer

A

Endometrioid adenocarcinoma

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24
Q

What is the main associated factor in endometrioid Adenocarcinoma

A

Prolonged estrogenic stimulation

Defect in the PTEN tumor suppressor pathway

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25
Q

Common risk factors of endometrioid adenocarcinoma

A 
Obesity 
diabetes 
 nulliparity 
early Menarche 
Late  menopause
All have in common hyperestrinism
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26
Q

Can woman with ovarian agenesis develop endometrial cancer

A

No unless treated with exogenous estrogens

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27
Q

What factor is cooperated with the fact that there is high frequency of endometrial cancer in women with Œstrogen secreting granulosa cell tumors

A

Body weight - 10x more if above 23kg overweight

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28
Q

Why is there a reduced risk of endometrial cancer with cigarette smoking

A

interference with hepatic conversion of estrone to active metabolites estriol

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29
Q

Which drug used for treatment of breast cancer increases risk of endometrial cancer because of synthesis of anti-estrogen which also has agonist activity

A

Tamoxifen

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30
Q

Most common histologic variant in endometrioid carcinoma

A

60% have glandular cells and are endometrioid adénocarcinoma

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31
Q

What are the three grades of endometrioid endometrial carcinoma based on

A

The ratio of glandular to solid elements solid elements signifying poorer differentiation

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32
Q

Grade 1 endometrioid ca Characteristics

A

Well differentiated cells
mostly neoplastic glands
minimal solid areas - less than 5%

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33
Q

Grade 2 Endometrioid carcinoma characteristics

A

Moderately differentiated cells
More than 50% glandular elements
Less than 50% solid tumor

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34
Q

Grade 3 and me triode carcinoma characteristics

A

Poorly differentiated cells

large areas of solid tumor more than 50%

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35
Q

Characteristics of non-endometrioid ca

A

Unrelated to estrogen exposure
women in their 60s and 70s
Adjacent endometrium usually atrophic - estrogen deficiency
p53 gene mutations
sometimes can be serous Endometrial intraepithelial carcinoma

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36
Q

What is the most common extra colony cancer in women Other than non-polyposis colon cancer syndrome

A

Non endometrioid cancer

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37
Q

Can you see areas of squamous metaplasia in well differentiated adenocarcinoma of endometrium

A

Yes

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38
Q

Gross morphology of endometrial ca

A

Diffuse or focal
May extend to myometrium cervix and vagina
Extend to parametrium and pelvic lymphatics

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39
Q

Pattern of growth of endometrial carcinoma

A

Exophytic Growth

May involve multiple areas

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40
Q

What are characteristics of a large tumors of endometrial carcinoma

A

Hemorrhagic

Necrotic

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41
Q

What are endometrial sarcomas

A

Where tumors arising from stem cells with ability to differentiate into homologous and heterologous tissues

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42
Q

Two types of endometrial sarcomas

A

Mixed homologous carcinosarcomas

Mixed mesodermal sarcomas

43
Q

What are trophoblatic disease of endometrium

A

Tumor is derived from chorionic tissue or germinal cells

44
Q

How do you call a trophoblastic disease coming from placenta

A

Gestational trophoblastic disease

45
Q

How do you call the disease coming from the gonads

A

None gestational trophoblastic disease

46
Q

Three forms of gestational trophoblastic disease

A

Hydatidiform mole
invasive mole
choriocarcinoma

47
Q

high level of this hormone can cause multicystic ovaries

A

Hcg

48
Q

Clinical features of hydatidiform moek

A 
Bleeding
Abortion of mole
Excess vomiting in early pregnancy 
Doughy consistency uterus
No fetal in complete mole 
Hypertension in 2nd trimester 
Bilateral enlarged cystic ovaries
49
Q

2 forms of hydatidiform mole

A

Complete mole

Partial mole

50
Q

Characteristics complete mole

A

No fetus
No fetal component
46XX from father empty ovum fertilized by sperm
Tolerance of women to husband tissues

51
Q

Partial mole characteristics

A 
Malformed fetus 
Partial maternal 
Partial paternal 
Placenta affected 
69xxx or xxy 
2 sperms fertilize one ovum
52
Q

Invasive mole characteristics

A

Myometrium penetration

Blood vessels and lungs by hydatidiform mole

53
Q

What is choriocarcinoma

A

Malignant tumor of trophoblast

54
Q

Hormone secreted abundantly in choriocarcinoma

A

HCG

55
Q

Characteristics of choriocarcinoma

A 
Pleomorphic cytotrophoblast 
Syncytiotrophoblast
Highly vascular
Blood vessels invasion 
Early metastasis to lungs 
Suburethral metastatic nodule
56
Q

Would you see a large bulky mass in uterine choriocarcinoma

A

No

57
Q

Men manifestation of choriocarcinoma

A

Irregular spotting of bloody brown sometimes foul smelling fluid

58
Q

Which means widespread metastases are characteristic of choriocarcinoma

A

Lungs vagina brain liver kidneys

59
Q

Treatment of choriocarcinoma

A

Evacuation of uterus contents
surgery
chemotherapy

60
Q

Result of chemotherapy in choriocarcinoma

A

Hundred percent success

61
Q

Which type of Korea carcinoma is more resistant to therapy

A

Non gestational

62
Q

Common tumors in the myometrium

A

Leiomyoma

Leiomyosarcoma

63
Q

Commonest tumor of uterus

A

Fibroids known as leiomyoma

64
Q

 main age affected by fibroids

A

Reproductive age

65
Q

Different classification of fibroids

A

Submucosal
intramural
subserosal

66
Q

Factors contributing in fibroids

A

Nulliparity
Delivery interval
Prolonged infertility

67
Q

Who is the most affected by fibroids

A

Young African woman in reproductive age

68
Q

Symptoms or presentation of fibroids

A

Heavy menstrual bleeding
intermenstrual bleeding
lower abdominal mass
lower abdominal pain

69
Q

Complications of fibroids

A 
Hyaline degeneration
 red degeneration
 fatty change 
necrosis 
cystic degeneration 
calcification 
torsion 
infertility 
Subfertility 
abortion 
polycythemia 
Sarcomatous change
70
Q

Which is more common fibroids orLeiomyosarcoma

A

Fibroids

71
Q

Incidence of Lieiomyosarcoma

A

1/1000

72
Q

Women affected by Leiomyosarcomas

A

Woman over 50 years old

73
Q

Gross and micro examination of Leiomyosarcoma

A 
Necrosis 
soft 
irregular borders 
invasion into neighboring myometrium 
no bulging above surface when cuts
Mitotic activity 
cellular atypia 
geographical necrosis 
sharp transitioned from viable tumor to large zones of necrosis
74
Q

Diagnostic criteria of leiomyosarcoma

A

Mitotic activity
cellular atypia
geographical necrosis

75
Q

Why are most leiomyosarcoma fatal

A

Because they are discovered very late so too late for therapy

76
Q

Five-year survival of leiomyosarcoma

A

20

77
Q

What is endometriosis

A

Endometrial tissue outside the uterus which is common in pelvis and genital tract

78
Q

What are the sites where you can find endometrial tissue in endometriosis

A 
Cæcum
genital tract system 
rectum 
naval 
laparotomy scar
79
Q

Causes of endometriosis

A

Deposits implanted at surgery
retrograde spill of menstrual debris
metaplasia of tissues into mullerian duct elements
lymphatic and hematogenous spread

80
Q

Main site involved in endometriosis

A 
Ovaries at 60%
Uterine adnexae-   Uterine ligament, rectal vagina septum, patch of Douglas,
pelvic  peritoneum
Fallopian tube
Rectosigmoid colon 
bladder
81
Q

What is adenomyosis

A

Ectopic endometrial tissue in the myometrium. Which can be diffuse or localized

82
Q

Which one is commoner adenomyosis that is diffused or localized

A

Diffused

83
Q

What accompanies adenomyosis

A

Overgrowth of muscle and connective tissue

84
Q

What is salpingitis

A

Inflammation of the fallopian tubes generally due to infection ascending from the lower genital tract

85
Q

What are the most common causes of organisms in salpingitis

A

N gonorrhea
E. coli
chlamydia
mycoplasma

86
Q

Is salpingitis do mostly monomicrobial or polymicrobial

A

Poly microbial

87
Q

Clinical presentation of salpingitis

A

Infiltration by polymorphonuclear leukocytes (. Lymphocytes and plasma cells)
pronounced edema
congestion of mucosal folds

88
Q

What is Pyosalpinx

A

When pus distend Fallopian tube In the late stage of salpingitis

89
Q

What is hydrosalpinx

A

When there’s transfer dates in fallopian tube that are distended due to late stage salpingitis

90
Q

Can you have peritonitis and pelvic inflammatory disease in salpingitis due to ascension of microorganism

A

Yes

91
Q

Do you have fibrinous adhesion between Fallopian tube seRosa and surrounding peritoneal surfaces in salpingitis

A

Yes

92
Q

Can you have a tubal ovarian abscess. In salpingitis

A

Yes

93
Q

Why are there complications in salpingitis

A

Damage of Fallopian tube

94
Q

How are adhesions in severe chronic salpingitis

A

Dense and form a blunted clubbed end of the tube

95
Q

What is the general consequence of damage of Fallopian tubes after clinics up in Gytis

A

Tubal motility and passage of sperm impairment so infertility

96
Q

Most common cause of ectopic pregnancy

A

Chronic salpingitis

97
Q

Where do most of the tuberculosis of female genital tract starts

A

In the tubes

98
Q

Why there may be infertility in tuberculosis salpingitis

A

Because of healing adhesions

99
Q

What’s benign tumors do you see in the fallopian tubes

A

Fibromas

Leiomyoma’s

100
Q

Are carcinomas of the fallopian tube common

A

No rare

101
Q

Main presentation of carcinoma a Fallopian tubes

A

Profuse vagina discharge

102
Q

Where is the most common sites of ectopic pregnancy

A

Ampulla of the tube

103
Q

In which woman do we see an increased incidence of ectopic pregnancy

A

In women using intraintrauterine contraceptive devices

Reproductive (14 decks)

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