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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
Common risk factors of endometrioid adenocarcinoma
``` Obesity diabetes nulliparity early Menarche Late menopause All have in common hyperestrinism ```
26
Can woman with ovarian agenesis develop endometrial cancer
No unless treated with exogenous estrogens
27
What factor is cooperated with the fact that there is high frequency of endometrial cancer in women with Œstrogen secreting granulosa cell tumors
Body weight - 10x more if above 23kg overweight
28
Why is there a reduced risk of endometrial cancer with cigarette smoking
interference with hepatic conversion of estrone to active metabolites estriol
29
Which drug used for treatment of breast cancer increases risk of endometrial cancer because of synthesis of anti-estrogen which also has agonist activity
Tamoxifen
30
Most common histologic variant in endometrioid carcinoma
60% have glandular cells and are endometrioid adénocarcinoma
31
What are the three grades of endometrioid endometrial carcinoma based on
The ratio of glandular to solid elements solid elements signifying poorer differentiation
32
Grade 1 endometrioid ca Characteristics
Well differentiated cells mostly neoplastic glands minimal solid areas - less than 5%
33
Grade 2 Endometrioid carcinoma characteristics
Moderately differentiated cells More than 50% glandular elements Less than 50% solid tumor
34
Grade 3 and me triode carcinoma characteristics
Poorly differentiated cells | large areas of solid tumor more than 50%
35
Characteristics of non-endometrioid ca
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
36
What is the most common extra colony cancer in women Other than non-polyposis colon cancer syndrome
Non endometrioid cancer
37
Can you see areas of squamous metaplasia in well differentiated adenocarcinoma of endometrium
Yes
38
Gross morphology of endometrial ca
Diffuse or focal May extend to myometrium cervix and vagina Extend to parametrium and pelvic lymphatics
39
Pattern of growth of endometrial carcinoma
Exophytic Growth | May involve multiple areas
40
What are characteristics of a large tumors of endometrial carcinoma
Hemorrhagic | Necrotic
41
What are endometrial sarcomas
Where tumors arising from stem cells with ability to differentiate into homologous and heterologous tissues
42
Two types of endometrial sarcomas
Mixed homologous carcinosarcomas | Mixed mesodermal sarcomas
43
What are trophoblatic disease of endometrium
Tumor is derived from chorionic tissue or germinal cells
44
How do you call a trophoblastic disease coming from placenta
Gestational trophoblastic disease
45
How do you call the disease coming from the gonads
None gestational trophoblastic disease
46
Three forms of gestational trophoblastic disease
Hydatidiform mole invasive mole choriocarcinoma
47
high level of this hormone can cause multicystic ovaries
Hcg
48
Clinical features of hydatidiform moek
``` 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
2 forms of hydatidiform mole
Complete mole | Partial mole
50
Characteristics complete mole
No fetus No fetal component 46XX from father empty ovum fertilized by sperm Tolerance of women to husband tissues
51
Partial mole characteristics
``` Malformed fetus Partial maternal Partial paternal Placenta affected 69xxx or xxy 2 sperms fertilize one ovum ```
52
Invasive mole characteristics
Myometrium penetration | Blood vessels and lungs by hydatidiform mole
53
What is choriocarcinoma
Malignant tumor of trophoblast
54
Hormone secreted abundantly in choriocarcinoma
HCG
55
Characteristics of choriocarcinoma
``` Pleomorphic cytotrophoblast Syncytiotrophoblast Highly vascular Blood vessels invasion Early metastasis to lungs Suburethral metastatic nodule ```
56
Would you see a large bulky mass in uterine choriocarcinoma
No
57
Men manifestation of choriocarcinoma
Irregular spotting of bloody brown sometimes foul smelling fluid
58
Which means widespread metastases are characteristic of choriocarcinoma
Lungs vagina brain liver kidneys
59
Treatment of choriocarcinoma
Evacuation of uterus contents surgery chemotherapy
60
Result of chemotherapy in choriocarcinoma
Hundred percent success
61
Which type of Korea carcinoma is more resistant to therapy
Non gestational
62
Common tumors in the myometrium
Leiomyoma | Leiomyosarcoma
63
Commonest tumor of uterus
Fibroids known as leiomyoma
64
 main age affected by fibroids
Reproductive age
65
Different classification of fibroids
Submucosal intramural subserosal
66
Factors contributing in fibroids
Nulliparity Delivery interval Prolonged infertility
67
Who is the most affected by fibroids
Young African woman in reproductive age
68
Symptoms or presentation of fibroids
Heavy menstrual bleeding intermenstrual bleeding lower abdominal mass lower abdominal pain
69
Complications of fibroids
``` Hyaline degeneration red degeneration fatty change necrosis cystic degeneration calcification torsion infertility Subfertility abortion polycythemia Sarcomatous change ```
70
Which is more common fibroids orLeiomyosarcoma
Fibroids
71
Incidence of Lieiomyosarcoma
1/1000
72
Women affected by Leiomyosarcomas
Woman over 50 years old
73
Gross and micro examination of Leiomyosarcoma
``` 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
Diagnostic criteria of leiomyosarcoma
Mitotic activity cellular atypia geographical necrosis
75
Why are most leiomyosarcoma fatal
Because they are discovered very late so too late for therapy
76
Five-year survival of leiomyosarcoma
20
77
What is endometriosis
Endometrial tissue outside the uterus which is common in pelvis and genital tract
78
What are the sites where you can find endometrial tissue in endometriosis
``` Cæcum genital tract system rectum naval laparotomy scar ```
79
Causes of endometriosis
Deposits implanted at surgery retrograde spill of menstrual debris metaplasia of tissues into mullerian duct elements lymphatic and hematogenous spread
80
Main site involved in endometriosis
``` Ovaries at 60% Uterine adnexae- Uterine ligament, rectal vagina septum, patch of Douglas, pelvic peritoneum Fallopian tube Rectosigmoid colon bladder ```
81
What is adenomyosis
Ectopic endometrial tissue in the myometrium. Which can be diffuse or localized
82
Which one is commoner adenomyosis that is diffused or localized
Diffused
83
What accompanies adenomyosis
Overgrowth of muscle and connective tissue
84
What is salpingitis
Inflammation of the fallopian tubes generally due to infection ascending from the lower genital tract
85
What are the most common causes of organisms in salpingitis
N gonorrhea E. coli chlamydia mycoplasma
86
Is salpingitis do mostly monomicrobial or polymicrobial
Poly microbial
87
Clinical presentation of salpingitis
Infiltration by polymorphonuclear leukocytes (. Lymphocytes and plasma cells) pronounced edema congestion of mucosal folds
88
What is Pyosalpinx
When pus distend Fallopian tube In the late stage of salpingitis
89
What is hydrosalpinx
When there’s transfer dates in fallopian tube that are distended due to late stage salpingitis
90
Can you have peritonitis and pelvic inflammatory disease in salpingitis due to ascension of microorganism
Yes
91
Do you have fibrinous adhesion between Fallopian tube seRosa and surrounding peritoneal surfaces in salpingitis
Yes
92
Can you have a tubal ovarian abscess. In salpingitis
Yes
93
Why are there complications in salpingitis
Damage of Fallopian tube
94
How are adhesions in severe chronic salpingitis
Dense and form a blunted clubbed end of the tube
95
What is the general consequence of damage of Fallopian tubes after clinics up in Gytis
Tubal motility and passage of sperm impairment so infertility
96
Most common cause of ectopic pregnancy
Chronic salpingitis
97
Where do most of the tuberculosis of female genital tract starts
In the tubes
98
Why there may be infertility in tuberculosis salpingitis
Because of healing adhesions
99
What’s benign tumors do you see in the fallopian tubes
Fibromas | Leiomyoma’s
100
Are carcinomas of the fallopian tube common
No rare
101
Main presentation of carcinoma a Fallopian tubes
Profuse vagina discharge
102
Where is the most common sites of ectopic pregnancy
Ampulla of the tube
103
In which woman do we see an increased incidence of ectopic pregnancy
In women using intraintrauterine contraceptive devices

Reproductive (14 decks)

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