Female Genital Pathology Flashcards
What is the commonest mechanism of entry for genital tract infection? When can infection occour?
> ascending infection
- at oestrus
- postpartum
- equine placenta during pregnancy as cervix doesnt completely seal
How may pathogens enter the genital tract? Give egs.
- ascending
- haematogenous (usually pregnancy eg. brucellosis, salmonellosis, pestiviris, herpesvirus, aspergillosis)
- descending (rare) some viral, chlamydia, ureaplasma
- transneural (rare) recrudescence of herpessvirus
What defense mechanisms protect the genital tract?
> innate
- vaginal epithelium, cervix, conformation, myometrial tone and uterus contraction, drainiage of secretions, neutrophils/macrophages/complement/cytokines
adaptive
- response to pathogens but tolerating of spermatozoa and foetus
- humoral ABs (IgA and IgG)
- cellular lymphocytes
How may hormones influence immunity and vice versa?
- oestrus ^ drainage
- oestrogen ^ disease resistance by upregulating T and B lymphs
- progesterone ^ susceptibility of disease
- Inflammation of uterus v PGF2a production -> no lysis of CL
Give 5 developmental abnormalites
- true hermaphrodite
- pseudo hermaphrodite
- chimerism
- tract anomaly
- ovarian anomalies
How is pseudohermaphrodism named?
after gonads not external genetalia
What is chimerism?
individual with cells from 2 sources eg. freemartinism
What is ovarian remnant syndrome?
Cycling animals despite neutering due to remnant left or present in peritoneal cavity
What should not be confused with functional cysts?
developmental cysts - no affect on cyclicity
Why do follicular or graafian cysts occour?
- lack of LH surge due to low GnRH or lack of receptors
- may be due to stress (cortisol) or infection
What is a follicular cyst?
failure of mature follicule to ovulate
> 2.5cm in cow
> 1cm in sow
What clinical signs may be associated with follicular cysts?
Acyclicity (sows) and nymphomania (cows)
What is a luteal cyst?
Anovulation with luteinisation of theca
Why do luteal cysts occour?
lack of LH
Clinical signs of luteal cysts? Tx?
- anoestrus
- PGF2a
What is a cystic corpora lutea? What should not be confused with this?
- normal ovulation
- ovulation papilla present
> can be confused with luteal cysts
Other than cysts what ovarian pathologys are possible?
- haemorrhage
- adhesions
- inflam “oophoritis” usually due to bacteria ascending/systemic
4 types of ovarian neoplasia? egs.
> germ cell - teratoma - dysgerminoma > gonadal stromal neoplasm - granulosa cell - thecoma - luteoma > epithelial neoplasm - cystadenoma - cystadenocarcinoma > 2* tumours - lymphoma - mammary carcinoma bitch - intestinal carcinoma cow
Hw do dysgeminomas appear grossly? micro? prognosis?
- smooth surface
- areas of harmorrhage or necrosis
- frequent mitototic figures and giant cells
- mostly benign and undfferentiated
prognosis of teratomas?
mostly benign and well differentiated
What are sex cord-stromal tumours and what clinical signs may they cuase? Prognosis?
- granulosa-theca cell tumour
- smooth surface with solid or cystic cut surface
- usualy benign
- produce steroids -> masculinisation (andrgoens) anoestrus (inhibin) and nymphomania (oestrogen)
How do epithlial neoplasms appear grossly? Different types?
- cystadenoma and cystcarcinoma
- often bilateral and shaggy, cauliflower like
Which species are epithelial neoplasmm most common?
dog
Prognosis of epithelial neoplasms?
- contact metaplasia possible, may spread by implantation on peritoneal surface
- ascites
What pathologies may fallopian tubes (salpinx) incur?
- hydrosalpinx congenital or aquired
- pyosalpinx
- salpingitis (usually 2* ascending infection, common in gilts)
What are the 3 main non-infectious pathologies of the uterus?
- torsion (preg or yo, may be at cervix or tip of horn)
- rupture (dystocia or fluid tx of uterus)
- prolapse (hypocalcaemia, oestrogen^ , dystocia)
What is CEH-pyo syndrome?
- cystic endometrial hyperplasia
- due to excessive and prolonged oestrogenic stimulation (endo or exogenous)
- predisposes pyo
Why may mucometra/hydrometra occour?
- congential or aquired obstruction
- excessive fluid production eg. with endometrial hyperplasia (more common in older dogs due to frequent gland hyperplasia each season)
When may endomeritis occour?
- post service due to semen
- post-partum
What occours with endometritis?
- infiltration of lymphoctes and plasma cells into mucosa
pathogeneis of endometritis?
- mild cases self-limiting
- severe cases can become chronic and fibrous (if no E4 to sitmulate inflammation)
- > persistnet CL in mare and cow if chronic
Which species commonly gets endometritis?
Mares - persistent mating induced esp. older mares due to conformation
Common endometritis pathogens in the cow?
> venereal - herpes virus - tritrichomonas foetus - campylobacter foetus venerealis > postpartum - pyogenic cocci - coliforms - T. pyogenes
Common endometrititis pathogens in the mare?
- a-haemolytic strep
- Klebsiella pnuemonia
- E. COli
- Taylorella Equigenitalis CEM
- pseudomonas aeroguinosa
How does metritits differ to endometritits?
All ayers of uterine wall affected
- more severe due to possible toxaemia/septicaemia
Pathology of metritits grossly?
- dull congested serosa
- paintbrush haemorrhages
- thickened, oedematous and friable uterinae wall
- yellow-red exudate with foul odour
Which dogs are commonly affected by pyometra?
- older nulliparous dogs
When does pyo usually present?
- few weeks after oestrus under progesterone exposure following oestrogen priming
- may be predisposed by UTI
- CEH (cystic endometrial hyperplasia) predisposes
Commonest pathogens causing pyo in the bitch?
- E.coli causing brownish viscous exudate
- Strep causing creay yellow exudate
What may occour after pyo?
- toxaemia/bacteraemia -> widespread extramedullary haemoatopoiesis ad immune-complex glomerulopathy
How does pyometra in the cow differ to the bitch?
- not due to EH
- uterine disease usually predisposes (endometrirtis/metritis)
- most early post-partum though may be venereal
What does pyo in the cow cause?
- persistent CL and ^ P4 levels
Why is pyo less life threatening in the cow?
Cervix functionaly closed but still slightly open allowing for discharge
-> rarely systemic signs seen
COmmon pyo pathogens of the cow
- haemolytic strep
- staph
- coliforms
- trueperella pyogenes
- pseudomonas auroguinosa
- tritrichomonas foetus venerealis
What pathogen usually causes pyo in the sow?
Trueperella pyogenes
How do horses differ to other spp. wrt pyo?
- mares continue cycling during disease, soemtimes prolonged cycle
- some cases follow dystocia with infection, many do not
- mostly no cervical closure -> discharge and seldom systemic disesse
Which pathogens are involved in equine pyo?
- strep zooepidemicus
- E. COli
- Actiniomyces spp.
- Pasturella spp.
- Pseudomonas
> similar to endometritits
Which species is most commonly affected by leiomyoma? Prognosis?
- Bitch
- benign but multiple also affecting cervix and vagina
- oestrogens responsible for maintaining -> spaying will eradicate
Gross and microscopic appearance of leimyoma?
- firm pink or white, swirled smooth muscle cells
Which species is most commonly afected by carcinoma? When is this diagnosed? What is it and why is it important?
- cows
- found at meal inspecition
- epithelial neoplasia with glandular pattern, firm neoplasm with fibrous response
- suspect EBL (actually lymphosarcoma) (enzootic bovine leukosis: Notifiable disease)
Where does uterine carcinoma usually metstasise to?
- regional LNs
- lungs
- seeding in peritoneum
What defines lymphosarcoma?
- arising in lymphoid tissue
Egs. of lymphsarcoma?
EBL
Which organs are affected by EBL?
- heart
- abomasum
- LNs
- uterus
Give egs. of non-infectious vulva and vaginal diseases
- persistent hymen, vaginal septum
- rupture
- stricture/stensosis
- abnormal tumefaction (swelling of the vulva, normal in season)
- hyperplasia, hypertrophy and prolpase
- vaginal cysts and polyps (common in older bitches)
What are the 4 inflammatory diseases of the vulva and vagina?
- post partum trauma
- granular vaginitis/vulvitis
- Herpesvirus (IPV, CHV-1, EHV-3 coital exanthema)
- Dourine (notifiable)
What is IPV? What is the equivalent in the opposite sex? Spread? Prognosis?
Infectious pustular vulvovaginitis, infectious balanoposthitis
- caused by BVH-1
- venereal or nose-vulva contact spread
- lymphoid nodules form,self limiting, only seen in hiefers
Which neoplasms are possible in the vulva and vagina?
- leiomyoma
- TVT
- fibropapilloma
- SCC
How are TVT cells different to normal?
Less chromosomes
How is TVT transmitted?
Venereal transmission of neoplastic cells
Histo of TVT?
- large, round, neoplastic cells, occasional large bizarre nuclei
Tx and prognosis of TVT?
- vincristine responsive
- metastasises in dogs with poor heALTH
What does BPV-1 cause?
fibropapilloma
What is SCC caused by?
radiation damage eg. sunlight
