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Gynae > gynae 2 > Flashcards

gynae 2 Flashcards

1
Q

What are the disorders of the fallopian tubes?

A
  1. Inflammations
    - Suppurative (Gonococci, Chlamydiae)
    - TB salpingitis
    - actinomycosis
  2. Ectopic Pregnancy and Endometriosis
  3. Tumours and Cysts
    - Hydatids of Morgagni, Adenomatoid Tumour and Adenocarcinoma
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2
Q

What disase mimics tumours of the ovary/fallopian tube? Pathogenesis?

A

Paratubal Cyst (Hydatids of Morgagni).

Remnants of Mullerian Duct

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3
Q

What is hydrosalpinx? Causes?

A

Blocked fallopian tube filled with fluid.

PID, Endometriosis

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4
Q

Some causes of pyosalpinx? Symptom? Treatment? Complication?

A

Chlamydia, E Coli, Staph. Strep.

Pelvic Pain

Antibiotics/Surgery

Infertility since creates obstruction and kinking of fallopian tubes

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5
Q

Consequences of salpingitis?

A
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6
Q

What is a risk factor in actinomycotic salpingitis?

A

IUCD users

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7
Q

What is the most common benign tumour of the fallopian tube?

A

Adenomatoid Tumour

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8
Q

Histological features of adenomatoid tumour?

A

Invagination of visceral mesothelium
Tubular spaces of varying sizes composed of flattened cells

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9
Q

Pathogenesis of adenomatoid tumour?

A

Proliferation of surface epithelium of fallopian tube = deeps into the wall of the fallopian tube, producing tubule-like structures within the stroma

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10
Q

What is the pathogenesis behind salpingitis isthmica nodosa?

A

Diverticulae from lumen going into the wall of the fallopian tube, leading to nodular bilateral swelling.

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11
Q

State 4 non-neoplastic ovarian cysts?

A
  1. Follicular Cysts
  2. multiple follicular cysts
  3. Corpus luteal cysts
  4. Endometriotic cysts
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12
Q

What is the pathogenesis of a follicular cyst?

A

Arise from unruptured follicles or from follicles that ruptured and sealed immediately. Filled with serous fluid

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13
Q

How does corpus luteal cyst look grossly? what is it associated with?

A

Yellowish thick cyst lining. menstrual irregularitis

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14
Q

What is the appearance of polycystic ovary?

A

Multiple cysts and stromal hyperplasia

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15
Q

What is the pathogenesis of PCOS?

A

Persistent Anovulatory state (hugh estrogens and androgens)

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16
Q

What are symptoms and complications of PCOS?

A

Obesity, Hirsute, Acne, Amenorrhoae

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17
Q

4 categories of ovarian neoplasms?

A
  1. Surface Epithelial Cells
  2. Germ Cell
  3. Sex Cord-Stroma
  4. Metastasis
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18
Q

Categories/Divisions of Ovarian Germ Cell Tumours?

A
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19
Q

What is the gross appearance of dysgerminoma?

A

Large, firm, bosselated external surface
Soft and fleshy

20
Q

What is the histological appearance of a dysgerminoma?

A

Nests of monotonous tumour cells with clear glycogen-filled cytoplasm

Fibrous septa with lymphocytes

21
Q

Types of teratomas?

A

Mature
- Benign: Cystic Teratoma, struma ovarii
- malignant: SCC, thyroid

Immature
(malignant)

22
Q

Yolk sac tumours histologically have what distinguishing characteristic? What marker is elevated? Who gets it?

A

Schiller-Duval bodies
Alpha fetoprotein
Children & Young Women

23
Q

How to distinguish immature and mature teratoma?

A

Primitive neuroepithelium

24
Q

State the 4 types of ovarian surface epithelial tumours

A
  1. Endocervical Differentiation - mucinous tumours
  2. Tubal Differentiation - serous tumours
  3. Endometrial Differentiation - Endometrioid and clear cell type
  4. Urothelial - Brenner Tumour
25
Q

What is the pathogenesis of the two types of epithelial tumours?

A

Type 1: Progression from benign to borderline to carcinoma
Type 2: From inclusion cysts/fallopian tube epithelium that show high grade features (serous)

26
Q

What are the histological criteria for borderline ovarian neoplasms?

A
  1. Epithelial Hyperplasia - stratification, tufts (papillary like structures instead of single epithelial layer)
  2. Atypia - mild tomoderate
  3. Minimal Mitotic Activity
  4. Absence of destructive stromal invasion
27
Q

Features of mucinous cystadenoma?

A
  1. Enlarged ovary
  2. Mucinous, Multiloculated
  3. locules filled with mucinous material
  4. Mucinous Epithelium
28
Q

Features of mucinous cystadenocarcinoma

A

Less mucinous differentiation - form complex glands invading into stroma, necrosis, lot of mitoses

29
Q

Features of serous cystadenoma?

A

Multi-loculated, serous fluid

Lining epithelium is ciliated (low cuboidal to columnar

30
Q

Features of Endometrioid Ovarian Tumours?

A

Endometrial type differentiation (endomtrium composed of tubular structures with stratified epithelium)

31
Q

Risk factor of Endometroid ovarian tumours?

A

Endometriosis (15% co exist)

32
Q

Risk of endometrioid ovarian tumours?

A

Most are carcinomas

33
Q

Gross and histological features of Clear Cell ovarian adenocarcinoma?

A

G: Solid/Cystic
H: Large sheets of epithelial cells with clear cytoplasm and tubules with hobnail nuclei

34
Q

Histological features of Brenner Tumour?

A

Nests of urothelial-like cells in a dense fibrous stroma
Nuclei folded onto self

35
Q

What is a fibroma-thecoma?

A

Stromal tumour with fibroblasts or plump spindle cells with lipid droplets

36
Q

What can fibroma-thecoma lead to?

A

Meig’s syndrome: fibroma, ascites, pleural effusion

37
Q

What is the gross appearance of a fibroma-thecoma?

A

Solid, uniform
or Cerebreform appearance

38
Q

Gross appearance of Granulosa Cell tumour?

A

Large, focally cystic to solid
Yellow areas of lipid laden cells

39
Q

Histological appearance of granulosa cell tumours?

A

Follicular pattern (call-exner bodies)
Cleaved, elongated nuclei (coffee bean)

40
Q

What stain is good for granulosa cell tumours?

A

Inhibin

41
Q

What are the complications of granulosa cell tumour?

A

Estrogen secretion
- endometrial hyperplasia & carcinoma

leading to precocious puberty

42
Q

Granulosa cell tumours are malignant due to the potential for local spread, but does not have distal mets beyond abdominal cavity

A

pls note

43
Q

Some features of sertoli-leydig cell tumours?
Just read and try to remember lol

A

Rare mesenchymal tumour of low grade malignant potential
Resembles embryonic testis
Androgen secreting
Common in young women

44
Q

How does mets to the ovary occur (4)

A
  1. Local infiltration into broad ligament
    - urethral obstruction
    - bladder involvement
  2. Peritoneal Spread
    - Ascites with malignant cells in fluid
    - peritoneal nodules
  3. Lymphatic spread
  4. Hematogenous Spread
45
Q

Where can Krukenberg tumours come from?

A

Mullerian - Uterus, FT, Peritoneum
Extramullerian - Breast, GIT

46
Q

Gross presentation of Krukenberg tumours?

A

Bilateral, friable and necrotic with vascular invasion

Gynae (3 decks)

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