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Reproductive > Gynecologic Pathology I > Flashcards

Gynecologic Pathology I Flashcards

1
Q

Indications for endometrial biopsy

A

determine cause of abnormal uterine bleeding, evacuation of ectopic pregnancy, assess response of endometrium to hormone tx

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2
Q

____ phase is the first 36-48 hours between ovulation and first histologic changes due to ovulation

A

interval

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3
Q

What is the first histologic evidence of ovulation

A

abundant subnuclear vacuoles

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4
Q

Histologic features of proliferative endometrium

A

mitoses, round regular glands, stratified nuclei

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5
Q

Histologic features of early secretory endometrium

A

subnuclear vacuoles, single row of nuclei

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6
Q

Histologic features of mid secretory endometrium (day 20-21)

A

prominent spiral arteries and predecidual change around them

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7
Q

Histologic features of late secretory endometrium (day 26-27)

A

confluent sheets of predecidua (pink) and lymphocytes

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8
Q

Excessive bleeding in both amount and duration of flow occurring at regular intervals.

A

Menorrhagia

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9
Q

Bleeding, usually not heavy, occurring at irregular intervals.

A

Metrorrhagia

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10
Q

Excessive bleeding with prolonged period of flow occurring at frequent and irregular intervals.

A

Menometrorrhagia

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11
Q

Painful menses

A

Dysmenorrhea

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12
Q

Abnormal bleeding that occurs at least one year after menopause.

A

Postmenopausal bleeding.

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13
Q

Abnormal bleeding prior to puberty may indicate

A

precocious puberty

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14
Q

Adolescent abnormal bleeding may indicate

A

dysfunctional bleeding or complications of pregnancy

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15
Q

Abnormal bleeding during reproductive years may indicate

A

complications of pregnancy, endometritis, dysfunctional bleeding, lesions

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16
Q

Abnormal bleeding in later years may indicate

A

atrophy, carcinoma, lesions

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17
Q

Alteration of the normal cyclical hormonal stimulation of the endometrium that is not postmenopausal bleeding or that does not occur in the presence of a pathologic process.

A

Dysfunctional uterine bleeding DUB

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18
Q

Clinically, DUB indicates _____

A

ovulatory dysfunction

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19
Q

Common histologic finding of DUB

A

stromal and glandular breakdown

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20
Q

Pathophysiology of DUB

A

without progesterone, estrogen will result in continued proliferation –> gland enlargement, irregular, disordered –> insufficient vascular support –> breakdown and bleeding

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21
Q

Collapse of stroma form what histological feature?

A

stromal blue balls –> collapsed, condensed balls with attenuated epithelial surface

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22
Q

____ is a result of lack of estrogen stimulation causing 25-50% of abnormal uterine bleeding in postmenopausal women.

A

endometrial atrophy –> cystic change of glands is common

23
Q

cystic atrophy of endometrium

A

stroma is less cellular and fibrotic; glands are cystically enlarged//no mitoses

24
Q

localized hyperplasia of basal endometrium present with abnormal bleeding and with no malignant potential

A

endometrial polyps

25
Q

Grossly, endometrial polyps can be ____ or ____ . (think jellyfish)

A

sessile or pedunculated

26
Q

Histologic features of polyps

A

irregular glands, thick walled blood vessels

27
Q

Benign smooth muscle tumor of the corpus, cervix, uterine ligaments, or ovaries.

A

leiomyoma/fibroids

28
Q

T/F leiomyomas are more common in AAs

A

T

29
Q

How are leiomyomas classified?

A

location

30
Q

leiomyoma in wall of myometrium

A

intramural

31
Q

leiomyoma under endometrium

A

submucosal

32
Q

leiomyoma on outer surface of uterus

A

subserosal

33
Q

symptoms of leiomyoma

A

uterine enlargement, multiple leiomyomas, abnormal bleeding, painful menses, infertility, spontaneous abortion

34
Q

complications of a pedunculated fibroid

A

torsion, infarction, separation from uterus = parasitic leiomyoma

35
Q

Difference between endometrial polyp and submucosal leiomyoma under hysteroscopy

A

submucosal leiomyoma has thinner membrane with visualizable blood vessel

36
Q

Difference between submucosal leiomyoma and endometrial polyp

A

former is a tumor of the myometrium and the latter arises from the endometrium

37
Q

Typical leiomyoma cut surface

A

well circumscribed, bulges from myometrium, solid white/tan, whorled appearance, no necrosis or hemorrhage

38
Q

Typical leiomyoma histological features

A

uniform, bland spindled muscle cells with fascicular arrangement, abundant pink cytoplasm, uniform/oval/cigar nuclei, fine chromatin, rare mitoses

39
Q

malignant counterpart of leiomyoma of the smooth muscle of uterus

A

leiomyosarcoma

40
Q

Which groups have higher rate of leiomyosarcoma?

A

AAs and pts on tamoxifen

41
Q

leiomyosarcoma gross features

A

loss of whorls, irregular margin, yellow, necrosis, hemorrhage

42
Q

Diagnostic features of leiomyosarcoma

A

invasion of myometrium, vascular invasion, increased cellularity, nuclear atypia, increased mitotic activity, coagulative necrosis

43
Q

Endometrial tissue (glands and stroma) outside uterine cavity in women of reproductive age –> pelvic peritoneum and ovaries.

A

endometriosis

44
Q

Risk factors for endometriosis

A

genetic, increased exposure to menstruation (cervical stenosis, volume of retrograde menstruation, duration of flow)

45
Q

3 theories of endometriosis pathophysiology

A

transplantation, metaplasia, induction

46
Q

endometriosis transplantation

A

endometrial fragments migrate to ectopic sites

47
Q

endometriosis metaplasia

A

metaplasia of peritoneum

48
Q

endometriosis induction

A

induction of undifferentiated mesenchyme in ectopic sites to form endometriotic tissue

49
Q

Chocolate cyst

A

endometriotic cyst of ovary –> thick brown cyst content

50
Q

Symptoms of endometriosis

A

secondary dysmenorrhea, pelvic pain, ascites, dyspareunia, infertility

51
Q

T/F there is no correlation between severity of symptoms and extent of endometriosis

A

T

52
Q

Presence of endometrial tissue within the uterine wall.

A

adenomyosis –> downgrowth of tissue into and between smooth muscle fascicles

53
Q

Symptoms of adenomyosis

A

menometorrhagia, dysmenorrhea, dyspareunia, pelvic pain

54
Q

Gross features of adenomyosis

A

functional endometrial nests within myometrium producing foci of hemorrhagic cysts in uterine wall

Reproductive (38 decks)

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