L69

Question 1

How does E vs P effect the endometrium? Describe roles of each during normal ovulation

Answer 1

E = proliferation, high during prolif/follicular phase
P = stop, from corpus luteum during secretory phase, preps endometrium for implantation
Drop P => period

Question 2

What is type 1 endometrial carcinoma morphology, genetics, RFs, and prognosis?

Answer 2

**Setting of E EXCESS**
Endometrioid (adenocarcinoma) 
PTEN (related to E)
RF = obesity HTN diabetes infertility 
Good prog (low stage)

Question 3

What is type 2 endometrial carcinoma morphology, genetics, and prognosis?

Answer 3

NO E excess
Serous, clear cell carcino-sarcoma
Older, thin AA women
p53 mutations (HY)
Poor prog

Question 4

Adenomyosis - what is it/presentation

Answer 4

Basalis (stem cell layer of endometrium) herniates into myometrium
Cysts will try to cycle as normal endometrium
Pain + enlarged urterus

Question 5

PID can lead to…

Answer 5

Infertility

Ectopic pregnancy

Question 6

PID and endometriosis are RF for what?

Answer 6

Tubal pregnancy

Question 7

What is acute endometritis?

Answer 7

Bacterial infection of endometrium due to retained products of delivery/miscarriage

Question 8

What is chronic endometritis? 4 possible causes

Answer 8

Chronic endometrium inflam

1. Chlamydia -> PID
2. Retained products of contraception
3. IUD
4. TB

Question 9

What medication is associated with endometrial polyp?

Answer 9

Tamoxifen
Give for breast cancer - anti E effects
Weak pro-E @ endometrium -> proliferation

Question 10

What is anovulation? Pt ages

Answer 10

Don’t have ovulation - no P secretory phase
So you get repeated E driven endometrial prolif
Cause of abnormal bleeding around 1st period or menopause

Question 11

Risk factors for anovulation

Answer 11

High E states: obesity, polycystic ovary syndrome

Changes to thyroid

Question 12

3 scenarios where you have unopposed E

Answer 12

1. Anovulation
2. Obesity
3. E producing tumor = granulosa tumor

Question 13

What is polycystic ovary syndrome?

Answer 13

High LH + low FSH

High levels E increase risk for endometrial carcinoma

Question 14

What is the precursor lesion of endometrial carcinoma? Cause? Presentation

Answer 14

Endometrial hyperplasia = EIN
Due to unopposed E
“Post-meno uterine bleeding”

Question 15

Treat endometrial hyperplasia in post-meno woman

Answer 15

Hysterectomy

Question 16

What is endometrial carcinoma?

Answer 16

Malig prolif of endometrial glands

Question 17

What is an endometrial carcinosarcoma? Gross appearance

Answer 17

Mixed tumor - multiple tissue types
V. aggressive
See mass in uterus w/ central necrosis

Question 18

What are endometrial leiomyomas?

Answer 18

Benign, SM mass

Question 19

Patho of leiomyoma

Answer 19

Related to E exposure - enlarge during preggo, decrease after menopause

Question 20

What is a leiomyosarcoma? Describe appearance. Common complication?

Answer 20

Malig SM mass
Necrosis + hemm
Met via blood to LUNGS

Question 21

What is endometriosis?

Answer 21

Benign endometrium in other parts of the body
Problem arises when tries to cycle like normal but in wrong place
Net = periodic bleeding

Question 22

How is endometriosis effected by E + P?

Answer 22

Resistant to P

More E production via stromal cells - treat w/ aromatase I

Question 23

How does endometriosis of the ovary look?

Answer 23

Chocolate cyst - lots of blood coag in ovary as endometrial tissue has cycled many times

Question 24

TESTQ: Major complication of endometriosis

Answer 24

Increased risk of

1. Endometrioid carcinoma (from endometrial hyerplasia)
2. Clear cell carcinoma

Question 25

TESTQ causes of acute salpingitis

Answer 25

Inflam of fallopian tubes

1. Gonorrhea
2. *IUD -> actinomyces

Question 26

Why you worried about chronic salpingitis?

Answer 26

Infertility