L69 Flashcards
How does E vs P effect the endometrium? Describe roles of each during normal ovulation
E = proliferation, high during prolif/follicular phase
P = stop, from corpus luteum during secretory phase, preps endometrium for implantation
Drop P => period
What is type 1 endometrial carcinoma morphology, genetics, RFs, and prognosis?
**Setting of E EXCESS** Endometrioid (adenocarcinoma) PTEN (related to E) RF = obesity HTN diabetes infertility Good prog (low stage)
What is type 2 endometrial carcinoma morphology, genetics, and prognosis?
NO E excess Serous, clear cell carcino-sarcoma Older, thin AA women p53 mutations (HY) Poor prog
Adenomyosis - what is it/presentation
Basalis (stem cell layer of endometrium) herniates into myometrium
Cysts will try to cycle as normal endometrium
Pain + enlarged urterus
PID can lead to…
Infertility
Ectopic pregnancy
PID and endometriosis are RF for what?
Tubal pregnancy
What is acute endometritis?
Bacterial infection of endometrium due to retained products of delivery/miscarriage
What is chronic endometritis? 4 possible causes
Chronic endometrium inflam
- Chlamydia -> PID
- Retained products of contraception
- IUD
- TB
What medication is associated with endometrial polyp?
Tamoxifen
Give for breast cancer - anti E effects
Weak pro-E @ endometrium -> proliferation
What is anovulation? Pt ages
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
Risk factors for anovulation
High E states: obesity, polycystic ovary syndrome
Changes to thyroid
3 scenarios where you have unopposed E
- Anovulation
- Obesity
- E producing tumor = granulosa tumor
What is polycystic ovary syndrome?
High LH + low FSH
High levels E increase risk for endometrial carcinoma
What is the precursor lesion of endometrial carcinoma? Cause? Presentation
Endometrial hyperplasia = EIN
Due to unopposed E
“Post-meno uterine bleeding”
Treat endometrial hyperplasia in post-meno woman
Hysterectomy
What is endometrial carcinoma?
Malig prolif of endometrial glands
What is an endometrial carcinosarcoma? Gross appearance
Mixed tumor - multiple tissue types
V. aggressive
See mass in uterus w/ central necrosis
What are endometrial leiomyomas?
Benign, SM mass
Patho of leiomyoma
Related to E exposure - enlarge during preggo, decrease after menopause
What is a leiomyosarcoma? Describe appearance. Common complication?
Malig SM mass
Necrosis + hemm
Met via blood to LUNGS
What is endometriosis?
Benign endometrium in other parts of the body
Problem arises when tries to cycle like normal but in wrong place
Net = periodic bleeding
How is endometriosis effected by E + P?
Resistant to P
More E production via stromal cells - treat w/ aromatase I
How does endometriosis of the ovary look?
Chocolate cyst - lots of blood coag in ovary as endometrial tissue has cycled many times
TESTQ: Major complication of endometriosis
Increased risk of
- Endometrioid carcinoma (from endometrial hyerplasia)
- Clear cell carcinoma
TESTQ causes of acute salpingitis
Inflam of fallopian tubes
- Gonorrhea
- *IUD -> actinomyces
Why you worried about chronic salpingitis?
Infertility
