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2420 Pathology > Module 10 Female Genital Tract > Flashcards

Module 10 Female Genital Tract Flashcards

1
Q

Transformation Zone

A
  • Meeting of squamous & glandular cells
  • Common site of cervical neoplasia
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2
Q

Cervix

A
  • Connects vagina to uterus
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3
Q

Cervical Dysplasia Precursor

A
  • Pre-cancerous changes in epithelial cells
  • Detected by pap test
  • Earlier intervention
  • Reduced incidence of invasive cancers
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4
Q

Cervical Squamous Dysplasia Grading

A
  • Squamous intraepithelial lesion (SIL)
  • High grade OR low grade
  • LG, HPV 6/11 OR low risk of invasive cancer progression
  • HG, HPV 16/18/31/33/35 OR invasive cancer precursor lesion
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5
Q

Cervical SIL Risk Factors

A
  • HPV
  • STI
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6
Q

HPV Risk Factors

A
  • Young age of first intercourse
  • Multiple sex partners
  • Unprotected intercourse
  • Smoking
  • Oral contraceptive use
  • Pregnancy
  • Diabetes
  • Immunosuppression
  • Poor hygiene
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7
Q

HPV Prevetion

A
  • Safe sex
  • Vaccine
  • Cervical screening
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8
Q

Pap Test

A
  • Scraping of cervical cells from transformation zone
  • Cells examined to detect dysplastic changes
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9
Q

Low Grade Lesions

A
  • Repeat pap test in 6 months
  • Spontaneous regression common
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10
Q

High Grade Lesions

A
  • Consistent abnormality with pap smear
  • Glandular or high grade SIL detected
  • Investigation by colposcopy (cervix exam & biopsy)
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11
Q

Cervical Cancer

A
  • 90% squamous cell carcinoma
  • 10 years for invasive
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12
Q

Cervical Cancer Risk Factors

A
  • HPV
  • STI
  • Immune deficiency
  • Infrequent screenings
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13
Q

Cervical Cancer Presentation

A
  • Abnormal vaginal bleeding
  • Post-coital spotting
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14
Q

Cervical Cancer Spread

A
  • Invade into vagina rectum/bladder
  • Metastasize to lymph nodes
  • Ureters impairment
  • Urinary obstruction
  • Uremia/death
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15
Q

Cervical Cancer Treatment

A
  • Early invasive cases, cone excision/hysterectomy
  • Low stage survival 90%
  • Advanced disease 20%
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16
Q

Cervical Cancer Screening

A
  • 21-69 women
  • Sexually active
  • HPV testing women >30
  • Normal cytology = 3 year screening
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17
Q

Ovary Function

A
  • Maturation of oocytes for ovulation
  • Production & secretion of sex hormones
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18
Q

Benign Epithelial Ovarian Tumours

A
  • Large
  • Cystic
  • Lack solid growth & invasion
  • Common in adults
  • Variety of microscopic subtypes (serous, mucinous)
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19
Q

Malignant Epithelial Ovarian Tumours

A
  • Most common form (ovarian carcinoma)
  • Leading cause of death from gynecologic malignancy
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20
Q

Ovarian Carcinoma Prognosis

A
  • Often asymptomatic
  • Non-specific symptoms until advanced stage
  • Lack of specific screening test
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21
Q

Ovarian Carcinoma Presentation

A
  • Mass in post-menopausal women
  • Pelvic pain
  • Increased abdominal girth
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22
Q

Ovarian Carcinoma Treatment

A
  • Surgical excision
  • Chemo for distant spread
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23
Q

Non-Modifiable Ovarian Carcinoma Risk Factors

A
  • Increasing age (63+ most common)
  • Having children late or never having children
  • Family history of ovarian, breast, colon cancer
  • Inherited mutation
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24
Q

Modifiable Ovarian Carcinoma Risk Factors

A
  • Obesity
  • Post-menopausal hormone therapy
  • Smoking
25
Q

Mature Cystic Teratoma

A
  • Derived from ovarian germ cells
  • Most common ovarian neoplasm in young females <30
26
Q

Mature Cystic Teratoma Treatment

A
  • Surgical removal
  • Immature neural tissue (malignant risk)
27
Q

Dysgerinoma

A
  • Most common malignant germ cell tumour
  • Equivalent of testicular seminoma
28
Q

Metastatic Carcinoma

A
  • Common site for spread of other cancers
  • GI, breast, endometrium
  • Involve both ovaries
  • Poor prognosis
29
Q

Uterus Function

A
  • Nurture developing fetus
30
Q

Uterus Structure

A
  • Hallow muscular organ
  • In pelvis
  • Fundus (upper uterus) attaches to fallopian tubes
  • Lower uterus connects to vagina through cervix
31
Q

Uterus Layers

A
  • Mucosa (inner most) endometrium, gland stroma
  • Muscular wall (middle) myometrium
  • Peritoneal surface (outer) serosa
32
Q

Endometrial Hyperplasia

A
  • Unbalanced hormones alter menstrual cycle
  • Sporadic or missed ovulation
33
Q

Endometrial Hyperplasia Development

A
  • Increased estrogen
  • Proliferative endometrium
  • Unopposed growth
  • Endometrial hyperplasia
  • Endometrial carcinoma
34
Q

Non-Atypical Hyperplasia

A
  • Low risk of progression to carcinoma (1-3%)
  • Progestin therapy treatment
35
Q

Atypical Hyperplasia

A
  • High risk of progression to carcinoma (20-50%)
  • Surgery (removal of ovaries/fallopian tubes/uterus)
  • High dose progestins (preserve uterus in younger)
36
Q

Endometrial Carcinoma

A
  • Most common female genital tract malignancy
  • 85% associated with unopposed estrogen stimulation
  • 15% estrogen independent (more aggressive)
37
Q

Endometrial Carcinoma Risk Factors

A
  • Unopposed estrogen
  • Failure to ovulate (perimenopausal)
  • Polycystic ovarian disorder (hormonal disturbances)
  • Obesity
  • Hormone replacement therapy
  • Functional tumours (produce estrogen)
38
Q

Endometrial Carcinoma Prognosis

A
  • Abnormal uterine bleeding (post-menopausal)
  • Endometrial biopsy
  • Well differentiated & low stage = good prognosis
  • Non-estrogen associated deep invasion = poor prognosis
39
Q

Endometrial Carcinoma Treatment

A
  • Surgery (removal of ovaries/fallopian tubes/uterus)
  • Radiation
  • Chemo (higher stages)
40
Q

Leiomyomas

A
  • Most common female genital tract neoplasm
  • Fibroids (benign tumours of smooth muscle)
  • Present in 30-50% of females 30+
  • Present in 75% of hysterectomy specimens
  • Growth affected by hormonal alterations
41
Q

Leiomyomas Appearance

A
  • Round
  • Well-circumscribed
  • White whorled nodules
  • Various sizes
  • Often multiple
  • Locations include submucosal, intramural, subserosal
42
Q

Leiomyomas Treatment

A
  • None if asymptomatic
  • Hysterectomy if symptomatic
43
Q

Leiomyomas Clinical Presentation

A
  • Submucosal lesions on endometrium, cause bleeding
  • Pelvic pain
  • Dysmenorrhea
  • Infertility
44
Q

Fallopian Tube Function

A
  • Transport mature ovum toward uterus
  • Site of fertilization
45
Q

Ectopic Pregnancy

A
  • 1 in 150 pregnancies
  • Implant at site other than endometrial cavity
  • Typically in fallopian tube
46
Q

Ectopic Pregnancy Etiology

A
  • Any disease resulting in scarring/distortion of tubes
  • Increase risk of infection, adhesions, endometriosis
47
Q

Fallopian Tube with Ectopic Pregnancy

A
  1. Implantation of fertilized ovum in tube
  2. Chorionic villi of developing placenta invade tube wall
  3. Tube expands as embryo grows
  4. Risk of rupture with intraperitoneal hemorrhage/shock
48
Q

Ectopic Pregnancy Treatment

A
  • Early detection
  • Surgical excise affected tube segment
  • Methotrexate/chemo
49
Q

Endometriosis

A
  • Benign endometrial tissue outside of normal uterus location
  • Very common (10% of female population)
  • Unable to expel blood
  • Tissue expands to form hemorrhagic nodules/cysts
  • Dense adhesion from scaring
50
Q

Endometrosis Symptoms

A
  • Pelvic pain
  • Dysmenorrhea
51
Q

Endometrosis Sites

A
  • Ovaries (most frequent 80%)
  • Pelvic organs (vulva, bladder, colon, umbilicus)
52
Q

Retrograde Menstruation

A
  • Endometrial tissues travel through tubes
  • Implants onto other organs
53
Q

Metaplastic Transformation

A
  • Cells in peritoneum/connective tissues
  • Into endometrial cells
54
Q

Vascular/Lymphatic Dissemination

A
  • Endometrial tissues travel through blood vessels/lymphatics
  • Deposit elsewhere (benign metastases)
55
Q

Stem/Progenitor Cell Theory

A
  • Circulating stem cells from bone marrow undergo differentiation
  • Becoming endometrial tissue
56
Q

Endometriosis Treatment

A
  • Meds (pain, oral contraceptive)
  • Surgery (remove lesioned tissue & adhesions)
57
Q

Pelvic Inflammatory Disease

A
  • Infectious/inflammatory disorder of upper genital tract
  • Ascending infections (microorganisms introduced)
  • Sexual intercourse introduces organisms
58
Q

Pelvic Inflammatory Disease Treatment

A
  • Invasive antibiotic therapy
  • Surgery

2420 Pathology (13 decks)

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