Non0-neoplastic dz of female reproductive tract Flashcards
Trichomonas structure
large flagellated protozoa
REMEMBER, IT IS AN STD
What are the symptoms of trichomonas infection
Yellow vaginal discharge, dyspaerunia (painful intercourse), dysuria (painful urination)
What will teh cervix look like during a trichomonas infection?
Inflamed like a strawberry
Predisposing factors to Candida infection?
Diabetes Mellitus, Pregnancy, Oral contraceptives
Presentation of candida infection?
Cottage cheese appearance of discharge, discomfort, itching
If an HSV II infection reactivates in pregnancy, the newborn may acquire fatal infection during passage through the birth canal
Active herpetic lesions at the time of delivery necessitate a C-section.
Characteristic appearance of HSC infected cells in pap smear?
cytomegaly, multi-nucleation, intra-nuclear inclusions
Pelvic Inflammatory Disease causes
- Gonococcus, Chlamydia, mycoplasma, enteric bacteria, strep and staph.
GMC, E, Staph Strep
Presentation of PID
lower abdominal pain, adnexal tenderness, prominent discomfort when the cervix is manipulated (chandelier sign)
Complications of PID?
ruptures of tubo-ovarian abscess, peritonitis, sepsis, infertility, bowel obstruction
Most common and most severe infection in women?
Gonorrhea
Structure of Neisseria Gonorrhoeae?
gram negative diplococcus
How does gonorrheal PID come about?
Spreads upward.
- Ascends from periuthral glands and perivaginal glands through the cervix and the endometrial cavity where they cause acute cervicitis and endometritis.
- Infection spreads on the mucosal surface of the fallopian tubes to the ovaries and pelvic organs
Most common site of ectopic pregnancy
fallopian tubes (95%)
Ectopic pregnancy presentation
sudden abdominal pain, shock like presentation about 6-12 weeks following a previous menstrual period.
Physiology of menstrual cycle slide
know it
During the proliferative phase, how would you characterize the endometrium?
Straight glands with psuedo-stratified epithelium.
No mucin production
Stroma is composed of spindle cells with scant cytoplasm, high mitotic rate
Labia major covered by
skin
Labia minor
non-keratinizing squamous epithelium
Endocervical canal lined by?
glandular epithelium
Upper 2/3 of the endometrum is called
zona functionalis
Lower 1/3 is the basal layer
of the endometrium
What does the trichomonas vaginalis organism look like?
Its a protozoa, looks a lot like a neutrophil swimming around
Gross appearance of PID
adnexa show mall like conglomerates replacing the tubes and ovaries. Inflamed tube and ovaries surrounded by fibrous tissue
The masses are composed of inflammatory exudate, necrotic debris, and fibrous tissue.
May rupture causing peritonitis/ sepsis. May also turn into a sac containing clear fluid
Endometrial hyperplasia
Prolonged, abnormally high estrogen stimulation without progesterone effect
Conditions that cause endometrial hyperplasia?
Stein-leventhal syndrome, perimenopause, estrogen tumors, obesity
What is the normal gland to stroma ratio
50:50
What is the gland to stroma ratio in endometrial hyperplasia?
DOMINATING GLANDS over stroma
What is a chandelier sign?
Discomfort when the cervix is manipulated…suggests PID
Primary infxn that causes PID?
Post-partum endometriosis, Intrauterine device, curretage
More common cause of PID is the introduction of organisms through sex
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What causes the infertility in PID patients
stricture of the fallopian tubes
Two most common causes of PID
chlamydia and gonorrhaea
What does the post-menopausal endometrium look like?
- inactive or simple cystic glands
- No evidence of proliferation or secretion
- ## Dense inactive stroma
KNOW…In hyperplasia, there is no secretion!!! If you see mucin, it is not hyperplasia
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WHen looking for hyperplasia, look for glands with no stroma between them and no secretion
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