Pathology Flashcards
The menstrual cycle can be divided into 2 subtypes?
- ovarian cycle (describes changes to the ovaries)
- uterine cycle (describes changes to the uterus)
What are the stages of the ovarian cycle?
- follicular phase
- ovulation phase
- luteal phase
Explain the follicular phase?
- primordial follicles mature
- granulosa cells proliferate -> oestrogen and progesteerone
If no fertilisation occurs what happens to the corpus luteum?
- becomes the corpus albicans
How long does the luteal phase last?
- 14 days
What are the stages of the uterine cycle?
- menstrual phase
- proliferative phase
- secretory phase
Explain the proliferative phase
- occurs in the uterine cycle
- thickening of the stratum functionalis
- influence under oestrogen
Explain the secretory phase?
- driven via progesterone
- glands become more torturous
Indications for endometrial biopsy?
- abnormal uterine bleeding
- infertility
- spontaneous and therapeutic abortion
- assessment of response to hormone therapy
- high risk endometrial cancer screening
Define menorrhagia?
- prolonged and increased menstrual flow
Define metrorrhagia?
- regular intermenstrual bleeding
Define polymenorrhoea?
- menses occurring at <21 days
Causes of abnormal uterine bleeding (AUB)
- Pregnancy
- miscariage
- anovulatory cycles
- endometrosis
- leiomyoma
- exogenous hormones
- neoplasia
Define dysmenorrhoea?
- painful periods
How might the endometrium be assessed
- transvaginal USS
- hysteroscopy
- endometrial pipette biopsy
- dilation and curettage
Explain disorganised uterine bleeding (DUB)
- Irregular uterine bleeding
- no organic cause
- can be ovulatory or anovualtory
Inflammation of the endometrium is called?
- endometritis
Potential causes of endometritis?
- neisseria
- chlamydia
- TB
- Intrauterine contraceptive device
- postpartum
- granulomatous
Explain molar pregnancy?
- abnormal proliferation of trophoblasts
- non-viable fertilised egg implants
- partial (69 chromosomes)
- complete (46 chromosomes)
Explain a partial molar pregnancy?
- both maternal and parental chromosomes
- too many pairs - 69
Explain a complete molar pregnancy?
- No maternal DNA
- 2x parternal (46 chromosomes)
How will molar pregnancies appear on histology?
- swollen choronic villus
- extremely high HCG
Structural causes of AUB
- PALM
- Polyp
- adenomyosis
- leiomyoma
- malignancy
Non-structural causes of AUB?
- COEIN
- Coagulopathy
- ovulatory dysfunction
- endometrial
- iatrogenic
What is adenomyosis
- endometrial glands and stoma within the myometrium
Symptoms of adenomyosis?
- menorrhagia
- dysmenorrhoea
- AUB
What is leiomyoma?
- benign smooth muscle tumour
- aka. fibroids
- growth oestrogen dependent?
leiomyosarcoma may develop from what?
- leiomyoma
