Pathology Flashcards
What are the three phases of the ovarian cycle?
Follicular phase
Ovulation
Luteal phase
What are the three phases of the uterine cycle?
Menstrual phase
Proliferative phase
Secretory phase
Which hormone influences the proliferative phase?
Oestrogen
Which hormone influences the secretory phase?
Progesterone
In the secretory phase, the glands appear more wiggly. True/false?
True
Give some types of abnormal uterine bleeding
Menorrhagia Metrorrhagia Polymenorrhoea Polymenorrhagia Menometrorrhagia Amenorrhoea Oligomenorrhoea
Give some causes of abnormal uterine bleeding
Pregnancy
Anovulatory cycles
Endometritis
Endometrial polyps
What is the main investigation used for the endometrium?
Transvaginal ultrasound
What thickness of endometrium is an indication for biopsy?
> 4mm (post-menopause)
>16mm (pre-menopause)
What techniques can be used to sample the endometrium?
Endometrial pipelle
Dilatation and curretage
What is dysfunctional uterine bleeding?
Irregular uterine bleeding reflecting a disruption in hormonal stimulation to endometrial lining
What is endometritis?
An inflammation of the endometrium (plasma cells)
Give some causes of endometritis
Neisseria Chlamydia CMV Coil Postpartum Granulomatous Post curettage
What occurs in molar pregnancy?
Abnormal form of pregnancy where a non-viable fertilised egg implants in uterus
In a complete molar pregnancy, whose DNA is present?
Only paternal - 46 YY
In a partial molar pregnancy, whose DNA is present?
Both maternal and paternal - 69 XXY
How many cell layers line the normal endocervix?
One
What is the most common site of neoplasia in the cervix?
Transformation zone
The transformation zone is a junction between which epithelia?
Squamous (ectocervical)
Columnar (endocervical)
What occurs in cervical erosion?
Exposure of endocervical epithelium to acid environment causes physiological metaplasia
Give some causes of inflammatory pathology in the cervix
Cervicitis
Cervical polyp
Give some causes of neoplastic pathology in the cervix
Cervical intraepithelial neoplasia (CIN)
Squamous carcinoma
Adenocarcinoma
Which virus serotypes are the main cause of cervical cancer?
HPV 16 and 18
Give some risk factors for CIN/cervical cancer
Presence of high risk HPV (multiple sexual partners)
Long term OCP use
Smoking
Immunosupression
Which histological feature shows HPV infection in the cervix?
Koilocytosis
Histopathologically, when does cervical cancer occur?
When squamous cells have invaded the basement membrane
Give some histological features of CIN
Delay in maturation/differentiation
Nuclear abnormalities (increased nucleocytoplasmic ratio)
Excess mitotic activity
What occurs in CIN stage I?
The basal 1/3 of the epithelium is occupied by abnormal cells
What occurs in CIN stage II?
Abnormal cells extend to middle 1/3
What occurs in CIN stage III?
Abnormal cells occupy full thickness of epithelium
How is squamous cervical carcinoma staged?
Stage 1 - confined to cervix
Stage 2 - spread to adjacent organs
Stage 3 - involves pelvic wall
Stage 4 - distant mets or involvement or rectum/bladder
Give some symptoms of squamous cervical carcinoma
Abnormal bleeding (post-coital/menopausal)
Pelvic pain
Haematuria
Ureteric obstruction
In squamous cervical carcinoma, lymphatic spread is early and haematogenous is late. True/false?
True
What is the preinvasive phase of endocervical adenocarcinoma?
Cervical glandular intraepithelial neoplasia (CGIN)
Give some risk factors for endocervical adenocarcinoma
Higher social class
Later onset of sexual activity
Smoking
HPV
Which women commonly get vulvar invasive squamous carcinoma?
Elderly women
Which lymph nodes are most commonly affected by VISC?
Inguinal
How does vulvar Paget’s disease present?
Crusting rash
