Pathology

Question 1

two classifications of the menstrual cycle

Answer 1

ovarian cycle

uterine cycle

Question 2

phases of the ovarian cycle

Answer 2

follicular phase
ovulation
luteal phase

Question 3

phases of the uterine cycle

Answer 3

menstrual phase
proliferative phase
secretory phase

Question 4

indications for endometrial biopsy

Answer 4

• Abnormal uterine bleeding
• Investigation for infertility
• Spontaneous and therapeutic abortion
• Assessment of response to hormonal therapy
• Endometrial ablation
• Work up prior to hysterectomy
• Thickened endometrium on scan
• Endometrial cancer screening in high-risk patients

Question 5

define menorrhagia

Answer 5

prolonged and increased menstrual flow

Question 6

define amenorrhoea

Answer 6

absence of menstruation

Question 7

define oligomenorrhoea

Answer 7

intervals of >35 days

Question 8

methods of assessing the endometrium

Answer 8

TVUS
hysteroscopy
endometrial pipelle
dilatation and curettage

Question 9

required history for pathologist in endometrial biopsy

Answer 9

age
date of LMP and cycle length
pattern of bleeding
hormones
recent pregnancy

do not need to know number of pregnancies or drugs without hormonal influences

Question 10

what is dysfunctional uterine bleeding?

Answer 10

irregular uterine bleeding reflecting a disruption in normal cyclic pattern of ovulatory hormonal stimulation

Question 11

what is adenomyosis?

Answer 11

presence of endometrial glands and stroma within the myometrium

Question 12

what is a leiomyoma?

Answer 12

benign tumour of smooth muscle

Question 13

normal ectocervix layers

Answer 13

basement membrane and stromal cells
basal and parabasal cells
exfoliating cells (smear), squamous epithelium

Question 14

lining of the endocervix

Answer 14

columnar epithelium

Question 15

pathology types in the cervix

Answer 15

• inflammatory

- neoplastic

Question 16

CIN grading

Answer 16

• CIN I= basal 1/3rd of epithelium occupied by abnormal cells. Raised mitotic figures and surface quite mature with slightly abnormal nuclei
• CIN II= abnormal cells extend to middle 1/3rd
• CIN III= abnormal cells occupy full thickness of epithelium. This is a carcinoma in-situ

Question 17

what makes it carcinoma?

Answer 17

breaks through basement membrane

Question 18

cervical staging score?

Answer 18

Figo 2018

Question 19

where does cervical glandular intraepithelial neoplasia (CGIN) originate from?

Answer 19

endocervical epithelium

Question 20

triple assessment in breast disease

Answer 20

1. Clinical= history and examination
2. Imaging= mammography, USS, MRI
3. Pathology= cytopathology, histopathology

Question 21

what is included in breast cytopathology?

Answer 21

FNA
fluid
nipple discharge
nipple scrap

Question 22

what is included in breast histopathology?

Answer 22

1. Diagnostic techniques= needle core biopsy, vacuum assisted biopsy (large volume), skin biopsy and incisional biopsy of mass.
2. Therapeutic techniques= vacuum, excisional biopsy and resection (WLE and mastectomy)

Question 23

what is gynaecomastia?

Answer 23

breast development in males

Question 24

causes of gynaecomastia

Answer 24

exogenous/ endogenous hormones
cannabis
drugs acting on HPG-axis
liver disease