Pathology Of Female Tract Practical

Question 1

What type of epithelium lines the ectocervix?

Answer 1

Non-keratinising stratified squamous epithelium

Question 2

What shape is multifarious cervix?

Answer 2

Transverse shaped

Question 3

Other organs that have non-keratinised stratified squamous epithelium?

Answer 3

Anal canal
vagina
Oral cavity
Oesophagus

Question 4

Which other sites have squamous columnar junction?

Answer 4

And-rectal junction

Oseophago-gastric junction

Question 5

2 most common high risk HPVs?

Answer 5

16 and 18

Question 6

2 most common low risk HPVs?

Answer 6

6 and 11

Question 7

A cell infected by HPV shows koliocytosis which consists of?

Answer 7

Clear cytoplasm

Question 8

CIN 1 impact the..?

Answer 8

Lower third of the epithelium

Question 9

Advanced cervical cancer symptoms?

Answer 9

Post coital bleeding
Foul smelling discharge
Intermenstrual bleeding
Weight loss when advanced

Question 10

What is most likely histology of cervical cancer?

Answer 10

95% of cervical cancers are squamous cell carcinoma

Question 11

Transformation zone is made up of?

Answer 11

Metaplasia squamous epithelium

Question 12

Other sites that produce oestrogen?

Answer 12

Ovary, subcutaneous fat and adrenal glands

Question 13

In secretory endometrium phase the cells show?

Answer 13

Subnuclear vacuolation

Question 14

Indications of hysterectomy?

Answer 14

Menorrhagia

a) Fibroid uterus
b) Early ca cervix
c) Ca endometrium
d) Ca ovary
e) Uterine prolapse
f) Dysfunctional uterine
bleeding

Question 15

What is the best time to
sample the endometrium  
when investigating  
infertility,  follicular 
or luteal  phase ? Why?

Answer 15

From Day 16 onwards 
because the Pathologist 
will be able to tell the 
Gynaecologist whether the 
patient has ovulated or not; 
therefore, it is important to 
provide date of  LMP when 
submitting  specimens to
the lab

Question 16

Metrorrhagia?

Answer 16

Vaginal bleeding that occurs outside of expected menstrual bleeding

Question 17

Causes of dysfunctional uterine bleeding?

Answer 17

Menorrhagia
Intermenstrual bleeding
Polymenorrhoea
Metrorrhagia

Question 18

Most common tumour of uterus?

Answer 18

Fibroid

Question 19

Fibroid uterus more common in?

Answer 19

African origin

Question 20

Where can fibroid uterus be located?

Answer 20

Submucosal- under endometrium
Intramural- within myometrium
Subserosal-under peritoneum

Question 21

Fibroid consists of and so is called?

Answer 21

Smooth muscle, leiomyoma

Question 22

Clinical presentation of leiomyomas?

Answer 22

1. Asymptomatic
2. Abnormal uterine bleeding
3. Pain-dysmenorrhoea
4. Bladder symptoms- frequency
5. Impaired infertility-recurrent miscarriage
6. preterm labour, obstructed labour

Question 23

How does IUD prevent intrauterine bleeding?

Answer 23

The most common IUCD used to control abnormal uterine bleeding is the Mirena which slowly releases progesterone and suppresses endometrial proliferation and stops the bleeding

Question 24

Radiological investigations to detect carcinoma of endometrium?

Answer 24

Patients with endometrial cancer invariably present with PMB; investigations include:
Hysteroscopy and biopsy
Ultrasound – to assess endometrial thickness; may detect polyp
MRI to assess local spread, i.e. depth of the tumour invasion of the myometrium
CT scan to assess for local spread into lymph nodes and distant metastases → chest , abdomen and pelvis

Question 25

Placenta Previa?

Answer 25

Baby’s placenta covers the mothers cervix

Question 26

Abruptio placenta?

Answer 26

Premature separation of placenta from uterus

Question 27

Placenta accreta?

Answer 27

Placenta grows too deeply in uterine wall

Question 28

Why is lower uterine segment used for Caesarean section?

Answer 28

(i) Much thinner and easier to suture than the fundus
(ii) Easier to control bleeding
(iii) Reduced risk of rupture in subsequent pregnancies

Question 29

Causes of PPH?

Answer 29

This uterus did not contract after delivery to close off the intra-myometrial vessels resulting in PPH
This is called uterine atony, most likely to due to prolonged labour which lead to the C/Section
Most common cause of PPH is retained products of conception
Clotting abnormalities e.g. low platelets

Question 30

Which segment do you cut across ?

Answer 30

Lower uterine segment

Question 31

The peritoneal layer on surface of uterus is called?

Answer 31

Perimetrium

Question 32

When the ovary is in follicular phase, the endometrium is in?

Answer 32

Proliferation phase, glands are tubular and cells show mitotic activity. Stroma is dense.

Question 33

When corpus luteum is formed endometrium is in?

Answer 33

Secretory phase, cells show subnuclear vacuolation

Question 34

What are most dysfunctional uterine bleeding due to?

Answer 34

Hormonal imbalance

Question 35

A pipelle sample will have?

Answer 35

A lot of blood

Question 36

Bikini line skin incision is termed?

Answer 36

Pfannenstiel incision