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Systemic Pathology I > Pathology of the Female Reproductive System > Flashcards

Pathology of the Female Reproductive System Flashcards

1
Q

What determines sex? What hormones will the sexes produce for sexual development?

A

presence/absence of Y chromosomes

XY = testes = testosterone and Anti-Mullerian hormones allows the Wolffian (mesonephric) duct to persist and the Mullerian (paramesonephric) duct to regress

XX = ovaries = Mullerian duct persists and the Wolffian duct regresses

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2
Q

What determines external genitalia development?

A

hormones from the gonads —> penis and scrotum or clitoris and vulva

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3
Q

What are disorders of sexual development?

A

abnormalities of sex chromosome origin that result in abnormal appearing genitalia

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4
Q

What is clitoromegaly?

A

partial fusion of the vulvar lips caused by true hermaphroditism (ovotestes) causing the female genitalia to be partially masculinized due to exposure to testosterone and AMH

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5
Q

What is ovotestes?

A

true hermaphroditism where females become masculinized due to the presence of testosterone and AMH from Sertoli cells

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6
Q

True hermaphroditism:

A

abnormal internal reproductive organs from a bitch
- hypoplastic uterus
- bilateral ovotestes with an attached epididymis

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7
Q

Ovotestes:

A
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8
Q

What is Freemartinism?

A

disorder with female and male bovine twins where a female is genetically female, but has many male characteristics making them infertile, but the male is normal

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9
Q

What causes Freemartinism?

A

anastomoses develop between the placental vascular system of the 2 fetuses and male hormones masculinize/sterilize the female genital organs causing them to become hypoplastic

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10
Q

What are the 6 common presentations of Freemartinism?

A
  1. hypoplasia of ovaries and uterus
  2. ovotestes
  3. failure of the paramesonephric duct to fuse and form a single uterine body
  4. presence of vesicular glands
  5. uterus and vagina do not communicate
  6. prominent clitoris and a long tuft of hair attached ventrally to the vulva
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11
Q

Where are follicle-stimulating hormone (FSH) ad luteinizing hormone developed (LH)? What do they do?

A

FSH - anterior pituitary; initiates growth of the follicle

LH = anterior pituitary; stimulated follicular growth and rupture/formation of CL

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12
Q

Where are estrogen, progesterone, and prostaglandins produced? What do they do?

A

ESTROGEN = ovaries; prepares uterus for pregnancy and causes secondary female characteristics

PROGESTERONE = CL and placenta; maintains pregnancy

PROSTAGLANDINS = causes CL rupture and follicular rupture

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13
Q

Follicle development:

A
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14
Q

What cysts form on the outside and inside of the ovaries?

A

OUTSIDE = periovarian cysts common in bitches, mares, and cats, typically from embryonic structures and most commonly an incidental finding

INSIDE = ovarian cysts that are follicular, rete ovarii, and sub/surface epithelial in origin - tends to cause disease

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15
Q

Where do periovarian cysts arise from?

A

remnants of the Mullerian duct (paramesonephric) and Wolfiann duct (mesonephric)

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16
Q

What are cystic epoophorons?

A

cysts that arise from the mesonephric tubules (Wolffian) and extend from the proximal pole of the ovary
- common in mares
- typically an incidental finding

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17
Q

What are fimbrial cysts?

A

paramesonephric duct cysts that extend from the fimbriae of the uterine tube
- common in mares
- incidental finding

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18
Q

What cysts are commonly found near the uterus?

A

cystic remnant of a mesonephric duct, typically found adjacent to the uterine tube

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19
Q

What are the 3 most common types of intraovarian cysts?

A
  1. cystic rete ovarii - arises from mesonephric (Wolffian) duct remnants at the hilus of the ovary
  2. epithelial inclusion cyst of the mare - normal epithelium of the ovary become trapped in the ovarian stroma at the ovulation fossa
  3. follicular cysts (anovulatory follicular cyst)
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20
Q

In what animals are cystic rete ovarii most common? Where does this arise from? Where are they most commonly found?

A

dogs, cats, guinea pigs

mesonephric (Wolffian) duct remnants

hilus of the ovary

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21
Q

How do epithelial inclusion cysts occur? Where are they most commonly found? How do they cause infertility?

A

surface epithelium of the ovary becomes entrapped during ovulation

ovulation fossa

block ovulation and compress the ovary

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22
Q

What makes epithelial inclusion cysts different compared to ovarian follicle cysts?

A

persist and slowly increase in size

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23
Q

Epithelial inclusion cyst:

A
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24
Q

What kind of follicular cysts occurs inside of the ovary? What causes this? What is a common sign?

A

anovulatory follicular cysts (Graffian follicle) - larger than usual at ovulation

failure of the mature follicle to ovulate, causing it to persist

hyperestrogenism - bone marrow suppression and changes in uterus
(cystic endometrial hyperplasia > mucometra > pyometra)

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25
Q

How do you determine if a follicle is actually becoming a cysts in cows, sows, sheep/goats, and bitches?

A

SIZE
- cows > 2.5 cm
- sows 1 cm
- sheep/goats 1 cm
- bitches 0.75 cm

26
Q

Follicular cysts:

A
27
Q

What is duplication of the ovaries?

A

2 ovaries present where one should be

28
Q

What is ovarian remnant syndrome?

A

ovarian tissue remains inside of the body after a female dog has been spayed, resulting in the continued production of estrogen and signs of heat

29
Q

What happens during equine ovarian varicosities?

A

veins dilate, causing thrombosis and infarction in severe cases, however most are incidental
- most common in old mares

30
Q

What is oophoritis? What is the most common cause?

A

inflammation of the ovary

ascending infection from uterus

31
Q

What are granulosa (theca) cell tumors? What are 2 common signs?

A

unilateral, large, cystic masses that are usually benigns and produce estrogen, inhibin, testosterone, and AMH

  1. nymphomania, Stallion-like behavior
  2. atrophy of the contralateral ovary
32
Q

What is dysgerminoma? How does it present? How does metastasis compare in dogs and horses?

A

comparable to seminoma in testicle, ovarian tumor originating from germ cells

unilateral, solid, soft

dogs = 10-20% metastasize
horses = more aggressive

33
Q

How do teratomas present?

A
  • well-differentiated and benign
  • have differentiation into 2 of the 3 germ cell layers
  • frequently have teeth, hair, lung tissue, fat, nerves, etc.
34
Q

In what species are ovarian carcinomas/cystadenocarcinomas most common? Where do they arise from?

A

+++ dogs, chickens

surface epithelium of SES

35
Q

How do most ovarian carcinomas/cystadenocarcinomas present?

A
  • bilateral > unilateral
  • papillary structures extending from the surface giving them cauliflower-like appearance
  • peritoneal implantation leads to ascites
36
Q

Ovarian carcinoma/cystadenocarcinoma:

A
37
Q

Ovarian carcinoma/cystadenocarcinoma, chicken:

A
38
Q

What is hydrosalpinx? What are 2 common causes?

A

blockage resulting in fluid accumulation in the salpinx

  1. blockage from congenital defects (freemartinism, segmental aplasia of the uterine horn)
    2 inflammation
39
Q

What is salpingitis commonly secondary to?

A
  • uterine disease
  • traumatic from manual manipulation of the ovary
40
Q

How does acute and chronic salpingitis compare?

A

ACUTE: T. pyogenes, Staph/Strep, pyosalpinx

CHRONIC: Mycoplasma, ureaplasma

41
Q

Uterus:

A
42
Q

What is this?

A

segmental aplasia of the uterus

43
Q

What is the difference between endometritis and metritis?

A

ENDOMETRITIS: inflammation confined to the endometrium (postcoitus, postparturition)

METRITIS: invades the myometrium and is most commonly bacterial (Campylobacter, Tritrichomonas, E. coli)

44
Q

What does endometritis commonly predispose the animal to?

A

pyometra

45
Q

How are endometrial biopsies graded to determine severity?

A
  1. glandular nesting/loss
  2. periglandular and interstitial fibrosis
  3. type of inflammation

graded I, II, III

46
Q

How does the grade of endometrial biopsies determine the chances of carrying a foal to term?

A

Grade I = > 80%
Grade II = >50-80%
Grade IIb = >10-50%
Grade III = 10% or less

47
Q

How do the presence of neutrophils, lymphocytes, and eosinophils determine the type of inflammation occurring the endometrial biopsies?

A

NEUTROPHILS = active inflammation, bacterial infection

LYMPHOCYTES = chronic inflammation

EOSINOPHILS = pneumovagina and/or pooling urine into vagina making it susceptible to uterine infections

48
Q

Why is cystic endometrial hyperplasia so important?

A

common prelude to other conditions

49
Q

Endometrial hyperplasia, canine:

A
50
Q

What hormones are released in CEH-pyometra syndome? What do they cause?

A

ESTROGEN: hyperplasia of endometrial glands

PROGESTERONE: causes epithelium to become secretory; hyperplasia of endometrial glands

51
Q

When is CEH-pyometra syndrome most common? What is the most common cause? What are 2 possible sequela?

A

few weeks after estrus, especially in bitches that are not bred

E. coli

  1. toxemia, bacteremia
  2. glomerulonephritis
52
Q

What is the most common cause of pyometra in cows?

A

endometritis —> inhibition of CL destruction —> persistence of CL —> increase in progesterone —> pyometra

53
Q

What 3 uterine neoplasias are most common?

A
  1. leiomyoma/leiomyosarcoma
  2. uterine adenocarcinoma
  3. lymphoma (BLV)
54
Q

In what animals are uterine leiomyomas most common?

A
55
Q

What is the most common tumor in domestic rabbits? How do they present?

A

uterine adenocarcinoma

multicentric masses, usually involving both horns

56
Q

What is the most common cause of uterine lymphoma?

A

bovine leukemia virus (BLV)

57
Q

What are the 3 most common causes of uterine torsion?

A
  1. gravid uterus
  2. hydrometra/pyometra
  3. uterine neoplasia
    - can result in death of fetus and rupture
58
Q

What are 3 common predisposing causes of uterine prolapse?

A
  1. prolonged dystocia relieved by forced traction
  2. retained plascenta
  3. postparturient hypocalcemia
59
Q

When is uterine artery rupture most common? What is it caused by?

A

old mares with multiple pregnancies and copper deficiencies

weakening of the wall of the artery as a result of advanced age and repeated enlargement and shrinkage of the vessels

60
Q

When does uterine artery rupture most commonly happen in regards to the pregnancy? What happens when it is severe?

A

peripartum

hemorrhage into the abdomen and hypovolemic shock
- mild = hemorrhage maintained in broad ligament

61
Q

What are endometrial polyps made out of? What do they look like? What can they predispose to?

A

CT stroma with dilated glands (common in dogs and cats)

pedunculated

prolapse

62
Q

What is subinvolution of placental sites (SIPS)? What 3 things can it cause?

A

prolonged uterine hemorrhage following whelping that manifests as bloody vaginal discharge lasting more than 6 weeks, and is usually self-limiting

  1. ascending infection
  2. endometritis
  3. open pyometra

Systemic Pathology I (25 decks)

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