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203: Theme 3: Gynaecological pathway, common gynaecological disorders and sexual health > Pathology of the female reproductive tract 1 > Flashcards

Pathology of the female reproductive tract 1 Flashcards

1
Q

Type of cell in vulva and vagina

A

Stratified squamous epithelium

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2
Q

Vagina at puberty

A

Oestrogen secreted by the ovary stimulates maturation of squamous epithelial cells

Glycogen is formed within mature squamous epithelial cells

Glycogen in cells shed from the surface is a substrate for vaginal anaerobic organisms

Lactobacilli produce lactic acid keeping vaginal pH below 4.5

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3
Q

Parts of the cervix

A

Ectocervix

Endocervix

Transformation zone

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4
Q

Ectocervix cells

A

Stratified squamous epithelium

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5
Q

Endocervix cells

A

Single layer of tall, mucin producing columnar cells

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6
Q

The endocervix surface area

A

Columnar epithelium lines tiny blind ending channels

These radiate out from the endocervical canal into the surrounding stroma

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7
Q

Ectocervix covered by

A

Stratified squamous epithelium

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8
Q

Endocervix is lined by

A

Columnar epithelium

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9
Q

Junction between the endocervix and ectocervix is called

A

The squamo columnar junction

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10
Q

Formation of the transformation zone

A

During puberty the cervix changes shaped

The lips of the cervix grow

The distal end of the endocervix opens

Endocervical mucosa becomes exposed to the vaginal environment

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11
Q

Squamous metaplasia

A

The distal endocervical columnar epithelium is exposed to the acidic vaginal environment

Not suited to this so undergoes metaplasia

Reserve cells in this area proliferate and mature to form squamous epithelium

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12
Q

Metaplasia definition

A

A transformation of cell type from one kind of mature differentiated cell type to another kind of mature differentiated cell type

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13
Q

Squamous metaplasia over time

A

At first the metaplastic squamous epithelium is thin and delicate

With time the metaplastic epithelium comes to be as strong and well formed as that on the ectocervix

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14
Q

Myometrium

A

Bundles of smooth muscle, vasculature and nerves

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15
Q

Endometrium in proliferation phase

A

(before ovulation)

  1. Tubular glands
  2. Specialised stroma
  3. Blood vessels

Mitoses in glands

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16
Q

Endometrium in secretory phase

A
  1. Cork screw glands
  2. Specialised stroma
  3. Blood vessels

Secretion in glands

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17
Q

Neoplasia

A

New growth- abnormal, uncoordinated and excessive cell growth

Persists following withdrawal of stimulus and associated with genetic alterations

18
Q

Nomenclature of neoplasms

A

Different neoplasms have different behaviour

Accurate . identification and naming therefore important for treating the patient

19
Q

Neoplasm behaviour

A

Benign or malignant

20
Q

Neoplasms histogenesis

A

Recognising the cell of origin

21
Q

Benign neoplasms

A

Remain localised and doesn’t invade surrounding tissues

Generally slowly

Good resemblance of parent tissue

22
Q

Leiomyoma of the myometrium

A

A benign neoplasms of smooth muscle

Localised

Slow growing

Closely resembles parent tissue

23
Q

Consequences of benign neoplasms

A

Pressure on adjacent tissue

Obstruction of lumen of a hollow organ

Hormone production

Transformation into a malignant neoplasm

Symptoms for the patient

24
Q

Benign neoplasms, clinical problems

A

Pressure on adjacent tissue
- bladder (frequency), rectosigmoid (constipation)

Obstruction to lumen of a hollow organ
- adjacent (ureters) blocking endocervix

Hormone production
- erythropoietin producing polycythaemia

Transformation into a malignant neoplasm
- probably malignancy arises de novo

25
Q

Behaviours of neoplasms: malignant

A

Invade into surrounding tissues

Spread via lymphatics to lymph nodes and blood vessels to other sites

Generally relatively quickly

Variable resemblance to parent tissue

26
Q

Malignant neoplastic tissue looks different to normal tissue

A

Loss of differentiation

Loss of cellular cohesion

Enlarged irregular dark nuclei

Increased number of mitoses

27
Q

Consequences of malignant neoplasms

A

Destruction of adjacent tissue

Metastasis

Blood loss from ulcerated surfaces

Obstruction of a hollow viscera

Production of hormones

Weight loss and debility

Anxiety and pain

28
Q

Histogenesis of neoplasms

A

Classified by cell of origin

Determined by examining tissue under the microscope

Resemblance to parent tissue correlates with clinical behaviour

29
Q

Terminology of neoplasia

A

Neoplasms have the suffix - oma

Malignant epithelial tumours are carcinomas

Carcinomas are named for the epithelial cell type which they resemble

Carcinomas of glandular epithelium are called adenocarcinomas

Malignant stromal tumours are sarcomas

30
Q

Malignant tumours of the vulva

A

Squamous

Squamous cell carcinoma

31
Q

Malignant tumours of the vagina

A

Squamous

Squamous cell carcinoma

32
Q

Malignant tumours of the cervix

A

Squamous
- squamous cell carcinoma

Glandular
- adenocarcinoma

33
Q

Malignant tumours of the endometrium

A

Glandular
- adenocarcinoma

Stroma
- stromal sarcoma

34
Q

Malignant tumours of the myometrium

A

Smooth muscle

Leiomyosarcoma

35
Q

Dysplasia

A

Pre malignant state

There is an accumulation of cells which look somewhat like malignant cells but do not invade the basement membrane

Dysplastic lesions may progress to invasive malignancy

Recognising dysplastic lesions allows early treatment before invasion occurs

36
Q

Dysplasia definition

A

Disordered growth and differentiation characterised by increased proliferation, atypia of cells and decreased differentiation

37
Q

Dysplasia at sites of metaplasia

A

Squamous metaplasia of the cervical transformation zone

Squamous metaplasia of the bronchial epithelium

Glandular metaplasia of the distal oesophagus

38
Q

Dysplastic cell nuclei

A

Have a higher ratio of nuclear size to cytoplasmic volume

Nuclei show the same features that we associate with malignancy

39
Q

Difference between dysplasia and carcinoma

A

Invasion through the basement membrane

40
Q

Human papillomavirus

A

Infects epithelium

Confined to local site of infection without viraemia

Over 130 HPV types, some of which infect the anogenital mucosa

Double stranded DNA virus 7.9Kbp

41
Q

HPV prevention/ treatment

A

HPV vaccination

Population based screening

  • cervical sample cytology
  • cervical sample HPV test

Colposcopy

Treatment of high grade dysplasia

Large loop excision of the transformation zone

203: Theme 3: Gynaecological pathway, common gynaecological disorders and sexual health (9 decks)

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