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obs and gynae > pathology of the uterus > Flashcards

pathology of the uterus Flashcards

1
Q

ovarian cycle

A

-follicular phase
-ovulation
-luteal phase

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2
Q

uterine cycle

A

-menstrual phase
-proliferative phase
-secretory phase

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3
Q

what hormone for proliferative phase

A

oestrogen

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4
Q

what hormone for secretory phase

A

progesterone

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5
Q

what effect for menstrual phase

A

necrosis

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6
Q

indications for endometrial sampling

A

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

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7
Q

what is menorrhagia

A

prolonged and increased menstrual flow

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8
Q

what is metorrhagia

A

regular intermenstrual bleeding

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9
Q

polymenorrhoea

A

menses occurring at <21 day interval

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10
Q

what is polymenorrhagia

A

increased bleeding and frequent cycle

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11
Q

what is menometrorrhagia

A

prolonged menses and intermenstrual bleeding

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12
Q

what is amenorrhoea

A

absence of menstruation > 6 months

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13
Q

what is oligomenorrhoea

A

menses at intervals of > 35 days

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14
Q

causes of abnormal uterine bleeding in adolescence/early reproductive life

A

-usually due to anovulatory cycles
-pregnancy/miscarriage
-endometritis
-bleeding disorders

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15
Q

causes of AUB in reproductive/perimenopause life

A

-Pregnancy/miscarriage
-DUB: anovulatory cycles, luteal phase defects,
-Endometritis
-Endometrial/endocervical polyp
-Leiomyoma
-Adenomyosis
-Exogenous hormone effects
-Bleeding disorders
-Hyperplasia
-Neoplasia: cervical, endometrial

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16
Q

causes of AUB post menopause

A

-Atrophy
-Endometrial polyp
-Exogenous hormones: HRT, tamoxifen
-Endometritis
-Bleeding disorders

17
Q

how thick does endometrium need to be to indicate a biopsy

A

over 4mm in post menopausal
16mm in premenopausal

18
Q

histological assessment of endometrial samples for AUB

A

-Is the sample adequate/representative for the given clinical scenario
-Is there evidence of fresh/old breakdown/haemorrhage
-Is there an organic benign abnormality? (polyp, endometritis, miscarriage)
-Is there evidence for dysfunctional bleeding?
-Is there hyperplasia (atypical/non atypical) or malignancy?

19
Q

what is DUB

A

irregular uterine bleeding that reflects a disruption in the normal cyclic pattern of ovulatory hormonal stimulation to the endometrial lining

20
Q

cause of DUB

A

mostly due to anovulatory cycles
-commonest at either end of reproductive life
-corpus luteum does not form
-continued growth of functionalis layer

21
Q

what is luteal phase deficiency

A

-insufficient progesterone or poor response by the endometrium to progesterone
-abnormal follicular development (inadequuate FSH/LH)
-poor corpus luteum

22
Q

organic causes of AUB in the endometrium

A

-endometritis
-polyp
-miscarriage

23
Q

organic causes of AUB in the myometrium

A

-adenomyosis
-meiomyoma
-leiomyoma

24
Q

how is endometritis diagnosed histologically

A

by recognising an abnormal pattern of inflammatory cells

25
Q

what protects the endometrium from infection

A

cervical mucous plug and cyclical shedding of the endometrium

26
Q

micro-organisms that can cause endometritis

A

Neisseria
Chlamydia
TB
CMV
Actinomyces
HSV

27
Q

other causes of endometritis

A

-intra-uterine contraceptive device
-post partum
-postabortal
-post curettage
-chronic endometritis NOS
-granulomatous
-associated with leiomyomata or polyps

28
Q

endometrial polyps

A

-Common
-Usually asymptomatic but may present with bleeding or discharge
-Often occur around and after the menopause
-Almost always benign
-BUT endometrial carcinoma can present as a polyp

29
Q

what is a molar pregnancy

A

-abnormal form of pregnancy in which non-viable fertilized egg implants in the uterus
-a form os gestational trohpblastic disease which grows as a mass characterised by swollen chorionic villi
-moles can be partial or complete

30
Q

what causes complete moles

A

caused by a single or two sperm combining with an egg which has lost its DNA
-only parental DNA is present in a complete mole

31
Q

what causes partial moles

A

when the egg is fertilised by two sperm or by one sperm which reduplicates itself yielding the genotypes of 69,XXY
-partial moles gave both maternal and paternal DNA

32
Q

what is adenomyosis

A

endometrial glands and stroma within the myometrium

33
Q

what is a leiomyoma

A

benign tumour of smooth muscle, may be found in locations other than the uterus
-growth is oestrogen dependent

obs and gynae (21 decks)

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