Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Reproduction > Pathology of the Uterus > Flashcards

Pathology of the Uterus Flashcards

See PPT slides for histology images

1
Q

2 branches of the menstrual cycle

A

ovarian

Uterine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Phases of ovarian cycle (3)

A

Follicular phase
Ovulation
Luteal phase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Phases of uterine cycle (3)

A

Menstrual phase

  • Day 1 (1st day of period)
  • Endometrium proliferates for 14 days or longer

Proliferative phase

Secretory phase - only occurs if ovulation has taken place

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Glands in the secretory phase do not grow - True or Fase

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Indications for endometrial sampling

A

Abnormal uterine bleeding

Investigation for infertility

Spontaneous and therapeutic abortion - exclude molar pregnancy

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Indications for endometrial sampling

A

Abnormal uterine bleeding

Investigation for infertility

Spontaneous and therapeutic abortion - exclude molar pregnancy

Assessment of response to hormonal therapy

Endometrial ablation - eradication of endometrium ( requires biopsy first)

Work up prior to hysterectomy for benign indications

Incidental finding of thickened endometrium on scan

Endometrial cancer screening in high risk patients - arises due to high levels of estrogen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Types of abnormal uterine bleeding (AUB)

A

Menorrhagia: prolonged and increased menstrual flow

Metrorrhagia regular intermenstrual bleeding

Polymenorrhoea menses occurring at < 21 day interval

Polymenorrhagia increased bleeding and frequent cycle

Menometrorrhagia prolonged menses and intermenstrual bleeding

Amenorrhoea absence of menstruation > 6 months

Oligomenorrhoea Menses at intervals of > 35 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Causes of AUB in Adolescence

A

Anovulatory cycles - most common cause

Pregnancy/miscarriage

Endometritis - inflammation of endometrium

Bleeding disorders - clotting abnormality means more clots or bleeding than normal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Causes of AUB in Reproductive life/ perimenopause

A

Pregnancy/miscarriage

DUB: anovulatory cycles, luteal phase defects,

Endometritis

Endometrial/endocervical polyp - growth of the endometrium into the uterine cavity

Leiomyoma - commonest tumour, smooth muscle tumour, aka fibroid

Adenomyosis - glands of stroma in the myometrium (muscular wall)

Exogenous hormone effects

Bleeding disorders

Hyperplasia

Neoplasia: cervical, endometrial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Causes of AUB post menopause

A

Atrophy – shedding causing slight bleeding

Endometrial polyp

Exogenous hormones: HRT, tamoxifen - causes proliferation of endometrium as it is full of oestrogen

Endometritis

Bleeding disorders

Hyperplasia
Endometrial carcinoma
Sarcoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

List the methods of assesing the endometrium

A
  1. TVUS

2. Hysteroscopy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

TVUS

A

Endometrial thickness of >4mm in postmenopausal women (16mm in premenopausal) is generally taken as an indication for biopsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Methods of sampling the endometrium

A
  1. endometrial pipelle

2. Dilatation and curettage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Features of Endometrial Pipelle

A

3.1mm diameter, no dilatation needed

No anaesthesia

Outpatient procedure

Very safe

Limited sample

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Features of dilatation and curettage

A

Most common operation performed on women

Most thorough sampling method

Can miss 5% hyperplasias/cancers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What history is required for sampling?

A 
Age
Date of LMP and length of cycle
Pattern of bleeding
Hormones
Recent pregnancy

Do not need to know number of pregnancies, drugs without hormonal influences etc.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Factors considere when assesing histological samples of endometrium

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?

18
Q

A biopsy in the menstrual phase is useful. True or False?

A

False

No architecture, all fallen apart due to shedding, hence cannot discern much

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 (no organic cause for bleeding)

20
Q

DUB due to anovulatory cycles

A

Commonest at either end of reproductive life

Corpus luteum does not form

Continued growth of functionalis layer
( Polycystic ovary syndrome, hypothalamic dysfunction, thyroid disorders, hyperprolactinaemia)

Luteal phase deficiency – insufficent progesterone or poor response by the endometrium to progesterone. Abnormal follicular development (inadequate FSH/LH) – poor corpus luteum

21
Q

Endometritis

A

Histologically endometritis is diagnosed by recognising an abnormal pattern of inflammatory cells
Cervical mucous plug protects the endometrium from ascending infection
Cyclical shedding of the endometrium also makes it relatively resistant

22
Q

Micro-organisms causing endometritis

A 
Neisseria
Chlamydia
TB - rare
CMV
Actinomyces
HSV
23
Q

Inflammation without specific organisms causing endometritis

A

IUD - contraception

Postpartum

Postabortal

Post curettage

Chronic endometriosis NOS

Granulomatous (sarcoid, foreign body post ablation)

Associated with leiomyomata or polyps

24
Q

Features of endomotrial 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

Polyps can tort causing obstruction to blood flow and necrosis

25
Q

Features of endomotrial polyps

A

Common

Usually asymptomatic but may present with bleeding or discharge - Polyps can tort causing obstruction to blood flow and necrosis

Often occur around and after the menopause

Almost always benign

BUT endometrial carcinoma can present as a polyp

26
Q

Are miscarriage specimens common?

A

YES white

27
Q

What is molar pregnancy?

A

Abnormal form of pregnancy in which a non-viable fertilised egg implants in the uterus (or tube

Form of gestational trophoblastic disease which grows as a mass characterised by swollen chorionic villi

28
Q

How is daignosis of molar pregnancy made?

A

Diagnosis based on products of conception

29
Q

What is a complete mole?

A

Caused by a single (incidence is about 90%) or two (incidence is about 10%) sperm combining with an egg which has lost its DNA (the sperm then reduplicates forming a “complete” 46 chromosome set. Only paternal DNA is present in a complete mole

30
Q

What is a partial mole?

A

occurs when egg is fertilized by two sperm or by one sperm which reduplicates itself yielding the genotypes of 69,XXY (triploid). Partial moles have both maternal and paternal DNA

31
Q

Consequence of complete mole?

A

Risk of progression and spread to choriocarcinoma

32
Q

Findings of MRI scan in complete mole

A

Enlarged uterus

33
Q

Which hormone is abnormally high in molar pregnancy?

A

HCG

34
Q

Myometric causes of AUB

A
  1. Adenomyosis

2. Leiomyoma

35
Q

What is adenomyosis?

A

Endometrial glands and stroma within the myometrium

Causes menorrhagia/dysmenorrhea

36
Q

What is leiomyoma?

A

Benign tumour of smooth muscle, may be found in locations other than the uterus

37
Q

Features of leiomyoma

A

Single or multiple
May distort uterine cavity
Growth is oestrogen dependant
Progression to malignancy (leiomyosarcome) rare

38
Q

Microscopic appearance of leiomyoma

A

Mainly smooth muscle is seen

Endometrium runs over the surface of the growth

39
Q

Microscopic appearance of biopsy during proliferative phase

A

Lined by epithelium (glandular)
Glands are the round structures
Little spots in the cytoplasm –mitotic figures – indicate that glands are actively growing under the influence of estrogen - proliferative phase

40
Q

Microscopic appearance of biopsy during secretory phase

A

Pale space underneath the gland – early secretory phase – no mitotic figures, stopped growing, now have secretion in the nuclei

In proliferative phase – glands look same everyday

Secretive phase – gradual change in gland structure – more complex and wiggly, later fill with secretions

Perfect environment created for blastocyst

If there is no fertilization, this sheds returning to day 1 of menstrual cycle

Reproduction (32 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions