Pathology of Uterus Flashcards

1
Q

List stages of the ovarian cycle

A

Follicular phase
Ovulation
Luteal phase

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2
Q

List stages of the uterine cycle

A

Menstrual phase
Proliferative phase
Secretory phase

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3
Q

List pathological features of the uterus in the proliferative phase. Which harmone is involved in this process?

A

Tubular glands with columnar cells and surrounding dense stroma are proliferating to build up the endometrium following shedding with previous menstruation
Oestrogen

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4
Q

List pathological features of the uterus in the secretory phase. Which harmone is involved in this process?

A

Large torturous glands with luminal secretions

Prgoesterone

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5
Q

List indications for endometrial biopsy

A
Abnormal uterine bleeding
Investigation for infertility
Spontaneous and therapeutic abortion
Endometrical cancer screening
Response to harmonal therapy
Endometrial ablation
Prior to hysterectomy
Thickened endometrium on scan
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6
Q

What is dysfunctional uterine bleeding?

A

Abnormal uterine bleeding that reflects disruption in normal cyclic pattern of ovulatory harmonal stimulation to the uterine lining with no organic cause

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7
Q

What is post-menopausal bleeding?

A

Abnormal uterine bleeding > 1 year after cessation of menstruation

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8
Q

List causes of abnormal uterine bleeding in adolescence and early reproductive life

A

DUB
Pregnancy/ miscarriage
Endometritis
Bleeding disorders

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9
Q

What is the commonest cause of DUB? How does this appear pathologically?

A

Anovulatory cycles
End of reproductive life and corpus luteum doesn’t form causinginsufficient progesterone and continued growth of functionalis layer
Disordered proliferation - glands and stroma continue to grow

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10
Q

List ADDITIONAL causes of abnormal uterine bleeding pre-menopause and reproductive life

A
Endometrial/endocervical polyp
Leiomyoma
Adenomyosis
Hyperplasia
Exogenous harmone effects
(DUB
Pregnancy/ miscarriage
Endometritis
Bleeding disorders)
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11
Q

List causes of abnormal uterine bleeding post-menopause

A
Atrophy
Endometrial polyp
Exogenous harmones (HRT, tamoxifen)
Endometritis
Bleeding disorders
Hyperplasia/ endometrial carcinoma/sarcoma
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12
Q

List the three main methods of assessing the endometrium

A

Endometrial biopsy
TVUS
Hysteroscopy

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13
Q

An endometrial thickness of >__mm in postmenopausal women (__mm in premenopausal) is the indication for endometrial biopsy

A

4

16

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14
Q

State the main methods for sampling the endometrium

A

Endometrial pipette

Dilatation + curettage

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15
Q

Give examples of conditions causing anovulatory cycles and DUB

A

PCOS
Hypothalamic dysfunction
Thyroid disorders
Hyperprolactinaemia

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16
Q

List organic causes of abnormal uterine bleeding affecting the endometrium

A

Endometritis
Polyp
Miscarriage

17
Q

List organic causes of abnormal uterine bleeding affecting the myometrium

A

Adenomyosis

Leiomyoma

18
Q

What is endometritis?

A

Abnormal pattern of inflammatory cells in the endometrium of the uterus typically due to ascending infection bypassing the cervical plug (or invasive procedure or insertion of contraceptive device)

19
Q

Chronic endometritis is related to which inflammatory condition?

A

PID

20
Q

What are endometrial polyps? How do they present?

A

Benign mass in the inner lining of the uterus

Usually asymptomatic, or bleeding, discharge around menopause

21
Q

List the pathological features present in the products of conception of miscarriage

A

Foetal red blood cells

Chorionic villi

22
Q

What is a molar pregnancy? What are the main pathological features?

A

A form of gestational trophoblastic disease - an abnormal pregnancy in which a non-viable fertilised egg implants in the uterus
Abnormal proliferating trophoblast
Chorionic villi

23
Q

What are the features of a partial molar pregnancy?

A

Egg fertilised by 1 or 2 sperm which reduplicates forming a triploid genotype (69XXY)
Both maternal and paternal DNA

24
Q

What are the features of a complete molar pregnancy?

A

Usually 1 sperm combining with an egg which has lost its DNA, sperm reduplicates forming a complete set of 46 chromosomes
Only paternal DNA

25
Q

Which type of molar pregnancy - complete or partial - has an increased risk of choriocarcinoma?

A

Complete molar pregnancy

26
Q

What is adenomyosis? How does it present? What are the main pathological features?

A

Endometritis in smooth muscle of the uterus causing menorrhagia/ dysmenorrhoea
Endometrial glands and stroma in myometrium

27
Q

What is leiomyoma? How does it present? What are the main pathological features?

A

Benign oestrogen-dependant tumour of smooth muscle which can exist in and distort the uterine cavity
Menorrhagia, infertility, mass effect, pain
Interlacing smooth muscle cells