Pathology - Uterus

Question 1

what two cycles occur alongside each other in the menstrual cycle?

Answer 1

ovarian

uterine

Question 2

what are the three phases of the ovarian cycle?

Answer 2

follicular phase
ovulation
luteal phase

Question 3

what occurs in the follicular phase of the menstrual cycle?

Answer 3

maturation of follicles

Question 4

what cells produce the hormones that drive the uterine cycle?

Answer 4

granulose cells in the follicles

Question 5

how long does ovulation take?

Answer 5

around one day

Question 6

what happens to the oocyte after ovulation?

Answer 6

picked up by the fimbriae of the uterine tube

Question 7

what happens to the follicle in the luteal phase?

Answer 7

become the corpus luteum

Question 8

what hormones are produced by the corpus luteum in the luteal phase?

Answer 8

oestrogen

progesterone

Question 9

what happens to the corpus luteum if fertilisation does not occur?

Answer 9

it starts to degenerate

Question 10

what are the three phases of the uterine cycle?

Answer 10

menstrual phase
proliferative phase
secretory phase

Question 11

how long does a typical menstrual phase last?

Answer 11

3-8 days

Question 12

when does the proliferative phase begin?

Answer 12

at the same time as the menstrual phase

Question 13

what happens in the proliferative phase?

Answer 13

proliferation of the endometrium to replace what was lost

Question 14

when does the secretory phase occur?

Answer 14

just after menstruation

Question 15

what drives the secretory phase?

Answer 15

progesterone from the corpus luteum

Question 16

what are two possible investigations that can be done to assess the endometrium?

Answer 16

TVUS

hysteroscopy

Question 17

what endometrial thickness is taken as an indication for a biopsy?

Answer 17

> 4mm if postmenopausal

> 16mm if premenopausal

Question 18

what two methods may be used to take an endometrial biopsy?

Answer 18

endometrial pipelle - outpatient, smaller sample

dilatation and curettage - anaesthetic, better sample

Question 19

what information is required to be sent alongside an endometrial biopsy to histology?

Answer 19

age
date of LMP + cycle length 
pattern of bleeding 
hormones 
recent pregnancy

Question 20

what is menorrhagia?

Answer 20

prolonged and increased menstrual flow

Question 21

what is metorrhagia?

Answer 21

regular intermenstrual bleeding

Question 22

what is polymenorrhoea?

Answer 22

menses occurring at <21 day intervals

Question 23

what is polymenorrhagia?

Answer 23

increased bleeding and frequency of cycles

Question 24

what is menometorrhagia?

Answer 24

prolonged menses with intermenstrual bleeding

Question 25

what is amenorrhoea?

Answer 25

absence of menstruation for >6 months

Question 26

what is oligomenorrhoea?

Answer 26

menses at intervals of >35 days

Question 27

what is disordered uterine bleeding?

Answer 27

AUB with no organic cause

Question 28

what is AUB?

Answer 28

abnormal uterine bleeding

Question 29

what is DUB?

Answer 29

disordered uterine bleeding

Question 29

what is DUB?

Answer 29

disordered uterine bleeding

Question 29

what is DUB?

Answer 29

disordered uterine bleeding

Question 30

what is PMB?

Answer 30

post menopausal bleeding

Question 31

what is postmenopausal bleeding?

Answer 31

AUB >1 year after the cessation of menstruation

Question 32

what is the most common cause of DUB?

Answer 32

anovulatory cycles

Question 33

how is endometritis histologically diagnosed?

Answer 33

plasma cells in the endometrial stroma

Question 34

what two things make endometritis rare?

Answer 34

cervical mucous plug prevents ascending infection | cyclical shedding of the endometrium

Question 35

is infectious or non infectious endometritis more common?

Answer 35

non infectious

Question 36

name some infections that can cause endometritis

Answer 36

``` neisseria chlamydia TB CMV HSV ```

Question 37

name some non infectious causes of endometritis

Answer 37

intrauterine contraceptive device's postpartum granulomatous polyps

Question 38

how do endometrial polyps present?

Answer 38

usually asymptomatic may have bleeding or discharge

Question 39

when do endometrial polyps often occur?

Answer 39

around/after the menopause

Question 40

what malignancy can present as an endometrial polyp?

Answer 40

endometrial carcinoma

Question 41

what is a molar pregnancy?

Answer 41

an abnormal form of pregnancy in which a non-viable fertilised egg implants in the uterus

Question 42

what characterises the mass in molar pregnancy?

Answer 42

swollen chorionic villi

Question 43

what are the two types of molar pregnancy?

Answer 43

complete | partial

Question 44

what causes a complete mole?

Answer 44

one or two sperm combining with an egg that has no DNA sperm duplicates to form a complete chromosome set

Question 45

what DNA is present in a complete mole?

Answer 45

only paternal

Question 46

what can a complete mole invade into?

Answer 46

the myometrium

Question 47

what is there a risk of in a complete mole?

Answer 47

developing into choriocarcinoma

Question 48

what is choriocarcinoma?

Answer 48

malignancy of trophoblasts

Question 49

when does a partial mole occur?

Answer 49

when the egg is fertilised by one sperm that duplicates/two sperm

Question 50

what genotype is seen in a partial mole?

Answer 50

69 XXY

Question 51

what DNA is seen in a partial mole?

Answer 51

maternal and paternal

Question 52

what is adenomyosis?

Answer 52

when there are endometrial glands and stroma in the myometrium

Question 53

how does adenomyosis present?

Answer 53

menorrhagia | dysmenorrhoea

Question 54

what is leiomyoma?

Answer 54

a benign tumour of smooth muscle cells

Question 55

what is growth of a uterine leiomyoma dependent on?

Answer 55

oestrogen