Reproductive System Flashcards
Lobule
Made of small ducts
Non-neoplastic conditions (2)
- Fibrocystic changes (hormonally driven)
2. Inflammatory conditions
Fibrocystic changes
Hormonally driven
Fibrosis -cystically dilated ducts
Pre-menopausal young adults
Very common
Acute mastitis
Inflammatory condition
Lactating women
Can lead to abcess
Fibroademona
Benign tumors 20-30yo Often self-detected lump Biphasic tumors Taken out surgically
Biphasic tumors
Epithelial proliferation and stromal proliferation
Carcinoma of the breast
Most common malignant tumor in women (1/9)
Rises from epithelium of breast ducts and lobules
Can metastasize
Ductal and lobular carcinoma in situ
Precursor lesions
Proliferation of cancerous cells limited to the duct
No invasion through basement membrane - cannot metastasize
Risk factors of breast cancer
Female > male Family history, genes White>African>East Asians Post-menopausal women Estrogen excess Non-malignant proliferative breast changes
How is breast cancer diagnosed?
Self detection
Mammographic screening
Distant metastasis
Breast biopsy
Prognosis in breast cancer
Stage, tumor type, grade, ER/PR/HER2 status (treatment potential)
Breast cancer metastases
Most common site is to regional lymph nodes of the axilla
Can distantly metastasize to brain, liver, lung, bone
Tissue tupe of vulva, vagina, exocervix
Squamous epithelium
Tissue type of endocervix
Glandular epithelium
Tissue type of myometrium
Smooth muscle
Tissue type of endometrium
Glandular epithelium
Tissue type of fallopian tubes
Ciliated, tubal epithelium
Follicles
Contained in ovaries
Oocytes and sex cord cells
Ovaries
Connective tissue stroma, oocytes and sex cord cells
Hormonal regulation of female reproductive system
Hypothalamic-pituitary-ovarian axis
Hypothalamus secretions
Secretes GnRH
Pituitary secretions
Secretes FSH and LH
Ovarial follicle secretions
Secretes estrogen - ovulation
Corpus luteum secretions
Secretes estrogen and progesterone
Follicular phase
Characterized by rising estrogen
Luteal phase
Characterized by rising estrogen and progesterone
Phases of endometrium
Proliferative, secretory, menstrual (shedding)
Bacterial infections (4)
- Neisseria gonorhea
- Tremponema pallidum (syphilis)
- Streptococcus and staphylococcus
- Chlamydia trachomatis
Viral infections (2)
- Genital herpes
2. HPV
Fungal infections
Candida albicans (yeast infection)
Pelvic inflammatory disease
Upper gynecologic tract
General term to describe inflammation/infection that ascends from lower to upper genital tract
Polymicrobial: chlamydia, gonorrhea, others
Causes inflammation, abscess formation, scarring
Can have no symptoms, pain, fever, infertility
Endometriosis
Foci of endometrium found outside uterus
Most often located on ovary, pelvic peritoneum, fallopian tube, vagina
Retrograde menstrual flow
Causes cyclic pain, infertility
Uterine fibroid
Very common neoplasms of smooth muscle
Squamous cell carcinoma
Vulva, vagina, cervix
Many are HPV related
Leiomyoma
Benign tumor of the myometrium - smooth muscle
Tumors of the uterus (2)
- Endometrium: carcinoma
2. Myometrium: leiomyoma
Tumors of the ovaries (3)
- Tumors of surface epithelium
- Germ cell tumors
- Sex cord stromal tumors
Tumors of fallopian tube
Carcinoma
Human Papilloma virus
Variety of pathologies (depending on virus type)
Infection, sometimes neoplasia
High and low risk
Low risk HPV
6 + 11 Condyloma accuminatum (warts) and low risk lesions
High risk HPV
16 + 18
Premalignant lesions of cervix, vulva, vagina, anus, penis
Invasive squamous cell carcinoma
Diagnosis on pap (5)
- Negative
- Atypical cells of undetermined significance
- LSIL
- HSIL
- Carcinoma
Colposcopy
In the event of an abnormal pap
To visualize cervix for biopsy
Endometrial adenocarcinoma
Related to hyperestrinism - obesity, hormone replacement therapy
May be preceded by endometrial hyperplasia
Occurs in perimenopausal, postmenopausal women
Solitary cysts (2)
- Follicular cysts
2. Corpus luteum cyst
Polycystic ovary syndrome (POS)
Associated with hormone disturbances, menstrual irregularities, hirsutism, infertility
Tumors of surface epithelium (ovaries)
Malignant: serous or mucinous cystadenocarcinoma
Benign: serous or mucinous cystadenoma
Germ cell tumors (ovaries)
Teratoma Usually less than 25 yo Arise from primordial germ cells that migrate from yolk sac in early embryogenesis Mature embryonic tissues Occasionally malignant
Sex cord stromal tumors (ovaries)
Granulosa cell tumor
Pregnancy
Fertilization (spermatozoa + oocyte in fallopian tube)
Inplantation (zygote implans in endometrium)
Placenta, fetal sac and fetus develop
Placenta parts (3)
- Chorionic villi
- Maternal vessels
- Amniotic membranes
Pathology of pregnancy (3)
- Fertilization problems
- Implantation problems
- Placental problems
Fertilization problems
Abnormal ovum or sperm
Implantation problems
PID - fallopian tube scarring
Ectopic pregnancy
Placental problems (2)
- Placenta previa
2. Placenta accreta
Placenta previa
Covers cervical os
Needs C section, bleeding during pregnancy
Placenta accreta
Penetrates into uterine wall
Into myometrium, and occasionally beyond
Placenta does not separate properly at birth, may cause extensive bleeding and require surgery
Ectopic pregnancy
Implantation outside of uterine cavity
Fallopian tube > ovary > pelvic peritonium
Often caused by scarring from PID, prior surgery, endometriosis
Pain, or rupture of fallopian tube
Medical emergency
