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203: Reproduction and endocrinology > T3 L1 &2 :Pathology of the Female Reproductive Tract 1 & 2 > Flashcards

T3 L1 &2 :Pathology of the Female Reproductive Tract 1 & 2 Flashcards

1
Q

what hormone secreted at puberty causes maturation of squamous epithelial cells and of which organ

A

Oestrogen

Vagina

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2
Q

what is formed within mature squamous epithelial cells

A

Glycogen

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3
Q

what is the purpose of glycogen in vaginal cells

A

Glycogen in cells shed from the surface is a substrate for vaginal anaerobic organisms (dominated by lactobacilli)

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4
Q

what is the function of Lactobacilli

A

Lactobacilli produce lactic acid keeping vaginal pH below 4.5

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5
Q

describe the different components of the cervix

A
  • Ectocervix
  • Endocervix
  • Transformation zone
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6
Q

What type of cells are within the ectocervix

A

stratified squamous epithelium

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7
Q

what type of cells are within the endocervix

A

Single layer of tall, mucin producing columnar cells

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8
Q

what contributes to the large surface area of the endocervix

A
  • Columnar epithelium lines tiny blind ending channels (‘clefts’)
  • These radiate out from the endocervical canal into the surrounding stroma
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9
Q

what type of epithelium is the ectocervix covered by

A

stratified squamous epithelium

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10
Q

what type of epithelium is the endocervix covered by

A

columnar epithelium

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11
Q

what is the junction between the endocervix and ectocervix called

A

‘squamo-columnar junction

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12
Q

describe the formation of the transformation zone

A
  • During puberty the cervix changes shape
  • The lips of the cervix grow
  • The distal end of the endocervix opens
  • Endocervical mucosa becomes exposed to the vaginal environment
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13
Q

what is the endocervical columnar epithelium exposed to & what does this cause

A

Acidic vaginal environment

Reserve cells in this area proliferate and mature to form squamous epithelium: This process is called squamous metaplasia

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14
Q

define metaplasia

A

a transformation of cell type from one kind of mature differentiated cell type to another kind of mature differentiated cell type

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15
Q

what happens after metaplasia occurs

A
  • At first, the metaplastic squamous epithelium is thin and delicate (lots of proliferation & maturation is incomplete)
  • With time, the metaplastic epithelium comes to be as strong and well formed as that on the ectocervix
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16
Q

what is the myometrium

A

Bundles of smooth muscle, vasculature and nerves of the cervix

17
Q

when and what is the proliferative phase in the endometrium

A

-Before ovulation & has mitosis

1) Tubular glands
2) Specialised Stroma
3) Blood vessels

18
Q

what occurs in the secretory phase in the endometrium

A

1) Cork screw glands
2) Specialised stroma
3) Blood vessels

19
Q

define neoplasia

A

‘new growth’ – abnormal, uncoordinated and excessive cell growth.

persists following withdrawal of stimulus and associated with genetic alterations
20
Q

what are neoplasms classified according to

A

Neoplasms are classified according to their behaviour and histogenesis

Behaviour:  Benign or Malignant

Histogenesis: Recognising the cell of origin
21
Q

describe benign neoplasms

A

Remains localised and doesn’t invade surrounding tissues

Generally grow slowly

Good resemblance of parent tissue

22
Q

give an example of a benign neoplasm

A

Leiomyoma of the myometrium‘ fibroid ’

It closely resembles parent tissue

23
Q

what are the consequences of benign neoplasms

A
  • Pressure on adjacent tissue
  • Obstruction of lumen of a hollow organ
  • Hormone production
  • Transformation into a malignant neoplasm
  • Symptoms for the patient
24
Q

what are the clinical problems for benign neoplasms

A

Pressure on adjacent tissue
-Bladder (frequency) Rectosigmoid (constipation)

Obstruction to lumen of a hollow organ
-Adjacent (ureters) Blocking endocervix

Hormone production
-? Erythropoietin producing polycythaemia

Transformation into a malignant neoplasm
-Probably malignancy arises de novo

Abnormal uterine bleeding, pain

25
Q

describe malignant neoplasms

A

-Invade into surrounding tissues

Spread via lymphatics to lymph nodes and blood vessels to other sites (metastasis)

Generally grow relatively quickly

Variable resemblance to parent tissue
26
Q

how does malignant tissue appear to be

A
  • loss of differentiation
  • loss of cellular cohesion
  • enlarged irregular dark nuclei
  • increased numbers of mitoses
27
Q

what are the consequences of malignant neoplasms

A
  • Destruction of adjacent tissue
  • Metastasis
  • Blood loss from ulcerated surfaces
  • Obstruction of a hollow viscera
  • Production of hormones
  • Weight loss and debility
  • Anxiety and pain
28
Q

Terminology of neoplasms

A

Neoplasms have the suffix – oma

Malignant epithelial tumours are carcinomas

Carcinomas are named for the epithelial cell type which they resemble

Carcinomas of glandular epithelium are called adenocarcinomas

Malignant stromal tumours are sarcomas

29
Q

What type of cell types can be

A

Vulva squamous squamous cell carcinoma

Vagina squamous squamous cell carcinoma

Cervix squamous squamous cell carcinoma
glandular adenocarcinoma

Endometrium glandular adenocarcinoma
stroma stromal sarcoma

Myometrium sm muscle leiomyosarcoma

30
Q

Define Dysplasia and the type of lesions

A

This state is termed dysplasia

disordered growth and differentiation characterised by increased proliferation (more mitoses), atypia of cells and decreased differentiation

(There is an accumulation of cells which look somewhat like malignant cells but do not invade the basement membrane)

Dysplastic lesions may (but don’t always) progress to invasive malignancy

Recognising dysplastic lesions allows early treatment before invasion occurs

31
Q

what is the UK and USA terminology for dysplasia

A

UK: Cervical intra-epithelial neoplasia (CIN)

US: Squamous intra-epithelial lesion (SIL)

32
Q

what does the degree of the dysplasia predict

A

the likelihood of developing invasive malignancy

Grade % progress to CIN3 % progress to SCC
CIN1 11 1
CIN2 22 5
CIN3 - 40

33
Q

what are the typical types of dysplasia in different areas of the body

A
  • squamous metaplasia of the cervical transformation zone
  • squamous metaplasia of the bronchial epithelium
  • glandular metaplasia of the distal oesophagus
34
Q

what is the difference between how dysplastic and normal surface cells appear

A

Normal surface cells have a small nucleus and lots of cytoplasm

Dysplastic cells have a higher ratio of nuclear size to cytoplasmic volume, and the nuclei show the same features that we associate with malignancy

35
Q

what is the difference between dysplasia and carcinoma

A

is invasion through the basement membrane

36
Q

what does HPV infection cause

A

HPV infection causes CIN and cervical cancer

37
Q

what does the HPV infect

A

infect epithelium

38
Q

give some high risk HPV and low risk

A

High Risk HPV 16,18,31,33,35,39,45,51,52,56,58,59,68

Low Risk HPV
6,11,40,42,43,44,54,61,72,81

39
Q

What are the prevention measures against the HPV infection

A

HPV vaccinations

203: Reproduction and endocrinology (53 decks)

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