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CP > Uterine and ovarian pathology > Flashcards

Uterine and ovarian pathology Flashcards

1
Q

what is endometriosis?

A

ectopic endometrium which causes bleeding into tissues which leads to fibrosis

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2
Q

what is the symptoms of those with endometriosis?

A

25% are asymptomatic, dysmenorrhoea, dyspareunia, pelvic pain, sub fertility, pain on passing stool and dysuria

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3
Q

what is linked with endometriosis?

A

ectopic pregnancy, ovarian cancer and IBD

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4
Q

what are some treatments of endometriosis?

A

medical treatments include

  • COCP
  • GnRH agonists/antagonists
  • progesterone antagonists

Surgical treatments

  • ablation
  • tah-bso
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5
Q

what is endometritis?

A

inflammation of the endometrium caused by foreign bodies, chronic retained products and infection

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6
Q

what are the symptoms of endometritis?

A

abdominal/pelvic pain, pyrexia, discharge, dysuria and abnormal vaginal bleeding

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7
Q

how to treat endometritis?

A

analgesia, abx and remove cause

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8
Q

how to diagnose endometritis?

A

biochemistry/microbiology, USS

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9
Q

what are endometrial polyps?

A

Sessile/polypoid E2-dependent uterine overgrowths

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10
Q

what are the symptoms of endometrial polyps?

A

often asymptomatic, intermenstrual/post menopausal bleeding, menorrhagia, dysmenorrhoea

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11
Q

how to diagnose endometrial polyps?

A

USS, Hysteroscopy

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12
Q

how to treat endometrial polyps?

A

medical

P4/GnRH agonists, surgical curettage

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13
Q

what is leiomyoma?

A

uterine fibroids, benign myometrial tumours with E2/P4- dependent growth

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14
Q

what are the risk factors for leiomyoma?

A 
genetics
nulliparity,
obesity,
PCOS,
HTN
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15
Q

what are the symptoms of leiomyoma?

A

often asymptomatic,
menorrhagia (iron deficient anaemia),
sub fertility/pregnancy problems

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16
Q

how do you diagnose leiomyoma?

A

Bimanual examination

USS

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17
Q

what is the treatment for leiomyoma?

A

medical

  • IUS
  • NSAIDs
  • OCP
  • P4
  • FE2+

non-medical

  • Artery embolisation
  • Ablation
  • TAH
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18
Q

what is the prognosis for leiomyoma?

A
  • menopausal regression

- malignancy risk 0.01%

19
Q

what is endometrial hyperplasia?

A

excessive endometrial proliferation

20
Q

what is the risk factors for endometrial hyperplasia? 6

A
  • obesity
  • exogenous E2
  • PCOS
  • E2-producing tumours
  • tamoxifen
  • HNPCC (PTEN Mutations)
21
Q

what are the types of endometrial hyperplasia?

A
  • simple non-atypical, simple atypical

- complex non-atypical, complex atypical

22
Q

what are the symptoms of endometrial hyperplasia?

A

abnormal bleeding - IMB/PCB/PMB

23
Q

how do you diagnose endometrial hyperplasia?

A

USS, Hysteroscopy +/- biopsy

24
Q

how do you treat endometrial hyperplasia?

A 
?medical 
-IUS
-P4
surgical 
-TAH
25
Q

what is the prognosis endometrial hyperplasia?

A

endometrial adenocarcinoma

regression

26
Q

what is the malignant progression of hyperplasia?

A
  1. normal
  2. Non-atypical hyperplasia
  3. atypical hyperplasia
  4. endometrioid adenocarcinoma
27
Q

what is the most common cancer of the female genital tract?

A

endometrial adenocarcinoma

28
Q

what is the prognosis of endometrial adenocarcinoma?

A

stage 1 = 90% 5yr survival

stage 2-3 = <50%

29
Q

what is the treatments of endometrial adenocarcinoma?

A

medical (P4)
surgery (TAH-BSO)
adjuvant therapy (chemo-/radiotherapy)

30
Q

what are the symptoms of endometrial adenocarcinoma?

A

PMB/IMB pain if late

31
Q

What is Polycystic ovary syndrome?

A

Endocrine disorder; hyperandrogenism, menstrual abnormalities, polycystic ovaries

32
Q

what are the links to PCOS?

A

infertility, endometrial hyperplasia/adenocarcinoma

33
Q

what are the treatments of pcos?

A

Lifestyle (weight loss)
medical (metformin, OCP, Clomiphene)
surgical (ovarian drilling)

34
Q

what are the diagnosis criteria for PCOS?

A

rotterdam criteria 2/3 of polycystic ovaries
hyperandrogenism (hirsuitism/biochemical)
irregular periods >35days

35
Q

what tests are done to diagnose for PCOS?

A

USS
fasting biochemical screen (low FSH, High LH, testosterone, DHEAS)
OGTT

36
Q

what are the origin of ovarian neoplasms?

A

surface epithelial tumours
sex-cord stromal tumours
germ cell tumours

37
Q

what are the 3 major carcinoma histologic types of epithelial tumours?

A

Serous (tubal)
Mucinous (endocervical)
Endometrioid (endometrium)

38
Q

what is serous cystuadenocarcinoma characterised by?

A

characterised by complex, branching and glands incorporating slit-like spaces

39
Q

what % of ovarian tumours are germ cell tumours?

A

15-20% of all ovarian tumours

40
Q

what are the risk factors for ovarian cancer?

A 
FH 
older age 
PMH breast cancer
smoking,
E2-only HRT
Lynch 2 syndrome,
obesity 
nulliparity
41
Q

what are the protective factors for ovarian cancer?

A

OCP
Breastfeeding
Hysterectomy

42
Q

what are the symptoms of ovarian cancer?

A

non-specific symptoms; pain, bloating, weight loss, PV bleeding, urinary frequency, anorexia

43
Q

what is the prognosis of ovarian cancer?

A

overall 5 years 43% survival

CP (14 decks)

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