Uterine Body - Endometrium and Myometrium

Question 1

What is dysfunctional uterine bleeding (DUB)?

Answer 1

• Irregularity of menstruation unrelated to an anatomical cause
• Includes intramenstrual bleeding and menorrhagia
• Anovulatory cycles, irregularly established secretory change in the endometrium, and irregular menstrual shedding may all contribute

Question 2

What are endometrial polyps composed of?

Answer 2

• Endometrial glands around a fibro-vascular core

Question 3

What are risk factors for endometrial carcinoma?

Answer 3

• Age >50

- Lynch syndrome (loss of DNAMMR gene)

Question 4

How is endometrial carcinoma staged?

Answer 4

• Stage I (confined to myometrium; A = inner half, B = outer half)
• Stage II (involves stroma of cervix)
• Stage IIIA (serosal surface of adnexae)
• Stage IIIB (vagina or parametrium)
• Stage IIIC (pelvic or para-aortic nodes)
• Stage IVA (bladder or bowel mucosa)
• Stage IVB (distant metastases)

Question 5

What is adenomyosis?

Answer 5

• Basal endometrium extends abnormally into hyperplastic myometrium
• Often present with dysmenorrhea and mennorhagia

Question 6

Describe leiomyosarcomas

Answer 6

• Commonest malignant non-epithelial tumour
• Softer mass, less well circumscribed outline
• Haemorrhage, necrosis

Question 7

What is gestational trophoblastic disease?

Answer 7

• Group of conditions characterised by excessive proliferation of trophoblast
• Hydatidiform mole os most common (large oedematous chorionic villi)

Question 8

What is molar gestation?

Answer 8

• An abnormal form of pregnancy in which a non-viable fertilized egg implants in the uterus and will fail to come to term