Uterine disorders Flashcards
Mucous retention cyst of endocervical columnar cells occurring when a cleft has been covered by squamous metaplasia
Nabothian cyst
Most common lesion of the cervix, assoc w/ intermenstrual or postcoital bleeding
Cervical polyps
HPV types involved in Cervical dysplasia
16,18,31,33
Current classification system in reporting cervical cytology
Bethesda system
Histology of endocervix
Columnar glandular cells
Histology of ectocervix
Stratified squamous epithelium
Screening recommendation of pap smear
3 yrs after onset of sexual activity
Age 21 yrs
Frequency of pap smear in less than 30 y/o
annually in conventional method
every 2 yrs in liquid-based method
Intervention for ASCUS pap smear result
Colposcopy and biopsy
Test used using iodine for cervical squamous cells to contrast for biopsy
Schiller’s test
Test used when T-zone cannot be evaluated
Diagnostic conization
Grade 1: very mild-mild dysplasia
Low Grade SIL
Grade 2-3: mod to cancer-in-situ (mitotic figures contained in epith)
High-grade SIL
Mgt for CIN I
Observe, repeat pap smear in 3 mos
CIN 2-3 tx
Ablative therapy (cryotx, CO2 laser) Excisional procedure (LEEP or cold knife conization) Hysterectomy (if fertility is undesired)
FIGO stage I of cervical Ca
confined to the cervix
Most common stage of presentation in cervical cancer
Stage III
Mainstay tx for cervical Ca
Chemoradiation
FIGO stage II
beyond uterus but not to the pelvic wall or to the lower 3rd of the vagina
FIGO Stage III
Causes hydronephrosis, involves lower third of vagina
Most common cause of death in cervical ca
Uremia
HPV type in genital warts
6, 11
Only carcinoma that is staged clinically
Cervical cancer
Vaccine sched for Quadrivalent HPV vaccine
0-2-6 mos
Most common anatomic mullerian anomaly
Category 5: Septate
2 Categories of Mullerian anomalies assoc w/ 2nd trimester loss
2: Unicornuate
4: Bicornuate
Most common type of myoma/ fibroid
intramural
Most common type of myoma assoc with heavy and prolonged bleeding
Submucous myoma
What drug is assoc with endometrial polyps
tamoxifen
When do you order for biopsy in a patient with endometrial polyp instead of simple UTZ only?
> 35 y/o with AUB
Presence of glands and stroma in abberant location
Endometriosis
Most common site of endometriosis
Ovaries
4 etiology of endometriosis
Retrograde menstruation
Coelemic metaplasia
Lymphatic / vascular metastasis
Iatrogenic dissemination
3 cardinal histo features of endometriosis
Ectopic endometrial glands
Ectopic endometrial stroma
Hemorrhage on adjacent tissues (hemosiderin-laden macrophages)
Definitive diagnostic procedure for endometriosis
Laparoscopy
Growth of endometrial glands and stroma into the uterine myometrium to a depth of at least 2.5 mm from basalis layer
Adenomyosis
Definitive tx for endometriosis
TAHBSO
Treatment for ovarian endometriosis >2 cm and adnexal enlargements >8cm
Surgical (TAHBSO)
> 35 y/o, mostly asymptomatic, but in multiparous, with dysmenorrhea and menorrhagia, diffusely enlarged uterus (2-3x bigger)
Adenomyosis
Diagnostic exam for endometrial hyperplasia
Endometrial sampling (Cytologic aplasia -most impt determinant for premalignant potential)
Histo with the highest risk of progression to endometrial cancer
Complex with atypia
Pathophy of endometrial hyperplasia
Chronic unopposed estrogen exposure
After tx of endometrial hyperplasia, how many months should the biopsy be repeated?
6 mos
Most common cause of postmenopausal bleeding
Endometrial atrophy
Precursor of endometrial carcinoma
Atypical complex hyperplasia
Most common subtype of endometrial cancer
Endometroid
Double cervix arising from uterine didelphys with double vagina
Bicollis
