Uterine pathology Flashcards
What are some indications for endometrial biopsy
AUB infertility abortion ablation incidental finding of thick endometrium on scan
what are some causes of AUB in adolescence / early life
DUB
pregnancy/miscarraige
endometriosis
bleeding disorders
Causes of AUB in reproductive life / perimenopause
pregnancy / miscarraige DUB endometriosis polyp Adenomyosis Hyperplasia neoplasia
Causes of AUB in post menopausal life
atrophy endometriosis polyp hormone therapy (HRT, tamoxifen) carcinoma hyperplasia sarcoma
Give some methods of assessing endometrium
transvaginal ultrasound scan (TVUS)
Hysteroscopy
what thickness of endometrium is an indication for biopsy
> 4mm for post menopausal women
> 16mm for premenopausal women
What is DUB
abnormal uterine bleeding with no organic cause
What causes DUB
disruption to normal cyclic pattern of ovulatory hormonal stimulation to the endometrial lining
What are the two types of DUB and describe it
anovulatory (85%) of cases, and ovulatory
anovulatory: corpus luteum does not form, continuous growth of stratum functionalis
seen in PCOS, thyroid disorder, hypothalamic dysfunction, hyperprolactinaemia
what is the management of DUB
progesterones COC pill danazol GnRH analogues NSAIDs antifibrinolytics mirena coil endometrial resection / ablation / hysterectomy
How is endometritis diagnosed histologically
by the recognition of abnormal pattern of inflammatory cells
What are some infective causes of endometritis
Niesseria
Chlamydia
TB
HSV
what are some non-infective causes of endometritis
postabortal post curettage post partum granulomatous endometritis IUCD chronic endometritis NOS
What is adenomyosis and how does it present
presence of endometrial glands and stroma in myometrium
menorrhagia and dysmenohrea
What is leiomyoma and how does it present
benign oestrogen dependant tumour of smooth muscle cell
menorrhagia, infertility, pain
