Uterine pathology Flashcards
Hormone responsible for the proliferative phase of the endometrium
Oestrogen
Hormone responsible for the proliferative phase of the endometrium?
Progesterone
Hormones involved once fertilisation takes place?
Progesterone
hCG
What is dysfunctional uterine bleeding?
Abnormal uterine bleeding with no organic cause
What is post-menstrual bleeding?
Abnormal uterine bleeding more than 1 year after cessation of menstruation
Which exogenous hormones could cause AUB post menopause?
Tamoxifen
HRT
Endometrial thickness as indication for biopsy
Post-menopause, do biopsy if greater than 4mm
Pre-menopause - do if greater than 16mm
Most thorough endometrial sampling method
Dilatation and curettage (also the most common operation performed on women)
REQUIRED history (LEARN)
- age
- LMP and length of cycle
- pattern of bleeding
- hormones
- RECENT pregnancy
Do NOT need to know number of pregnancies, drugs without hormonal influence etc
When you take a biopsy, which endometrial stage is the least useful?
Menstrual phase
Pathology behind anovulatory dysfunctional uterine bleeding
- corpus luteum does not form
- continued growth of functionalis layer
A benign tumour, derived from smooth muscle in the uterus
Leiomyoma
Endometrial polyps are usually benign but why should you be carfeul?
Endometrial carcinoma can present as a polyp
What is a molar pregnancy?
When a non-viable fertilised egg implants in the uterus
What is a complete mole?
When 1 (or sometimes 2) sperm fertilise an egg which has lost its DNA
- the sperm DNA then reduplicates to form a “complete” 46 chromosome set
- only paternal DNA is present in a complete mole
What type of DNA is present in a complete mole?
Only paternal DNA is present in a complete mole
What is a partial mole?
When an egg is fertilised by 2 sperm or 1 sperm which reduplicates itself yielding the genotypes of 69 XXY (triploid).
Partial moles have both paternal and maternal DNA
What type of DNA in a partial mole?
Paternal and maternal
Are complete or partial moles at greater risk of developing into a choriocarcinoma?
Complete moles have higher risk
What is a choriocarcinoma?
A malignant tumour of trophoblast
What causes growth of leiomyomas?
Oestrogen dependent
What are leiomyomas made from?
Smooth muscle
