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Reproduction and Sexual Health > Uterine Pathology > Flashcards

Uterine Pathology Flashcards

1
Q

What phases make up the ovarian cycle?

A

Follicular phase
Ovulation (Day 14)
Luteal phase

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2
Q

What phases make up the uterine cycle?

A

Menstrual phase (day 1)
Proliferative phase
Secretory phase

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3
Q

Describe the proliferative phase of the endometrium:
Time
Hormone involved
Effect

A

Day 1 - 14
Oestrogen
Growth

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4
Q

Describe the secretory phase of the endometrium:
Time
Hormone involved
Effect

A

Day 16 - 28
Progesterone
Secretion

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5
Q

Describe the menstrual phase of the endometrium:
Time
Hormone involved
Effect

A

Day 1 - 3
Withdrawal of hormones
Necrosis

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6
Q

Describe the fertilised phase of the endometrium:
Time
Hormone involved
Effect

A

From secretory phase onwards (day 16)
Progesterone and HCG
Hypersecretion and decidualisation

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7
Q

What are indications for endometrial sampling?

A

Abnormal uterine bleeding
Investigations for infertility
Spontaneous and therapeutic abortion
Assessment of response to hormonal therapy
Prior to ablation to check that tissue is benign
Prior to hysterectomy
Endometrial cancer screening in high risk patients e.g. Lynch syndrome

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8
Q

Define menorrhagia

A

Prolonged and increased menstrual flow

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9
Q

Define metrorrhagia

A

Regular intermenstrual bleeding

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10
Q

Define polymenorrhoea

A

Menses occuring at <21 day interval

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11
Q

Define polymenorrhagia

A

Increased bleeding and frequent cycle

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12
Q

Define menometorrhagia

A

Prolonged menses and intermenstrual bleeding

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13
Q

Define amenorrhoea

A

Absence of menstruation >6 months

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14
Q

Define oligomenorrhoea

A

Menses at intervals >35 days

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15
Q

What is dysfunctional uterine bleeding?

A

Abnormal uterine bleeding without an organic cause

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16
Q

What is peri-menopausal bleeding?

A

Abnormal uterine bleeding (AUB) more than 1 year after cessation of menstruation

17
Q

What is the most common cause of AUB in adolescence?

A

Anovulatory cycles - if the woman doesn’t ovulate then the endometrium keeps growing until it outgrows its blood supply and dies

18
Q

What is the most common cause of AUB in reproductive life?

A

Pregnancy/ miscarriage

19
Q

What is the most common cause of AUB in post-menopausal women?

A

Atrophy

20
Q

How can the breast cancer drug Tamoxifen cause uterine bleeding?

A

Anti-oestrogenic drug but paradoxical stimulation of oestrogen in endometrium

21
Q

What does sarcoma in uterus affect?

A

Stromal cells of endometrium

Smooth muscle cells of myometrium

22
Q

How can the endometrium be assessed?

A

Transvaginal ultrasound

Hysteroscopy - endometrial pipelle or dilatation and curettage

23
Q

What are the indications for a biopsy after transvaginal ultrasound?

A

If the endometrial thickness is:
>4mm in postmenopausal
>16mm in premenopausal

24
Q

What are organic causes of AUB in the endometrium?

A

Endometriosis
Polyps
Miscarriage

25
Q

What are organic causes of AUB in myometrium?

A

Adenomyosis

Leiomyoma

26
Q

What are causes of endometriosis?

A 
Infection - neisseria, chlamydia, TB, CMB, acinomyces, HSV
IUD
Post-partum
Post-curattage
Granulomatous (sarcoid etc)
Associated with leiomyomata or polyps
27
Q

What is chronic plasmacytic endometritis?

A

Infectious - associated with PID

Plasma cells in endometrium

28
Q

What is granulomatous endometritis?

A

Collection of epithelial macrophages

Granular disease - sarcoid, TB

29
Q

What are the clinical signs and symptoms of endometrial polyps?

A

Usually asymptomatic

Sometimes bleeding or discharge

30
Q

Are endometrial polyps benign or malignant?

A

Almost always benign

Can occur due to endometrial carcinoma

31
Q

What is a molar pregnancy?

A

Non-viable fertilised egg implants in uterus

A form of gestational trophoblastic disease characterised by swollen chorionic villi

32
Q

What are the types of molar pregnancies?

A

Complete mole

Partial mole

33
Q

How is a complete mole formed?

A

One or two sperm combine with egg that has no DNA (i.e. only paternal DNA)

34
Q

How is a partial mole formed?

A

When an egg is fertilised by 2 sperm or by 1 sperm which reduplicates
i.e. 69XXY

35
Q

What is a potential malignancy risk of complete moles?

A

Risk of developing into choriocarcinoma (malignant tumour of trophoblast)

36
Q

What is adenomyosis?

A

Endometrial glands and stroma within the myometrium

37
Q

What is leiomyoma?

A

Benign tumour of the smooth muscle

Reproduction and Sexual Health (18 decks)

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