Uterine pathology Flashcards
What is the most common causative organisms of endometritis?
Neisseria gonorrhoea
Chlamydia
What is chronic endometritis associated with?
Pelvic inflammatory disease
When do endometrial polyps most commonly occur?
Around and after menoapuse
What is a molar pregnancy?
When a non-viable fertilized egg implants in uterus (or tube)
What is a complete mole?
When 1 or 2 sperm combine with egg without DNA
Sperm reduplicates forming complete 46 chromosome set
What DNA is present in a complete mole?
ONLY paternal DNA
What is partial mole?
Egg is fertilized by 2 sperm or 1 sperm that then reduplicates itself
Forming a 69 XXY chromosome set
What DNAis present in a partial mole?
BOTH maternal & paternal DNA
Which form of molar pregnancy is at highest risk of developing into choriocarcinoma?
Complete hydatidiform moles
What is adenomyosis?
Endometrial glands & stroma within myometrium
How does adenomyosis present?
Mennorhagia or dysmennorrhoea
What is a leiomyoma?
Benign tumour of smooth muscle
What is leiomyoma growth dependent on?
Oestrogen
How would a leiomyoma present?
Menorrhagia
Infertility
Mass effect
Pain
What is endometriosis?
Growth of ectopic endometrial tissue outside he uterine cavity
How does endometriosis present?
Chronic pelvic pain Dysmenorrhoea (pain often starts before bleeding) Deep dyspareunia Subfertility Urinary symptoms Dyschezia (painful pooing)
What is the gold standard investigation for endometriosis?
Laparoscopy
How is endometriosis managed?
Symptomatic relief (NSAIDs) COC Progestrogens GnRH analogues IUS Surgery
How does endometrial hyperplasia present?
Abnormal bleeding
What sort of patients does endometrial carcinoma tend to present in?
50-60 y/o
Obese
What should be considered if endometrial carcinoma presents in a younger woman?
Predisposition (PCOS or Lynch syndrome)
What is the precursor for endometroid carcinoma?
Atypical hyperplasia
What drives endometroid carcinoma?
Unopposed oestrogen
What is Lynch syndrome?
Autosomal dominant inheritance of a defective DNA mismatch repair gene
What feature do tumours associated with Lynch syndrome exhibit?
Microsatellite instability
Which type of endometrial cancer is more aggressive and has a worse prognosis?
Serous carcinoma
How does endometrial serous carcinoma spread?
Along Fallopian tubes & peritoneal surfaces
