Uterine Pathology Flashcards
What are the phases of the uterine cycle?
menstrual phase; prolfierative phase; secretory phase
When is the proliferative phase?
days 1-14
When is the secretory phase?
days 16-28
When is the menstrual phase?
days 1-3
What is the main hormone in the proliferative phase?
oestrogen
What is the main hormone in the secretory phase?
progesterone
What is decidualisation?
changes that happen to endometrial cells to prepare for pregnancy
What hormone is involved in decidualisation?
hCG
What is ppost-menopausal bleeding?
abnormal uterine bleeding >1 year after cessation of menstruation
What are the causes of abnormal uterine bleeding in early repro life?
DUB usually due to anovulatory cycles; pregnnacy/miscarriage; endometritis; bleeding disorders
What are the causes of AUB in reproductive life/perimenopause?
pregnancy/miscarriage;DUB-anovulatory cycles; luteal phase defects; endometritis; polyps; leiomyom; adenomyosis; exogenous hormone effects; hyperplasia
What are the causes of AUB post-menopause?
atrophy; endometrial polyp; exogenous hormones (HRT; tomaxifen); endometritis; bleeding disorders’ endometrial carcinoma
What is the indication for endometrial biopsy in postmenopausal women?
endometrial thickenss >4mm
What is the indication for endometrial biopsy in premenopausal women?
16mm
What are the methods of sampling the endometrium?
endometrial pipelle; dilatation and curretage
When is the least informative time for endometrial biopsy?
menstrual phase
What is dysfunctional uterine bleeding?
irregular uterine bleeding that reflects a disruption in the normal cyclic pattern of ovulatory hormonal stimulation to the endometrial lining- no organic cause
What is luteal phase deficiency?
insufficent progesterone or poor response by endometrium to progesterone. abnormal follicular development (inadeuqate FHS/LH)- poor corpus luteum
What is the most common cause of DUB?
anovulatory cycles
What happens in anovulatory cycles?
corpus luteum does not form; continued growth of functionalis layer
What are the endometrial causes of AUB?
endometritis; polyp; miscarriage
What are the myometrial causes of AUB??
adenomyosis; leiomyoma
What is the appearnace of endometritis histolofically?
abnormal pattern of inflammatory cells
What are the common microbes implicated in endometritis?
neisseria; chlamydia; TB; CMV; actinomyces; HSV
What ar ethe causes of endometritis without specific organisms?
intrauterine contraceptive device; postpartum; postabortal; postcurretage; chronic endometritis; granulomatous; polyps or leiomyoma
What is chronic plasmacytic endometritis?
infectious unless proved otherwise; associated iwth PID
When do endometrial polyps tend to occur?
around and after the menopause
What ar ethe symtpoms of endometrial polyps?
asymotomatic but may present with bleding or discharge
What is the risk with endometrial polyps?
endometrial carcinoma can present as a polyp, almost always benign though
What is molar pregnancy?
abnormal form of pregnancy in which a non-viable fertilised egg implants in the uterus or tubes
What is molar pregnancy a form of?
gestational trophoblastic disease
What is a complete mole caused by?
1 or 2 sperm combining wit han egg which has lost its DNA, only paternal DNA
What is a partial mole?
egg is fertilised by 1 or 2 sperm which reduplicates itself yielding 69 XXY (triploid)
What is the risk of choriocarcinoma with complete and partial moles?
complete hydatiform moles have higher risk
What is adenomyosis?
endometrial glands and stroma within the myometrium
How does adenomyosis present?
menorrhagia/dysmenorrhea
What are the symptoms with leiomyoma?
menorrhagia; infertility, mass effect; pain
What does growth of leiomyoma depend on?
oestogen
