uterine pathology

Question 1

when does the proliferative phase occur

Answer 1

starts day 1

lasts 2 weeks

Question 2

which hormone causes the proliferative phase

Answer 2

oestrogen

Question 3

what occurs during the proliferative phase

Answer 3

growth of glands and storm

Question 4

when does the secretory phase occur

Answer 4

after ovulation

days 16-28

Question 5

which hormone is involved in the secretory phase

Answer 5

progesterone

Question 6

why does menstruation occur

Answer 6

absence of hormones

Question 7

which hormones are involved after fertilisation and what is their effect

Answer 7

progesterone (hyper secretion)

HCG (decidualisation)

Question 8

what do granulosa cells do

Answer 8

produce hormones

Question 9

what is the function of the corpus luteum

Answer 9

produces progesterone and causes the endometrium to become hyper secretory

Question 10

what is the corpus albicans

Answer 10

degenerated corpus albicans

Question 11

what changes occurs histologically during the secretory phase

Answer 11

increasing tortuosity and lumenal secretions

Question 12

indications for endometrial sampling

Answer 12

abnormal uterine bleeding
investigation of infertility
spontaneous and therapeutic abortion
assessment of response to hormonal therapy
endometrial ablation
work up prior to hysterectomy for benign indications
incidental finding of thickened endometrium on scan
endometrial cancer screening in high risk patients

Question 13

what is menorrhagia

Answer 13

prolonged and increased menstrual flow

Question 14

menorrhagia

Answer 14

regular intermenstrual bleeding

Question 15

polymenorrhoea

Answer 15

menses occurring at <21 day interval

Question 16

polymenorrhagia

Answer 16

increased bleeding and frequent cycle

Question 17

menomotrorrhagia

Answer 17

prolonged menses and intermenstrual bleeding

Question 18

amenorrhoea

Answer 18

absence of menstruation >6 months

Question 19

oligomenorrhoea

Answer 19

menses at interval of >35 days

Question 20

dysfunctional uterine bleeding

Answer 20

abnormal uterine bleeding with no organic causes

Question 21

causes of AUB in adolescent and early reproductive life

Answer 21

DUB usually due to anovulatory cycles
pregnancy/miscarriage
endometritis
bleeding disorders

Question 22

causes of AUB in reproductive life/perimenopause

Answer 22

pregnancy/miscarriage 
DUB: anovulatory cycles, luteal phase defects 
endometritis 
endometrial/endocervical polyp
leiomyoma 
adenomyosis (endometriosis in the myometrium)
exogenous hormone effects 
bleeding distoders 
hyperplasia 
neoplaisa

Question 23

causes of AUB in post menopause

Answer 23

atrophy
endometrial polyp
exogenous hormones (HRT, tamoxifen)
endometritis 
bleeding disorders 
hyperplasia 
endometrial carcinoma 
sarcoma

Question 24

what endometrial thickness is classed as abnormal in postmenopausal women

Answer 24

> 4 mm

Question 25

endometrial thickness is classed as abnormal in premenopausal women

Answer 25

>16 mm

Question 26

histological assessment of endometrial samples

Answer 26

is the sample adequate is there evidence of fresh/old breakdown/haemorrhage is there an organic benign abnormality (poly, endometritis, miscarriage) is the evidence for dysfunctional bleeding is there hyperplasia or malignancy

Question 27

what occurs during an anovulatory cycle

Answer 27

corpus luteum does not form | continued growth f functionalis layer (glands get bigger)

Question 28

how is endometritis diagnosed histologically

Answer 28

abnormal pattern of inflammatory cells

Question 29

how is the endometrium resistant to infection

Answer 29

cervical mucus plug protects the endometrium from ascending infection cyclical shedding of the endometrium

Question 30

micro-organisms that cause endometritis

Answer 30

``` neisseria chlamydia TB CMV actinomyces HSV ```

Question 31

when do endometrial polys most commonly occur

Answer 31

around or after menopause

Question 32

which malignancy may present as an endometrial polyp

Answer 32

endometrial carcinoma

Question 33

what is molar pregnancy

Answer 33

an abnormal form of pregnancy in which a non-viable fertilised egg implants in the uterus (or Fallopian tube)

Question 34

what type of disease is molar pegnancy and what is it characterised by

Answer 34

gestational trophoblastic disease | a mass characterised by swollen chorionic villi

Question 35

what is a complete mole

Answer 35

caused by a single or two sperm combining with an egg which has lost its DNA (the sperm then reduplicates forming a 'complete' 46 chromosome set) only paternal DNA is present in a complete mole

Question 36

what is a partial mole

Answer 36

egg is fertilised by two sperm or one sperm that replicates itself yielding the genotype 69, XXY the have both maternal and paternal DNA

Question 37

complete moles have a higher risk of developing into which cancer

Answer 37

choriocarcinoma

Question 38

what is adenomyosis

Answer 38

endometrial glands and stroma within the myometrium

Question 39

what is leiomyoma

Answer 39

benign tumour of smooth muscle, may be found in locations other than the uterus

Question 40

which hormone is leiomyoma growth dependent on

Answer 40

oestrogen

Question 41

which cancer can leiyomyoma develop into

Answer 41

leiomyosarcoma