uterine pathology Flashcards
when does the proliferative phase occur
starts day 1
lasts 2 weeks
which hormone causes the proliferative phase
oestrogen
what occurs during the proliferative phase
growth of glands and storm
when does the secretory phase occur
after ovulation
days 16-28
which hormone is involved in the secretory phase
progesterone
why does menstruation occur
absence of hormones
which hormones are involved after fertilisation and what is their effect
progesterone (hyper secretion)
HCG (decidualisation)
what do granulosa cells do
produce hormones
what is the function of the corpus luteum
produces progesterone and causes the endometrium to become hyper secretory
what is the corpus albicans
degenerated corpus albicans
what changes occurs histologically during the secretory phase
increasing tortuosity and lumenal secretions
indications for endometrial sampling
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
what is menorrhagia
prolonged and increased menstrual flow
menorrhagia
regular intermenstrual bleeding
polymenorrhoea
menses occurring at <21 day interval
polymenorrhagia
increased bleeding and frequent cycle
menomotrorrhagia
prolonged menses and intermenstrual bleeding
amenorrhoea
absence of menstruation >6 months
oligomenorrhoea
menses at interval of >35 days
dysfunctional uterine bleeding
abnormal uterine bleeding with no organic causes
causes of AUB in adolescent and early reproductive life
DUB usually due to anovulatory cycles
pregnancy/miscarriage
endometritis
bleeding disorders
causes of AUB in reproductive life/perimenopause
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
causes of AUB in post menopause
atrophy endometrial polyp exogenous hormones (HRT, tamoxifen) endometritis bleeding disorders hyperplasia endometrial carcinoma sarcoma
what endometrial thickness is classed as abnormal in postmenopausal women
> 4 mm
endometrial thickness is classed as abnormal in premenopausal women
> 16 mm
histological assessment of endometrial samples
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
what occurs during an anovulatory cycle
corpus luteum does not form
continued growth f functionalis layer (glands get bigger)
how is endometritis diagnosed histologically
abnormal pattern of inflammatory cells
how is the endometrium resistant to infection
cervical mucus plug protects the endometrium from ascending infection
cyclical shedding of the endometrium
micro-organisms that cause endometritis
neisseria chlamydia TB CMV actinomyces HSV
when do endometrial polys most commonly occur
around or after menopause
which malignancy may present as an endometrial polyp
endometrial carcinoma
what is molar pregnancy
an abnormal form of pregnancy in which a non-viable fertilised egg implants in the uterus (or Fallopian tube)
what type of disease is molar pegnancy and what is it characterised by
gestational trophoblastic disease
a mass characterised by swollen chorionic villi
what is a complete mole
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
what is a partial mole
egg is fertilised by two sperm or one sperm that replicates itself yielding the genotype 69, XXY
the have both maternal and paternal DNA
complete moles have a higher risk of developing into which cancer
choriocarcinoma
what is adenomyosis
endometrial glands and stroma within the myometrium
what is leiomyoma
benign tumour of smooth muscle, may be found in locations other than the uterus
which hormone is leiomyoma growth dependent on
oestrogen
which cancer can leiyomyoma develop into
leiomyosarcoma
