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REPRO > Uterine Pathology > Flashcards

Uterine Pathology Flashcards

1
Q

What is in the ovarian cycle?

A
  1. Follicular
  2. Ovulation—day 14 (breaking of ovumin fallopian tube)
  3. Luteal—release of progesterone
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2
Q

What is in the uterine cycle?

A
  1. menstrual phase (day 1-3)
  2. proliferative—longest phase at 14 days (day 1-14)
  3. secretory phase (day 16-28) —wont get secretory unless ovulation occurs
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3
Q

What drives the proliferative phase?

A

ESTROGEN

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4
Q

What is the predominant hormone in the SECRETIVE phase?

A
  • progestrone
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5
Q

What occurs in the uterus in menopause?

A

the uterine wall is not growing nor shedding

- very thin

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6
Q

What is the graafian follicle?

A
  • the principle ovum

- surrounded by hormone secreting cells

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7
Q

WHat does the corpus luteum produce?

A

progesterone

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8
Q

What change is seen in the glands in the secretory phase?

A
  • glands are more complex and wiggly

- cells are filled with secretions

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9
Q

Why do endometrial sampling?

A

Abnormal uterine bleeding

Investigation for infertility

Spontaneous and therapeutic abortion

Assessment of response to hormonal therapy –obesity > endometrial cancer

Endometrial ablation—eradication of the endometrium

Work up prior to hysterectomy for benign indications

Incidental finding of thickened endometrium on scan

Endometrial cancer screening in high risk patients

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10
Q

Wh./at is metorrhagia?

A
  • regular INTERMENSTRUAL bleeding
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11
Q

What is DUB?

A
  • DYSRUPTED uterine bleeding

- —d/t anovulatory cycles

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12
Q

Causes of AUB in adolesence.

A

PREGNANCY/ miscarriage

  • endometritis
  • bleeding d.o
  • anovulatory cycle
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13
Q

Causes of AUB in peri-menopausal/reproductive women?

A
  • pregnancy. miscarriage
  • leiomyoma (fibroid/ smooth m. tumor)
  • endometritis
  • endocervical polyp
  • adenomyosis (endometrium found in the smooth
    m. )
  • exogenous hormone
  • hyperplasia
  • neoplasia
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14
Q

How to asses the endometrium?

A
  1. TVUS
    - – measure the thickness from one side to the other
    - >4mm thickness= INDICATION for biopsy
  2. hysteroscopy
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15
Q

Name an outpatient procedure for sampling the endometrium and why it is so?

A

Endometrial Pipelle

  • no anesthesia
  • very safe
  • LIMITED sample (can’t reach further up)
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16
Q

What is D&C?

A

Dilatation and Curettage

  • MOST COMMON sampling of endometrium
  • —can miss 5% of cancer and hyperplasias
17
Q

What is needed for hx prior to endometrial sampling?

A
  • age
  • Date of LMP
    and length of cycle
  • pattern of bleeding
  • hormones
  • recent preg.
18
Q

What to search histologically for a pt coming in with AUB?

A
  • benign abnormality (polyp, endometritic, miscarriage)?
  • DUB?
  • hyperplasia
  • evidence of fresh/old hemorrhage.
19
Q

What is DUB defined as?

A

irregular uterine bleeding that reflects a disruption in the normal cyclic pattern of ovulatory hormonal stimulation to the endometrial lining (no organic cause for bleeding)

20
Q

Why does anovulatory cycle occur?

A
  • d/t to no formation of Corpus Luteum. scretory phase does not occur and proliferation phase keeps going (continued growth of Stratum Functionalis)
21
Q

What occurs in endometritis?

A 
- - inflammation of uterine lining 
caused by:
- MICROORGANISMS 
- IUD
- POST-curettage 
- Postabortal
-postpartum 
a/w polyps
22
Q

What is a.w granulomatous endometritis ?

A

TB

SARCOIDOSIS

23
Q

What is a consequence of endometrial polyps?

A
  • twisting of the polyp around its stalk—may lead to ischemia
24
Q

When does endometrial polyp appears?

A
  • often AROUND MENOPAUSE

- almost always BENIGN (smooth contours)

25
Q

What is a molar pregnancy>

A
  • abnormal pregnancy
26
Q

Who’s dna does a complete mole hold?

A
  • ONLY PATERNAL DNA; 2 male copies or a single sperm combining with an empty egg —-placenta forms and no fetus
  • genotypes of 46
27
Q

How is Partial mole diff.?

A
  • either: egg fertilized by 2 sperms OR single sperm REDUPLICATES itself and fetilizes egg
  • genotypes of 69
28
Q

Risk of complete mole ?

A
  • — may progress to CHORIOCARCINOMA

- —higher risk than partial moles developing this cancer

29
Q

WHat hormonal finding is found with molar pregnancy?

A
  • high hCG levels

- released by the SYNCTIOTROPHOBLAST

30
Q

How does a fibroid present as?

A
  • menorrhagia/ infertility/ mass effect/ pain
  • SINGLE or MULTIPLE
  • growth is estrogen dependent
31
Q

What is a malignant leiomyoma?

A
  • pure smooth muscle

- spindle-y cells

32
Q

What conditions cause anovulation?

A
  • conditions causing Luteal Phase deficiency (either INSUFFICIENT progesterone or POOR response by the endometrium to progesterone)
  • —Or could be inadequate FSH/LH (poor corpus luteum)
33
Q

Microsomal Causes of Endometritis

A 
Neisseria
Chlamydia
TB
CMV
Actinomyces
HSV
34
Q

How may an endometrial polyp present as?

A
  • ASYMPTOMATIC

- may present with BLEEDING or DISCHARGE

35
Q

What does adenomyosis present as?

A
  • endometrial glands and STROMA is within the myometrium

- causes menorrhagia and dysmenorrhoea

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