Uterus

Question 1

What are the three layers of the uterus and 2 layers of innermost layer?

Answer 1

Perimetrium, Myometrium, Endometrium -(basalis(regeneraltive cells), functionalis (shed in menses))

Question 2

What are the 2 types of cells in mucosa of uterus

Answer 2

glandular and stromal(support the glands) - both hormone responsive and both can get tumors

Question 3

Describe timing in menstrual cycle

Answer 3

day 1 - first day of menses
follicular (menstrual/proliferative)phase (14-21 days) -menses to day before LH surge
luteal (secretory)phase - (14 days)

Question 4

What can be tested for proof of ovulation?

Answer 4

subnuclear vacuoles in the glandular epithelium (2-3 days post ovulation) - early secretory phase

Question 5

What happens histologically in the menstrual phase

Answer 5

stromal breakdown - fragmented glands, with lots of blood

Question 6

What is dysfunctional uterine bleeding

Answer 6

unscheduled bleeding - presumed to be hormonal abnormality - must rule out structural causes first

Question 7

oligomenorrhea defintion

Answer 7

intervals > 35 days

Question 8

polymenorrhea definiton

Answer 8

intervals <24 days

Question 9

menorrhagia definiton

Answer 9

excessive bleeding with normal intervals

Question 10

metrorrhagia definiton

Answer 10

excessive flow and duration at irregular intervals

Question 11

menometrorrhagia definiton

Answer 11

irregular menses

Question 12

withdrawal bleeding definiton

Answer 12

bleeding following the withdrawal of hormones

Question 13

cause of abnormal uterine bleeding prepuberty

Answer 13

precocious puberty

Question 14

cause of abnormal uterine bleeding reproductive age

Answer 14

Pregnancy complications
organic lesions (leiomyoma, adenomyosis, polyps, endometrial hyperplasia, carcinoma)
Dysfunctional uterine bleeding(anovulotory cycle, ovulatory dysfunctional bleeding(inadequate luteal phase

Question 15

cause of abnormal uterine bleeding - adolescence

Answer 15

anovulatory cycle

coagulation disorders

Question 16

cause of abnormal uterine bleeding - perimenopausal

Answer 16

Dysfunctional uterine bleeding

Organic lesions - biopsy

Question 17

cause of abnormal uterine bleeding - post menopausal

Answer 17

endometrial atrophy

organic lesions - biopsy

Question 18

what is an anovulatory cycle

Answer 18

dysfunctional uterine bleeding - no known cause
increased prolonged, unopposed estrogen stimulation
->unstable endometrium
common around menarch/perimenopausal

Question 19

what is inadequate luteal phase?

Answer 19

dysfunctional uterine bleeding
abnormal corpus luteum fxn -> low progesterone
presents as infertility w/ menorrhagia or amenorrhea
biopsy shows histology >2 days behind clincal date of menses

Question 20

Why do oral contraceptives cause dysfunctional uterine bleeding

Answer 20

effects on endometrium depending on E-P ratio and sequence of ingestion (hypoactive endometrial mucosa)

Question 21

What is acute endometritis

Answer 21

inflammation of endometrium caused by vaginal bacteria like strep group A or Staph - retained products of conception(remove and treat w/ ABs)

Question 22

What is chronic endometritis

Answer 22

chronic inflammation of endometrium due to 
chronic PID
Retained products of conception
IUDs
TB

Question 23

What would a biopsy of chronic endometritis show

Answer 23

plasma cells - not normal in endometrium

Question 24

How can chronic endometritis present

Answer 24

metromenorrhagia
dysmenorrhea
pain
infertility

Question 25

What is endometriosis

Answer 25

presence of endometrial tissue(glands and stroma) outside of uterus

Question 26

What is adenomyosis

Answer 26

presence of endometrial tissue in the myometrium

forms an adenomyoma