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Zak, Endo/Repro 2 > Uterus and Endometrium Pathology > Flashcards

Uterus and Endometrium Pathology Flashcards

1
Q

What is the most frequent cause of abnormal uterine bleeding?

A

Anovulatory cycle

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2
Q

What are the most common bacterial infections to cause acute endometriosis?

A

Group A Hemolytic Strep

Staph

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3
Q

What is the most common bacteria to cause chronic endometriosis?

A

Chlamydia

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4
Q

Sx’s = abnormal bleeding, pain, discharge, and infertility

A

Chronic Endometriosis

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5
Q

What are the main 4 associations with chronic endometriosis?

A

Chronic PID
Retained gestational tissue
IUD’s
TB

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6
Q

Def: presence of ectopic endometrial tissue outside the uterus

A

Endometriosis

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7
Q

What differentiated ectopic endometrial tissue from normal endometrial tissue?

A

Increased E production d/t increased aromatase in ectopic tissue and release of pro-inflammatory factors

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8
Q

Endometriosis is associated with a 3x increased risk of _____

A

Endometrioid ovarian cancer

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9
Q

What mutations are most common in endometriosis?

A

PTEN

ARID1A

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10
Q

Morph: red-blue/yellow-brown nodules beneath the mucosal/serosal surfaces with ovarian cysts with brown fluid from previous hemorrhage (Chocolate cysts)

A

Endometriosis

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11
Q

What are the major Sx’s of endometriosis?

A

Dysmenorrhea, dyspareunia
Pelvic pain
Infertility
Dysuria and pain on defecation

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12
Q

Def: endometrial tissue within the uterine wall (myometrium)

A

Adenomyosis

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13
Q

What are the major Sx’s of adenomyosis?

A

Menomerorrhagia
Colicky dysmenorrhea
Dyspareunia
Pelvic pain

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14
Q

Morph: irregular nests of endometrial stroma within the myometrium

A

Adenomyosis

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15
Q

Def: exophytic masses projecting into the endometrial cavity

A

Endometrial polyps

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16
Q

Sx’s = abnormal bleeding d/t ulceration or necrosis

A

Endometrial polyps

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17
Q

What cancer may endometrial polyps give rise to?

A

Adenocarcinoma

18
Q

Endometrial polyps are associated with the use of what?

A

Tamoxifen

19
Q

What is d/t prolonged E stimulation of the endometrium and the precursor to endometrial carcinoma?

A

Endometrial hyperplasia

20
Q

What mutation is most common in endometrial hyperplasia?

A

PTEN

21
Q

Pts with which syndrome have an increased risk of endometrial carcinoma and breast cancer?

A

Cowden syndrome

22
Q

Morph: increased gland:stroma ratio with no atypia

A

Non-atypical endometrial hyperplasia

23
Q

Morph: complex patterns of proliferating glands displaying nuclear atypia and rounded cells with loss of perpendicular orientation to basement membrane

A

Atypical endometrial hyperplasia

24
Q

Well-differentiated cells that arise in the setting of endometrial hyperplasia

A

Endometrial carinoma

25
Q

What mutation is most common in endometrial carcinoma?

A

PTEN

26
Q

Poorly differentiated cells that arise in the setting of endometrial atrophy

A

Serous carcinoma

27
Q

What mutation is most common in serous carcinoma?

A

TP53

28
Q

What is serous carcinoma associated with?

A

Peritoneal disease

29
Q

What are the Sx’s of carcinoma of the endometrium?

A

Irregular/post-menopausal bleeding with excessive leukorrhea

30
Q

What are the 4 stages of carcinoma of the endometrium

A

Stage 1 = confined to uterus
Stage 2 = uterus and cervix
Stage 3 = outside uterus, within true pelvis
Stage 4 = outside true pelvis, in bladder/rectum

31
Q

Def: endometrial adenocarcinomas with a malignant mesenchymal component that can take a number of forms

A

Malignant Mixed Mullerian Tumors (carcinosarcoma)

32
Q

What mutations are most common in MMMT’s

A

PTEN
TP53
PIK3CA

33
Q

Morph: bulky, polypoid mass that may protrude into the cervical os

A

MMMT

34
Q

Def: E sensitive, large, broad-based endometrial polypoid growths that may prolapse through the cervical os

A

Adenosarcoma

35
Q

Def: multiple benign SM neoplasms

A

Leiomyomas (Fibroids)

36
Q

What are the major Sx’s of Leiomyomas?

A

AUB
Urinary frequency
Impaired fertility
Sudden pain from infarct

37
Q

Morph: sharply circumscribed, discrete, round, firm, gray-white tumors within them myometrium with a whorled pattern on cut section

A

Leiomyoma (Fibroid)

38
Q

What is the mutation associated with Leiomyomas?

A

MED12

39
Q

Def: arise from myometrium or endometrial stromal precursor cells

A

Leiomyosarcoma

40
Q

Morph: nuclear atypia, high mitotic index, and zonal necrosis

A

Leiomyosarcoma

41
Q

What mutation is associated with Leiomyosarcomas?

A

MED12

42
Q

What should pts be worried about following surgery for removal of Leiomyosarcomas?

A

Recurrance

Zak, Endo/Repro 2 (33 decks)

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