Uterus: Endometrium And Myometrium

Question 1

Growth of endometrium is driven by what hormone? Preparation of the endometrium for implantation is driven by what hormone? Shedding is due to the loss of what hormone?

Answer 1

Estrogen, progesterone, and loss of progesterone.

Question 2

What is asherman syndrome, whats going on and what is the cause?

Answer 2

Secondary amenorrhea because you lose the basalis layer. Remember, this is the regenerative layer or the stem cells for the endometrium. Every time you shed and need to grow that functionalis layer again, the basalis layer does that.
Caused by overaggressive D and C

Question 3

What is going on during anovulatory cycle?

Answer 3

There is a normal estrogen driven growth phase, but no secretory phase because we don’t have progesterone. So the problem is too much growth because you are basically stacking growth phases.
Common cause of dysfunctional uterine bleeding during menstruation and menopause.

Question 4

What is the underlying cause of acute endometritis and what are the two common agents?

Answer 4

Retained products of conception

Group a strep and staph

Question 5

3 presenting signs of acute endometritis?

Answer 5

Fever, AUB, and pelvic pain

Question 6

What are the two characteristic cells of chronic endometritis and which one is a must for diagnosing chronic endometritis and why?

Answer 6

Lymphocytes and plasma cells. Plasma cells are a must because lymphocytes are normally in the endometrium.

Question 7

4 common causes of chronic endometritis?

Answer 7

Retained products of conception, chronic PID (chlamydia), IUD and TB

Question 8

3 presenting symptoms of chronic endometritis?

Answer 8

AUB, pelvic pain, and infertility

Question 9

How does an endometrium polyp present and what is the classic presenting symptom?

Answer 9

Protrusion of endometrium and presents as AUB.

Question 10

Endometrium polyps can present as a side effect of taking what drug and why?

Answer 10

Tamoxifen because the medicine has weak pro estrogenic effects on the endometrium.

Question 11

How do we define endometriosis?

Answer 11

Ectopic endometrial tissue outside of the uterus. Need both glands and stroma.

Question 12

3 classic presenting signs of endometriosis?

Answer 12

Pelvic pain, abnormal periods, and infertility

Question 13

What is the leading theory of patho for endometriosis?

Answer 13

Retrograde theory. Menstrual products go backwards instead of out and head up to the Fallopian tubes and ovary.

Question 14

What is the metaplastic theory of endometriosis?

Answer 14

Müllerian duct can give rise to several different epithelium types and there is endometrial metaplasia.

Question 15

What is the lymphatic dissemination theory of endometriosis?

Answer 15

Endometrial tissue spreads via lymphatics and spread to other sites.

Question 16

What is the most common site of endometriosis and what is the classic presenting sign for that site?

Answer 16

Ovary.

Chocolate cyst

Question 17

What is the presenting sign for the following sites of endometriosis? Uterine ligament, pouch of Douglas, bladder wall, bowel serosa, and Fallopian tube?

Answer 17

Pelvic pain, pain when pooping, pain when urinating, ab pain and adhesions, and scarring.

Question 18

What are the two consequences of getting endometriosis in the Fallopian tubes?

Answer 18

Infertility and ectopic tubal pregnancies

Question 19

What causes increased levels of estrogen in ectopic endometrial tissue?

Answer 19

Aromatase

Question 20

What is going on when there is endometriosis in soft tissue?

Answer 20

Gun powder lesions. These little brown/yellow hemorrhagic nodules.

Question 21

What is adenomyosis?

Answer 21

When we have endometriosis in the myometrium

Question 22

What risk is increased with endometriosis and particularly at which ectopic site?

Answer 22

Carcinoma, especially in the ovary.