Uterus path I Flashcards
what are the 2 phases of menstrual cycle
follicular and luteal
what does endometrium look like in proliferative phase
simple tubules with mitoses because of E
what does Endometrium look like in early secretory phas
subnuclear vacuoles because of P
what does endometrium look like in mid secretory phase
periarteriolar decidual phase
what does endometriuml ook like in late secretory phase
inflammatory cells
what will endometrium look like in menstrual phase
stromal breakdown, hemorrhage
“aria stella” appearance of endometrium
pregnancy, hyperseceretoy
what defines oligomenorrhea
intervals greater than 35 days
what defines polymenorrhea
intervals less than 24 days
what defines menorrhagia
excessive bleeding with normal intervals
what is metorrhagia
excessive flow and duration at irregular intervals
what is menometrorrhagia
irregular menses mmr
most common cause of an anovulatory cycle in repro age
unnoposed E
can be obesity, malnutrition, intesnse athletes
what can cause abnormal uterine bleeding in perimenopausal women
dysfunctional uterine bleeding
anovulatory cycle
irregular shedding
carcinoma, hyperplasia, polyps
what can cause abnormal uterine bleeding in post menopausal owmen
endometrial atrophy
carcinoma, hyperplasia, polyps
dysfunctional uterine bleeding is what type of Dx
by exclusion
why do anovulatory cycles cause bleeding
increased unopposed E causes endometrium to break down with bleeding
Bx shows irregular dilated glands and stromal breakdown
what causes inadequate luteal phase
abnormal corpus luteum function gives low P in secretory phase
presentation of inadequate luteal phase
infertility with menorrhagia or amenorrhea
what is Bx of endometrium show in inadequate luteal phase
histo date >2 days behind the clinical date of menstrual cycle
what will Bs show in acute endometritis
neutros
what type of bacteria cause acute endometritis
vaginal bacteria like Strep Group A and staph
arise after delivery or miscarriage
Tx for acute endometritis
curetting the endometrial cavity to remove fragments or otherwise broad spectrum antibiotics
Bx look like in chronic endometritis
plasma cells
what can cause chronic endometritis
chronic PID
retained products of conception
IUD
TB
presentation chronic endometritis
metromenorrhagia, dysmenorrhea, pain, infertility
what do plasma cells look like on histo
nucleus is at the edge not center
there is a clear huff around the nucleus
what is endometriosis
presence of endometrial tissue outside uterus
what is adenomyosis
presence of endometrial tissue in the myometrium
if there is a discrete mass in the myometrium what is this called
adenomyoma
most common locations for endometriosis
ovaries>uterine ligaments>rectovaginal septum? cul de sac? pelvic peritoneum > bowel >genitalia etc can occur on lapartomy scars
Sx of endometriosis
infertility: cyclic dysmenorrhea, cyclic pelvic pain, scarring of involved orgains dyspareunia
what are the 3 theories of endometriosis
metastatc or regurgitation theory: implantation of menstrual tissue
metaplastic: arise from mesothelium- mullerian origin
extrauterine stem/progenitor cell: bone marrow stem, progenitors differentiate into endometrial tissue
endometriosis increases risk 3x for what
ovarian cancer, clear cell types
PTEN and ARID1A
what is a “chocolate cyst”
old black blood in ovarian cyst
what is an endometrial polyp
benign endometrial polyp
pedunculate or sessile
presents with bleeding
Surgery
what is endometrial hyperplasia
increased proliferation of endometrial glands relative to stroma
Dx endometrial hyperplasia in patient, want to monitor for what in future
endometrial carcinoma because has strong relationship
what can cause endometrial hyperplasia
prolonged E stimulation
obesity, menopause, PCOD, stein-leventhal syndrome, granulosa cell tumors of ovary, E replacement therapy
What is EIN
endometrial intraepithelial neoplasm
complex hyperplasia with atypia
what type of mutation occurs with endometrial hyperplasia that is associated with the carcinomas
inactivation of PTEN tumor suppressor gene on 10q23
Cowden syndrome
germline mutation of PTEN that has high incidence of endometrial CA
what happens downstream from loss of PTEN
activation PI3K-AKT promoting cell death
warburg effect
cancers use aerobic glycolysis, increase uptake of glucose
certain factors like cMYC deregulate metabolic pathways
what pattern of endothellial hyperplasia is associated with adenocarcinom
disorderd proliferative pattern: from anovulutaory cycles
