Uterus path I

Question 1

what are the 2 phases of menstrual cycle

Answer 1

follicular and luteal

Question 2

what does endometrium look like in proliferative phase

Answer 2

simple tubules with mitoses because of E

Question 3

what does Endometrium look like in early secretory phas

Answer 3

subnuclear vacuoles because of P

Question 4

what does endometrium look like in mid secretory phase

Answer 4

periarteriolar decidual phase

Question 5

what does endometriuml ook like in late secretory phase

Answer 5

inflammatory cells

Question 6

what will endometrium look like in menstrual phase

Answer 6

stromal breakdown, hemorrhage

Question 7

“aria stella” appearance of endometrium

Answer 7

pregnancy, hyperseceretoy

Question 8

what defines oligomenorrhea

Answer 8

intervals greater than 35 days

Question 9

what defines polymenorrhea

Answer 9

intervals less than 24 days

Question 10

what defines menorrhagia

Answer 10

excessive bleeding with normal intervals

Question 11

what is metorrhagia

Answer 11

excessive flow and duration at irregular intervals

Question 12

what is menometrorrhagia

Answer 12

irregular menses mmr

Question 13

most common cause of an anovulatory cycle in repro age

Answer 13

unnoposed E

can be obesity, malnutrition, intesnse athletes

Question 14

what can cause abnormal uterine bleeding in perimenopausal women

Answer 14

dysfunctional uterine bleeding
anovulatory cycle
irregular shedding
carcinoma, hyperplasia, polyps

Question 15

what can cause abnormal uterine bleeding in post menopausal owmen

Answer 15

endometrial atrophy

carcinoma, hyperplasia, polyps

Question 16

dysfunctional uterine bleeding is what type of Dx

Answer 16

by exclusion

Question 17

why do anovulatory cycles cause bleeding

Answer 17

increased unopposed E causes endometrium to break down with bleeding
Bx shows irregular dilated glands and stromal breakdown

Question 18

what causes inadequate luteal phase

Answer 18

abnormal corpus luteum function gives low P in secretory phase

Question 19

presentation of inadequate luteal phase

Answer 19

infertility with menorrhagia or amenorrhea

Question 20

what is Bx of endometrium show in inadequate luteal phase

Answer 20

histo date >2 days behind the clinical date of menstrual cycle

Question 21

what will Bs show in acute endometritis

Answer 21

neutros

Question 22

what type of bacteria cause acute endometritis

Answer 22

vaginal bacteria like Strep Group A and staph

arise after delivery or miscarriage

Question 23

Tx for acute endometritis

Answer 23

curetting the endometrial cavity to remove fragments or otherwise broad spectrum antibiotics

Question 24

Bx look like in chronic endometritis

Answer 24

plasma cells

Question 25

what can cause chronic endometritis

Answer 25

chronic PID retained products of conception IUD TB

Question 26

presentation chronic endometritis

Answer 26

metromenorrhagia, dysmenorrhea, pain, infertility

Question 27

what do plasma cells look like on histo

Answer 27

nucleus is at the edge not center | there is a clear huff around the nucleus

Question 28

what is endometriosis

Answer 28

presence of endometrial tissue outside uterus

Question 29

what is adenomyosis

Answer 29

presence of endometrial tissue in the myometrium

Question 30

if there is a discrete mass in the myometrium what is this called

Answer 30

adenomyoma

Question 31

most common locations for endometriosis

Answer 31

ovaries>uterine ligaments>rectovaginal septum? cul de sac? pelvic peritoneum > bowel >genitalia etc can occur on lapartomy scars

Question 32

Sx of endometriosis

Answer 32

infertility: cyclic dysmenorrhea, cyclic pelvic pain, scarring of involved orgains dyspareunia

Question 33

what are the 3 theories of endometriosis

Answer 33

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

Question 34

endometriosis increases risk 3x for what

Answer 34

ovarian cancer, clear cell types | PTEN and ARID1A

Question 35

what is a "chocolate cyst"

Answer 35

old black blood in ovarian cyst

Question 36

what is an endometrial polyp

Answer 36

benign endometrial polyp pedunculate or sessile presents with bleeding Surgery

Question 37

what is endometrial hyperplasia

Answer 37

increased proliferation of endometrial glands relative to stroma

Question 38

Dx endometrial hyperplasia in patient, want to monitor for what in future

Answer 38

endometrial carcinoma because has strong relationship

Question 39

what can cause endometrial hyperplasia

Answer 39

prolonged E stimulation | obesity, menopause, PCOD, stein-leventhal syndrome, granulosa cell tumors of ovary, E replacement therapy

Question 40

What is EIN

Answer 40

endometrial intraepithelial neoplasm | complex hyperplasia with atypia

Question 41

what type of mutation occurs with endometrial hyperplasia that is associated with the carcinomas

Answer 41

inactivation of PTEN tumor suppressor gene on 10q23

Question 42

Cowden syndrome

Answer 42

germline mutation of PTEN that has high incidence of endometrial CA

Question 43

what happens downstream from loss of PTEN

Answer 43

activation PI3K-AKT promoting cell death

Question 44

warburg effect

Answer 44

cancers use aerobic glycolysis, increase uptake of glucose | certain factors like cMYC deregulate metabolic pathways

Question 45

what pattern of endothellial hyperplasia is associated with adenocarcinom

Answer 45

disorderd proliferative pattern: from anovulutaory cycles