Uterus Pathoma Flashcards
What is asherman syndrome?
Secondary amenorrhea from loss of basal layer and scarring. From aggressive curettage (scraping of uterine wall in surgery)
How do you get bleeding in anovulatory cycle?
Endometrium grows on top of previous growth b/c driven by estrogen proliferative stage without the progesterone secretory stage. So you get cells overgrow blood supply
Acute vs chronic endometritis?
Chronic will have PLASMA CELLS. Presents as uterine bleeding, pain and infertility.
Both acute and chronic are fever bleeding and pain. And often from retained products from conception. Chronic can be from chlamydiy, IUD, TB (granuloma)
What drug has a side of effect of endometrial polyp?
Tamoxifen for breast cancer. It is a SERM that is pro estrogen in uterus
3 theories of endometriosis deco?
Retrograde mensturation: some product goes backwards (leading theory). MOST IMPORTANT
Metaplastic: mullerian duct produced shit in the wrong place
Lymphatic dissemination: see endometriousus to weird places like lung
What is a chocolate cyst?
Endometriosis to the ovary and looks like chocolate from bloody debris
Endometriosis to pouch of douglas?
hurts to shit!
What is adenomyosis?
Endometriosis into myometrium. (think Adeno with secretory and myo with muscle, so name makes sense). KNOW THAT IT WILL BE ON TESTs!!
Dx of endometriosis?
Laparoscopy with surface lesions that are blue/black/brown
Rx: of endometriosis?
hormone manipulation/ablation/salpingo-oophorectomy to remove stimulation +/- hysterectomy
Postmenopausal bleeding in fat women can be caused by what?
Endometrial hyperplasia b/c it is unappeased estrogen causing it! (fat makes estrone) and no progesterone to fight it
Is endometrial hyperplasia a big concern?
If on histology you see cellular atypic, it can progress to carcinoma!!!!!
What genetic trait makes you at risk for endometrial carcinoma?
HNPCC.
What is most common carcinoma of female genital tract?
Endometrial carcionnma
What are the 2 pathways to endometrial carcinoma?
- endometrial hyperplasia from unopposed estrogen (you would have seen cellular atypic). Endometrioid looks like normal endometrium. 50-60 years old. Mutationts in PTEN suppressor
- Sporadic pathway: no hyperplasia. Atrophic endometrium causes it and it is old women
Genetic mutation in endometrial carcionma for hyperplasia type?
PTEN suppressor is changed
Genetic mutation in sporadic pathway of endomtrial carcinoma?
P53 mutation
What do you see on his to for sporadic pathway endometrial carcinoma
Serous papillary and psammoma bodies (easy to remember b/c papillary thyroid also had psamomma bodies)
What is the bad kind of endometrial carcinoma? What causes it?
Serous papillary endometrial carcinoma and P53 mutation in atrophying endometrium. It is in elderly women
What is a leiomyoma? Is it concerning?
Smooth muscle benign proliferation. Not concerning especially if multiple growths. They will enlarge in preggers and shrink in menopause (makes sense, estrogen sensitive).
Smooth msucle mass of myometrium, what do you hope it looks like?
White whorley is important b/c benign. If hemorrhage or necrosis, likely leiomyosarcoma
Does leiomyoma become malignant?
NO NO NO IT DOES NOT! Which is good because tons of women have leiomyoma
Leiomyoma causes what problems?
Mass, changes shape of uterus and might not be able to get plantation of ova. Can stretch endometrium and cause bleeding
How do you know if a smooth muscle mass of myometrium is leiomyosarcoma? (there are 4 ways, on is a very helpful hint in particular)
One mass suggests sarcoma (thats the biggie)
hemorrhage/necrosis
post menopausal (leiomyoma would shrink normally after menopause
Cellular atypia on histology
