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Reproductive > Pathology > Flashcards

Pathology Flashcards

1
Q

Which hormone drives endometrial growth during the first 14 days of the menstrual cycle?

A

Oestrogen

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2
Q

Secretory changes, resulting from ovulation is under the influence of which hormone?

A

Progesterone

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3
Q

What is the dominant follicle also known as?

A

The graafian follicle.

This contains the secondary oocyte and granulosa cells.

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4
Q

What do granulosa cells produce?

A

Hormones

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5
Q

What is menorrhagia?

A

Prolonged and increased menstrual flow.

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6
Q

What thickness of endometrium in post-menopausal women indicates that an endometrial biopsy should be carried out?

A

> 4mm

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7
Q

What is disordered uterine bleeding?

A

Irregular uterine bleeding owing to disruption of the normal cyclic hormonal pattern.

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8
Q

What is the most common cause of DUB?

A

Anovulatory cycles.

Seen at the start and end of reproductive life.

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9
Q

What causes luteal phase deficiencies?

A

Poor response/Insufficient progesterone.

May be due to abnormal follicular development or a poor corpus luteum.

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10
Q

What is endometritis?

A

Inflammation of the endometrium.

Can be caused by infection, an IUD or occur following pregnancy.

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11
Q

What is molar pregnancy?

A

Abnormal pregnancy in which a non-viable egg implants. No chance of progression.

Sperm combines with egg that has lost its DNA.

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12
Q

What cancer is increased risk in molar pregnancy?

A

Choriocarcinoma

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13
Q

What is adenomyosis?

A

The presence of endometrial glands and stroma within the myometrium.

Can cause long, heavy, painful periods.

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14
Q

What is leiomyoma?

A

A very common benign tumour of smooth muscle found within the uterus.

This is the pathological name for a fibroid.

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15
Q

What is leiomyoma growth dependent on?

A

Oestrogen

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16
Q

What is the triple assessment carried out in breast disease?

A

Clinical (history and examination)
Imaging (can be mammography, USS or MRI)
Histopathology/Cytopathology

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17
Q

What does cytopathology involve?

A

FNA

Fluid and nipple testing

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18
Q

Why is histopathology preferred to cytopathology?

A

Cytopathology disrupts context of sample, therefore cannot determine if any invasion has occurred.

As histopathology involves biopsy, the context is preserved, allowing a clear diagnosis.

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19
Q

What is wide local excision?

A

A method used to remove a lesion of interest, with a margin.

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20
Q

What is gynaecomastia?

A

Breast development in males.

Results from ductal growth, without lobular development.

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21
Q

What can cause gynaecomastia?

A

Exogenous/Endogenous hormones
Cannabis
Prescription drugs
Liver disease

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22
Q

What is fibrocystic change?

A

Development of fluid-filled cysts in the breasts. Accompanied by intervening fibrosis.

Most cases are perimenopausal/in their 40s.

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23
Q

How do fibrocystic changes present?

A

Can be asymptomatic and often an incidental finding.

Some may have sudden/cyclical pain with ill-defined breast lumpiness.

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24
Q

What is metaplasia?

A

A change of one fully differentiated cell type to another.

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25
Q

Should fibrocystic change be investigated?

A

Yes, in order to rule out malignancy.

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26
Q

How does fibroadenoma present?

A

A benign solitary lump which is a painless, firm and mobile mass.

Will appear solid on USS.

27
Q

Should fibroadenoma be removed?

A

Only on patient request - reassurance may be sufficient.

28
Q

What are the 2 types of sclerosing lesions?

A

Sclerosing adenosis

Radial scar

29
Q

What are sclerosing lesions?

A

Benign, disorderly, proliferations of acini and stroma. Can cause mass or calcification.

30
Q

How does sclerosing adenosis present?

A

Can be asymptomatic or painful, with a tenderness and/or lumpiness.

Often seen alongside other breast changes.

There is a risk of progression to carcinoma.

31
Q

How often is a radial scar seen?

A

Very common. Often multiple are seen at the same time. These can be bilateral.

32
Q

Should a radial scar be treated?

A

Yes, as risk of in-situ or invasive carcinoma existing within this lesion.

Treat with excision/vacuum biopsy.

33
Q

What causes fat necrosis?

A

Local trauma

Warfarin therapy

34
Q

What occurs in fat necrosis?

A

Disruption of adipocytes, causing leakage. Results in an inflammatory response and subsequent scarring.

35
Q

What is seen histologically in the case of fat necrosis?

A

Foamy macrophages

36
Q

What is affected in duct ectasia?

A

The subareolar ducts.

37
Q

What symptoms are seen in duct ectasia?

A

Pain
Episodic inflammation
Bloody/Purulent discharge

38
Q

What can duct ectasia lead to?

A

Fistulation
Nipple retraction
Distortion

39
Q

What is associated with duct ectasia?

A

Smoking

40
Q

What causes acute mastitis/abscess?

A

Duct ectasia

Lactation

41
Q

How is acute mastitis/abscess treated?

A

Antibiotic or drainage (if needed).

Treat underlying cause.

42
Q

What is seen in Phyllodes tumour?

A

Stromal overgrowth

43
Q

Is Phyllodes tumour benign?

A

Not necessarily.

It depends on the stromal features.

It can be benign, borderline or malignant.

44
Q

Does Phyllodes tumour metastasize?

A

Rarely

45
Q

How can intraduct papilloma present?

A

Nipple discharge (may be bloody)
Nodules
Calcification

Can be asymptomatic in some cases - therefore identified through screening.

46
Q

Is metastasis to the breast common?

A

No

47
Q

What is commonly the cause of angiosarcoma of the breast?

A

Breast radiotherapy

48
Q

Where does metastasis to the breast originate from?

A 
Bronchial
Ovarian (serous)
Clear cell carcinoma of the kidney
Malignant melanoma
Soft tissue tumours
49
Q

What cells does a breast carcinoma originate within?

A

Glandular epithelium of the TDLU.

This is a form of adenocarcinoma.

50
Q

What are the 2 forms of carcinoma-in-situ seen in breast pathology?

A

Lobular

Ductal

51
Q

What is Paget’s disease of the nipple?

A

A high grade DCIS which extends along ducts, reaching the epidermis of the nipple.

52
Q

Is Paget’s disease of the nipple invasive?

A

No, as it only occupies the existing structures.

53
Q

How is DCIS treated?

A

Surgery and adjuvant radiotherapy.

54
Q

What is microinvasive carcinoma?

A

DCIS with invasion of less than 1mm.

55
Q

When malignant epithelial cells have breached the basement membrane, what is it referred to as?

A

Invasive breast carcinoma

56
Q

Which ethnicity is most likely to suffer breast cancer?

A

White

57
Q

What plays a key role in breast cancer development?

A

Hormones

58
Q

What genetic conditions predispose to breast cancer?

A

BRCA1/BRCA2
p53 mutation
Peutz-Jeghers syndrome

59
Q

What is the most common form of breast cancer?

A

Ductal carcinoma

60
Q

What % of breast cancers are oestrogen receptor positive?

A

80%

61
Q

What does the presence of oestrogen receptors indicate about a breast cancer?

A

That it would be sensitive to anti-oestrogen therapy.

62
Q

What are examples of anti-oestrogen therapies?

A

Oophorectomy
Tamoxifen
Aromatase inhibitors
GnRH antagonists

63
Q

What drug is advised in those with HER2 receptor overexpression?

A

Trastuzumab

64
Q

What are common sites of breast cancer spread?

A 
Bone
Liver
Brain
Lungs
Abdominal viscera
Female genital tract

Reproductive (28 decks)

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