Pathology of the reproductive tract Flashcards

1
Q

What are the male and female chromosomes?

A
XX = female
XY = male
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2
Q

How is male sex determined?

A

Sex determining region of Y

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3
Q

What are the male and female gonads?

A

Testis

Ovary

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4
Q

Name the ducts that develop into male and female reproductive organs

A

Paramesonephric duct = female

Mesonephric duct = males

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5
Q

Describe the development of male and female reproductive organs in the foetus

A
  • At the caudal pole of the kidney you will have the gonad developing and you will also have pairs of ducts Paramesonephric and Mesonephric.
  • In the embryo both ducts will develop and they tract down and will ultimately join the urogenital sinus.
  • When the gonad differentiates into ovary and starts secreting female hormones the paramesonephric duct will develop into the uterine tubes and horns and the mesonephric duct will regress.
  • On the male side, the mesonephric duct will differentiate into vas deferens and the paramesonephric duct will regress.
  • These then fuse with the urogenital sinus which will either develop into a vagina in the female or a penis and scrotum in the male
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6
Q

The development of male reproductive organs is under the influence of which hormones?

A

Testosterone

Malarian inhibitory hormone

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7
Q

What are the 3 major categories of disorders of sexual development?

A
  • Abnormal or missing chromosome
  • DSD with normal female karyotype
  • DSD with normal male karyotype
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8
Q

Define intersex

A

Ambiguous genitalia with features of male and female (tubular and / or external genitalia)

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9
Q

Define hermaphroditism

A

The presence of both ovarian and testicular gonadal tissue

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10
Q

Describe two examples of sex chromosomal disorders

A
  • XO (Turner syndrome) or XXX: females with severe ovarian dysgenesis, hypoplasia and immature reproductive tract.
  • XXY (Klinefelter’s syndrome): males with testicular hypoplasia
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11
Q

Male tortoiseshell cats are the result of?

A

XXY sexual chromosomal disorder (Klinefelter’s syndrome)

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12
Q

Describe an XX SRY negative disorder of sexual development

A
  • Undifferentiated gonad which has the potential to differentiate into ovary and testis; ovotesticular
  • Usually true hermaphrodite
  • Phenotypically female with masculinisation
  • Inherited in American cocker spaniel (AR)
  • Associated with the polled gene in goats (polled intersex syndrome – PIS)
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13
Q

Describe the two XY SRY positive disorders of sexual development

A
  • XY SRY-positive; testicular DSD with female phenotype (male pseudohermaphrodite). Lack of anti-malarian hormone
  • XY SRY-positive; testicular DSD with male phenotype e.g. cryptorchidism where the testis don’t descend from the abdomen into the scrotum
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14
Q

What is the function of anti-malarian hormone?

A

AMH is the hormone that inhibits the female elements of the reproductive tract from developing so males are supposed to have this

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15
Q

Describe freemartinism

A
  • Form of ovarian dysgenesis in cattle
  • Fusion of placental vessels during pregnancy + sharing of blood between twins during early embryonic development (bone marrow chimeras)
  • Ovarian inhibition of female twin = Sterile female twin from a set of heterozygotic twins
  • Male unaffected.
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16
Q

Name some ovarian circulatory disorders

A
  • Intrafollicular haemorrhage - physiological, during ovulation
  • Traumatic haemorrhage
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17
Q

What is a cyst?

A

Fluid containing structure, lined by a normal epithelium

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18
Q

Describe ovarian follicular cysts

A
  • Arise from secondary follicles that fail to ovulate, involute or luteinise
  • Failure in LH release during oestrus
  • Common in cattle and pigs + seen in dogs, cats, sheep + goats; very rare in horses
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19
Q

How do follicular cysts affect cattle?

A
  • Multiple follicular cysts give rise to hyperoestrogenism

- Can lead to behavioural changes i.e. nymphomania

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20
Q

Where can primary ovarian neoplasms originate from?

A
  • Surface epithelium
  • Ovarian stroma: granulosa cells (lining cells of the follicle)
  • Ovarian germ cells
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21
Q

Which ovarian cysts arise from the surface epithelium?

A
  • Papillary cystadenoma: most common in bitches, can be multicentric + involve both ovaries
  • Papillary cystadenocarcinoma
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22
Q

Describe ovarian papillary cystadenocarcinoma and its complications

A
• Occurs in older bitches
• Invasive growth; 	
- implantation on peritoneum 
- invasion + obstruction of lymphatic vessels + veins 
• Ascites; widespread distant metastases
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23
Q

What is the DDx for an ovarian papillary cystadenocarcinoma?

A

Mesothelioma = neoplasm of the lining cells of the peritoneal cavity

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24
Q

What is an adenoma?

A

Benign tumour of glands

25
Q

Name the tumour arising from the gonadal stroma

A

Granulosa cell tumour

26
Q

Which spp get granulosa cell tumours?

A

Cow, mare, dog, cat

27
Q

Describe a granulosa cell tumour in a cow or mare

A
  • Usually unilateral, benign, often very large

- Secretion of progesterone, oestradiol and/or testosterone

28
Q

What are granulosa cell tumours associated with in dogs and cats?

A

Hyperoestrogenism

29
Q

Describe the structure of a granulosa cell tumour

A
  • Normal anatomy of the ovarian follicle = lined by granulosa cells
  • When these cells become neoplastic they attempt to recapitulate that follicular structure – see abnormal follicular type structures which often dilate and become cystic
  • Cyst is full of proteinaceous fluid +/- small amounts of blood
30
Q

Name two tumours arising from germ cells

A
  • Dysgerminoma

- Teratoma

31
Q

Describe the features of a dysgerminoma

A
  • Occur most often in older bitches
  • Female counterpart to testicular seminoma in males
  • Usually unilateral, 20% metastasise to regional LN + transcoelomically
  • Germ cells are primitive cells – not differentiated
32
Q

Describe the features of a teratoma

A
  • Uncommon – mainly bitch + occ. mare / cow.
  • Arise from multipotential cells that produce tissues from 2 or 3 embryological layers (ectoderm, mesoderm + endoderm). Produce mature tissue from all 3 embryological lineages all within the same mass
  • Mostly benign but occasionally malignant (teratocarcinoma).
33
Q

How does a teratoma appear grossly?

A
Get bits of skin, hair, tooth, bone, brain, intestine, anything
The ovary (or testis) will be massively enlarged when you do the spay or castrate
34
Q

What are some acquired abnormalities of uterine (fallopian) tubes?

A
  • Hydrosalpinx
  • Salpingitis
  • Pyosalpinx
35
Q

Define hydrosalpinx

A

Clear, watery fluid in tubes, due to obstruction either at abdominal or uterine ostium

36
Q

Define salpingitis

A

Inflammation of the uterine tube due to ascending infection (cattle)

37
Q

What are the 3 types of uterine displacement?

A
  • Torsion
  • Prolapse
  • Rupture
38
Q

Describe the features of uterine torsion

A
  • Usually gravid uterus (pregnant state)
  • Multiparous animals: can be in one horn
  • With relaxation of uterine bands and foetal movements
  • Elongated uterine horns in veterinary spp which are susceptible to torsion
  • Acute passive congestion in the organ which is developing into a haemorrhagic infarction
39
Q

Describe the consequences of uterine torsion in cattle

A

Whole organ -> congestion, haemorrhagic necrosis, foetal death

40
Q

Describe uterine prolapse in veterinary spp

A

Cow: with post-parturient hypocalcaemia or after dystocia – tissue becomes friable so need to be careful when replacing

41
Q

Endometrial hyperplasia occurs due to?

A

Result of excessive/ prolonged female hormonal stimulation

42
Q

What hormones cause endometrial hypoplasia in different veterinary spp?

A
  • Ungulates (hoofed mammals), rodents: oestrogens

- Dog, cat: progesterone acting on oestrogen-primed endometrium

43
Q

Describe oestrogen mediated endometrial hyperplasia

A
  • Hyperplasia = organ enlarges due to proliferation of cells (increase in number)
  • Prolonged non-cyclic oestrogen stimulation or
  • Excessive levels of circulating oestrogens
44
Q

What are the effects of oestrogen mediated endometrial hyperplasia?

A

• Hypertrophy of myometrium
• Hyperplasia of endometrium -> cystic endometrial hyperplasia
• Hydrometra or mucometra
- Endometrial cells have the ability to divide so the endometrium grows through hyperplasia

45
Q

Describe progesterone mediated endometrial hyperplasia

A
  • Most common in bitches
  • Cows in association with retained CL
  • Predisposes uterus to infection + pyometra
  • Progesterone stimulates glandular secretion
  • In oestrogen-primed endometrium -> increased synthesis of progesterone receptors + enhanced effect of progesterone
46
Q

What occurs in sequelae to inflammation of the non-gravid uterus?

A
  • Septicaemia/toxaemia, pyaemia
  • Metritis, pyometra
  • Ascending infection (salpingitis; pyelonephritis)
47
Q

What is pyometra and which spp are affected?

A
  • Acute / chronic suppurative inflammation of uterus with large quantities of pus in lumen
  • Bitch, queen: bacterial infection of cystic, hyperplastic endometrium (“cystic endometrial hyperplasia-pyometra complex”)
48
Q

What are the non-specific causative agents of pyometra?

A

E. coli, Proteus, Staphylococcus, Streptococcus

49
Q

How does the cervix affect a pyometra

A

Can be open or closed, disease more severe with a closed cervix due to accumulation of purulent material

50
Q

What are the consequences of pyometra?

A

Bacteria can enter bloodstream -> toxic shock and DIC

51
Q

How does pyometra present grossly?

A

Brown, foul smelling purulent material within the uterus

Very enlarged uterine horns under pressure

52
Q

Describe pyometra in cattle

A

Persistent CL due to failure of PGF2alpha (no luteolysis) -> continued progesterone secretion + decreased myometrial contraction with +/- closed cervix

53
Q

Describe pyometra in mares

A
  • Postpartum infection independent of persistent CL
  • Often discharge observed
  • Commonly isolated: Streptococcus zooepidemicus, E. coli, Pseudomonas aeruginosa, Pasteurella
54
Q

What occurs in sequelae to pyometra in cattle and mares?

A
  • Resolution (often through vet intervention + PGF2alpha administration).
  • Metritis - toxaemia/septicaemia
  • Rupture of the uterus with peritonitis
55
Q

Name two primary tumours of the uterus

A
  • Leiomyoma

- Adenocarcinoma

56
Q

Where does a leiomyoma arise from?

A

Smooth muscle cells of myometrium + also vagina, cervix

57
Q

Describe the features of a leiomyoma

A
  • Made up smooth muscle: spindloid cells with cigar shaped nuclei
  • Most frequent uterine neoplasm in bitch + cat
  • Space occupying lesion
  • Variation: leiomyosarcoma - locally invasive
58
Q

Describe uterine adenocarcinoma

A
  • Tumour of endometrial glands
  • Frequent in older rabbits (>2y; 60% >4y) often multiple, metastasise frequently
  • Occasionally seen in cows