47 Disease of female genital system 2 Flashcards Preview

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Flashcards in 47 Disease of female genital system 2 Deck (38)
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1
Q

What is endometriosis?

A

Ectopic endometrium causing bleeding int the tissues and fibrosis.

2
Q

How does endometriosis present? (8).

A
25% are symptomatic.
Dysmenorrhoea.
Dyspareunia (pain on sex).
Pelvic pain.
Sub fertility.
Pain on passing stool.
Dysuria.
3
Q

Epidemiology of endometriosis?

A

6-10% of women.

30 - 40 y/o.

4
Q

What are the causes of acute endometritis? (3).

Histology?

A

Retained POC, prolonged rupture of membranes, complicated labour.
Neutrophils

5
Q

What are the causes of chronic endometritis? (4).

Histology?

A

Pelvic inflammatory disease, retained gestational tissue, endometrial TB, IUCD infection.
Lymphocytes + plasma cells.

6
Q

What are the symptoms of endometritis? (5).

A
Abdo/pelvic pain.
Pyrexia.
Discharge.
Dysuria.
Abnormal vaginal bleeding.
7
Q

What is endometritis?

A

Inflammation of the endometrium.

8
Q

What are endometrial polyps?

A

Sessile/polypoid estradiol (E2) dependant uterine overgrowths.

9
Q

What are the symptoms of endometrial polyps? (5).

A
Often asymptomatic.
Intermenstrual bleeding.
Post menopausal bleeding.
Dysmenorrhoea.
Menorrhagia.
10
Q

What is a leiomyomata?

A

Benign myometrial tumour with estradiol (E2)/progesterone (P4) dependent growth.

11
Q

What are the risk factors for leiomyomata? (5).

A
Genetics.
Nulliparity.
Obesity.
PCOS.
Hypertension.
12
Q

What are the symptoms of a leiomyomata? (4).

A

Often asymptomatic.
Menometrorrhagia (prolonged, heavy bleeds).
Subfertility/pregnancy problems.
Pressure symptoms.

13
Q

What are the hormonal features of endometrial hyperplasia? (2).

A

Increased estradiol.

Decreased progesterone.

14
Q

What are the symptoms of endometrial hyperplasia? (3).

A

Intermenstrual, postmenopausal or postcoital bleeding.

15
Q

What are the risk factors for endometrial hyperplasia? (6).

A
Obesity.
Exogenous estradiol. 
PCOS.
Estradiol-producing tumours.
Tamoxifen.
HNPCC (PTEN mutations).
16
Q

Type 1 endometroid endometrial carcinoma:

Incidence, age, type, mutations, E2 status.

A
75% of endometrial carcinoma.
Pre-menopausal.
Hyperplasia.
PTEN, Kras.
E2 +ve.
17
Q

Type 2 serous endometrial carcinoma:

Incidence, age, type, mutations, E2 status.

A
25% of endometrial carcinoma.
Post-menopausal.
Atrophy.
p53.
E2 -ve.
18
Q

What is polycystic ovary syndrome?

A

Complex endocrine disorder:
Hyperandrogenism.
Menstrual abnermalities.
Polycystic ovaries.

19
Q

What hormonal changes are seen in PCOS?

A

Decreased FSH.

Increased LH, testosterone + DHEAS.

20
Q

What are the rotterdam criteria?

A

Used for PCOS. 2/3 of:
Hyperandrogenism (hirsuitism/biochem).
Irregular periods >35 days.
Polycystic ovaries.

21
Q

What is hypergonadotrophic hypogonadism?

A

Primary failure of the gonads.

22
Q

What are the congenital causes of 1o gonadal failure in females? (2).

A
Turner syndrome (XO).
Kleinfelter syndrome (XXY).
23
Q

What is hypogonadotrophic hypogonadism?

A

Hypothalamic/pituitary failure leading to 2o gonadal failure.

24
Q

What are the causes of 2o gonadal failure in females? (5).

A
Sheehan's syndrome.
PCOS.
Empty sella syndrome.
Brain injury.
Pituitary tumours.
25
Q

How does gonadal failure present in females? (4).

A

Amenorrhoea/absent menarche.
Delayed puberty.
Decrease sex hormone levels.
± increase in LH/FSH levels.

26
Q

What are the three origins of ovarian neoplasms?

A

Sex cord stromal tumours.
Germ cell tumours.
Surface epithelial stromal tumours.

27
Q

What are the three types of serous epithelial neoplasms of the ovary?

A

Serous.
Mucinous.
Endometroid.

28
Q

What is a malignant tumour of the ovarian epithelium called?

A

Cystadenocarcinoma.

29
Q

What is a dysgerminoma?

A

Germinomatous tumour of the ovary. Malignant.

30
Q

What are the three types of non-germinomatous tumours of the ovary?
Which is the only one that can be benign?

A

Teratomas (some are benign).
Yolk sac tumours.
Choriocarcinomas.

31
Q

What does a teratoma differentiate towards?

A

Multiple germ layers.

If embryonal/foetal tissue present then malignant.

32
Q

What does a choriocarcinoma differentiate towards? Malignant?

A

Placenta. Yes.

33
Q

What are the three types of sex cord stomal tumours in females?

A

Thecoma/ fibrothecoma/ fibroma.
Granulosa cell tumour.
Sertoli-Leydig cell tumour.

34
Q

What do thecomas, fibrothecomas and granulosa cell tumours produce?

A

Estradiol (E2).

35
Q

What do sertoli-leydig cell tumours produce in females?

A

Androgens.

36
Q

What are the risk factors for ovarian tumours? (6).

A
FH.
Increasing age.
PMH breast cancer.
Smoking.
E2-only HRT.
Lynch II syndrome.
37
Q

What are the protective factors for ovarian tumours? (3).

A

OCP.
Breastfeeding.
Hysterectomy.

38
Q

Which tumours metastasise to the ovaries?

A

Mullerian tumours (uterus, fallopian, perineum).
GI, pancreatobiliary, breast, melanoma.
Bladder, rectal.

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