9: Pathology of the uterus Flashcards Preview

Reproduction Week 1 2018/19 > 9: Pathology of the uterus > Flashcards

Flashcards in 9: Pathology of the uterus Deck (35)
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1

Which hormone causes the endometrium to proliferate?

Oestrogen

2

Which hormone maintains the endometrium during the luteal phase and encourages uterine secretions?

Progesterone

3

What term is used to describe the appearance of the endometrium when the egg cell is fertilised?

Decidualised

4

Which hormones are involved in the uterine cycle if the egg is cell is actually fertilised?

hCG

Progesterone

if not, corpus luteum degenerates and these aren't produced

5

What are the elements of the proliferative endometrium which you can see on histology?

Columnar epithelium

Stromal cells

Glands

6

In the proliferative phase of the uterine cycle, which aspects of the endometrium grow?

Stroma

Glands

7

What is the corpus luteum?

Remnant of leading follicle left when egg is released

Produces progesterone to maintain endometrium

8

In the event of no fertilisation, what does the corpus luteum degenerate to form?

Corpus albicans

9

What phase of the uterine cycle starts when ovulation occurs?

Secretory phase

because progesterone is being produced

10

How does the endometrium change in the secretory phase?

Glands become torturous - wiggly

Glands fill with secretions

11

If no fertilisation occurs, what happens to the endometrium?

Loss of blood supply

Sloughing Menstruation

12

What is a genetically inherited syndrome which causes GI polyposis and increases a woman's chances of developing endometrial cancer?

Lynch syndrome / HNPCC

13

What is the difference between abnormal and dysfunctional uterine bleeding?

Abnormal bleeding - organic cause: infection, tumour, miscarriage, ectopic/molar pregnancy

Dysfunctional bleeding - no abnormal cause: pathology is hormonal or idiopathic

14

What is the most common cause of dysfunctional uterine bleeding?

Anovulation

common at extremes of age

15

How does anovulation cause dysfunctional uterine bleeding?

No ovulation > no corpus luteum to produce progesterone

Prolonged oestrogen production > Prolonged proliferation of endometrium

Eventually sloughs due to loss of blood supply > Heavy bleeding

16

Which tumours can cause abnormal uterine bleeding?

Endometrial polyps

Leiomyomas (fibroids)

17

What are endometriosis and adenomyosis?

Growth of endometrium / glands outwith the uterus

Grow in response to oestrogen

Cause pain

18

What inflammatory condition causes abnormal uterine bleeding?

Endometritis

19

What drugs used to control menopausal symptoms can cause abnormal uterine bleeding?

HRT

Tamoxifen

20

An endometrial thickness of over ___ mm is an indication for biopsy.

4 mm

21

What investigation is used to assess endometrial thickness?

Transvaginal ultrasound

22

Which investigation is used to view the endometrium?

Hysteroscopy

23

What are two methods of taking an endometrial biopsy?

Pipelle biopsy

Dilatation and curettage

24

What is a disadvantage of using a pipelle over D&C for taking an endometrial biopsy?

You can't see the endometrium while taking the sample

25

Between pipelle biopsy and D&C, what is the preferred method for taking endometrial samples?

D&C

Because you can see the endometrium while you're doing it

26

During which phase of the uterine cycle are endometrial biopsies not particularly useful?

Menstrual phase

because glands and stroma are falling apart

27

If endometrial glands grow for months e.g anovulation, what can they form?

Cysts

28

Despite being in the muscle layer, how do leiomyomas cause abnormal uterine bleeding?

Contraction stretches blood vessels, stroma and glands

29

Endometritis is inflammation of the endometrium which can be either infectious or non-infectious.

What symptom can it cause?

How do you recognise it on histology?

Abnormal uterine bleeding

Inflammatory cells (shouldn't be there; chronic - plasma cells, acute - neutrophils & macrophages)

30

What type of endometritis does tuberculosis cause?

Granulomatous endometritis

big closed off rings of inflammatory cells