Conditions of the Uterus, Cervix, Ovaries, and Tubes

Question 1

What embryological structure gives rise to the uterus, cervix, upper 1/3 of vagina, and fallopian tubes?

Answer 1

Paramesonephric Ducts (Mullerian)

Question 2

Failure of the paramesonephric ducts to fuse during week 9 can result in:

Answer 2

Uterus didelphysis- separate uterine bodies, cervix’s, and fallopian tube

Bicornate Uterus

Question 3

Uterine Leiomyomas (Fibroids)

Answer 3

Benign tumors from proliferation of smooth muscle cells of the myometrium that are spherical, circumscribe, with a whirled appearance
MOST COMMON neoplasm of uterus

Question 4

Symptoms of a uterine leiomyoma

Answer 4

bleeding, pressure, pain, infertility.

MOST COMMON cause of hysterectomy

Question 5

3 locations of a fibroid

Answer 5

1. subserosal
2. intramural- within myometrium; most common
3. submucosal

Question 6

Treatment for a Fibroid

Answer 6

Estrogen+ Progesterone
Progesterone only
GnRH agonist
Uterine Artery Embolization

Question 7

Endometrial Polyps

Answer 7

friable protrusion of endometrium into the cavity that can cause menorrhagia, post-menopausal bleeding.
Mostly benign

Question 8

What type of cyst forms from squamous metaplasia that entraps mucus-secreting columnar cells?

Answer 8

Nabothian Cervical Cyst. Appears opaque

Question 9

Most common benign growth of the cervix

Answer 9

Cervical polyp

Endocervical more common than ectocervical

Question 10

Persistant, unopposed estrogen can cause what endometrial abnormality?

Answer 10

Hyperplasia 
Common causes of estrogen spike: 
PCOS 
Obesity
SERMs

Question 11

How does the WHO classify Endometrial Hyperplasia?

Answer 11

Simple vs. Complex

With/without atypia

Question 12

What is the limit of thickness of the endometrial lining in a postmenopausal woman before a diagnosis of hyperplasia is made?

Answer 12

4mm

Question 13

What are the 3 categories of Ovarian Tumors?

Answer 13

1. Functional
2. Benign
3. Malignant

Question 14

If an ovarian follicle fails to rupture, what type of cyst can form?

Answer 14

follicular cyst (name makes sense)

Question 15

The corpus luteum fails to regress after 14 days, and hemorrhages. When does this usually occur in the ovulation cycle?

Answer 15

2-3 days after ovulation. A CL cyst forms first, and then hemorrhages to become a hemorrhagic cyst

Question 16

Describe PCOS

Answer 16

Usually caused by hyperinsulinemia that results in GnRH secretion that leads to high LH. Theca-Leutin cells secrete androgens in excess. This process is unopposed

Question 17

Are functional ovarian cysts usually painful?

Answer 17

No, they are asymptomatic and usually regress in the next cycle.

Question 18

3 categories of benign ovarian tumors

Answer 18

1. Epithelial- most common
2. Sex-cord
3. Germ cell

Question 19

What is the most common epthelial ovarian tumor?

Answer 19

Serous Cystadenoma (resembles fallopian tube) 
Psammoma bodies present

Question 20

Describe Sex-cord tumors

Answer 20

derive from granulose-theca cells
Produce estrogenic component
Precocious menarche and thelarche, hyperplasia

Question 21

Describe a cystic teratoma

Answer 21

Common ovarian neoplasm that occurs in reproductive years. Contains fully differentiated tissue from all 3 germ layers.
Kristen’s teratoma with teeth in it