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Female reproductive pathology Flashcards

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1
Q

Label A-C of the ovary

A
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2
Q

Follicle development:

Name each stage of follicle development [7]

A
  1. Primordial follicle
  2. Early Primary Follicle
  3. Late Primary Follicle
  4. Secondary Follicle
  5. Terteriay / Graffian Follicle
  6. Corpus luteum
  7. Corpus albican
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3
Q

At which stage is first meiotic division complete by

  1. Primordial follicle
  2. Early Primary Follicle
  3. Late Primary Follicle
  4. Secondary Follicle
  5. Tertiary / Graffian Follicle
  6. Corpus luteum
  7. Corpus albican
A

At which stage is first meiotic division complete by

  1. Primordial follicle
  2. Early Primary Follicle
  3. Late Primary Follicle
  4. Secondary Follicle
  5. Terteriay / Graffian Follicle
  6. Corpus luteum
  7. Corpus albican
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4
Q

At which stage does second meiotic division start
1. Primordial follicle
2. Early Primary Follicle
3. Late Primary Follicle
4. Secondary Follicle
5. Tertiary / Graffian Follicle
6. Corpus luteum
7. Corpus albican

A

At which stage does second meiotic division start
1. Primordial follicle
2. Early Primary Follicle
3. Late Primary Follicle
4. Secondary Follicle
5. Tertiary / Graffian Follicle
6. Corpus luteum
7. Corpus albican

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5
Q

When are the primordial follicles formed during development? [1]

Where are primordial follicles found in ovary? [1]

Describe the cell type the primordial follicles are comprised of [1]

A

Formed during first 5 months of development

Location: outside of ovary

Cell type: single layer of squamous follicular cells

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6
Q

What level of development are primordial follicles in? [1]

When do they develop further? [1]

A

They remain in the first meiotic division

At puberty they begin to develop further

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7
Q

When do primordial follicles get triggered develop into early primary follicles? [1]

A

At start of each menstrual cycle

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8
Q

Follicle development:

Early primary follicle:

A

They remain in the first meiotic division

At puberty they begin to develop further

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9
Q

Follicle development:

Early primary follicle

Describe the structure

What cell structural change occurs after their development from primordial follicle? [1]

Which hormone triggers change from primordial follicle to early primary follicle? [1]

A
  • Central oocyte & single layer of cuboidal cells
  • Squamous (primordial) to cuboidal
  • Stimulated by FSH

Note the cuboidal cells surrounding the oocyte

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10
Q

Follicle development:

What changes in structure occur from early primary folllicle to a late primary follicle? [2]

A
  • Follicular cells proliferate into stratified epithelium called zona granulosa
  • Development of zona pellucida occurs: layer that seperates oocyte from the follicular cells

-

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11
Q

Which two structural layers are created whe the late primary follicle develops? [2]

A

Zona pellucida
Zona granulosa

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12
Q

Which part of the follicle does sperm bind to?

Zona granulosa
Zona pellucida
Oocyte
Theca cells

A

Which part of the follicle does sperm bind to?

Zona granulosa
Zona pellucida
Oocyte
Theca cells

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13
Q

Follicle development:

What development occurs from late primary follicle to secondary follicle? [3]

A
  • Follicular antrum within granulosa layer
  • Thicker zona pellucida
  • Larger zona granulosa
  • Larger oocyte
  • Thecal cells outside of follicle proliferate
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14
Q

Describe how the formation of oestrogen occurs in oocyte

A
  • Cholesterol from blood stream goes to thecal cells (both located on outside of follicle)
  • Theca cells catalyse cholesterol into androgens, but lack aromatase to finalise conversion into oestrogen
  • Androgens move to granulosa cells, which have aromatose; granulosa cells are stimulated by FSH to make oestrogen
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15
Q

At which stage in follicle development is the oocyte a 2N haploid? [1]

A

Tertiary / Graffian

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16
Q

Follicle development

Which structural changes occur when the oocyte develops into a tertiary oocyte?

A
  • Large follicular antrum makes up most of follicle
  • Corona radiata develops: layer of cells that surrounds the zona pellucida
    Corona radiatia
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17
Q

Follicle development:

The ovum is released when the oocyte is in the tertiary / graffian oocyte stage.

What structure is produced and what changes occur to produce this?

A
  • After release of ovum the remaining cells of the granulosa and theca interna form corpus luteum
  • At centre of corpus luteum forms a blood clot
  • On outside: granulosa lutein & theca lutein cells
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18
Q

Corpus luteum:

What is the role of granulosa cells after ovulation? [1]

A

granulosa cells: switch from making oestrogen to making progesterone

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19
Q

Corpus luteum:

Which hormone maintains the blood clott if fertilisation occurs? [1]

If fertilisation does not occur, which structure does the corpus luteum turn into? [1]

A
  • Blood clot maintained by bHCG if fertilised
  • If not fertilised: turns in corpus albicans
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20
Q

If fertilisaton hasn’t / doesnt occur, which hormone activates the cells of the corpus luteum?

If fertilisaton occurs which hormone activates the cells of the corpus luteum? [1]

A
  • Pre / no fertilisation: LH
  • Fertilisation: bHCG
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21
Q

Follicle cevelopment:

Why would corpus luteum transition to corpus albicans? [1]

A

Corpus luteum to corpus albicans if no fertilisation occurs

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22
Q

How long does the corpus luteum stay active before turning into a corpus albicans if oocyte is not fertilised? [1]

What happens to the corpus albican when it degenerates? [1]

The decrease of which hormone causes this to happen? [1]

A

14 days

Secretory cells degenerate and are phagocytosed by macrophages and replaced by fibrous material

Due to drop in LH

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23
Q

Describe what atretic follicles are and why they are formed [2]

Which hormone decreasing creates atretic follicles? [1]

A

Atretic follicles:

  • Several primordial follicles are stimulated to develop - but only one completes the development to become the ovum
  • The rest undergo a process called atresia which can occur at any stage – become scar tissue and break down: look like little corpus albucans
  • Triggered by decrease if FSH
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24
Q

Describe the cell structure of the oviduct / uterine tube [2]

What are the two types of epithelium found? [2]

A

Structure:
* wall of smooth muscle
* elaborate mucosa: appears like a labyrinth

Epithelium consists of:
- Ciliated cells (move ovum along)
- Non-ciliated cells: secrete lubricating secretions to nourish & protect ovum

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25
What are the 3 layers of the uterus?
**Endometrium**: Mucosal layer - when the ovum is coming into contact with endometrium, should be in secretory phase **Myometrium**: SMC **Perimetrium**: Serosal layer
26
Explain the roles of the two layers of the endometrium? [2] State if their size stays constant or changes
**Stratum functionalis**: - Expands and vascularises during the menstrual cycle - Variable size **Stratum basilis** - Stem cell layer - Remains constant in size
27
What is the role of myometrium of uterus? [1] Which hormone is myometrium responsive to? [1]
- Allows for expansion & contraction - Responsive to **oxytocin**
28
Name the three stages in the uterine cycle and which hormones drive each phase [6]
**Proliferative phase**: driven by **oestrogen** **Secretory phase:** Driven by **progesterone** **Menstrual phase**: driven by **progesterone levels falling**
29
Describe each stage of the uterine cycle [3]
**Proliferative stage**: * Robust growth of epithelial cells in stratum functionalis * Formation of coiled and densely packed glands **Secretory phase**: * Glands become more complexly coiled & filled with **secretions** (appears pink) rich in **glycogen** and **glycoproteins** * **Endometrium** is maximum **thickness** **Menstrual phase:** * If fertilisation occurs - **nohCG** and **corpus luteum degenerates** * Spiral arteries in endometrium **constrict** and tissue becomes ischemic * Cells die and this causes sloughing of stratum functionalis * Forms the menstrual flow
30
Describe the structure of the endocervix [1] and ectocervix [1]
Endocervix: * Simple columnar epithelium Ectocervix: * Stratified squamous
31
What is the epithelial cell structure of the vagina? [1] Why does the vagina release glycogen into epithelium? [1] Describe the structure of CT found behind ^ [1]
**Stratified squamous epithelium** (small degree of keratinisation) The release of glyocgen feeds **commensal bacteria Lactobacillus lactic** Vagina has **dense irregular CT**
32
What is the name for smear for cervical cancer screening? [1] Which virus are you initially investigating before / presence would warrent futher histoligcal investigations? [1]
**Pap smear** First look for **HPV presence** If present – then take cells and do histological slides to see if **dysplastic**
33
Describe the difference in appearance between normal and dysplastic cervical cells [2] Which cell types are most commonly effected in cervical cancer? [1]
**Normal**: Flattened, big, small nucleus & large cytoplasm **Dysplastic cells:** reduced cytoplasm (& therefore ratio of nucleus to cytoplasm) **Cervical epithelial cells most commonly effected**
34
Describe the classifications for cervical intraepithelial neoplastic (CIN) cells
Neoplasia starts near basement membrane / at the basal cells **Mild (CIN 1):** * Neoplasia found 1/3rd of way into epithelium **Moderate (CIN 2):** * Neoplasia found 2/3rds of way into epithelium **Severe (CIN 3):** * Neoplasia found all way to epithelium
35
Cervical cancer: Basal cells confined to the lower third indicate a []-grade lesion Basal cells in the upper two-thirds indicate a []-grade lesion
Basal cells confined to the lower third indicate a **low-grade lesion** Basal cells in the upper two-thirds indicate a **high-grade lesion**
36
What is important to remember with most HPV cells? [1]
Most HPV infected cells are **self-limiting** But if persistent than can develop into **cervical cancer**
37
What is a big risk factor for endometrial cancer? [1]
Obesity (40% cases are linked)
38
# Endometrial cancer: Caused by excess of which hormone? [1] Treatment? [1]
- Excess **oestrogen** - Tx: **hysterectomy**
39
How does endometrial cancer appear histologically? [1]
They can grow as **polypoid masses** that project into endometrial cavity: * Irregular crowded glands lined by columnar epithelium with pseudostratified nuclei and mild atypical cytologic
40
What are fibroids aka? [1]
**Leiomyoma**
41
Leiomyoma are proliferations of which cell type? [1] Driven by XS of which hormone? [1] Which part of the vagina are fibroids found? [1]
* **SMC** proliferations * Driven by **oestrogen** rise * In **myometrium**
42
Where do ovarian cancers predominately arise from? [3]
**Ovary** **Fallopian tubes** **Peritoneum**
43
Which cell types are the predominate type that cause ovarian cancer? [1]
**Serous ovarian cancer:** **2/3rds of cases epithelial ovarian cancer** (outer coating of ovary and peritoneum – CT around the ovary, not the cyst itself)
44
Ovarian cancer - describe the histopathology of serous cystadenoma [2]
**Multi-cystic** with fine papillary projections from cyst wall Thin walled cysts lined with c**iliated pseudostratified cuboidal** pr columnar epithelium
45
Desrcibe histopathology of germ cell tumours of the ovary [2] Which cell types are they from? [1]
**Germ cell tumours of ovary (GCT) are rapidly growing neoplasms derived from pleuripotent primordial germ cells** **95% are mature cystic teratomas** (encapsulated tumours with mature tissue or organ components) - usually benign; 5% are malignant Can find teeth in them
46
Desrcibe histopathology of germ cell tumours of the ovary [2] Which cell types are they from? [1]
**Germ cell tumours of ovary (GCT) are rapidly growing neoplasms derived from pleuripotent primordial germ cells** **95% are mature cystic teratomas** (encapsulated tumours with mature tissue or organ components) - usually benign; 5% are malignant Can find teeth in them
47
Desrcibe histopathology of germ cell tumours of the ovary [2] Which cell types are they from? [1]
**Germ cell tumours of ovary (GCT) are rapidly growing neoplasms derived from pleuripotent primordial germ cells** **95% are mature cystic teratomas** (encapsulated tumours with mature tissue or organ components) - usually benign; 5% are malignant Can find teeth in them
48
What type of follicle is this? Explain why 1. Primordial follicle 2. Early Primary Follicle 3. Late Primary Follicle 4. Secondary Follicle 5. Tertiary / Graffian Follicle 6. Corpus luteum 7. Corpus albican
What type of follicle is this? Explain why **1. Primordial follicle** 2. Early Primary Follicle 3. Late Primary Follicle 4. Secondary Follicle 5. Tertiary / Graffian Follicle 6. Corpus luteum 7. Corpus albican | single layer of squamous follicular cells
49
What type of follicle is this? Explain why 3. 1. Primordial follicle 2. Early Primary Follicle 3. Late Primary Follicle 4. Secondary Follicle 5. Tertiary / Graffian Follicle 6. Corpus luteum 7. Corpus albican
What type of follicle is this? Explain why 3. 1. Primordial follicle 2. Early Primary Follicle **3. Late Primary Follicle** 4. Secondary Follicle 5. Tertiary / Graffian Follicle 6. Corpus luteum 7. Corpus albican | 3 layers; Zona granulosa thickens & ZP develops
50
What type of follicle is this? Explain why 3. 1. Primordial follicle 2. Early Primary Follicle 3. Late Primary Follicle 4. Secondary Follicle 5. Tertiary / Graffian Follicle 6. Corpus luteum 7. Corpus albican
What type of follicle is this? Explain why 3. 1. Primordial follicle 2. Early Primary Follicle 3. Late Primary Follicle 4. Secondary Follicle **5. Tertiary / Graffian Follicle** 6. Corpus luteum 7. Corpus albican
51
Label A-E of this tertiary follicle
A: zona pellcuida B: corona radiata C: Antrum D: oocyte E: zona granulosa
52
What type of follicle is this? Explain why 3. 1. Primordial follicle 2. Early Primary Follicle 3. Late Primary Follicle 4. Secondary Follicle 5. Tertiary / Graffian Follicle 6. Corpus luteum 7. Corpus albican
What type of follicle is this? Explain why 3. 1. Primordial follicle 2. Early Primary Follicle 3. Late Primary Follicle **4. Secondary Follicle** 5. Tertiary / Graffian Follicle 6. Corpus luteum 7. Corpus albican | Increase n layers of zona granulosa Thicker zona pellucida Larger oocyte
53
What type of follicle is this? Explain why 3. 1. Primordial follicle 2. Early Primary Follicle 3. Late Primary Follicle 4. Secondary Follicle 5. Tertiary / Graffian Follicle 6. Corpus luteum 7. Corpus albican
What type of follicle is this? Explain why 3. 1. Primordial follicle **2. Early Primary Follicle** 3. Late Primary Follicle 4. Secondary Follicle 5. Tertiary / Graffian Follicle 6. Corpus luteum 7. Corpus albican
54
What type of follicle is this? Explain why 3. 1. Primordial follicle 2. Early Primary Follicle 3. Late Primary Follicle 4. Secondary Follicle 5. Tertiary / Graffian Follicle 6. Corpus luteum 7. Corpus albican
What type of follicle is this? Explain why 3. 1. Primordial follicle 2. Early Primary Follicle 3. Late Primary Follicle 4. Secondary Follicle 5. Tertiary / Graffian Follicle 6. Corpus luteum **7. Corpus albican**
55
What type of follicle is this? Explain why 3. 1. Primordial follicle 2. Early Primary Follicle 3. Late Primary Follicle 4. Secondary Follicle 5. Tertiary / Graffian Follicle 6. Corpus luteum 7. Corpus albican
What type of follicle is this? Explain why 3. 1. Primordial follicle 2. Early Primary Follicle 3. Late Primary Follicle 4. Secondary Follicle 5. Tertiary / Graffian Follicle **6. Corpus luteum** - blood clot present 7. Corpus albican
56
What type of follicle is this? Explain why 3. 1. Primordial follicle 2. Early Primary Follicle 3. Late Primary Follicle 4. Secondary Follicle 5. Tertiary / Graffian Follicle 6. Corpus luteum 7. Corpus albican
What type of follicle is this? Explain why 3. 1. Primordial follicle 2. Early Primary Follicle 3. Late Primary Follicle 4. Secondary Follicle 5. Tertiary / Graffian Follicle **6. Corpus luteum** - blood clot present 7. Corpus albican
57
Label A-E of the ovary
A: antral follicle B: cortex C HIlus D: medulla E: corpus luteum
58
What type of follicle is this? [1]
Graffian follicle.
59
What type of follicle is this? [1]
Corpus albicans
60
What type of follicle is this? [1]
Secondary Follicle
61
What type of follicle is this? [1] Label A & B [2]
A: **Zona pellucida** B: **Follicular cells**
62
63
A: theca cells / theca interna B: zona pellucida C: follicular antrum D: cumulus cells E: granulosa cells
64
Label A-D
A: granulosa cells B: secondary oocyte C: corona radiata D: zona pellucida
65
What type of luteal cells are A & B? [2]
A: granulosa luteal cells B: theca luteal cells
66
Label the phase of each uterine cycle the endometrium is in [4]
67
Corpus luteum:
**Theca lutein cells**. They synthesize progesterone.
68
Late proliferative - note extensive glands that do not appear saw-toothed and do not contain secretions in their lumen. Estradiol would predominate in this phase.
69
Graafian follicle
70
Atretic follicle
71
Corona radiata Zona pellucida Plasma membrane
72
Oestrogen & progesterone (corpus luteum)
73
Primary follicle
74
secretory (looks saw toothed)
75
What do cells of cervical neoplasm looked like compared to non-neoplastic cells? [1]
arked nuclear atypia and enlargement compared with surrounding intermediate cells
76
what level of cervical intraepithelial neoplasia (CIN) is depicted? [1]
**CIN III:** diffuse basal / parabasal type, no maturation difference across all layers
77
what level of cervical intraepithelial neoplasia (CIN) is depicted? [1]
CIN I: **dysplastic cells are confined to the lower third of the epithelium**
78
what level of cervical intraepithelial neoplasia (CIN) is depicted? [1]
CIN II: dysplastic cells are distributed in the upper third of the epithelium in addition to lower third
79
what level of cervical intraepithelial neoplasia (CIN) is depicted? [1]
CIN III
80
Which of A & B is fibroids and endometrial cancer? [1]
A: fibroids B: endometrial cancer
81
What type of follicle is this? [1]
primordial
82
What type of follicle is this? [1]
Secondary
83
What type of follicle is this? [1]
Corpus albicans
84
Which phase of the menstrual cycle is this endometrial slide taken from? [1]
Menstrual
85
What are the name of these arteries depcited in the endometrium? [1]
spiral arteries
86
Which phase of the menstrual cycle is this endometrial slide taken from? [1]
proliferative stage

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