Female Reproductive System Practical Flashcards
(68 cards)
Define polycystic ovarian syndrome (PCOS).
PCOS is a complex endocrine disorder characterized by hyperandrogenism, menstrual abnormalities, polycystic ovaries, chronic anovulation, and decreased fertility.
What are the diagnostic criteria for polycystic ovaries?
Presence of 20 or more follicles in at least one ovary (each measuring 2–9 mm) or total ovarian volume greater than 10 cm³.
What is a major gynaecological risk associated with polycystic ovaries and why?
Risk of endometrial hyperplasia and carcinoma due to increased free serum estrogen levels.
Define endometriosis.
The presence of endometrial tissue outside the uterus (ectopic locations).
Endometriosis can be found in the ovaries and in the following sites (in
decreasing order of frequency): uterine ligaments, rectovaginal
septum, pelvic peritoneum, large and small bowel and appendix,
mucosa of cervix, vagina and fallopian tubes, and laparotomy scars.
Why is ovarian endometriosis sometimes called a ‘chocolate cyst’?
The lesions bleed like normal endometrium; accumulated old blood gives a brown ‘chocolate-like’ appearance.
What are some sites endometriosis can occur in?
Ovaries, uterine ligaments, rectovaginal septum, pelvic peritoneum, bowel, appendix, cervix, vagina, fallopian tubes, and surgical scars (in decreasing order of frequency).
What is the most common histologic subtype of cervical cancer?
Squamous cell carcinoma (~80%). Adenocarcinoma (~15%) is harder to detect because it starts higher in the cervix.
What causes cervical cancer and how is it prevented?
Caused by high-risk HPV strains (16, 18, 31, 33, 45, 52, 58). Prevented by HPV vaccination (e.g., Gardasil9) and screening (Pap smear for HPV DNA).
How does advanced cervical carcinoma spread, and what are its complications?
Spreads locally to paracervical soft tissue, bladder, ureters (resulting in hydronephrosis), rectum, and vagina.
Most patients with advanced cervical cancer die of the
consequences of this local invasion rather than due to
metastatic disease.
Which microorganisms are commonly associated with PID?
Neisseria gonorrhoeae, Chlamydia, and enteric bacteria.
What are complications might be associated with the lesion shown?
Pyosalpinx, tubo-ovarian abscess, infertility, tubal blockage, ectopic pregnancy, hydrosalpinx, peritonitis, and bacteremia.
What increases the risk of ectopic pregnancy?
Pelvic inflammatory disease is
a major risk factor for
ectopic pregnancy.
Other conditions which lead to
scarring/distortion of the tubes can also lead to an
increased risk (eg surgery, leiomyoma)
What are typical symptoms of ectopic pregnancy?
Abdominal pain and vaginal bleeding 6–8 weeks after the last menstrual period, correlating with distension of
fallopian tube. Tubal rupture may cause hemorrhagic shock.
Define gestational trophoblastic disease (GTD).
A group of tumors involving placental tissue, including hydatidiform mole (complete or partial), invasive mole, choriocarcinoma, and placental site trophoblastic tumour (PSTT).
What is the karyotype of a complete hydatidiform mole?
46,XX or 46,XY—entirely paternal origin due to fertilization of an empty ovum.
What are potential complications of a complete mole?
Invasive mole and choriocarcinoma.
Is leiomyosarcoma malignant and what is its origin?
Yes, it is a malignant tumor of smooth muscle origin; it does not evolve from a leiomyoma.
What are the histilogical and macroscopic features of leiomyosarcoma?
Hemorrhage, necrosis, local invasion, cellular atypia, and high mitotic activity.
What are the histilogical and macroscopic features of leiomyoma?
Well-defined mass.
Well circumscribed, with no invasion, no apparent
necrosis or heamorrhage.
Is leiomyoma benign or malignant and what symtoms does it cause?
Benign.
Menorrhagia, dysmenorrhea, dyspareunia; may also lead to infertility if they distort the uterine cavity; and if the individual is pregnant ‘fibroids’ can increase the risk of miscarriage or lead to problems with labour.
What are risk factors for endometrial carcinoma?
Obesity, diabetes, hypertension, anovulatory infertility, granulosa cell tumors - linked to unapposed estrogen.
All these conditions are associated with prolonged estrogenic
stimulation of endometrial glands to proliferate while progesterone
levels are insufficient to inhibit proliferation and stimulate
differentiation to a secretory gland phenotype.
What are histologic subtypes of ovarian epithelial tumors?
Serous, mucinous, and endometrioid, based on epithelial pattern.
Describe features of serous cystadenoma.
Large cystic areas with thin papillary projections; lined by cells producing serous fluid.
The cysts are lined by epithelial cells which secrete fluid to fill/dilate/form the cyst. Different cell types can line these cysts giving rise to different types of fluid. This is a ‘serous cystadenoma’ so cells lining cyst are like those of fallopian tube producing serous fluid. Sometimes cells are glandular type like those of endocervix and secrete mucoid fluid (mucinous cystadenoma).
Why is ovarian carcinoma usually detected late?
Vague symptoms and hidden location allow late-stage diagnosis.
