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SYSTEMIC PHARMACOLOGY > Gynae - fallopian tube and ovary > Flashcards

Gynae - fallopian tube and ovary Flashcards

1
Q

diseases affecting fallopian tubes

A 
- Inflammations:
Suppurative (Gonococcus & 
chlamydiae), TB salpingitis and actinomycosis (IUCD)
- Ectopic pregnancy and endometriosis
- Tumours and cysts:
Hydatids of Morgagni
adenomatoid tumour adenocarcinoma
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2
Q

hydatids of Morgagni

A

benign cystic structures - remnants of mullerian duct

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3
Q

hydrosalpinx

  • definition
  • cause
A

blocked fallopian tube that is filled with fluid
- tubal blockage caused by previous pelvic infection (pelvic inflammatory disease)/ endometriosis (endometrium cells growing in FT)

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4
Q

pyosalpinx

  • definition
  • cause
  • clinical symptom/ complication
  • treatment
A 
pyo = pus
fallopian tube filled w/ pus 
- Caused by infection by  Chlamydia, NG, E. Coli, Staphylococci, Streptococci
- Pelvic pain
Infertility
- treatment: Antibiotics/surgery
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5
Q

actinomycotic salpingitis

  • cause
  • who does it affect (increased risk)
  • treatment
A
  • infection by filamentous branched clubbed organism, gram-positive, non-acid fast
  • IUCD (Intrauterine Contraceptive Device) users have increased risk
  • antibiotics treatment
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6
Q

adenomatoid tumour

  • benign/malignant
  • symptoms
  • micro appearance
A

Most common benign tumour of fallopian tube
- Usually asymptomatic
- Invagination of visceral mesothelium
Tubular spaces of varying sizes composed of flattened cells

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7
Q

Salpingitis Isthmica Nodosa

  • complications
  • location
A
  • infertility, ectopic pregnancy - cause the lumen of the FT gets constricted and small
  • Bilateral in 80% of cases with nodular swellings
    swelling caused by diverticulae communicating with lumen cause swellings
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8
Q

Non-neoplastic ovarian cysts (4)

A
  • Follicular cysts
  • Multiple follicular cysts (polycystic ovary syndrome)
  • Corpus luteal cysts (after ovulation)
  • Endometriotic cysts
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9
Q

Follicular cysts

- cause

A
  • Arise from unruptured
    follicles or from follicles that ruptured and sealed immediately
    -> Filled with serous fluid

big sized cysts may mimick tumour

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10
Q

corpus luteal cyst

- associated cause

A

yellowish thick cyst lining the ovary

Associated with menstrual irregularities

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11
Q

polycystic ovary

  • clinical symptoms
  • pt physical appearance
  • histo appearance
A
  • Amenorrhoea + Persistent anovulatory state
  • physical appearance:
    Obese, hirsute (hair on chest), acne
  • Multiple cysts & stromal hyperplasia

high estrogen and androgen levels

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12
Q

ovarian neoplasms (4)

A 
- surface epithelial stromal cell tumours (most common)
(EOT)
- germ cell tumour
- sex cord stroma tumours
- tumours metastasised to ovary
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13
Q

ovarian germ cell tumours (5)

A
  • seminoma (m)
  • dysgerminoma (m)
  • yolk sac tumour (m)
  • choriocarcinoma (m)
  • teratoma (mature - b, immature - m)
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14
Q

dysgerminoma

  • gross appearance
  • histo appearance
A
  • large and firm/ soft and fleshy
    monotonous tumour cell w/ clear glycogen filled cytoplasm
    fibrous septa w/ lymphocytes
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15
Q

mature teratomas

A

mature teratomas form majority of germ cell tumours

benign: cystic teratoma (colour resembles thyroid follicles w/ colloid),
Struma ovarii
malignant: SCC, thyroid

(immature teratomas are all malignant)

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16
Q

yolk sac tumour

  • affects who
  • malignancy
  • characteristics
A
  • Children and young women
  • Highly malignant
  • Differentiation towards yolk sac
    Rich in alpha-fetoprotein -> tests strongly for AFB
    Schiller-Duval bodies - central fibrovascular space
17
Q

surface epithelium tumours

A 
- Endocervical differentiation: 
Mucinous tumours - cystadenoma (B) and cystadenocarcinoma (M)
- Tubal differentiation: 
Serous tumours - cystadenoma (B) and cystadenocarcinoma (M)
- Endometrial differentiation: 
endometrioid and clear cell (M) type 
- Transitional/urothelial: 
Brenner tumour (B)
B = beign
M = malignant
18
Q

pathogenesis of ovarian epithelial tumours (2 types)**

A

Type 1 tumours: progress from benign through borderline tumours that give rise to low-grade carcinomas.
Type II tumours: arise from inclusion cysts/FT epithelium that show high grade features (serous)
- majority of malignant epithelial tumours are serous!!**

19
Q

mucinous cystadenoma histo features

A

lined by mucin epithelium

locule containing mucin

20
Q

borderline ovarian neoplasms histo criteria

A
  • Epithelial hyperplasia – stratification, tufts
  • Atypia –mild to moderate
  • Minimal mitotic activity
  • Absence of destructive stromal invasion
21
Q

mucinous tumours

  • clinical presentation
  • complications
A
  • massively enlarged abdomen

- rupture -> release mucin into peritoneal cavity

22
Q

endometroid ovarian tumour

  • malignancy
  • histo features
  • prognosis
A

most of them are malignant

  • Contain tubular glands resembling endometrium
  • prognosis better than serous carcinoma
23
Q

clear cell ovarian adenocarcinoma

- gross and histo appearance

A

uncommon
- Grossly solid/cystic
- Large sheets of epithelial cells with clear cytoplasm and tubules with hobnail nuclei (bulbous nuclei w/ projections into cytoplasm)
cystic spaces lined by nucleus

24
Q

brenner tumour

  • malignancy
  • size
  • histo appearance
A
  • Benign
  • 1-8cm
  • Nests of urothelial-like cells in a dense fibrous stroma
25
Q

sex cord/stromal tumours

  • malignancy
  • types
A

mainly benign - low grade malignancy

  • thecomas (fibroma)
  • granulosa cell (most common)
26
Q

thecoma (fibroma)

  • malignancy
  • histo features
  • clinical presentation
A
  • benign
  • Stromal tumours with fibroblasts (fibroma) or plump spindle cells with lipid droplets (thecoma)
  • Meig’s syndrome: Fibroma, ascites, pleural effusion
27
Q

granulosa cell tumour

  • malignancy
  • gross and histo appearance
A
  • malignant: spreads locally
  • large tumour (cystic/solid). yellow areas (lipid laden luteinized cells)
  • Follicular pattern (call-exner bodies)
    Cleaved, elongated nuclei (coffee bean shape)
28
Q

spread of malignant ovarian neoplasms (4 ways)

A 
- Local infiltration into broad ligament:
Urethral obstruction
Bladder involvement
- Peritoneal spread
Ascites with malignant cells in fluid
Peritoneal nodules
- Lymphatic spread
- Hematogenous spread
Lung nodules
29
Q

ovarian tumours caused by metastasis (from other sites)

  • 2 types (from where it comes from)
  • location it affects
  • gross appearance
A
  • Mullerian: Uterus, FT, peritoneum
    Extramullerian (outside genitalia tract): breast, GIT
    (GIT - Krukenberg**)
  • Bilateral
  • Friable and necrotic with vascular invasion
    invades through ovarian surface
30
Q

where can teratomas occur

A 
- germ cell origin: (sexual gametes)
testes/ovaries
sacro-coccyx
brain 
mediastinum
31
Q

metastatic tumour from GIT

- micro appearance

A

krukenberg tumour

diffused, signet ring cells

SYSTEMIC PHARMACOLOGY (22 decks)

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