Pathology

Question 1

phases of the ovarian cycle

Answer 1

follicular
ovulation
luteal

Question 2

phases of the uterine cycle

Answer 2

menstrual
proliferative
secretory

Question 3

when does proliferative phase of uterine cycle occur

Answer 3

day 1-14

Question 4

what hormone is mainly present in the proliferative phase

Answer 4

oestrogen

Question 5

when does the secretory phase of uterine cycle occur

Answer 5

day 16-28

Question 6

what hormone is mainly present in the secretory phase

Answer 6

progesterone

Question 7

what day of the uterine cycle is menstruation

Answer 7

day 1-3

Question 8

causes of abnormal uterine bleeding in young women

Answer 8

DUB- usually anovulatory
Pregnancy/miscarriage
Endometritis
Bleeding disorders

Question 9

causes of abnormal uterine bleeding in peri-menopausal women

Answer 9

polyp
leiomyoma
adenomyosis
neoplasia 
hormone defects
DUB

Question 10

causes of abnormal uterine bleeding in post-menopausal women

Answer 10

atrophy
endometrial polyp
carcinoma/sarcoma 
HRT
Endometritis

Question 11

what endometrial thickness in post menopausal women indicates a biopsy

Answer 11

> 4mm

Question 12

what endometrial thickness in pre-menopausal women indicates a biopsy

Answer 12

> 16 mm

Question 13

history needed before endometrial biopsy

Answer 13

Age 
Date of last period + length of cycle
pattern of bleeding
hormones
recent pregnancies

Question 14

definition of dysfunctional uterine bleeding (DUB)

Answer 14

irregular uterine bleeding that reflects a disruption In the normal cyclic pattern of ovulatory hormonal stimulation to endometrial lining

Question 15

what are most cases of DUB caused by

Answer 15

anovulatory cycles

Question 16

what happens in anovulatory cycles

Answer 16

corpus luteum does not form - continued growth of functionalis layer

Question 17

causes of an anovulatory cycle

Answer 17

PCOS 
Hypothalamic dysfunction 
thyroid disorders 
hyperprolactinaemia 
luteal phase deficiency

Question 18

what happens in luteal phase deficiency

Answer 18

insufficient progesterone/ poor response of endometrium to progesterone
abnormal follicular development (inadequate FSH/LH)
poor corpus luteum formation

Question 19

pathological causes of abnormal uterine bleeding

Answer 19

endometritis 
polyp
adenomyosis 
leiomyoma 
miscarriage

Question 20

causes of endometritis

Answer 20

Neisseria, chlamydia, TB, HSV
IUCD
post-partum granulomatous

Question 21

what is endometritis associated with

Answer 21

leoimyoma

polyps

Question 22

what indicates chronic endometritis

Answer 22

plasma cells in the stroma of the endometrium

ie. chronic plasmacytic endometritis

Question 23

what is chronic endometritis associated with

Answer 23

pelvic inflammatory disease

Question 24

features of a polyp

Answer 24

common, usually asymptomatic
benign
may cause bleeding/discharge

Question 25

treatment of endometritis

Answer 25

ampicillin + gentamicin + metronidazole

Question 26

what age do polyps present

Answer 26

around/after menopause

Question 27

what is a molar pregnancy

Answer 27

non-viable fertilised egg implants in the uterus

Question 28

what type of disease is molar pregnancy

Answer 28

gestational trophoblastic disease

Question 29

what is a complete mole

Answer 29

egg has lost its DNA. | Fertilised- only paternal DNA is present

Question 30

what is a partial mole

Answer 30

haploid egg | fertilised + reduplicates/fertilised by 2 sperm- Triploidy

Question 31

which mole has higher risk of choriocarcinoma

Answer 31

complete

Question 32

what is adenomyosis

Answer 32

endometrial glands + stroma within the myometrium

Question 33

symptoms of adenomyosis

Answer 33

menorrhagia | dysmenorrhoea

Question 34

what is a leiomyoma

Answer 34

fibroid- Benign tumour of smooth muscle

Question 35

symptoms of leiomyoma

Answer 35

menorrhagia pain infertility

Question 36

what is growth of leiomyoma dependent on

Answer 36

oestrogen

Question 37

what is the transitional zone of the cervix

Answer 37

junction between squamous cells on the outer cervix and columnar cells on the inner cervix

Question 38

what can alter the position of the transitional zone

Answer 38

menarche pregnancy menopause

Question 39

what is cervical erosion

Answer 39

exposure of endocervical epithelium to the acid environment of the vagina

Question 40

what does cervical erosion lead to

Answer 40

squamous metaplasia

Question 41

what are nabothian cysts

Answer 41

mucus filled cyst on the surface of the cervix

Question 42

what causes nabothian cysts

Answer 42

squamous epithelium grows over the glands and block them

Question 43

symptoms of cervicitis

Answer 43

often asymptomatic vaginal discharge dysuria intermenstrual/post coital bleeding

Question 44

what can cause cervicitis

Answer 44

chlamydia HSV gonorrhoea follicular cervicitis

Question 45

what is follicular cervicitis

Answer 45

inflammation of the sub epithelial reactive lymphoid follicles in the cervix

Question 46

what is follicular cervicitis also known as

Answer 46

chronic lymphofollicular cervicitis

Question 47

what HPV are associated with cervical cancer

Answer 47

16 + 18

Question 48

what is cervical intra-epithelial neoplasia (CIN)

Answer 48

Pre-invasive stage of cervical cancer

Question 49

where doe CIN occur

Answer 49

at transformation zone

Question 50

symptoms of CIN

Answer 50

asymptomatic

Question 51

what causes CIN

Answer 51

dysplasia of squamous cells

Question 52

what is koilocytosis

Answer 52

squamous epithelial cell that has undergone a number of structural changes due to HPV infection

Question 53

stages of CIN

Answer 53

1. Normal squamous epithelium 2. Koilocytosis 3. CIN 1 4. CIN 2 5. CIN 3

Question 54

Histological changes seen in CIN

Answer 54

Hyperchromasia Pleomorphism Excess mitotic activity More immature basal cells

Question 55

what is hyperchromasia

Answer 55

dark staining nuclei due to increased DNA content

Question 56

most common cervical tumour

Answer 56

invasive squamous carcinoma

Question 57

why is invasive squamous carcinoma preventable

Answer 57

develops from CIN- can be picked up by screening

Question 58

symptoms of cervical cancer

Answer 58

abnormal bleeding- post coital/post menopausal pelvic pain haematuria ureteric obstruction

Question 59

what lymph nodes does cervical cancer spread to

Answer 59

para-aortic

Question 60

what is cervical glandular intra-epithelial neoplasia (CGIN)

Answer 60

pre-invasive phase of endocervical adenocarcinoma

Question 61

where does CGIN originate from

Answer 61

endocervical epithelium

Question 62

prognosis of endocervical adenocarcinoma

Answer 62

worse than squamous

Question 63

who gets vulvar invasive squamous carcinoma

Answer 63

elderly women

Question 64

what lymph nodes does vulvar invasive squamous carcinoma spread to

Answer 64

inguinal

Question 65

how does vulvar pagets disease present

Answer 65

crusting rash

Question 66

what do tumour cells in vulvar pagets disease contain

Answer 66

mucin

Question 67

where does the tumour arise from in vulvar pagets disease

Answer 67

sweat glands in the skin