Pathology

Question 1

What are the three phases of the ovarian cycle?

Answer 1

Follicular phase
Ovulation
Luteal phase

Question 2

What are the three phases of the uterine cycle?

Answer 2

Menstrual phase
Proliferative phase
Secretory phase

Question 3

Which hormone influences the proliferative phase?

Answer 3

Oestrogen

Question 4

Which hormone influences the secretory phase?

Answer 4

Progesterone

Question 5

In the secretory phase, the glands appear more wiggly. True/false?

Answer 5

True

Question 6

Give some types of abnormal uterine bleeding

Answer 6

Menorrhagia
Metrorrhagia
Polymenorrhoea
Polymenorrhagia
Menometrorrhagia
Amenorrhoea
Oligomenorrhoea

Question 7

Give some causes of abnormal uterine bleeding

Answer 7

Pregnancy
Anovulatory cycles
Endometritis
Endometrial polyps

Question 8

What is the main investigation used for the endometrium?

Answer 8

Transvaginal ultrasound

Question 9

What thickness of endometrium is an indication for biopsy?

Answer 9

> 4mm (post-menopause)

>16mm (pre-menopause)

Question 10

What techniques can be used to sample the endometrium?

Answer 10

Endometrial pipelle

Dilatation and curretage

Question 11

What is dysfunctional uterine bleeding?

Answer 11

Irregular uterine bleeding reflecting a disruption in hormonal stimulation to endometrial lining

Question 12

What is endometritis?

Answer 12

An inflammation of the endometrium (plasma cells)

Question 13

Give some causes of endometritis

Answer 13

Neisseria
Chlamydia
CMV
Coil
Postpartum
Granulomatous
Post curettage

Question 14

What occurs in molar pregnancy?

Answer 14

Abnormal form of pregnancy where a non-viable fertilised egg implants in uterus

Question 15

In a complete molar pregnancy, whose DNA is present?

Answer 15

Only paternal - 46 YY

Question 16

In a partial molar pregnancy, whose DNA is present?

Answer 16

Both maternal and paternal - 69 XXY

Question 17

How many cell layers line the normal endocervix?

Answer 17

One

Question 18

What is the most common site of neoplasia in the cervix?

Answer 18

Transformation zone

Question 19

The transformation zone is a junction between which epithelia?

Answer 19

Squamous (ectocervical)

Columnar (endocervical)

Question 20

What occurs in cervical erosion?

Answer 20

Exposure of endocervical epithelium to acid environment causes physiological metaplasia

Question 21

Give some causes of inflammatory pathology in the cervix

Answer 21

Cervicitis

Cervical polyp

Question 22

Give some causes of neoplastic pathology in the cervix

Answer 22

Cervical intraepithelial neoplasia (CIN)
Squamous carcinoma
Adenocarcinoma

Question 23

Which virus serotypes are the main cause of cervical cancer?

Answer 23

HPV 16 and 18

Question 24

Give some risk factors for CIN/cervical cancer

Answer 24

Presence of high risk HPV (multiple sexual partners)
Long term OCP use
Smoking
Immunosupression

Question 25

Which histological feature shows HPV infection in the cervix?

Answer 25

Koilocytosis

Question 26

Histopathologically, when does cervical cancer occur?

Answer 26

When squamous cells have invaded the basement membrane

Question 27

Give some histological features of CIN

Answer 27

Delay in maturation/differentiation Nuclear abnormalities (increased nucleocytoplasmic ratio) Excess mitotic activity

Question 28

What occurs in CIN stage I?

Answer 28

The basal 1/3 of the epithelium is occupied by abnormal cells

Question 29

What occurs in CIN stage II?

Answer 29

Abnormal cells extend to middle 1/3

Question 30

What occurs in CIN stage III?

Answer 30

Abnormal cells occupy full thickness of epithelium

Question 31

How is squamous cervical carcinoma staged?

Answer 31

Stage 1 - confined to cervix Stage 2 - spread to adjacent organs Stage 3 - involves pelvic wall Stage 4 - distant mets or involvement or rectum/bladder

Question 32

Give some symptoms of squamous cervical carcinoma

Answer 32

Abnormal bleeding (post-coital/menopausal) Pelvic pain Haematuria Ureteric obstruction

Question 33

In squamous cervical carcinoma, lymphatic spread is early and haematogenous is late. True/false?

Answer 33

True

Question 34

What is the preinvasive phase of endocervical adenocarcinoma?

Answer 34

Cervical glandular intraepithelial neoplasia (CGIN)

Question 35

Give some risk factors for endocervical adenocarcinoma

Answer 35

Higher social class Later onset of sexual activity Smoking HPV

Question 36

Which women commonly get vulvar invasive squamous carcinoma?

Answer 36

Elderly women

Question 37

Which lymph nodes are most commonly affected by VISC?

Answer 37

Inguinal

Question 38

How does vulvar Paget's disease present?

Answer 38

Crusting rash