Pathology of the Uterus

Question 1

What should the endometrial thickness be in a premenopausal women?

Answer 1

16mm or less

Question 2

What should the endometrial thickness be in a post menopausal woman?

Answer 2

4mm or less

Question 3

What are the two options for getting a uterine biopsy?

Answer 3

Endometrial pipelle biopsy

Dilatation and Curretage

Question 4

What 5 things are important to include on an endometrial biopsy sample?

Answer 4

Age
Date of LMP and length of cycle
Pattern of bleeding
Hormones
Recent pregnancy

Question 5

What is the most common cause of dysfunctional uterine bleeding?

Answer 5

Anovulatory cycles

Question 6

When are anovulatory cycles most common?

Answer 6

Either end of reproductive life

Question 7

What is the most common cause of endometritis?

Answer 7

Infection

Question 8

A 37 year old women presents with lower abdominal pain, fever and abnormal bleeding. On histology you see an abnormal pattern on inflammatory cells in the endometrium.

Answer 8

Acute endometritis (most commonly due to infection)

Question 9

When is the most common time for endometrial polyps to occur?

Answer 9

Around and after menopause

Question 10

How many days does the corpus luteum continue to secrete progesterone for in the absence of pregnancy?

Answer 10

14 days

Question 11

What type of tumour is a fibroid?

Answer 11

Benign smooth muscle tumour

Question 12

What hormone are fibroids dependent on?

Answer 12

Oestrogen

Question 13

A condition where endometrial glands and stroma extend into the myometrium causing painful periods.

Answer 13

Adenomyosis

Question 14

When is red degeneration of a fibroid most likely to occur?

Answer 14

During pregnancy

Question 15

A patient who is known to have fibroids presents with abdominal pain at 9 weeks pregnant. What might have happened?

Answer 15

Red degeneration of the fibroid

Question 16

What is the name given to fibroids that are located within the wall of the uterus? (they are the most common type)

Answer 16

Intramural

Question 17

What is the name given to fibroids that are located underneath the peritoneal surface of the uterus (they can become very large or grow in a papillary manner to become pedunculated)

Answer 17

Subserosal

Question 18

What is the term used to describe a pedunculated fibroid that detached from the uterus?

Answer 18

Parasitic leiomyoma

Question 19

What is the name given to fibroids that are located just under the lining of the uterine cacity and can distort the uterine cavity; meaning even small lesions may lead to infertility?

Answer 19

Submucosal

Question 20

What is the name given to fibroids that are located in the wall of the cervix?

Answer 20

Cervical fibroids

Question 21

What type of symptoms do you usually get with subserosal fibroids and why?

Answer 21

Pressure symptoms and pelvic pain. This is because these tumours can continue to grow outward and increase in size to put pressure on the surrounding organs

Question 22

Which type of fibroid most commonly presents with pressure symptoms?

Answer 22

Subserosal

Question 23

What type of hydatiform mole is caused by a single sperm combining with an egg that has lost its DNA?

Answer 23

Complete

Question 24

What type of hydatiform mole is caused by two sperms?

Answer 24

Partial mole

Question 25

Which type of hydatiform moles have a higher risk of developing into a choriocarcinoma?

Answer 25

Complete

Question 26

What type of tissue is choriocarcinoma a tumour of?

Answer 26

Trophoblast

Question 27

What is the pathological finding of hydatiform moles?

Answer 27

Swollen chorionic villi

Question 28

What is endometritis?

Answer 28

Inflammation of the endometrium that is not part of the usual endometrial cycle

Question 29

What disease is characterised by plasma cells in the endometrium?

Answer 29

Chronic endometritis

Question 30

What might cause granulomas to be found in the endometrium?

Answer 30

Chronic endometritis caused by TB, sarcoidosis or fungal infection

Question 31

Where are the most common sites of endometriosis?

Answer 31

Ovaries Pouch of Douglas Posterior Pelvic Peritoneum

Question 32

In which disease do you see chocolate cysts on the ovary?

Answer 32

Endometriosis

Question 33

What causes the sub fertility associated with endometriosis?

Answer 33

The inflammation associated with endometriosis leads to the formation of adhesions which may lead to secondary abnormalities of the fallopian tubes.

Question 34

Are the chorionic villi formed from the fetus or the mother?

Answer 34

Fetus