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Module 203 Reproduction & endocrinology > PC: pathology of female genital tract 1 > Flashcards

PC: pathology of female genital tract 1 Flashcards

1
Q

Why is a Caesarean section done at the lower uterine segment?

A

Much thinner and easier to suture than the fundus
Easier to control bleeding
Reduced risk of rupture in subsequent pregnancies

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2
Q

What is the bikini line incision for a c-section known as?

A

Pfannenstiel incision

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3
Q

What is the cell type of the ectocervical mucosa?

A

Non-keratinising stratified squamous epithelium

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4
Q

What organs have non-keratinising stratified squamous epithelium?

A 
Ectocervical mucosa
Oesophagus
Vagina
Anal canal
Oral cavity
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5
Q

Describe the endocervical mucus

A

Columnar cells

Secretes mucus

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6
Q

What can the endocervical mucosa differentiate into?

A

Squamous epithelium

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7
Q

What is the cervical squamo-columnar junction?

A

Where stratified squamous epithelium meets columnar epithelium

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8
Q

What is the transformation zone?

A

Area of changing cells

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9
Q

Describe a nulliparous cervix

A

Smooth, round external os

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10
Q

Describe a multiparous cervix

A

Transverse shaped external os

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11
Q

What specimens are submitted to the path lab?

A

Smears for cytology
Colposcopic biopsies following abnormal smear
Loop excision biopsies for treatment of CIN
Hysterectomies for early cervical cancer

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12
Q

What specimens from the uterus are submitted to the path lab?

A 
Pipelle endometrial sample
Endometrial curettings
Subtotal hysterectomy
Vaginal hysterectomy
Hysterectomy, tubes and ovaries
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13
Q

What are the most common types of high-risk HPV?

A

16 and 18

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14
Q

What are the most common types of low-risk HPV?

A

6 and 11

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15
Q

What is koilocytosis?

A

Presence of koilocytes, pathogenic feature of HPV

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16
Q

What is CIN?

A

Cervical intraepithelial neoplasia

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17
Q

What is CIN 1?

A

Precancerous or dysplastic cells which involve lower 1/3 of epithelium

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18
Q

What is CIN 2?

A

2/3 of epithelium are involved by dysplastic epithelium

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19
Q

What is CIN 3?

A

Dysplastic cells involve full thickness of epithelium

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20
Q

What are the presenting symptoms of advanced cervical cancer?

A

Post-coital bleeding
Foul-smelling discharge
Intermenstrual bleeding
Weight loss when advanced

21
Q

95% of cervical cancers are what type?

A

Squamous cell carcinoma

22
Q

What is the transformation zone made up of in SCC?

A

Metaplastic squamous epithelium

23
Q

How is SCC of the cervix classified?

A

Depending on the amount of keratin produced

24
Q

What is the menstrual cycle under the influence of?

A

Hypothalamus - pituitary - ovarian axis

25
Q

Where are oestrogens produced from?

A

Ovaries
Adrenal glands
Subcutaneous fat

26
Q

What do obese women have a higher risk of developing breast and endometrial cancer?

A

The subcutaneous fat produces oestrogen

27
Q

What is the endometrium like in the follicular phase?

A

Proliferative phase endometrium
Glands are tubular
Cells show mitotic activity
Stroma is dense

28
Q

What is the endometrium like when corpus luteum is present in the ovary?

A

Secretory phase endometrium

Cells show characteristic subnuclear vacuolation

29
Q

When is the best time to sample the endometrium when investigating infertility?

A

From day 16

Can tell if patient has ovulated or not

30
Q

What are the indications for a hysterectomy?

A 
Fibroid uterus
Early cancer of the cervix
Cancer of the endometrium
Cancer of the ovary
Uterine prolapse
Dysfunctional uterine bleeding
31
Q

Give examples of dysfunctional uterine bleeding

A

Menorrhagia
Intermenstrual bleeding
Polymenorrhoea
Metorrhagia

32
Q

What is the most common tumour of the uterus?

A

Fibroid tumour

33
Q

What is submucosal?

A

Under the endometrium

34
Q

What is intramural?

A

Within myometrium

35
Q

What is subserosal?

A

Under peritoneum

36
Q

What is a leiomyoma?

A

Smooth muscle tumour

37
Q

What is a leiomyosarcoma?

A

Malignant smooth muscle tumour

38
Q

How do leiomyomas present?

A 
Asymptomatic 
Abnormal uterine bleeding
Pain - may include dysmenorrhoea 
Bladder symptoms 
Impaired fertility, recurrent miscarriage
39
Q

How can leiomyomas present in pregnancy?

A

Preterm labour
Abnormal lie
Obstructed labour
Pain if infarcted due to increase vascularity

40
Q

What are the presenting symptoms of a submucosal fibroid?

A

Dysmenorrhoea
Abnormal uterine bleeding
Signs and symptoms of anaemia
Urinary symptoms

41
Q

How is cancer graded?

A

According to how close they resemble the cell of origin

42
Q

What is grade 1?

A

Well differentiated

Closely resemble cell of origin

43
Q

What is grade 2?

A

Moderately differentiated

Some areas resemble cell of origin, some don’t

44
Q

What is grade 3?

A

Poorly differentiated
No resemblance to cell of origin
High rate of proliferation - invade BV, lymphatics and spread to lymph nodes and other organs

45
Q

What is used to stage gynaecological cancers?

A

FIGO

46
Q

How are cancers in the body stage?

A

TNM

47
Q

What is T in terms of staging cancer?

A

Tumour size or depth of invasion depending on organ
T1, T2, T3, T4
Patients with T1 have 95% 5 year survival

48
Q

What is N in terms of staging cancer?

A

Lymph node spread
Prognosis depends on number of lymph nodes involved
N0, N1, N2

49
Q

What is M in terms of staging cancer?

A

Metastasis to liver, lung, brain, bone

M0, M1

Module 203 Reproduction & endocrinology (52 decks)

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