Uterine Pathology

Question 1

What are the phases of the uterine cycle?

Answer 1

menstrual phase; prolfierative phase; secretory phase

Question 2

When is the proliferative phase?

Answer 2

days 1-14

Question 3

When is the secretory phase?

Answer 3

days 16-28

Question 4

When is the menstrual phase?

Answer 4

days 1-3

Question 5

What is the main hormone in the proliferative phase?

Answer 5

oestrogen

Question 6

What is the main hormone in the secretory phase?

Answer 6

progesterone

Question 7

What is decidualisation?

Answer 7

changes that happen to endometrial cells to prepare for pregnancy

Question 8

What hormone is involved in decidualisation?

Answer 8

hCG

Question 9

What is ppost-menopausal bleeding?

Answer 9

abnormal uterine bleeding >1 year after cessation of menstruation

Question 10

What are the causes of abnormal uterine bleeding in early repro life?

Answer 10

DUB usually due to anovulatory cycles; pregnnacy/miscarriage; endometritis; bleeding disorders

Question 11

What are the causes of AUB in reproductive life/perimenopause?

Answer 11

pregnancy/miscarriage;DUB-anovulatory cycles; luteal phase defects; endometritis; polyps; leiomyom; adenomyosis; exogenous hormone effects; hyperplasia

Question 12

What are the causes of AUB post-menopause?

Answer 12

atrophy; endometrial polyp; exogenous hormones (HRT; tomaxifen); endometritis; bleeding disorders’ endometrial carcinoma

Question 13

What is the indication for endometrial biopsy in postmenopausal women?

Answer 13

endometrial thickenss >4mm

Question 14

What is the indication for endometrial biopsy in premenopausal women?

Answer 14

16mm

Question 15

What are the methods of sampling the endometrium?

Answer 15

endometrial pipelle; dilatation and curretage

Question 16

When is the least informative time for endometrial biopsy?

Answer 16

menstrual phase

Question 17

What is dysfunctional uterine bleeding?

Answer 17

irregular uterine bleeding that reflects a disruption in the normal cyclic pattern of ovulatory hormonal stimulation to the endometrial lining- no organic cause

Question 18

What is luteal phase deficiency?

Answer 18

insufficent progesterone or poor response by endometrium to progesterone. abnormal follicular development (inadeuqate FHS/LH)- poor corpus luteum

Question 19

What is the most common cause of DUB?

Answer 19

anovulatory cycles

Question 20

What happens in anovulatory cycles?

Answer 20

corpus luteum does not form; continued growth of functionalis layer

Question 21

What are the endometrial causes of AUB?

Answer 21

endometritis; polyp; miscarriage

Question 22

What are the myometrial causes of AUB??

Answer 22

adenomyosis; leiomyoma

Question 23

What is the appearnace of endometritis histolofically?

Answer 23

abnormal pattern of inflammatory cells

Question 24

What are the common microbes implicated in endometritis?

Answer 24

neisseria; chlamydia; TB; CMV; actinomyces; HSV

Question 25

What ar ethe causes of endometritis without specific organisms?

Answer 25

intrauterine contraceptive device; postpartum; postabortal; postcurretage; chronic endometritis; granulomatous; polyps or leiomyoma

Question 26

What is chronic plasmacytic endometritis?

Answer 26

infectious unless proved otherwise; associated iwth PID

Question 27

When do endometrial polyps tend to occur?

Answer 27

around and after the menopause

Question 28

What ar ethe symtpoms of endometrial polyps?

Answer 28

asymotomatic but may present with bleding or discharge

Question 29

What is the risk with endometrial polyps?

Answer 29

endometrial carcinoma can present as a polyp, almost always benign though

Question 30

What is molar pregnancy?

Answer 30

abnormal form of pregnancy in which a non-viable fertilised egg implants in the uterus or tubes

Question 31

What is molar pregnancy a form of?

Answer 31

gestational trophoblastic disease

Question 32

What is a complete mole caused by?

Answer 32

1 or 2 sperm combining wit han egg which has lost its DNA, only paternal DNA

Question 33

What is a partial mole?

Answer 33

egg is fertilised by 1 or 2 sperm which reduplicates itself yielding 69 XXY (triploid)

Question 34

What is the risk of choriocarcinoma with complete and partial moles?

Answer 34

complete hydatiform moles have higher risk

Question 35

What is adenomyosis?

Answer 35

endometrial glands and stroma within the myometrium

Question 36

How does adenomyosis present?

Answer 36

menorrhagia/dysmenorrhea

Question 37

What are the symptoms with leiomyoma?

Answer 37

menorrhagia; infertility, mass effect; pain

Question 38

What does growth of leiomyoma depend on?

Answer 38

oestogen