Uterine Pathology I

Question 1

internal and external os

Answer 1

opening of cervix

• to uterus- internal
• to vagina - external

Question 2

layers of uterus

Answer 2

myometrium
basalis
functionalis - this shed at menses

has glands and stroma - make up mucosa layer

Question 3

day 1 of menstrual cycle

Answer 3

1st day of menses

Question 4

phases of menstrual cycle

Answer 4

follicular - day 1 to day before LH surge

luteal - day of LH surge to onset of menses

Question 5

length of menstrual cycle

Answer 5

14-21 days in follicular
14 days luteal

little variability age 20-40
significant variability first 5-7 years and last 10 years of menstruation

Question 6

proliferative phase

Answer 6

estrogen

Question 7

secretory phase

Answer 7

progesterone

Question 8

POD2-3

Answer 8

ovulation

-subnuclear vacuoles

Question 9

POD9

Answer 9

mid-secretory phase

-periarteriolar decidual change

Question 10

POD12

Answer 10

late-secretory phase

-predecidua, inflammatory cells

Question 11

menometrorrhagia

Answer 11

irregular menses

Question 12

metrorrhagia

Answer 12

excessive flow and duration at irregular intervals

Question 13

menorrhagia

Answer 13

excessive bleeding - normal intervals

Question 14

withdrawal bleeding

Answer 14

bleeding follows withdrawal of hormones

Question 15

oligomenorrhea

Answer 15

intervals greater than 35 days

Question 16

polymenorrhea

Answer 16

intervals less than 24 days

Question 17

dysfunctional uterine bleeding

Answer 17

dx of exclusion

-unschedule bleeding, presumed to be consequence of hormonal/functional abnormality

Question 18

subnuclea vacuolizations

Answer 18

early secretory phase

Question 19

abnormal uterine bleeding in perimenopause and menopause women

Answer 19

if have lesion - need biopsy

-carcinoma, hyperplasia, polyps

Question 20

most common cause of anovulatory cycle in repro age

Answer 20

unopposed estrogen

Question 21

anovulatory cycle

Answer 21

prolonged and unopposed estrogen stimulation

endometrium unstable with breakdown

Question 22

inadequate luteal phase

Answer 22

abnormal corpus luteum
-low progesterone

infertility

bx - histo date is >2 days behind clinical date of menstrual cycle**

Question 23

bx - histo date is >2 days behind clinical date of menstrual cycle**

Answer 23

inadequate luteal phase

Question 24

neutrophils in endometrium

Answer 24

acute endometritis

infections that areise after delivery or miscarriage

vaginal bacteria

strep group A and staph - polymicro

tx - broad spectrum antibiotics

Question 25

plasma cells in endometrium

Answer 25

chronic endometritis

Question 26

chronic endometritis

Answer 26

chronic PID retained products of conception IUD TB

Question 27

presence of endometrium tissue outside endometrium

Answer 27

endometriosis

Question 28

presences of endometrium tissue inside myometrium

Answer 28

adenomyosis forms discrete mass - adenomyoma

Question 29

locations of endometriosis

Answer 29

``` ovary uterine ligament rectovaginal septum cul de sac pelvic peritoneum bowel genitalia bladder mucosa ```

Question 30

cyclic pelvic pain

Answer 30

endometriosis

Question 31

infertility

Answer 31

40% of endometriosis fallopian tubes or ovary

Question 32

metastatic theory

Answer 32

endometriosis from implantation of menstrual tissue

Question 33

metaplastic theory

Answer 33

endometriosis arises from mesothelium - bc mullerian origin

Question 34

extrauterine stem cell theory

Answer 34

endometriosis from bone marrow cells that differentiate to endometrial tissue

Question 35

endometriosis

Answer 35

see glands and stroma** cyclic pain pattern COX-2 inhibitors - control inflammation

Question 36

endometriosis tissue

Answer 36

cycles with menstrual cycle - including bleeding

Question 37

risks with endometriosis

Answer 37

2x increase in ovarian cancer of endometroid and clear cell types

Question 38

PTEN and ARID1A mutations

Answer 38

endometroid and clear cell ovarian cancer

Question 39

chocolate cyst

Answer 39

endometrioma endometriosis tissue in ovary - fills with lbood

Question 40

powder burn

Answer 40

endometriosis of cervix

Question 41

endometrial polyps

Answer 41

benign - but may contain neoplastic foci tx - surgery present with bleeding

Question 42

increased gland to stroma ratio

Answer 42

endometrial hyperplasia proliferation of endometrial glands relative to stroma

Question 43

endometrial hyperplasia

Answer 43

obesity, menopause, PCOS (stein leventhal syndrome), granulosa cell tumor of ovary, prolonged estrogen therapy relationship to endometrial carcinoma

Question 44

obese women

Answer 44

prolonged estrogen stimulation | -endometrial hyperplasia

Question 45

stein-leventhal syndrome

Answer 45

PCOS

Question 46

EIN

Answer 46

endometrial intraepithelial neoplasia - atypia tx - hysterectomy increased estrogen**

Question 47

PTEN

Answer 47

inactivation of this tumor suppressor gene -endometrial hyperplasia chromosome 10q23.3

Question 48

cowden syndrome

Answer 48

mutation of PTEN | -high incidence of endometrial cancer

Question 49

warburg effect

Answer 49

increased glucose uptake by tumor cells

Question 50

loss of PTEN

Answer 50

activation of PI3K-AKT | -promoting cell growth

Question 51

atypia

Answer 51

EIN