Pathology

Question 1

The menstrual cycle can be divided into 2 subtypes?

Answer 1

• ovarian cycle (describes changes to the ovaries)

- uterine cycle (describes changes to the uterus)

Question 2

What are the stages of the ovarian cycle?

Answer 2

• follicular phase
• ovulation phase
• luteal phase

Question 3

Explain the follicular phase?

Answer 3

• primordial follicles mature

- granulosa cells proliferate -> oestrogen and progesteerone

Question 4

If no fertilisation occurs what happens to the corpus luteum?

Answer 4

• becomes the corpus albicans

Question 5

How long does the luteal phase last?

Answer 5

• 14 days

Question 6

What are the stages of the uterine cycle?

Answer 6

• menstrual phase
• proliferative phase
• secretory phase

Question 7

Explain the proliferative phase

Answer 7

• occurs in the uterine cycle
• thickening of the stratum functionalis
• influence under oestrogen

Question 8

Explain the secretory phase?

Answer 8

• driven via progesterone

- glands become more torturous

Question 9

Indications for endometrial biopsy?

Answer 9

• abnormal uterine bleeding
• infertility
• spontaneous and therapeutic abortion
• assessment of response to hormone therapy
• high risk endometrial cancer screening

Question 10

Define menorrhagia?

Answer 10

• prolonged and increased menstrual flow

Question 11

Define metrorrhagia?

Answer 11

• regular intermenstrual bleeding

Question 12

Define polymenorrhoea?

Answer 12

• menses occurring at <21 days

Question 13

Causes of abnormal uterine bleeding (AUB)

Answer 13

• Pregnancy
• miscariage
• anovulatory cycles
• endometrosis
• leiomyoma
• exogenous hormones
• neoplasia

Question 14

Define dysmenorrhoea?

Answer 14

• painful periods

Question 15

How might the endometrium be assessed

Answer 15

• transvaginal USS
• hysteroscopy
• endometrial pipette biopsy
• dilation and curettage

Question 16

Explain disorganised uterine bleeding (DUB)

Answer 16

• Irregular uterine bleeding
• no organic cause
• can be ovulatory or anovualtory

Question 17

Inflammation of the endometrium is called?

Answer 17

• endometritis

Question 18

Potential causes of endometritis?

Answer 18

• neisseria
• chlamydia
• TB
• Intrauterine contraceptive device
• postpartum
• granulomatous

Question 19

Explain molar pregnancy?

Answer 19

• abnormal proliferation of trophoblasts
• non-viable fertilised egg implants
• partial (69 chromosomes)
• complete (46 chromosomes)

Question 20

Explain a partial molar pregnancy?

Answer 20

• both maternal and parental chromosomes

- too many pairs - 69

Question 21

Explain a complete molar pregnancy?

Answer 21

• No maternal DNA

- 2x parternal (46 chromosomes)

Question 22

How will molar pregnancies appear on histology?

Answer 22

• swollen choronic villus

- extremely high HCG

Question 23

Structural causes of AUB

Answer 23

• PALM
• Polyp
• adenomyosis
• leiomyoma
• malignancy

Question 24

Non-structural causes of AUB?

Answer 24

• COEIN
• Coagulopathy
• ovulatory dysfunction
• endometrial
• iatrogenic

Question 25

What is adenomyosis

Answer 25

- endometrial glands and stoma within the myometrium

Question 26

Symptoms of adenomyosis?

Answer 26

- menorrhagia - dysmenorrhoea - AUB

Question 27

What is leiomyoma?

Answer 27

- benign smooth muscle tumour - aka. fibroids - growth oestrogen dependent?

Question 28

leiomyosarcoma may develop from what?

Answer 28

- leiomyoma