Path 5 Ex4

Front 1

-Acute endometritis: most commonly associated with

Back 1

with prior delivery or miscarriage

Front 2

Non-specific chronic or acute endometritis may be associated with

Back 2

Chlamydia

Front 3

bleeding at inappropriate time in menstrual cycle

Back 3

Metrorrhagia

Front 4

dysfunctional uterine bleeding

Back 4

abnormal bleeding without definable organic cause; usually due to anovulatory cycles, which lead to estrogen stimulation unopposed by progesterone-continued proliferative activity of the glands which may become irregular (“disordered proliferative endometrium”)

Front 5

Causes of AUB may vary with age
Prepuberty:
Adolescence:
Reproductive age:
Perimenopausal:
Postmenopausal

Back 5

Prepuberty: Precocious puberty of hypothalamic, pituitary, or ovarian origin
Adolescence: Anovulatory cycle, coagulation disorders
Reproductive age:Complications of pregnancy (always think of this first!), organic lesion,DUB
Perimenopausal:DUB, organic lesion
Postmenopausal:Atrophy, organic lesion

Front 6

Endometrial polyps are

Back 6

Fibromuscular stroma,thick-walled blood vessels, glands which may be irregular in distribution and/or configuration

Front 7

Endometrial polyps are unresposive to

Back 7

estrogen but not progesterone; may be seen in tamoxifen-treated patients (weak estrogenic effect on endometrium)
Chromosome 6p21 rearrangements may be seen, in common with benign mesenchymal tumors
--Not premalignant, but adenocarcinoma may arise within them

Front 8

Endometrial tissue present in the myometrium of the uterine wall; downgrowth of the endometrium
--“Globular” uterus

Back 8

Adenomyosis

Front 9

Chronic endometritis are characterized by

Back 9

lymphocytes and plasma cells, the plasma cells are neccesary for the diagnosis of chronic endometritis given that lymphocytes are normally found in the endometrium

Front 10

What causes chronic endometritis?

Back 10

retained products of concepcion, chronic pelvic inflammatory disease, IUD, TB. Presents as abnormal bleeding and infertility

Front 11

Whats the anovulatory cycle?

Back 11

Lack of ovulation that results in an estrogen driven proliferative phase without a subsequent progesterone driven secretory phase

Front 12

What is endometriosis and how does it present?

Back 12

Endometrial glands and stroma outside of the uterine endometrial lining most likely due to retrograde menstruation with menstruation at an ectopic site
Presents with pain during menstruation and pelvic pain; may cause infertility

Front 13

Endometriosis most typically affects the ovary, however when the myometrium is involved it is called

Back 13

adenomyosis

Front 14

Endometriosis increases the risk of carcinoma especially when it affects the

Back 14

the ovary

Front 15

Endometrial hyperplasia occurs as consequence of

Back 15

unopposed estrogen due to obesity. polycistic ovary syndrome and estrogen replacement. And it is classified histologically based on architectural growth pattern (simplex or complex) and presence or absence of cellular atypia

Front 16

Endometrial hyperplasia presents as

Back 16

postmenopausal uterine bleeding

Front 17

The major complication in endometrial hyperplasia leading to carcinoma progression is

Back 17

presence of simple hyperplasia with atypia

Front 18

What is the most common invasive carcinoma of the female genital tract

Back 18

Endometrial carcinoma

Front 19

Endometrial carcinoma presents in 2 types, hyperplasia or type 1 and sporadic or type 2. At what ages do each present?

Back 19

type 1: avg age is 60
Type 2: avg age is 70

Front 20

The risk factors involved in type 1 endometrial hyperplasia are

Back 20

with obesity, hypertension, diabetes, unopposed estrogen. Usually it is low grade and indolent

Front 21

What are the characteristic of type 2 endometrial carcinoma?

Back 21

It is serous and is characterized by papillary structures with psammoma body formation and p53 mutation is common. This are aggresive tumors

Front 22

what is a malignant mixed mullerian tumor?

Back 22

poorly-differentiated carcinoma with sarcomatous differentiation which may be homologous (like tissue normally found in the uterus) or heterologous (like tissue not found in the uterus-skeletal muscle, cartilage, bone)

Front 23

where does MMMT arise?

Back 23

in the setting of endometrial atrophy with Endometrial Intraepithelial Carcinoma-malignant-appearing cells in pre-existing epithelium
-p53 mutation is early event in carcinogenesis
-Usually high stage at presentation, aggressive

Front 24

most common tumor in women

Back 24

Leiomyoma (benign)=”fibroids arising from myometrium usually asymptomatic that presents in premenopausal women and during pregnancy gets enlarged and shrinks after menopause

Front 25

What would gross exam on a women with Leiomyoma show?

Back 25

well defined, white whorled mass that may distort the uterus and impinge on pelvic structures

Front 26

what is a Leiomyosarcoma

Back 26

it's a malignant smooth muscle arising from the myometrium and arises de novo and do not arise from leiomyomas.

Front 27

Who gets Leiomyosarcoma and what would gross exam reveal?

Back 27

Post menopausal women. Single lesion with areas of necrosis and hemorrhage.

Front 28

Tumors of spindle-shaped smooth muscle cells with some features of malignancy but which do not meet diagnostic criteria for malignancy

Back 28

Smooth muscle tumors of uncertain malignant potential (STUMP)

Front 29

-well-circumscribed nodule of endometrial stromal cells; benign

Back 29

Endometrial stromal nodule

Front 30

infiltrating neoplasm of endometrial stromal cells; low grade malignancy

Back 30

-Endometrial stromal sarcoma