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35 Cards in this Set
- Front
- Back
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What are the different broad classes of uterine tumors?
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Epithelial
Mesenchymal MIxed |
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What are the different pathologic growths from uterine epithelia?
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Hyperplasia
Adenocarcinoma |
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What are the different pathologic growths from uterine mesenchyma?
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Smooth muscle
Endometrial stromal |
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What are the different kinds of "mixed" uterine pathology?
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Benign: polyps
Malignant: carcinosarcoma |
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What stimulates proliferation of endometrial glands?
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Estrogen
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What phase of the menstrual cycle has the most variability?
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Proliferative phase
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What is the appearance of a healty proliferative endometrium?
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Well-spaced glands
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What hormone regulates the secretory phase?
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Progesterone.
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What does the corpus luteum transform into when it involutes?
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Corpus albicans
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What is the effect of pregnancy on the corpus luteum?
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Maintains it!
Progesterone secretion continues. |
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What are the effects of estrogen on the endometrium?
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Prolifferation of glands, stroma, and spinal arteries
Induction of progesterone receptors |
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What's the effect of progesterone on the endometrium?
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Glandular secretion
Stromal decidualization |
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If there is bleeding in a post menopausal woman, what do you think?
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MALIGNANCY.
Until proven otherwise. |
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What is the classfiication system for abnormal uterine bleeding?
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PALM COEIN
PALM: structural abnormalities COEIN: structurally normal uterus |
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What are the members of the PALM group?
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Polyps
Adenomyosis Leiomyomas Mlignancy |
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What's the appearance of a uterine polyp?
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Cystic hyperplasia
Dilated glands Loose stroma |
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What is the process that occurs in adenomyosis?
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Symmetric enlargement of the uterus without mass
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What are the symptoms of adenomyosis?
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Nonspecific:
Bleeding abnormalities Pressure |
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What is a key histologic feature of endometrial hyperplasia?
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Glands are SUPER CLOSE.
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What is the effect of chornic estrogen excess?
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Benign endometrial hyperplasia due to:
Remodeling Thrombi Variable density |
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What is the finding when benign endometrial hyperplasia changes to something more worrisome?
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THe glandular architecture begins to get all messed up.
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How do you differentiate atypical hyperplasia and carcinoma?
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Confluence of glands:
It's a rather subjective finding. :( |
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What are the different types of endometrial hyperplasia?
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Hyperplasia WITHOUT cytologic atypia (simple, complex)
Atypical hyperplasia (simple, complex) |
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What are the properties of simple hyperplasia?
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Not as much branching
Glands are more well formed Diffuse |
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What are cancer rates from atypical hyperplasia? Non-atypical?
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Atypical: 23%
Non-atypical: 2% |
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What are some features on an endometrial biopsy that make you think: CANCER!
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True desmoplasia
Confluence of epithelium Papillary growth |
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What's the management of atypical hyperplasia and adenocarcinoma?
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Histerectomy
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What are leiomyomas?
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Smooth muscle overgrowth of the uterus.
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What's teh gross appearance of a leiomyoma?
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White circles!
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What's the clinical presentation of leiomyoma uteria?
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Slowly enlarge until menopause, then regress
SLOW. |
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What is responsible for the growth of leiomyomas?
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Estrogen!
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What's the treatment of leiomyomas?
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Anti-estrogen
Myomectomy |
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What's the clinical presentation of a leiomyosarcoma?
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Post-menopausal RAPIDLY ENLARGING UTERUS
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What's the gross appearance of a leiomyosarcoma?
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Solitary mass
Hemorrhage with areas of necrosis |
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What's the prognosis for a leiomyosarcoma?
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POOR.
50% survival in Stage I-II. |
