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Questions and Answers
What hormonal changes drive the growth of the endometrium during the proliferative phase?
What hormonal changes drive the growth of the endometrium during the proliferative phase?
What condition is characterized by secondary amenorrhea due to loss of the basalis and scarring?
What condition is characterized by secondary amenorrhea due to loss of the basalis and scarring?
What is the primary cause of acute endometritis?
What is the primary cause of acute endometritis?
Which cells are essential for the diagnosis of chronic endometritis?
Which cells are essential for the diagnosis of chronic endometritis?
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What symptom is commonly associated with endometrial polyps?
What symptom is commonly associated with endometrial polyps?
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What is the likely mechanism behind endometriosis?
What is the likely mechanism behind endometriosis?
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Which of the following conditions is characterized by abnormal uterine bleeding and pelvic pain as notable symptoms?
Which of the following conditions is characterized by abnormal uterine bleeding and pelvic pain as notable symptoms?
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What side effect may arise from the use of tamoxifen related to the endometrium?
What side effect may arise from the use of tamoxifen related to the endometrium?
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What is the most common site of involvement in endometriosis?
What is the most common site of involvement in endometriosis?
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Which histological feature is the most significant predictor for the progression of endometrial hyperplasia to carcinoma?
Which histological feature is the most significant predictor for the progression of endometrial hyperplasia to carcinoma?
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In which pathway does endometrial carcinoma arise from endometrial hyperplasia?
In which pathway does endometrial carcinoma arise from endometrial hyperplasia?
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What is the characteristic histological finding in sporadic endometrial carcinoma?
What is the characteristic histological finding in sporadic endometrial carcinoma?
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Which of the following conditions is NOT a risk factor for developing endometrial carcinoma?
Which of the following conditions is NOT a risk factor for developing endometrial carcinoma?
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What type of cyst is commonly associated with ovarian endometriosis?
What type of cyst is commonly associated with ovarian endometriosis?
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What is the average age of presentation for women with endometrial carcinoma arising from the sporadic pathway?
What is the average age of presentation for women with endometrial carcinoma arising from the sporadic pathway?
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Which symptom is most commonly associated with endometrial hyperplasia?
Which symptom is most commonly associated with endometrial hyperplasia?
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Study Notes
Endometrium and Myometrium
- Endometrium: The mucosal lining of the uterine cavity.
- Myometrium: The smooth muscle layer underneath the endometrium.
- Endometrium is hormone-sensitive.
- Estrogen drives growth (proliferative phase).
- Progesterone prepares for implantation (secretory phase).
- Progesterone loss leads to shedding (menstrual phase).
Asherman Syndrome
- Secondary amenorrhea due to basalis loss and scarring.
- Often a consequence of aggressive dilation and curettage (D&C).
Anovulatory Cycle
- Lack of ovulation.
- Results in estrogen-driven proliferation without a subsequent progesterone-driven secretory phase.
- Leads to uterine bleeding due to proliferative gland breakdown and shedding.
Acute Endometritis
- Bacterial infection of the endometrium.
- Often caused by retained products of conception (e.g., after delivery or miscarriage).
- Symptoms include fever, abnormal uterine bleeding, and pelvic pain.
Chronic Endometritis
- Chronic inflammation of the endometrium.
- Characterized by lymphocytes and plasma cells.
- Causes include retained products, chronic pelvic inflammatory disease, IUDs, and tuberculosis.
- Symptoms include abnormal uterine bleeding, pain, and infertility.
Endometrial Polyp
- Hyperplastic protrusion of the endometrium.
- Often presents with abnormal uterine bleeding.
- Tamoxifen can cause endometrial polyps (it has weak pro-estrogenic effects on the endometrium, while being anti-estrogenic on the breast).
Endometriosis
- Endometrial glands and stroma outside the uterine lining.
- Often caused by retrograde menstruation and implantation at ectopic sites.
- Symptoms include dysmenorrhea and pelvic pain, potentially causing infertility.
- Endometriosis behaves like the normal endometrium with its cycle.
- Common sites of involvement include the ovaries (chocolate cysts), uterine ligaments, pelvic pain, pouch of Douglas, bladder wall, bowel serosa, and fallopian tubes.
- Involvement of the uterine myometrium is called adenomyosis.
- Risk of carcinoma may increase at endometriosis sites, particularly in the ovaries.
Endometrial Hyperplasia
- Increase in endometrial glands relative to stroma.
- Often occurs due to unopposed estrogen (e.g., obesity, polycystic ovary syndrome, estrogen replacement).
- Presents with postmenopausal bleeding
- Classified as simple or complex, with or without atypia.
- Atypia is a significant predictor of potential progression to carcinoma.
Endometrial Carcinoma
- Malignant growth of endometrial glands.
- Most common invasive carcinoma of the female genital tract.
- Often presents with postmenopausal bleeding.
- Can develop from hyperplasia or arise sporadically.
- Risk factors include early menarche, late menopause, nulliparity, infertility with anovulatory cycles, and obesity.
- Histology can be endometrioid or serous.
Leiomyoma (Fibroids)
- Benign smooth muscle tumors of the myometrium.
- Often multiple and common in premenopausal women and grow during pregnancy.
- Common symptoms include abnormal uterine bleeding, infertility, and pelvic mass.
Leiomyosarcoma
- Malignant smooth muscle tumors arising from the myometrium (not from leiomyomas).
- Typically found in postmenopausal women.
- Gross examination often reveals a single lesion with necrosis and hemorrhage.
- Histologically characterized by necrosis, mitotic activity, and cellular atypia.
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Description
Test your knowledge on the endometrium and myometrium, including important concepts such as hormonal responses, conditions like Asherman syndrome, and issues related to anovulatory cycles. This quiz covers various aspects of uterine health and related pathologies.
