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Femenine repro-pathology

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drnieves's version from 2017-06-14 14:50

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Partial moleBening, trophoblasts focally hyperplastic; villi focally enlarged hydropic; Fetal tissue triploid
Complete moleBenign, trophoblasts diffusely hyperplastic; villi diffusely enlarged, hydropic.
Invasive molemalignant, trophoblasts diffusely hyper plastic with myometrial invasion; villi diffusely enlarged, hydropic.
ChoriocarcinomaMalignant; trophoblasts diffusely enaplastic/ necrotic with vascular invasion. NO VILLI
PolypWell circumscribed collection of endometrial tissue within uterine wall. SM
Leiomyoma (fibroid)MC benign tumor. Estrogen sensitive. Present with miscarriages or abnormal bleeding (anaemia).
Subserosal leiomyomairregular enlargement of uterus. If posterior can cause constipation.
Leiomyomawhorled pattern of sm bundles with well demarcated border.
AdenomyosisExtension of endometrial tissue into myometrium. Due to hyperplasia of basal layer.
Dysmenorrhea, menorrhagia, uniformely enlarged, soft, globular uterusAdenomyosis sx
Adenomysis txGnRH agonists, hysterectomy.
EndometriosisNon neoplastic endometrial glands/stroma outside endometrial cavity. MC site are ovaries, pelvis, peritoneum.
Endometriosisappears as endometrioma (blood filled chocolate cyst). Due to retrograde flow, metaplastic transformation of multipotent cells, transportation of endometrial tissue via lymphatics.
Cyclic pelvi pain, bleeding, dysmenorrhea, dysparurinea, dyschezia, infertility. Normal size uterusendometriosis sx
Endometriosis txNSAIDs, OCPs, progestins, GnRH agonists, donazol, laparoscopy
EndometritisInflammation of endometrium.
Retained products of conception after delivery, miscarriage, abortion, or foreign bodyendometritis
Endometritis txgentamycin + clindamycin +/- ampicillin
Endometrial hyperplasiaAbnormal endometrial gland proliferation due to excess estrogen.
Have increased risk of endometrial carcinomaendometrial hyperplasia.
Endometrial hyperplasia sxpostmenopausal bleeding.
Risk factor for endometrial hyperplasiaanovulatory cycles, HRT, POS, granulosa cell tumor.
Endometrial carcinomaMC gynecologic malignancy. 55-65 yrs. Vaginal bleeding.
Endometrial carcinoma risk factorsprolonged estrogens without progestins, obesity, diabetes, HTN, nulliparity, late menopause, Lynch syndrome.
Ashuman syndromeobstruction from scarring of uterine cavity. 2ry amenorrhea.
Anovulatory cycle causesPregnancy, POS, obesity, HPO axis abnormalities, premature ovarian failure, hyperprolactinemia, thyroid disorders, eating disorders, competitive athletics, Cuching's, adrenal insufficiency.
Pudendal nProvides motor and sensory innervation to the perianal region. Originates in S2-S4. Sensory branches innervate the external genitalia and skin around anus and perineum. Motor branches innervate pelvic floor muscles, external urethral and anal sphincters.
Stretch injuryPudendal n injury due its curved course around ischial spine. May result in denervation and weakness of the voluntary perineal musculature= fecal/urinary incontinence, perineal pain, and sexual dysfunction.
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