9 - Gynae - Endometriosis + Chronic Pelvic Pain - Endometriosis Flashcards Preview

CP2 > 9 - Gynae - Endometriosis + Chronic Pelvic Pain - Endometriosis > Flashcards

Flashcards in 9 - Gynae - Endometriosis + Chronic Pelvic Pain - Endometriosis Deck (9):
1

what age range esp?
What is it?
Most common in who?

30-45
presence and growth of endometrium like tissue outside the uterus
nulliparous women

2

Pathology - dependent on?
-regresses when? (2 times)
-can occur throughout pelvis but esp where? (2 places)
-accumulated altered blood - colour? can form what? where?
-endometriosis causes ? with progressive fibrosis and ?
-in most severe cases pelvis is ? (organs ?) by adhesions

oestrogen
preg and post meno
on/behind ovaries, uterosacral ligs
dark brown
chocolate cyst / endometrioma
ovaries
inflam
adhesions
frozen - immobile

3

Aetiology - probably due to ?menstruation (in pelvis)
-this is common and not always ass w endometriosis
-distant foci may be from what 3 types of spread?
-some ? link

retrograde
mechanic, blood, lymph
genetic

4

Hx points - often ?
-important cause of ? ? pain
-usual pattern?
-PCs include...? before onset of period, ? dyspareunia, ?, pain on ? ? during menses, occasionally ? problems
-what causes acute pain and could be first Sx?
-what three Sx are uncommon but suggest severe disease?

aSx
chronic pelvic pain
cyclical
dysmenorrhea
deep
subfertility
passing stool
menstrual
rupture of a endometrioma
rectal bleeding, cyclical haematuria, umbilical bleeding

5

DDx of endometriosis - 5 things

IBS
Adenomyosis
other causes of pelvic masses
chronic PID
CPP

6

Ex points - if mild, the pelvis may feel ?
-2 common findings on VE?
-advanced cases - uterus is ? and ? from adhesions, and a ? nodule of endometriosis may be found on ??/visible on ? Ex

normal
tenderness, thickening behind uterus/adnexa
immobile and retroverted
rectovaginal
digital exam
speculum

7

Ix - sometimes ? is raised
- name 3 Ixs and what can be added to them?

-CA125
-Laparoscopy +/- biopsy
-TVUSS
-MRI +/- IV pyelogram and barium studies

8

Ix - Laparoscopy
-diagnosis only made after ? +/- ?
-active lesions are ? resicles or ? marks on peritoneum
-what shows less active disease?
-what shows severe disease?

visualisation +/- biopsy
red
punctate
white scars/brown spots
extensive adhesions and ovarian endometriomas

9

Ix - TVUSS - useful for diagnosing what? may also show what ?
-peritoneal endometriosis not seen on USS but may be on ?
- what warrants assessment w MRI +/- IV pyelogram and barium studies?

ovarian endometrioma
adenomyosis
MRI
evidence of deeply infiltrating endometriosis, ureteric, bladder and bowel involvement

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