Adnexal Path and infertility Flashcards
(60 cards)
1
Q
Endometriosis
A
- ectopic location of functional endo tissue
- attaches to fallopian tubes, ov, colon and bladder
2
Q
Endometriosis clinical findings
A
- asymptomatic
- dysmenorrhea
- pelvic pain
- irrgular menses
- dyspareunia
- infertility
3
Q
endometriosis sono findings
A
- difficult to vis w/ U/S
- obscure organ boundries
- fixation of ov posterior to UT
- endometrioma
4
Q
endometrioma
A
- focal collection of ectopic endo tissue
“chocolate cyst”
5
Q
endometrioma clinical findings
A
- asymptomatic
- metromenorrhagia
- dysmenorrhea
- dyspareunia
- palpable pelvic mass
- infertility
6
Q
endometrioma sono findings
A
- hypo homo adnexal mass
- thick well defined wall margins
- diffuse low level echos w/ or w/o solid components
- avascular mass
- fluid
- mass w/ not regress in size on serial sonogram
7
Q
krukenberg tumor
A
- metastatic lesions
- primary lesion from gastic carcinoma
- other primary structures include large intestine, breast, or appendix
8
Q
krukenberg tumor clinical findings
A
- asymptomatic
- abd pain
- bloating
9
Q
krukenberg tumor sono findings
A
- bilat adnexal or ov mass
- oval or lobulated margins
- hypo areas w/in mass
- posterior enhancement
- ascities
10
Q
paraovarian cyst
A
- mesothelial in origin
- typically located in broad ligaments
- not assoc with hx of PID, surgery or endometriosis
11
Q
paraov cyst clinical findings
A
- asymptomatic
- pelvic pain
- palpable pelvic mass
12
Q
para ov cyst sono findings
A
- round or ovoid anechoic adnexal mass
- separate from ipsilateral ov
- thin smooth wall margins
0 stable size on serial sonograms
13
Q
PID
A
- bacterial infection
- diverticulitis
- appendicities
14
Q
PID clinical findings
A
- abd pain
- fever
- vag discharge
- urinary frequency
15
Q
PID sono findings
A
- normal pelvic appearence
- thick and hypervascular endo
- complex tubular adnexal mass
- ill defined multilocular adnexal mass
16
Q
carcinoma of tubes
A
- dysplasia
- carcinoma in situ
17
Q
carcinoma of tubes clinical findings
A
- pelvic pain
- abnormal bleeding
- pelvic pain
18
Q
carcinoma of tubes sono findings
A
- sausage shaped complex adnexal mass
- papillary projections
19
Q
hydrosalpnix
A
- PID
- endometriosis
- postoperative adhesion
20
Q
hydrosalpnix clinical findings
A
- asymptomatic
- pelvic fullness
- infertility
21
Q
hydrosalpnix sono findings
A
- tuboovarian abscess
- loops of bowel
22
Q
pyosalpnix
A
- bacterial infection
- pus in fallopian tubes
23
Q
pyosalpnix clinical findings
A
- asymptomatic
- low grade fever
- pelvic fullness
24
Q
pyosalpnix sono findings
A
- complex tubular adnexal mass
- wall thickness >5 mm
- irregular margins
- mass attenuates the sound
25
salpingitis
inflammation of tubes
26
salpingitis clinical findings
- pelvic pain
- fever
- dyspareunia
- leukocystosis
27
salpingitis sono findings
- nodular, thick tubular adnexal mass
- complex adn mass
- posterior enhancement
28
tuboovarian abscess
- pelvic infection
| - STD
29
tuboovarian abscess clinical findings
- severe pelvic pain
- fever
- leukocytosis
- nausea/ vomiting
30
tuboovarain abscess sono findings
- complex multilocular adn mass
- ill defined wall margins
- total breakdown or normal adnexal anatomy
31
Infertility is suggested when coneption doesnt occur w/in
1 year
32
infertility is caused by
male or female reproductive abnormalities
33
most common cause of female infertility is
ovulatory disorder
- PCOS
- luteinizing unruptured follicle syndrome
- luteal phase inadequacy
34
Other causes of female infertility
oviduct disease, congenital ut anomalies, endo pathology, cx mucus abnormality, nutritional factors, metablic disorder and synechiae
35
fibroids are responsible for what percent of infertility cases
15
36
Ovarian Induction Therapy
medications are injected to stimulate follicular development
37
Ovarian induction therapy stimulates
pituitary gland to increase secretion of FSH
38
Ovarian Induction Therapy follicular growth is monitored by
periodic US exam
39
Ovarian Induction Therapy estrodial levels are monitored for
timing of intramuscular injection of hCG
40
In Vitro Fertilization
mature ova are aspirated with US guidance
41
In Vitro Fertilization is accumplished in what setting
laboratory
42
In Vitro Fertilization endo is prepared to accept
embryo
43
In Vitro Fertilization embryos are transferred into
endo
44
Gamete Intrafollicular Transfer requires
ovulation stimulation and retrieval of oocyte
45
Gamete Intrafollicular Transfer oocytes are mixed with
sperm and then transferred into tubes
46
Zygote Intrafallopian Transfer
zygote is transferred into fallopian tubes
47
What type of uterus has a high incidence of infertility
septae
48
Endo thickness >8 mm is assoc with a
decrease in infertility
49
Full luteal function is expected with an endo thickness of 11 mm or greater during mid ____ phase
luteal
50
Baseline study before therapy, assess for the presence of an
ov cyst or follicle
51
During induction therapy, monitor the
size and number of follicles per ov
52
count and measure only the follicles greater than
1 cm
53
Optimal follicle size before ovulation is
1.5 - 2 cm
54
Correlate estradiol level with
size and number of follicles
55
Ectopic pregnancy
more common in patients with hx of infertility
56
Mutliple gestations are most common with
IVF 25%
57
Ovarian Hyperstimulation Syndrome is caused by
high hCG levels
58
Ovarian Hyperstimulation Syndrome clinical findings
lower abd or back pain, abd distention, nasuea/ vomiting, hypotension and leg edema
59
Ovarian Hyperstimulation Syndrome multicystic enlargement measures
>5 mm
60
Ovarian Hyperstimulation Syndrome additional sono findings include
ascites and pleural effusion
