B8-082 Benign Uterine Disorders

Question 1

differential of AUB in postmenopausal females [3]

Answer 1

endometrial cancer
atrophic vaginitis
vaginal/cervical tumor

Question 2

structural causes of AUB in females of reproductive age

Answer 2

Polyp
Adenomyosis
Leiomyoma
Malignancy

PALM

Question 3

non-structural causes of AUB in females of reproductive age [5]

Answer 3

Coagulopathy (VWD)
Ovulatory disorder
Endometrial
Iatrogenic
Not otherwise classified

COEIN

Question 4

benign collection of endometrial tissue in the uterine wall that extend into the uterine cavity

Answer 4

endometrial polyps

Question 5

endometrial polyps grow in response to […]

Answer 5

estrogen

Question 6

tamoxifen is a risk factor for the development of

Answer 6

endometrial polyps

(polyps should be removed to prevent malignancy)

Question 7

evaluation of endometrial polyps should include [3]

Answer 7

TVUS
hysteroscopy
biopsy to confirm benign

Question 8

treatment of endometrial polyps [3]

Answer 8

surgical removal
progestins
temporary GnRH analogs

Question 9

endometrial polyp removal is always recommended for what patient population?

Answer 9

postmenopausal females

(highest risk of malignancy)

Question 10

in premenopausal females, endometrial polyps greater than […] cm should be removed due to increased risk of malignancy

Answer 10

1.5

Question 11

first-line imaging study for evaluation of AUB

Answer 11

TVUS

Question 12

firm, mobile uterus that is nontender and enlarged with discrete nodules

Answer 12

leiomyoma

(may present with pelvic pain due to pressure of size of fibroid)

Question 13

benign uterine tumor presenting with multiple, discrete tumors

Answer 13

uterine leiomyoma

Question 14

prevalence of leiomyoma is higher in what patient populations?

Answer 14

african americans

Question 15

sensitive to estrogen/progesterone levels
increased symptoms during pregnancy

Answer 15

leiomyoma

Question 16

in a patient presenting with symptoms of leiomyoma, make sure to get what lab?

Answer 16

bHCG

Question 17

treatment for asymptomatic leiomyoma

Answer 17

observation

(will shrink postpartum/menopause)

Question 18

most frequently mutated gene in muliple leiomyomas

Answer 18

MED12

(mediator of RNA pol. II transcription)

Question 19

gene associated with large, singular leiomyomas

Answer 19

HMGA2

Question 20

enlarged, tender, boggy uterus

Answer 20

adenomyosis

Question 21

“venetian blinds” appearance on TVUS

Answer 21

adenomyosis

Question 22

[adenomyosis vs leiomyoma]

indistinct borders

Answer 22

adenomyosis

Question 23

[adenomyosis vs leiomyoma]

distinct, round borders

Answer 23

leiomyoma

Question 24

[adenomyosis vs leiomyoma]

thin, parallel, vertical shadowing on TVUS
“venetian blinds”

Answer 24

adenomyosis

Question 25

[adenomyosis vs leiomyoma] dense with edge shadowing on TVUS

Answer 25

leiomyoma

Question 26

[adenomyosis vs leiomyoma] tiny cysts/cystic striations

Answer 26

adenomyosis

Question 27

[adenomyosis vs leiomyoma] solid cyst

Answer 27

leiomyoma

Question 28

[adenomyosis vs leiomyoma] increased vascularity with penetrating vessels

Answer 28

adenomyosis

Question 29

[adenomyosis vs leiomyoma] can be submucosal, intramural, or subserosal

Answer 29

leiomyoma

Question 30

[adenomyosis vs leiomyoma] contiguous or centrally located in myometrium

Answer 30

adenomyosis

Question 31

diffusely enlarged uterus with some cystic areas within myometrium

Answer 31

adenomyosis

Question 32

initial test to order in patient with enlarged uterus

Answer 32

bHCG

Question 33

most effective treatment for patients with adenomyosis

Answer 33

levonorgestrel releasing IUD | mirena

Question 34

treatment of adenomyosis when fertility is not a consideration

Answer 34

hysterectomy (cannot "cut out" adenomyosis like you can fibroids)

Question 35

risk factors for adenomyosis

Answer 35

multiparous c-section endometrial curettage/evacuation (inside out theory mediated via TIAR pathway)

Question 36

treatment for symptom resolution of leiomyoma

Answer 36

oral contraceptives

Question 37

myomectomy is a viable treatment option for [adenomyosis/leiomyoma]

Answer 37

leiomyoma

Question 38

develops outside the uterus, and is therefore not associated with uterine bleeding

Answer 38

endometriosis