Benign Conditions of Uterus, Cervix, Ovary, Tubes - Moulton Flashcards
Most common cause for hysterectomy
Symptomatic fibroids
Risk factors for fibroids
- Older in reproductive years
- AA
- Nulliparity
- FHx
Symptoms of uterine fibroids
- ***Bleeding (prolonged/heavy)
- Pelvic pressure
- Pelvic pain
- Infertility/abortions (submucosal especially)
- Urinary frequency
Bleeding from leiomyoma…most common location?
Submucosal
Treating leiomyoma (3)
Combo OCP
Progesterone (Depo, Mirena)
Depo-Lupron (GnRH)
On cervical exam, opaque bump w/ a yellow or blue hue adjacent to the Os. Dx?
How does it form?
Nabothian cyst (NORMAL)
Squamous metaplasia entraps columnar cells (and thus mucus retention) underneath
On cervical exam, beefy red mass protruding from cervical Os. No symptoms. Dx?
Endocervical polyp
Endometrial biopsy result shows complex hyperplasia with atypia. Consider what? Why?
Hysterectomy - higher likelihood of cancer
***Definition of endometrial hyperplasia on ultrasound
Must do what?
> 4 mm in postmenopausal woman
Biopsy it
Hyperplasia without atypia…treatment?
With atypia…treatment?
Progestin (maybe an IUD), check in 3 months
Hysterectomy
Types of functional ovarian cysts (define each)
- Follicular (lined by granulosa - follicle doesn’t rupture)
- Lutein (doesn’t regress)
- Hemorrhagic (hemorrhage of corpus luteum at ovulation)
- Polycystic (PCOS)
Bilateral, large cysts, recently pregnant
Prognosis?
Theca-lutein cysts
Will come down on own
Are most functional ovarian cysts symptomatic? Usually do what?
Potential complication?
NO - usually regress
Can undergo ovarian torsion if large enough
***Most common ovarian neoplasm in ALL women
Pain?
Cystic teratoma (dermoid cyst)
Mild to intermittent, can be bad if torsion occurs or rupture
***When do you order a CA 125?
POST-menopause w/ sign of ovarian mass
