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WH 2 > benign gyn d/o > Flashcards

benign gyn d/o Flashcards

1
Q

3 common presentations of benign pelvic d/o

A

AUB
pelvic pain
infertility

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2
Q

uterine diseases

A

fibroids (“leiomyoma”)
polyps
hyperplasia

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3
Q

ovarian d/o

A

cysts
tubo-ovarian abscess (TOA)
benign neoplasma

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4
Q

OB d/o

A

pregnancy
ectopic
molar pregnancy (gestational trophoblastic neoplasia)

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5
Q

what influences leiomyomas? how?

A

estrogen
its larger with increased estrogen

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6
Q

3 types of leiomyoma

A

intramural
submucosal
subserosal

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7
Q

intramural leiomyoma location

A

myometrium

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8
Q

submucosal leiomyoma location

A

right below endometrium

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9
Q

3 signs of leiomyomas

A

irregularly enlarged uterus
asymmetric uterus
firm uterus

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10
Q

which disorder can have stress urinary incontinence as a symptom?

A

leiomyoma (usually asymptomatic tho)

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11
Q

treatment for leiomyoma

A

hysterectomy
myomectomy
OCP
GnRH analogs
embolization

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12
Q

what is a polyp

A

any mass of tissue projecting outward from surrounding tissue

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13
Q

where do most polyps arise?

A

fundus

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14
Q

between fibroids and polyps, which can become malignant

A

polyps (infrequent tho)

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15
Q

which uterine dz has tamoxifen, obesity, lynch or coden syn and postmenopause HRT as RF?

A

polyps

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16
Q

sx of polyps

A

recurring menorrhagia
post-menopausal bleeding

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17
Q

signs of polyps on exam

A

normal uterus with protruding polyp

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18
Q

tx of polpys

A

surgical resection if having sx OR >1.5cm, multiple, fertility concerns, cervical protrusion

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19
Q

tissue origin of fibroids vs polyps

A

fibroids– smooth muscle
polyps— epithelium

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20
Q

which is typically bigger- polyp or fibroids

A

fibroids are bigger

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21
Q

when do you tx fibroids?

A

only if symptomatic

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22
Q

which is more influenced by estrogen– fibroids or polyps?

A

polyps

23
Q

what is hyperplasia

A

proliferation of endometrial glands when theres more glans-stroma ratio than normal

24
Q

what causes hyperplastia

A

chronic unopposed estrogen stimulation

25
Q

simple vs complex hyperplasia

A

simple— glands are dilated w/ occasional outpouch
complex– back to back w/ luminal outpouching and minimal intervening stroma

26
Q

what does “with nuclear atypia” mean?

A

progression to endometrial cancer is 10x higher

27
Q

sx of hyperplasia

A

heavy bleeding or intramenstrual bleeding
post menopausal bleeding

28
Q

signs of hyperplasia on exam

A

anemia

29
Q

how is hyperplasia diagnosed

A

endometrial biopsy
US of endometrial stripe

30
Q

the only time megace is not used to tx hyperplasia

A

if it is premenopause without atypia

31
Q

how do you treat hyperplasia with atypia?

A

premenopause– hysteroscopy w/ D&C–> hysterectomy or megace
postmenopause– hysterectomy, megace

32
Q

how do you tx hyperplasia w/o atypia?

A

premenopause— medroxyprogesterone or IUD
postmenopause— treat unopposed estrogen, megace

33
Q

when do ovarian cysts typically develop?

A

during menstrual years

34
Q

what is a functional-follicle cyst?

A

happens bc fluid doesn’t get reabsorbed in not fully developed follicle

35
Q

sx of functional-follicle ovarian cyst

A

typically asymptomatic
can alter cycle, cause pelvic pressure and pain

36
Q

what does functional-follicle ovarian cyst look like on US?

A

smooth, thin walled unilocular mass
disappears spontaneously but OCP can reduce it

37
Q

what are the two types of functional lutein ovarian cysts?

A

corpus luteum cysts
theca lutein cysts

38
Q

difference between corpus luteum and theca lutein cysts

A

corpus may cause torsion, may cause internal bleeding if it ruptures
theca is usually bilateral and has straw colored fluid

39
Q

3 types of fallopian tube diseases

A

congenital
infectious
functional

40
Q

what is congenital fallopian tube dz

A

absence of tubes

41
Q

what is infectious fallopian tube dz

A

any STD that can cause adhesions

42
Q

what is functional fallopian tube dz

A

scarring from gyn procedure
ectopic or normal pregancny

43
Q

sx of fallopian tube d/o

A

infertility
there are no signs seen in PE

44
Q

how is fallopian tube d/o treated?

A

depends on cause– could reanastomose tube w/ surgery

45
Q

where does gestational trophoblastic neoplasia arise?

A

fetal tissue

46
Q

3 types of gestational trophoblastic neoplasia

A

hydatidiform mole
invasive mole
choriocarcinoma

47
Q

what is the most common type of gestational trophoblastic neoplasia

A

hyatidiform mole

48
Q

what does hyatidiform mole look like?

A

grape like vesicles filling uterus

49
Q

which type of gestational trophoblastic neoplasia may cause distant metastases

A

invasive mole

50
Q

which type of gestational trophoblastic neoplasia follows term pregnancy or abortion?

A

choriocarcinoma

51
Q

sx of gestational trophoblastic neoplasia?

A

1st trim bleeding
dramatic N/V

52
Q

what are signs of gestational trophoblastic neoplasia?

A

vaginal bleeding
preeclampsia or eclampsia
no fetal heart tones
larger uterus than expected

53
Q

how is gestational trophoplastic neoplasia diagnosed?

A

US– multiple echoes
quantitative beta-HCG serum >100k (molar?)
thyroid studies

WH 2 (8 decks)

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