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Benign GYN Pathology Flashcards

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1
Q

What is uterine didelphys?

A

Failure of Mullerian ducts to fuse, 2 uterine cavities, 2 cervices, 2 vaginal canals

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2
Q

What complications are associated with didelphys?

A

malposition, preterm labor, miscarriage

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3
Q

What is bicornuate uterus? Bicollis vs unicollis?

A

Partial failure of Mullerian duct fusion
Bicollis: 2 uterine cavities, 2 cervices, 1 vaginal canal
Unicollis: 2 uterine cavities, 1 cervix, 1 vaginal canal

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4
Q

What is unicornuate uterus?

A

Half develops: 1 uterine horn, 1 tube, 1 ovary

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5
Q

What is septate uterus?

A

Reabsorption/duplication anomaly: septum creates 2 uterine cavities, 2 cervices within 1 fundus

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6
Q

What is the MC uterine shape abnormality?

A

Septate

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7
Q

What is subseptate uterus?

A

Septum divides endometrial canal but not cervix

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8
Q

What is commonly associated with septate uterus?

A

Infertility

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9
Q

What is aplasia?

A

Failure of uterus to develop from Mullerian duct

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10
Q

What is male pseudohermaphroditism?

A

Gonads are testes but secondary sex characteristics/ext genitalia resemble female

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11
Q

What is female pseudohermaphroditism?

A

Person with ovaries but secondary sex characteristics/ext genitalia resemble male

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12
Q

What is true hermaphroditism?

A

Person born with ovarian and testicular tissue, commonly 1 or both are ovotestis (both tissues)

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13
Q

What is ambiguous genitalia?

A

Intersex, any variation in gonadal sex chromosome chain

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14
Q

What is precocious puberty?

A

Abnormal early development of sexual maturity, usually before 8

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15
Q

What is the sono app of precocious puberty?

A

Adult shaped uterus, ovary volume > 1 cm cubed

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16
Q

What is hydrometra?

A
  • Abnormal fluid collection in uterus
  • MC premenarche
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17
Q

What are causes of hydrometra?

A

Imperforate hymen, congenital vaginal atresia

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18
Q

What is pyometra?

A

Mucinous and infectious fluid collection in uterus

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19
Q

What is hydrometrocolpos?

A

Serous fluid within vagina and uterus

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20
Q

What is hematometrocolpos and what causes it?

A

Menses accumulates within vagina/uterus, caused by cervical obstruction/malignancy/stenosis in older pts

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21
Q

What are clinical symptoms of fluid collections?

A

Pelvic discomfort, painful defecation/urination

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22
Q

What is the MC benign GYN tumor?

A

Leiomyoma

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23
Q

What are characteristics of leiomyomas?

A

Highly degenerative/proliferative, change size, calc formation

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24
Q

What are the four classifications of leiomyomas?

A
  • Intramural: in myometrium
  • Subserosal: in perimetrium
  • Submucosal: adjacent/abutting endo
  • Pedunculated: attached to uterine tissue by stalk
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25
What are clinical symptoms of leiomyoma?
Pain, menorrhagia, enlarged uterus, irregular menses
26
What is sono app of leiomyoma?
- variable echogenicity - shadowing - well defined - solid - doppler, stalk flow
27
What is adenomyosis?
Endo tissue embedded into myometrium
28
What are clinical signs of adenomyosis?
Cramping, dysmenorrhea, enlarged uterus
29
What is the sono app of adenomyosis?
- hypoechoic ut - heterogeneous myometrium - diffusely enlarged - myometrial microcysts - echogenic foci
30
What is endometrial hyperplasia? What should be done if a pt has this?
Abnormal thickening of endo due to high levels of estrogen, biopsy due to risk of atypical precancerous cells
31
What is associated with endo hyperplasia?
Tamoxifen
32
What are symptoms and sono app of endo hyperplasia?
Uterine bleeding, thickened endo w/ or w/o cystic changes
33
What is endometrial polyp and what are the signs?
Overgrowth of endo tissue, abnormal uterine bleeding
34
What is the sono app of endo polyp?
- diffuse/focal endo thickening - possible vascularity - pedunculated - use of sonohysterogram to visualize when distended w/ fluid
35
What are nabothian cysts?
Benign asymptomatic cervical cysts
36
What is the sono app of nabothian cyst?
anechoic, well defined, within cervical os
37
What is endometriosis?
Endometrial tissue located outside of endo/myometrium, benign proliferative disease
38
Who is endometriosis MC in?
White women of higher socioeconomic class who delay children
39
What are the 2 forms of endometriosis?
Diffuse: implants, localized: endometrioma
40
What are the four stages of endometriosis?
1: minimal, few/superficial implants 2: mild: addl implants, deeper involvement 3: moderate: numerous implants, ov involvement, sono visible adhesions, infertility 4: severe: multiple dense adhesions
41
Where are implants common with endometriosis?
- ovaries (80% of cases) - fallopian tubes - broad ligament - posterior CDS - pelvic peritoneum
42
What are the symptoms of endometriosis?
- chronic pain - infertility 4 Ds: - dysmenorrhea - dyspareunia: painful sex - dysuria - dyschezia: painful defecation
43
What is a follicular cyst?
When dominant follicle fails to ovulate, may cause menstrual irregularities
44
What is a corpus luteum cyst?
After dominant follicle ruptures and ova is expelled, mild hemorrhage at rupture site
45
What are the signs of corpus luteum cyst?
Pain, N/V (progesterone), enlarged, tender ovary
46
What is the appearance of a corpus luteum?
- complex cyst - ring of fire - persistent in early OB exams - FF in post CDS
47
What is a theca lutein cyst? What are they associated with?
Develops due to high hCG - gestation trophoblastic neoplasia - ovarian hyperstimulation syndrome - multiple/single preg
48
What are the clinical signs of theca lutein cyst? Sono app?
- Pain, light bleeding, early preg symptoms - Always bilat, large, multilocular cysts
49
What is a paraovarian cyst?
From Gartner's Duct/Wolffian Duct remnant, found in broad ligament
50
What is the clinical presentation of a paraovarian cyst?
20-40 yo, asymptomatic, pain if large
51
What is the sono app of paraovarian cyst?
Anechoic, thin-walled, defined, variable size
52
What is a serous cystadenoma? Clinical signs?
Common epithelial tumor - asymptomatic - complications due to size - pelvic pain, discomfort - bloating
53
What is the sono app of a serous cystadenoma?
- 1-3 cm - unilateral - cystic with debris - smooth walls, possible septations
54
What is a mucinous cystadenoma?
Epithelial tumor that produces mucin/gelatinous material that fills the cyst/loculations
55
What are the clinical signs of mucinous cystadenoma?
- complications due to size - abdominal distention and pain - vomiting, indigestion, constipation - urinary incontinence - fatigue
56
What is the sono app of mucinous cystadenoma?
Large, multi septations, medium echoes
57
What is a mature cystic teratoma?
Germ cell tumor w/ teeth, hair, bone (dermoid)
58
What is the clinical presentation of mature cystic teratoma?
- young women (repro age) - mild-acute pain - adnexal fullness - pressure
59
What is the sono app of mature cystic teratoma?
Cystic/complex, calcification w/ shadowing "tip of the iceberg"
60
What is theca cell tumor? Clinical signs?
Solid, unilateral mass found in meno/postmeno women, pain and pressure
61
What is the sono app of theca cell tumor?
- enlarged ov - solid - shadowing - calcs - cystic degeneration
62
What is a fibroma?
Stromal tumor associated with Meig's syndrome
63
What is the clinical triad associated with fibroma? Other symptoms?
- Benign ovarian tumor - Hydrothorax/pleural effusion - Ascites Other: focal pelvic pain, pressure if large
64
What is the sono app of fibroma?
Solid, hyperechoic
65
What is a Brenner tumor?
- Rare, solid mass - Possible association with Meig's syndrome - Rarely malignant, possibility
66
What are the signs of Brenner tumor?
- asymptomatic - vaginal bleeding - palpable pelvic mass - pelvic pain
67
What is the sono app of Brenner tumor?
- hypoechoic, homogeneous - defined - typically unilat
68
What pathologies are associated with Meig's syndrome?
Fibroma, Brenner tumor
69
What is an endometrioma? What is it AKA?
- Implantation of endometrial tissue outside of uterus - Chocolate cyst: large cysts filled w/ brown fluid
70
What are clinical symptoms of endometriomas?
Dyspareunia, metromenorrhagia, dysmenorrhea
71
What is the sono app of endometrioma?
Defined, cystic mass with low-level echoes, punctate calcs
72
What causes ovarian torsion? What are the signs?
Caused by ovarian mass or cyst Sudden onset of severe pain, N/V, palp adnexal mass
73
What is the sono app of torsion?
- enlarged ov - hyperechoic, heterogeneous - dilated peripheral vessels - lack of doppler flow or decrease
74
What are the effects of polycystic ovarian disease?
Associated with Stein-Leventhal syndrome - polycystic ovaries - hirsutism - amenorrhea - enlarged ovaries - obesity - impaired fertility
75
What is the appearance of polycystic ovarian disease?
Bilat, enlarged ovaries, multiple peripheral cysts "string of pearls"
76
What is pelvic inflammatory disease?
Acute or chronic inflammatory condition of uterus, cervix, ovaries, fallopian tubes, peritoneal surfaces
77
What is PID caused by?
STI, IUD, extension of abdominal/pelvic abscesses, complication of post-abortion or childbirth
78
What is the clinical presentation of PID?
- severe pelvic pain - fever, shaking, chills, leukocytosis - vaginal discharge/bleeding - rebound tenderness - dyspareunia
79
What is endometritis?
Inflammation of endometrium, complication of PID
80
What is the sono app of endometritis?
- normal or thickened endo - air or fluid in endo cavity - increased vascularity
81
What is salpingitis?
Inflammation of fallopian tube, complication of PID
82
What is the sono app of salpingitis?
- distended tube w/ thickened walls - pyosalpinx in acute cases - hydrosalpinx in chronic cases - increased vascularity
83
What is tubo-ovarian abscess?
Abscess formation w/i fallopian tube and ovarian tissue, complication of severe PID
84
What are the clinical signs of tubo-ovarian abscess?
- high fever, elev WBC - severe pelvic/RUQ pain - N/V - peritonitis - Fitz-Hugh-Curtis syndrome (liver capsule inflammation, adhesions)
85
What is the sono app of tubo-ovarian abscess?
- multilocular complex uterine/adnexal mass - debris, septations, irregular thick walls - commonly bilat - debris in pelvis
86
What is pelvic congestion sydrome? Who does it affect?
Dilated tortuous veins >4-5 mm near uterus, possibly adnexas Common in women who had multiple pregnancies
87
What are signs of pelvic congestion syndrome?
Chronic pelvic pain

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