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Clin Med III exam III > Benign Uterine and Ovarian Disease > Flashcards

Benign Uterine and Ovarian Disease Flashcards

(57 cards)

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1
Q

Most common pelvic tumor in women

A

fibriods

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2
Q

Where do fibriods arise from

A

smooth muscle cells of the myometrium

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3
Q

Locations of fibriods

A
  • intramural
  • subserosal
  • submucisal
  • cervical
  • pedunculated submucosal or subserosal
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4
Q

Most common location of fibriod

A

intramural

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5
Q

Signs and symptoms of fibriods

A

typically asymptomatic

  • heavy or prolonged menstrual bleeding
  • pelvic pressure/pain
  • urinary frequency
  • anemia
  • reproductive dysfunction
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6
Q

What would an exam show for fibriods

A

-enlarged uterus
-irregular uterus
+/- tenderness

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7
Q

Diagnostics for fibriods

A
  • transvaginal US
  • sonohysterography
  • hysteroscopy
  • MRI
  • hysterosalpingography (HSG)
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8
Q

Treatment of fibriods

A

treat symptomatically

  • NSAIDs (dysmenorrhea)
  • OCPS/IUD
  • surgery
GnRH analogue (leupron)
Danazol
(severe cases)
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9
Q

When do you do surgery for fibriods

A
  • bulk related sx’s
  • infertility
  • miscarriages
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10
Q

Surgical options for fibriods

A
  • hysterectomy
  • myomectomy
  • endometrial ablation
  • uterine artery embolization
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11
Q

What is adenomyosis

A

ectopic endometrial tissue within the myometrium

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12
Q

“Boggy Uterus”=

A

adenomyosis

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13
Q

Signs and symptoms of adenomyosis

A
  • heavy menstrual bleeding
  • dysmenorrhea
  • chronic pelvic pain
  • diffusely enlarged uterus
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14
Q

When does adenomyosis present

A

40-50 years old

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15
Q

Definitive diagnosis of adenomyosis

A

histology s/p hysterectomy

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16
Q

Ways to give a probable diagnosis of adenomyosis

A
  • transvaginal US
  • MRI

“asymmetric thickening or the myometrium”
“linear striations”
“loss of clear endomyometrial border”
“increased myometrial heterogeneity”

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17
Q

Treatment of adenomyosis

A

hysterectomy is only definitive tx

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18
Q

Alternative tx for adenomyosis

A
  • OCP/IUD
  • lupron
  • aromatase inh (anastrozole, letrozole)
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19
Q

What is endometriosis

A

presence of normal endometrial mucosa abnormally implanted in locations other than the uterine cavity

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20
Q

What happens to the ectopic tissue in endometriosis

A

respond to hormonal fluctuations–> prostaglandins–> inflammatory process and scarring of tissue

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21
Q

Common sites of endometriosis

A
  • ovaries (most common)
  • perimetrium
  • posterior cul de sac
  • broad ligamnet
  • rectosigmoid colon
  • bladder
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22
Q

Symptoms of endometriosis

A
  • can be aymptomatic
  • dysmenorrhea
  • heavy or irregular bleeding
  • pelvic pain
  • lower abd pain/back pain
  • dyspareunia
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23
Q

Physical exam findings for endometriosis

Study These Flashcards
A
  • lateral displacement of the cervix
  • localized tenderness in pouch of douglas/ nodule
  • pain wiht movement of the uterus
24
Q

Complication of endometriosis

Study These Flashcards
A
  • endometrioma
  • adhesion formation
  • pain
  • anatomic distortion
  • infertility
  • implantation on nearby structures
25
Diagnosis of endometriosis
laparoscopy w/ biopsy classic blue black powder burned appearance
26
Options for tx of endometriosis (medical)
- hormonal contraceptions - GnRH hormone analogues (lupron) - danazol
27
Surgical management for endometriosis
- hysterectomy +/- oophorectomy - laparoscopic uterine nerve ablation - drainage and laparoscopic cystectomy - laparoscopy and surgical endometrial implant ablation
28
What is the most common cystic ovarion lesion
functional ovarian cyst
29
Types of functional ovarian cysts
- follicular - corpus luteal - theca lutein - endometrioma
30
What are the two types of cysts
- simple cysts | - complex cysts (debris,blood, varied wall thickness)
31
How do follicular cysts appear on US
simple unilocular, anechoic cyst with a thing smooth wall
32
When does a follicular cyst occur
when the rupture of a mature follicle doesnt occur
33
When do corpus luteal cyst occur
after ovulation
34
"ring of fire" on doppler=
corpus luteal cyst
35
What causes a theca lutein cyst
overstimulation by hCG
36
Which cysts are unilateral? Bilater?
unilateral: corpus luteal, follicular bilateral: theca lutein
37
Mature cystic teratoma
benign germ cell tumor
38
How does a MCT appear
cystic--> calcifications, fat, sebaceous tissue, hair, teeth
39
MCT's are associated with ___ when ___
ovarian torsion if >5cm
40
Two types of cystadenomas. Which one is more common?
serous mucinous (filled with mucinous material) Serous is more common
41
What is a cystadenofibroma
surface epithelial tumor
42
What does a cystadenofibroma resemble
malignant tumor
43
Treatment of cystadenofibroma
oophroectomy
44
What could a sudden onset of sharp pain indicate?
ruptured cyst
45
Complications of cysts
- ovarian torsion (large cysts) - hemorrhagic cyst - persistent pain or pressure
46
Diagnostics for benign cysts
- US (first line) - CT pelvis (malignancy) - MRI (if doing surg) - hCG - CA125 (post menopause w/ cyst >5cm) - diagnostic lap
47
Ovarian cancer marker
CA125
48
Treatment of ovarian cyst
- analgesia - OCP (recurrent functional cyst) - ovarian cystectomy or oophorectomy
49
When is surgery considered for cysts
- symptomatic - persistent 5 to 10 cm cyst - ovarian torsion - suspected malignancy
50
When is surgery done with follicular or corpus luteal cysts
if very large or hemorrhagic with rupture
51
Anterior compartment prolapse
aka. cystocele hernia of the nateria vaginal wall with descent of bladder
52
Posterior compartment prolapse
aka. rectocele hernia of posterial vaginal segment with descent of the rectum
53
Enterocele
hernia of the intestines to or through the vaginal wall
54
Uterine prolapse
descent of apex of vagina into lower vagina to or beyond the vaginal introitus
55
Uterine procidentia
hernia of all three compartment through to vaginal introitus
56
When do you treat pelvic organ prolapse
only if symptomatic
57
What are the treatments for pelvic organ prolapse?
- pessary - pelvic floor muscle exercise - surgery (anterior cloporrhaphy, posterior cloporrhaphy, sacral colpopexy, hysterectomy)

Clin Med III exam III (10 decks)

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