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Ultrasound OBGYN > Class 6 > Flashcards

Class 6 Flashcards

(57 cards)

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1
Q

True or False: In past decades cervical carcinoma was more common than endometrial carcinoma worldwide

A

True

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2
Q

True or False: In USA, endometrial carcinoma is more common than Cervical Carcinoma

A

True

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3
Q

Why is Cervical Carcinoma more common in USA than endometrial carcinoma?

A
  • Early diagnosis of cervical CA with PAP smear and cone biopsy
  • Increased patient life span
  • Postmenopausal estrogen use
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4
Q

What are risk factors for development of endometrial carcinoma?

A
  • OBESITY
  • DIABETES
  • HIGH BLOOD PRESSURE
  • SHORT IN HEIGHT
  • JEWISH
  • AGE (postmenopausal)
  • ESTROGEN USE AFTER MENOPAUSE
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5
Q

What are some of the effects of endometrial carcinoma?

A
  • Dysfunctional uterine bleeding without ovulation
  • Hyperplasia of the endometrium
  • Polycystic ovaries (Stein-Leventhal Syndrome)
  • Theca Granulosa Cell tumor
  • Tamoxifen use for breast cancer
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6
Q

Where does endometrial carcinoma begin? Where does it grow to?

A

It begins in the endometrium then grows toward the myometrium

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7
Q

True or False. The greater degree of infiltration of endometrial carcinoma into the myometrium, the GREATER the prognosis

A

False: The greater degree of infiltration of endometrial carcinoma into the myometrium, the POORER the prognosis

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8
Q

What determines the STAGE of endometrial carcinoma?

A

The degree of tumor spread

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9
Q

What determines the GRADING of endometrial carcinoma?

A

The Tumor differentiation

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10
Q

What are the signs and symptoms of Endometrial Carcinoma?

A
  • Bleeding or discharge after menopause

- PAIN

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11
Q

What are some treatment options for Endometrial Carcinoma?

A
  • Complete hysterectomy with bilateral oophorectomy
  • Lymphadenectomy
  • Pre or Post Operative radiation therapy
  • Chemotherapy
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12
Q

US appearance of Endometrial Carcinoma

A
  • Uterus may appear normal
  • Uterus may be increased in size
  • Endometrium may be thickened
  • Endometrial cavity may be fluid filled
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13
Q

What are some of the differential diagnoses for Endometrial Carcinoma?

A
  • ENDOMETRIAL HYPERPLASIA
  • ENDOMETRIAL POLYPS
  • LEIOMYOMA
  • CERVICAL CARCINOMA (causing hematometra or pyometra)
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14
Q

True or False: Leiomyosarcoma is the MALIGNANT counterpart of Fibroid

A

True

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15
Q

Is Leiomyosarcoma common or rare? What is the percentage of uterine tumors?

A

Rare and 3% of uterine tumors

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16
Q

If a fibroid has a growth spurt, what malignancy is suspected?

A

Leiomyosarcoma

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17
Q

What age is Leiomyosarcoma most common?

A

50’s

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18
Q

Can an Ultrasound distinguish leiomyoma from Leiomyosarcoma?

A

No

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19
Q

True or False: On an ultrasound a Leiomyosarcoma may present as inhomogeneous uterine mass with areas of cystic degeneration

A

True

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20
Q

What are some risk factors for Cervical Carcinoma?

A
  • EARLY SEXUAL ENCOUNTERS
  • MULTIPLE SEXUAL PARTNERS
  • INFECTION BY STD OR A SEX PARTNER WHO HAS AN STD
  • HUMAN PAPILLOMA VIRUS (causes genital warts)
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21
Q

What is the most common cell type for Cervical Carcinoma?

A

Squamous cells

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22
Q

True or False: The prognosis for Cervical Carcinoma does not depend on the stage at diagnosis

A

False: PROGNOSIS DEPENDS ON STAGE AT DIAGNOSIS

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23
Q

True or False: In Cervical Carcinoma metastases is via Lymphatic system of pelvis

24
Q

What is the staging of Cervical Carcinoma?

Study These Flashcards
A

STAGE 1 - confined to cervix
STAGE 2 - spread to vagina, upper cervix, and parametrium
STAGE 3 - spread to lower portion of vagina and to pelvic wall
STAGE 4 - extends beyond true pelvis, bladder and/or rectal involvement, mets to distant organs (lung, bone, and liver)

25
What are the signs and symptoms of Cervical Carcinoma?
- ABNORMAL PAP SMEAR - VAGINAL DISCHARGE - INTERMITTENT BLEEDING (especially after intercourse) MORE ADVANCED STAGES: - Bladder irritability - Back pain - Ureteral obstruction
26
What are some treatment options for Cervical Carcinoma?
``` -SURGICAL or DEPENDANT UPON THE STAGE OF DISEASE -CONE BIOPSY -RADICAL HYSTERECTOMY -RADIATION THERAPY -CHEMOTHERAPY ```
27
Ultrasound Appearance of Cervical Carcinoma?
Stage 1 OR 2 - May be no change in cervical appearance - Cervix may appear bulky or irregular - Cervix may exhibit changes in echogenicity - Hematometra or pyometra may be present due to cervical stenosis
28
What are some of the differential diagnoses for Cervical Carcinoma?
- LEIOMYOMA INVOLVING THE CERVIX - ENDOMETRIAL CARCINOMA INVOLVING THE CERVIX - ENDOMETRIAL POLYPS PROLAPSED INTO THE VAGINA
29
What causes Gestational Trophoblastic Disease?
Abnormal Proliferation of the Trophoblast: supplying the embryo with nourishment and later forming the major part of the placenta
30
What are the three types of Gestational Trophoblastic Disease?
- HYDATIFORM MOLE - benign trophoblastic disease - INVASIVE MOLE (CHORIOADENOMA DESTRUENS) - malignant nonmetastatic trophoblastic disease - CHORIOCARCINOMA - malignant metastatic trophoblastic disease
31
True or False: 1 in 100 pregnancies in US and Europe result in Hydatiform Mole
False: 1 in 1000 pregnancies in US and Europe result in a Hydatiform Mole The highest incidences are in Far East and Asia
32
What are some of the Risk factors for Gestational Trophoblastic Disease?
- AGE (OVER 40YEARS OR UNDER 20 YEARS) - PREVIOUS MOLAR PREGNANCY - BLOOD TYPE - BIRTH CONTROL PILLS - NUMBER OF SEXUAL PARTNERS - SOCIOECONOMIC
33
What are the 2 types of Hydatiform Mole?
Complete and Incomplete
34
What is a COMPLETE Hydatiform Mole?
- Fertilization of defective ovum by single sperm that duplicates - Fertilization of one ovum by two sperm - Higher malignant potential - Hydropic degeneration and swelling of the chorionic villi - Proliferation of the trophoblast - Absence of fetus and amnion
35
What is an INCOMPLETE Hydatiform Mole?
- Fertilization of a normal egg by two sperm - Fertilization of a normal ovum by a sperm with a diploid set of chromosomes - Focal and less advanced hydatiform changes - Some villi spared and not others - Fetus, fetal parts, or amniotic sac rarely present
36
A Theca Lutein Cysts is found in 20-30% of patients with what kind of pregnancy?
Molar Pregnancy
37
What is a molar pregnancy?
Molar pregnancy is an abnormal form of pregnancy in which a non-viable fertilized egg implants in the uterus and will fail to come to term.
38
What is the cause of Theca Lutein Cysts?
Elevated levels of Human chorionic gonadotropin (hCG)
39
True or False: Theca Lutein Cysts are unilateral
False: They are Bilateral
40
True or False: Theca Lutein Cysts are prone to hemorrhage
True
41
How long after the evacuation of the uterus will a Theca Lutein Cyst remain?
2-4 Months
42
What is Gestational trophoblastic disease (GTD)?
Gestational trophoblastic disease (GTD) is a group of pregnancy-related conditions that develop inside a woman's uterus (womb). The abnormal cells start in the tissue that would normally become the placenta. The placenta is the organ that develops during pregnancy to feed the fetus.
43
What are the signs and symptoms of Gestational trophoblastic disease (GTD)
- IRREGULAR VAGINAL BLEEDING DURING PREGNANCY - DISCREPANT UTERINE HEIGHT - HYPEREMESIS - PREECLAMPSIA
44
Lab findings for Gestational trophoblastic disease (GTD)?
ELEVATED SERUM hCG >100,000mIU/ml Triple the normal level Continue to rise 100 days after LMP
45
US Findings in 1st trimester for Gestational trophoblastic disease (GTD)
- Blighted ovum - Missed abortion - Degenerating leiomyoma - Hydropic placenta - Endometrial cancer - Adenomyosis
46
US Findings in 2nd trimester for Gestational trophoblastic disease (GTD)
- Soft tissue mass with sonolucent areas of different sizes - “snow flake or lacey pattern” - Absence of fetal parts - Myometrium may appear hypoechoic - Uterus large for dates - Bilateral theca lutein cysts may be present
47
What is an invasive mole?
Invasive mole is a tumorous growth associated with gestation and falls under the spectrum of gestational trophoblastic disease
48
Chorioadenoma Destruens is also known a?
Invasive Mole
49
True or False: Invasive moles are Malignant non-metastatic trophoblastic diseases that are a progression of a benign disease
True
50
What percentage do invasive moles occur?
15-18% of cases
51
Invasive moles penetrate and invade what area?
the Myometrium
52
If elevated levels of hCG are present, what is the suspected reason?
Invasive Mole
53
Ultrasound Appearance of an invasive mole
``` Cannot distinguish from benign condition Enlarged uterus Cystic spaces of varying sizes Echogenic areas within uterus Diagnosed after hysterectomy with examination of myometrium ```
54
What is Choriocarcinoma?
Choriocarcinoma is a fast-growing cancer that occurs in a woman's uterus (womb) Malignant Metastatic Trophoblastic Disease
55
What percentage of Hydatiform moles become choriocarcinoma?
2-5%
56
Choriocarcinoma develops from 1/2 ______ and another 1/2 ______
- 1/2 DEVELOP FROM MOLAR PREGNANCY | - 1/2 DEVELOP FROM NORMAL PREGNANCY, ECTOPIC OR MISCARRIAGE
57
Molar Pregnancy Treatment
- Surgery - Radiation - Chemotherapy

Ultrasound OBGYN (9 decks)

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