Diseases of the female genital system part 2 Flashcards
(45 cards)
What is Endometriosis?
Ectopic Endometrium which causes bleeding into tissues and fibrosis.
It affects 30-40yr olds.
What are the symptoms, investigations, treatments and links to other conditions of endometriosis?
Symptoms:
- Dysmenorrhoea (painful menstrual cramps.)
- Dyspareunia (pain during sex)
- pelvic pain
- subfertility
- pain passing stool
- dysuria (pain during urination)
Investigation:
-Laparoscopy
Treatment:
- Medical (Progesterone antagonists, COCP, GnRH agonist/anagonists)
- Surgical
links to:
- Ectopic pregnancy
- Ovarian cancer
- IBD
What is Endometritis?
What are the causes of acute vs. chronic endometritis?
Inflammation of the endometrium.
Acute - Retained placenta. (neutrophils causes inflammation)
Chronic - endometrial TB, chlamydial infection. (histology = lymphocytes / plasma cells)
What are the symptoms, investigations and treatments of Endometritis?
Symptoms:
- Abdo/pelvic pain,
- Pyrexia (fever)
- discharge
- dysuria (pain when urinating)
- abnormal vaginal bleeding
Investigation:
-Biochemistry/microbiology test
Treatment:
- Analgesia
- remove cause
What are the symptoms of endometrial polyps?
They are often asymptomatic, however the following can occur:
- Intermenstrual bleeding
- post menopausal bleeding
- menorrhagia (heavy period)
- dysmenorrhoea (painful cramps)
What investigations and treatments are done for endometrial polyps?
Investigation : -Hysteroscopy Treatment : -Medical (P4/GnRH agonists) -surgical removal
What is a leiomyomata?
It is a uterine fibroid.
A benign myometrial tumour with eostrogen and progesterone dependant growth.
What are the risk factors of leiomyomata?
- Genetics
- nulliparity (no child birth)
- obesity
- PCOS
- hypertension
What are the symptoms pf leiomyomata?
- Often Asymptomatic
- Menometrorrhagia (excessive uterine bleeding)
- subfertility
- urinary problems during pressure on the bladder
What are the investigations and treatments for leiomyomata?
What is the prognosis after treatment?
Investigations:
- Bimanual examination
- USS (ultrasound scan)
Treatment:
- IUS (intra uterine system contraception)
- NSAIDs,
- OCP (oral contraceptive pill)
- P4 (progesterone)
- Iron
Prognosis:
- menopausal regression
- malignancy risk 0.01%
What is endometrial hyperplasia?
excessibe endometrial proliferation due to increased oestrogen and decreased progesterone.
What are the risk factors of endometrial hperplasia?
- obesity
- exogenous eostrogen
- PCOS (poly cystic ovary syndrome)
- tamoxifen (breast cancer drug)
- Oestrogen producing tumours.
What are the different types of endometrial hyperplasia?
Typical Hyperplasia (only 1-3% progess to malignancy)
Atypical Hyperplasia (23 - 48% are carcinoma on hysterectomy)
What are the symptoms / complications of endometrial hyperplasia?
-Abnormal bleeding
What investigations are done for endometrial hyperplasia?
- Ultrasound scab
- Hysteroscopy
- biopsy
What are the treatments for endometrial hyperplasia?
- Intra Uterine System (contraception)
- Progesterone
- surgical (Total abdominal hysterectomy)
What is the prognosis of endometrial hyperplasia?
If left untreated it can develop into endometrial adenocarcinoma.
How does endometrial hyperplasia progress?
1) Normal
2) Non Atypical Hyperplasia
3) Atypical Hyperplasia
4) Endometroid Carcinoma
What are the 2 types of endometrial adenocarcinoma?
1) Endometroid :
- Arises from endomtrial intraepithelial neoplasia.
- caused by unopposed oestrogen stimulation.
- Usually affects young women.
- HAS PTEN MUTATION, (no P53 Mutation)
2) Non-endometroid or Serous:
- Arises from inactive or atrophic endometrium.
- It is not associated with oestrogen.
- HAS P53 MUTATION but NO PTEN MUTATION.
- affects elderly women. has a poor prognosis.
What are the symptoms / complications of Endometrial Carcinoma?
- Post menopausal Bleeding
- Inter menstrual bleeding
What investigations are done for Endometrial Carcinoma?
- Ultrasound scan
- biopsy
- hysteroscopy
What are the treatments for endometrial carcinoma?
- Progesterone
- Total abdominal hysterectomy.
What is Polycystic Ovary Syndrome?
Endocrine disorder that has 3 characteristics:
1) Hyperandrogenism (increased testosterone)
2) Menstrual abnormalities
3) Polycystic ovaries
What are the investigations done for PCOS?
- Ultrasound scan
- biochemical screen (decreased FSH, Increased LH, Increased testosterone, Increased DHEAS).
- glucose tolerance test.
