Endometriosis Flashcards
(54 cards)
what is endometriosis
A condition where endometrial tissue grows outside endometrium
what is the most common type of endometriosis
pelvic endometriosis
what is a less common type of endo
extrapelvic endo
what is the genetic risk with endo
first degree relative on mother’s side = 7-10x risk
what is the suspected hormonal pathogenesis of endo
may have ↓ response to progesterone on endometrium from ↓ receptors on endometrial tissue/ implants = inability to cause apoptosis of endometrial tissues
what is the suspected mechnical pathogenesis of endo
cervical stenosis = retrograde menstruation
what is the suspected immunological pathogenesis of endo
△ T+B cell function, lvl of cytokines and GF in endometrial tissue
Immunologic abnormality prevents clearance of endometrial tissue fragments from exiting peritoneum OR
Immune system stimulation caused by presence of endometrial tissue in peritoneum = increased inflammation
what is the mullerian embryonic theory of endo
during embryonic development, remnants present in other parts of the body which can form endometrial tissue
what is the lymphatic and vascular metastasis that can cause endo
extrapelvic- transport of lesions through vascular/ lymph system
what is the coelomic metaplasia theory of endo
metaplasia of cells in mesothelial lining of the organs = transforms normal peritoneal cells into endometrium like
what is the endometrial stem cell implantation that can lead to endo
endo cells originate from stem cells
sx of endo
Pain: pelvic, abdominal, lower back
Dysmenorrhea + pain with ovulation
Spotting or bleeding b/w periods
GI sx (more if GIT involved): painful BM, diarrhea during period, abd bloating
Painful urination or increased urgency (if bladder involved
Heavy periods
endo symptoms are more linked to
1. severity of implants
2. placement of implants
2
endo sx often resolve with
menopause
an endo diagnosis can be based on
S/S
Transvaginal ultrasound (for deep implants or abnormal sites)
Laparoscopy (+confirmed with biopsy) or CT or MRI
Sometimes CA-125 but is not specific for endo and more for ovarian cancers (may be increased if endo on ovaries)
T or F: staging matches well with severity of sx
F
pharm classes used for endo
NSAIDs
CHC
progestins
LNG-IUS
danazol
GnRH agonists and antagonists
what do progestins do in endo
atrophy of endometrial tissues
what is dienogest used for in endo
to manage pelvic pain + shown to be as effective as leuprolide
what is danazol
Androgen derived from 17-a ethinyl testosterone = androgenic effects
danazol MOA
Suppresses pituitary ovarian axis = ↓FSH and LH = directly inhibits ovarian steroidogenesis = ↓ E = atrophy of endometrial implants
danazol AEs
acne, weight gain, fluid retention, hirsutism, deepening of voice, ↑LFT, ↓HDL, ↑LDL
Most reversible, except for lowering voice
what is contraindicated for danazol
severe liver disease, hyperlipidemia
what to monitor for if on danazol
LFTs if >6mths
