Endometriosis Flashcards Preview

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Flashcards in Endometriosis Deck (42):
1

Is there a familial association with endometriosis?

Yes

2

What, generally, are the major s/sx of endometriosis?

-Chronic pelvic pain
-Infertility
-Progressive dysmenorrhea

3

What is the retrograde menstruation theory on the pathogenesis of endometriosis?

Direct implantation of endometrial cells in inappropriate places

4

What is the vascular lymphatic dissemination theory of endometriosis?

Distant sites of endometriosis through spread through lymphatics

5

What is the coelomic theory of endometriosis?

Multipotential cells in the peritoneal cavity differentiate inappropriately, and respond to hormone changes

6

What are the three major risk factors for the development of endometriosis?

-Early menarche
-Shorter cycle interval
-Prolonged heavy bleeding

7

What are the three major protective factors for endometriosis?

-Higher parity
-Increased duration of lactation
-Regular exercise

8

Where does endometriosis usually occur?

-On both ovaries and fallopian tubes
-Round ligament
-Sigmoid colon

9

What is the pouch of douglas (posterior cul-de-sac)?

Area anterior to the rectum, and posterior to the uterus

10

Is deep or superficial dyspareunia more common with endometriosis?

Deep

11

True or false: the s/sx of endometriosis correlate well with extent of tissue

False

12

What is an endometrioma?

Endometriosis on the ovary

13

What is the only way to definitively diagnose endometriosis?

Look at it--scope or surgery

14

What is the classic presentation of endometriosis?

Pts with dysmenorrhea that does not respond to NSAIDs

15

What is the ddx of endometriosis?

-PID
-GI dysfunction
-Interstitial cystitis

16

True or false: pts with endometriosis usually have an normal pelvic exam

True

17

What is a diagnostic test to assess for endometriosis?

Trial of GnRH agonist like leuprolide

Will initially have increased s/sx, but will eventually subside with continued therapy

18

What is the role of imaging studies for endometriosis?

Not sensitive

19

What are the histological findings of endometriosis?

Glands in a field of inflammation

20

What are the three major goals of medical therapy for endometriosis?

-Reduction in pelvic pain
-Minimize surgical intervention
-Preserve fertility

21

What is expectant management of endometriosis?

-Wait it out to birth a child or when menopause comes (if older)

22

What is the medical management, generally, of endometriosis? Does this preserve fertility?

-Induction of atrophy of the endometrial tissue
-Will maintain fertility

23

What is the MOA of using NSAIDs + oral contraceptives to treat endometriosis?

Reduces inflammation and

24

What is the MOA of using progesterone in treating endometriosis?

Suppresses FSH/LH release and the resulting steroidogenesis

25

What is the MOA of danazol in the treatment of endometriosis?

Suppresses FSH and LH production

26

What is the MOA of using leuprolide in treating endometriosis?

GnRH agonism will ultimately downregulate the pituitary

27

What is the role of hormonal IUDs with endometriosis?

Will not change hormones, just uterus's response

28

What are the surgical options for treating endometriosis?

-Limited cauterization of ectopic endometrial tissue
-Total hysterectomy or a bilateral oophorectomy

29

What fraction of women who had conservative surgical treatment for endometriosis will require surgery within 5 years?

1/3

30

What are the risks and benefits of a total hysterectomy for treating endometriosis?

Will prevent recurrence of endometriosis, but will send into menopause right meow

31

What is the gene on the Y chromosome that causes the development of the fetus into a male? What specifically does this cause?

SRY gene

Causes the mesonephric duct to form instead of regress

32

If the SRY gene is not present, what happens to the mesonephric ducts?

Regressed and replaced by the paramesonephric ducts

33

The gonads arise from what?

Intermediate mesoderm within the urogenital ridge

34

What do the genital ducts arise from?

Paired mesonephric, and paramesonephric ducts

35

The mesonephric duct gives rise to what?

Male genital duct

36

What paramesonephric ducts give rise to what?

Female genital ducts

37

What part of the female genitalia develops from the paramesonephric duct? (5)

-Upper 1/3 of vagina
-Cervix
-Uterus
-Fallopian tubes
-Ovary

38

What develops from the urogenital sinus? (3)

-Lower 2/3 of vagina
-Bulbourethral glands
-Vestibule

39

What, generally, are Mullerian anomalies?

Incomplete fusion or incomplete resorption of the septum

40

What causes a septated uterus, and what is the treatment?

incomplete resorption of the uterine septum. Needs to be surgically corrected

41

What cause a bicornuate uterus?

Incomplete fusion of the Mullerian ducts

42

What causes uterine didelphys?

Complete failure of fusion (double uterus, vagina, and cervix)