Endometriosis and Adenomyosis Flashcards Preview

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Flashcards in Endometriosis and Adenomyosis Deck (40):
1

what is the diagnositic test of of choice for endometriosis?

laparoscopy

2

what does the tissue biospy of endometriosis show? (if anything, focus on the major two findings)

endometrial glands, hemosiderin-laden macrophages, and stroma (remember, endometrial glands and stroma should be found in the uterus and NOT outside)

3

what are the two most common sites of endometriosis?

ovary and pouch of douglas

4

what is the age range in which endometriosis is most common?

20s and 30s

5

t or f: endometriosis is common in multiparous women

FALSE; common in nulliparous women (THINK about this .. focus on estrogen relationship)

6

t or f: endometriosis is the most likely cause of infertility in women over the age of 30 without a hx of PID

TRUE

7

t or f: pelvic lymph nodes are a common site of endometriosis

TRUE

8

t or f: severity of symptoms correlates with quantity of ectopic endometrial tissue

FALSE: instead, it may correlate with the DEPTH of the ectopic tissue

9

t or f: the prolonged bleeding of endometriosis can cause scarring (adhesions)

TRUE (this is what may result in the chronic pelvic pain; the adhesions also with contribute to infertility)

10

t or f: with a positive family hx a pt may develop endometriosis at an earlier age than the family member

TRUE

11

what is the official term for pain with defecation?

dyschezia (how is this related to the deck? it may point towards implants on rectosigmoid

12

what is the most popular theory behind endometriosis?

retrograde menstruation

13

explain the theory of retrograde menstruation

endometrial tissue fragments are retrogradely transportred through the fallopian tubes and implant there or intra-abdominally w/ prediliction for ovaries

14

which theory of endometriosis explains its location outside of the pelvis?

vascular/lymphatic transport

15

t or f: endometrial glands and stroma can be implanted during clinician procedures (ex: c-section)

TRUE - called iatrogenic dissemination

16

what is the typical endometriosis uterus?

tender FIXED RETROflexed (with scarring POSTERIOR to uterus)

17

what is characteristic of the uterosacral ligaments with endometriosis?

nodular in nature or thickening and induration

18

women with endometriosis can develop a type of ovarian cyst called what?

endometrioma/chocolate cyst (these are tender, palpable, and freely mobile mplanted masses that occurs within the ovarian capsule and bleed)

19

t or f: endometrial tissue must be biopsied for definitive diagnosis of endometriosis

TRUE (remember, the gold std for diagnosis is lapratomy with biopsy proven hemodierin laden macrophages)

20

an endometrial implant red in color signifies what in terms of duration of time for the implant?

red - new

21

an endometrial implant brown in color signifies what in terms of duration of time for the implant?

brown - older

22

what color are the oldest implants? (which indicates scar tissue)

white

23

what is the maximum amount of time to be on estrogen suppression for treatment of endometriosis?

six months

24

t or f: often there is improvement with pregnancy with endometriosis symptoms

TRUE - secondary to tempory cessation of menses

25

t or f: the primary goal with medical treatment of endometriosis is to induce amenorrhea

TRUE

26

GnRH agonists (such as leuprolide) suppresses what hormone, inducing what state?

FSH; pseudomenopause - (remember, these should only be used for six months total as they are associated with osteoporosis

27

what is the definitive treatment of endometriosis?

TAH/BSO

28

englarged, globular, "boggy" uterus on physical exam is indicative of what?

adenomyosis

29

what is the major difference btwn endometriosis and adenomyosis?

ectopic endometrial tissue does NOT function like normal uterine tissue and is NONresponsive to hormones in the normal manner.

30

what is the definition of adenomyosis?

ectopic endometrial glands and strom found within the myometrium leading to SYMMETRICALLY ENLARGED AND GLOBULAR UTERUS

31

how can you differentiate btw adenomyosis and fibroids?

TVUS

32

t or f: adenomyosis is most common in nulliparous women

FALSE - rare!!!

33

t or f: adenomyosis pain is commonly cyclical

FALSE - commonly NON-cyclical

34

t or f: adenomyosis is typically associated with an assymetrically enlarged uterus

FALSE - symmetrical!!

35

what is the definitive treatment of adenomyosis?

hysterectomy

36

t or f: endometrial ablation will not improve adenomyosis symptoms

TRUE

37

what is proven medical therapy for adenomyosis?

none - no proven medical tx.

38

adenomyosis or endometriosis: typically found in older, multiparous women

adenomyosis

39

adenomyosis or endometriosis: the tissueis responsive to hormonal stimulation

endometriosis

40

adenomyosis or endometriosis: associated with cyclical pain

endometriosis