Exam 2 Uterine Dz Flashcards Preview

Q4 Women's Health > Exam 2 Uterine Dz > Flashcards

Flashcards in Exam 2 Uterine Dz Deck (25):
1

Uterine Fibroids (Myomas)? (4)

Most C pelvic tumor
Most C need for hyster
Collagen/smooth mm/elastin in pseudocapsule
C in blacks in 40s

2

Uterine Fibroids caused by?

U/K
E2 makes them grow but doesn't cause them

3

Uterine Fibroids classification:

Submucosal (0,I,II)?

Subserosal?

Intramural?

Just below endometrium

Serosal surface of uterus

w/i uterine wall

4

Uterine Fibroids presentation? (6)

Sxs in ~1/2, depends on location/size

Abn uterine bleed = submucosal (↑ SA of endometrium)

Pain

Pelvic pressure = mass/compression of organs

Infertile = impinged uterine cavity

Miscarriage

5

Uterine Fibroids exam findings?

Bimanual exam =
Hard mass
Irregular shape
Enlargement

6

Uterine Fibroids labs?

Hct/Hgb = anemia

7

Uterine Fibroids imaging?

Transvag US
Saline sonohystogram (US w/ saline injection)
Hysteroscopy (camera)
MRI for planning

8

Uterine Fibroids meds mgmt? (3)

GnRH analog
Steroids (if heavy/long bleeds): E2/P2
Transexamic acid (if heavy/long bleeds): Lysteda during menstruation

9

Uterine Fibroids Expectant Mgmt?

May shrink postpartum or postmeno
Annual pelvic
Watch CBC for anemia
If ↑ sxs or size -> treat

10

leimyosarcoma is?

Uterine CA U in postmeno
Rapid enlarg mass w/ pain and d/c

11

Depo Lupron for Uterine Fibroids? (4)

Depo Lupron (GnRH analog):
Temp induce meno -> ↓E2 -> ↓ size
Fix anemia
↓ blood loss in surgery
Don't use > 6 mo

12

Uterine Fibroids; Myomectomy? (3)

Hysteroscopic Myo?

Preserves fertility/uterus
High recurrence
C-section req'd to avoid uterine rupture

Only for submucosal fibroids
P fluid overload during procedure

13

Uterine Fibroids; Ablation?

For heavy bleeds
Must remove fibroids first
Still need contraceptive

14

Uterine Fibroids: Uterine Artery Embolization? (4)

Preserves uterus NOT fertility
Kills blood supply to fibroid
Not for numerous/large fibroids
Postembolization Synd

15

Postembolization Synd? (6)

Must hospitalize
Endometritis/Uterine infection
Non-puss d/c
Embolization agent on non-target tissues
Uterine necrosis, sepsis, bacterima, death

16

Endometriosis is?

Causes what? (6)

Benign, chronic E2-dependent disorder
Endomet glands/stroma at extra uterine sites
Lesion expansion premenstrual

Retrograde flow through tubes/peritoneum
Vascular/Lymph spread
Coelomic metaplasia
Infertility
↑ risk of autoimm dz
↑ risk of ovarian CA-125

17

Endometriosis exam findings? (3)

Posterior cul-de-sac tender
Fixed or retrovert uterus from adhesions
Adnexal masses/tender

18

Endometriosis imaging/studies? (3)

Pelvic US

Laparoscopy =
Erythema/Petechia
Ovary "Chocolate Cysts" (most C site of dz)

Bx = confirms dx

19

Endometriosis tx:

Mild?

Mod/Severe? (5)

Watch/NSAIDs

Interrupt endo stim:
OCP (cause endo atrophy)
Progestins
Depot Lupron (↓ E2/P2)
Lap w/ fulguration (electrical destruction)
Hyster w/ salping-oophorectomy

20

Endometrial CA?

Risk factors? (4)

Most C gyn CA
U by 60yo

Continuous E2 therapy
Lynch Synd
Cowden Syn
Polycyst

21

Endometrial CA Type 1?

From unopposed E2
Well-differentiated tumors
Good prognosis

22

Endometrial CA Type 2?

Independent of E2
U w/ endo atrophy
Poor diff, poor prog

23

Endometrial CA presentation?

Abn vag bleed (heavy, inter spotting, post meno bleed)
Abd cramps
Back pain
Wgt loss
Painful sex

24

Endometrial CA studies? (7)

CBC
CA-125
Pap
D&C
Transvag US
MRI-CT
Endo Bx

25

Endometrial CA tx?

Hyster w/ salpoogectomy + pelvic and peraortic lymphadenoectomy
Radio/Chemo