M3: Extra Pelvic Pathology

Question 1

what is hydrocolpos

Answer 1

retention of vaginal secretions in the vagina before puberty

Question 2

what is hydrometrocolpos

Answer 2

retention of uterine and vaginal secretions in the vagina and uterus, before menses or after menopause

Question 3

what causes hydrocolpos and hydrometrocolpos

Answer 3

imperforate hymen

Question 4

which is more severe, hydrocolpos or hydrometrocolpos

Answer 4

hydrometrocolpos

Question 5

what is hematocolpos

Answer 5

blood trapped in the vagina

Question 6

what is hematometra

Answer 6

blood trapped in the uterus

Question 7

what is hematometrocolpos

Answer 7

blood trapped in the uterus and vagina

Question 8

what causes hematocolpos, hematometra, and hematometrocolpos

Answer 8

imperforate hymen

Question 9

what are the 3 things to look for on US when looking for any type of fluid/blood trapped in the uterus/vagina organs

Answer 9

level of obstruction
echogenicity
fluid-fluid levels

Question 10

what are gartner’s duct cysts

they are remnants of which ducts

Answer 10

cysts along the vagina (gardener snakes live in dark holes)

mesonephric duct remnants

Question 11

where are gartner’s duct cysts usually located

do they produce symptoms

Answer 11

on the lateral or anterolateral wall

asymptomatic usually

Question 12

is US used to diagnose vaginal carcinoma

Answer 12

no, used to help stage and to asses pelvic spread or distal mets

Question 13

what are nabothian cysts

Answer 13

retention cysts of cervical secretions

Question 14

how are carcinomas or the cervix diagnosed

Answer 14

PAP

Question 15

if cervical cancer causes obstruction, what can this lead to

Answer 15

hematometra or renal hydro

Question 16

risk factors for cervical cancer

Answer 16

HPV
BCPs
smoking
DES in utero
weak immune system

Question 17

what are some US findings for cervical cancer

Answer 17

hematometra or hydro
complex cervical mass
bulky cx w/ irregular borders
tumor invasion of bladder
liver mets, enlarged para AO lymphnodes

Question 18

what is the complications of an incompetent cervix

Answer 18

preterm labor

Question 19

causes of an incompetent cervix

Answer 19

trauma
DES - T shaped uterus
idiopathic

Question 20

how is the length of the cervix best assessed

Answer 20

translabial or EV

Question 21

what is endometriosis

how does it usually exit the uterus

Answer 21

growth of endo tissue outside of uterine cavity

retrograde tubal transmission

Question 22

2 types of endometriosis

Answer 22

internal: adenomyosis
external: endometriosis

Question 23

common sites of endometriosis

Answer 23

ovaries
fallopian tubes
broad ligament
pouch of douglas

Question 24

how is endometriosis diagnosed

Answer 24

laparoscopy

Question 25

what is one characteristic trait of endometriosis and what does this cause

Answer 25

adhesions which make the pelvic organs immobile and can block fallopian tubes

Question 26

how should you check for pelvic immobility

Answer 26

dynamic EV..... if - means no mobility

Question 27

symptoms of endometriosis

Answer 27

``` dysmenorrhea dysparunia infertility menorrhagia palpable mass called an endometrioma ```

Question 28

what type of mass is associated w/ endometriosis

Answer 28

endometrioma/chocolate cyst

Question 29

how does a endometrioma appear on US

Answer 29

well defined mainly cystic mass may see fluid/fluid levels

Question 30

which area is commonly the first effected by endometriosis

Answer 30

rectovaginal septum

Question 31

what is the DDX for endometriosis

Answer 31

hemorrhagic ovarian cyst ovarian cyst adenoma tubo-ovarian abcess (TOA)

Question 32

what is the TX for endometriosis

Answer 32

drugs - hormones, BCP Laser sugery hysterectomy and oophrectomy HIGH RECURRENCE RATE

Question 33

what is PID

Answer 33

infection of female genital tract

Question 34

causes of PID

Answer 34

STI - gonorrhea or chlamydia | pyogenic (infectious)

Question 35

symptom stages of PID

Answer 35

1 - endometritis : asymptomatic or vaginal discharge w/ tenderness 2 - pyosalpinx: : febrile. acute pelvic pain and abnormal vag bleeding may develop hydrosalpinx 3 -TOA stage: acute abdo pain, increased WBCs, may develop fitzhugh curtis syndrome

Question 36

what is fitzhugh curtis syndrome

Answer 36

perihepatitis (inflammation of liver capsule) w/ small abscesses on the capsule which can lead to adhesions

Question 37

symptom of fitzhugh curtis syndrome what lab tests will be altered

Answer 37

RUQ pain increased liver enzymes

Question 38

is fitzhugh curtis syndrome associated w/ PID

Answer 38

yes

Question 39

if a patient has salpingitis and the tubes are blocked, what pathology will you see

Answer 39

pyosalpinx

Question 40

w/ salpingitis, once the infection is gone, what will pyosalpinx turn into

Answer 40

hydrosalpinx which will be chronic

Question 41

US appearance of stage 1 acute PID

Answer 41

stage 1 is endometritis.... thick endo, fluid in canal or could appear normal...

Question 42

US appearance of stage 2 acute PID

Answer 42

stage 2 is pyosalpinx.... hypoechoic, S shaped Fallopian tubes w/ smooth walls

Question 43

US appearance of stage 3 acute PID

Answer 43

stage 3 is TOA.... multiocular mass, irregular borders, fluid-fluid levels and air w/in mass

Question 44

US appearance of chronic PID

Answer 44

distended S shaped Fallopian tubes

Question 45

ddx of chronic PID

Answer 45

ovarian cyst or sm cystadenoma

Question 46

# define hemaphroditism what is a true hemaphrodite

Answer 46

having both male and female sex traits +/- ambiguous genitalia... true hemaphrodite have both ovaries and testes

Question 47

are hemaphrodites infertile

Answer 47

yes

Question 48

possible cause of hemaphroditism

Answer 48

fusion of 2 heterozygous twin zygotes after fertilization

Question 49

do hemaphrodites have increased risk of gonadal cancer

Answer 49

yes

Question 50

what is a pseudohemaphrodite

Answer 50

has chromosomes of one sex but develops sex traits of the opposite sex

Question 51

describe a male pseudohemaphrodite

Answer 51

genetically male w/ testes, develops F characteristics maybe due to lack of androgens

Question 52

describe a female pseudohemaphrodite

Answer 52

genetically female w/ ovaries, develops M characteristics maybe due to excessive androgens

Question 53

another name for fallopian tube carcinoma

Answer 53

serous tubal intraepithelial carcinoma (STIC)

Question 54

where is it believed that most fallopian tube carcinomas begin

Answer 54

fimbriae of the tubes

Question 55

most fallopian tube carcinomas are which type

Answer 55

adenocarcinomas

Question 56

the remaining fallopian tube carcinomas that are not adenocarcinomas, are which type

Answer 56

endometrioid or clear cell adenocarcinoma

Question 57

US appearance of fallopian tube carcinoma

Answer 57

similar to ovarian cancer | complex and sausage shaped

Question 58

Will women w/ chronic PID be infertile

Answer 58

Yes