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Ob/Gyne 2 > Module 1 : Uterine Pathology > Flashcards

Module 1 : Uterine Pathology Flashcards

(55 cards)

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1
Q

mullarian duct abnormalities

A
  • arrested development
  • failure of fusion
  • failure of resorption
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2
Q

type of arrested development

A
  • unicornuate uterus
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3
Q

unicornuate uterus characteristics

A
  • deviation of the fundal endometrium to the left or the right
  • banana shaped uterus
  • highest association of renal anomalies arising on the CONTRALATERAL SIDE
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4
Q

two types of failure of fusion

A
  • bicornuate uterus

- uterine didelphys

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5
Q

bicornuate uterus characteristics

A
  • two uterine bodies one cervix one vagina

- indent on outer contour of uterus

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6
Q

uterine didelphys characteristics

A
  • two of everything
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7
Q

two types of failure of resorption

A
  • septate
  • sub septate
    + most unfavourable outcomes in pregnancy (embryo implants in the separation) but can be surgically fixed
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8
Q

septate uterus characteristics

A
  • > 1cm indentation on inner contour of uterus
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9
Q

sub septate uterus characteristics

A
  • < 1cm indentation on inner contour of uterus
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10
Q

MRKH syndrome

A
  • distal vagina present

- complete agenisis of the uterus and cervix

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11
Q

what is a prolapsed uterus

A
  • descent of the uterus down the vagina
  • caused from weak pelvic floor muscles
  • clinical diagnosis not sonographic
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12
Q

what is Asherman’s syndrome and what does it cause

A
  • endometrial lining is replaced by fibrous lesions
  • a scar in the endometrium
  • causes loss of menstruation and infertility
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13
Q

causes of Asherman’s syndrome

A
  • secondary to D&C, multiple abortions, or infection
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14
Q

appearance of Asherman’s syndrome

A
  • thick or thin endo
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15
Q

AV malformations of the uterus charateristics

A
  • rare
  • anastomosis of artery and vein
  • causes = congenital, trauma or surgery
  • symptoms = menorrhagia
  • sonographic appearance = difficult to see without color
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16
Q

neoplastic definition

A
  • multiplication of abnormal cells, malignant or benign
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17
Q

non neoplastic definition

A
  • multiplication of normal cells
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18
Q

types of non neoplastic conditions

A
  • endometrial hyperplasia
  • endometrial polyps
  • adenomyosis
  • uterine varices
  • endometritis
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19
Q

cause of endometrial hyperplasia

A
  • unopposed estrogen stimulation from ovarian dysfunction
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20
Q

when does endometrial hyperplasia occur

A
  • immediately after menarche and also before menopause
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21
Q

symptoms of endometrial hyperplasia

A
  • irregular bleeding
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22
Q

sonographic appearance of endometrial hyperplasia

A
  • thick ( >14mm) hyperechoic endo

- involving most of endo or focal

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23
Q

DDX of endometrial hyperplasia

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A
  • endometrial cancer

- polyps

24
Q

thickness of endo in the secretory phase

25
thickness of endo in the proliferative phase
4-8mm
26
thickness of endo int he post menopausal phase
> 5mm investigative + EV + hysterosonogram + endo cancer
27
endo polyps characteristics
- endometrial growth extending into the canal from a stalk - may protrude in to the cervix if it has a long stalk - may cause bleeding or be asymptomatic
28
sonographic appearance of polyp
- thick hyperechoic endometrium
29
DDX of polyps
- endo cancer | - endo hyperplasia
30
what is adenomyosis
- extension of endo tissue beyond the endometrium into the myometrium - form of endometriosis - usually occurs in posterior wall of uterus - can cause pain and abnormal bleeding
31
sonographic appearance of adenomyosis
- slight diffuse uterine enlargement - hypo echoic or cystic lesions within myometrium - focal lesions - look like fibroid or polyp - unequal myo thickness - endo not in centre of uterus
32
Venetian blind appearance
- multiple shadowing lines in the posterior aspect of uterus myometrium demonstrating adenomyosis
33
prominent arcuate vessels & varices
- dilated vessels around the uterus - increase after pregnant - use color to distinguish between ovaries
34
what is endometritis
- inflammation of endo | - can occur postpartum or with PID
35
sonographic appearance of endometritis
- normal endo - irregular endo - fluid filled cavity or GAS BUBBLES from micro organisms - usually patient on anti bionics or febrile
36
two types of benign uterine neoplasia
- leiomyoma (fibroid) | - lipoleiomyoma
37
what is a leiomyoma
- benign neoplastic mass of fibromuscular tissue - MOST COMMON TUMOR IN FEMALE PELVIS - increase as older and African Americans
38
what are fibroids influenced by
- increase in estrogen + pregnant + menopause
39
symptoms of fibroids
- menorrhagia - pain or pressure - palpable mass - infertility
40
3 classifications of fibroids
- intramural - submucosal - subserosal
41
intramural fibroid characteristics
- confined to myometrium (muscle) | - most common
42
submucosal fibroid characteristics
- projecting into the uterine cavity - can be pedunculated (have a stalk) - can cause bleeding
43
subserosal fibroid characteristics
- project from perimetrium - can be pedunculated - can be found in broad ligament + SOME FOUND UP NEAR BELLY BUTTON (REASON WHY WE SWEEP UP THAT FAR)
44
sonographic appearance of fibroids
- hypo echoic with high attenuation - enlarged uterus with irregular contour - calcification in older women - can be complex with necrosis
45
fibroids with pregnancy
- enlarge with increase estrogen - rapidly growing may result in lack of blood supply and necrosis - large fibroid near cervix would inhibit delivery
46
lipoleiomyoma
- lipocytes (fat) and fibromuscular tissue | - uncommon
47
sonographic appearance of lipleiomyoma
- very hyperechoic and attenuating | - appear similar to a dermoid
48
2 malignant uterine neoplasias
- leiomyosarcoma | - endometrial cancer
49
leiomyosarcoma characteristics
- rare - could arise form preexisting fibroid - symptoms are same for fibroid
50
sonographic appearance of leiomysarcoma
- degenerating fibroid appearance | - may see local invasion of surrounding organs or hepatic metastases
51
endometrial carcinoma
- most commonly occurring in post menopausal women | - symptoms = POST MENOPAUSAL BLEEDING
52
stages of endo cancer
stage 1 = confined to uterus stage 2 = confined to uterus stage 3 = spread beyond uterus yet confined to pelvis stage 4 = distal metastasis
53
increased risk for endo cancer
- strong association with estrogen therapy - obesity - hypertension - diabetes - PCOS - granulosa cell tutors of ovary
54
sonographic appearance of endo cancer
- thick echogenic endo | - difficult to distinguish from hyperplasia or polyps
55
tamoxifen
- non steroidal anti estrogen hormonal drug - used in treating breast cancer - estrogen antagonist to uterus resulting in stimulation of endo - increases risk of endo cancer by 1% but benefit of breast cancer treatment outweighs risk - sonographic appearance = heterogenous bizarre endo

Ob/Gyne 2 (19 decks)

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