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Quiz 2 Flashcards

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1
Q

what are the congenital anomalies of the uterus?

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

arrested development

A
  • bilateral

- unicornuate unicollis

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3
Q

failure of fusion

A

mullarian ducts fail to fuse

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4
Q

what can failure of fusion result in?

A

depends where failure occurs

  • bicornuate unicollis
  • bicornuate bicollis
  • dideplhsys
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5
Q

is bicornuate unicollis one or two uteri?

A

defect is lower but still one uterus, more difficult to distinguish from didelphsys

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6
Q

is didelphsys one or two uteri?

A

2 separate uterus and cervix, sometimes results in 2 separate vaginas

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7
Q

describe bicornuate

A
  • uterus exterior is indented where did not fuse

- failure of fusion happens more superiorly

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8
Q

is bicornuate or didelphsys more common?

A

bicornuate

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9
Q

what is the difference between unicollis and bicollis?

A

where failure of fusion occurs

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10
Q

can you become pregnant with bicornuate uterus?

A

yes but

  • preterm delivery because of growth restrictions
  • caesarean section
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11
Q

is didelphsys common or rare?

A

rare

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12
Q

can you become pregnant with a didelphsys uterus?

A

yes but rare

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13
Q

failure of resorption

A
  • median septum does not get resorbed
  • normal exterior uterine contour
  • differing degrees of resorption (septate, sub septate)
  • arcuate (slight dip)
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14
Q

septate uterus is the most common____________

A

“Mullerian Duct Anomaly”

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15
Q

what is failure of resorption associated with?

A
  • spontaneous abortions

- fertility issues

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16
Q

How do we tell if there is an Anomaly with 2D Ultrasound?

A

Should see endometrium dividing when scanning transversely through the uterus

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17
Q

what is the treatment for anomaly of uterus?

A

hysteroscope laser the septum

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18
Q

what may be a reason for miscarriages?

A

failure resorption

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19
Q

when would you plan for early delivery?

A

failure of fusion

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20
Q

when would be the best time to scan for a UTERINE ANOMALY?

A

secretory phase

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21
Q

Diethylstilbestrol (DES)

A

Associated with Uterine anomalies

  • drug taken by mother discontinued in 1971
  • given in 1st trimester had direct effect on Mullerian system of fetus (crosses placenta)
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22
Q

what may an ultrasound of the uterus show if a mother had taken DES?

A
  • diffuse decrease in uterine size

- irregular T-shaped uterine cavity

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23
Q

what are some uterine abnormalities?

A
  • leiomyoma (fibroids)
  • lipomatous uterine tumors
  • leiomyosarcoma
  • adenomyosis
  • arteriovenous Malformations
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24
Q

what is a fibroid or leiomyoma?

A

benign solid tumor of the uterus

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25
what is a fibroid or leiomyoma composed of?
smooth muscle cells and fibrous connective tissue
26
what is the most common neoplasm of the uterus?
leiomyoma or fibroid
27
what is the most common cause of enlargement of non pregnant uterus?
leiomyoma or fibroids
28
what do fibroids depend on?
estrogen (this is why they usually decrease in menopause)
29
what are symptoms of fibroids?
-pain -uterine bleeding (frequently asymptomatic)
30
what are the 3 classifications of fibroids?
- intramural - submucosal - subserosal
31
what is the most common fibroid?
intramural
32
intramural fibroid
confined to the myometrium | completely surrounded by myometrium
33
submucosal fibroid
- projecting into uterine cavity (distorting or displacing endo) - produce symptoms associated with infertility
34
Subserosal (pedunculated subserosal & subserosal) fibroid
- projecting outward from myometrium | - distort outer contour of uterus
35
intraligamentous
Pedunculated Subserosal fibroid can project between leaves of broad ligament
36
______ of all fibroids are located in cervix
8%
37
what kind of fibroid would a cervical fibroid be?
any of the three
38
sonographic appearance of a fibroid
- hypoechoic - heterogenous echotexture - areas of attenuation - frequently distort the external contour of uterus
39
what do we mention when describing fibroid location
- type of fibroid | - location(anterior/posterior wall, fundal, cervical)
40
what do we do if their are multiple fibroids?
measure the 3 largest
41
what is an US role for fibroids?
- location - size - is it a fibroid?
42
how do we know if fibroid is attached to the uterus?
turn on colour and put pressure
43
when can post menopausal fibroids increase in size?
if on HRT or Tamoxifen
44
Fibroids and postmenopausal women
rarely develop usually decrease in size become calcified
45
when may fibroids increase in size?
- pregnancy | - anovulatory cycles (unopposed estrogen)
46
which fibroid would we measure if we saw one?
submucosal because it would be the one to cause bleeding
47
what problems could occur with fibroid and pregnancy?
location -check if in cervix size -it gets larger with pregnancy
48
what are the complications associated with fibroids?
- may outgrow blood supply - degenerating or necrotic fibroids when outgrow blood supply - pedunculated fibroids
49
which colour flow is usually represented with fibroids?
peripheral flow????
50
transabdominal for fibroids
- larger FOV - Better assessing large fibroids - can be missed if just using TVP
51
transvaginal for fibroids
- good at detecting small fibroids - origin of large pedunculated, subserosal fibroids vs. adnexal mass - fundal fibroids on retroverted uterus
52
what is the treatment of symptomatic fibroids?
- uterine artery embolization - surgical treatment (hysterectomy) - medical treatment
53
are Lipomatous Uterine Tumors or Lipoleimyomas bengin or malignant?
benign
54
what do Lipomatous Uterine Tumors or Lipoleimyomas consist of?
- mature lipocytes - smooth muscle - fibrous tissue
55
what does Lipomatous Uterine Tumors or Lipoleimyomas look like sonographically?
- highly echogenic - absence of color flow within - usually asymptomatic - make sure within uterus
56
what can Lipomatous Uterine Tumors or Lipoleimyomas be confused with?
ovarian dermoid
57
Leiomyosarcoma
- rare - malignant - may arise from leiomyoma - asymptomatic or uterine bleeding - same symptoms and appearance "fibroid"
58
what is the clue to Leiomyosarcoma?
rapid growth and post menopausal growth
59
Adenomyosis
endometrial glands and stroma within myometrium
60
what are the 2 forms of Adenomyosis?
- diffuse | - nodular
61
Adenomyosis diffuse
- more common | - widely scattered adenomyosis foci within the myometrium
62
Adenomyosis nodular
composed of adenomyomas (circumscribed nodules)
63
what is the clinical presentation of Adenomyosis?
Nonspecific - Uterine enlargement - Pelvic pain - Dysmenorrhea - Menorrhagia - Seen more in women who have had children
64
which probe is better for looking at adenomyosis?
transvaginal
65
sonographic features of adenomyosis?
Diffuse ut enlargement - Diffusely heterogeneous myometrium - Asymmetrical thickening of myometrium - Inhomogeneous hypoechoic areas - Myometrial cysts - Poor delineation of endo-myometrial border - Focal tenderness with transvaginal transducer - Subendometrial echogenic linear striations - Subendometrial echogenic nodules
66
what can be confused with adenomyosis?
fibroid
67
Lieomyomas
- usually well defined | - peripheral vascularity
68
Localized Adenomyomas
- ill defined borders | - internal vascularity
69
Arteriovenous malformations (AVM's)
Vascular plexus of arteries and veins with no capillary network
70
what are the most cases for Arteriovenous malformations (AVM's)?
- pelvic trauma - surgery - gestational trophoblastic neoplasia
71
what is the symptom for AVM's?
severe vaginal bleeding
72
when is AVM usually diagnosed?
post abortion and postpartum periods
73
what is the sonographic appearance of AVM's?
- multiple tortuous anechoic structures - subtle myometrial heterogenicity - myometrial or endometrial mass
74
what does colour look for AVM's?
coloured mosaic pattern
75
what does spectral doppler look for AVM's?
- high velocity - low resistance arterial flow - high venous velocity (like an artery)
76
Differential Diagnosis of AVM’s
- retained products of conception (RPOC) - GTN (gestational trophoblastic neoplasia) - subinvolution of placental bed
77
what help to distinguishing differential diagnosis of AVM's?
negative hCG
78
what is the treatment for AVM's?
-Wait to see if resolve (maybe not AVM) -severe bleeding immediate treatment (embolization)
79
Monckeberg’s Arteriosclerosis
Form of arteriosclerosis | -Hardening of the vessels or calcification of blood vessels
80
what is found in Monckeberg’s Arteriosclerosis?
calcium deposits are found in the muscular middle layer of the walls of arteries (the tunica media)
81
where does Monckeberg’s Arteriosclerosis occur?
- peripheral - coronary arteries - GENITAL ORGAN ARTERIES
82
what is the cause of Monckeberg’s Arteriosclerosis?
unknown
83
what is Monckeberg’s Arteriosclerosis associated with?
- Diabetes - Chronic kidney disease - Lupus - Chronic inflammatory conditions
84
what are sonographic features of adenomyosis?
Diffuse ut enlargement - Diffusely heterogeneous myometrium - Asymmetrical thickening of myometrium - Inhomogeneous hypoechoic areas - Myometrial cysts - Poor delineation of endo-myometrial border - Focal tenderness with transvaginal transducer - Subendometrial echogenic linear striations - Subendometrial echogenic nodules
85
is it normal to have fluid in the endo?
small amount
86
when measuring endo, do we include the fluid in our measurement?
NO
87
what are the indications for pelvic ultrasound specific for endometrium?
Bleeding - irregular - heavy - spotting
88
what are causes for endometrial thickening?
- pregnancy - retained products of conception - fibroids (submucosal) - endometritis - adhesions - hyperplasia - polyps - carcinoma
89
when can endometritis occur?
- postpartum - after D&C - associated with PID
90
what is the sonographic appearance of endometritis?
- thick or irregular - may or may not contain fluid - gas with acoustic shadowing
91
what are some causes of abnormal bleeding from the endometrium?
especially in post menopausal women - hyperplasia - polyps - endometrial carcinoma - atrophy
92
what is endometrial hyperplasia?
overgrowth of endometrial glands
93
what are the 2 types of endometrial hyperplasia?
hyperplasia | cystic hyperplasia
94
what is the most common reason for hyperplasia?
unopposed estrogen stimulation in peri/post menopausal women
95
what are risk factors for hyperplasia?
- Anovulatory cycles - Polycystic ovarian disease - Obese women (increase in estrogens) - Estrogen producing tumors
96
what does hyperplasia cause?
common cause of abnormal bleeding
97
what is the sonographic appearance of hyperplasia?
thick echogenic well defined endometrium may have cystic areas
98
what are the differential diagnoses for hyperplasia?
- diffuse polyps - endo carcinoma - endometrial atrophy that is displaying cystic components (makes look thick)
99
describe endometrial polyps
- benign - growth projecting into cavity - pedunculated or broad based - common - increase in peri-postmenopausal women - mostly asymptomatic or bleeding - single/multiple
100
what is the sonographic appearance of endometrial polyps?
- echogenic focal area within endo - endometrial thickening - same echogenicity as the endometrium
101
what is the differential diagnosis for polyps?
- hyperplasia - endometrial cancer - submucosal fibroid
102
what is a good imaging modality for differentiating a polyp vs fibroid?
sonohysterography
103
what is shown on US with the endometrium in a polyp?
polyp seen arising from endo
104
what is shown on US with the endometrium with a fibroid?
normal layer endo is seen overlying
105
what is the treatment of polyps?
- Dilation and Curettage | - hysteroscopy recommended if still bleeding and endo is over 8mm
106
what is the most common gynecologic malignancy in north America?
endometrial carcinoma
107
is endometrial carcinoma curable?
highly curable
108
who does endometrial carcinoma mostly occur in?
postmenopausal women
109
what is the most common clinical presentation of endometrial carcinoma?
uterine bleeding
110
what is the sonographic appearance of endometrial carcinoma?
- heterogenous echotexture - irregular or poorly defined margins - can cause obstruction blocks the cervix (hydrometra or hematometra)
111
what is the differential diagnosis of thickened endometrium in peri or post menopausal women
-hyperplasia -polyps -cancer need biopsy for diagnosis
112
what is the role of sonography for pre operation endometrial cancer?
- determine myometrial invasion | - intact sub endometrial halo (inner layer of myometrium)
113
what are some uterine sarcomas?
``` -leiomyosarcomas arise from endo -carcinosarcomas -endometrial stromal sarcoma -adenosarcomas -undifferentiated sarcomas ```
114
what is found in majority of women with PMB?
endometrial atrophy
115
what does endometrial atrophy look like sonographically?
- usually thin (less than 5mm) | - homogenous
116
what is normal measurement of a symptomatic postmenopausal women with endometrial bleeding?
5mm or less ( greater than this is considered abnormal)
117
what is the normal measurement of an asymptomatic patient with no bleeding?
8mm or less
118
what is the effect on the endometrium in postmenopausal women on HRT?
- unopposed estrogen linked increase risk of endo cancer and hyperplasia - usually on continuous combined - sequential (get menses) endo similar appearance pre menopausal women - increased thickness
119
what is tamoxifen?
-nonsteroidal -antiestrogen used in therapy with breast cancer
120
what is the effect of tamoxifen on premenopausal women?
-decreases estrogen
121
what is the effect of tamoxifen on postmenopausal women?
increase estrogen therefore increase risk of endo cancer
122
what is the sonographic appearance of tamoxifen?
- cystic changes | - polyps
123
Asherman’s Syndrome
formation of intrauterine adhesions
124
when can ashermans syndrome occur?
posttraumatic or post surgical
125
what can asherman's syndrome cause?
infertility or reccurent pregnancy loss
126
what usually happens to women who have had several dilatation and curettage procedures?
ashermans syndrome
127
what is the affect of asherman's syndrome on a patient?
- infertility - painful periods - miscarriages - absence of period - pelvic pain
128
what may adhesions cause?
- amenorrhea - repeated miscarriages - infertility
129
what are the sign and symtoms of adhesions? (asherman's syndrome)
- menstrual irregulataries - cyclic pelvic pain - amenorrhea - repeated miscarriages - infertility
130
what is the sonographic appearance of asherman's syndrome?
- Hyperechoic uterine lining - scar tissue in uterine cavity | - May be seen as hyperechoic bands traversing through the endometrial cavity.
131
what is the treatment for asherman's syndrome?
- hysteroscopy done - estrogen therapy - sometimes a balloon or stent placed within endo until it is healed
132
what kind of treatment would you use if it is focal?
hysteroscopy with directed biopsy
133
what kind of treatment would you use if it is diffuse?
blind-nondirected biopsy
134
what is a sonohysterography?
sterile solution into endometrial cavity under ultrasound guidance
135
when is sonohysterography usually preformed?
- days 4 & 7 of cycle | - postmenopausal women at anytime
136
when would we not do a sonohysterography?
- if patient may be pregnant | - acute pelvic inflammatory disease
137
what are treatments for symptomatic patients?
- endometrial ablation | - IUCD
138
what is the treatment for irregular bleeding in perimenopausal women?
endometrial ablation
139
what are the complications of post endometrial ablation?
- Cornual hematometra or central hematometra - cause pain - Postablation tubal sterilization syndrome
140
what is the Ultrasounds role post ablation?
- Fluid can be absorbed by the body so fluid collections not evident - should be scanned when symptomatic
141
what can help with irregular bleeding?
mirena
142
what does mirena do?
secretes progesterin (progesterone) no estrogen
143
what are the causes of a thick endometrium?
- PREGNANCY - POLYPS - CARCINOMA - HYPERPLASIA - retained products of conception - Fibroid (makes it look thick) - endometriosis - adhesions
144
what are causes of uterine bleeding in peri/post menopausal women?
- hyperplasia - polyps - endometrial carcinoma - atrophy - fibroid
145
sonographic appearance of polyp
- thick endometrium - hyperechoic - homogenous - well defined - focal or diffuse
146
sonographic appearance of carcinoma
- thick endometrium - irregular border - invading myometrium
147
sonographic appearance of hyperplasia
- thick endometrium - hyperechoic - homogenous - well defined - cystic changes within
148
sonographic appearance of atrophy
- thin endometrium | - homogenous
149
what is the sonographic appearance of a fibroid vs polyp-submucosal fibroid
- hypoechoic - heterogenous - endometrium going over fibroid (displaces endometrium)
150
what is the sonographic appearance of a fibroid vs polyp-polyp
- hyperechoic - stalk (arterial pedicle) - homogenous - arises from endometrium
151
what does PMB stand for and what is it?
post menopausal bleeding IT IS A SYMPTOM
152
what is the most likely cause of PMB?
endometrial atrophy-could be cancer
153
What is considered an abnormal endometrial measurement associated with PMB?
over 5mm
154
How can a sonographer tell if it is endometrial cancer?
we cannot tell if its cancer (biopsy can)
155
What endometrial measurement is considered normal in an asymptomatic patient?
8mm or less
156
What measurement would they biopsy and why?
Over 11mm it correlates with a person who's bleeding, may be cancer
157
Name an ultrasound procedure that is ordered to provide more information regarding the endometrium.
Sonohysterography-inject saline into endometrial cavity
158
Name 2 types of endometrial biopsy’s and reason for doing one over the other?
Directed and nondirected (blind) biopsy-to distinguish focal from diffuse abnormalities
159
When is the best time to evaluate a menstruating women’s endometrium and why?
early proliferative | Because the endometrium is thin and fibroid/polyp/e.t.c can be seen best
160
what are indications for ovarian pathology?
- pain - palpable mass - irregular bleeding - fam history of ovarian tumor/cancer
161
what are we looking for in an ovarian scan?
- ectopic pregnancy - cysts - tumors - inflammatory bowel disease - appendicitis
162
what is transvaginal good at looking at?
ovaries
163
what is the most common cause of “ovarian enlargement” in young women?
nonneoplastic lesions "functional cysts"
164
what are the types of nonneoplastic lesions "follicular cysts"?
- follicular - corpus luteal - theca luteal
165
when is a normal follicle found?
1st half of menstrual cycle
166
what do the normal follicles usually measure?
up to 2.5 cm at maturity
167
when do follicular cysts form?
mature follicle fails to ovulate and it develops if fluid in a nondominant follicle fails to resorb
168
what is the sonographic appearance of a follicular cyst?
- anechoic - thin walled - posterior enhancement - known as a simple cyst - measures equal or over 3cm
169
what are some follicular cyst facts?
- larger than follicle - unilateral - asymptomatic - incidentally found on US - usually resolve on their own
170
when do corps luteal form?
after ovulation failure of absorption or excessive bleeding into corpus luteum
171
how big are corpus luteal cysts?
larger than 4-5 cm
172
what are corpus luteal cysts compared to follicular cysts?
- less common - more symptomatic - larger
173
are corpus luteal cysts unilateral or bilateral?
unilateral
174
what are corpus luteal cysts more prone to?
more prone to rupture or hemorrhage
175
what is a major symptom of corpus luteal cyst?
pain
176
what is a differential of diagnosis corpus luteal cyst?
ectopic pregnancy (if positive B-hCG and no intrauterine pregnancy)
177
sonographic appearance of corpus luteum
- Small ,<4cm - Hypoechoic - isoechoic - Cyst with low-level internal echoes - Usually thicker wall than a follicle - Crenulated appearance - Peripheral rim of Color (Ring of Fire) - Involutes before menstruation
178
sonographic appearance of corpus luteal cyst
>4cm | If hemorrhage differing U/S appearances due to variable appearance of blood
179
what is the largest of functional ovarian cysts?
theca luteal cysts
180
what is theca luteal cysts associated with?
high levels of hCG
181
when do theca luteal cysts mostly occur?
- gestational trophoblastic disease | - ovarian hyperstimulation syndrome
182
are theca luteal cysts unilateral or bilateral?
BILATERAL
183
sonographically luteal cyst sonographically
- bilateral - multilocular - +++large
184
what are complication in functional cysts?
- hemorrhage - enlargement - rupture - torsion
185
what does complications in functional cysts equal?
ACUTE PAIN!!
186
where can internal haemorrhage occur?
functional cysts
187
what is the most common hemorrhagic cyst?
corpus luteal cyst
188
what is the symptom of hemorrhagic cysts?
acute onset of pelvic pain
189
What is the appearance of an Acute Hemorrhagic Cyst?
- hyperechoic (blood when old-can go back to anechoic) - reticular pattern (thin septations) - mimic a solid mass - smooth posterior wall - posterior enhancement - diffuse low level echoes may be seen
190
Why are there so many different sonographic appearances of hemorrhagic cysts
blood changes as it ages (new is anechoic and it hoes to echogenic back to anechoic)
191
Does Colour Doppler help with diagnosis?
no flow within clot but demonstrate peripheral vascularity because clots move-normally no blood flow in a cyst
192
What could free fluid in the pelvis indicate?
confirms diagnosis of leaking or ruptured hemorrhagic cyst
193
differential diagnosis of hemorrhagic cyst
- corpus luteal cyst - endometrioma - ectopic (positive B-hCG)
194
when do functional cysts resolve?
within 1-2 menstrual cycles
195
when do we follow up for a functional cyst?
in 6 wks
196
when does ovarian remnant syndrome occur?
patient has undergone bilateral oophorectomy
197
what can ovarian remnant syndrome cause?
- pain | - compression of distal ureter
198
sonographic appearance of ovarian remnant syndrome
Small to large cysts Simple to complex Thin rim of ovarian tissue
199
Surface Epithelial Inclusion Cysts
Nonfunctional cysts Usually in postmenopausal periphery
200
Surface Epithelial Inclusion Cysts sonographic appearance
Tiny, sometimes punctate foci Can grow to several cms not likely to hemorrhage
201
Extraovarian Cysts
Paraovarian Cysts & Paratubal Cysts
202
Peritoneal Inclusion Cysts
fluid accumulates within adhesions separate from ovary
203
Paraovarian Cysts & Paratubal Cysts
Mostly asymptomatic Typically small Found in Broad Ligament Ipsilateral ovary close to but separate from cyst
204
Paraovarian Cysts & Paratubal Cysts sonographic appearance
anechoic internal echoes within do not change with cycle
205
Peritoneal Inclusion Cysts
- Benign cystic mesothelioma or benign encysted fluid - Extraovarian origin - Premenopausal women
206
you can get a Peritoneal Inclusion Cysts if you have a history of what?
- abdominal surgery - trauma - PID - endometriosis
207
what is the main producer of peritoneal fluid?
ovary
208
what is the treatment of Peritoneal Inclusion Cysts
- suppression with oral contraceptives | - fluid aspiration
209
Peritoneal Inclusion Cysts sonographic appearance
- Multiloculated cystic adnexal masses - Bizarre shape - “presence of an intact ovary amid septations and fluid”
210
what are the differential diagnosis of peritoneal inclusion cysts?
- paraovarian | - hydrosalpinx (fluid in fallopian tubes)
211
paraovarian
- usually round or ovoid - not associated with surgery, infection, or trauma - separate from ovary
212
Hydrosalpinx (fluid within fallopian tubes)
- tubular or ovoid structure - visible folds - ovary is outside
213
what are Pregnancy-Associated Ovarian Lesions?
- hyperstimulated ovaries-theca luteal cysts - ovarian hyperstimulation syndrome - hyperreatio luteinalis - luteoma (rare)
214
Theca Luteal Cysts
Largest of functional cysts | Bilateral, multilocular ++large
215
Hyperstimulated Ovaries- theca luteal cysts
- response to increased levels of hCG | - usually associated ovulation induction
216
what is Hyperstimulated Ovaries- theca luteal cysts?
ovarian blood vessels react abnormally to hCG and leak fluid
217
Hyperstimulated Ovaries- theca luteal cysts sonographic appearance
- Bilaterally Enlarged ovaries with multiple cysts - Usually resolve during pregnancy - Risk of torsion
218
Mild OHSS
Ovaries enlarged but <5cm | Lower abd discomfort
219
Moderate OHSS
Weight gain 5 to 10 lbs. Ovaries measure btw 5 & 12 cm May have nausea and vomiting
220
Severe OHSS
``` >10 lb. weight gain Severe abd pain & distension Ovaries > 12cm in diameter, multiple large, thin walled cysts Associated ascites and pleural effusions LOOK in Morrisons Pouch ```
221
what is the treatment for Ovarian Hyperstimulation Syndrome?
- Conservative - replace fluids and electrolytes | - Resolves 2 to 3 weeks
222
Hyperreactio Luteinalis (HL) aka theca luteal in later pregnancy
Abnormal response to circulating hCG Patient had NO ovulation induction therapy Mostly Occurs in 3rd trimester
223
where is Hyperractio Luteinalis (HL) more likely to occur?
patient who has polycystic ovarian disease
224
Sonographically HL
Bilaterally enlarged ovaries | Multiple cysts
225
Difference btw HL and OHS
Occurs in 3rd trimester Ovaries not as large Resolves spontaneously
226
Luteoma of pregnancy
Rare Solid Benign Most asymptomatic Luteinize stromal cells produce androgens 30% experience maternal virilization (male traits & mother)
227
Luteomas Sonographically
Heterogeneous Mostly hypoechoic mass Can be Highly vascular
228
what is the most common cause of maternal virilization?
luteomas
229
which anomaly has a heart shaped uterus?
bicornuate
230
what is the most common cause of ovarian enlargement?
functional cysts
231
do labs
finnish
232
primary infertility
couples who have not become pregnant after at least 1 year having unprotected intercourse
233
secondary infertility
couples who have been able to get pregnant at least once, but now are unable
234
3 causes of male infertility
- low semen quality - obstruction of efferent ducts - ejaculation malfunction
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3 causes of female infertility
- primary ovarian insuffiency - ovulation failure - tubal obstruction
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Name a common fertility drug administered to women who have anovulatory cycles.
clomid or pergonal
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Explain the following fertility treatment: IVF
``` Follicular Aspiration • Needle inserted into follicle + suction to remove follicular fluid (hopefully including ovum) • done with U/S guidance • Several removed; quantified in lab • Sperm injected into egg (in-vitro) • Grown for 2-5 days ET – Embryo Transfer • Transferred directly to uterine cavity via catheter • ‘implantation’ stage ```
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ZIFT
ZIFT- Zygote Intra-fallopian Transfer | -transfers a fertilized egg into fallopian tubes
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GIFT
GIFT- Gamete Intra-fallopian Transfer | -transfers a mixture of sperm and ovum into the fallopian tubes
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what is a severe symptom of OHS?
shortness of breath
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why is shortness of breath associated with OHS?
blood clot in legs causes shortness of breath because a clot in the leg could break off and move to the pulmonary artery. Treatment would be blood thinners and compression socks
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when would you scan a women in her menstrual cycle?
patient is scanned from day 9 through to ovulation
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Explain the following fertility treatment: ovarian stimulation
Controlled ovarian hyperstimulation (COH) is a process in which the ovaries are stimulated by fertility medication to produce ovulatory follicle(s). Typically, a combination of oral fertility medication and injectible fertility hormones are used to stimulate the ovary to produce mature follicles.

Pelvic (5 decks)

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