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reproduction and sexual health > uterine disorders > Flashcards

uterine disorders Flashcards

(59 cards)

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1
Q

what is the fancy name for a uterine fibroid

A

leiomyoma

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2
Q

what is a uterine fibroid

A

benign smooth muscle tumour

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3
Q

what are the 3 main types of fibroids

A

subserosal, intramural and submucosal

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4
Q

most common symptom of fibroids

A

heavy menstrual bleeding

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5
Q

clinical sign of fibroids on bimanual examination

A

a solid mass or enlarged uterus

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6
Q

what are some other symptoms of fibroids

A

pressure symptoms, abdominal distension, subfertility

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7
Q

imaging in suspected fibroids

A

ultrasound

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8
Q

which layer of the uterus to fibroids arrise from

A

myometrium

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9
Q

medical management of fibroids

A

NSAIDs, tranexamic acid, GnRH analogues, COCP or mirena coil

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10
Q

surgical management of fibroids

A

myomectomy, hysterectomy, ablation

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11
Q

what is adenomyosis

A

presence of functional endometrial tissue within the myometrium of the uterus

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12
Q

name some processes that may cause adenomyosis

A

pregnancy + childbirth, caesarean, uterine surgery

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13
Q

clinical presentation of adenomyosis

A

menorrhagia, dysmenorrhoea, deep dyspareunia, irregular bleeding

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14
Q

definitive diagnosis of adenomyosis

A

histology after a hysterectomy

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15
Q

first line investigation in suspected adenomyosis

A

TVUS

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16
Q

curative treatment of adenomyosis

A

hysterectomy

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17
Q

symptom management of adenomyosis in women wanting contraception

A

mirena coil!!
cocp as alternative

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18
Q

surgical management of adenomyosis in women wanting to preserve fertility

A

uterine artery embolisation

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19
Q

symptom management of adenomyosis in women not wanting contraception

A

Tranexamic acid when there is no associated pain (antifibrinolytic – reduces bleeding)
Mefenamic acid when there is associated pain (NSAID – reduces bleeding and pain)

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20
Q

what happens in endometriosis

A

endometrial tissue proliferates outside of the uterine cavity

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21
Q

what is an endometrioma

A

lump of endometrial tissue outside of the uterus - usually ovary

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22
Q

name 2 risk factors for endometriosis

A

early menarche and family history

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23
Q

what is the most common presenting complaint in endometriosis

A

cyclical pelvic pain - occurs at the time of menstruation

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24
Q

name some other symptoms of endometriosis

Study These Flashcards
A

dysmenorrhoea, dyspareunia, dysuria, dyschezia, subfertility

25
what is dyschezia
difficult, painful defecating
26
clinical sign of endometriosis
fixed, retroverted uterus
27
gold standard for diagnosing endometriosis
laparoscopy
28
first line investigation for endometriosis
TVUS
29
microscopy of a chocolate cyst
endometrial glands and stroma
30
medical management of endometriosis
analgesia and NSAIDs COCP
31
name some complications of endometriosis
adhesions, infertility, ectopic pregnancy
32
name some risk factors for endometrial cancer
nulliparity, obesity, early menarche + late menopause, PCOS, oestrogen only HRT
33
when do women usually present with endometrial cancer
50-60 yrs
34
what should be suspected in young women presenting with endometrial cancer
lynch syndrome
35
why is obesity a risk factor for endometrial cancer
associated with the endocrine and inflammatory effects of adipose tissue
36
what is the most common type of endometrial cancer
adenocarcinoma
37
what is the most common presentation of endometrial cancer
post menopausal bleeding
38
inheritance seen in lynch syndrome
autosomal dominant
39
what is the main pathophysiology of lynch syndrome
defective DNA mismatch repair gene
40
which type of endometrial cancer has the better prognosis and why
type 1 - usually confined to the uterus at presentation
41
what are the 2 main types of endometrial cancer and which is more common
type 1 !!! - endometrioid and mucinous carcinoma type 2 - serous and clear cell carcinoma
42
what is the precursor for type 1 endometrial cancer
atypical hyperplasia
43
what is linked to type 1 endometrial cancer
unopposed oestrogen
44
which type of endometrial cancer can be associated with lynch syndrome
type 1
45
what is the precursor for type 2 endometrial cancer
serous epithelial carcinoma
46
who is affected by type 2 endometrial cancer
elderly post-menopausal women
47
what mutation is associated with type 2 endometrial cancer
TP53 mutation and overexpression
48
how does type 2 endometrial cancer commonly spread
along the fallopian tube mucosa and peritoneal surfaces
49
how does endometrial cancer commonly spread
directly into the myometrium and cervix
50
how is endometrial cancer staged
FIGO staging system
51
first line investigation of suspected endometrial cancer
TVUS
52
positive TVUS finding of suspected endometrial cancer and what is done next
endometrial thickness > 4mm in postmenopausal women endometrial biopsy
53
what imaging can be used to stage endometrial cancer
MRI and CT
54
investigation of an endometrial tumour associated with lynch syndrome
immunohistochemistry and testing for microsatellite instability
55
how many stages are there in the FIGO classification of endometrial cancer and what do they mean
Stage 1: Confined to the uterus Stage 2: Invades the cervix Stage 3: Invades the ovaries, fallopian tubes, vagina or lymph nodes Stage 4: Invades bladder, rectum or beyond the pelvis
56
what is the most common uterine sarcoma
leiomyosarcoma
57
what are subserosal uterine fibroids
grow outside the uterus
58
what are intramural uterine fibroids
grow within the uterine muscle
59
what submucosal uterine fibroids
grow underneath the uterine lining into the endometrial lining

reproduction and sexual health (18 decks)

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