Uterine Disorders Flashcards Preview

Reproductive Medicine Exam 2 > Uterine Disorders > Flashcards

Flashcards in Uterine Disorders Deck (33)
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1
Q

What mullerian disorder of the uterus is most commonly seen with pregnancy loss?

A

Uterine Septum

2
Q

What uterine anatomical change is frequently associated with mid-trimester loss of pregnancy of pre-term birth?

A

Bicornuate or Unicornuate Uterus

3
Q

How do vaginal septums occur?

A

Incomplete canalization of the mullerian tubercle

4
Q

When to vaginal septums typically present?

A

Typically around puberty due to pelvic mass or amenorrhea

5
Q

What imaging study is useful in diagnosing uterine and tubal disorders?

A

Hysterosalpingogram

6
Q

__________ Syndrome results commonly from intrauterine synechiae (adhesions) usually due to recurrent curettage

A

Asherman’s Syndrome

7
Q

T/F: Patients requiring recurrent curettage due to miscarriage or elective pregnancy termination are more at risk for Asherman’s Syndrome

A

True

8
Q

_____ _________ is inflammation of the endometrial lining that typically occurs from an ascending infection (Gc/Chl) from the lower genital tract

A

Benign Endometritis

9
Q

T/F: In non-pregnant population, endometritis is most commonly associated with Pelvic Inflammatory Disease

A

True

10
Q

Are endometrial polyps typically benign or malignant?

A

Benign

11
Q

How are benign endometrial polyps diagnosed?

Treated:

A

Dx: Sonohysterogram

Tx: Hysteroscopic Resection

12
Q

_____ ______ is described as the presence of ectopic endometrial glands and stroma in the myometrium which typically presents in parous women between the ages of 35-50 y.o.

A

Benign Adenomyosis

13
Q

How may a uterus feel/appear on physical examination in a patient with Adenomyosis?

A

Diffusely enlarged, globular, tender uterus

14
Q

How is adenomyosis diagnosed?

A

Clinical Suspicion

US or MRI

15
Q

How is adenomyosis managed?

A
  1. r/o co-esistent pathology
  2. NSAIDs +/- Hormones
  3. Hysterectomy
16
Q

What is the most common solid pelvic tumor in women?

A

Leiomyoma Uteri

17
Q

What is a Leiomyoma Uteri?

A

Benign tumors of smooth muscle origin

18
Q

T/F: The majority of Leiomyoma Uteri are symptomatic

A

False

The majority are asymptomatic

19
Q

Although Leiomyoma Uteri is asymptomatic…..

What would the most common symptom be at presentation?

A

Bleeding Abnormalities

20
Q

What imaging modality is commonly used to work up Leiomyoma Uteri?

A

US

MRI is occassionally used

21
Q

How is asymptomatic Leiomyoma Uteri managed?

A

No treatment required

22
Q

What is the goal of management for symptomatic Leiomyoma Uteri?

A

Control Hormonal Regulation and minimize unopposed estrogen

23
Q

Will OCPs shrink uterine fibroids?

A

No

24
Q

What medication class have shown to reduc uterine bulk from Leiomyoma Uteri?

A

GnRH Agonists

25
Q

What is the only viable management option for Leiomyoma Uteri in women who wish to preserve fertility?

A

Myomectomy

26
Q

What is the most DEFINITIVE management for Leiomyoma Uteri?

A

Hysterectomy

27
Q

A 49 y/o female patient presents for routine gyne exam. She reports that for the last 6 months her menses have been getting longer and heavier. She also says she has been experiencing urinary frequency and constipation. Her abdominal exam is unremarkable. On pelvic exam, you feel a slightly enlarged irregular uterus and a left adnexal mass that moves with the uterine fundus. No other clinical findings. What is the most likely diagnosis?

A

Leiomyoma Uteri

28
Q

What is the most common etiology of endometrial hyperplasia?

A

Unopposed Estrogen

29
Q

What is the biggest risk factor for endometrial hyperplasia?

A

Obesity

30
Q

What breast CA medication places a patient at higher risk for developing endometrial hyperplasia?

A

Tamoxifen

31
Q

How could endometrial hyperplasia diagnosed?

A
  1. PAP Smear with glandular cells
  2. Endometrial Biopsy
  3. US
  4. Hysteroscopy with D&C
32
Q

How is endometrial hyperplasia without atypia managed?

A

Cyclical Progestrin Therapy

33
Q

Case #8: A 52 y/o obese patient with persistent menorrhagia undergoes an endometrial bx and is diagnosed with atypical adenomatous hyperplasia. What is the next best step in management?

A) Hysteroscopy/D & C to confirm no adenocarcinoma followed by total abdominal hysterectomy
B) Observation with repeat biopsy in 3 months
C) D & C to confirm no adenocarcinoma followed by daily Progesterone therapy
D) Oral Progesterone for 14 days a month and repeat biopsy in 6 months

A

A) Hysteroscopy/D & C to confirm no adenocarcinoma followed by total abdominal hysterectomy