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Ob / Gyn 2 > Uterine pathology > Flashcards

Uterine pathology Flashcards

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1
Q

The Müllerian ducts fuse to form the

A

Uterus, cervix and upper vagina

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2
Q

Which ends of the Müllerian ducts fuse

A

Caudal

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3
Q

The infused ends of the Müllerian ducts form the

A

Fallopian tubes

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4
Q

What is a unicornate

A

Form of arrested development
Deviation of the fundal endometrium to the Lt or Rt
Banana shaped uterus

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5
Q

What Müllerian duct abnormality has the highest association of renal anormialites arising on the contralateral side

A

Unicornuate

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6
Q

Bicornuate uterus and uterine didelphys is a form of what mullarian duct abnormality

A

Failure of fusion

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7
Q

What are the forms of Müllerian duct abnormalities that are from failure of resorption

A

Septations >1cm indictation

Subseptate

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8
Q

What is a prolapsed uterus

A

The decent the uterus down the vagina

Caused by weak pelvic floor muscles

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9
Q

Is a prolapsed uterus diagnosed sonographically

A

No

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10
Q

What is asherman’s syndrome

A

When the endometrial lining is replaced by fibrous adhesions
It is considered a scar in the endometrium
Occurs after a D&C, multiple abortions or infections

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11
Q

Can asherman’s syndrome vary in appearance of a thick to thin endometrium

A

Yes

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12
Q

What does asherman’s syndrome cause

A

Loss of menstruation and infertility

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13
Q

are AV malformations of the uterus common or rare

A

Rare

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14
Q

What is the cause of AV malformations of the uterus and what are the symptoms

A

Congenital
From trauma or surgery

  • menorrhagia
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15
Q

What is the sonographic apperance of AV malformations of the uterus

A

Difficult to assess until the use of colour Doppler

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16
Q

What is neoplasia

A

Multiplication of abnormal cells, can be malignant or benign

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17
Q

What are non neoplasticism conditions

A 
Endometrial hyperplasia 
Endometrial polyps
Adenomyosis
Uterine varices
Endometritis
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18
Q

What is endometrial hyperplasia

A

Unopposed estrogen stimulation from ovarian dysfunction

Occurs immediately after menarche and also before menopause (premenopausal)

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19
Q

What can endometrial hyperplasia cause

A

Irregular uterine bleeding

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20
Q

What is the sonographic appearance of endometrial hyperplasia

A

Thick hyperechoic endometrium

Can Involve most, focal or modular parts of the endometrium

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21
Q

What is a DDX of endometrial hyperplasia

A

Endometrial CA or polyps

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22
Q

What are endometrial polyps

A

Endometrial growth extending into the canal from a stalk

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23
Q

What can endometrial polyps protrude into and what can it cause

A

Into the cervix if it has a long stalk

Bleeding or be asymptomatic

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24
Q

What type of test is done to see endometrial polyps

A

Sonohysterogram

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25
What is adenomyosis
Extension of endometrial tissue (glands and storma) beyond the endometrium into the myometrium
26
What is adenomyosis a form of
Endometriosis because it is an ectopically placed endometrium into the myometrium and causes the endo/myometrium junction to be less pronounced (fuzzy) or jagged.
27
Where does adenomyosis typically occur in the uterus
Posterior wall
28
What can adenomyosis cause
Pain | Abnormal bleeding
29
What is the sonographic appearance of adenomyosis
Slight diffuse uterine enlargement Hypoechoic or cystic lesions within the myometrium May have focal lesions May look like a fibroid or polyp Myometrium of unequal thickness ~endometrium is not in the centre of the uterus
30
What is adenomyosis appearance often described as
Venetian blind | ~which is multiple lines shadowing in the posterior aspect of the uterus in the myometrium
31
Where are uterine varices typically found on
The lateral aspect of the uterus, colour Doppler will help differentiate from an ovary
32
What is endometritis
Inflammation of the endometrium
33
When does endometritis often occur
Postpartum Or PID
34
What is the sonographic appearance of endometritis
Normal endometrium Irregular endometrium Fluid filled cavity to it can demonstrate gas bubbles from micro-organisms
35
Leiomyoma and lipoleiomyoma are
Benign uterine neoplasia
36
What is leiomyoma
Aka fibroids A benign neoplasticism mass of fibromuscular tissue Most common tumor in the female pelvis And most commonly found in African American women
37
Leiomyoma are influenced by
Increase in estrogen | ~like pregnancy or menopause
38
If leiomyoma is malignant what is called and is it common or rare
Leiomyosarcoma and it is rare
39
What are symptoms from leiomyoma
``` Menorrhagia Pain Pressure Palpable mass on pelvic exam Infertility ```
40
What are classifications of leiomyoma
Intramural Submucosal Sub serosal
41
Where are intramural fibroids
Confined in the myometrium | Most common
42
Where are submucosal fibroids
Project into the uterine cavity Can be pedunculated Can cause bleeding
43
Where are subserosal fibroids
Project from perimetrium Can be pedunculated Can be found in the broad ligament
44
What are the sonographic appearances of fibroids
Hypoechoic with high attenuation Enlarged uterus with irregular contour Calcifications may be present in older women May be complex looking with degeneration and necrosis
45
Why can fibroids look necrotic
Because they have outgrown their blood supply
46
What happens to fibroids with pregnancy
Enlarge from the increase in estrogen Because of rapid growth it may result in necrosis from lack of adequate blood supply Large fibroids near cervix can inhibit delivery of the fetus ~c-section would become necessary
47
Where are fibroids typically located in the uterus
Lateral aspect
48
What are lipoleiomyoma and are they common
Lipocystes (fat) and fibromuscular tissue | They are uncommon
49
What is the sonographic appearance of lipoleiomyoma
Very hyperechoic and attenuating | Appear similar to dermoid
50
Leiomyosarcoma and endometrial carcinoma are
Malignant uterine neoplasias
51
What is leiomyosarcoma
Rare May arise from pre-exisiting fibroid Has the same symptoms as fibroids
52
What is the sonographic appearance of leiomyosarcoma
Degenerating fibroid appearance | May see local invasion of surrounding organs or hepatic metastasis
53
What is endometrial ca
Makes up 90% of all uterine malignancies | Most common in postmenopausal women
54
What is the symptom of endometrial ca
Postmenopausal bleeding
55
How many stages are there of endometrial ca
4
56
What is stage 1 endometrial ca
Confined to the endometrium
57
What is stage 2 endometrial ca
Confined to the uterus
58
What is stage 3 endometrial ca
Spread beyond the uterus but still within the pelvis
59
What is stage 4 endometrial ca
Distal metastasis (i.e liver)
60
What are the risk factors associated with developing endometrial ca
``` Strong association with estrogen therapy (HRT) obesity Hypertension Diabetes PCOS Granulosa cell tumour of the ovary ```
61
What is the sonographic appearance of endometrial ca
Thick echogenic endometrium | Ifficulty distinguishing from hyperplasia or polyps
62
What is tamoxifen
A non-steroidal anti-estrogen hormonal drug Used in the treatment of breast ca An estrogen antagonist to the uterus resulting in simulation of the endometrium
63
What does tamoxifen increase the risk for
Developing endometrial ca by 1% but the benefit for breast cancer outweighs the risk for uterine ca
64
What is the sonographic appearance of the endometrium when a patient is on tamoxifen
Heterogenous and bizarre

Ob / Gyn 2 (8 decks)

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