Uterus and ovaries A&P, Pathophysiology

Question 1

what is the isthmus

Answer 1

area where the wall of the tube is thickest

Question 2

What is the functional outermost layer of the uterus

Answer 2

stratum functionalis

Question 3

what is the base layer of the uterus

Answer 3

stratum basalis

Question 4

what occurs when endometrial tissue is outside of the uterine cavity

Answer 4

endometriosis

Question 5

what is endometriosis hallmarked by

Answer 5

dysmenorrhea, dyspareunia, infertility

Question 6

what is adenomyosis

Answer 6

enlargement of the myometrium due to presence of endometrial glands in this layer of the uterus - essentially a form of endometriosis

Question 7

what is the acronym for abnormal uterine bleeding

Answer 7

PALM-COEIN
PALM is the structural causes
COEIN is nonstructural

Question 8

What does PALM-COEIN stand for

Answer 8

Polyps
Adenomyosis
Leiomyoma (aka fibroid)
Malignancy

Coagulopathy
Ovulatory dysfunction
Endometrial
Iatrogenic
Not otherwise classified

Question 9

what is anovulatory cycle

Answer 9

no spike in LH or no ovulation there will be no corpus luteum - lack of progesterone

Question 10

what can occur with anovulatory cycle

Answer 10

elevated estrogen can cause increased bleeding from change in vascular development of the endometrium

Question 11

what is an overgrowth of the endometrial glands

Answer 11

endometrial hyperplasia

Question 12

what patients do we see endometrial hyperplasia in more

Answer 12

older patients and obesity

Question 13

what is the presentation of endometrial hyperplasia

Answer 13

abnormal uterine bleeding

Question 14

what is an overgrowth of endometrial glands and stroma

Answer 14

endometrial polyps

Question 15

where are endometrial polyps formed

Answer 15

around a vascular bed and will hang in a pedunculated fashion

Question 16

what are leiomyomas

Answer 16

fibroids or myomas
similar to polyps but are arising from smooth muscle and fibroblasts

Question 17

what are the symptoms of leiomyomas

Answer 17

depend on size and location - may cause severe menorrhagia, menometrorrhagia, can become necrotic if they twist, found at infertility workup

Question 18

what is an ascending infection from vagina and cervix

Answer 18

pelvic inflammatory disease

Question 19

what can be included with pelvic inflammatory disease

Answer 19

salpingitis, endometriosis, myometritis, oophoritis, tubo-ovarian abscess

Question 20

what can result as of PID

Answer 20

development of long term consequences as a result of the scaring/inflammation

Question 21

what is the most common causative agent of PID

Answer 21

gonorrhea and chlamydia
-e.coli can be associated with post-menopausal women
often thought to be polymicrobial

Question 22

What is the most common sexually transmitted disease

Answer 22

Chlamydia trachomatis

Question 23

when assessing for chlamydia what is the lab test

Answer 23

only grows on living media

Question 24

What is the cycle of N.gonorrhea

Answer 24

binds to fallopian tubes - endotoxin destroys cilia of surrounding cells - taken into the cells via endocytosis - transported in via endocytotic vacuole (of host cell) in which it multip

Question 25

what is the presentation of gonorrhea

Answer 25

urethritis (dysuria, discharge) can infect epididymis, prostate and rectum septic arthritis: typically in only 1 or two joints

Question 26

What is inflammation of intrauterine lining that is most commonly associkated with PID

Answer 26

endometritis

Question 27

what is endometritis associated with

Answer 27

PID and transcervical procedures

Question 28

What is the inflammation of the fallopian tube

Answer 28

salpingitis

Question 29

What is tubo-ovarian abscess

Answer 29

complication of PID, develops in pts with salpingitis inflammatory, infectious pathology with collection of purulent fluid within fallopian tube or ovary

Question 30

what is the presentation of tubo-ovarian abscess

Answer 30

acute pelvic/abdominal pain fevers/chills discharge adnexal tenderness/mass

Question 31

what is hallmarked by ovarian cysts, obesity, alternation in menses, increased androgen production

Answer 31

polycystic ovarian syndrome

Question 32

What are some of the genetic links associated with PCOS

Answer 32

P450c alteration LH receptor gene abnormalities DENND1A alteration Thyroid adenoma gene

Question 33

what occurs due to PCOS

Answer 33

incomplete ovulation hirsutism menorrhagia when menses occurs, dysmenorrhea as well endometrial hyperplasia

Question 34

what are signs and symptoms of PCOS

Answer 34

irregular or prolonged periods fluid filled sacs or cysts growth of extra, unwanted hair hair loss excessive cramping and bloating during menstruation acne and other skin problems psychological stress and depression fatigue pelvic pain rapid weight gain

Question 35

What is ovarian torsion

Answer 35

enlargement of ovary will cause twist around the ligament of ovary which encases the vascular supply progression will -> arterial obstruction necrosis = ischemia

Question 36

What side is ovarian torsion most common on

Answer 36

right side

Question 37

what is the presentation of ovarian torsion

Answer 37

severe, sudden onset of adnexal pain, vomitting