W10_05 Endometriosis Flashcards Preview

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Flashcards in W10_05 Endometriosis Deck (17)
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1
Q

define endometriosis

A

the presence of endometrial glands and stroma outside of the uterus; can be a cause of secondary dysmenorrhea

2
Q

define adenomyosis

A

infiltration of endomtrial glands and stroma in the myometrium

3
Q

what are 4 proposed theories for endometriosis?

A

retrograde menstruation;
hematogenous or lymphatic transport;
altered immunologic responses;
coelomic metaplasia

4
Q

where do endometriosis lesions most typically present?

A

dependent portion of the pelvis - cul-de-sac, posteriod uterus, etc

5
Q

note: some sort of polygenic inheritance for endometriosis

A

ok

6
Q

what’s the classic triad of endometriosis?

A

dysmenorrhea, deep dyspareunia, infertility;
also, chronic pelvic pain

7
Q

what are other symptoms of endometriosis?

A

menstrual irregularities, dyschezia, dysuria, hematochezia, hematuria

8
Q

what are physical findings of endometriosis?

A

focal tenderness on pelvic exam;
uterosacral nodularity (almost pathonomonic for endometriosis);
fixed retroversion of uterus;
adnexal mass with tenderness

9
Q

what are laparoscopic findings of endometriosis?

A

lesions: clear, red, white, black powder burn

10
Q

how to definitively diagnose endometriosis?

A

surgery. Note that findings correlate poorly with symptoms. Also you can start medical treatment before surgery

11
Q

what’s the first line therapy for endometriosis pain?

A

NSAIDs, OCP, Progestin

12
Q

what’s the second line therapy for endometriosis pain?

A

prostaglandin analog - dienogest, anti-estrogen agents (Danazol), GnRH agonist

13
Q

what’s the difference between conservative surgery and definitive surgery in endometriosis?

A

conservative is just getting the lesions, while definitive is removing tubes, ovaries, uterus

14
Q

what are the two conservative surgery methods?

A

ovarian cystectomy “enucleation” or ;
cyst aspiration with cauterization

15
Q

note: there’s an increased incidence of ovarian cancer among women with endometriosis (although it’s still low)

A

cancers include endometriod and clear cell cancers

16
Q

how to tell if the ovarian cancer transformed from endometriosis?

A

both endometriosis and malignancy within same ovary;
carcinoma must arise from the endometriosis;
specimen must have histological characteristics of endometriosis;
morphological continuation between benign and malignant epithelium

17
Q

note: only about 0.9% of cases fit the 4 sampson criteria for endometriosis to malignancy transformation

A

ok

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