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IMG1036 (OB-GYN 2) > week 1- uterine pathology > Flashcards

week 1- uterine pathology Flashcards

1
Q

another name for fibroids

A

leiomymoa

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2
Q

cause of leiomymoa

A

unknown

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3
Q

leiomyoma typically arise after menarche and regress after ___ implicating ___ as a promoter of growth

A
  • menopause

- estrogen

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4
Q

leiomyoma (fibroids) are __ tumours

A

bengign

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5
Q

benign tumors of smooth muscle cells and fibrous CT, single or multiple and vary in size`

A

leiomyoma

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6
Q

Rate of occurrence for leiomyoma is markedly greater in ___ than ___

A

African American

whites

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7
Q

3 areas where leiomyoma affcets in the uterus

A
  1. intramural (within myometrium)
  2. submucosal (beneath endometrium)
  3. subserosal (serosal)
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8
Q

serosal surface of uterus projecting into the peritoneal cavity, including pedunculated myomas

A

subserosal (serosal)

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9
Q

types of leiomyoma (4)

A
  1. pedunculated
  2. submucosal
  3. subserosal
  4. calcified
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10
Q

symptoms of ___ include:

  • menorrhagia (long bleed)
  • spotting
  • abdominal girth
  • pain
  • urinary frequency/ urgency
  • low back pain
  • leg discomfort/ swelling
A

leiomyoma

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11
Q

sonographic findings of leiomyoma

A
  • heterogeneous myometrium
  • irreg endometrial stripe
  • hypoechoic areas in myo
  • whorled internal architecture of mass
  • calcifications
  • posterior bladder contour change
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12
Q

what to do when requisition says: asymptomatic for leiomyoma

A

routine & FU

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13
Q

what to do when requisition says: large myomas and desire to become preg

A

myomectomy

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14
Q

what can the use of a prostaglandin or oral contraceptive do for leiomyoma

A

reduce eliminate symptoms bc control estrogen/progesterone levels

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15
Q

Pedunculated uterine leiomyomas occur when the fibroid is in continuity with the uterus. They may grow either ____ or ___

A
  • within uterine cavity (submucosal)

- outside the uterus (subsersosal)

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16
Q

appearance of calcified myoma

A

echogenic

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17
Q

___ calcifications of the uterus image as echogenic foci in the periphery.

A

arcuate artery

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18
Q

if the location of the myoma is difficult to determine it is likely ____. However disruption of endometrium could result in categorization as a ____

A
  • intramural (within myometrium)

- submucosal

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19
Q

within myometrium

A

intramural

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20
Q

beneath endometrium

A

submucosal

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21
Q

beneath the outer layer

A

subserosal

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22
Q

excessive growth of endometrium

A

endometrial hyperplasia

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23
Q

endometrial hyperplasia caused by

A
  • high estrogen
  • HRT (hormone replacement therapy)
  • tamoxifen therapy
  • diabetes
  • obesity
  • PCOD/ anovulatory cycles
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24
Q

t/f: endometrial hyperplasia increases womens risk for endometrial cancer and must be closely monitored

A

true

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25
Q

main cause of abnormal uterine bleeding

A

endometrial hyperplasia

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26
Q

upper limit endometrial thickness in premenopausal women

A

14mm

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27
Q

upper limit endometrial thickness in women on tamoxifen

A

10mm

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28
Q

upper limit endometrial thickness in postmenopausal women

A

8mm

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29
Q

Rx endometrial hyperplasia

A
  • Hysteroscopy
  • progesterone orally
  • IUD (progesterone containing)
  • hysterectomy
  • D&C (dilation & curettage)
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30
Q

removal of uterus

A

Hysterectomy

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31
Q

sonographic finding of hyperplasia

A
  • thickened endo

- homogeneous , hererogenic endo w/ small cystic areas

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32
Q

The findings of endo hyperplasia on US are nonspecific – a __ or ___ is necessary to confirm diagnosis

A
  • biopsy

- D&C (scrape your uterus)

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33
Q

adhesion of the endometrium

A

Asherman’s Syndrome/ Synechia

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34
Q

synechia / asherman’s syndrome is due to

A
  • trauma
  • surgery
  • c-section
  • d&c
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35
Q

fertility problems, normal-absent menses, recurrent pregnancy loss are common with ___

A

asherman’s syndrome / synechia

36
Q

Rx of ashermans syndrome/ synechia is

A

removal or rupture of the intrauterine adhesion

37
Q

HSG

A

Hysterosalpingography

38
Q

endometrium appears normal or hypoechoic with bridge like bands

A

US appearance for ashermans syndrome/ synechia

39
Q

SIS stands for

A

Saline infusion sonohysterography

40
Q

when is SIS used

A

for ashermans syndrome/ synechia

41
Q

what do we look at when we scan the uterus (6)

A
  • size
  • echogenicity
  • contour
  • shape
  • fluid in the PCDS
  • endometrium –> size
42
Q

pedunculated can be found ___ around the uterus because it is ____

A

anywhere

on a “string”

43
Q

t/f: Leiomyoma are commonly incidental findings

A

true

44
Q

from the muscles & CT, in different spaces, defined based on where they are situated, pt may have no symptoms until they grow (can cause swelling in legs)

A

Leiomyoma

45
Q

Tamoxifen

A

hormonal med given to women with certain type of breast cancer

46
Q

differential diagnosis

A

when something look likes it could be one condition so you need to look at signs and symptoms to differentiate between what the condition really is

47
Q

what helps to distinguish a benign from malignant process

A

3D (colour doppler)

48
Q

what plane allows further evaluation of the uterine lining

A

coronal

49
Q

bridging / adhesions of ___ is asherman’s syndrome

A

endometrium

50
Q

characterized by a large base located in the uterine wall (thicker)

A

amniotic sheet

51
Q

Color Doppler ___ (shows/ does not show) blood flow in the majority of synechial bands, while this is not typical of amniotic bands

A

shows

52
Q

synechial bands ____ show blood flow

A

do

53
Q

amniotic bands ___ show blood flow

A

do not

54
Q

during pregnancy asherman’s syndrome is called

A

amniotic sheets or folds

55
Q

endometrial polyp is Common benign lesion, involving the ___ of the endometrium

A

thickening

56
Q

how are polyps identified

A

saline infusion (SIS)

57
Q

Uterine Arterial Venous Malformation can occur in what parts of the uterus

A

endometrium or myometrium

58
Q

Uterine Arterial Venous Malformation is most commonly found in

A

myometrium

59
Q

result from formation of multiple arteriovenous fistulous communications within the uterus without an intervening capillary network.

A

UVAM

60
Q

AVM ((arterial venous malformation)) as seen with colour doppler

A

Abundant turbulent flow

High velocity, low resistance flow

61
Q

Polypoid appearance in endometrium indicate

A

AVM (arterial venous malformation)

62
Q

colpos refers to the ___

A

vagina

63
Q

Metra means the ___

A

uterus

64
Q

Hydrometrocolpos is fluid in

A

both vagina and uterus

65
Q

Hematocolpos is

A

blood in the vagina

66
Q

Hydrametra is

A

fluid in the uterus

67
Q

Hematometra is

A

blood in the uterus

68
Q

Hydrocolpos is

A

fluid in the vagina

69
Q

Hematometracolpos is

A

blood in both uterus and vagina

70
Q

does pain accomodate hydrosalpinx ?

A

NO, usually no pain

71
Q

the older the hematoma gets the ___ complex it becomes. Why?

A

more

starts to coagulate

72
Q

can you always see pedunculated on transvaginal?

A

No, can go far from uterus you need to do transabdonminal

73
Q

Most common gynecologic cancer in USA

A

endometrial carcinoma

74
Q

high/ longer exposure to this hormone means higher chance for endometrial carcinoma

A

estrogen

75
Q

endometrial carcinoma found in ___ (older/ younger) women .. what age?

A

older

60-70 yrs

76
Q

clinically presents as:
Bleeding
Pain
Uterine distention

A

endometrial carcinoma

77
Q

stage 1 indicates

A

localized / confined carcinoma

78
Q

stage 4 indicates

A

carcinoma spread through blood to lymph nodes etc

79
Q

stage 2/3 indicates

A

carcinoma spread adjacently to surrounding organs

80
Q

if you see changes in cervix it likely means the carcinoma is in what stage

A

late stage

81
Q

best modality for METS

A

CT / MRI

82
Q

best modality for cervix carcinoma

A

pap smear

83
Q

Sonography is important role in evaluating what with IUD

A

it is in proper location

84
Q

how does IUD look on US

A

echogenic line in endometrial canal

85
Q

if IUD is NOT seen on US then what imaging technique is used

A

x-ray

IMG1036 (OB-GYN 2) (3 decks)

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