Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

PCM IV Final > 11. Pelvic Pain > Flashcards

11. Pelvic Pain Flashcards

1
Q

approach to pt with pelvic pain

A
  1. Hx
  2. PE
  3. DDx
  4. Directed testing
  5. Treatment plan
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what is important to note when taking hx of a premenopausal W with pelvic pain

A

menstrual history and menstrual profile

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what is menstrual profile

A
  1. menarche
  2. cycle length and variability
  3. flow
  4. dysmenorrhea
  5. cramping/pain/radiation
  6. changes in bowel or bladder
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

PE of pt with pelvic pain

A
  1. General appearance
  2. Head to toe: skin, back, spine, abdomen, pelvic, bladder and bowel eval
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Glands and stroma, invading into the walls of the uterus.

A

adenomyosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

DDx of cyclic pelvic pain

A
    1. Endometriosis *** => ectopic glands and stroma
    1. Mittelschmerz => pain with ovulation
    1. Dysmenorrhea
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

DDx of non-cyclic pelvic pain

A
  1. Interstitial cystitis
  2. Diverticulitis
  3. Hernia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

MEnstrual related causes of pelvic pain

A
  1. Endometriosis
  2. Adenomyosis
  3. Mittelschmerz
  4. Post-ablation syndrome = menstrual fluid behind scar in uterus
  5. Leiomyoma
  6. Catamenial
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

A cloning phenomena, where proliferation of cells can enlarge the uterus, the adnexa, or the supporting ligaments of the uterus. These may be intramural, pedunculated, subserosal, ligamentous, cervical, or intracavitary.

A

leiomyoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

ectopic glands in stroma in other places of body

A

catamenial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

theories of endometriosis

A
  1. Coelomic metaplasia = metaplasia of cells from ovarian and peritoneal surfaces
  2. retrograde menstruation +> retrograde flow of endometrial cells through tubes and onto pelvic surfaces
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

ovarian related causes of pelvic pain

A
  1. Ovarian cysts
    1. painful with rupture, bleeding or leaking of fluid
  2. OVarian torsion
    1. rotation on suspensory l; precipitated by cyst or mass that is >5cm
  3. OVarian remnant = ovarian tissue regenerates/grows in response to gonadotropins, forming a cyst or mass.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

MC reason for cyclic pelvic pain

A

ovarian cysts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

how do OCS affect risk of ovarian cysts, ovarian and uterine cancer

A

decrease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

bilateral removal of ovaries causes what?

ovarian remnants most often on __ side

A

increased estradoil

L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

fallopian tube causes of pelvic pain

A
  1. Obstruction of flow or infection (hematosalpinx = blood; pyosalpinx = pus; hydrosalpinx = fluid) are the MC.
    1. Pain with distension of lumen
  2. PID Salpingitis
    1. peritonitis + abscess or spsis
    2. pain, fever, high WBC/EST
  3. Ectopic PG
    1. pain w distension/rupture
17
Q

when can a IUP be detected on

- transvaginal sonography

- transabdominal US

A
  • transvaginal sonography: >1200 mIU/mL hCG
  • transabdominal US: >2000 mIU/mL hCG
    *
18
Q

Uterus causes of pelvic pain

A
  1. endometritis
  2. IUD
  3. Threatened/septic abortions, post-term pain
    1. = pain when round ligament is stretched early in PG
19
Q

what is endometritis and what can cause

A
  • infection of uterine cavity
  • ascending infection with strep, myoplasma, ureaplasma, haemophilus, anaerobes
20
Q

cervicitis is most likely due to ___

A

STI

21
Q

vascular causes of pelvic pain

A
  • 1. pelvic congestion: dilated veins in pelvis (broad ligament, paratubal/ovarian supporting structures, paravaginal/vulvar)
    • pain and congestion after activity, standing, sex or period
22
Q

noncyclic causes of pelvic pain due to bladder

A
  1. UTI,
  2. urinary retention
  3. bladder prolapse

Pain = centra land related to bladder patterns

23
Q

A defect in the protective layer of the bladder => causing frequency, burning pain, decreased bladder compliance, UTI-like symptoms, and flares of increased symptoms

A

interstitial colitis

24
Q

what can be seen in intersitial colitis and is pathognomonic

A

Hunners uclers = red area with prominant radial vessels but nOT A TRUE ULCER

25
Q

UReter causes of bladder pain

A
  1. Stone
    1. => pain is anterior/flank pain d/t renal colic
  2. Fibrosis, injury, endometriosis => ureteral obstruction or stenosis
    1. lower abdomnal painm flank, lower back
26
Q

bowel related causes of pelvic pain; which are cyclic vs non

A
  1. IBD (Crohns or UC) = non-cyclic
  2. IBS = cyclic due to shared nerve pathways in presence of endometriouss
  3. Diverticulitis, Chronic constipation, intolerance
    1. pain, bloating and bowel discomfort
  4. Appendiciits = mid-abdomina => RLQ pain
    1. fever, anorexia, bloating and pain
    2. perforation = sepsis and shock
27
Q

dx appendicitis

A

mc-buneys point: 1/3 of distance from ASIS to BB

28
Q

MC hernia in women

A

indirect inguinal

29
Q

nerological caues of bladder pain

A
  1. Varicella Zoster (shingles) or Nerve entrapment (ilioingiinal/genitogemorial)
    1. => lower ABD pain that radiates to groin/anteiror thigh and worse when extend back
  2. Pelvic floor neuralgia/pudendal neuralgia
    1. Pain in deep pelvis/ paravaginal/vaginal tissue: cant poop or pee and occurs when lifting or strain
30
Q
  1. Dysuria
  2. Dysmenorrhea
  3. Dyscheziais
  4. Dyspareunia
  5. Dyssnergiais
A
  1. Dysuria = painful urination
  2. Dysmenorrhea = painful period
  3. Dyscheziais = painful bowel movement = constiaption
  4. Dyspareunia = painful sex
  5. Dyssnergiais = disturb of musclar/neuromuscular coordinatio
31
Q

difference in acute and chronic pelvic pain

A

acute = sudden onset of lower adbominal pain less than 3 months

chronic = lower abdominal pain that lasts 4 months or longer and is NOT related/seperate from organ system or menses

PCM IV Final (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions