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Womens Health > 27- Diseases Of The Uterus And Adnexa > Flashcards

27- Diseases Of The Uterus And Adnexa Flashcards

1
Q

What is uterine leiomyoma?

A

Localized proliferation of smooth muscle cells surrounded by a pseudocapsule
High prevalence
Peaks in the 5th decade
Classified by their anatomic locations
Estrogen sensitive
Fibroids grow in pregnancy and shrink in menopause

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2
Q

What is the symptoms of fibroids?

A

Most of time asymptomatic and found incidentally
Bleeding
Pressure
Pain

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3
Q

What are the characteristics of vaginal bleeding from fibroids?

A

Most often from submucosal fibroids
Progressively increase amount of blood loss
Alteration of the contractile function of endometrium
Pressure necrosis exposes vascular beds

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4
Q

What is the correlation between bleeding and fibroids?

A

Abnormal bleeding is not always caused by fibroids even if present
Increasing amount of bleeding in a regular pattern suggests fibroid
Irregular pattern suggest hormonal problem

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5
Q

How does fibroids causes pelvic pressure ?

A

Enlargement of fibroids causes a sensation of pressure or fullness in the lower abdomen or pelvis without any abnormal bleeding
Other symptoms are frequency, GI symptoms, hydronephrosis

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6
Q

Do fibroids cause pain?

A

Pain is not a common presentation of fibroids

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7
Q

How to treat fibroids?

A

No treatment if asymptomatic
Myomectomy if pregnancy is desired
If pregnancy is not desired- progesterone supplementation, GnRH agonist, hysterectomy

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8
Q

What are the etiologies of endometriosis ?

A

Polymicrobial
Group B strep
Gram negative (e colo, proteus, klebsiella)

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9
Q

How to treat endometriosis ?

A

First line- ampicillin, clindamycin and gentamycin
If no C section can omit clindamycin
piperacillin, ampicillin/sublactam
Cefotetan, cefoxitin, cefotaxime

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10
Q

What is endometritis?

A

Rarely seen outside of pregnacy but does occur
Seen with PID
Rare cause of infertility
Caused by chlamydia gonorrhea and mycoplasma

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11
Q

How to treat endometritis?

A

Polyp removal by D&C

Hysteroscopy

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12
Q

What is adenomyosis?

A

Presence of endometrial tissue in the myometrium
Common cause of secondary dysmenorrhea
Can cause menorrhagia

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13
Q

How to treat adenomyosis?

A

Oral contraceptives pills
Levonorgesterol intrauterine system
Hysterectomy

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14
Q

What are the classification of endometrial hyperplasia?

A

Simple- excessive proliferation of endometrial glands

Complex- abnormal proliferation of glands, not stromal elements

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15
Q

What is the most common gynecologic cancer?

A

Endometrial cancer

90% of cases are estrogen dependent

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16
Q

What are the risk factors for endometrial cancer?

A 
Obesity 
Diabetes
Hypertension
Unopposed estrogen use
Early menarche
Late menopause 
Low parity
Diabetes
17
Q

How to treat endometrial cancer?

A

Surgery- total hysterectomy with bilateral salpingo-oophorectomy
Radiation for patients that cannot undergo surgery

18
Q

What are the characteristics of follicular cysts?

A

Most frequently occurring cysts
From failure of a dominant follicle or immature follicle failing to undergo atresia
Treatment with repeat US 6-8 weeks,OCPs

19
Q

What are the characteristics of corpus luteum cysts?

A

Post ovulation may cause progesterone to be produced beyond normal leading to amenorrhea
Can be hemorrhagic
Most common is sexually active women 21-25
Sudden onset lower abdominal pain after sex

20
Q

What is endometrioma?

A

Ovarian involvement of endometriosis
Less common
Surgery done for chronic pelvic pain

21
Q

What are the characteristics of torsion?

A

Most often seen in patients with benign ovarian lesions which twist and occlude vascular supply
Acute lower abdominal pain often with change of position, nausea and vomiting

22
Q

What are the characteristics of benign cystic teratoma (dermoid cyst)?

A

Named byVirchow
Derivatives of all 3 layers
Can contain hair, teeth and cartilage components
Rupture is devastating- significant chemical peritonitis

23
Q

What is ovarian fibroma?

A

Most common solid benign tumor of ovary
Associated with Meigs syndrome ( hydrothorax, ascites, ovarian fibroma)
Treated by excision

24
Q

What are the types of epithelial cell neoplasm?

A

Mucinous cystadenoma- 2 nd most common, less malignant than serous
Serous cystadenoma- most common , range from benign to malignant

25
Q

What is Brenner tumor?

A

Benign solid epithelial tumor
More common as patient ages
Treated by surgery

26
Q

What are the types of benign stromal neoplasm?

A

Granulosa theca cell tumors- feminization

Sertoli leydig cell tumors- virilization

27
Q

What are the characteristics of ovarian cancer?

A

2nd most common gynecologic malignancy
Most common cause of death from gynecological malignancy
Most are diagnosed in stage 3
Treated by surgery

28
Q

What is the treatment for tubo-ovarian abscess?

A

Hospitalization
IV fluid support
Antibiotics

Womens Health (26 decks)

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