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OB Review > Adnexal Path and infertility > Flashcards

Adnexal Path and infertility Flashcards

1
Q

Endometriosis

A
  • ectopic location of functional endo tissue

- attaches to fallopian tubes, ov, colon and bladder

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2
Q

Endometriosis clinical findings

A
  • asymptomatic
  • dysmenorrhea
  • pelvic pain
  • irrgular menses
  • dyspareunia
  • infertility
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3
Q

endometriosis sono findings

A
  • difficult to vis w/ U/S
  • obscure organ boundries
  • fixation of ov posterior to UT
  • endometrioma
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4
Q

endometrioma

A
  • focal collection of ectopic endo tissue

“chocolate cyst”

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5
Q

endometrioma clinical findings

A
  • asymptomatic
  • metromenorrhagia
  • dysmenorrhea
  • dyspareunia
  • palpable pelvic mass
  • infertility
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6
Q

endometrioma sono findings

A
  • hypo homo adnexal mass
  • thick well defined wall margins
  • diffuse low level echos w/ or w/o solid components
  • avascular mass
  • fluid
  • mass w/ not regress in size on serial sonogram
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7
Q

krukenberg tumor

A
  • metastatic lesions
  • primary lesion from gastic carcinoma
  • other primary structures include large intestine, breast, or appendix
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8
Q

krukenberg tumor clinical findings

A
  • asymptomatic
  • abd pain
  • bloating
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9
Q

krukenberg tumor sono findings

A
  • bilat adnexal or ov mass
  • oval or lobulated margins
  • hypo areas w/in mass
  • posterior enhancement
  • ascities
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10
Q

paraovarian cyst

A
  • mesothelial in origin
  • typically located in broad ligaments
  • not assoc with hx of PID, surgery or endometriosis
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11
Q

paraov cyst clinical findings

A
  • asymptomatic
  • pelvic pain
  • palpable pelvic mass
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12
Q

para ov cyst sono findings

A
  • round or ovoid anechoic adnexal mass
  • separate from ipsilateral ov
  • thin smooth wall margins
    0 stable size on serial sonograms
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13
Q

PID

A
  • bacterial infection
  • diverticulitis
  • appendicities
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14
Q

PID clinical findings

A
  • abd pain
  • fever
  • vag discharge
  • urinary frequency
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15
Q

PID sono findings

A
  • normal pelvic appearence
  • thick and hypervascular endo
  • complex tubular adnexal mass
  • ill defined multilocular adnexal mass
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16
Q

carcinoma of tubes

A
  • dysplasia

- carcinoma in situ

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17
Q

carcinoma of tubes clinical findings

A
  • pelvic pain
  • abnormal bleeding
  • pelvic pain
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18
Q

carcinoma of tubes sono findings

A
  • sausage shaped complex adnexal mass

- papillary projections

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19
Q

hydrosalpnix

A
  • PID
  • endometriosis
  • postoperative adhesion
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20
Q

hydrosalpnix clinical findings

A
  • asymptomatic
  • pelvic fullness
  • infertility
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21
Q

hydrosalpnix sono findings

A
  • tuboovarian abscess

- loops of bowel

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22
Q

pyosalpnix

A
  • bacterial infection

- pus in fallopian tubes

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23
Q

pyosalpnix clinical findings

A
  • asymptomatic
  • low grade fever
  • pelvic fullness
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24
Q

pyosalpnix sono findings

A
  • complex tubular adnexal mass
  • wall thickness >5 mm
  • irregular margins
  • mass attenuates the sound
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25
Q

salpingitis

A

inflammation of tubes

26
Q

salpingitis clinical findings

A
  • pelvic pain
  • fever
  • dyspareunia
  • leukocystosis
27
Q

salpingitis sono findings

A
  • nodular, thick tubular adnexal mass
  • complex adn mass
  • posterior enhancement
28
Q

tuboovarian abscess

A
  • pelvic infection

- STD

29
Q

tuboovarian abscess clinical findings

A
  • severe pelvic pain
  • fever
  • leukocytosis
  • nausea/ vomiting
30
Q

tuboovarain abscess sono findings

A
  • complex multilocular adn mass
  • ill defined wall margins
  • total breakdown or normal adnexal anatomy
31
Q

Infertility is suggested when coneption doesnt occur w/in

A

1 year

32
Q

infertility is caused by

A

male or female reproductive abnormalities

33
Q

most common cause of female infertility is

A

ovulatory disorder

  • PCOS
  • luteinizing unruptured follicle syndrome
  • luteal phase inadequacy
34
Q

Other causes of female infertility

A

oviduct disease, congenital ut anomalies, endo pathology, cx mucus abnormality, nutritional factors, metablic disorder and synechiae

35
Q

fibroids are responsible for what percent of infertility cases

A

15

36
Q

Ovarian Induction Therapy

A

medications are injected to stimulate follicular development

37
Q

Ovarian induction therapy stimulates

A

pituitary gland to increase secretion of FSH

38
Q

Ovarian Induction Therapy follicular growth is monitored by

A

periodic US exam

39
Q

Ovarian Induction Therapy estrodial levels are monitored for

A

timing of intramuscular injection of hCG

40
Q

In Vitro Fertilization

A

mature ova are aspirated with US guidance

41
Q

In Vitro Fertilization is accumplished in what setting

A

laboratory

42
Q

In Vitro Fertilization endo is prepared to accept

A

embryo

43
Q

In Vitro Fertilization embryos are transferred into

A

endo

44
Q

Gamete Intrafollicular Transfer requires

A

ovulation stimulation and retrieval of oocyte

45
Q

Gamete Intrafollicular Transfer oocytes are mixed with

A

sperm and then transferred into tubes

46
Q

Zygote Intrafallopian Transfer

A

zygote is transferred into fallopian tubes

47
Q

What type of uterus has a high incidence of infertility

A

septae

48
Q

Endo thickness >8 mm is assoc with a

A

decrease in infertility

49
Q

Full luteal function is expected with an endo thickness of 11 mm or greater during mid ____ phase

A

luteal

50
Q

Baseline study before therapy, assess for the presence of an

A

ov cyst or follicle

51
Q

During induction therapy, monitor the

A

size and number of follicles per ov

52
Q

count and measure only the follicles greater than

A

1 cm

53
Q

Optimal follicle size before ovulation is

A

1.5 - 2 cm

54
Q

Correlate estradiol level with

A

size and number of follicles

55
Q

Ectopic pregnancy

A

more common in patients with hx of infertility

56
Q

Mutliple gestations are most common with

A

IVF 25%

57
Q

Ovarian Hyperstimulation Syndrome is caused by

A

high hCG levels

58
Q

Ovarian Hyperstimulation Syndrome clinical findings

A

lower abd or back pain, abd distention, nasuea/ vomiting, hypotension and leg edema

59
Q

Ovarian Hyperstimulation Syndrome multicystic enlargement measures

A

> 5 mm

60
Q

Ovarian Hyperstimulation Syndrome additional sono findings include

A

ascites and pleural effusion

OB Review (12 decks)

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