Adnexal Pathology

Question 1

What is the ascending order of infection in Pelvic Inflammatory Disease

Answer 1

From Vagina>CX>Uterus>Tubes>Ovary & Adnexa

Question 2

Name 3 Pathogens of PID (Pelvic Inflammatory Disease)

Answer 2

Chlamydia, E. Coli, Nisseria Gonorrhea

Question 3

A collection of fluid within a scarred or obstructed fallopian tube

Answer 3

Hyddrosalpinx

Question 4

Hydrosalpinx is caused by ________ which is pus in tube, being treated and replaced with fluid

Answer 4

Pyosalpinx

Question 5

Name the 3 Stages of PID

Answer 5

Stage I)Ednometritus, Stage II)Subacute or Acute Salpingitis, pyosalpinx Stage III) Broad ligament & ovarian involvement, (TOA) Tubo-ovarian abscess develops
Fitz-Hugh-Curtis Syndrome–

Question 6

What are the sono findings in Stage 1 PID

Answer 6

Thick, irregular endo, +/- air in Endo.=aka-irregular”dirty shadowing”

Question 7

What is found in Stage II PID =(Subacute Salpingitis)

Answer 7

Pyosalpinx = enlarged tube w/complex fluid inside (pus)

Question 8

What are 2 sono findings in Stage III PID

Answer 8

(TOA) = Complex adnexal mass
Peritonitis & acute Peri hepatitis

                       *Note In Fitz-Hugh-Curtis Syndrome--- Ascites & fluid are seen in periportal space

Question 9

Long standing condition with scarring adhesions; can have Infertility, bowel obstructions, uterus & ovaries scar together

Answer 9

Chronic PID

Question 10

List the sono findings of Chronic PID

Answer 10

Hydtosalpinx “Indefinite Uterus” means no good definition around UT & Ovaries–(all scarred together)

Question 11

What are the Clinical Signs of PID

Answer 11

1) Pain
2) Fever
3) Increased White Count

Question 12

Describe and name the Pain related to PID

Answer 12

Lower Abd./Pelvic Pain
CMT= cervical motion tenderness=”Chandelier Sign”

*Note
As a Sonographer you can note this-pain when probe touches Cx. Tell Rad…

Question 13

The presence of functional endometrial tissue outside the uterine cavity
The tissue responds to hormones and cycles just like nml endo
Implants may be anywhere in the body

Answer 13

Endometriosis

Question 14

Most common location for Endometriosis

Answer 14

Ovary 80% **

Question 15

Other locations for Endometriosis

Answer 15

Tubes
Broad ligament
Posterior Cul de Sac
Peritoneum

Question 16

Who are most likely candidates to get Endometriosis

Answer 16

Whites & Women of childbearing age;

** Gets worse w/age

Question 17

What are 2 Forms of Endometriosis

Answer 17

Diffuse
Localized
*Note Both forms usu. co-exist

Question 18

Scattered endometrial implants

Answer 18

Diffuse Endometriosis

Question 19

Referred to as “Chocolate Cyst”

Answer 19

Localized Endometriosis

Question 20

What are the clinical signs referred to as 4 D’s

Answer 20

Dysmenorrhea–painful menses
Dyspareuria–painful intercourse
Dysuria–painful urination
Dyschezia–painful defecation

Question 21

What is one “BIG” problem assoc. w/Endometriosis

Answer 21

Infertility

Question 22

What are the causes for infertility assoc. w/Endometriosis

Answer 22

Ovaries get scarred from the implants

Tubes get scarred

Question 23

Endometriosis has 4 Stages: Name them

Answer 23

Stage 1 Minimal-a few, superficial implants
Stage 2 more implants and deeper
Stage 3 Moderate–Ovaries affected & adhesions (scar)
Stage 4 Severe=Stage 3 & more dense adhesions

Question 24

Which stage in Endometriosis is Ovaries affected

Answer 24

Stage 3

Question 25

Which 2 Stages are affected by adhesions

Answer 25

Stages 3 & 4

Question 26

When appendix measures _____ it is called _______

Answer 26

6mm, appendicitis

Question 27

When a stone is seen in appendix

Answer 27

apendicolith