Brainscape's Knowledge GenomeTM

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


See full index

R2F > Benign conditions of the Uterus, Ovary and Fallopian Tubes > Flashcards

Benign conditions of the Uterus, Ovary and Fallopian Tubes Flashcards

1
Q

uterus and cervix- development

A
  • upper vagina, cervix, uterus, fallopian tubes formed from mullerian (paramesonephric) ducts
  • no Y chrom- no mullerian inhibiting substance- leads to development of paramesonephric system and regression of mesonephric system
  • paramesonephric ducts arise at 6 wks- at 9 wks they fuse in midline and form uterovaginal primordium
  • septum resolves later- leads to a single cervix and uterus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

failure of paramesonephric ducts to fuse can lead to

A
  • uterus didelphysis- 2 separate uterine bodes with its own cervix, fallopian tube, and vagina
  • bicornuate uterus w/ or w/o dbl cervix
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

incomplete dissolution of midline fusion of paramesonephric ducts leads to

A

-septate uterus

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

mullerian agenesis (MRKH syndrome)

A
  • complete lack of development of paramesonephric system

- absence of uterus and most of vagina

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

congenital anomalies of cervix

A

result of malfusion of paramesonephric ducts

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

uterine and cervical anomalies- due to?

A
  • spontaneous (mostly)

- DES- small T-shaped endometrial cavity; cervical collar deformity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Uterine leiomyomas

A

(fibroids)

  • benign tumors- smooth m cells of myometrium
  • most common neoplasm of uterus!!!
  • 70% of women have them by 50
  • most asx
  • if sx- uterine bleeding, pelvic pressure/pain, infertility- most common indication for hysterectomy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Fibroids- risk factors

A
  • inc age during reprod yrs
  • Af Am- 2-3X
  • nulliparity
  • FH
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Fibroids- pathogenesis

A
  • unknown factors
  • rarely form b/f menarche or enlarge after menopause- estrogen stim prolif of smooth m cells
  • 40% enlarge during pregnancy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Fibroids- characteristics

A
  • spherical, well circumscribed, white firm lesions w/ whirled appearance
  • may degenerate and cause pain- during pregnancy, 10% undergo a painful red degeneration caused by bleeding into the tumor
  • may calcify in postmenopausal pts
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Fibroids- types

A
  • subserosal
  • intramural- most common
  • submucosal- heavy menstrual bleeding is common
  • cervical
  • intraligamentous
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

fibroids- sx’s

A
  • 80% are asx
  • pelvic pain/pressure
  • severe pain is not common (unless red degeneration/acute infarction)
  • freq of urination
  • prolonged/heavy bleeding- most common sx!!
  • infertility
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

fibroids- signs

A
  • bimanual exam- enlarged, irregularly shaped uterus; palpated mass moves with cervix
  • US- distinguish b/w adnexal masses and leiomyomas
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

fibroids- diff dx

A
  • ovarian neoplasms
  • tubo-ovarian infl mass
  • pelvic kidney
  • bowel mass
  • colon cancer
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

fibroids- medical tx

A
  • combo (estrogen, progesterone)- 1st option
  • progesterone-only
  • GnRH agonist- Depo-Lupron (dec fibroid size)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

fibroids- surgical tx

A
  • myomectomy
  • endometrial ablation (to dec menstrual flow)
  • uterine a embolization (occlude the a feeding the fibroid)
  • hysterectomy -definitive tx
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Myomectomy

A
  • fibroids will often grow back
  • if endometrial cavity is entered, future delivers must be c-section
  • if an adequate amt of uterine tissue remains after- hysterectomy is warranted
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Endometrial polyps

A
  • form from the endometrium- create soft friable protrusion into endometrial cavity
  • menorrhagia, spontaneous, or post menopausal bleeding
  • US- focal thickening of endometrial stripe- saline hysterosonography and hysteroscopy for better detection
  • most are benign hyperplastic masses- need to remove with hysteroscopy- endometrial hyperplasia and carcinoma may also present as polyps
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Nabothian cervical cyst

A
  • appear opaque with a yellowish/bluish hue
  • result from squamous metaplasia- a layer of superficial squamous epit cells entrap a layer of columnar cells- columnar cells continue to secrete mucus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Cervical polyp

A
  • most common benign growths on the cervix
  • sx- none, coital bleeding, menorrhagia
  • remove in office- rarely malignant
  • endocervical- more common, beefy red
  • ectocervical- less common, pale
21
Q

endometrial hyperplasia

A
  • result of persistent unopposed estrogen- PCOS/anovulation, granulosa theca cell tumors, obesity, exogenous estrogens, tamoxifen
  • precursor to endometrial cancer!!
22
Q

endometrial hyperplasia- classification

A
  • simple w/o atypia- 1% progress to cancer
  • complex w/o atypia- 3%
  • simple with atypia- 9%
  • complex with atypia- 27%
23
Q

endometrial hyperplasia- sx, dx, tx

A
  • intermenstrual, heavy/prolonged bleeding
  • dx- sample endometrium; US reveals endometrial lining > 4 mm in postmenopausal female
  • tx- simple and complex W/O atypia- progestin, resample in 3 months
  • simple and complex WITH atypia- hysterectomy
24
Q

congenital anomalies of ovaries

A

uncommon

  • 2 X chrom are required for normal ovary development
  • Turner syndrome (45X)- small streaked ovaries
  • AIS/Testicular feminization (46XY)- phenotypically F, lack androgen Rs
25
Q

congenital anomalies of fallopian tubes

A

rare

-DES- shortened, distorted tubes

26
Q

Benign conditions of ovary

A
  • functional cyst
  • benign neoplastic cyst- epit, sex-cord stromal, germ cell
  • malignant cysts
27
Q

Functional cysts

A
  • follicular cysts- ovarian follicle fails to rupture
  • corpus luteum cysts
  • hemorrhagic cysts- hemorrhage into corpus luteum cyst 2-3 days after ovulation
  • polycystic ovaries
28
Q

Functional cyst- Theca-lutein cyst

A
  • b/l, large
  • in pts with high HCG- pregnancy, choriocarcinoma, hydatidiform molar pregnancy, ovulation induction
  • regress when gonadotropin levels fall
29
Q

Functional cyst- luteoma of pregnancy

A
  • hyperplastic rxn of ovarian theca cells- secondary to prolonged HCG stim
  • reddish-brown nodules
  • regress spontaneously postpartum
30
Q

Functional cyst- polycystic ovarian cyst

A
  • chronic anovulation, hyperandrogenism, insulin R
  • enlarged ovaries- mult small follicles
  • inc LH levels promote androgen secretion from ovarian theca cells- elevated androgens
  • peripheral conversion of androgen to estrogen- suppress FSH from pit gland
31
Q

Functional ovarian cyst- clinical, dx, management

A
  • asx, usually regress during subsequent cycle, can become large and undergo torsion
  • dx- bimanual exam (enlarged, mobile cyst), US
  • tx- if asx, place on OCP’s; rule out ectopic pregnancy, torsion, tubo ovarian abscess
32
Q

Benign neoplastic ovarian tumors

A
  • epit- serous, mucinous, brenner
  • sex-cord stroma- fibroma, granulosa-theca, sertoli-leydig cell
  • germ cell- teratoma (dermoid)- most common benign ovarian neoplasm in premenopausal women!!!
33
Q

Serous Cystadenoma

A
  • most common epit ovarian tumor (75%)
  • 10% b/l, 25% malignant
  • tx- surgical
  • histo- psammoma bodies
34
Q

Mucinous cystadenoma

A
  • second most common epit tumor (20%)
  • 85% benign
  • assoc with mucocele of appendix
  • can lead to pseudomyxoma peritonei
35
Q

Brenner tumor

A
  • small smooth solid
  • usually benign with a large fibrotic component that encases epithelioid cells that resemble transitional cells of bladder
36
Q

Sex Cord stromal ovarian neoplasms

A
  • if feminine- granulosa or theca cell tumor

- if masculine diff- sertoli leydig cell tumor

37
Q

Granulosa-theca cell tumor

A
  • produces estrogen

- feminizing signs, sx’s

38
Q

Sertoli-Leydig tumor

A
  • produce androgens

- virilizing effects

39
Q

fibroma

A
  • solid, encapsulated, smooth-surfaced tumor- bundles of fibrocytes
  • most common benign SOLID ovarian tumor
  • doesnt secrete sex steroids
  • Meigs syndrome- ascites, right pleural effusion (hydrothorax)
40
Q

Germ cell tumors

A
  • 60% of ovarian neoplasms in infants/children

- cystic teratoma

41
Q

Benign cystic teratoma

A

(dermoid cyst)

  • most common ovarian neoplasm!!!
  • median age- 30 yo
  • diff tissue from all 2 embryonic germ layers
42
Q

benign ovarian tumors- clinical features

A
  • asx
  • enlarge very slowly
  • mild pain
  • can be painful- if torsion; rupture of cyst
43
Q

benign ovarian tumors- dx

A
  • abd and bimanual pelvic exam
  • US
  • tumor markers- CA 125
  • laparoscopy
44
Q

epit benign ovarian tumors- management

A
  • unilateral salpingo-oophorectomy
  • if mucinous cystadenoma- appendectomy
  • if young pts- cystectomy for ovarian preservation
45
Q

sex-cord stromal tumors- management

A

-unilateral salpingo-oopherectomy

46
Q

germ cell tumors (Benign cystic teratoma)- management

A
  • ovarian cystectomy

- evaluate other ovary- b/l 20%

47
Q

fallopian tubes- benign conditions

A
  • hydrosalpinx- from infection

- pyosalpinx- from infection

48
Q

primary risk factor for ovarian torsion

A

-ovarian mass > 5 cm

49
Q

ovarian torsion- classic presentation

A

-acute onset of unilateral pain, N/V
-dx- US!!
-definitive dx- direct visualization
tx- detorsion and ovarian cystectomy

R2F (18 decks)

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