Benign Conditons Of Uterus, Cervix, Ovary And Tubes Flashcards
Most of the time uterine and cervical anomalies are caused by what?
DES exposure
What is the most common neoplasm of the uterus?
Fibroids
4 symptoms of fibroids when they are symptomatic?
Uterine bleeding, pelvic pain, pelvic pressure, infertility
Fibroids are the most common indication for what?
Hysterectomy
4 types of fibroids and which one is most common?
Cervical, submucosa, intramural (within myometrium and most common), subserosal
Two ways we can see/find fibroids?
Palpate them within the cervix
US
4 differentials for fibroids?
Ovarian neoplasm
Tubo-ovarian inflammatory mass
Bowel mass
Colon cancer
3 lines of treatment for a fibroid with medication?
Combo estrogen/pro first
Only pro
GnRH agonist
4 surgical treatments of fibroids?
Myomectomy
Endometrial ablation
Uterine artery embolization, cut the fibroid off from blood supply
Hysterectomy
How to treat endometrial polyps and what can the polyps cause?
Remove with hysteroscopy since hyperplasia and carcinoma can present as polyps too
Heavy bleeding, post menopausal bleeding
What are the most benign growths of the cervix?
Ectocervical and endocervical polyps
2 differences between endocervical and ectocervical polyps?
Endo more common and beefy red
Ecto less common and pale color
5 causes of endometrial hyperplasia?
PCOS and anovulation Granulosa theca cell tumor Obesity Exogenous estrogen Tamoxifen
4 types of endometrial hyperplasia?
Simple no atypia
Complex no atypia
Simple with atypia
Complex with atypia
1 symptoms and endometrial hyperplasia and how to make the diagnosis?
Heavy bleeding
Sample the endometrium and US the endometrium and make sure it is over 4 mm
How to treat endometrial hyperplasia?
Give progesterone for simple and complex with no atypia
Hysterectomy for simple and complex with atypia
Two syndromes that jack the ovaries up?
Turner 45XO
Androgen insensitivity syndrome 46XY
4 functional cysts of the ovary?
Follicular, lutein, hemorrhagic, and polycystic
2 things to know about a functional theca lutein cyst?
Bilateral and develop in patients with high hCG levels
2 things to know about the functional luteuoma of pregnancy cyst?
Hyperplastic reaction of the thec cells with high hCG
Reddish brown nodules
Three things he wants us to know that PCOS is associated with?
Chronic anovulation, too much androgen and insulin resistance
What is the most common benign ovarian neoplasm in a premenopausal women?
Cystic teratoma or Dermoid
Mucinous ovarian tumors, endometrioid ovarian tumors and serous ovarian tumors resemble what epithelium respectively?
Endocervical
Endometrium
Fallopian tubes
What is the most common epithelial ovarian tumor, treatment, and histo of it?
Serous
Surgery
Psammoma bodies
2nd most common epithelial tumor of the ovary? Associated condition?
Mucinous
Mucocele of appendix
How to distinguish serous epi tumor vs. mucinous?
Mucinous is multiloculated and larger
Hormone coming out of granulosa theca cells and what is the effect? Same question for sertoli leydig tumors?
Estrogen and feminizing
Androgen and man making
What is the most common solid benign tumor of the ovary?
Fibroma
Triad of meigs syndrome?
Fibroma, ascites, and pleural effusions
What is the most common ovarian neoplasm found in women of all ages?
Cystic teratoma
Why can ovarian tumors be painful?
Torsion and rupture causing peritonitis
4 things that can aid us in the diagnosis of benign ovarian tumors?
Ab/pelvic exam
US
Tumor markers like ca 125
Laparoscopy
How do we usually treat epithelial ovarian tumors? What if its mucinous? How might we change it if it is a lady who hasn’t had kids yet? Post menopausal women?
Unilateral tube and ovary removal
Take out appendix as well
Perform a cystectomy to preserve the ovary
Hysterectomy with bilateral tube and ovary out
How do we usually treat stromal cell tumors and fibromas?
Unilateral tube and ovary out
Resection of ovary
3 things when treating a mature cystic teratoma?
Ovarian cystectomy
Check other ovary because they can be bilateral
Clean pelvis out
2 most common benign conditions of the Fallopian tube?
Infection and inflammation
What is one of the most common gynecology emergencies and what is the primary risk factor?
Ovarian torsion.
Ovarian mass greater than 5 cm
Classic presentation of ovarian torsion, best way to diagnose, treatment?
Acute unilateral pain
US
Remove the cyst, if ovary is necrotic then remove tube and ovary.