Benign Disorders of the Lower and Upper Genital Tract

Question 1

MC tumor found on the vulva d.t. occlusion of sebaceous cyst

Answer 1

Sebaceous cyst

Question 2

MC large cyst of the vulva

Answer 2

Bartholin duct cyst

Question 3

The entire cyst or abscess is INCISED and sutured to the vaginal mucosa

Answer 3

Marsupialization

Question 4

MC benign solid tumor of the vulva

Answer 4

Fibroma

Question 5

2nd MC frequent type of benign vulvar mesenchymal tumor

Answer 5

Lipoma

Question 6

Mucus filled retention cysts

Retention mucus cysts of endocervical columnar cells usually at the transformation zone

Answer 6

Nabothian cysts

Question 7

Remnants of the mesonephric duct (Wolffian) that can become cystic

Tend to lie DEEPER in the cervical stroma and on the external surface of the cervix

Answer 7

Mesonephric cysts

Question 8

Can implant on or near the cervix

Red or purple in color

Cyclic pain and dyspareunia

Answer 8

Endometriosis

Question 9

Benign growths that may be pedunculated or sessile

Intermenstrual or postcoital spotting

Answer 9

Cervical Polyp

UTZ: single central feeding vessel

Management:
Polypectomy

Question 10

Benign growths that may arise in the cervix or prolapse into the cervical or vaginal canal from the endometrial cavity

intermenstrual bleeding
dyspareunia and bladder or rectal pressure

Answer 10

Cervical Fibroids

UTZ: peripheral vascular channels

Management:
Myomectomy or Hysterectomy

Question 11

Presence and growth of the glands and stroma of the lining of the uterus in an ABERRANT or HETEROTOPIC location

Answer 11

ENDOMETRIOSIS

LAPAROSCOPY - GOLD STANDARD FOR DIAGNOSIS

MRI - BEST DIAGNOSTIC TOOL

Question 12

Classic symptom of endometriosis

Answer 12

PELVIC PAIN

Question 13

Theories on Etiology of Endometriosis

Answer 13

Retrograde menstruation
Lymphatic and Vascular Dissemination
Metaplasia
Iatrogenic
Genetic Predisposition
Immunologic Changes
Hormonal Influences

Question 14

Classic symptoms of Endometriosis

Answer 14

Cyclic pelvic pain

Infertility

Question 15

Medical Management for Endometriosis - induction of amenorrhea

Answer 15

PSEUDO-MENOPAUSE EFFECT
Anti-estrogen
Hyperandrogenic effect (Danazol)

MEDICAL OOPHORECTOMY
GnRH agonist (Leuprolide)

PSEUDOPREGNANCY STATE
High dose OCP

Question 16

Localized benign overgrowths of endometrial glands and stroma over a vascular core

abnormal uterine bleeding

Answer 16

Endometrial Polyp

Presence - PELVIC UTZ
Size - Sonohysterogram
Number of polyps - Hysteroscopy

Question 17

Benign monoclonal tumors with each tumor resulting from propagation of a single muscle cell

Answer 17

Leiomyoma

Question 18

Medical Management for Uterine Leiomyomas

Answer 18

GO PAN AM

GnRH agonists
*Nafarelin Acetate, Leuprolide, Acetate Depot, Goserelin

Progestins
*Medroxyprogesterone Acetate, Mirena IUD, Norethindrone Acetate

P
*OCP

Antifibrinolytics - Tranexamic acid

NSAIDs

Androgenic steroids - Danazol and Gestrinone

Mifepristone

Question 19

Surgical Procedures for Leiomyoma

Answer 19

Uterine Artery Embolization (UAE)
Magnetic Resonance Guided Focused Ultrasound Surgery
Myomectomy
Hysterectomy

Question 20

Presence of endometrial tissue in the uterine myometrium – abnormal bleeding and pain

uterus - soft and globular

Answer 20

ADENOMYOSIS

Management:
IUD

Definitive Treatment:
Hysterectomy

Question 21

Well circumscribed collection of endometrial tissue within the uterine wall

Answer 21

ADENOMYOMA

Question 22

Benign Ovarian Lesions of the Ovary

Answer 22

Follicular cyst
Corpus Luteum cyst
Theca lutein cyst
Endometrioma

Question 23

Halban’s triad

Answer 23

Corpus Luteum Cyst

spotting with delay in menses
unilateral pelvic pain
small tender adnexal mass