benign gyn d/o

Question 1

3 common presentations of benign pelvic d/o

Answer 1

AUB
pelvic pain
infertility

Question 2

uterine diseases

Answer 2

fibroids (“leiomyoma”)
polyps
hyperplasia

Question 3

ovarian d/o

Answer 3

cysts
tubo-ovarian abscess (TOA)
benign neoplasma

Question 4

OB d/o

Answer 4

pregnancy
ectopic
molar pregnancy (gestational trophoblastic neoplasia)

Question 5

what influences leiomyomas? how?

Answer 5

estrogen
its larger with increased estrogen

Question 6

3 types of leiomyoma

Answer 6

intramural
submucosal
subserosal

Question 7

intramural leiomyoma location

Answer 7

myometrium

Question 8

submucosal leiomyoma location

Answer 8

right below endometrium

Question 9

3 signs of leiomyomas

Answer 9

irregularly enlarged uterus
asymmetric uterus
firm uterus

Question 10

which disorder can have stress urinary incontinence as a symptom?

Answer 10

leiomyoma (usually asymptomatic tho)

Question 11

treatment for leiomyoma

Answer 11

hysterectomy
myomectomy
OCP
GnRH analogs
embolization

Question 12

what is a polyp

Answer 12

any mass of tissue projecting outward from surrounding tissue

Question 13

where do most polyps arise?

Answer 13

fundus

Question 14

between fibroids and polyps, which can become malignant

Answer 14

polyps (infrequent tho)

Question 15

which uterine dz has tamoxifen, obesity, lynch or coden syn and postmenopause HRT as RF?

Answer 15

polyps

Question 16

sx of polyps

Answer 16

recurring menorrhagia
post-menopausal bleeding

Question 17

signs of polyps on exam

Answer 17

normal uterus with protruding polyp

Question 18

tx of polpys

Answer 18

surgical resection if having sx OR >1.5cm, multiple, fertility concerns, cervical protrusion

Question 19

tissue origin of fibroids vs polyps

Answer 19

fibroids– smooth muscle
polyps— epithelium

Question 20

which is typically bigger- polyp or fibroids

Answer 20

fibroids are bigger

Question 21

when do you tx fibroids?

Answer 21

only if symptomatic

Question 22

which is more influenced by estrogen– fibroids or polyps?

Answer 22

polyps

Question 23

what is hyperplasia

Answer 23

proliferation of endometrial glands when theres more glans-stroma ratio than normal

Question 24

what causes hyperplastia

Answer 24

chronic unopposed estrogen stimulation

Question 25

simple vs complex hyperplasia

Answer 25

simple--- glands are dilated w/ occasional outpouch complex-- back to back w/ luminal outpouching and minimal intervening stroma

Question 26

what does "with nuclear atypia" mean?

Answer 26

progression to endometrial cancer is 10x higher

Question 27

sx of hyperplasia

Answer 27

heavy bleeding or intramenstrual bleeding post menopausal bleeding

Question 28

signs of hyperplasia on exam

Answer 28

anemia

Question 29

how is hyperplasia diagnosed

Answer 29

endometrial biopsy US of endometrial stripe

Question 30

the only time megace is not used to tx hyperplasia

Answer 30

if it is premenopause without atypia

Question 31

how do you treat hyperplasia with atypia?

Answer 31

premenopause-- hysteroscopy w/ D&C--> hysterectomy or megace postmenopause-- hysterectomy, megace

Question 32

how do you tx hyperplasia w/o atypia?

Answer 32

premenopause--- medroxyprogesterone or IUD postmenopause--- treat unopposed estrogen, megace

Question 33

when do ovarian cysts typically develop?

Answer 33

during menstrual years

Question 34

what is a functional-follicle cyst?

Answer 34

happens bc fluid doesn't get reabsorbed in not fully developed follicle

Question 35

sx of functional-follicle ovarian cyst

Answer 35

typically asymptomatic can alter cycle, cause pelvic pressure and pain

Question 36

what does functional-follicle ovarian cyst look like on US?

Answer 36

smooth, thin walled unilocular mass disappears spontaneously but OCP can reduce it

Question 37

what are the two types of functional lutein ovarian cysts?

Answer 37

corpus luteum cysts theca lutein cysts

Question 38

difference between corpus luteum and theca lutein cysts

Answer 38

corpus may cause torsion, may cause internal bleeding if it ruptures theca is usually bilateral and has straw colored fluid

Question 39

3 types of fallopian tube diseases

Answer 39

congenital infectious functional

Question 40

what is congenital fallopian tube dz

Answer 40

absence of tubes

Question 41

what is infectious fallopian tube dz

Answer 41

any STD that can cause adhesions

Question 42

what is functional fallopian tube dz

Answer 42

scarring from gyn procedure ectopic or normal pregancny

Question 43

sx of fallopian tube d/o

Answer 43

infertility there are no signs seen in PE

Question 44

how is fallopian tube d/o treated?

Answer 44

depends on cause-- could reanastomose tube w/ surgery

Question 45

where does gestational trophoblastic neoplasia arise?

Answer 45

fetal tissue

Question 46

3 types of gestational trophoblastic neoplasia

Answer 46

hydatidiform mole invasive mole choriocarcinoma

Question 47

what is the most common type of gestational trophoblastic neoplasia

Answer 47

hyatidiform mole

Question 48

what does hyatidiform mole look like?

Answer 48

grape like vesicles filling uterus

Question 49

which type of gestational trophoblastic neoplasia may cause distant metastases

Answer 49

invasive mole

Question 50

which type of gestational trophoblastic neoplasia follows term pregnancy or abortion?

Answer 50

choriocarcinoma

Question 51

sx of gestational trophoblastic neoplasia?

Answer 51

1st trim bleeding dramatic N/V

Question 52

what are signs of gestational trophoblastic neoplasia?

Answer 52

vaginal bleeding preeclampsia or eclampsia no fetal heart tones larger uterus than expected

Question 53

how is gestational trophoplastic neoplasia diagnosed?

Answer 53

US-- multiple echoes quantitative beta-HCG serum >100k (molar?) thyroid studies