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Women's Health > Benign GYN Pathology > Flashcards

Benign GYN Pathology Flashcards

1
Q

What is uterine didelphys?

A

Failure of Mullerian ducts to fuse, 2 uterine cavities, 2 cervices, 2 vaginal canals

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2
Q

What complications are associated with didelphys?

A

malposition, preterm labor, miscarriage

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3
Q

What is bicornuate uterus? Bicollis vs unicollis?

A

Partial failure of Mullerian duct fusion
Bicollis: 2 uterine cavities, 2 cervices, 1 vaginal canal
Unicollis: 2 uterine cavities, 1 cervix, 1 vaginal canal

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4
Q

What is unicornuate uterus?

A

Half develops: 1 uterine horn, 1 tube, 1 ovary

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5
Q

What is septate uterus?

A

Reabsorption/duplication anomaly: septum creates 2 uterine cavities, 2 cervices within 1 fundus

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6
Q

What is the MC uterine shape abnormality?

A

Septate

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7
Q

What is subseptate uterus?

A

Septum divides endometrial canal but not cervix

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8
Q

What is commonly associated with septate uterus?

A

Infertility

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9
Q

What is aplasia?

A

Failure of uterus to develop from Mullerian duct

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10
Q

What is male pseudohermaphroditism?

A

Gonads are testes but secondary sex characteristics/ext genitalia resemble female

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11
Q

What is female pseudohermaphroditism?

A

Person with ovaries but secondary sex characteristics/ext genitalia resemble male

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12
Q

What is true hermaphroditism?

A

Person born with ovarian and testicular tissue, commonly 1 or both are ovotestis (both tissues)

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13
Q

What is ambiguous genitalia?

A

Intersex, any variation in gonadal sex chromosome chain

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14
Q

What is precocious puberty?

A

Abnormal early development of sexual maturity, usually before 8

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15
Q

What is the sono app of precocious puberty?

A

Adult shaped uterus, ovary volume > 1 cm cubed

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16
Q

What is hydrometra?

A
  • Abnormal fluid collection in uterus
  • MC premenarche
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17
Q

What are causes of hydrometra?

A

Imperforate hymen, congenital vaginal atresia

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18
Q

What is pyometra?

A

Mucinous and infectious fluid collection in uterus

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19
Q

What is hydrometrocolpos?

A

Serous fluid within vagina and uterus

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20
Q

What is hematometrocolpos and what causes it?

A

Menses accumulates within vagina/uterus, caused by cervical obstruction/malignancy/stenosis in older pts

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21
Q

What are clinical symptoms of fluid collections?

A

Pelvic discomfort, painful defecation/urination

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22
Q

What is the MC benign GYN tumor?

A

Leiomyoma

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23
Q

What are characteristics of leiomyomas?

A

Highly degenerative/proliferative, change size, calc formation

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24
Q

What are the four classifications of leiomyomas?

A
  • Intramural: in myometrium
  • Subserosal: in perimetrium
  • Submucosal: adjacent/abutting endo
  • Pedunculated: attached to uterine tissue by stalk
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25
Q

What are clinical symptoms of leiomyoma?

A

Pain, menorrhagia, enlarged uterus, irregular menses

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26
Q

What is sono app of leiomyoma?

A
  • variable echogenicity
  • shadowing
  • well defined
  • solid
  • doppler, stalk flow
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27
Q

What is adenomyosis?

A

Endo tissue embedded into myometrium

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28
Q

What are clinical signs of adenomyosis?

A

Cramping, dysmenorrhea, enlarged uterus

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29
Q

What is the sono app of adenomyosis?

A
  • hypoechoic ut
  • heterogeneous myometrium
  • diffusely enlarged
  • myometrial microcysts
  • echogenic foci
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30
Q

What is endometrial hyperplasia? What should be done if a pt has this?

A

Abnormal thickening of endo due to high levels of estrogen, biopsy due to risk of atypical precancerous cells

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31
Q

What is associated with endo hyperplasia?

A

Tamoxifen

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32
Q

What are symptoms and sono app of endo hyperplasia?

A

Uterine bleeding, thickened endo w/ or w/o cystic changes

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33
Q

What is endometrial polyp and what are the signs?

A

Overgrowth of endo tissue, abnormal uterine bleeding

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34
Q

What is the sono app of endo polyp?

A
  • diffuse/focal endo thickening
  • possible vascularity
  • pedunculated
  • use of sonohysterogram to visualize when distended w/ fluid
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35
Q

What are nabothian cysts?

A

Benign asymptomatic cervical cysts

36
Q

What is the sono app of nabothian cyst?

A

anechoic, well defined, within cervical os

37
Q

What is endometriosis?

A

Endometrial tissue located outside of endo/myometrium, benign proliferative disease

38
Q

Who is endometriosis MC in?

A

White women of higher socioeconomic class who delay children

39
Q

What are the 2 forms of endometriosis?

A

Diffuse: implants, localized: endometrioma

40
Q

What are the four stages of endometriosis?

A

1: minimal, few/superficial implants
2: mild: addl implants, deeper involvement
3: moderate: numerous implants, ov involvement, sono visible adhesions, infertility
4: severe: multiple dense adhesions

41
Q

Where are implants common with endometriosis?

A
  • ovaries (80% of cases)
  • fallopian tubes
  • broad ligament
  • posterior CDS
  • pelvic peritoneum
42
Q

What are the symptoms of endometriosis?

A
  • chronic pain
  • infertility
    4 Ds:
  • dysmenorrhea
  • dyspareunia: painful sex
  • dysuria
  • dyschezia: painful defecation
43
Q

What is a follicular cyst?

A

When dominant follicle fails to ovulate, may cause menstrual irregularities

44
Q

What is a corpus luteum cyst?

A

After dominant follicle ruptures and ova is expelled, mild hemorrhage at rupture site

45
Q

What are the signs of corpus luteum cyst?

A

Pain, N/V (progesterone), enlarged, tender ovary

46
Q

What is the appearance of a corpus luteum?

A
  • complex cyst
  • ring of fire
  • persistent in early OB exams
  • FF in post CDS
47
Q

What is a theca lutein cyst? What are they associated with?

A

Develops due to high hCG
- gestation trophoblastic neoplasia
- ovarian hyperstimulation syndrome
- multiple/single preg

48
Q

What are the clinical signs of theca lutein cyst? Sono app?

A
  • Pain, light bleeding, early preg symptoms
  • Always bilat, large, multilocular cysts
49
Q

What is a paraovarian cyst?

A

From Gartner’s Duct/Wolffian Duct remnant, found in broad ligament

50
Q

What is the clinical presentation of a paraovarian cyst?

A

20-40 yo, asymptomatic, pain if large

51
Q

What is the sono app of paraovarian cyst?

A

Anechoic, thin-walled, defined, variable size

52
Q

What is a serous cystadenoma? Clinical signs?

A

Common epithelial tumor
- asymptomatic
- complications due to size
- pelvic pain, discomfort
- bloating

53
Q

What is the sono app of a serous cystadenoma?

A
  • 1-3 cm
  • unilateral
  • cystic with debris
  • smooth walls, possible septations
54
Q

What is a mucinous cystadenoma?

A

Epithelial tumor that produces mucin/gelatinous material that fills the cyst/loculations

55
Q

What are the clinical signs of mucinous cystadenoma?

A
  • complications due to size
  • abdominal distention and pain
  • vomiting, indigestion, constipation
  • urinary incontinence
  • fatigue
56
Q

What is the sono app of mucinous cystadenoma?

A

Large, multi septations, medium echoes

57
Q

What is a mature cystic teratoma?

A

Germ cell tumor w/ teeth, hair, bone (dermoid)

58
Q

What is the clinical presentation of mature cystic teratoma?

A
  • young women (repro age)
  • mild-acute pain
  • adnexal fullness
  • pressure
59
Q

What is the sono app of mature cystic teratoma?

A

Cystic/complex, calcification w/ shadowing
“tip of the iceberg”

60
Q

What is theca cell tumor? Clinical signs?

A

Solid, unilateral mass found in meno/postmeno women, pain and pressure

61
Q

What is the sono app of theca cell tumor?

A
  • enlarged ov
  • solid
  • shadowing
  • calcs
  • cystic degeneration
62
Q

What is a fibroma?

A

Stromal tumor associated with Meig’s syndrome

63
Q

What is the clinical triad associated with fibroma? Other symptoms?

A
  • Benign ovarian tumor
  • Hydrothorax/pleural effusion
  • Ascites
    Other: focal pelvic pain, pressure if large
64
Q

What is the sono app of fibroma?

A

Solid, hyperechoic

65
Q

What is a Brenner tumor?

A
  • Rare, solid mass
  • Possible association with Meig’s syndrome
  • Rarely malignant, possibility
66
Q

What are the signs of Brenner tumor?

A
  • asymptomatic
  • vaginal bleeding
  • palpable pelvic mass
  • pelvic pain
67
Q

What is the sono app of Brenner tumor?

A
  • hypoechoic, homogeneous
  • defined
  • typically unilat
68
Q

What pathologies are associated with Meig’s syndrome?

A

Fibroma, Brenner tumor

69
Q

What is an endometrioma? What is it AKA?

A
  • Implantation of endometrial tissue outside of uterus
  • Chocolate cyst: large cysts filled w/ brown fluid
70
Q

What are clinical symptoms of endometriomas?

A

Dyspareunia, metromenorrhagia, dysmenorrhea

71
Q

What is the sono app of endometrioma?

A

Defined, cystic mass with low-level echoes, punctate calcs

72
Q

What causes ovarian torsion? What are the signs?

A

Caused by ovarian mass or cyst
Sudden onset of severe pain, N/V, palp adnexal mass

73
Q

What is the sono app of torsion?

A
  • enlarged ov
  • hyperechoic, heterogeneous
  • dilated peripheral vessels
  • lack of doppler flow or decrease
74
Q

What are the effects of polycystic ovarian disease?

A

Associated with Stein-Leventhal syndrome
- polycystic ovaries
- hirsutism
- amenorrhea
- enlarged ovaries
- obesity
- impaired fertility

75
Q

What is the appearance of polycystic ovarian disease?

A

Bilat, enlarged ovaries, multiple peripheral cysts
“string of pearls”

76
Q

What is pelvic inflammatory disease?

A

Acute or chronic inflammatory condition of uterus, cervix, ovaries, fallopian tubes, peritoneal surfaces

77
Q

What is PID caused by?

A

STI, IUD, extension of abdominal/pelvic abscesses, complication of post-abortion or childbirth

78
Q

What is the clinical presentation of PID?

A
  • severe pelvic pain
  • fever, shaking, chills, leukocytosis
  • vaginal discharge/bleeding
  • rebound tenderness
  • dyspareunia
79
Q

What is endometritis?

A

Inflammation of endometrium, complication of PID

80
Q

What is the sono app of endometritis?

A
  • normal or thickened endo
  • air or fluid in endo cavity
  • increased vascularity
81
Q

What is salpingitis?

A

Inflammation of fallopian tube, complication of PID

82
Q

What is the sono app of salpingitis?

A
  • distended tube w/ thickened walls
  • pyosalpinx in acute cases
  • hydrosalpinx in chronic cases
  • increased vascularity
83
Q

What is tubo-ovarian abscess?

A

Abscess formation w/i fallopian tube and ovarian tissue, complication of severe PID

84
Q

What are the clinical signs of tubo-ovarian abscess?

A
  • high fever, elev WBC
  • severe pelvic/RUQ pain
  • N/V
  • peritonitis
  • Fitz-Hugh-Curtis syndrome (liver capsule inflammation, adhesions)
85
Q

What is the sono app of tubo-ovarian abscess?

A
  • multilocular complex uterine/adnexal mass
  • debris, septations, irregular thick walls
  • commonly bilat
  • debris in pelvis
86
Q

What is pelvic congestion sydrome? Who does it affect?

A

Dilated tortuous veins >4-5 mm near uterus, possibly adnexas
Common in women who had multiple pregnancies

87
Q

What are signs of pelvic congestion syndrome?

A

Chronic pelvic pain

Women's Health (10 decks)

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