benign tumours

Question 1

RF for myoma

Answer 1

afro carribena women 
genetics
nulliparity ( NB)obsesity - increased levels of oestroegen 
early menarche
FH 
VItamin d deficiency ?

Question 2

tx myoma

Answer 2

gnrh agonists - antagonises estrogen which is needed for growth

Question 3

classication of myomas

Answer 3

intramural
submucosal - peducntulated
subserosal- peduncultated
cervical

Question 4

what does the texture of the myoma tell you

Answer 4

more hardness- more fibrosis

more soft- mote muscle

Question 5

symptoms

Answer 5

a lot of times its aympotmatic
dysfunctional uterine bleeding - prolonged menstraul bleeding mennorrhagia
pain - does not usually occur in uncomplicated myomas
feeling of pressure

Question 6

indications for surgery for myoma

Answer 6

1. excessisve bleeding
   Protrusion of myoma through cervical os into vagina
    Rapid growth (may be leiomyosarcoma rather than benign leiomyoma)
    Repetitive pregnancy loss
    Infertility
    Enlarged uterine size (>12weeks pregnancy size)
    Progressive hydronephrosis

Question 7

which type of fibroid is assoiated with heavy bleeding

Answer 7

submucosal because now you are interfering with the cavity of the uterus and also interstiaial

Question 8

what would hysterocopic removal be best for which fibroid

Answer 8

submucosal

Question 9

how do know ehere the fibroid is

Answer 9

physical exam bi manual exam

ultrasound and MRI

Question 10

SECODNARY CHANGES DIVIDED INTO

Answer 10

1. degenerative
2. vascular changes
3. inflammation
4. malignant transformation

Question 11

degenerative changes

Answer 11

hyaline (most common) , fatty, red, calcification, atrophy , myoxomatous degeneration , pseudocytsic degeneration

Question 12

msot common symmptom of fibroids

Answer 12

bleeding, menorrhagia prolonged menstraul periods duratiron or heavy

Question 13

when would you experience pain

Answer 13

if the uterus is contracting to deliver the nascient myoma or if you have torsion or infarction of pedunculated myoma

Question 14

what is the tumour made up of

Answer 14

smooth muscle and fibrous tissue and its texture depends on the compositions between the 2

Question 15

which is the most common type

Answer 15

intramural

Question 16

the 2 most common causes of enlarged uterus

Answer 16

fibroids and adenomyosis

Question 17

what is adenomyseos and symptoms

Answer 17

endometrium moves into the muscular layer
it’s a diffuse thickening of uterus . When this happens in a small area, or is localized, it is called an adenomyoma.

symptoms very similar to fibroids, pain during sex, dysfunctional uterine bleeding (heavier periods) , and also painful periods

Question 18

rf dor adenomyoma

Answer 18

usually occurs in women who have had children

women who have had uterine surgery inc c - section

Question 19

other causes of enlarged uterus

Answer 19

endometrial cancer , cervical cancer

Question 20

which types of fibroids are likely to cause symmetrically enlarged uterus

Answer 20

submucosal

Question 21

whats the caution with gnrh agonists

Answer 21

not more than 24 weeks - risk of osteoproesis

Question 22

non conservative tx 1.

Answer 22

1. Abdominal myomectomy:
2. Hysteroscopic myomectomy
3. Laparoscopic myomectomy:
4. Uterine artery embolisation may provide a targeted degeneration of the fibroid. This may also preserve fertility.(not commonly done due to complications)
5. laser ablation use heat to cause necorise
6. cryomyloysis
7. defintive - hysterectomy

Question 23

what can a speculum exam shows you in general

Answer 23

allows you to see the cervix
test for any infections like STD
any cancers
insert an IUD, or empty the womb (if open)