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Clin Med III exam III > Benign Uterine and Ovarian Disease > Flashcards

Benign Uterine and Ovarian Disease Flashcards

1
Q

Most common pelvic tumor in women

A

fibriods

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2
Q

Where do fibriods arise from

A

smooth muscle cells of the myometrium

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3
Q

Locations of fibriods

A
  • intramural
  • subserosal
  • submucisal
  • cervical
  • pedunculated submucosal or subserosal
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4
Q

Most common location of fibriod

A

intramural

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5
Q

Signs and symptoms of fibriods

A

typically asymptomatic

  • heavy or prolonged menstrual bleeding
  • pelvic pressure/pain
  • urinary frequency
  • anemia
  • reproductive dysfunction
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6
Q

What would an exam show for fibriods

A

-enlarged uterus
-irregular uterus
+/- tenderness

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7
Q

Diagnostics for fibriods

A
  • transvaginal US
  • sonohysterography
  • hysteroscopy
  • MRI
  • hysterosalpingography (HSG)
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8
Q

Treatment of fibriods

A

treat symptomatically

  • NSAIDs (dysmenorrhea)
  • OCPS/IUD
  • surgery
GnRH analogue (leupron)
Danazol
(severe cases)
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9
Q

When do you do surgery for fibriods

A
  • bulk related sx’s
  • infertility
  • miscarriages
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10
Q

Surgical options for fibriods

A
  • hysterectomy
  • myomectomy
  • endometrial ablation
  • uterine artery embolization
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11
Q

What is adenomyosis

A

ectopic endometrial tissue within the myometrium

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12
Q

“Boggy Uterus”=

A

adenomyosis

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13
Q

Signs and symptoms of adenomyosis

A
  • heavy menstrual bleeding
  • dysmenorrhea
  • chronic pelvic pain
  • diffusely enlarged uterus
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14
Q

When does adenomyosis present

A

40-50 years old

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15
Q

Definitive diagnosis of adenomyosis

A

histology s/p hysterectomy

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16
Q

Ways to give a probable diagnosis of adenomyosis

A
  • transvaginal US
  • MRI

“asymmetric thickening or the myometrium”
“linear striations”
“loss of clear endomyometrial border”
“increased myometrial heterogeneity”

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17
Q

Treatment of adenomyosis

A

hysterectomy is only definitive tx

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18
Q

Alternative tx for adenomyosis

A
  • OCP/IUD
  • lupron
  • aromatase inh (anastrozole, letrozole)
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19
Q

What is endometriosis

A

presence of normal endometrial mucosa abnormally implanted in locations other than the uterine cavity

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20
Q

What happens to the ectopic tissue in endometriosis

A

respond to hormonal fluctuations–> prostaglandins–> inflammatory process and scarring of tissue

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21
Q

Common sites of endometriosis

A
  • ovaries (most common)
  • perimetrium
  • posterior cul de sac
  • broad ligamnet
  • rectosigmoid colon
  • bladder
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22
Q

Symptoms of endometriosis

A
  • can be aymptomatic
  • dysmenorrhea
  • heavy or irregular bleeding
  • pelvic pain
  • lower abd pain/back pain
  • dyspareunia
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23
Q

Physical exam findings for endometriosis

A
  • lateral displacement of the cervix
  • localized tenderness in pouch of douglas/ nodule
  • pain wiht movement of the uterus
24
Q

Complication of endometriosis

A
  • endometrioma
  • adhesion formation
  • pain
  • anatomic distortion
  • infertility
  • implantation on nearby structures
25
Q

Diagnosis of endometriosis

A

laparoscopy w/ biopsy

classic blue black powder burned appearance

26
Q

Options for tx of endometriosis (medical)

A
  • hormonal contraceptions
  • GnRH hormone analogues (lupron)
  • danazol
27
Q

Surgical management for endometriosis

A
  • hysterectomy +/- oophorectomy
  • laparoscopic uterine nerve ablation
  • drainage and laparoscopic cystectomy
  • laparoscopy and surgical endometrial implant ablation
28
Q

What is the most common cystic ovarion lesion

A

functional ovarian cyst

29
Q

Types of functional ovarian cysts

A
  • follicular
  • corpus luteal
  • theca lutein
  • endometrioma
30
Q

What are the two types of cysts

A
  • simple cysts

- complex cysts (debris,blood, varied wall thickness)

31
Q

How do follicular cysts appear on US

A

simple unilocular, anechoic cyst with a thing smooth wall

32
Q

When does a follicular cyst occur

A

when the rupture of a mature follicle doesnt occur

33
Q

When do corpus luteal cyst occur

A

after ovulation

34
Q

“ring of fire” on doppler=

A

corpus luteal cyst

35
Q

What causes a theca lutein cyst

A

overstimulation by hCG

36
Q

Which cysts are unilateral? Bilater?

A

unilateral: corpus luteal, follicular
bilateral: theca lutein

37
Q

Mature cystic teratoma

A

benign germ cell tumor

38
Q

How does a MCT appear

A

cystic–> calcifications, fat, sebaceous tissue, hair, teeth

39
Q

MCT’s are associated with ___ when ___

A

ovarian torsion if >5cm

40
Q

Two types of cystadenomas. Which one is more common?

A

serous

mucinous (filled with mucinous material)

Serous is more common

41
Q

What is a cystadenofibroma

A

surface epithelial tumor

42
Q

What does a cystadenofibroma resemble

A

malignant tumor

43
Q

Treatment of cystadenofibroma

A

oophroectomy

44
Q

What could a sudden onset of sharp pain indicate?

A

ruptured cyst

45
Q

Complications of cysts

A
  • ovarian torsion (large cysts)
  • hemorrhagic cyst
  • persistent pain or pressure
46
Q

Diagnostics for benign cysts

A
  • US (first line)
  • CT pelvis (malignancy)
  • MRI (if doing surg)
  • hCG
  • CA125 (post menopause w/ cyst >5cm)
  • diagnostic lap
47
Q

Ovarian cancer marker

A

CA125

48
Q

Treatment of ovarian cyst

A
  • analgesia
  • OCP (recurrent functional cyst)
  • ovarian cystectomy or oophorectomy
49
Q

When is surgery considered for cysts

A
  • symptomatic
  • persistent 5 to 10 cm cyst
  • ovarian torsion
  • suspected malignancy
50
Q

When is surgery done with follicular or corpus luteal cysts

A

if very large or hemorrhagic with rupture

51
Q

Anterior compartment prolapse

A

aka. cystocele

hernia of the nateria vaginal wall with descent of bladder

52
Q

Posterior compartment prolapse

A

aka. rectocele

hernia of posterial vaginal segment with descent of the rectum

53
Q

Enterocele

A

hernia of the intestines to or through the vaginal wall

54
Q

Uterine prolapse

A

descent of apex of vagina into lower vagina to or beyond the vaginal introitus

55
Q

Uterine procidentia

A

hernia of all three compartment through to vaginal introitus

56
Q

When do you treat pelvic organ prolapse

A

only if symptomatic

57
Q

What are the treatments for pelvic organ prolapse?

A
  • pessary
  • pelvic floor muscle exercise
  • surgery (anterior cloporrhaphy, posterior cloporrhaphy, sacral colpopexy, hysterectomy)

Clin Med III exam III (10 decks)

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