Ch. 45 Pathology of the Adnexa Flashcards
_______ is an inclusive term that refers to all pelvic infections
PID
PID stands for
pelvic inflammatory disease
______ is an infection/inflammation of the endometrium
endometritis
______ is an infection/inflammation of the fallopian tubes
salpingitis
______ is an infection/inflammation of the uterine wall
myometritis
______ is an infection/inflammation of the uterine serosa and broad ligaments
parametritis
_____ is an infection/inflammation of the ovary
oophoritis
TOA stands for
tubo-ovarian abscess
______ is an abscess involving the ovary and the fallopian tube
tubo-ovarian abscess
______ is a fluid collection in the fallopian tube
hydrosalpinx
______ is blood in the fallopian tube
hematosalpinx
______ is pus in the fallopian tube
pyosalpinx
______ is an infection/inflammation of the cervix
cervicitis
Which of the following is NOT a risk factor for PID
diabetes
A patient with PID is at increased risk for
ectopic pregnancy
Which of the following is NOT a cause of PID
endometriosis
Which of the following is NOT an example of an instrumental procedure done on the pelvis
cholecystectomy
The normal fallopian tube is commonly seen on sonographic exams
false
______ is helpful in distinguishing dilated fallopian tubes from vessels
color flow doppler/power
Which of the following is NOT a common cause of hydrosalpinx
intrauterine pregnancy IUP
The sonographic appearance of endometritis is
thick endometrium, possibly with fluid in the endometrial cavity
A complex mass with septations, irregular margins, commonly located in the cul de sac is probably
a tubo ovarian abscess
A thick-walled, hyperemic tube with nodules or diverticuli in the uterine adnexae is associated with
salpingitis
_____ can obscure normal tissue planes, making borders difficult to see
PID
_______ describes an infection of the pelvis that extends to involvement of the bladder, ureter and bowel
peritonitis
______ is a condition in which functioning endometrial tissue is located outside the uterus
endometriosis
Which of the following is NOT a common clinical symptom of endometriosis
amenorrhea
_____ is characterized by tiny endometrial implants scattered throughout the pelvis
diffuse endometriosis
______ is a localized form of endometriosis
endometrioma
______ is another term for endometrioma
chocolate cyst
A patient comes to the emergency room with intense pelvic pain. She has a fever and elevated white count. She gave birth to a little girl 5 days ago. What condition should the doctor suspect
endometritis
A patient comes to the emergency room with intense pelvic pain. She has a fever and elevated white count. She gave birth to a little girl 5 days ago. What condition should the doctor suspect
endometritis and PID
_____ is the ectopic occurrence of nests of endometrial tissue in the myometrium
adenomyosis
Mrs. Smith is 42 years old. She went to the doctor complaining of heavy, painful periods. This was a fairly new symptom for her. On pelvic exam, the doctor thought the uterus felt large. He ordered a sonogram which revealed a hypoechoic, heterogeneous, large uterus. The radiologist recommended an MRI for confirmation of what suspected diagnosis
adenomyosis
Is the interventional and post operative application transvaginal or transabdominal: aspirate benign cyst
both
Is the interventional and post operative application transvaginal or transabdominal: drain TOA/abscess
TV
Is the interventional and post operative application transvaginal or transabdominal: drain post operative fluid collections
both
Is the interventional and post operative application transvaginal or transabdominal: biopsy solid pelvic masses
TV
Is the interventional and post operative application transvaginal or transabdominal: evaluate post operative mass
both
Is the interventional and post operative application transvaginal or transabdominal: follow post op hematoma
both
Is the interventional and post operative application transvaginal or transabdominal: evaluate surgical site
TV
Is the interventional and post operative application transvaginal or transabdominal: evaluate surgical site
TV
What are the symptoms of PID
severe pelvic pain, fever, vaginal discharge, abnormal bleeding, history of infertility
Patients with PID have an increased risk of
ectopic pregnancy
Which route of infection for PID is most common
sexual transmission
Clinical findings of PID
large/palpable/bilateral mass on pelvic exam, extreme pain on pelvic exam, vaginal discharge, fever
PID has _____ vascularity and _______ flow which is an inflammatory response
increased, lower resistance
Is there a doppler signal or peristalsis with hydrosalpinx or pyosalpinx
no
Thick walled tube with increased vascular flow and nodules within the lumen
acute salpingitis
Serosa of uterus/tube becomes sticky die to inflammation and sticks to ovary, forming a loculated pus collection (abscess)
TOA
Does TOA require surgical drainage
no
Difficult to see sonographically because impants very small
diffuse endometriosis
Usually occurs due to PID
endometritis
In endometriosis, if inflammation has spread to tubes/ovaries, we will see all findings of
PID
In endometriosis, post partum, retained products of conception, placenta are difficult to differentiate from
hematoma, blood clots or inflammatory debris
Nests of endometrial tissue within the myometrium
adenomyosis
May be caused by multiple pregnancies and elevated estrogen levels
adenomyosis