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Penny - OB CH > Chapter 20 - Postmenopausal Sonography & Sonohysterography > Flashcards

Chapter 20 - Postmenopausal Sonography & Sonohysterography Flashcards

1
Q

irregular bands of tissue

A

adhesions

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2
Q

lack of ovulation

A

anovulation

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3
Q

a syndrome characterized by endometrial adhesions that typically occur as a result of scar formation after some types of uterine surgery

A

Asherman syndrope

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4
Q

the surgically removal of both ovaries & both fallopian tubes

A

bilateral salpingo-oophorectomy

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5
Q

another name for menopause

A

climacteric

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6
Q

the buildup of plaque within the arteries that supply the myocardium of the heart

A

coronary heart disease

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7
Q

a procedure in which the cervix is dilated and the uterine cavity is scraped with a curette

A

dilation & curretage

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8
Q

measurement of the endometrium from basal layer to basal layer excluding both the adjacent hypoechoic myometrium & the intracavitary fluid ( if present)

A

double layer thickness

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9
Q

hormone replacement therapy that involves the administration of synthetic estrogen

A

estrogen replacement therapy

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10
Q

the medical treatment used to accommodate the reduction of estrogen and progesterone that occurs during menopause

A

hormone replacement therapy

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11
Q

an increase in the number of cells of a tissue or an organ

A

hyperplasia

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12
Q

endoscopy of the uterine cavity

A

hysteroscopy

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13
Q

the spread of cancer from a distant site

A

metastasis

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14
Q

having birthed no children

A

nulliparity

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15
Q

a bone density that is lower than normal

A

osteopenia

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16
Q

bone loss that predisposes the indivdual of fractures

A

osteoporisis

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17
Q

time prior to menopause

A

perimenopausal

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18
Q

the surgical removal of a polyp

A

polypectomy

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19
Q

shaped like a polyp

A

polypoid

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20
Q

vaginal bleeding after the onset of menopause

A

postmenopausal vaginal bleeding

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21
Q

the time after menopause

A

postmenopause

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22
Q

the time directly after giving birth and extending to about 6 weeks

A

postpartum

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23
Q

a hormone replacement therapy that involves administering synthetic progesterone

A

progesterone therapy

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24
Q

the presence of pus within the uterus

A

pyometra

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25
Q

a sonographic procedure that uses saline instillation into the endometrial cavity & fallopian tubes to evaluate for internal abnormalities

A

saline infusion sonohysterography

26
Q

adhesions

A

synechiae

27
Q

benign ovarian sex cord-stromal tumor that produces estrogen in older women

A

thecoma

28
Q

the formation of a clot within a blood vessel with the potential to travel a distant site and cause an occlusion

A

thromboembolism

29
Q

the removal of the uterus & cervix

A

total abdominal hysterectomy

30
Q

Estrogen replacement therapy (ERT) reduces the risk of developing what

A

Osteoporosis
Coronary heart disease
colon cancer
alzheimer disease

31
Q

What is HRT used for

A

Used to combat the reduction of estrogen (to prevent menopausal symptoms)

32
Q

Unopposed (ERT) increased the risk of which condition

A 
Endometrial carcinoma (>5mm)
breast cancer
thromboemobilsim 
hypertension 
possibly, diabetes
33
Q

Combined estrogen and progesterone therapy can eliminate the chances of endometrial carcinoma?
True or false

A

Appearance and thickness is variable (looks like normal menstrual cycle)

34
Q

What is a common indication for postmenopausal sonography?

A 
Endometrial atrophy 
uncontrolled HRT
Endometrial Hyperplasia 
Endometrial Polyps
Submucosal/Intracavitary leiomyoma 
Ovarian tumors
35
Q

What is the normal endometrial thickness with no postmenopausal bleeding?

A

<8mm

36
Q

What is the normal endometrial thickness with positive postmenopausal bleeding ?

A

<5mm

37
Q

What is the most common cause of post menopausal bleeding??

A

endometrial atrophy

38
Q

Sonographic appearance of endometrial atrophy?

A
  1. thin endometrium <5mm

2. Intracavitary fluid may be seen

39
Q

What is common cause of abnormal vaginal bleeding

A

Endometrial Hyperplasia *perimenopausal patients (also can be in postmenopausal women and women in reproductive years)

40
Q

What is endometrial hyperplasia a result from?

A

Results from the unopposed stimulation of estrogen of the endometrium

41
Q

Which risk or form of endometrial hyperplasia may progress to endometrial cancer

A

Atypical adenomatous hyperplasia (often in post menopausal women)

42
Q

Clinical findings of Endometrial hyperplasia

A
  1. Abnormal uterine bleeding
  2. PCOS
  3. Obesity
  4. Tamoxifen therapy
    estrogen producing ovarian tumors
    (if patent on Tamoxifen therapy endometrial Cancer >10mm)
43
Q

Sonographic findings of endometrial hyperplasia

A
  1. Thickened echogenic endometrium (>8mm)
  2. small cystic areas within the endometrium
    (ESP says: - Premenopausal women EC>14mm)
    -patient on Tamoxifen EC>10mm
    -Postmenopausal women on estrogen only EC>5mm
    -Postmenopausal women in estrogen phase can be up to 8mm, then in progesterone phase, EC decreases
44
Q

Endometrial polyp

A

Small nodules of hyperplastic endometrial tissue may cause abnormal vaginal bleeding in both postmenopausal or Perimenopausal women

45
Q

What will an endometrial polyp most often contain?

A

A small vessel and have cystic areas within it

46
Q

How are endometrial polyp most often contain?

A

A small vessel and have cystic areas within it

47
Q

How are endometrial polyps better visualized

A

Using sale infusion sonohysterography

48
Q

What are the treatment of endometrial polyps

A

polypectomy with use of hysteroscopy

49
Q

Clinical findings of endometrial polyps

A
  1. can be aysmptomatic
  2. menometrorrhagia
  3. intermenstrual bleeding
  4. infertility
50
Q

Sonographic findings of endometrial polyps

A
  1. Focal thickening of endometrium
  2. diffuse thickening of endometrium
    * discrete mass in the endometrium, focal, round and echogenic
    * possibly vascular stalk demonstrated with color doppler
51
Q

What is the most common encountered gynecologic malignancy?

( female genital tract malignancy?

A

Endometrial carcinoma

52
Q

Endometrial Carcinoma is most often in the form of

A

adenocarinoma

53
Q

Endometrial carcinoma occurs in

A

postmenopausal women

54
Q

endometrial carcinoma are associated with what rosk

A
  1. Nulliparity
  2. Obesity
  3. Chronic Anovulation
  4. Stein-Leventhal Syndrome (PCOS)
  5. hx of Tamoxifen therapy
  6. Estrogen producing tumors
  7. Postmenopausal, with an increased risk if on estrogen replacement therapy
  8. Strong family hx of uterine cancer
55
Q

What is the peak age incidence when diagnosing endometrial carcinoma

A

50-65

56
Q

Which tumors have a poorer prognosis with endometrial carcinoma

A

Tumors with penetration into the surrounding myometrium have a poorer prognosis. than those confirmed to the endometrium

57
Q

What type of flow will endometrial carcinoma have with pulse doppler?

A

low impedance flow in the presence of endometrial carcinoma

58
Q

Suspicion of endometrial carcinoma lead to what

A
  1. endometrial biopsy
  2. endocervical curettage
  3. CA-125 testing
  4. total abdominal hysterectomy
  5. bilateral salpino-oopherectomy
59
Q

Clinical findings of endometrial carcinoma

A
  1. post menopausal bleeding
  2. intermenstrual bleeding
  3. enlarged uterus
  4. increased C-125 levels
  5. Pain as a result of uterine distention
60
Q

Sonographic findings of endometrial carcinoma

A
  1. thickened endometrium
  2. heterogenous uterus
  3. enlarged uterus with lobular contour
  4. endometrial fluid
  5. polypoid mass with endo
  6. inhomogenetiy and thickenign of endometrial echoes (>4-5mm) especially in post menopausal woman (varies w/ patients hormone status

Penny - OB CH (18 decks)

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