Chapter 21 PID and Infertility Flashcards
What form of permanent birth control would be seen sonographically as echogenic, linear structures within the lumen of both isthmic portions of fallopian tubes
Essure devices
Excessive hair growth in women in areas where hair growth is normally negligible would be seen with:
Stein-Leventhal syndrome
Risk factors for PID are:
*IUD
*Multiple sex partners
*Post childbirth
What is another name for an endometrioma?
Chocolate cyst
The most common initial clinical presentation of PID is:
Vaginitis
Fitz-Hugh-curtis syndrome could be described as:
Clinical findings of GB disease as a result of PID
Assisted reproductive therapy can result in:
*Heterotopic pregnancy
*Multiple gestations
*OHS
Polycystic ovarian syndrome may also be referred to as:
Stein-Leventhal syndrome
PID can lead to:
*Infertility
*Ectopic pregnancy
*Scar formation in the fallopian tubes
What term is used to describe painful intercourse?
Dyspareunia
Causes of female infertility include:
- Polycystic ovary syndrome
- Asherman syndrome
- Endometriosis
Amenorrhea, hirsutism, and obesity describe the clinical features of:
Stein-Leventhal syndrome
Infertility is defined as:
The inability to conceive a child after 1 year of trying
The sonographic “string of pearls” sign is indicative of:
Polycystic ovary syndrome
Sonographic findings of OHS include:
- Cystic enlargement of the ovaries
- Ascites
- Pleural effusions
The development of adhesions within the uterine cavity is termed:
Asherman syndrome
OHS can cause multiple large follicles to develop on the ovaries termed:
Theca lutein cysts
What is another name for adhesions within the endometrial cavity?
Synechiae
Patients with OHS are at increased risk for:
Ovarian torsion
The presence of pus within the uterus defines:
Pyometra
The occurrence of having both an intrauterine and extrauterine pregnancy at the same time describes:
Heterotopic pregnancy
_____would be described as functional cysts that are found in the presence of elevated levels of hCG?
Theca lutein cysts
Complex-appearing fluid within the fallopian tubes seen with PID is most likely:
Pyosalpinx
The sonographic evidence of a hyperemic fallopian tube us considered with:
Salpingitis
The presence of functional, ectopic endometrial tissue outside the uterus is termed:
Endometriosis
The development of adhesions between the liver and the diaphragm as a result of PID is termed:
Fitz-Hugh-Curtis syndrome
A patient presents to the sonography department with a fever, chills and vaginal discharge sonographically, what would you not encounter?
Uterine adhesions
______would be the least likely clinical finding for a patient with endometriosis?
Hyperandrogenism
The sonographic finding of a tubular, simple-appearing, anechoic structure within the adnexa is most consistent with:
Hydrosalpinx
What is the radiographic procedure used to evaluate the patency of the fallopian tubes?
Hysterosalpigography
______is the means by which twins, triplets, quadruplets and quintuplet pregnancies are reduced
Selective reduction
_______is the presence of many small cysts along the periphery of the ovary whereas another manifestation is many small cyst dispersed throughout the ovary
“String of pearls” sign
_____, also referred to as stein-leventhal syndrome, is an endocrinologic ovarian disorder linked with infertility
Polycystic ovary syndrome (PCOS)
_______is the degeneration of the endometrium with advanced age, most often seen in postmenopausal women
Endometrial atrophy
____is a benign, smooth muscular tumor of the uterus that may also be referred to as a fibroid or uterine myoma
Uterine leiomyoma
_____is the presence of intrauterine adhesions or synechiae within the uterine cavity that typically occur as a result of scar formation after uterine surgery
Asherman syndrome
_____is defined as functional, ectopic endometrial tissue located outside the uterus
Endometriosis
______is a perihepatic infection that results in liver capsule inflammation from pelvic infections such as gonorrhea and chlamydia
Fitz-Hugh-Curtis syndrome
The progression of the infection into the cervix is termed:
Cervicitis
______consists of a mixture of FSH and luteinizing hormone and it is often giving in conjunction with hCG
Pergonal
______is a drug that is used to stimulate the pituitary gland to secrete increased amounts of follicle-stimulating hormone (FSH)
Clomiphene citrate (clomid)
______is the stimulation of the ovaries by hormonal therapy to treat infertility
Ovulation induction
The _____is a permanent form of birth control that uses small coils placed into the proximal isthmic segment of the fallopian tube
Essure device
_____is the inflammation of the endometrium
Endometritis
______is an infection of the upper genital tract
PID
Patient who have an IUD that has perforated into the uterine wall will often complain of:
- Irregular or heavy bleeding
- Cramping
Adhesion develop within the pelvis that lead to the fusion of the ovaries and the dilated tubes, a condition known as:
Tubo-ovarian complex
The ______is another T-shaped IUD, although it utilizes copper in its composition to inhibit sperm transport or to prevent fertilization
ParaGard
The _______, a small plastic, T-shaped IUD, distorts the uterine cavity and also releases small amounts of progestin to impede implantation and produce light bleeding
Mirena
Clinical findings of tubo-ovarian complex and tubo-ovarian abscess
- Findings consistent with PID
Clinical findings of polycystic ovary syndrome
- Stein-leventhal syndrome (amenorrhea, hirsutism and obesity)
- Infertility
- Oligomenorrhea
- Hyperandrogenism
Clinical findings of Asherman syndrome
- History of D&C, trauma, and uterine surgery
- Recurrent pregnancy loss
- Amenorrhea or hypomenorrhea
Clinical findings of salpingitis
- Findings consistent with PID
- Pelvic tenderness
- Fever
- Leukocytosis
Clinical findings of endometritis
- History of recent abortion, postpartum, D&C, surgery or intrauterine device
- Pelvic tenderness
- Fever
- Leukocytosis
Clinical findings of chronic pelvic inflammatory disease
- Continual pelvic or abdominal pain
- Infertility (resulting from adhesions and scaring of the fallopian tubes)
- Possible palpable adnexal mass
- Irregular menses
- Purulent vaginal discharge
Clinical findings of Acute pelvic inflammatory disease
- Possible history of a STD
- Fever
- Chills
- Pelvic pain and/or tenderness
- Purulent vaginal discharge
- Vaginal bleeding or itchiness
- Dyspareunia
- Leukocytosis
Clinical findings of a uterine leiomyoma
- Pelvic pressure
- Menorrhagia
- Palpable abdominal mass
- Enlarged, bulky uterus
- Urinary frequency
- Dysuria
- Constipation
- Infertility
Clinical findings of endometriosis
- patient may be asymptomatic
- Pelvic pain
- Infertility
- Dysmenorrhea
- Menorrhagia
- Dyspareunia
- Painful bowel movements
Clinical findings of ovarian hyperstimulation syndrome
- Fertility treatment, including ovulation induction
- Electrolyte imbalance
- Oliguria
- Nausea
- Vomiting
- Abdominal distension
- Ovarian enlargement
Sonographic findings of endometritis
- Thickened echogenic or irregular appearing endometrium
- Endometrial fluid
- Ring-down artifact from gas or air within the endometrium
Sonographic findings of ovarian hyperstimulation syndrome
- Cystic enlargement of the ovaries > 5cm
- Ascites
- Possible pleural effusion
Sonographic findings of Asherman syndrome
- Bright areas within the endometrium
- Sonohysterography findings include bright bands of tissue traversing the uterine cavity
Sonographic findings of Tubo-ovarian complex
- Thickened, irregular endometrium
- Pyosalpinx or hydrosalpinx
- Cul-de-sac
- Multicystic and solid comple adnexa masses
- Ovaries and tubes recognized as distinct structures but the ovaries will not be separated from the tube by pushing with vaginal probe
Sonographic findings of salpingitis
- Distended fallopian tube filled with echogenic material (pus) or anechoic fluid
- Hyperemic flow within or around the affected fallopian tube depicted with color doppler
- Nodular, thickened wall of the fallopian tube
Sonographic findings of tubo-ovarian abscess
1.Thickened, irregular endometrium
2. Pyosalpinx or hydrosalpinx
3. Cul-de-sac fluid
4. Multicystic and solid complex adnexal masses
5. Complete loss of borders of all adnexal structures and the development of a congiomerated adnexal (possibly bilateral) mass
Sonographic findings of an endometriosis
- Predominantly cystic mass with low-level internal echoes (may resemble a hemorrhagic cyst)
- Anechoic or complex mostly cystic mass with posterior enhancement and may contain a fluid-fluid level
Sonographic findings of a uterine leiomyoma
- Hypoechoic mass within the uterus
- Posterior shadowing from mass
- Degenerating fibroids may have calcifications or cystic components
- Multiple fibroids appear as an enlarged, irregular shaped, diffusely heterogeneous uterus
Sonographic findings of PID:
- Hydrosalpinxx
- Scars may be noted within the dilated tube and appear as echogenic bonds within the tube
- Development of adhesions may obliterate distinct borders of organ because they become fixated to each other
- Multicystic and solid complex adnexal mass
Sonographic findings of acute PID:
- Thickened, irregular endometrium (endometritis)
- Ill-defined uterine borders
- Tubular structures representing dilated fallopian tubes containing echogenic material (pyosalpinx)
- Tubular structures representing dilated fallopian tubes containing simple appearing, anechoic fluid (hydrosalpinx)
- Cul-de-sac fluid
- Multicystic and solid complex adnexal mass
