Conditions of Uterus/Cervix

Question 1

When do the Mullerian (paramesonephric) ducts arise?

Answer 1

6 weeks

Question 2

When should the Mullerian (paramesonephric) ducts fuse at midline?

Answer 2

9 weeks

Question 3

Uterine Didelphys is caused by?

Answer 3

Failure of the Paramesonephric ducts to fuse

Question 4

What will be present with uterine Didelphys?

Answer 4

2 uterine cavities
2 cervices
Possibly 2 vaginas

Question 5

If the midline septum of the Mullerian ducts does not resolve, what will occur?

Answer 5

Septate Uterus

Question 6

Meyer-Rokitansky-Kuster-Hauser Syndrome is caused by? What results?

Answer 6

Mullerian duct AGENESIS

– absence of uterus and upper vagina

Question 7

Anomalies of the uterus and cervix usually occur _____

Answer 7

Spontaneously

Question 8

DES exposure in utero will cause what 2 anomalies?

Answer 8

• T shaped endometrial cavity

- Cervical collar deformity

Question 9

If a T shaped endometrial cavity and cervical collar deformity are present, what occured?

Answer 9

DES exposure in utero

Question 10

What are uterine Fibroids?

Answer 10

Uterine Leiomyomas

Question 11

Uterine Leiomyomas are benign or malignant? What cells proliferate where?

Answer 11

Benign

– Smooth muscle cells proliferate in myometrium

Question 12

What is the most common neoplasm of the uterus?

Answer 12

Uterine Leiomyomas = fibroids

Question 13

What are some risk factors for Fibroids?

Answer 13

Increased age
Black
No pregnancies

Question 14

What is the presentation of Uterine Leiomyomas?

Answer 14

Usually asymptomatic

– possible bleeding, pelvic pain or pressure

Question 15

How do Fibroids (leiomyomas) look?

Answer 15

Spherical white-tan and well circumscribed

Question 16

What does the cut section of a fibroid look like?

Answer 16

Whorled

Question 17

Subserosal Leiomyoma

Answer 17

Beneath uterine serosal surface

Question 18

Intramural Leiomyoma

Answer 18

Within the myometrium

Question 19

Submucosal Leiomyoma

Answer 19

Beneath the endometrium

Question 20

Cervical Intraligamentous Leiomyoma

Answer 20

Between the broad ligaments

Question 21

What location of Fibroids is the most common and which type can become pedunculated?

Answer 21

Most common = Intramural (within myometrium)

Pedunculated = Submucosal (beneath endometrium)

Question 22

How may a Fibroid be discovered?

Answer 22

Bimanual exam or US

=> enlarged or irregular uterus

Question 23

How will the Fibroid be felt with a bimanual exam and what is it described as?

Answer 23

Mass will move with the cervix

– described in “week size”

Question 24

What is the first line treatment for Leiomyomas?

Answer 24

Oral contraceptive pills (estrogen + progesterone)

Question 25

Besides oral contraceptive pills, what other pills can be given for Fibroids?

Answer 25

Progesterone only | GnRH agonist

Question 26

There are many surgical options for Uterine Leiomyomas. Which will require future pregnancy deliveries to be delivered by C section and is prone to recurrence?

Answer 26

Myomectomy

Question 27

Which surgical option for a Fibroid involves occluding the artery that feeds the fibroid and causes necrosis?

Answer 27

Uterine Artery Embolization

Question 28

What is the only definitive therapy for Leiomyomas?

Answer 28

Hysterectomy

Question 29

What is the only definitive therapy for Fibroids?

Answer 29

Hysterectomy

Question 30

Endometrial polyps are usually ____

Answer 30

Benign

Question 31

What will be seen on ultrasound with an Endometrial Polyp?

Answer 31

Focal thickening of the endometrial stripe

Question 32

When trying to view an Endometrial Polyp, what gives a better view than a regular US?

Answer 32

Saline Hysterosonography

Question 33

What is the treatment of Endometrial polyps?

Answer 33

Remove with hysteroscopy

Question 34

What part of the cervix is more common for polyps to occur at?

Answer 34

Endocervix

Question 35

How do Endocervical Polyps look?

Answer 35

Beefy red

Question 36

How do Ectocervical Polyps look?

Answer 36

Pale

Question 37

Treatment of Cervical Polyps?

Answer 37

Remove in office

Question 38

What is a possible sign of an Endometrial or Cervical polyp?

Answer 38

Bleeding

Question 39

What causes Endometrial Hyperplasia?

Answer 39

Unopposed Estrogen

Question 40

List the 4 types of Endometrial Hyperplasia and their correlated risk of becoming cancer

Answer 40

- Simple without atypia = 1% - Complex without atypia = 3% - Simple with atypia = 9% - Complex with atypia = 27%