Disorders of the Uterus

Question 1

Abnormal Uterine Bleeding Palm Coein

Answer 1

Polyp Coagulation
Adenomyosis Ovulatory dysfunction
Leiomyoma Endometrial
Malignancy Iatrogenic
Not yet classified

Question 2

Abnormal Uterine Bleeding: Terms

Answer 2

Polymenorrhea: cycles less than 24 days
Menorrhagia: heavy menstrual bleeding
Metrorrhagia: bleeding between periods
Oligomenorrhea: cycles> 35 days

Question 3

Pelvic Laparoscopy

Answer 3

considered the primary diagnostic modality for endometriosis.
classic lesions are blue-black or have a powder-burned appearance.

Question 4

Endometriosis MEDS: GnRH analogs

Answer 4

Used for 6 months to suppress ovulation

Lupron

Question 5

Endometriosis MEDS: Oral contraceptives

Answer 5

Used for 6- months to suppress ovulation
BCP’s
Vaginal ring
Patch

Question 6

Endometriosis MEDS: Medroxyprogestone acetate

Answer 6

Used for 6-9 months
May need oral estrogen for breakthru bleedings
Provera, Depo-Provera

Question 7

Endometriosis MEDS: Danazol

Answer 7

Used for 4-6 months
Lowest dose necessary to suppress ovulation
Weight gain
Hirsutism
Acne

Question 8

Endometriosis MEDS: Aromatase inhibitors

Answer 8

block the synthesis of estrogen
Used if endometriosis is resistant to other therapies
Letrozole

Question 9

Type I Endometrial Cancer

Answer 9

endometrioid adenocarcinoma
Most common (75%)
Low grade and usually confined to uterus at Dx
Precursor: endometrial intraepithelial neoplasia (atypical endometrial hyperplasia):
30-50% undiagnosed, coexisting cancer

Question 10

Type II Endometrial Cancer

Answer 10

papillary serous/clear cell
Poorer prognosis
High grade; likely to have spread beyond uterus at time of Dx
More common in black women and smokers

Question 11

Adenomyosis

Answer 11

Presence of endometrial glands and stroma in the myometrium
Induction of hypertrophy and hyperplasia of myometrium
Generalized: Uniform uterine enlargement
Focal or nodular: Uterus may be normal size but asymmetric