endometrial conditions

Question 1

Endometrial polyp - definition/appearance

Answer 1

Well circumscribed collection of endometrial tissue within uterine wall. May contain smooth muscle cells

Question 2

Endometrial polyp - location/presentation

Answer 2

• can extend into cavity in the form of polyp

- assymptomatic/painless abnormal uterine bleeding

Question 3

Adenomyosis - definition/due to

Answer 3

Extension of endometrial tissue (grandular) into uterine myometrium. Caused by hyperplasia of basal layer

Question 4

Adenomyosis - presentation

Answer 4

1. dysmenorrhea
2. menorrhagia
3. uniformly enlarged, soft, globular uterus

Question 5

Adenomyosis - treatment

Answer 5

1. GnRH agonists

2. Hysterectomy

Question 6

MC tumor in females

Answer 6

Leiomyoma (fibrinoid)

Question 7

Leiomyoma (fibrinoid) - increased incidence in

Answer 7

• African ameriancs

- peak at 20-40

Question 8

Leiomyoma (fibrinoid) - definition/gross appearance/transformation

Answer 8

benign SM tumor
multiple dicrete tumors
malignant transformation (leiomyosarcoma) is rare

Question 9

Leiomyoma (fibrinoid) - pathophysiological characteristic

Answer 9

Estrogen sensitive –> increased tumor size in pregnancy and decreased with menopause

Question 10

Leiomyoma (fibrinoid) - presentation

Answer 10

1. asymptomatic
2. abnormal uterine bleeding
3. miscarriage
4. iron deficiency anemia (if severe bleeding)

Question 11

Endometrial hyperplasia - definition/mechanism

Answer 11

abnormal endometrial gland proliferation usually caused by excess estrogen stimulation

Question 12

Endometrial hyperplasia - complications (and mechanism)

Answer 12

high risk for endometrial carcinoma - nuclear atypia is greater risk factor than complex (vs simple) architecture

Question 13

Endometrial hyperplasia - presentation

Answer 13

postmenopausal vaginal bleeging

Question 14

Endometrial hyperplasia - risk factors

Answer 14

1. anovulatory cycles
2. hormone replacement therapy
3. polycystic ovarian sydrome
4. granulosa cell tumor

Question 15

Leiomyoma (fibrinoid) - histology

Answer 15

whorled pattern of of SM bundles with well demarcated borders

Question 16

endometrial carcinoma - age

Answer 16

55-65

Question 17

endometrial carcinoma typically preceded by

Answer 17

encometrial hyperplasia

Question 18

endometrial carcinoma - present with

Answer 18

vaginal bleeding

Question 19

endometrial carcinoma - risk factors

Answer 19

1. prolonged use of estrogen without progestins
2. obesity
3. diabetes
4. hypertension
5. nulliparity
6. late menopause
7. Lynch syndrome

Question 20

endometritis - definition/association

Answer 20

Inflammation associated with retained products of conception following delivery, miscarriage, abortion, or foreign body (IUD)

Question 21

endometritis - mechanism

Answer 21

retained materials in uterus –> infection by bacterial flora from vagina or intestine tract

Question 22

endometritis - treatment

Answer 22

gentamicin + clindamycin +/- ampicillin

Question 23

Endometriosis - definition/location

Answer 23

non-neoplastic endometrial glands/stroma outside endometrial cavity. Can be anywhere –> MC at ovary (frequent bilateral), pelvis, peritoneum

Question 24

Endometriosis in ovary

Answer 24

appears as edometrioma (blood-filled chocolate cyst)

Question 25

Endometriosis may be due to

Answer 25

1. retrorade flow (menstruation)
2. metaplastic transformation of multipotent cells`
3. trnasportation of endometrial tissue via lymphatic system

Question 26

Endometriosis - uterus size

Answer 26

normal

Question 27

Endometriosis - presentation

Answer 27

1. cyclic pelvic pain
2. bleeding
3. dysmenorrhea
4. Dysparenia
5. pain with defacation
6. infertility

Question 28

endomtriosis - treatment

Answer 28

1. NSAID
2. OCP
3. progestins
4. GnRH agonists
5. Danazol
6. Laparoscopic removal