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FINALS - OBS, GYNAE, BREAST > endometrial pathology > Flashcards

endometrial pathology Flashcards

1
Q

causes PMB

A

vaginal atrophy // HRT // endometrial hyperpalsia // endometiral cancer // cervical, ovarian, vaginal cancer

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2
Q

most common cause PMB

A

vaginal atrophy

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3
Q

invx for all women over 55 + PMB

A

2 week USS for endometrial thickness

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4
Q

what endometrial thickness is worrying for cancer

A

5mm+

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5
Q

what are fibroids

A

benign smooth muscle tumours of uterus

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6
Q

who gets fibroids

A

black women, middle aged, in response to oestrogen

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7
Q

features fibroids

A

heavy periods (iron def) // lower abdo pain, painful periods, bloating // urinary if big // POLYCYTHAEMIA from EPO (rare)

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8
Q

invx fibroids

A

transvag USS

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9
Q

types of fibroid

A

submucosa (into uterine cavity) // subserosal (grow into abdomen on edge of uterus) // intramural (in myometrium)

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10
Q

mx asymptomatic fibroids

A

none needed - review

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11
Q

mx of menorrhagia from fibroids

A

levonestrogel IUS // mefenamic acid (NSAID) or tranexamic acid // COCP, POP, injection

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12
Q

medical mx fibroids

A

GnRH agonist to shrink (before surgery)

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13
Q

SE fibroid medical mx

A

menopausal symtpoms eg flushes, vaginal dryness // loss of bone mineral density

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14
Q

surgical mx fibroids

A

fibroid ablation // myomectomy (for childbearing) // hysterectomy // uterine artery embolism

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15
Q

complications fibroids

A

subfertility, iron def, red degeneration , torsion

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16
Q

when does fibroid degeneration tend to occur

A

in pregnancy (grows with oestroegen) –> baby outstrips their blood supply –> degeneration

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17
Q

symptoms fibroid degeneration

A

low fever, pain, vomiting

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18
Q

mx fibroid degeneration

A

bed rest and analgesia 4-7 days

19
Q

what is endometriosis

A

growth of endometrial tissue outside uterus

20
Q

symptoms endometriosis

A

pevic pain // secondary dysmennorhea (pain before period) // deep dyspareunia // subfertile // urinary symptoms // painful bowel

21
Q

invx endometriosis

A

(USS not v useful) // laparoscopy = gold

22
Q

1st line mx endometriosis

A

NSAIDs +/- paracetamol

23
Q

2nd line mx endometriosis

A

COCP or progesterones

24
Q

3rd line mx endometriosis

A

GnRh analogues (eg goserelin, danazol)

25
Q

surgical mx endometriosis

A

lap excision or ablation + adhesiolysis (good for conception also)

26
Q

only curative mx endometriosus

A

total hysterctomy

27
Q

what is adenomyosis

A

endometrial tissue in myometrium

28
Q

symptoms adenomyosis

A

dysmenorrhoea // menorrhagia // large, boggy uterus

29
Q

invx adenomyosis

A

MRI

30
Q

who usually gets adenomyosis

A

women with children in their 40s

31
Q

mx adenomyosis

A

tranexamic acid // GnRH // uterine artery embolism // hysterectomy (definitive mx)

32
Q

features endometrial hyperplasia

A

abnormal bleeding eg intermenstrual, post menopausal

33
Q

mx simple endometrial hyperplasia w/o atypia

A

high dose progesterone (or IUS) –> repeat 3-4 months

34
Q

mx endometrial hyperplasia + atypia

A

hysterectomy

35
Q

types of endometrial hyperplasia

A

simple, complex, atypical

36
Q

hormonal RF endometrial cancer

A

increased oestrogen - no kids, early menarche, late menopause,

37
Q

meds RF endometrial cancer

A

unopposed oestrogen (eg HRT without progesterone) , tamoxifen

38
Q

metabolic RF endometrial cancer

A

obesity // DM // PCOS

39
Q

protective factors endometrial cancer

A

kids // COCP // smoking

40
Q

symptoms endometrial cancer

A

PMB!!! // premenopausal = menorrhagia or intermentrual bleeding

41
Q

invx for endometrial cancer

A

TVUS endometrial thickness (<4mm) // hysteroscopy with endometrial biopsy

42
Q

mx endometrial cancer

A

TAH + BSO +/- post-op radio

43
Q

complications hysterectomy

A

acute urianry retention // enterocele or vaginal vault prolapse

FINALS - OBS, GYNAE, BREAST (27 decks)

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