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Year Three - Reproductive System > Endometriosis > Flashcards

Endometriosis Flashcards

1
Q

What is endometriosis?

A

It is is a defined as a chronic condition in which there is ectopic endometrial tissue that grows outside of the uterine cavity

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2
Q

In what seven locations can endometriosis occur?

A

Ovaries

Pouch of Douglas

Uterosacral ligament

Pelvic peritoneum

Bladder

Umbilicus

Lungs

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3
Q

What is endometrioma?

A

A lump of endometrial tissue outside the uterus

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4
Q

What is the pathophysiological cause of endometriosis?

A

The pathophysiology is unclear

However, it is proposed that retrograde menstruation occurs, in which endometrial cells travel backwards from the uterine cavity, through the fallopian tubes and out into the pelvis and peritoneum – where they can deposit and grow

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5
Q

What are the ten risk factors associated with endometriosis?

A

White Race

Family History

Autoimmune Disease

Early Menarche

Late Menopause

Delayed Childbearing

Nulliparity

Uterine Defects

Low Body Mass Index

Smoking

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6
Q

What are the eleven clinical features of endometriosis?

A

Chronic Pelvic Pain

Dysmenorrhoea

Deep Dyspareunia

Reduced Organ Mobility

Tender Nodule Posterior Vaginal Fornix

Visible Vaginal Endometriotic Lesions

Subfertility

Dysuria

Urinary Urgency

Haematuria

Dyschezia

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7
Q

What is the most common presenting symptom of endometriosis?

A

Chronic Pelvic Pain

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8
Q

Describe the pelvic pain associated with endometriosis

A

It tends to present cyclically, occurring a few days before menstruation

However, in cases where adhesions have formed, the pain may be constant

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9
Q

What is dyschezia?

A

It is defined as painful bowel movements

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10
Q

What are the three investigations used to diagnose endometriosis?

A

Urine Pregnancy Test

Transvaginal Ultrasound Scan

Laparoscopy

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11
Q

How are urine pregnancy tests used to investigate endometriosis?

A

They should be conducted in all women of a reproductive age in order to exclude a diagnosis of pregnancy

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12
Q

What is a feature of endometriosis on transvaginal ultrasound scans?

A

Endometriomas

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13
Q

What is important to note about transvaginal ultrasound scans in diagnosing endometriosis?

A

A normal scan doesn’t exclude a diagnosis of endometriosis

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14
Q

What is the gold standard investigation used for endometriosis?

A

Laparoscopy

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15
Q

What are the two features of endometriosis on laparoscopy?

A

Endometriomas

Chocolate Cysts

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16
Q

What are the three pharmacological managements used to treat endometriosis?

A

Simple Analgesia

Contraceptive Management

GnRH Analogues

17
Q

What is the first line pharmacologcial option for endometriosis?

A

Simple Analgesia

18
Q

Name two simple analgesics used to manage endometriosis

A

NSAIDs

AND/OR

Paracetamol

19
Q

When are contraceptives used to manage endometriosis?

A

They are the second pharmacological management option of endometriosis

20
Q

How are contraceptives used to manage endometriosis?

A

They supress ovulation and reduce endometrial thickening, which causes atrophy of the endometrial lesions

21
Q

Name three contraceptives are used to manage endometriosis

A

Combined Oral Contraceptive Pill

Medroxyprogesterone Acetate

Mirena Intrauterine System

22
Q

When are GnRH analogues used to manage endometriosis?

A

They are the third line pharmacological mangement option

23
Q

How are GnRH analogues used to treat endometriosis?

A

They induce a psuedomenopause, in which oestrogen levels are reduced and ovulation is supressed

This causes atrophy of endometrial lesions

24
Q

Name two GnRH analogues used to manage endometriosis

A

Zoladex

Prostap

25
Q

What are the three surgical management options of endometriosis?

A

Laparoscopic Endometrial Excision

Laparoscopic Endometrial Ablation

Laparoscopic Hysterectomy

26
Q

When is laparoscopic endometrial excision used to manage endometriosis?

A

It is a surgical management option recommended in women who wish to preserve their fertility

27
Q

What is laparoscopic endometrial excision?

A

It involves laparoscopic excision of endometriomas

28
Q

What is important to note about laparoscopic endoemtrial excision management of endometriosis?

A

This surgical management option will result in relapses and therefore surgery may have to be repeated

29
Q

When is laparoscopic endoemtrial ablation used to manage endometriosis?

A

It is a surgical management option recommended in women who wish to preserve their fertility

30
Q

What is laparoscopic endoemetrial ablation?

A

It involves laparoscopic application of heat to destroy endometriomas

31
Q

What is important to note about laparoscopic endoemtrial ablation management of endometriosis?

A

This surgical management option will result in relapses and therefore surgery may have to be repeated

32
Q

When is laparoscopic hysterectomy used to manage endometriosis?

A

It is the surgical management option recommended in women who don’t wish to preserve their fertility

33
Q

What is laparoscopic hysterectomy?

A

It involves surgical removal of the uterus

34
Q

What two endoemtriosis management options improve fertility?

A

Laparoscopic Endometrial Excision

Laparoscopic Endometrial Ablation

35
Q

What are the four complications assoicated with endometriosis?

A

Endometrioma Rupture

Endometrioma Adhesions

Bladder Obstruction

Infertility

36
Q

What is the clinical feature of endometrioma rupture?

A

Intense pelvic pain, which is not cyclical with menstruation

37
Q

What is the investigation used to diagnose endoemtrioma rupture?

A

Ultrasound Scan

38
Q

What is a feature of endometrioma rupture on US?

A

Pelvic Free Fluid

Year Three - Reproductive System (52 decks)

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