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NCMN 109B > Endometriosis > Flashcards

Endometriosis Flashcards

1
Q

the presence of endometrial tissue outside
the uterus

A

endometriosis

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2
Q

Tissue is morphologically and functionally similar to endometrial tissue and in which responds to hormones in cyclical manner.

A

endometriosis

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3
Q

There are several theories of endometriosis’ etiology:

A
  1. Sampson’s theory of menstrual regurgitation and implantation. (Metastatic theory)
  2. Coelomic metaplasia theory
  3. Lymphatic and Vascular metastasis theory
  4. Genetic factors
  5. Immunological factors
  6. Inflammation
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4
Q

Original coelomic membrane transforms into endometrial
tissue.

A

Coelomic metaplasia theory

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5
Q

Explains endometriosis in ectopic sites

A

Coelomic metaplasia theory

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6
Q

Lymphatic and hematogenous spread of endometrial cells

A

Lymphatic and Vascular metastasis theory

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7
Q

Extensive communication of lymphatics between uterus, tubes, ovaries, pelvic and vaginal lymph nodes, kidneys and umbilicus

A

Lymphatic and Vascular metastasis theory

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8
Q

Increased risk of up to __ times if _____________________ has or had endometriosis

A

7; first degree relative

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9
Q

Reduced clearance of endometrial cells due to _______________________________________________________________

A

decreased natural killer cell activity or macrophage activity.

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10
Q

Endometriosis is associated with

A

subclinical peritoneal inflammation

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11
Q

PELVIC ENDOMETRIOSIS

A
  • PERITONEUM
  • OVARIES
  • DEEP INFILTRATING
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12
Q

Metastatic theory

A
  1. Retrograde menstruation
  2. Endometrial fragments transported to the peritoneal cavity
  3. Viable cells implant and grow
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13
Q

EXTRAPELVIC ENDOMETRIOSIS

A

GASTROINTESTINAL TRACT
URINARY TRACT
SCAR ENDOMETRIOSIS
VAGINAL ENDOMETRIOSIS
THORACICENDOMETRIOSIS

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14
Q

CLINICAL PRESENTATION

A
  1. PAIN
  2. ABNORMAL BLEEDING
  3. INFERTILITY
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15
Q

Pain
CLASSICAL TRIAD:

A

SECONDARY DYSMENORRHEA, DYSPAREUNIA, DEEP
SEATED PELVIC PAIN

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16
Q

ABNORMAL BLEEDING MAY INCLUDE

A

PREMENSTRUAL SPOTTING, POLYMENORRHEA AND MENOMETRORRHAGIA

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17
Q

PRESENT IN MAJORITY OF THE WOMEN WITH ENDOMETRIOSIS

A

INFERTILITY

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18
Q

CYCLICAL RECTAL BLEEDING OR HEMATURIA

A

EXTRAPELVIC ENDOMETRIOSIS

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19
Q

CYCLICAL PAIN AND BLEEDING AT SCAR

A

SCAR ENDOMETRIOSIS

20
Q

UMBILICAL MASS WITH CYCLICAL PAIN

A

UMBILICAL ENDOMETRIOSIS

21
Q

CYCLICAL HEMOPTYSIS AND HEMOTHORAX

A

PULMONARY ENDOMETRIOSIS

22
Q

OTHER SYMPTOMS

A

EXTRAPELVIC ENDOMETRIOSIS
SCAR ENDOMETRIOSIS
UMBILICAL ENDOMETRIOSIS
PULMONARY ENDOMETRIOSIS

23
Q

How is Endometriosis Diagnoses?

A

TRANSVAGINAL ULTRASOUND
Magnetic resonance imaging (MRI)
Laparoscopy
Pelvic exam

24
Q

this test won’t definitively tell your doctor whether you have endometriosis, but it can identify cysts associated with endometriosis

A

TRANSVAGINAL ULTRASOUND

25
Helps locate the exact location and size of endometrial implants
Magnetic resonance imaging (MRI)
26
A procedure that allows the surgeon to view inside your abdomen using a laparoscope ( a camera) inserted through your abdomen using a small incision in order to look for signs of endometrial tissues outside the uterus or get a tissue sample for biopsy.
Laparoscopy
27
Direct palpation to the areas in your pelvis for abnormalities, such as cysts on your reproductive organs or scars behind your uterus. Often it's not possible to feel small areas of endometriosis unless they've caused a cyst to form.
Pelvic Exam
28
What are the medical management of Endometriosis (Symptomatic Cases)
- Drug Treatment - Minimally invasive surgery - Surgery
29
What are the medical management of Endometriosis (Asymptomatic Cases)
Observation for 6-8 months with Investigation of possible infertility
30
DRUG THERAPY FOR ENDOMETRIOSIS
Combined oral contraceptives Oral progesterone Danazol Gonadotropin releasing hormone
31
Combined oral contraceptives can be administered
intermittently or continuously
32
what prevents long-term use of Combined oral contraceptives?
High incidence of side effects and risk of thrombusembolism
33
tend to thin the lining of the uterus which stops regular periods and lessens the chance for break-through bleeding or spotting and has similar activity against endometriosis lesions
Oral progesterone
34
A synthetic derivative of testosterone
Danazol
35
Mildly anabolic, anti estrogenic and anti-progesterone
Danazol
36
it works by decreasing the amount of hormones made by the ovaries
Danazol
37
Common side effects of Danazol
- Weight gain, acne flushing, voice changes. - Abnormal hair growth, decrease breast size, vaginal dryness.
38
Administered continuously to decrease and suppress pituitary gonadotropins.
Gonadotropin releasing hormone
39
Gonadotropin releasing hormone causes
atrophy of the endometriotic tissues
40
prolonged use of Gonadotropin releasing hormone causes
hypo-estrogenism and menopausal symptoms such as vaginal dryness and osteoporosis
41
menopausal symptoms
vaginal dryness and osteoporosis
42
MINIMAL INVASIVE SURGERIES
1. Aspiration of peritoneal fluid in cul-de-sac 2. Destruction of endometriotic implants by diathermy cauterization or through laser surgery. 3. Larger lesions and chocolate cysts can be excised. Residual lesions can be dealt with by hormonal therapy. 4. Laparoscopic breaking of adhesions in pelvis to relieve dysmenorrhea and pelvic pain.
43
Why opt for surgery?
Failed medical therapy Medication causes Infertility Recurrence due to failed medication therapy Chocolate cyst ovary
44
Indications for surgery:
Advanced stage of disease Large lesions Failed medical therapy Elderly parous women
45
_________________ is more effective than medical intervention for addressing infertility associated with endometriosis.
Surgery
46
can be used to treat endometriosis in women who do not wish to conceive.
HYSTERECTOMY
47
NURSING DIAGNOSES
- Chronic pain related to endometrial pelvic implants - Anxiety related to effect of endometriosis on fertility - Deficient knowledge related to diagnosis and treatment options - Ineffective sexuality patterns related to the manifestations of endometriosis

NCMN 109B (7 decks)

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