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OB/GYN > Endometriosis > Flashcards

Endometriosis Flashcards

1
Q

Is there a familial association with endometriosis?

A

Yes

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2
Q

What, generally, are the major s/sx of endometriosis?

A
  • Chronic pelvic pain
  • Infertility
  • Progressive dysmenorrhea
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3
Q

What is the retrograde menstruation theory on the pathogenesis of endometriosis?

A

Direct implantation of endometrial cells in inappropriate places

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4
Q

What is the vascular lymphatic dissemination theory of endometriosis?

A

Distant sites of endometriosis through spread through lymphatics

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5
Q

What is the coelomic theory of endometriosis?

A

Multipotential cells in the peritoneal cavity differentiate inappropriately, and respond to hormone changes

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6
Q

What are the three major risk factors for the development of endometriosis?

A
  • Early menarche
  • Shorter cycle interval
  • Prolonged heavy bleeding
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7
Q

What are the three major protective factors for endometriosis?

A
  • Higher parity
  • Increased duration of lactation
  • Regular exercise
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8
Q

Where does endometriosis usually occur?

A
  • On both ovaries and fallopian tubes
  • Round ligament
  • Sigmoid colon
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9
Q

What is the pouch of douglas (posterior cul-de-sac)?

A

Area anterior to the rectum, and posterior to the uterus

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10
Q

Is deep or superficial dyspareunia more common with endometriosis?

A

Deep

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11
Q

True or false: the s/sx of endometriosis correlate well with extent of tissue

A

False

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12
Q

What is an endometrioma?

A

Endometriosis on the ovary

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13
Q

What is the only way to definitively diagnose endometriosis?

A

Look at it–scope or surgery

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14
Q

What is the classic presentation of endometriosis?

A

Pts with dysmenorrhea that does not respond to NSAIDs

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15
Q

What is the ddx of endometriosis?

A
  • PID
  • GI dysfunction
  • Interstitial cystitis
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16
Q

True or false: pts with endometriosis usually have an normal pelvic exam

A

True

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17
Q

What is a diagnostic test to assess for endometriosis?

A

Trial of GnRH agonist like leuprolide

Will initially have increased s/sx, but will eventually subside with continued therapy

18
Q

What is the role of imaging studies for endometriosis?

A

Not sensitive

19
Q

What are the histological findings of endometriosis?

A

Glands in a field of inflammation

20
Q

What are the three major goals of medical therapy for endometriosis?

A
  • Reduction in pelvic pain
  • Minimize surgical intervention
  • Preserve fertility
21
Q

What is expectant management of endometriosis?

A

-Wait it out to birth a child or when menopause comes (if older)

22
Q

What is the medical management, generally, of endometriosis? Does this preserve fertility?

A
  • Induction of atrophy of the endometrial tissue

- Will maintain fertility

23
Q

What is the MOA of using NSAIDs + oral contraceptives to treat endometriosis?

A

Reduces inflammation and

24
Q

What is the MOA of using progesterone in treating endometriosis?

A

Suppresses FSH/LH release and the resulting steroidogenesis

25
Q

What is the MOA of danazol in the treatment of endometriosis?

A

Suppresses FSH and LH production

26
Q

What is the MOA of using leuprolide in treating endometriosis?

A

GnRH agonism will ultimately downregulate the pituitary

27
Q

What is the role of hormonal IUDs with endometriosis?

A

Will not change hormones, just uterus’s response

28
Q

What are the surgical options for treating endometriosis?

A
  • Limited cauterization of ectopic endometrial tissue

- Total hysterectomy or a bilateral oophorectomy

29
Q

What fraction of women who had conservative surgical treatment for endometriosis will require surgery within 5 years?

A

1/3

30
Q

What are the risks and benefits of a total hysterectomy for treating endometriosis?

A

Will prevent recurrence of endometriosis, but will send into menopause right meow

31
Q

What is the gene on the Y chromosome that causes the development of the fetus into a male? What specifically does this cause?

A

SRY gene

Causes the mesonephric duct to form instead of regress

32
Q

If the SRY gene is not present, what happens to the mesonephric ducts?

A

Regressed and replaced by the paramesonephric ducts

33
Q

The gonads arise from what?

A

Intermediate mesoderm within the urogenital ridge

34
Q

What do the genital ducts arise from?

A

Paired mesonephric, and paramesonephric ducts

35
Q

The mesonephric duct gives rise to what?

A

Male genital duct

36
Q

What paramesonephric ducts give rise to what?

A

Female genital ducts

37
Q

What part of the female genitalia develops from the paramesonephric duct? (5)

A
  • Upper 1/3 of vagina
  • Cervix
  • Uterus
  • Fallopian tubes
  • Ovary
38
Q

What develops from the urogenital sinus? (3)

A
  • Lower 2/3 of vagina
  • Bulbourethral glands
  • Vestibule
39
Q

What, generally, are Mullerian anomalies?

A

Incomplete fusion or incomplete resorption of the septum

40
Q

What causes a septated uterus, and what is the treatment?

A

incomplete resorption of the uterine septum. Needs to be surgically corrected

41
Q

What cause a bicornuate uterus?

A

Incomplete fusion of the Mullerian ducts

42
Q

What causes uterine didelphys?

A

Complete failure of fusion (double uterus, vagina, and cervix)

OB/GYN (33 decks)

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