Endometriosis

Question 1

endometriosis

Answer 1

abnormal growth of tissue that histologically resemble endometrial tissue and responsive to hormones

found on pelvic organs and peritoneal surface

Question 2

endometriosis ticks

Answer 2

FH 
prolonged estrogen exposure 
heavy bleeding during menses 
obstruction of menstrual flow 
high consumption of trans fat

Question 3

protective factors endometriosis

Answer 3

multiparous
late menarche
extended intervals of lactation
increased omega 3

Question 4

mc pathophys theory

Answer 4

cells blow backwards thru fallopian tubes and into peritoneal cavity during menses

Question 5

endometriosis related pelvic pain

Answer 5

due to increased production of inflammatory and pain mediators

Question 6

subfertlity due to

Answer 6

anatomic distortion

pelvic adhesions and endometriosis _ production of hostile substance

Question 7

lesions mc found

Answer 7

dependent portion of pelvis

Question 8

endometriosis first appears

Answer 8

red, petechial lesion

grows dark brown, black or blue powder burn

grow further into cysts and extensive adhesions

Question 9

choclate cysts

Answer 9

lesions on an ovary

Question 10

endometrioma

Answer 10

exotic implants within an ovary

Question 11

why does endometriosis cause PMS

Answer 11

more endometrium on other organs

Question 12

symptoms (are/are not) correlated with extent of dz

Answer 12

ARE NOT

Question 13

peak presentation age

Answer 13

25-35 y.o.

Question 14

classic symptoms

Answer 14

1. pelvic pain
2. dyspareunia
3. infertility

Question 15

pain of endometriosis

Answer 15

dull crampy pelvic pain

pain creases throat mesntruation

can occur with urination or defecation

constant backache and fatigue

Question 16

PE of endometriosis

Answer 16

tender nodules in posterior vaginal fornix and tender adnexal masses

fixed uterine position

Question 17

definitive dx endometriosis

Answer 17

direct visualization of implants by laparoscopy

Question 18

TVUS endometriosis

Answer 18

ground glass appearance

Question 19

stage I

Answer 19

minimal disease

isolated implants no adhesions

Question 20

stage II

Answer 20

implants <5 cm

scattered on peritoneum and ovaries

Question 21

stage III

Answer 21

multiple implants

peritubal and preovarian adhesions

Question 22

stave IV

Answer 22

multiple superficial and deep implants
large ovarian endometriosis
filmy dense adhesions

Question 23

mild symptoms tx

Answer 23

no initiation

observation and pt education

Question 24

moderate symptoms tx

Answer 24

hormone agents

OCs, depo, Mirena

prostaglandin inhibitors (COX-2/NSAIDS)

Question 25

second line moderate symptoms tx

Answer 25

GnRH agonists

danazol

Question 26

danazol MOA

Answer 26

FSH and LH inhibition

prevents steroidogeneis in corpus lute

Question 27

severe symptoms

Answer 27

women treated surgically

destruction of implants and excision of adhesions