Endometriosis Flashcards
endometriosis
abnormal growth of tissue that histologically resemble endometrial tissue and responsive to hormones
found on pelvic organs and peritoneal surface
endometriosis ticks
FH prolonged estrogen exposure heavy bleeding during menses obstruction of menstrual flow high consumption of trans fat
protective factors endometriosis
multiparous
late menarche
extended intervals of lactation
increased omega 3
mc pathophys theory
cells blow backwards thru fallopian tubes and into peritoneal cavity during menses
endometriosis related pelvic pain
due to increased production of inflammatory and pain mediators
subfertlity due to
anatomic distortion
pelvic adhesions and endometriosis _ production of hostile substance
lesions mc found
dependent portion of pelvis
endometriosis first appears
red, petechial lesion
grows dark brown, black or blue powder burn
grow further into cysts and extensive adhesions
choclate cysts
lesions on an ovary
endometrioma
exotic implants within an ovary
why does endometriosis cause PMS
more endometrium on other organs
symptoms (are/are not) correlated with extent of dz
ARE NOT
peak presentation age
25-35 y.o.
classic symptoms
- pelvic pain
- dyspareunia
- infertility
pain of endometriosis
dull crampy pelvic pain
pain creases throat mesntruation
can occur with urination or defecation
constant backache and fatigue
PE of endometriosis
tender nodules in posterior vaginal fornix and tender adnexal masses
fixed uterine position
definitive dx endometriosis
direct visualization of implants by laparoscopy
TVUS endometriosis
ground glass appearance
stage I
minimal disease
isolated implants no adhesions
stage II
implants <5 cm
scattered on peritoneum and ovaries
stage III
multiple implants
peritubal and preovarian adhesions
stave IV
multiple superficial and deep implants
large ovarian endometriosis
filmy dense adhesions
mild symptoms tx
no initiation
observation and pt education
moderate symptoms tx
hormone agents
OCs, depo, Mirena
prostaglandin inhibitors (COX-2/NSAIDS)
second line moderate symptoms tx
GnRH agonists
danazol
danazol MOA
FSH and LH inhibition
prevents steroidogeneis in corpus lute
severe symptoms
women treated surgically
destruction of implants and excision of adhesions
