endometriosis Flashcards
1
Q
endometriosis
A
endometrial tissue outside of the uterus
- found in the fallopian tubes, ovaries or ovarian ligaments
2
Q
aietiology of endometriosis
A
- retrograde menstruation theory - blood carrying endometrial cells and tissue migrate to the fallopian tubes and other structures during menstruation
- dysfunction of immune system - b cells + t cells do not recognise benign endometrial tissue
- Metaplastic theory - cells of the peritoneum can transform into endometrial tissue
- can travel via lymph nodes and blood
- stem cells can differentiate into
3
Q
risk factors for endometriosis
A
- family history of endometriosis
- late menopause
- early menarche
- nulliparity
4
Q
pathophysiology of endometriosis
A
- ectopic tissue is benign and doesn’t grow out of control
- ectopic tissue still has - oestrogen receptors thus responds by proliferating and secretion during menses
- Ectopic endometrial tissue ;
- higher levels of enzyme aromatase which produces its own oestrogen
- releases pro inflammatory factors which causes inflammation and scarring - Scar tissue forms adhesions - binding of organs and structures
- promotes growth of new blood vessels to keep endometrial tissue alive - changes in hormone levels causes ectopic to bleed
5
Q
complications of endometriosis
A
- endometriomas - chocolate cysts containing old, dark blood and shed tissue
- could rupture and cause more pain and inflammation - increases mutations in certain genes - PTEN - increases risk of ovarian cancer
- Subfertility - 30 - 40% of women subfertile due to inflammation and scarring
6
Q
symptoms - dependent on location of endometrial cells
A
- Pelvic pain
- bleeding
- dysmenorrhea - painful menstruation
- dyspareunia - painful sexual intercourse
- POUCH OF DOUGLAS - dyschezia (pain with defecation)
- Bladder - urgent/frequent/painful urination
- Intestines - abdominal pain
( generally symptoms get worse during periods )
7
Q
diagnosis
A
- gold standard - laproscopy
2. confirm - biopsy
