Endometriosis

Question 1

average age and range for periods to begin

Answer 1

13 - can be 10-16

Question 2

how much is a heavy period in ml

Answer 2

> 80ml

Question 3

what is the pathology of endometriosis

Answer 3

endometrial tissue outside the lining of the uterus that responds to hormones and sheds during menstruation

Question 4

5 presentations of endometriosis

Answer 4

HMB
Pain
bleeding or spotting between periods
dyspareunia
pain on urination or pooing

Question 5

true/false endometriosis can cause back pain

Answer 5

true

Question 6

true/false endometriosis can cause infertility

Answer 6

true

Question 7

give 4 common sites for endometriosis to occur

Answer 7

anywhere in reproductive tract
GI tract
peritoneum
pouch of douglas

Question 8

what stage is small patches on other organs

Answer 8

stage 1 - minimal

Question 9

what stage is peritoneal involvement, scarring and adhesions

Answer 9

stage 3 - moderate

Question 10

what stage is beginning to infiltrate other organs

Answer 10

stage 2 - mild

Question 11

what stage is infiltration of many pelvic organs with distortion to normal anatomy

Answer 11

stage 4 - severe

Question 12

what is the gold standard dignosis of endometriosis

Answer 12

a diagnostic laparoscopy

Question 13

give 3 investigations of endometriosis

Answer 13

pelvic exam, US, diagnostic laparoscopy

Question 14

3 methods of management

Answer 14

analgesia
hormones
surgical

Question 15

hormonal treatments for endometriosis

Answer 15

CHC, POP, Mirena, injection and GnRH analogues

Question 16

4 surgical treatment for endometriosis

Answer 16

ablation, hysterectomy, pelvic clearance or endometrioma excision

Question 17

give an 1 indication for surgical management

Answer 17

fertility treatment

Question 18

findings on examination

Answer 18

reduced organ mobility, visible lesions and tender nodularity in the posterior vaginal fornix

Question 19

1st line analgesia

Answer 19

NSAIDs or paracetamol

Question 20

how do GnRH hormones work

Answer 20

induce a ‘pseudo-menopause’ due to low oestrogen levels - can be given with oestrogen to relieve those menopausal side-effects

Question 21

true/false - medical therapy is 1st line to treat fertility problems

Answer 21

false - has no significant impact on fertility rates