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OBGYN > Endometriosis and Adenomyosis > Flashcards

Endometriosis and Adenomyosis Flashcards

1
Q

what is the diagnositic test of of choice for endometriosis?

A

laparoscopy

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2
Q

what does the tissue biospy of endometriosis show? (if anything, focus on the major two findings)

A

endometrial glands, hemosiderin-laden macrophages, and stroma (remember, endometrial glands and stroma should be found in the uterus and NOT outside)

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3
Q

what are the two most common sites of endometriosis?

A

ovary and pouch of douglas

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4
Q

what is the age range in which endometriosis is most common?

A

20s and 30s

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5
Q

t or f: endometriosis is common in multiparous women

A

FALSE; common in nulliparous women (THINK about this .. focus on estrogen relationship)

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6
Q

t or f: endometriosis is the most likely cause of infertility in women over the age of 30 without a hx of PID

A

TRUE

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7
Q

t or f: pelvic lymph nodes are a common site of endometriosis

A

TRUE

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8
Q

t or f: severity of symptoms correlates with quantity of ectopic endometrial tissue

A

FALSE: instead, it may correlate with the DEPTH of the ectopic tissue

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9
Q

t or f: the prolonged bleeding of endometriosis can cause scarring (adhesions)

A

TRUE (this is what may result in the chronic pelvic pain; the adhesions also with contribute to infertility)

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10
Q

t or f: with a positive family hx a pt may develop endometriosis at an earlier age than the family member

A

TRUE

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11
Q

what is the official term for pain with defecation?

A

dyschezia (how is this related to the deck? it may point towards implants on rectosigmoid

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12
Q

what is the most popular theory behind endometriosis?

A

retrograde menstruation

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13
Q

explain the theory of retrograde menstruation

A

endometrial tissue fragments are retrogradely transportred through the fallopian tubes and implant there or intra-abdominally w/ prediliction for ovaries

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14
Q

which theory of endometriosis explains its location outside of the pelvis?

A

vascular/lymphatic transport

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15
Q

t or f: endometrial glands and stroma can be implanted during clinician procedures (ex: c-section)

A

TRUE - called iatrogenic dissemination

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16
Q

what is the typical endometriosis uterus?

A

tender FIXED RETROflexed (with scarring POSTERIOR to uterus)

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17
Q

what is characteristic of the uterosacral ligaments with endometriosis?

A

nodular in nature or thickening and induration

18
Q

women with endometriosis can develop a type of ovarian cyst called what?

A

endometrioma/chocolate cyst (these are tender, palpable, and freely mobile mplanted masses that occurs within the ovarian capsule and bleed)

19
Q

t or f: endometrial tissue must be biopsied for definitive diagnosis of endometriosis

A

TRUE (remember, the gold std for diagnosis is lapratomy with biopsy proven hemodierin laden macrophages)

20
Q

an endometrial implant red in color signifies what in terms of duration of time for the implant?

A

red - new

21
Q

an endometrial implant brown in color signifies what in terms of duration of time for the implant?

A

brown - older

22
Q

what color are the oldest implants? (which indicates scar tissue)

A

white

23
Q

what is the maximum amount of time to be on estrogen suppression for treatment of endometriosis?

A

six months

24
Q

t or f: often there is improvement with pregnancy with endometriosis symptoms

A

TRUE - secondary to tempory cessation of menses

25
Q

t or f: the primary goal with medical treatment of endometriosis is to induce amenorrhea

A

TRUE

26
Q

GnRH agonists (such as leuprolide) suppresses what hormone, inducing what state?

A

FSH; pseudomenopause - (remember, these should only be used for six months total as they are associated with osteoporosis

27
Q

what is the definitive treatment of endometriosis?

A

TAH/BSO

28
Q

englarged, globular, “boggy” uterus on physical exam is indicative of what?

A

adenomyosis

29
Q

what is the major difference btwn endometriosis and adenomyosis?

A

ectopic endometrial tissue does NOT function like normal uterine tissue and is NONresponsive to hormones in the normal manner.

30
Q

what is the definition of adenomyosis?

A

ectopic endometrial glands and strom found within the myometrium leading to SYMMETRICALLY ENLARGED AND GLOBULAR UTERUS

31
Q

how can you differentiate btw adenomyosis and fibroids?

A

TVUS

32
Q

t or f: adenomyosis is most common in nulliparous women

A

FALSE - rare!!!

33
Q

t or f: adenomyosis pain is commonly cyclical

A

FALSE - commonly NON-cyclical

34
Q

t or f: adenomyosis is typically associated with an assymetrically enlarged uterus

A

FALSE - symmetrical!!

35
Q

what is the definitive treatment of adenomyosis?

A

hysterectomy

36
Q

t or f: endometrial ablation will not improve adenomyosis symptoms

A

TRUE

37
Q

what is proven medical therapy for adenomyosis?

A

none - no proven medical tx.

38
Q

adenomyosis or endometriosis: typically found in older, multiparous women

A

adenomyosis

39
Q

adenomyosis or endometriosis: the tissueis responsive to hormonal stimulation

A

endometriosis

40
Q

adenomyosis or endometriosis: associated with cyclical pain

A

endometriosis

OBGYN (21 decks)

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