Endometriosis and Adenomyosis Flashcards
1
Q
Most common locations of endometrial tissue (2):
A
- Ovary
- Pelvic peritoneum (anterior/posterior cul-de-sac)
2
Q
Theories for transport of endometrial tissue:
A
- Lymphatics (Halban)
- Metaplastic transformation (Meyer)
- Retrograde menstruation (Sampson)
3
Q
Risk factors for endometriosis (4):
A
- Nulliparity
- Early menarche
- Prolonged menses
- Mullerian abnormalities
- Autoimmune disorders
4
Q
Presentation of endometriosis:
A
- Cyclic pelvic pain peaking at menses
- Abnormal bleeding
- Bowel/bladder symptoms
- Subfertility
5
Q
Medical management of endometriosis:
A
- NSAIDs Induction of pseudopregnancy: - Combined OCPs - Progestins Induce pseudomenopause: - Danazol (androgen derivative) - GnRH agonist - Aromatase inhibitors
6
Q
Mechanism of endometrial medical therapy:
A
Pseudopregnancy: - Suppress ovulation and menstruation - Decidualize endometrial implants Pseudomenopause: - Lack of estrogen --> decreased stimulation of endometrial implants --> atrophy
7
Q
Why does adenomyosis not respond well to combined OCPs?
A
Endometrial tissue in adenomyosis is from the basalis layer –> no stromal/glandular elements (decreased proliferative/secretory changes)
8
Q
Risk factors for adenomyosis:
A
- Parity
9
Q
Most accurate and most common evaluation for adenomyosis:
A
Accurate: MRI
Common: sonogram
