Endometriosis and Adenomyosis

Question 1

____ refers ti the presence and growth of the glands and stroma of the lining of the uterus

Answer 1

Endometriosis

due to retrograde menstruation, lymphatic vascular dissemination, metaplasia, iatrogenic, genetic predisposition, immunologic changes, hormonal

Question 2

What is the classic symptoms of endometriosis?

Answer 2

Pelvic pain

SSx: cyclic pelvic pain and infertility

Question 3

What are the classic pelvic finding of endometriosis?

Answer 3

1. fixed retroverted uterus with scarring

2. Tenderness posterior to the uterus

Question 4

What is the primary goal in treating endometriosis?

Answer 4

Induction of amenorrhea

Question 5

What drug provides a pseudomenopause effect in patients with endometriosis?

Answer 5

Danazole 400 to 800mg/day for 6 months

Question 6

What drug has a medical oophorectomy effect in patients with endometriosis?

Answer 6

Leuprolide 3.75 mg IM/month

This is a GnRH agonist

Question 7

What can you give in patients with endometriosis who cannot tolerate high dosage of estrogen?

Answer 7

Give progestin

DMPA 150mg IM q3 months

Question 8

Adenomyosis is derived from what layer of the endometrium

Answer 8

Basalis layer

Question 9

What is the most common presentation of adenomyosis?

Answer 9

Symmetrical

diffuse involvement of anterior and posterior walls of the uterus resulting in a uniformly enlarged uterus

Question 10

___ adenomyosis refers to focal areas are involved

Answer 10

Asymmetrical

Question 11

What is the standard criterion in diagnosing adenomyosis?

Answer 11

Presence of endometrial glands and stroma more than one low-powere field (2.5mm) from the basalis layer of the endometrium

Question 12

What are the signs and symptoms of a symptomatic woman with adenomyosis

Answer 12

1. > 35 years old
2. Multiparous
3. dysmenorrhea and menorrhagia
4. Diffusely enlarged uterus (2-3 times larger)

Question 13

What diagnostic modality will differentiate adenomyosis from uterine myomas?

Answer 13

MRI