ERU-20 Postmenopausal Sonography & Sonohysterography

Question 1

What is the normal endometrial thickness for a postmenopausal patient?

Answer 1

without postmenopausal bleeding: <8mm
with PMB: <5mm
Should appear thin and echogenic

Question 2

What is the most common cause of PMB?

Answer 2

endometrial atrophy

Question 3

What is endometrial hyperplasia?

Causes?

Answer 3

The result of unopposed estrogen on the endometrium.

PCOS, tamoxifen, obesity, estrogen-producing ovarian tumors (thecoma or granulosa cell), endometrial carcinoma

Question 4

What is the sonographic appearance of endometrial carcinoma?

What tumor marker is associated?

Answer 4

Thickened endometrium with possible fluid and a polypoid mass.
Low impedance flow with pulsed Doppler.

CA-125

Question 5

CA-125 is linked to which cancers?

Answer 5

ovary, endometrium, breast, GI tract, lungs

can also be elevated in PID, fibroids, and pregnancy

Question 6

What is Asherman syndrome?

How is it diagnosed?

Answer 6

The presence of intrauterine adhesions or synechiae within the uterine cavity, usually due to scar (D&C) which can cause infertility, hypomenorrhea, pregnancy loss.

Hysterography

Question 7

Measurement of the endometrial cavity should start where and end where?

Answer 7

basal layer to basal layer