Extra Pelvic Pathology Flashcards
A septum remains in the lumen of the vagina between what
Urogential sinus
Upper vagina
What is the structure called when the septum remains in the lumen of the vagina
Hymen
An imperforated hymen occurs if
The hymen does not rupture
If the hymen does not rupture it causes
Hydrocolpos
Hematocolpos
What are the types of retention of fluid in the pelvis
Hydrocolpos
Hydrometrocolpos
What is hydrocolpos
Fluid in the vagina
Occurs before puberty
Is the retention of vaginal secretions
What is hydrometrocolpos
The more severe form of hydrocolpos
Occurs before menses or after menopause
It is secreations in the uterus and vagina
Hematocolpos
Occurs after puberty
Blood trapped in the vagina
Hematometra
Retention of blood in the uterus
Typically caused by a imperorate hymen
Hematometrocolpos
Blood in the uterus and vagina
What is the role of sonography in hema/hydrocolpos
Identify the level of obstruction
Evaulate the echogenicity
Look for fluid fluid levels
What is fluid fluid levels
When there is 2 different types of fluid present in the same area
What are gartner’s duct cysts and what are they caused by
Cysts along the vagina
Caused by mesonephric duct
Gartner’s duct cysts can occur
In single or multiple
Usually on the lateral or anterolateral wall
Gartner’s duct cysts usually are
Asymptomatic and found incidentally
In cases of vagnial carcinaoma is sonography used in the diagnosis
No
What is sonography used for in cases of vaginal CA
To help stage
To assess pelvic spread and distal metastasis
What is a nabothian cyst
A common retention cyst that usually occurs in multiples
What makes up a nabothian cyst
Entrapped cervical secreations
Ca of the cervix is diagnosed
Clinically, with a PAP smear
What can Ca of the cervix cause obstruction of
Uterus
Renal
What is the role of sonography in Ca of the cervix
Used to help stage
What are the risk factors for cervical Ca
Infection by HPV Early sexual activity Multiple sexual partners Low socioeconomic status Smoking BCP Weakened immune system DES in utero
What is the sonographic findings of cervical Ca
Hematometra from cervical stenosis Multiple cystic areas within a solid cervical mass Bulky cervix Irregular cervical boarders Mass extending form cervix to pelvic sidewall Tumor invasion of the bladder Hydronephrosis Liver Mets Paraaortic nodes
A incompetent cervix can cause
Preterm labour and delivery
A incompetent cervix will have what in the 2nd or early 3rd trimester
Cervical effacement
What are the causes of a incompetent cervix
Trauma
DES
Idiopathic
What is the best way to asses for a incompetent cervix
Tarnslabial
Trans vaginal
What is DES
Diesthlstilbestrol
Discontinued in 1971
Caused t shaped uteruses
What are the 2 different types of adnexal pathology
Endometriosis
PID
Endometriosis is
The growth of endometrial tissue outside the uterine cavity
What are the 2 types of endometriosis
Internal
Eternal
What is another name for internal endometriosis
Adenomyosis
What is external endometriosis called
Endometriosis
Endometriosis usually occurs where
Ovaries
Fallopian tubes
Broad ligament
Pouch of Douglas
Endometriosis can cause
Adhesions
What are the symptoms of endometriosis
Dysmenorrhea Dysparunia Infertility Menorrhagia Palpable mass -endometrioma
What is a endometrioma
Aka chocolate cyst
Well defined, predominantly cystic mass with low level echos
Can see fluid to fluid levels
Is endometriosis easy or difficult to diagnosis with sonography
Difficult
What are the DDx for endometriosis
Hemorrhagic ovarian cyst
Ovarian cyst adenoma
Turbo-ovarian abscess
What is the Tx for endometriosis
Drugs
Laser surgery
Hysterectomy
Oophrectomy
PID
Pelvic inflammatory disease
What are the causes of PID
STI
Pyogenic
What are the different STI’s that can cause PID
Gonorrhea
Chlamydia
What are the different Pyogenic causes for PID
IUCD
Surgery
Postpartum
Crohon’s disease
What is stage 1 PID
Asymptomatic
Or
Vaginal discharge and tenderness
What is stage 2 PID
Febrile
Acute pelvic pain
Abnormal vaginal bleeding
-can develop hydrosalpinx
What is stage 3 PID
TOA stage
Acute abdominal pain
Increased WBC; can develope Fitzhugh Curtis syndrome
What is Fitzhugh Curtis Syndrome
Pain on inspiration.
Perihepatitis - inflammation of the liver capsule
RUQ pain
Small absecesses on liver capsule- can lead to adhesions
Increased liver enzymes
Salpingitis occurs
When the Fallopian tube walls become thickened and edmeatous
What can happen in salpingitis when the tubes are blocked
Pyosalpinx
Once pyosalpinx is treated and the infected material is reabsorped what is the chronic result
Hydrosalpinx
Sonographic appearance of stage 1 PID
Thick endo
Fluid in the endo canal or normal appearance
What is the sonographic appearance of stage 2 PID
Hypoechoic s-shaped Fallopian tubes with low-level echoes
Fallopian tube walls are smooth
What is the sonographic apperance of stage 3 PID
Multiocular mass
Irregular boarders
Fluid-fluid layers, air within mass
What is the sonographic appearance of chronic PID
Distended S-shaped tubes
Thin walls
What is the DDx of chronic PID
Ovarian cyst
Small cystadenoma as
Hermaphroditism is when a person
Possesses both male and femal sex traits +/- ambiguous genitalia
true hermaphroditism
Possessing both ovarian and testicular tissue
Infertile
Increase risk for gonadal Ca
Can be due to the fusion of 2 heterozygous twin zygotes right after fertilization
Pseudo hermaphroditism
Possessing chromosomes for one sex but developing sex traits of the opposite sex
A male pseudo hermaphrodite is and what can cause it
Genetically male but has female characteristics
- lack of androgens
A female pseudo hermaphrodite is and what can cause it
Genetically female but has male charactistics -excessive androgens
CHEETAH
Cystadenoma /ca Hemorrhagic cyst Ectopic Endometrioma Teratoma Abscess Hydrosalpinx
Sonography with pelvic masses
Confirm the presence of mass
Determine the masses origin
Evaulate: size, echogencity, consistency, contour of mass, vasculature
Demonstrate the involvement of other organs
Document if ascites to other metastatic lesions are present
