Fibroids Flashcards

1
Q

Define fibroids.

A

Benign tumor (leiomyoma) arising from myometrium.

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2
Q

Explain the aetiology of fibroids.

A

Hormone dependentL contain large numbers of oestrogen and progesterone receptors, Enlarge in pregnancy (high OES) and shrink in menopause (low OES).

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3
Q

What are the risk factors for fibroids?

A

Nuliparity, FHx, obese.

Reduced risk with smoking and hormonal contraception.

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4
Q

What are the different classifications of fibroids?

A

Can be submucosal, intramural or subserosal.

Rounds of smooth muscle and connective tissue.

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5
Q

What are the secondary changes fibroids can undergo?

A

Hyaline degeneration (mucopolysaccharides deposit around fibres)

Calcification (postmenopausal)

Red degeneration (coagulative necrosis, pregnancy)

Cystic change (liquefaction)

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6
Q

Summarise the epidemiology of fibroids.

A

30% women reproductive age

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7
Q

Recognise the presenting symptoms of fibroids.

A

Menhorragia

Dysmenhorrea

Abdominal swelling

Pressure symptoms

Dyspareunia

Miscarriage

Infertility

Often asymptomatic

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8
Q

Recognise the signs of fibroids on physical examination.

A

Abdomen: May be palpable

Vaginal: Uterine enlargement

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9
Q

Identify appropriate investigations for fibroids and interpret the results.

A

Blood: FBC for anaemia

USS: TVS to diagnose.

Other: Hysetroscopy – can see submucosal ones.

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10
Q

Generate a management plan for fibroids.

A

No treatment if asymptomatic.

Medical: Tranaxemic acid and mefenamic acid. COCP, IUS, GnRH analogues.

Surgical: Endometrial ablation, transcervical resection of fibroid, uterine artery embolisation, myomectomy, hysterectomy.

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11
Q

Identify the possible complications of fibroids and its management.

A

Anaemia (menhorragia)

Miscarriage

Infertility

Malignant change (leiomyosarcoma).

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12
Q

Summarise the prognosis for patients with fibroids.

A

10y recurrence after removal 15%.

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