fibrous band separating supravaginal cerix from bladder. ext btw layers of broad lig - imp bc uterine a runs inside-CRX > sx once invaded - invasion? loss of T2 dark ring normally surrounding cervix

GYN Flashcards by Samantha Lee

salpingitis isthmica nodosa

AUNT MINNI

-nodular scarring prox 2/3 FT

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cervical cancer important staging

IIA-beyond cervix but no parametrical invasion=sx

IIB-parametral involvement but no ext to pelvic side wall-crx/rad

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parametrium

fibrous band separating supravaginal cerix from bladder. ext btw layers of broad lig

imp bc uterine a runs inside-CRX > sx once invaded
invasion? loss of T2 dark ring normally surrounding cervix

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org of met to:

ant wall upper 1/3
pst wall lower 1/3

upper genital

- GI

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cervical/vaginal cysts

nabothian
gartner
bartholin
skene-periurethral glands –> recurr UTIs, obstruction

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embryologic org: mullerian duct, wolffian duct, UG sinus

MD-uterus, FT, upper 2/3 vag
WD-vd, sv, epididymis
UG sinus-prostate, lower 1/3 bag

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arcuate uterus

mild smooth concavity of uterine fundus (instead of normal straight/convex)

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critical endometrial stage

2 (cervical stroma invasion)-high risk LN mets

-IA (<50%) –> IB (>50%) also increase risk LN mets

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endometrial cancer img

-T1 iso, T2+ish, hypoenh, DW+

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cumulus oophorus

collection of cells in mature dominant follicle signaling imminent ovulation)

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fertility mds

clomiphene citrate

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theca lutein cysts ass

multifetal pregn
gestational trophoblastic dx
ovarian hyperstimulation syndrome

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thecae lutein cysts physio

functional cyst rel to overstep from b-hcg

- large 2-3cm cysts w/ ML/spokewheel app

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ovarian hyperstimulation syndrome

effusions
ascites
shock

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next step: ovarian cyst on CT and US, size cut off

-CT: 3cm (premeno) & 1cm (post meno) cutoffs for US

US: 7 cm (premeno), 5 cm (post meno)-for 3mo f/u

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max ovarian volume in post meno woman

6mL

-8cc at 40 –> 1cc at 70

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fibroid types

hyaline-MC
hypercellular-resp well to embo
lipoleiomyoma

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img hyaline fibroid

-T1/2 dark, homog enh

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img hyper cellular fibroid-

T1-
T2+ (tightly packed SM cells)
-homog enh

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img lipoleiomyoma

T1+, T2+, high rim enh

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fibroid degeneration types

none enh (dead tissue), ex: myxoid minimally
1) hyaline (Classic)-fibroid outgrows bs –> accumulation proteinaceous tissue (var, but usually T1/2(-)
2) red (corneous)-venous thrombosis during pregnancy. T1 bright rim (classic)
3) myxoid-uncommon. T1-, T2+, minimal enh
4) cystic degen-uncommon. T1-, T2+, no enh

normal myometrial junctional zone

<5mm

tamoxifen on endom

polyps
HP
cancer

T2 shading

T2 shortening (darkening) of a lesion that is T1 bright

endometrioma cancer risk

- endometroid | - clear cell

next step: ovarian solid nodule w/o flow

- US-r/o dermoid | - if not dermoid-call sx

serous vs mutinous cystadenocarcinoma

- serous-UL (fewer sept), BL, papillary prj, ascites =mets | - mucinous-ML, pseudomyxoma peritonea, pap prj less common

adult big abd mases

ovarian desmoid sarcoma

ovarian cancer rfs

-smoking known for mucinous

endometroid ovarian cancer

2nd MC - BL 15% - from endometrial cancer (25%) or from endometrioma

order of ovarian cancer incidence

1) serous 2) endometroid 3) mutinous

hydrosalpinx signs

- "cogwheel"=normal longitudinal folds bc thickening - "string sign-incomplete septae - "waste sign"-tubular mass w/ indentation of its opposing walls-differentiates hyrdosalpinx from ovarian mass"

ovarian fibroma & fibrothecoma

- benign tumor of middle aged women - T2- band (vs fibroid) - no Ca (vs brenner tumor)

Meigs syndrome

- ascites - pleural eff - benign ovarian tumor (fibroma mc)

Fibromatosis

tumor like enlargement of ovaries due to ovarian fibrosis - 25 yo girl - ass-omental fibrosis, sclerosis peritonitis - bw for T2 sign=black garland sign - mx-+/- sx

brenner tumor/ovarian transitional cell carcinoma

- ovarian epithelial tumor 50-70yo | - Ca v common (vs fibroma/fibrothecoma)

struma ovarii

- subtype of ovarian teratoma containing thyroid tissue rel to hyperTh - img: dark thick colloid in otherwise T2+ cyst

ovarian mets

10% - colon, gastric, breast, lung, CL ovary - krukenburg-from GI (usually stomach)

peritoneal inclusion cyst

passive (lad of walls) fluid filled mass that conforms to shape of pelvis and surr ovary

gestational trophoblastic dx types

- complete (70%)-entire placenta, no fetus, diploid karyotype. - partial (30%-partial placenta, triploidy fetus

img gestational trophoblastic dx

- complete: 1st TM=snowstorm, highly vas. 2nd TM-bunch of grapes (cysts) - partial: enlarged placenta; mult diff anechoic lesions. +/-fetal parts - theca lutein cysts

complications gestational trophoblastic dx

- hyperemesis (b-hcg) - future mole - invasive (myom) - chorioCA-myom, parametric, hematog to body

invasive myom appearance

-masses, dilated vess, areas of hem/necr

choriocarcinoma-what, hx, img, rx

- only trophoblasts (no villous) - myo/parametrium and hematog spread - v vasular (bleed like stink!) - b-hcg rise 8-10 wks after evaluation molar pregn - mx-MTX

endom polyp vs subendo fibroid vs endom cancer

poly: - hyper or hypoechoic - acute angles - stalk w/ central vessel ``` subendo fibroid: broad base -obtuse angle -MF per vascularity -htpoecho w/ overlying hyperechoi endom ``` cancer: - flat, irregular; can be polypoid - myom invasion

size of nodules in an endometrioma concerning for malignancy

3mm

US dx accuracy of endometrioma

90% (same as MRI)

azzopardi syndrome

testicular Ca not associated with mass, ie: burnt out testicular cancer

classic vs limited testicular microlithiasis

class 5+ Ca in img. Ass with GCT (limited <5, not ass)

theca lutein cysts in setting of molar pregnancy

20-60% resolve 6-8 wks after involution -ass w/ increased risk gestation trophoblastic mal

junctional zone invasive endom CA or vs invasive mole vs adenomyosis

disrupted rather than thickened