GYNE SE2 endometriosis

Question 1

most common site of endometriosis implantation

Answer 1

all pelvic organs (ex. Ovaries) and pelvic peritoneum

Question 2

three theories on endometriosis

Answer 2

transplantation, coelomic, induction theory

Question 3

transtubal regurgitation during menstruation daw

Answer 3

transplantation theory (also the most common)

Question 4

explain coelomic theory

Answer 4

SPONTANEOUS transformation of coelomic epithelium into endometrial tissue

Question 5

explain induction thoery

Answer 5

INDUCED transformation of coelomic epithelium into endometrial tissue

Question 6

best explanation for why may endometriosis in far areas (lungs, thighs)

Answer 6

hematogenous dissemination

Question 7

three clinical presentations of endometriosis

Answer 7

PROGRESSIVE PAIN (like dysmenorrhea but lasts even after period), SUBFERTILITY (spontaneous abortion) and specific EXTRA-PELVIC ssx

Question 8

most common finding on PE

Answer 8

fixed uterus AND small tender nodulations on cul de sac

Question 9

PE findings of more advanced disease

Answer 9

retroverted fixed uterus AND reduced mobility of ovaries and oviduct

Question 10

tumor marker of endometriosis

Answer 10

CA 125

Question 11

gold standard for diagnosis

Answer 11

Laparoscopy

Question 12

only way to confirm diagnosis

Answer 12

Histologic confirmation

Question 13

findings on laparoscopy

Answer 13

“powder burns” “chocolate cyst” “gunshot lesions”

Question 14

three cardinal histologic features

Answer 14

ectopic endometrial glands, ectopic endometrial stroma, hemorrhage into the adjacent tissue

Question 15

classification is based on three things

Answer 15

1 location, extent, depth of implants, 2 presence severity of adhesions, 3 presence size of endometrioma

Question 16

first line medical management for endometriosis

Answer 16

oral contraceptives

Question 17

best medical management, induces a menopause state

Answer 17

GnRH

Question 18

surgery is mandatory if

Answer 18

large or ruptured endometrioma, ureteral or intestinal obstruction,

Question 19

tx for endometrioma <3 mm

Answer 19

aspirate, irrigate, inspect for intracystic lesions using ovarian cystoscopy

Question 20

tx for endometrioma >3 mm

Answer 20

aspirate, incise and remove cyst from ovraian cortex

Question 21

tx for severe endometriosis

Answer 21

3 months of GnRH first THEN oophorectomy or TAHBSO