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Gyne > GYNE SE2 uterus lesions > Flashcards

GYNE SE2 uterus lesions Flashcards

1
Q

MC benign lesion of uterus

A

leiomyoma

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2
Q

other names of leiomyoma

A

myoma, fibroids, fibromyoma

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3
Q

MC location of myomas

A

BODY of uterus

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4
Q

5 types of myomas based on position in the uterus

A

intramural (MC), subserous, submucous – also, broad ligament and intracavitary

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5
Q

all myomas start as ______ type

A

intramural

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6
Q

knobby contour during PE

A

subserous myoma (kasi nakakapa mo siya dahil nasa serosa nga)

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7
Q

called parasitic myoma if super laki na

A

subserous myoma

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8
Q

most troublesome, assoc with bleeding and distortion of uterine cavity

A

submucous myoma

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9
Q

seen as HUMPS and BUMPS in d and c

A

submucous myoma

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10
Q

Ddx of broad ligament myoma

A

adnexal mass

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11
Q

current theory for myoma etiology

A

SOMATIC MUTATION of myocyte, with contributions from estrogen and progesterone

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12
Q

gross appearance of myoma

A

gllistening pearl white, smooth muscle in whorled appearance, with PSEUDOcapsule

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13
Q

true or false – more fibrous tissue in histo slide == more atrophy and degeneration

A

TRUE

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14
Q

fate of myomas depend on _____

A

BLOOD SUPPLY (less blood supply, more degeneration)

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15
Q

three degrees of degeneration

A

hyaline, red/carneous/infarction, malignant

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16
Q

mildest and MC degree of degeneration

A

hyaline

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17
Q

most acute form of degeneration

A

red/carneous/infarction – CAUSES SEVERE PAIN

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18
Q

malignant degeneration into what type of CA?

A

leiomyoSARCOMA

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19
Q

three main symptoms of myoma

A

pressure sx (urinary frequency, constip, hydroureter), pelvic pain (dysme), AUB (menorrhagi)

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20
Q

classic sign of development of leiomyosarcoma

A

rapid growth of uterine myoma AFTER menopause (cos dapat liliit na siya pag menopause cos la na hormones)

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21
Q

diagnosis for myoma

A

pelvic exam and ultrasound

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22
Q

diagnostic and therapeutic for SUBMUCOSAL myoma

A

hysteroscopy

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23
Q

main indication for myomectomy

A

women who want to get pregnant pa

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24
Q

main indication for hysterectomy

A

kung cancer talaga, and kung complete na ang reproductive career

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25
Q

most common medical tx to reduce estrogen and progesterone circulating levels

A

GnRH agonist

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26
Q

advantages of medical tx before surgery

A

uterine fibroid shrinkage AND induction of amenorrhea

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27
Q

mgt for prolapsed myoma of the cervix

A

Hysteroscopic resection then Abx coverage

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28
Q

newest modality, ambulatory non surgical technique

A

transcatheter UTERINE ARTERY embolization

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29
Q

gross appearance of “intravenous leiomyomatosis”

A

SPAGHETTI tumor (cos smooth muscles invade the venous channels of pelvis and abd peritoneum)

30
Q

benign dse with multiiple small nodules over the surface of pelvic and abd peritoneum

A

Leiomyomatosis Peritonealis Disseminata (as in disseminated yung leiomyoma sa peritoneum)

31
Q

localized overgrowths of endometrial gland and stroma BEYOND the surface of endometrium

A

endometrial polyps

32
Q

main symptom of endometrial polyps

A

wide range of ABNORMAL BLEEDING patterns

33
Q

MC loction of polyps

A

FUNDUS of the uterus

34
Q

appearance of immature endometrium of endometrial polyps

A

swiss cheese

35
Q

rate of malignant transformation of polyps

A

0.50%

36
Q

benign condition in which numerous small polyps are discovered throughout the endometrial cavity

A

POLYPOID hyperplasia

37
Q

diagnostic criteria of endometrial polyps (MUST KNOW)

A

endometrial glands, endometrial stroma, central vascular channels

38
Q

management of polyps

A

remove by hysteroscopy or curettage THEN biopsy (impt)

39
Q

uterus is distended with blood and is secondary to gynatresia

A

hematometra

40
Q

2 MC congenital causes of hematometra

A

imperforate hymen AND transverse vaginal septum

41
Q

main ssx of hematometra

A

primary or secondary amenorrhea, AND cyclic lower abd pain

42
Q

infection of accumulated blood

A

pyometra

43
Q

how to diagnose hematometra

A

vaginal UTZ or pag dinilate mo cervix may dark brown black blood na lalabas

44
Q

major determinant of pre-malignant potential of endometrial hyperplasia

A

degree of cytologic atypia

45
Q

four classifications of endometrial hyperplasia

A

simple, complex, atypical simple, atypical complex

46
Q

swiss cheese hyperplasia

A

simple hyperplasia

47
Q

crowded glands with budding and infolding in decreased stroma

A

complex hyperplasia

48
Q

hyperplasia type with greatest premalignant potential

A

atypical complex hyperplasia

49
Q

main sx of endometrial hyperplasia

A

abnormal vaginal bleeding

50
Q

diagnostic and therapeutic for simple and complex hyperplasia

A

D and C

51
Q

tx for atypical complex hyperplasia BUT wants kids pa

A

continuous high dose progestin (megestrol acetate 40 mg tid-qid)

52
Q

tx for atypical complex hyperplasia AND ayaw na ng kids / old na

A

hysterectomy

53
Q

tx for atypical complex hyperplasia AND ayaw na ng kids BUT di kaya ng surgery

A

LONG TERM high dose progestine (megestrol acetate 40-160mg per day)

54
Q

MC malignancy of the female genital tract

A

endometrial cancer

55
Q

poorer prognosis, older postmenopausal women, with NO HISTORY of endometrial hyperplasia

A

estrogen INDEPENDENT (the opposite is true for estrogen dependent)

56
Q

main ssx of endometrial cancer

A

postmenopausal bleeding AND abnormal premenopausal and perimenopausal bleeding

57
Q

diagnostic procedure of choice for endo CA

A

fractional D and C (endocervix first then endometrium)

58
Q

grading of endo CA is based on ________

A

percentage of SOLID COMPONENTS in the tumor (less than 6, 6-50, more than 50%)

59
Q

endo CA with desmoplastic stroma

A

endometrioid CA

60
Q

endo CA wherein cells have hobne (?) configuration arranged in papilla with hyalinized stalk

A

Clear cell CA

61
Q

uterine papillary serous CA with high rate of extrauterine disease

A

Serous CA

62
Q

diagnosed in the presence of progestational stimulation

A

secretory CA

63
Q

endo CA with poor prognosis

A

papillary serous, clear cell, poorly differentiated tumors

64
Q

LN mets of endo ca goes to

A

inguinal femoral nodes, paraaortic nodes, and pelvic nodes

65
Q

three types of hysterectomy for endo ca

A

supracervical or subtotal, total, radical

66
Q

two types of surgical techniques for hysterectomy

A

traditional/open AND minimally invasive

67
Q

meaning of tahbso and blnd

A

total abdominal hysterectomy with bilateral salpingo-oophorectomy AND bilateral lymph node dissection

68
Q

classification of uterine sarcomas is based on _____

A

presence of either homologous or heterologous tissue

69
Q

MC uterine sarcoma

A

leiomyosarcoma (homologous type)

70
Q

diagnosis of leiomyosarcoma

A

> 5 mitosis per 10 HPO field with cytologic atypia (benign if 10)

71
Q

most active single agent against leiomyosarcoma

A

doxorubicin

Gyne (3 decks)

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