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Y4R5 - Gynecology I 👩‍🍼 > L1: Fibroid > Flashcards

L1: Fibroid Flashcards

1
Q

Another Name of Fibroid

A

Uterinne Leiomyoma

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2
Q

Def of Fibroid

A
  • It is a benign tumor arising from smooth muscles of the uterus and associated fibrous tissues.
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3
Q

Incidence of Fibroid

A
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4
Q

Etiology & PPT Factors for Fibroid

A
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5
Q

Hyper-Estrogenic States

A
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6
Q

NE of Fibroid

A
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7
Q

Sites of Fibroid

A
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8
Q

Sites of Fibroid

  • Corporeal
A
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9
Q

Sites of Fibroid

  • Cervical
A
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10
Q

Sites of Fibroid

  • Ligaments
A
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11
Q

Size of Fibroid

A

The size varies from a small seedling up to a large tumor filling the abdominal cavity.

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12
Q

Shape of Fibroid

A
  • Tumor may be spherical OR polypoidal
  • The uterus may be symmetrically OR asymmetrically enlarged.
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13
Q

Surface of Fibroid

A
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14
Q

Surrounding of Fibroid

A
  • The surrounding muscle fibers are compressed to form a false capsule.
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15
Q

Consistency of Fibroid

A
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16
Q

CS of Fibroid

A
  • It shows a whorl appearance & is paler than the surrounding.
  • It has a false capsule formed of the compressed surrounding myometrial muscles.
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17
Q

Capsule of Fibroid

A

The capsule is formed of compressed surrounding muscle fibers.

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18
Q

ME of Fibroid

A
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19
Q

Blood Supply of Fibroid

A
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20
Q

Complications & Pathological Changes in Fibroid

A
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21
Q

Complications & Pathological Changes in Fibroid

  • Degenerative Changes
A
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22
Q

Degenerative Changes in Fibroid

  • Hyaline Deg.
A
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23
Q

Degenerative Changes in Fibroid

  • Necrosis
A

Occurs at the tip of a fibroid polyp.

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23
Q

Degenerative Changes in Fibroid

  • Atrophy
A

Physiological atrophy after menopause or pregnancy.

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24
Q

Degenerative Changes in Fibroid

  • Cystic Deg.
A

It is either due to:
- Liquefaction of the hyaline material (false cyst)
- Telangiectasia (true cyst)

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25
Q

Degenerative Changes in Fibroid

  • Fatty Deg.
A
  • Precedes calcification
  • The tumor becomes yellow & rubbery in consistency
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26
Q

Degenerative Changes in Fibroid

  • Calcification
A
  • The tumor becomes stony hard
  • White patches are seen at the periphery.
  • X-ray: reveals an eggshell appearance [womb stone].
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27
Q

Degenerative Changes in Fibroid

  • Red Deg.
A
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28
Q

Incidence of Red Degeneration

A

Common in pregnancy due to:

  • Rapid growth of tumor
  • Increased vascularity
  • Increased fibrinogen
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29
Q

CP of Red Degeneration

A
  • Acute abdominal pain & tenderness
  • Vomiting, low-grade fever & tachycardia.
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30
Q

TTT of Red Degeneration

A
  • Treatment is mainly conservative as bed rest and analgesics,
  • Myomectomy for affected tumors only if conservative treatment failed
  • Surgery should be avoided to avoid bleeding.
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31
Q

Complications & Pathological Changes in Fibroid

  • Malignant Changes
A
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32
Q

Malignant Changes in Fibroid

  • Incidence
A

leiomyosarcoma is very rare (< 0.1% of myomas).

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33
Q

Malignant Changes in Fibroid

  • Criteria susspecting Malignant Changes
A
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34
Q

Complications & Pathological Changes in Fibroid

  • Vascular
A
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35
Q

Complications & Pathological Changes in Fibroid

  • Infection
A
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36
Q

Infection in Fibroid

  • Causes
37
Q

Infection in Fibroid

  • CP
A
  • Lower abdominal pain, tenderness
  • FAHM
  • Tachycardia.
38
Q

Infection in Fibroid

  • TTT
A
  • Antibiotics
  • Myomectomy or hysterectomy after control of fever.
39
Q

Complications & Pathological Changes in Fibroid

  • Pelvic Organs Changes
40
Q

Pelvic Organs Changes in Fibroid

  • Uterus
41
Q

Pelvic Organs Changes in Fibroid

  • Ovaries
A

Functional follicular cysts are commonly associated with fibroid.

42
Q

Pelvic Organs Changes in Fibroid

  • Tube
A
  • Chronic Salpingitis.
  • Tubal block by cornual fibroid.
  • Stretch of the tube due to large broad ligament fibroid.
43
Q

Pelvic Organs Changes in Fibroid

  • Urinary organs
44
Q

Complications & Pathological Changes in Fibroid

  • Torsion of pedunculated sub-serous fibroid
45
Q

Torsion of pedunculated sub-serous fibroid

  • PPT Factors
A
  • Moderate sized tumor with long pedicle
  • Pregnancy or puerperium.
46
Q

Torsion of pedunculated sub-serous fibroid

  • CP
A

Acute abdominal pain, shock in some cases.

47
Q

Torsion of pedunculated sub-serous fibroid

  • TTT
A
  • Anti-shock measures if the patient is shocked then
  • Myomectomy or hysterectomy
48
Q

Complications & Pathological Changes in Fibroid

  • Rupture of a surface vein on a sub-serous fibroid
49
Q

Rupture of a surface vein on a sub-serous fibroid
- CP

A

Picture of internal hemorrhage.

50
Q

Rupture of a surface vein on a sub-serous fibroid

  • TTT
A
  • Anti-shock measures followed by myomectomy or hysterectomy.
51
Q

Complications & Pathological Changes in Fibroid

  • Impaction (incarceration)
A
  • Occurs in cervical or posterior wall sub-serous myomas.
  • It is liable to occur in the premenstrual period.
52
Q

Complications & Pathological Changes in Fibroid

  • Complications during pregnancy
53
Q

Complications & Pathological Changes in Fibroid

  • Complications during labor & PP
54
Q

Dx of Fibroid

55
Q

Symptoms in Fibroid

56
Q

Symptoms in Fibroid

  • Asymp
A

accidentally discovered in many cases.

57
Q

Symptoms in Fibroid

  • AUB
58
Q

Symptoms in Fibroid

  • Pain
59
Q

Symptoms in Fibroid

  • Infertility
60
Q

Symptoms in Fibroid

  • Dys Group
A

dysuria, dyschazia, dysparuenia, dysmenorhea, and discharge.

61
Q

Symptoms in Fibroid

  • Mass
A

may be abdominal or pelvi-abdominal

62
Q

Signs of Fibroid

63
Q

Signs of Fibroid

  • General
64
Q

Signs of Fibroid

  • Abdominal
65
Q

Signs of Fibroid

  • Local & Pelvic
66
Q

INVx for Fibroid

67
Q

INVx for Fibroid

  • Lab
A

Blood picture, kidney function tests, liver function tests, estrogen level…

68
Q

INVx for Fibroid

  • Rad
69
Q

INVx for Fibroid

  • Endoscope
70
Q

INVx for Fibroid

  • Histopathology
A

Endometrial curettage to confirm diagnosis and to exclude malignancy

71
Q

Leiomyoma subclassification system (FIGO classification)

  • SM
72
Q

Leiomyoma subclassification system (FIGO classification)

  • O
73
Q

Leiomyoma subclassification system (FIGO classification)

  • Hybrid
74
Q

TTT of Fibroid

75
Q

TTT of Fibroid

  • Prohylactic
A
  • By avoidance of hyper-estrogenic state & proper ttt
76
Q

TTT of Fibroid

  • Actual TTT
77
Q

Actual TTT of Fibroid

78
Q

Actual TTT of Fibroid

  • Indications of No TTT But Follow up
79
Q

Actual TTT of Fibroid

  • Examples of Conservative Meds
A
  • GRH analogues
  • Progestogens

(For 6-9 Months)

80
Q

Actual TTT of Fibroid

  • Indications of Conservative Meds
81
Q

Actual TTT of Fibroid

  • Examples of Surgical TTT
82
Q

Mymectomy in Fibroid

  • Indications
A
  • Young patient < 40 years desiring pregnancy
  • Small sized uncomplicated fibroid.
83
Q

Mymectomy in Fibroid

  • Adv
A

The uterus is preserved for future pregnancies.

84
Q

Mymectomy in Fibroid

  • Timing
A

Postmenstrual to decrease bleeding.

85
Q

Mymectomy in Fibroid

  • Types
A
  • Abdominal [laparotomy or laparoscopy]
  • Vaginal [polypectomy or hysteroscopy].
86
Q

Mymectomy in Fibroid

  • Disadv
87
Q

Hysterectomy in Fibroid

  • Indications
88
Q

Hysterectomy in Fibroid

  • Types
89
Q

Salpingo-oophorectomy may be added in certain cases

Y4R5 - Gynecology I 👩‍🍼 (27 decks)

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