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Pelvic Pathology > Lesson 4 (Part 3) > Flashcards

Lesson 4 (Part 3) Flashcards

1
Q

What is the formula to find the size of the fibroid?

A

Length x width x height

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2
Q

What do we do if there are multiple fibroids?

A

We measure the largest 3

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3
Q

Why is it important to measure the submucosal fibroid?

A

Want to measure the submucosal fibroid because it is the one that is probably causing he bleeding
- even if it isn’t one of the biggest

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4
Q

How could you determine if the fibroid is truly originating from the uterus or if it is detached? (2)

A
  1. Use colour doppler
    - looking for a connection
  2. Apply pressure to help differentiate
    - if it stays it is pedunculated (subserosa)
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5
Q

What happens to fibroids in postmenopausal women? (3)

A
  1. Rarely develop
  2. Usually decrease in size or stabilize in size
  3. Become calcified
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6
Q

When can fibroids in postmenopausal women increase?

A

If they are on hormone replacement therapy or tamoxifen

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7
Q

What can fibroids do during pregnancy or anovulatory cycles?

A

They can increase in size

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8
Q

What problems could occur with fibroid and pregnancy? (3)

A
  1. Location
    - if in the cervix and it is large it can block the baby
  2. Size
    - bigger ones push on other structures
  3. Submucosa fibroids can be the reason of miscarriages
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9
Q

What are complication associated with fibroids in general? (3)

A
  1. May outgrow blood supply
    - ischemia and cystic degeneration
  2. Degenerating or necrotic fibroids when outgrow blood supply
    - areas of decreased echogenicity or cystic areas within calcifications
  3. Pedunculated fibroids
    - torsion can occur but RARE
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10
Q

What does colour doppler on fibroids usually demonstrate?

A

Peripheral flow

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11
Q

What are the advantages of using transabdominal to see fibroids? (3)

A
  1. Larger feild of view
  2. Better assessing for large fibroids
  3. Can be missed if just using transvaginal
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12
Q

What are the advantages of using transvaginal to see fibroids? (3)

A
  1. Good at detecting small fibroids
  2. Can tell the origin of large pedunculated, subserosal fibroids vs. adnexal masses
  3. Can see fundal fibroids on retroverted uterus
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13
Q

Are are 3 treatments of symptomatic fibroids?

A
  1. Uterine Artery Embolization
    - air can be seen in fibroid 1 month later
  2. Surgical treatment
    - hysterectomy
  3. Medical treatment
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14
Q

UAE

A

Uterine Artery Embolization

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15
Q

Lipoleimyomas

A

Uncommon and benign tumours

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16
Q

What are lipoleimyomas composed of? (3)

A
  1. Mature lipocytes
  2. Smooth muscle
  3. Fibrous tissue
17
Q

What does lipoleimyomas look like sonographically? (3)

A
  1. Highly echogenic
  2. Attenuating mass within the myometrium
  3. Absence of colour flow within
18
Q

Are lipoleimyomas usually symptomatic or asymptomatic?

A

Asymptomatic

19
Q

What can lipoleimyomas be confused with?

A

Ovarian demoid

- cyst

20
Q

Leiomyosarcoma

A

Rare and malignant tumours

21
Q

What can leiomyosarcoma arise from

A

Leiomyoma

22
Q

Are leiomyosarcoma usually symptomatic or asymptomatic?

A

Asymptomatic

- or uterine bleeding

23
Q

What are the symptoms and appearances of leiomyosarcoma?

A

The same as fibroids

24
Q

Where can you sometimes see leiomyosarcoma?

A

May see local invasion

  • bladder
  • rectum
  • distant metastases
25
Q

What is a clue with leiomyosarcoma (2)

A
  1. Rapid growth

2. Post menopausal growth

26
Q

What is considered a common condition?

A

Adenomyosis

27
Q

Adenomyosis

A

Endometrial glands and stroma within myometrium

28
Q

What is adenomyosis associated with?

A

Adjacent smooth muscle hyperplasia

29
Q

What are 2 forms of adenmyosis?

A
  1. Diffuse

2. Nodular

30
Q

What makes adenomyosis more severe?

A

The presence of fibroids

- makes it difficult to diagnose

31
Q

What does diffuse mean?

A

Widely scattered adenomyosis foci within the myometrium

  • the whole thing
  • more common
32
Q

What does nodular mean?

A

Composed of adenomyomas

  • circumscribed nodules
  • little spots

Pelvic Pathology (21 decks)

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