Lesson 5 (Part 1)

Question 1

Is fluid within the endometrial normal? (2)

Answer 1

1. A small amount is ok

2. Large amounts can be either benign or malignant

Question 2

Where do you measure for the endometrial when there is fluid? (2)

Answer 2

1. Measure either side of the fluid and add them together

2. Measure the whole thing and subtract the fluid measurement

Question 3

What is an indication for a pelvic US specific for the endometrium?

Answer 3

Bleeding

• irregular
• heavy
• spotting

Question 4

Metro

Answer 4

In between

Question 5

If bleeding is not cause by the myometrium or endometrium, then what else can cause it?

Answer 5

Bleeding can come from the fibroids in the submucosal region

Question 6

What are causes of endometrial thickening? (8)

Answer 6

1. Pregnancy
2. Retained products of conception
3. Fibroids
   - submucosal or intracavitary
4. Endometritis
5. Adhesions
6. Hyperplasia
7. Polyps
8. Carcinoma

Question 7

What are ashesions?

Answer 7

Scar tissues

Question 8

When can endometritis occur? (3)

Answer 8

1. Postpartum
2. After D&C
3. Associated with pelvic inflammatory disease

Question 9

PID

Answer 9

Pelvic inflammatory disease

Question 10

How does the endometrium appear sonographically? (3)

Answer 10

1. Thick and/or irregular
2. May or may not contain fluid
3. Gas with acoustic shadowing

Question 11

When is the best time to see a polyp in the endometrium?

Answer 11

In the early proliferative phase where the endometrium is as thin as possible

Question 12

What are causes of abnormal bleeding from the endometrium? (4)

Answer 12

1. Hyperplasia
2. Polyps
3. Endometrial Carcinoma
   - rare Endometrial Sarcoma
4. Atrophy

Question 13

Endometrial hyperplasia

Answer 13

Increase in the number of cells that lead to an over growth of endometrial glands
- irregular shape and size

Question 14

What are 2 common types of endometrial hyperplasia seen on US?

Answer 14

1. Hyperplasia

2. Cystic Hyperplasia

Question 15

What are 2 common types of endometrial hyperplasia seen on US?

Answer 15

1. Hyperplasia

2. Cystic Hyperplasia

Question 16

What is the most common reason for hyperplasia?

Answer 16

Unopposed estrogen stimulation in peri/postmenopausal women

Question 17

What is less common in peri/postmenopausal women and less common in reproductive years? (4)

Answer 17

1. Anovulatory cycles
2. Polycystic ovarian disease
3. Obese women
   - increase in estrogens
4. Estrogen producing tumors

Question 18

What is a common cause of abnormal uterine bleeding?

Answer 18

Hyperplasia

Question 19

What is a symptom of hyperplasia?

Answer 19

Uterine bleeding

Question 20

How does hyperplasia appear on US? (4)

Answer 20

1. Thick
2. Echogenic
3. Well defined endometrium
4. May have cystic areas
   - cystic hyperplasia

Question 21

What are 3 differential diagnosis for hyperplasia?

Answer 21

1. Diffuse polyps
2. Endometrial carcinoma
3. Endometrial atrophy that is displaying cystic components
   - makes look thick

Question 22

Are endometrial polyps benign or malignant?

Answer 22

Benign

• common
• single/multiple

Question 23

Where do endometrial polyps growth project?

Answer 23

Into the cavity

Question 24

Are endometrial polyps pedunculated and broad based?

Answer 24

Yes

Question 25

Who do endometrial polyps increase in?

Answer 25

Peri/postmenopausal women

Question 26

Is endometrial polyps symptomatic or asymptomatic?

Answer 26

Asymptomatic

- sometimes bleeding

Question 27

What is the sonographic appearance of endometrial polyps? (3)

Answer 27

1. Typically has an echogenic focal area within the endometrial
2. Endometrial thickening
   3, If has the same echogenicity as the endometrium probably a polyp

Question 28

What kind of appearance does a focal hyperechoic nodule have?

Answer 28

Tripe layer appearance

- late proliferative stage