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Pelvic Pathology > Lesson 5 (Part 3) > Flashcards

Lesson 5 (Part 3) Flashcards

1
Q

What are normal postmenopausal endometrium measurements with bleeding from a symptomatic patient?

A

5mm or less

- even with bleeding

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2
Q

What is normal postmenopausal endometrium bleeding caused by?

A

An atrophic endometrium

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3
Q

What are PMB postmenopausal endometrium measurements with bleeding from a symptomatic patient?

A

> 5mm is considered abnormal

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4
Q

What does bleeding indicate?

A

That the patient is symptomatic

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5
Q

What does it mean if you are over 5mm in a normal symptomatic bleeding patient?

A

You go for a biopsy

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6
Q

What are normal postmenopausal endometrium measurements from an asymptomatic patient?

A

8mm or less is considered normal

- no bleeding

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7
Q

What is the abnormal postmenopausal endometrium measurements from an asymptomatic patient?

A

9-11mm

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8
Q

When does an asymptomatic patient get a biopsy?

A

If 11mm or greater

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9
Q

What are the causes of metrorrhagia? (6)

A
  1. Hormone imbalance
  2. Abnormal growths
  3. Pregnancy complications
  4. Infection
  5. Systemic diseases
  6. Endometrial polyps
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10
Q

What are some causes for abnormal bleeding that are not specifically caused by the myometrium or endometrium? (6)

A
  1. Bleeding from the vulva/vagina
    - laceration, infection or cancer
  2. Cervix
    - polyps, fibroids or cancer
  3. Fallopian tubes
    - salpingitis, tumours or tubal pregnant and ovarian pathology
  4. Estrogen producing tumours
  5. Cancer
  6. Functional ovarian cysts
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11
Q

What are the effects of hormones on the postmenopausal endometrium and the endometrium appearances?

A

Leads to a thin atrophic appearing endometrium

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12
Q

Endometrial adhesions

A

Post traumatic, post infection post surgical in nature and may even cause infertility or re-occurrent pregnancy lost
they may bind an ovary to the side of the pelvic wall, or they may extend between the bladder and the uterus

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13
Q

Asherman’s syndrome

A

Is an acquired condition that refers to the existence of scar tissue in the uterus

  • formation of intrauterine adhesions
  • posttraumatic or postsurgical
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14
Q

What are the symptoms of ashermans syndrome? (2)

A
  1. Light or no periods

2. Trouble getting pregnant

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15
Q

Is ultrasound good at seeing synechiae?

A

Not the best at seeing it

- synechiae is a fact word for adhesion = bands of tissue sticking together

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16
Q

What is attributed with postmenopausal women on HRT?

A

Increased thickness

17
Q

What is unopposed estrogen linked to? (2)

A
  1. Increase risk of endometrial cancer

2. Hyperplasia

18
Q

Tamoxifen

A

Is a nonsteroidal, antiestrogen compound that is used in therapy for premenopausal and postmenopausal women with Breast Cancer

19
Q

What happens to premenopausal women?

A

They have a decrease in estrogen

20
Q

What happens to postmenopausal women?

A

Their estrogen can increase therefore increase their risk of endometrial cancer

21
Q

What is the sonographic appearance of tamoxifen? (5)

A
  1. Cystic changes
  2. Polyps
  3. Correlation between the endometrial thickness and 5 year duration of Tamoxifen treatment
  4. Cystic changes can be subendometrial
    - adenomyosis-like changes
  5. Can appear the same as hyperplasia
22
Q

What is not effective in early detection of endometrial cancer?

A

Routine US screening on an asymptomatic patient on Tamoxifen

23
Q

What is another term for endometrial adhesions?

A

Ashermans syndrome

24
Q

What can Endometrial adhesions cause?

A

Infertility or recurrent pregnancy loss

25
Q

Septate appearance

A

Wedge of fibrous tissue dividing uterine cavity

26
Q

Ashermans syndrome appearance

A

Adhesions (band like formations) crossing the lining of the uterus

27
Q

Bicornate uterus

A

Incomplete uniting of the uterus

28
Q

What is the etiology of ashermans syndrome? (2)

A
  1. Occurs in women who have had several dilatation and curettage procedures
  2. A severe pelvic infection unrelated to surgery
29
Q

What affect does ashermans syndrome have on a patient? (5)

A
  1. Infertility
  2. Painful periods
  3. Miscarriages
  4. Absence of period
  5. Pelvic pain
30
Q

What are S/S of ashermans syndrome? (5)

A
  1. Amenorrhea
  2. Repeated miscarriages
  3. Infertility
  4. Menstrual irregularities
    - very light periods or absence of periods
  5. Cyclic pelvic pain
    - scar tissue blocks the outflow of the menstrual blood, causing uterine cramping and pelvic discomfort or pain
31
Q

When are S/S for ashermans syndrome more likely to occur?

A

If they occur suddenly after a D&C or other uterine surgery

Pelvic Pathology (21 decks)

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