Lesson 6 (Part 1) Flashcards
What are causes of a thick endometrium? (7)
- Pregnancy
- Hyperplasia
- cystic - Polyps
- Carcinoma
- Fibroids
- submucosal or intra-cavity
- appear thick, but it is coming from the myometrium is a cause of bleeding - Endometritis
- Adhesions
What are causes of uterine bleeding in peri/postmenopausal bleeding? (5)
- Hormone imbalance
- Abnormal growths
- Systemic diseases
- Endometrial polyps
- Atrophy
Typical sonographic appearance of a thick endometrium? (3)
- Polyp
- Hyperplasia
- Carcinoma
Typical sonographic appearance of thin endometrium?
Atrophy
- on a postmenopausal female
Typical sonographic appearance of hyper echoic? (3)
- Polyp
- Hyperplasia
- Atrophy
- thin line
Typical sonographic appearance of inhomogenous?
Carcinoma
Typical sonographic appearance of homogenous? (2)
- Hyperplasia
2. Polyp
Typical sonographic appearance of well defined? (2)
- Hyperplasia
2. Polyp
Typical sonographic appearance of cystic changes within?
Cystic hyperplasia
Typical sonographic appearance of focal or diffuse?
Polyp
- but could also be carcinoma
Typical sonographic appearance of irregular borders?
Carcinoma
Typical sonographic appearance of invading the myometrium?
Carcinoma
What distinguishes a polyp from submucosal fibroid sonographically? (6)
- Polyp is hyper echoic
- Polyp has a stalk
- pedicle —> vascular - Polyp is homogeneous
- Polyp arises from the endometrium
- Submucosal fibroid displaces the endometrium
- Submucosal fibroid is heterogeneous and has no stalk = no colour, and is hypo echoic)
PMB
Postmenopausal bleeding
- symptomatic
What is the most likely cause of PMB?
Endometrial atrophy
- less than 5mm
What is considered an abnormal endometrial measurement associated with PMB?
5mm or less
How can a sonographer tell if it is endometrial cancer?
They cant tell, they need to biopsy
What endometrial measurement is considered normal in an asymptomatic patient?
8mm or less
What measurement would they biopsy and why? (2)
- Measure = over 11mm
- Biopsy = correlates with a person bleeding
- bleeding is symptomatic
Name an ultrasound procedure that is ordered to provide more information regarding the endometrium
Sonohysteropgraphy
Sonohysteropgraphy
Sterile saline into the endometrial cavity under the ultrasound guidance
Name 2 types of endometrial biopsy’s and reason for doing one over the other?
- Blind/ non directed
- cant see - Hysteroscope
- allows to see
When is the best time to evaluate a menstruating women endometrium? (1) Why? (2)
- When the endometrium is thin
- early proliferative - Trying to find congenital anomalies
- Trying to see if something is there that doesn’t belong
- we can see it the best here
this does not matter for a postmenopausal women
What are common indications for an ovarian US? (4)
- Pain
- Palpable Mass
- Irregular bleeding
- Family history of ovarian tumour or cancer
What are we looking for in an ovarian US? (5)
- Ectopic pregnancy
- if patient has positive B-hcg - Cysts
- Tumours
- Inflammatory Bowel Disease
- Appendicitis
What method of US is really good at looking at the ovaries?
Transvaginal
Why is a transvaginal a better method of looking at the ovaries?
- Better details
- Not always seen transabdominally
- due to bowel and gas
What do normal follicles usually measure up to?
- 5cm at maturity
- found 1st half of the menstrual cycle
What happens with a follicular cyst?
The mature follicle fails to ovulate or involute
What is the most common cause of ovarian enlargement in young women? (3)
- Follicular
- Corpus luteal
- Theca luteal
How does a follicular cyst develop?
If fluid in a nondominant follicle fails to resorb
