M3: Extra Pelvic Pathology Flashcards
what is hydrocolpos
retention of vaginal secretions in the vagina before puberty
what is hydrometrocolpos
retention of uterine and vaginal secretions in the vagina and uterus, before menses or after menopause
what causes hydrocolpos and hydrometrocolpos
imperforate hymen
which is more severe, hydrocolpos or hydrometrocolpos
hydrometrocolpos
what is hematocolpos
blood trapped in the vagina
what is hematometra
blood trapped in the uterus
what is hematometrocolpos
blood trapped in the uterus and vagina
what causes hematocolpos, hematometra, and hematometrocolpos
imperforate hymen
what are the 3 things to look for on US when looking for any type of fluid/blood trapped in the uterus/vagina organs
level of obstruction
echogenicity
fluid-fluid levels
what are gartner’s duct cysts
they are remnants of which ducts
cysts along the vagina (gardener snakes live in dark holes)
mesonephric duct remnants
where are gartner’s duct cysts usually located
do they produce symptoms
on the lateral or anterolateral wall
asymptomatic usually
is US used to diagnose vaginal carcinoma
no, used to help stage and to asses pelvic spread or distal mets
what are nabothian cysts
retention cysts of cervical secretions
how are carcinomas or the cervix diagnosed
PAP
if cervical cancer causes obstruction, what can this lead to
hematometra or renal hydro
risk factors for cervical cancer
HPV BCPs smoking DES in utero weak immune system
what are some US findings for cervical cancer
hematometra or hydro complex cervical mass bulky cx w/ irregular borders tumor invasion of bladder liver mets, enlarged para AO lymphnodes
what is the complications of an incompetent cervix
preterm labor
causes of an incompetent cervix
trauma
DES - T shaped uterus
idiopathic
how is the length of the cervix best assessed
translabial or EV
what is endometriosis
how does it usually exit the uterus
growth of endo tissue outside of uterine cavity
retrograde tubal transmission
2 types of endometriosis
internal: adenomyosis
external: endometriosis
common sites of endometriosis
ovaries
fallopian tubes
broad ligament
pouch of douglas
how is endometriosis diagnosed
laparoscopy
what is one characteristic trait of endometriosis and what does this cause
adhesions which make the pelvic organs immobile and can block fallopian tubes
how should you check for pelvic immobility
dynamic EV….. if - means no mobility
symptoms of endometriosis
dysmenorrhea dysparunia infertility menorrhagia palpable mass called an endometrioma
what type of mass is associated w/ endometriosis
endometrioma/chocolate cyst
how does a endometrioma appear on US
well defined
mainly cystic mass
may see fluid/fluid levels
which area is commonly the first effected by endometriosis
rectovaginal septum
what is the DDX for endometriosis
hemorrhagic ovarian cyst
ovarian cyst adenoma
tubo-ovarian abcess (TOA)
what is the TX for endometriosis
drugs - hormones, BCP
Laser sugery
hysterectomy and oophrectomy
HIGH RECURRENCE RATE
what is PID
infection of female genital tract
causes of PID
STI - gonorrhea or chlamydia
pyogenic (infectious)
symptom stages of PID
1 - endometritis : asymptomatic or vaginal discharge w/ tenderness
2 - pyosalpinx: : febrile. acute pelvic pain and abnormal vag bleeding
may develop hydrosalpinx
3 -TOA stage: acute abdo pain, increased WBCs, may develop fitzhugh curtis syndrome
what is fitzhugh curtis syndrome
perihepatitis (inflammation of liver capsule) w/ small abscesses on the capsule which can lead to adhesions
symptom of fitzhugh curtis syndrome
what lab tests will be altered
RUQ pain
increased liver enzymes
is fitzhugh curtis syndrome associated w/ PID
yes
if a patient has salpingitis and the tubes are blocked, what pathology will you see
pyosalpinx
w/ salpingitis, once the infection is gone, what will pyosalpinx turn into
hydrosalpinx which will be chronic
US appearance of stage 1 acute PID
stage 1 is endometritis….
thick endo, fluid in canal or could appear normal…
US appearance of stage 2 acute PID
stage 2 is pyosalpinx….
hypoechoic, S shaped Fallopian tubes w/ smooth walls
US appearance of stage 3 acute PID
stage 3 is TOA….
multiocular mass, irregular borders, fluid-fluid levels and air w/in mass
US appearance of chronic PID
distended S shaped Fallopian tubes
ddx of chronic PID
ovarian cyst or sm cystadenoma
define hemaphroditism
what is a true hemaphrodite
having both male and female sex traits +/- ambiguous genitalia…
true hemaphrodite have both ovaries and testes
are hemaphrodites infertile
yes
possible cause of hemaphroditism
fusion of 2 heterozygous twin zygotes after fertilization
do hemaphrodites have increased risk of gonadal cancer
yes
what is a pseudohemaphrodite
has chromosomes of one sex but develops sex traits of the opposite sex
describe a male pseudohemaphrodite
genetically male w/ testes, develops F characteristics
maybe due to lack of androgens
describe a female pseudohemaphrodite
genetically female w/ ovaries, develops M characteristics
maybe due to excessive androgens
another name for fallopian tube carcinoma
serous tubal intraepithelial carcinoma (STIC)
where is it believed that most fallopian tube carcinomas begin
fimbriae of the tubes
most fallopian tube carcinomas are which type
adenocarcinomas
the remaining fallopian tube carcinomas that are not adenocarcinomas, are which type
endometrioid or clear cell adenocarcinoma
US appearance of fallopian tube carcinoma
similar to ovarian cancer
complex and sausage shaped
Will women w/ chronic PID be infertile
Yes
