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OBGYN 2 > M3: Extra Pelvic Pathology > Flashcards

M3: Extra Pelvic Pathology Flashcards

1
Q

what is hydrocolpos

A

retention of vaginal secretions in the vagina before puberty

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2
Q

what is hydrometrocolpos

A

retention of uterine and vaginal secretions in the vagina and uterus, before menses or after menopause

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3
Q

what causes hydrocolpos and hydrometrocolpos

A

imperforate hymen

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4
Q

which is more severe, hydrocolpos or hydrometrocolpos

A

hydrometrocolpos

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5
Q

what is hematocolpos

A

blood trapped in the vagina

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6
Q

what is hematometra

A

blood trapped in the uterus

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7
Q

what is hematometrocolpos

A

blood trapped in the uterus and vagina

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8
Q

what causes hematocolpos, hematometra, and hematometrocolpos

A

imperforate hymen

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9
Q

what are the 3 things to look for on US when looking for any type of fluid/blood trapped in the uterus/vagina organs

A

level of obstruction
echogenicity
fluid-fluid levels

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10
Q

what are gartner’s duct cysts

they are remnants of which ducts

A

cysts along the vagina (gardener snakes live in dark holes)

mesonephric duct remnants

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11
Q

where are gartner’s duct cysts usually located

do they produce symptoms

A

on the lateral or anterolateral wall

asymptomatic usually

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12
Q

is US used to diagnose vaginal carcinoma

A

no, used to help stage and to asses pelvic spread or distal mets

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13
Q

what are nabothian cysts

A

retention cysts of cervical secretions

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14
Q

how are carcinomas or the cervix diagnosed

A

PAP

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15
Q

if cervical cancer causes obstruction, what can this lead to

A

hematometra or renal hydro

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16
Q

risk factors for cervical cancer

A 
HPV
BCPs
smoking
DES in utero
weak immune system
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17
Q

what are some US findings for cervical cancer

A 
hematometra or hydro
complex cervical mass
bulky cx w/ irregular borders
tumor invasion of bladder
liver mets, enlarged para AO lymphnodes
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18
Q

what is the complications of an incompetent cervix

A

preterm labor

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19
Q

causes of an incompetent cervix

A

trauma
DES - T shaped uterus
idiopathic

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20
Q

how is the length of the cervix best assessed

A

translabial or EV

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21
Q

what is endometriosis

how does it usually exit the uterus

A

growth of endo tissue outside of uterine cavity

retrograde tubal transmission

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22
Q

2 types of endometriosis

A

internal: adenomyosis
external: endometriosis

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23
Q

common sites of endometriosis

A

ovaries
fallopian tubes
broad ligament
pouch of douglas

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24
Q

how is endometriosis diagnosed

A

laparoscopy

25
Q

what is one characteristic trait of endometriosis and what does this cause

A

adhesions which make the pelvic organs immobile and can block fallopian tubes

26
Q

how should you check for pelvic immobility

A

dynamic EV….. if - means no mobility

27
Q

symptoms of endometriosis

A 
dysmenorrhea
dysparunia
infertility
menorrhagia
palpable mass called an endometrioma
28
Q

what type of mass is associated w/ endometriosis

A

endometrioma/chocolate cyst

29
Q

how does a endometrioma appear on US

A

well defined
mainly cystic mass
may see fluid/fluid levels

30
Q

which area is commonly the first effected by endometriosis

A

rectovaginal septum

31
Q

what is the DDX for endometriosis

A

hemorrhagic ovarian cyst
ovarian cyst adenoma
tubo-ovarian abcess (TOA)

32
Q

what is the TX for endometriosis

A

drugs - hormones, BCP
Laser sugery
hysterectomy and oophrectomy

HIGH RECURRENCE RATE

33
Q

what is PID

A

infection of female genital tract

34
Q

causes of PID

A

STI - gonorrhea or chlamydia

pyogenic (infectious)

35
Q

symptom stages of PID

A

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

36
Q

what is fitzhugh curtis syndrome

A

perihepatitis (inflammation of liver capsule) w/ small abscesses on the capsule which can lead to adhesions

37
Q

symptom of fitzhugh curtis syndrome

what lab tests will be altered

A

RUQ pain

increased liver enzymes

38
Q

is fitzhugh curtis syndrome associated w/ PID

A

yes

39
Q

if a patient has salpingitis and the tubes are blocked, what pathology will you see

A

pyosalpinx

40
Q

w/ salpingitis, once the infection is gone, what will pyosalpinx turn into

A

hydrosalpinx which will be chronic

41
Q

US appearance of stage 1 acute PID

A

stage 1 is endometritis….

thick endo, fluid in canal or could appear normal…

42
Q

US appearance of stage 2 acute PID

A

stage 2 is pyosalpinx….

hypoechoic, S shaped Fallopian tubes w/ smooth walls

43
Q

US appearance of stage 3 acute PID

A

stage 3 is TOA….

multiocular mass, irregular borders, fluid-fluid levels and air w/in mass

44
Q

US appearance of chronic PID

A

distended S shaped Fallopian tubes

45
Q

ddx of chronic PID

A

ovarian cyst or sm cystadenoma

46
Q

define hemaphroditism

what is a true hemaphrodite

A

having both male and female sex traits +/- ambiguous genitalia…

true hemaphrodite have both ovaries and testes

47
Q

are hemaphrodites infertile

A

yes

48
Q

possible cause of hemaphroditism

A

fusion of 2 heterozygous twin zygotes after fertilization

49
Q

do hemaphrodites have increased risk of gonadal cancer

A

yes

50
Q

what is a pseudohemaphrodite

A

has chromosomes of one sex but develops sex traits of the opposite sex

51
Q

describe a male pseudohemaphrodite

A

genetically male w/ testes, develops F characteristics

maybe due to lack of androgens

52
Q

describe a female pseudohemaphrodite

A

genetically female w/ ovaries, develops M characteristics

maybe due to excessive androgens

53
Q

another name for fallopian tube carcinoma

A

serous tubal intraepithelial carcinoma (STIC)

54
Q

where is it believed that most fallopian tube carcinomas begin

A

fimbriae of the tubes

55
Q

most fallopian tube carcinomas are which type

A

adenocarcinomas

56
Q

the remaining fallopian tube carcinomas that are not adenocarcinomas, are which type

A

endometrioid or clear cell adenocarcinoma

57
Q

US appearance of fallopian tube carcinoma

A

similar to ovarian cancer

complex and sausage shaped

58
Q

Will women w/ chronic PID be infertile

A

Yes

OBGYN 2 (15 decks)

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