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Midterm Flashcards

1
Q

what is endometriosis?

A

presence of functioning endometrial tissue outside of uterus

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2
Q

where does endometriosis mostly occur?

A
  • ovary
  • fallopian tube
  • broad ligament
  • posterior cul de sac
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3
Q

who does endometriosis mostly occur in?

A

women in reproductive years

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4
Q

what are the clinical symptoms of endometriosis?

A
  • dysmenorrhea
  • dyspareunia
  • infertility
  • urinary symtoms
  • dyscezia
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5
Q

what is another name for endometrioma?

A

chocolate cyst

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6
Q

what is the most common manifestation of endometriotic tissue?

A

endometrioma

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7
Q

what is endometrioma?

A

caused by bleeding of ectopic endo tissue within ovary

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8
Q

what are the symptoms of endometrioma?

A

usually asymptomatic but can have chronic discomfort with menses

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9
Q

endometrioma singular or multiple?

A

multiple

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10
Q

what is the typical sonographic appearance of endometrioma?

A
  • well defined
  • unilocular or multilocular
  • CYSTIC MASS CONTAINING DIFFUSE LOW LEVEL INTERNAL ECHOES (can have a fluid filled level
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11
Q

what does an endometrioma look like sonographically on a postmenopausal women?

A

anechoic or heterogenous

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12
Q

what is the differential diagnosis of endometrioma?

A

hemorrhagic cyst

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13
Q

what do hemorrhagic cysts look like?

A
  • free fluid in PCDS
  • reticular internal pattern
  • acute pain
  • resolve within a few menstrual cycles
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14
Q

when should you follow up with an endometrioma?

A

yearly no matter what age

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15
Q

what can endometriomas change into?

A

ovarian low grade invasive cancer

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16
Q

what are some ovarian low grade invasive cancers?

A
  • endometriod tumor

- clear cell tumor

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17
Q

what are some sonographic signs of endometriosis?

A

difficult to detect from US

  • usually accompanied by adhesions
  • obliterated PCDS
  • sliding sign (organs don’t move because they are stuck together)
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18
Q

what is the most severe endometriosis?

A

deep infiltrating endometriosis

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19
Q

what are the dependant areas of endometriosis?

A
  • anterior compartment (bladder)

- posterior compartment (cul de sac, rectum, etc)

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20
Q

what does deep infiltrating endometriosis look like?

A

hypoechoic nodules or diffuse nodular retroperitoneal thickening

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21
Q

what are some signs of endometriosis?

A
  • frozen pelvis
  • no free fluid in PCDS
  • retroflexed uterus at fundal aspect
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22
Q

what is ultrasound good at diagnosing?

A

endometriomas

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23
Q

what is the treatment to endometriomas?

A
  • birth control pills

- removal (laparoscopic surgery)

24
Q

what is polycystic ovarian syndrome also known as?

A

stein-Leventhal syndrome

25
what kind of condition is ovarian torsion?
acute condition
26
what is ovarian torsion?
partial or complete twisting of ovarian pedicle on its axis (frequently at mesosalpinx)
27
what does ovarian torsion cause?
- impairment of venous drainage and lymphatics causing congestion and edema of ovarian parenchyma - enlargement of the ovary
28
what are the non specific symptoms of ovarian torsion?
-severe pain -nausea -vomiting -fever -palpable mass same as appendicitis
29
who does ovarian torsion mostly effect?
usually young females, children , and pregnancy
30
why does ovarian torsion effect children?
because kids fallopian tubes are more longer so more mobile
31
what is the treatment for ovarian torsion?
surgery
32
what does ovarian torsion look like sonographically?
- unilateral enlarged ovary USUALLY RIGHT SIDED BECUASE OF SIGMOID ON THE LEFT THERE IS MORE MOBILITY ON THE RIGHT - free fluid in cul de sac
33
what percent of women have a pre-existing cyst or mass present
50-80%
34
what does doppler look like on ultrasound with ovarian torsion?
- decreased or absence of flow - blood flow does not exclude torsion - compare with other ovary
35
what does color doppler look like on US with ovarian torsion?
twisted or coiled vessels within vascular pedicle (whirlpool sign)
36
what is the bottom line with ovarian torsion on US?
an enlarged ovary should suggest torsion
37
what is the differential diagnosis for ovarian torsion?
- appendicitis - PID - ectopic - Ovarian cysts (can lead to torsion)
38
what are other reasons a sonographer would scan for ovarian torsion?
help rule out other problems - ruptured cysts - appendicitis - PID - ectopic
39
what is the 5th leading cause of death in women?
ovarian cancer
40
what are the risk factors for ovarian cancer?
- nulliparity - increasing age - FAM HISTORY OF OVARIAN CANCER - patient has a history of breast, endometrial or colon cancer
41
what are some signs and symptoms of ovarian cancer? (not clear)
- bloating - early satiated - pressure - indigestion
42
what are the types of ovarian tumors?
- epithelial (stroma) - germ cell - sex cord (stromal) - metastatic
43
what is the most common form of ovarian tumor?
epithelial (stroma)
44
what does a benign ovarian tumor look like on an ovary on US?
- well defined anechoic lesions | - thin septations
45
what does a malignant ovarian tumor look like on an ovary on US?
- irregular walls - thick irregular septations - mural nodules - solid echogenic elements
46
what should doppler findings be combined with?
- morphological - clinical findings - patient age - phase of menstrual cycle
47
what should be lower in malignant lesions?
- lower pulsatiity index (PI) | - lower resistive index (RI)
48
does cancer have a high or low diastolic flow?
high diastolic flow
49
what does colour and pulsed wave doppler look like on an ovary that is benign?
- more peripheral flow | - high resistive flow
50
what does colour and pulsed wave doppler look like on an ovary that is malignant?
- centralized flow - lower PI - lower RI - higher diastolic flow
51
what kind of disorder is polycystic ovarian syndrome?
endocrinologic disorder
52
what happens to LH and FSH for PCOS?
-serum LH elevated -FSH level depressed chronic anovulation
53
what is associated with PCOS?
infertility | early pregnancy loss
54
what are clinical signs and symptoms of PCOS?
- hyperandrogenism - oligomenorrhea or amenorrhea - hirsutism - obesity
55
what is the sonographic appearance of PCOS?
- bilateral enlarged ovaries - multiple small follicles located in the periphery - "string of pearls" - increased stromal echogenicity
56
what syndrome is talked about with the string of pearls appearance
PCOS

Pelvic (5 decks)

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