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Pelvic > Midterm > Flashcards

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
Q

what kind of condition is ovarian torsion?

A

acute condition

26
Q

what is ovarian torsion?

A

partial or complete twisting of ovarian pedicle on its axis (frequently at mesosalpinx)

27
Q

what does ovarian torsion cause?

A
  • impairment of venous drainage and lymphatics causing congestion and edema of ovarian parenchyma
  • enlargement of the ovary
28
Q

what are the non specific symptoms of ovarian torsion?

A

-severe pain
-nausea
-vomiting
-fever
-palpable mass
same as appendicitis

29
Q

who does ovarian torsion mostly effect?

A

usually young females, children , and pregnancy

30
Q

why does ovarian torsion effect children?

A

because kids fallopian tubes are more longer so more mobile

31
Q

what is the treatment for ovarian torsion?

A

surgery

32
Q

what does ovarian torsion look like sonographically?

A
  • 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
Q

what percent of women have a pre-existing cyst or mass present

A

50-80%

34
Q

what does doppler look like on ultrasound with ovarian torsion?

A
  • decreased or absence of flow
  • blood flow does not exclude torsion
  • compare with other ovary
35
Q

what does color doppler look like on US with ovarian torsion?

A

twisted or coiled vessels within vascular pedicle (whirlpool sign)

36
Q

what is the bottom line with ovarian torsion on US?

A

an enlarged ovary should suggest torsion

37
Q

what is the differential diagnosis for ovarian torsion?

A
  • appendicitis
  • PID
  • ectopic
  • Ovarian cysts (can lead to torsion)
38
Q

what are other reasons a sonographer would scan for ovarian torsion?

A

help rule out other problems

  • ruptured cysts
  • appendicitis
  • PID
  • ectopic
39
Q

what is the 5th leading cause of death in women?

A

ovarian cancer

40
Q

what are the risk factors for ovarian cancer?

A
  • nulliparity
  • increasing age
  • FAM HISTORY OF OVARIAN CANCER
  • patient has a history of breast, endometrial or colon cancer
41
Q

what are some signs and symptoms of ovarian cancer? (not clear)

A
  • bloating
  • early satiated
  • pressure
  • indigestion
42
Q

what are the types of ovarian tumors?

A
  • epithelial (stroma)
  • germ cell
  • sex cord (stromal)
  • metastatic
43
Q

what is the most common form of ovarian tumor?

A

epithelial (stroma)

44
Q

what does a benign ovarian tumor look like on an ovary on US?

A
  • well defined anechoic lesions

- thin septations

45
Q

what does a malignant ovarian tumor look like on an ovary on US?

A
  • irregular walls
  • thick irregular septations
  • mural nodules
  • solid echogenic elements
46
Q

what should doppler findings be combined with?

A
  • morphological
  • clinical findings
  • patient age
  • phase of menstrual cycle
47
Q

what should be lower in malignant lesions?

A
  • lower pulsatiity index (PI)

- lower resistive index (RI)

48
Q

does cancer have a high or low diastolic flow?

A

high diastolic flow

49
Q

what does colour and pulsed wave doppler look like on an ovary that is benign?

A
  • more peripheral flow

- high resistive flow

50
Q

what does colour and pulsed wave doppler look like on an ovary that is malignant?

A
  • centralized flow
  • lower PI
  • lower RI
  • higher diastolic flow
51
Q

what kind of disorder is polycystic ovarian syndrome?

A

endocrinologic disorder

52
Q

what happens to LH and FSH for PCOS?

A

-serum LH elevated
-FSH level depressed
chronic anovulation

53
Q

what is associated with PCOS?

A

infertility

early pregnancy loss

54
Q

what are clinical signs and symptoms of PCOS?

A
  • hyperandrogenism
  • oligomenorrhea or amenorrhea
  • hirsutism
  • obesity
55
Q

what is the sonographic appearance of PCOS?

A
  • bilateral enlarged ovaries
  • multiple small follicles located in the periphery
  • “string of pearls”
  • increased stromal echogenicity
56
Q

what syndrome is talked about with the string of pearls appearance

A

PCOS

Pelvic (5 decks)

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