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Ob/Gyne 2 > Module 1 : Uterine Pathology > Flashcards

Module 1 : Uterine Pathology Flashcards

1
Q

mullarian duct abnormalities

A
  • arrested development
  • failure of fusion
  • failure of resorption
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2
Q

type of arrested development

A
  • unicornuate uterus
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3
Q

unicornuate uterus characteristics

A
  • deviation of the fundal endometrium to the left or the right
  • banana shaped uterus
  • highest association of renal anomalies arising on the CONTRALATERAL SIDE
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4
Q

two types of failure of fusion

A
  • bicornuate uterus

- uterine didelphys

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5
Q

bicornuate uterus characteristics

A
  • two uterine bodies one cervix one vagina

- indent on outer contour of uterus

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6
Q

uterine didelphys characteristics

A
  • two of everything
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7
Q

two types of failure of resorption

A
  • septate
  • sub septate
    + most unfavourable outcomes in pregnancy (embryo implants in the separation) but can be surgically fixed
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8
Q

septate uterus characteristics

A
  • > 1cm indentation on inner contour of uterus
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9
Q

sub septate uterus characteristics

A
  • < 1cm indentation on inner contour of uterus
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10
Q

MRKH syndrome

A
  • distal vagina present

- complete agenisis of the uterus and cervix

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11
Q

what is a prolapsed uterus

A
  • descent of the uterus down the vagina
  • caused from weak pelvic floor muscles
  • clinical diagnosis not sonographic
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12
Q

what is Asherman’s syndrome and what does it cause

A
  • endometrial lining is replaced by fibrous lesions
  • a scar in the endometrium
  • causes loss of menstruation and infertility
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13
Q

causes of Asherman’s syndrome

A
  • secondary to D&C, multiple abortions, or infection
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14
Q

appearance of Asherman’s syndrome

A
  • thick or thin endo
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15
Q

AV malformations of the uterus charateristics

A
  • rare
  • anastomosis of artery and vein
  • causes = congenital, trauma or surgery
  • symptoms = menorrhagia
  • sonographic appearance = difficult to see without color
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16
Q

neoplastic definition

A
  • multiplication of abnormal cells, malignant or benign
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17
Q

non neoplastic definition

A
  • multiplication of normal cells
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18
Q

types of non neoplastic conditions

A
  • endometrial hyperplasia
  • endometrial polyps
  • adenomyosis
  • uterine varices
  • endometritis
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19
Q

cause of endometrial hyperplasia

A
  • unopposed estrogen stimulation from ovarian dysfunction
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20
Q

when does endometrial hyperplasia occur

A
  • immediately after menarche and also before menopause
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21
Q

symptoms of endometrial hyperplasia

A
  • irregular bleeding
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22
Q

sonographic appearance of endometrial hyperplasia

A
  • thick ( >14mm) hyperechoic endo

- involving most of endo or focal

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23
Q

DDX of endometrial hyperplasia

A
  • endometrial cancer

- polyps

24
Q

thickness of endo in the secretory phase

A

7-14mm

25
Q

thickness of endo in the proliferative phase

A

4-8mm

26
Q

thickness of endo int he post menopausal phase

A

> 5mm investigative
+ EV
+ hysterosonogram
+ endo cancer

27
Q

endo polyps characteristics

A
  • endometrial growth extending into the canal from a stalk
  • may protrude in to the cervix if it has a long stalk
  • may cause bleeding or be asymptomatic
28
Q

sonographic appearance of polyp

A
  • thick hyperechoic endometrium
29
Q

DDX of polyps

A
  • endo cancer

- endo hyperplasia

30
Q

what is adenomyosis

A
  • extension of endo tissue beyond the endometrium into the myometrium
  • form of endometriosis
  • usually occurs in posterior wall of uterus
  • can cause pain and abnormal bleeding
31
Q

sonographic appearance of adenomyosis

A
  • slight diffuse uterine enlargement
  • hypo echoic or cystic lesions within myometrium
  • focal lesions
  • look like fibroid or polyp
  • unequal myo thickness
  • endo not in centre of uterus
32
Q

Venetian blind appearance

A
  • multiple shadowing lines in the posterior aspect of uterus myometrium demonstrating adenomyosis
33
Q

prominent arcuate vessels & varices

A
  • dilated vessels around the uterus
  • increase after pregnant
  • use color to distinguish between ovaries
34
Q

what is endometritis

A
  • inflammation of endo

- can occur postpartum or with PID

35
Q

sonographic appearance of endometritis

A
  • normal endo
  • irregular endo
  • fluid filled cavity or GAS BUBBLES from micro organisms
  • usually patient on anti bionics or febrile
36
Q

two types of benign uterine neoplasia

A
  • leiomyoma (fibroid)

- lipoleiomyoma

37
Q

what is a leiomyoma

A
  • benign neoplastic mass of fibromuscular tissue
  • MOST COMMON TUMOR IN FEMALE PELVIS
  • increase as older and African Americans
38
Q

what are fibroids influenced by

A
  • increase in estrogen
    + pregnant
    + menopause
39
Q

symptoms of fibroids

A
  • menorrhagia
  • pain or pressure
  • palpable mass
  • infertility
40
Q

3 classifications of fibroids

A
  • intramural
  • submucosal
  • subserosal
41
Q

intramural fibroid characteristics

A
  • confined to myometrium (muscle)

- most common

42
Q

submucosal fibroid characteristics

A
  • projecting into the uterine cavity
  • can be pedunculated (have a stalk)
  • can cause bleeding
43
Q

subserosal fibroid characteristics

A
  • project from perimetrium
  • can be pedunculated
  • can be found in broad ligament
    + SOME FOUND UP NEAR BELLY BUTTON (REASON WHY WE SWEEP UP THAT FAR)
44
Q

sonographic appearance of fibroids

A
  • hypo echoic with high attenuation
  • enlarged uterus with irregular contour
  • calcification in older women
  • can be complex with necrosis
45
Q

fibroids with pregnancy

A
  • enlarge with increase estrogen
  • rapidly growing may result in lack of blood supply and necrosis
  • large fibroid near cervix would inhibit delivery
46
Q

lipoleiomyoma

A
  • lipocytes (fat) and fibromuscular tissue

- uncommon

47
Q

sonographic appearance of lipleiomyoma

A
  • very hyperechoic and attenuating

- appear similar to a dermoid

48
Q

2 malignant uterine neoplasias

A
  • leiomyosarcoma

- endometrial cancer

49
Q

leiomyosarcoma characteristics

A
  • rare
  • could arise form preexisting fibroid
  • symptoms are same for fibroid
50
Q

sonographic appearance of leiomysarcoma

A
  • degenerating fibroid appearance

- may see local invasion of surrounding organs or hepatic metastases

51
Q

endometrial carcinoma

A
  • most commonly occurring in post menopausal women

- symptoms = POST MENOPAUSAL BLEEDING

52
Q

stages of endo cancer

A

stage 1 = confined to uterus
stage 2 = confined to uterus
stage 3 = spread beyond uterus yet confined to pelvis
stage 4 = distal metastasis

53
Q

increased risk for endo cancer

A
  • strong association with estrogen therapy
  • obesity
  • hypertension
  • diabetes
  • PCOS
  • granulosa cell tutors of ovary
54
Q

sonographic appearance of endo cancer

A
  • thick echogenic endo

- difficult to distinguish from hyperplasia or polyps

55
Q

tamoxifen

A
  • non steroidal anti estrogen hormonal drug
  • used in treating breast cancer
  • estrogen antagonist to uterus resulting in stimulation of endo
  • increases risk of endo cancer by 1% but benefit of breast cancer treatment outweighs risk
  • sonographic appearance = heterogenous bizarre endo

Ob/Gyne 2 (19 decks)

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