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cnih > OB review- abnormal female pelvis > Flashcards

OB review- abnormal female pelvis Flashcards

1
Q

what is the 3rd most common gyneclogical malignancy?

A

cervical carcinoma

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2
Q

what is cervical carcinoma?

A
  • epithelial neoplasm
  • intermestrual or post coital bleeding
  • hypoechoic or heterogenous retrovesical mass
  • endometrial fluid collection
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3
Q

nabothian cyst on u/s?

A
  • cyst in the cervix
  • multiple or solitary anechoic structures <2cm
  • may contain internal echoes
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4
Q

what are nabothian cysts caused by? How do they present?

A
  • chronic cervicitis

- typically asymptomatic

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5
Q

Leiomyomas aka?

A
  • myomas

- fibroids

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6
Q

what are leiomyoma’s?

A
  • benign smooth muscle tumors

- most common pelvic tumor

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7
Q

what is the leading cause of hysterectomy?

A

leiomyomas

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8
Q

leiomyoma risk factors?

A
  • african american women
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9
Q

leiomyoma on u/s?

A
  • may be multiple and vary in size

- may cause pain if they degenerate

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10
Q

where are fibroids most commonly seen?

A

myometrial

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11
Q

4 locations of leiomyomas (fibroids)?

A
  1. intramural (myometrial): most common
  2. subderosal
  3. pedunculated
  4. submucosal
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12
Q

what kind of fibroid distorts the uterine contour?

A

suberosal

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13
Q

what type of fibroid grows off a stalk?

A

pedunculated

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14
Q

what type of fibroids cause abnormal uterine bleeding? (2)

A
  1. submucosal

2. intramural

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15
Q

what kind of fibroid is this?

A

subserosal

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16
Q

What kind of fibroid is this?

A

peduculated

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17
Q

what kind of fibroid is this?

A

submucosal

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18
Q

what is an adenomyosis?

A

glands and stroma from the basal layer of enometrium penetrate into the myometrium

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19
Q

clinical presentation of adenomyosis?

A
  • smooth muscle becomes hyperplastic
  • enlarged uterus
  • may be diffuse or focal
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20
Q

adenomyosis is found in what % of hysterectomy specimens?

A

70%

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21
Q

adenomyosis causes? (2)

A
  • dysmenorrhea

- abnormal uterine bleeding

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22
Q

sono apperance of adenomyosis?

A
  • myometrial alterations

- poor definition of endometrial and junctional zone caused by endometrial tissue extending form the basal layer

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23
Q

what is endometrial hyperplasia?

A
  • abnormal proliferation (growth) of the endometrium in response to excess or unopposed estrogen
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24
Q

endometrial hyperplasia on u/s?

A
  • endometrium is diffusely thickened

- asymmetric or focal thickening may be present

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25
Q

what is the most common gynecologic cancer?

A

endometrial adenocarcinoma

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26
Q

who does endometrial adenocarcinoma affect?

A

1 in 50 women

27
Q

most cases of endometrial adenocarcinoma get diagnosed when?

A

in postmenopausal women

28
Q

what is the most common clinical presentation of endometrial adenocarcinoma?

A

postmenopausal bleeding

29
Q

risk factors of endometrial adenocarcinoma? (5)

A
  1. unopposed estrogen stimulation
  2. obesity, nulliparity, diabetes, hypertension
  3. tamoxifen therapy for breast cancer
  4. chronic anovulation
  5. presence of atypical endometrial hyperplasia
30
Q

endometrial carcinoma on u/s?

A
  • endometrium >4mm in postmenopausal women
  • heterogenous
  • hematometra
  • enlarged uterus
31
Q

why is a biopsy needed with endometrial carcinoma?

A

to differentiate between hyperplasia and carcinoma

32
Q

what is an endometrial polyp?

A
  • benign focal overgrowth of endometrial glands and stroma
33
Q

size of endometrial polyp?

A

variable- some are 1mm, others fill endometrial canal

34
Q

where might an endometrial polyp extend to?

A
  • cervix or vagina
35
Q

who are endometrial polyps most prevenlent in?

A
  • perimenopausal

- postmenopausal

36
Q

what can polyps cause? (4)

A
  • coital spotting
  • intermenstrual bleeding
  • menorrhagia
  • menometrorrhagia
37
Q

polyp on u/s?

A
  • isoechoic to surrounding endometium
  • gives apperance of focal or global endometrial thickening
  • cystic spaces between polyp
  • vascularity feeding vessel
  • well- defined
38
Q

what is tamoxifen?

A
  • drug administered to women with brest cancer to block estrogenic effects on breat tissue
39
Q

what can tamoxifen cause and why?

A

can stimulate cell gorwth and proliferation in endometrial tissue, enhanching the risk of:

  • carcinoma
  • hyperplasia
  • polyps
40
Q

what is asherman syndrome?

A
  • adhesions froma pervious deep curretage or endometiral infection
41
Q

clinical presentation of asherman syndrome?

A
  • asymptomatic
  • amenorrhea
  • dysmenorrhea
  • hypomenorrhea
  • infertility
42
Q

ashermans syndrome on u/s?

A
  • inability to distinguish an endometrial cavity

- may have bright echoes in endometrial cavity

43
Q

what does retained product of conception (RPOC) typically contain?

A
  • placental tissue

- can persist for months causing abnormal utererine bleeding

44
Q

sono findings of RPOC (enlarged uterus)?

A
  • enlarged uterus- typically returns to normal size and shape within 6-8 weeks after delivary
45
Q

immediate postpartum findings of RPOC?

A
  • Residual fluid and echogenic material

- hemorrhage within the endometrial cavity

46
Q

How to rule out RPOC?

A
  • evaluate endometrial cavity for focal echogenic mass and asses endometrial thickness
47
Q

if endometrial thickness is less than ___mm, RPOC is unlikely

A

10mm

48
Q

RPOC is likely if what is seen?

A

if an echogenic mass with vascularity is present

49
Q

an echogenic mass without vasularity may represent what?

A
  • RPOC

- blood clots

50
Q
A

RPOC

51
Q

what is hematometra?

A

Blood trapped in endometrial cavity

52
Q

hematometra s/s? (4)

A
  • pelvic pain
  • amenorrhea
  • hypomenorrhea
  • pelvic mass
53
Q

hematometra is caused by? (3)

A
  • impoerforated hymen
  • cervical stenosis
  • vaginal neoplasm
54
Q

3 vaginal abnormalities?

A
  1. gartner duct cyst
  2. hematocolpos
  3. hematometrocolpos
55
Q

what is a gartner duct cyst?

A
  • small cyst within vagina
56
Q

what is a hematocolpos?

A

blood accumulation in the vagina

57
Q

what is hematometrocolpos?

A
  • blood accumulation in uterus and vagina
58
Q
A

hematometra

59
Q
A

gartner duct cyst

60
Q
A

hematometrocolpos

61
Q
A

hydrosalpinx

62
Q

what is hydrosalphinx?

A
  • distally blocked fallopian tube

- filled with serous or clear fluid

63
Q

hydrosalphinx on u/s?

A
  • sausage shaped
  • often bilateral
  • colour doppler helpful to R/O varix
64
Q

causes of hydrosalphinx? (5)

A
  • old infection
  • STD
  • previous surgury
  • adhesions
  • endometriosis

cnih (69 decks)

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