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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
what is the most common gynecologic cancer?
endometrial adenocarcinoma
26
who does endometrial adenocarcinoma affect?
1 in 50 women
27
most cases of endometrial adenocarcinoma get diagnosed when?
in postmenopausal women
28
what is the most common clinical presentation of endometrial adenocarcinoma?
postmenopausal bleeding
29
risk factors of endometrial adenocarcinoma? (5)
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
endometrial carcinoma on u/s?
- endometrium >4mm in postmenopausal women - heterogenous - hematometra - enlarged uterus
31
why is a biopsy needed with endometrial carcinoma?
to differentiate between hyperplasia and carcinoma
32
what is an endometrial polyp?
- benign focal overgrowth of endometrial glands and stroma
33
size of endometrial polyp?
variable- some are 1mm, others fill endometrial canal
34
where might an endometrial polyp extend to?
- cervix or vagina
35
who are endometrial polyps most prevenlent in?
- perimenopausal | - postmenopausal
36
what can polyps cause? (4)
- coital spotting - intermenstrual bleeding - menorrhagia - menometrorrhagia
37
polyp on u/s?
- isoechoic to surrounding endometium - gives apperance of focal or global endometrial thickening - cystic spaces between polyp - vascularity feeding vessel - well- defined
38
what is tamoxifen?
- drug administered to women with brest cancer to block estrogenic effects on breat tissue
39
what can tamoxifen cause and why?
can stimulate cell gorwth and proliferation in endometrial tissue, enhanching the risk of: - carcinoma - hyperplasia - polyps
40
what is asherman syndrome?
- adhesions froma pervious deep curretage or endometiral infection
41
clinical presentation of asherman syndrome?
- asymptomatic - amenorrhea - dysmenorrhea - hypomenorrhea - infertility
42
ashermans syndrome on u/s?
- inability to distinguish an endometrial cavity | - may have bright echoes in endometrial cavity
43
what does retained product of conception (RPOC) typically contain?
- placental tissue | - can persist for months causing abnormal utererine bleeding
44
sono findings of RPOC (enlarged uterus)?
- enlarged uterus- typically returns to normal size and shape within 6-8 weeks after delivary
45
immediate postpartum findings of RPOC?
- Residual fluid and echogenic material | - hemorrhage within the endometrial cavity
46
How to rule out RPOC?
- evaluate endometrial cavity for focal echogenic mass and asses endometrial thickness
47
if endometrial thickness is less than ___mm, RPOC is unlikely
10mm
48
RPOC is likely if what is seen?
if an echogenic mass with vascularity is present
49
an echogenic mass without vasularity may represent what?
- RPOC | - blood clots
50
RPOC
51
what is hematometra?
Blood trapped in endometrial cavity
52
hematometra s/s? (4)
- pelvic pain - amenorrhea - hypomenorrhea - pelvic mass
53
hematometra is caused by? (3)
- impoerforated hymen - cervical stenosis - vaginal neoplasm
54
3 vaginal abnormalities?
1. gartner duct cyst 2. hematocolpos 3. hematometrocolpos
55
what is a gartner duct cyst?
- small cyst within vagina
56
what is a hematocolpos?
blood accumulation in the vagina
57
what is hematometrocolpos?
- blood accumulation in uterus and vagina
58
hematometra
59
gartner duct cyst
60
hematometrocolpos
61
hydrosalpinx
62
what is hydrosalphinx?
- distally blocked fallopian tube | - filled with serous or clear fluid
63
hydrosalphinx on u/s?
- sausage shaped - often bilateral - colour doppler helpful to R/O varix
64
causes of hydrosalphinx? (5)
- old infection - STD - previous surgury - adhesions - endometriosis

OB review (10 decks)

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