PANCE prep book cards

Question 1

what kind of muscle makes up leiomyomas

Answer 1

benign uterus smooth muscle tumor

Question 2

why do leiomyomas regress after menopause?

Answer 2

their growth is related to estrogen production: so they shrink after menopause

Question 3

what are the different types of leiomyomas

Answer 3

intramural, submucosal, subserosal, parasitic, (pedunculated?)

Question 4

what is the MC presentation for a patient with leiomyomas (uterine fibroids)?

Answer 4

BLEEDING

dysmenorrhia, menorrhagia

Question 5

uterine fibroids can be described as: (soft, tender, nontender, assymetric, symmetric….etc.)?

Answer 5

asymmetric, hard, nontender

Question 6

how do you diagnose uterine fibroids?

Answer 6

ultrasound

Question 7

what are different ways to manage uterine fibroids?

Answer 7

1. observation: majority don’t need treatment

2. medical: inhibit estrogen

• leuprolide: GnRH agonist that causes GnRH inhibition when given continuously
• progestins: endomtrial atrophy –> decreases bleeding (medroxyprogesterone)
  3. surgical: hysterectomy or myomectomy (fibroids are the MC cause for hysterectomy)