Pelvic Mass Lecture Powerpoint

Question 1

Adenexal

Answer 1

Structures surrounding and funcitonally related to the uterus

Question 2

3 layers of the uterus

Answer 2

1) endometrium
2) myometrium
3) serosa/perineum

Question 3

The myometrium gives rise to this specific pathology

Answer 3

Uterine fibroid/leiomyomata

Question 4

Ovarian cyst

Answer 4

Fluid filled sac from a former ovum that did not disintegrate properly in the ovary, can be either simple or complex

Question 5

You palpate a central pelvic mass. What is your differential?

Answer 5

• Pregnancy
• uterine fibroid
• endometrial malignancy or uterine sarcoma
• ovarian or other mass presenting centrally

Question 6

Leiomyosarcoma

Answer 6

A malignant form of a leiomyoma

Question 7

Leiomyoma growth has been evidenced to be dependent on…

Answer 7

…estrogen levels

Question 8

Leiomyomas present with an absence of ____, and frequently have the mass move ____

Answer 8

ascites, with the uterus

Question 9

Definitive diagnosis for a leiomyoma is 3 items

Answer 9

• pregnancy test
• cbc
• transvaginal ultrasound****

Question 10

Adenomyosis

Answer 10

Endometriosis within the myometrium

Question 11

Treatment for a leiomyoma

Answer 11

Watchful waiting, drugs to push into chemically induced menopause, uterine artery embolization

Question 12

2 general surgical treaments for leiomyoma

Answer 12

1) hysterectomy is definitive because it eliminates current symptoms and chance for recurrent problems
2) myomectomy is removal of just the fibroid, preferable for women who have not completed childbearing, but they may come back

Question 13

Should you be able to palpate post menopausal ovaries?

Answer 13

nah fam

Question 14

Dermatoid cyst

Answer 14

An adenexal germ cell tumor that grows differentiated tissues such as hair and teeth

Question 15

Simple vs complex cysts, follicular vs luteal

Answer 15

Simple - functional cysts that just contain fluid in one cavity, are not as dangerous
complex - nonfunctional cysts with many diff cavities that become a malignant problem

Follicular - occurs during ovulation when follicle doesn’t rupture or nondominant follicle does not regress
Luteal - occurs when a corpus luteum does not regress as it should

Question 16

Ovarian cyst diagnosis

Answer 16

Ultrasound

Question 17

Tubo-ovarian abscess

Answer 17

Ascending infection from the uterus causing PID in the fallopian tube and ovary, risk of rupturing and causing death

Question 18

Vast majority of ectopics are ____, and within that the area most likely to occur is ____

Answer 18

tubal, the ampulla

Question 19

Classic triad of symptoms for ectopic pregnancy

Answer 19

Amenorrhea
Irregular vaginal bleeding
Pelvic pain

Question 20

Ectopic pregnancy diagnosis (2 big things)

Answer 20

1) serum hCG

2) transvaginal Ultrasound

Question 21

Leiomyomas are most likely to occur during this frame of a woman’s life

Answer 21

reproductive years to menopause