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Case Studies > Pelvic Powerpoints (PID, Infertility, Abnormal Uterine Bleeding, and Ovarian Masses) > Flashcards

Pelvic Powerpoints (PID, Infertility, Abnormal Uterine Bleeding, and Ovarian Masses) Flashcards

1
Q

What is endometriosis and what is it caused by?

A

endometrial tissue that is infiltrating outside of the uterus

caused by hormones.

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2
Q

What is the most common location of endometriosis?

A

The ovaries

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3
Q

What are the symptoms of endometriosis?

A

pain, abnormal uterine bleeding and dysmenorrhea.

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4
Q

What is an endometrioma and what is it caused by?

A

mass or lesion caused by accumulation of endometrial tissue

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5
Q

What is the nickname for an endometrioma?

A

chocolate cyst

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6
Q

Can we always diagnose an endometrioma or endometriosis?

A

not always.

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7
Q

What will an endometrioma look like on ultrasound?

A

well-define thin walls, anechoic, enhancement, avascular.

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8
Q

What are some differentials for an endometrioma?

A

hemorrhagic cysts, simple cyst, dermoid, or a fibroid.

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9
Q

Is polycystic ovarian disease an endocrine or exocrine disease process and how is it diagnosed?

A

endocrine

diagnosed from lab values

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10
Q

What disease causes anovulation?

A

polycystic ovarian disease

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11
Q

30% of polycystic ovarian disease are obese.

T/F

A

TRUE

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12
Q

What will the ovaries look like with a patient with polycystic ovarian disease?

A

bilateral ovaries w/ multiple follicles measuring 2-10 mm without a dominant follicle

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13
Q

What ovarian disorder will have the sign “string of pearls?”

A

polycystic ovarian disease

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14
Q

Bicornuate uterus’ will have _ vaginas, _ - _ cervixes, and __ uterus’.

( how many )

A

1 vagina, 1-2 cervix, and 2 uterus’

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15
Q

A didelphys uterus will have _ uterus, _ cervix and _ vaginas

A

COMPLETE separation (think di is 2 so two separate uterus’)

2 uterus, 2 cervix, 2 vaginas

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16
Q

With a septate uterus, there is a septum dividing the endo and a patient can get pregnant in one endo and not the other

t/f

A

TRUE

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17
Q

What is ovarian hyperstimulation caused by an what will it look like on ultrasound?

A

caused by infertility treatments and will have multiple large ovarian cysts.

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18
Q

What is PID (the dirty girl disease)

A

its a type of a sexually transmitted disease and can also be associate with abortions or childbirth

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19
Q

What are the syptoms of PID?

A

pain, fever/chills/ increased WBC, N/V, vaginal discharge and bleeding.

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20
Q

How is PID typically diagnosed and what labs will be elevated?

A

usually diagnosed though lab tests urine and vaginal secretions, and will have increased WBC

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21
Q

What are a few complications of PID?

A

chronic PID, infertility, ectopic pregnancy, chronic pain, and peritonitis

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22
Q

What will you see on Ultrasound with PID?

A

Salpingitis, pyosalpinx, hydrosalpinx, TOA, and endometritis

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23
Q

What is salpingitis?

A

infection of the tubes

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24
Q

Salpingitis includes thickened walls measuring greater than ___ mm. increased blood flow, and fluid in culdesac

A

5 mm

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25
Q

What is pyosalpinx and what can we do to distinguish between bowel and pyosalpinx?`

A

pyosalpinx is echogenic debri within tubes. The walls will be thickened

We can distinguish from bowel by watching for peristalsis

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26
Q

What is a tuboovarian complex?

A

bacteria from infection that reaches the ovaries.

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27
Q

What is a tuboovarian abscess

A

an abscess containg air or gas that is accompanied by pain, fever, discharge an bleeding.

MUST BE DRAINED

28
Q

What’s the difference between a Tuboovarian abscess and a tubo ovarian complex?

A

a tuboovarian abscess makes the ovaries and tubes unrecognizable whereas the tuboovarian complex, you can still distinguish both the ovary and tubea

29
Q

What is a peritoneal inclusion cyst and what is it caused by?

A

normal fluid released by ovary trapped in peritoneum.

Appears as irregular or loculated fluid around ovary.

Caused by trauma, surgery or TOA

30
Q

What is the clinical indications for an ovarian mass?

A

pelvic pain or fullness, palpable mass, history of ovarian or breast cancer.

31
Q

What are a few sex cell ovarian tumors?

A

fibromas, thecomas, ganulosa cell tumors, and sertoli-leydig cell tumors

32
Q

What is a fibroma?

A

a sex cell tumor that does not produce hormones and will be asymptomatic

33
Q

What is a thecoma tumor and what does it cause?

A

a sex cell tumor that produces estrogen and causes Meig’s with pleural effusion and ascites.

34
Q

What will both a fibroma and thecoma look like on US?

A

hypoechoic solid masses.

35
Q

What is the age range for a granulosa cell tumor and what is it caused by?

What’s it look like on US?

A

mostly postmenopausal and caused from estrogen.

thickened enometrium and variable ovary appearance.

36
Q

Can sertoli-leydig cell tumors be malignant?

A

yes..up to 20% are.

37
Q

What is an endometroid tumor?

A

an epithelial originated, possibly malignant cystic mass with solid components

It is often bilateral and is associated with endometrial cancer.

38
Q

When is mucinous cystadenocarcinoma typically diagnosed? (age range)

A

older populations.

39
Q

What will mucinous cystadenocarcinoma look like on US?

A

thicker septations, solid areas, and vascularity

40
Q

When is mucinous cystadenoma typically found and what will it look like on US?

A

younger populations, most are benign

sonographically it is multiloculated, internal echoes, thick septations, and papillary projections. VERY LARGE.

41
Q

What age range is a serous cystadenoma (benign)found and will it need surgery to be removed?

A

40-50 years of age.

yes surgery is needed.

42
Q

When age range is serous cystadenocarinoma (malignant) found and what lab value will be increased.

A

peri-post menopausal.

elevated CA125

43
Q

What is a dermoid?

besides the nastiest thing ever?

A

it is a germ cell composed of teeth, bones, nails, fat and hair.

44
Q

What are the clinical symptoms of a dermoid?

A

asymptomatic usually, possibly pelvic pain,

can be large and painful.

45
Q

On ultrasound, what will a dermoid look like?

A

nasty.

vascularity around periphery, fat/fluid levels, echogenic material within, posterior portional will be shadowed making measurements difficult

46
Q

A dermoid is associated with what sonographic sign?

A

tip of iceberg sign from echogenic material within.

47
Q

What are the clinical symptoms of ovarian torsion?

A

severe pain, N/V, possible palpable mass

48
Q

What are the sonographic finings of ovarian torsion?

A

large ovary with normal vascularity (venous flow is the first to go), cyst on ovary, and twisting of vessels outside ovary.

49
Q

where does the paraovarian cysts originate from

A

broad ligament adjacent to ovary.

50
Q

What is the normal follicle size?

A

3 cm

51
Q

If someone has the BRCA1 or BRCA 2 gene, what are they more at risk for?

A

ovarian masses

52
Q

What are some risk factors for endomentrial adenocarcinoma and what are the clinical symptoms?

A

hormone therapy, obesity, hypertension, diabetes, tamoxifen and nulliparity

clinical symptoms include abnormal uterine bleeding and post menopausual bleeding

53
Q

What will endometrial carcinoma look like on US?

A

thickened irregular or illdefine endometrium, enlarged uterus, invasion of myometrium and increase blood flow

54
Q

What does tamoxifen (used for breast cancer) do to the uterus?

A

it makes the endometrium heterogenous and thickened with cystic areas

55
Q

What is a polyp of the endometrium and where are they typically found?

A

overgrowths of enometrial glands and stroma

it is attached blood floby a stalk with blood flow

uterus or cervix

56
Q

What is hyperplasia of the endometrium and what causes it?

A

overgrowth of endometrial tissue

estrogen causing endometrium to constantly reproduce

57
Q

What is adenomyosis and what is it cause by?

A

cells rom basal layer of endometrium migrating into myometrium

unknown cause

58
Q

What are the symptoms of adenomyosis?

A

painful periods and abnormal uterine bleeding

59
Q

What is the sonographic findings of adenomyosis?

A

heterogenous, hypoechoic striations and cyst like areas, increased vascularity, and thickened posterior wall.

60
Q

Name the three locations of fibroids and their names.

A

Intramural-in myometrium

Submucosal- in endometrium

Subserosal-exophytic

61
Q

Which of the locations of fibroids causes abnormal uterine bleeding?

A

submucosal –in endo.

62
Q

What ethnicity is more at risk for fibroids?

A

african americans

63
Q

These fibroids are fed by estrogen.

T/F

A

true

64
Q

What are the symptoms of a fibroid?

A

calcify, pain, irregular bleeding, an feeling fullness.

65
Q

What are the types of abnormal uterine bleeding?

A

menorrhagia (long and heavy, menometorrhagia (irregular and heavy), after intercourse, infrequent.

66
Q

What are some causes of abnormal uterine bleeding?

A

Uterine-fibroids and adenomyosis

Endo- carcinoma, hyperplasia, and polyps

Reproductive tract- PID

Endocrine-hormone imbalance, PCOS, low weight, and thyroid condition, perimenopasual.

Case Studies (14 decks)

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