Repro CIS - Endometrosis

Question 1

What is a chocolate cyst?

Answer 1

Endometriosis in the ovary leading to a endometrioma

Question 2

6 things on the differential diagnosis list for a lady presenting with acute pelvic pain?

Answer 2

Ectopic pregnancy
Appendicitis
Ovarian torsion
PID
Endometrioma rupture
Adhesions causing obstruction

Question 3

99% of women with endometriosis who report symptoms before 15 also have what symptom?

Answer 3

Dysmenorrhea

Question 4

Although symptoms are continuous, severity is what dependent?

Answer 4

Hormonally dependent

Question 5

2 labs/imaging we can order for a ruptured endometrioma?

Answer 5

CA125

CT to see the active bleeding from the rupture

Question 6

What does it mean if the lady has a family history of endometriosis?

Answer 6

These ladies tend to have more severe endometriosis than mild or moderate

Question 7

5 clinical symptoms of endometriosis to remember?

Answer 7

Dysmenorrhea, pelvic pain, menorrhagia, infertility, pain associated with intercourse.

Question 8

When is the physical exam best to perform when suspicious of endometriosis and what are the 5 exam findings most commonly?

Answer 8

Best performed during early menses
Pelvic tenderness
Nodules on bimanual exam
Decreased uterine mobility
Tender/fixed nodular masses on Fallopian tube
Lumbar spine SD, especially extended lumbar type 2

Question 9

What do you need to rule out when diagnosing endometriosis and how? 3 things

Answer 9

Elevated CA125 because of ruptured endometrioma or malignancy
Rule out pregnancy with HCG
Rule out UTI or STD with UA and culture

Question 10

What are the two primary imaging modalities for gyn problems?

Answer 10

MRI and US

Question 11

What does histology show for endometriosis and what do we classically see when we visualize it?

Answer 11

Endometrial glands and stroma

Black powder burns

Question 12

It is often very difficult to diagnose endometriosis without what?

Answer 12

Surgical confirmation, so laparoscopy and biopsy.

Question 13

What is the potential complication of endometriosis?

Answer 13

Progressively worsening course that spreads all over

Question 14

6 main causes of endometriosis?

Answer 14

Retrograde menstruation, transformation of peritoneal cells into endometrial cells, embryonic cell transformation into endometrial cells, surgical scar implantation, endometrial cell transport by blood or lymph, immune system disorder where the body cant take out ectopic endometrial tissue.

Question 15

5 things on our differential diagnosis list for chronic pelvic pain?

Answer 15

Chronic PID, adhesions, adenomyosis, endometrioma, interstitial cystitis.