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RAD415 PT2 > reproductive pathology imaging > Flashcards

reproductive pathology imaging Flashcards

1
Q

what imaging modality is usually used for the female reproductive system

A

ultrasound (not CT or MRI due to dose)

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2
Q

which ducts did the uterus develop from and what are the 3 compartments/sections of the uterus

A
  • developed from mullerian ducts
  • fundus (top)
  • body
  • cervix (opening to vagina)
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3
Q

what is the normal appearance of the uterus on an ultrasound

A
  • trilaminar appearing structure
    (dark, light, dark) ( light stripe is the endometrial lining)
  • smooth pear shaped organ
  • thickness varies from 2-16mm
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4
Q

what is hypo and hyperechoic

A

hypo echoic = dark on US (not many echos)
hyper echoic = bright on US (many echos)

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5
Q

be aware that the uterus can be in different positions, anteverted or retroverted

A
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6
Q

what is a unicronate uterus

A
  • half a uterus
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7
Q

what is a didelphic uterus

A

double uterus and double cervix

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8
Q

what is a partial septate uterus

A

septum doesn’t extend to the cervix

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9
Q

what is complete septate uterus

A

septum, runs down the middle of the uterus (i.e., the womb) and divides it into two separate parts

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10
Q

what is a partial/complete bicornate uterus

A

partial fusion of Mullerian ducts resulting in a heart-shaped uterus instead of a pear shape

  • lesser or stronger degree depending on if it is partial or complete
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11
Q

what is arcuate uterus

A

mild indentation of the endometrium at the uterine fundus.

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12
Q

what is the general issue associated with uterine abnormalities

A
  • tight for baby development
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13
Q

know what fibroids look like on radiographic scan, where are fibroids seen?

A

in pelvic region

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14
Q

what are fibroids

A

benign growths developing around or in the uterus

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15
Q

what are the 5 different places in the uterus that a fibroid can develop

A
  • fundal subserosal (underneath serous membrane in fungus)
  • subserosal
  • intramural (in muscle)
  • submucosal (beneath mucous membrane)
  • pedunculate submucosal (closest to inner wall/inside of uterus)
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16
Q

which ethnicity of women are more likely to get fibroids

A

african

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17
Q

why is the suspected cause of fibroids

A
  • high oestrogen
  • nutritional factors e.g vitamin D deficiency
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18
Q

fibroids usually shrink after menopause and pregnancy

A
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19
Q

why might you experience pain with fibroids

A
  • cramps as uterus is continuously trying to contract to remove fibroids
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20
Q

must keep an eye out for fibroids as if they do not go on to shrink etc, they can become cancerous (leimyosarcoma)

A
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21
Q

what are 4 symptoms of fibroids

A
  • pelvic pain
  • renal pain
  • menorrhagia (heavy period)
  • dyspareunia (painful intercourse0
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22
Q

what is the endometrium of the uterus

A
  • lining of uterus where the embryo is planted
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23
Q

what is adenomyosis

A

endometrium invades the myometrium (invades muscle beneath it)

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24
Q

how could you spot adenomyosis on ultrasound

A
  • has the appearance of Venetian blinds
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25
Q

what is endometrial carcinoma

A

endometrial cancer

  • also invades myometrium
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26
Q

how can you spot endometrial carcinoma on ultrasound

A

irregular outline and mixed echotecture

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27
Q

what do the ovaries produce (hormones)

A
  • female reproductive cell / ova
  • produces estrogen and progesterone
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28
Q

what 2 hormones stimulate the release of the ovum in the ovaries

A

LH
FSH

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29
Q

what is an ovarian cyst

A

fluid filed sac within ovary

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30
Q

how can you spot an ovarian cyst on ultrasound

A
  • completely dark spots as they are fluid filled and so hypoechoic
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31
Q

what are 6 types of ovarian cysts

A
  • haemorrhagic
  • dermoid
  • endometrioma
  • mucinous cystadenoma
  • functional
  • malignante
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32
Q

what is a hemorrhagic cyst

A
  • acute haemorrhage into corpus lute ( a temporary collection of cells that forms on your ovary each menstrual cycle if you’re still getting a menstrual period)
  • bleeds into itself
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33
Q

how can you spot hemorrhagic cyst on ultrasound

A
  • nice and round BUT
  • shows extra dark as theres blood within the cyst
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34
Q

what is a dermoid cyst + what is a germ cell

A
  • contain elements from multiple germ cells
  • germ cell is a cell that can become any cll
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35
Q

how can you spot a dermoid cyst

A
  • can grow skin, hair, teeth, eyes nail etc
36
Q

what is endometrioma

A

collection of endometrial tissue forming cyst

37
Q

what 3 things can cause endometrioma

A
  • seeding of endometrial tissiue into peritoneum
  • activation of mesenchymal cells
  • transformation of peritoneal epithelium into functional peritoneum
38
Q

endometrioma occurs in up to 10% women of reproductive age

A
39
Q

what are some symptoms of endometrioma

A
  • pain
  • dysmenorrhea (painful periods)
  • dyspareunia
  • infertility
40
Q

what is endometriosis

A
  • loosely spread endometrial tissue growing outside of uterine cavity
41
Q

why is endometriosis painful

A
  • loose endometrial tissue can cause adhesion of organs abnormally (painful)
42
Q

what is mucinous cystadenoma

A

epithelial layer cyst containing mucin

  • benign
43
Q

how can the viewing of a mucinous cystadenoma vary on imaging

A
  • hypo echoic feature of the cyst depends on level of mucin content
44
Q

mucinous cystadenoma can grow very large and occupy much of pelvis, looking like a pregnant belly

A
45
Q

what is a functional cyst

A

simple fluid filled
no discerning features

46
Q

whats a malignant cyst

A

solid tumour

47
Q

what is the difference between functional and malignant cyst on imaging

A

functional =
thin walled
well defined border with ovary
dark

malignant =
thick and irregular
very bright (on US)
poorly defined border
adhesion to other organs (causing pain)

48
Q

when might a functional cysts become concerning

A

if the cyst does not heal/shrink on its own or continues to grow in size

49
Q

what is PCOS

A

polycystic ovarian syndrome

50
Q

what is the cause of PCOS

A

increased follicle release due to testosterone (approx 20), when follicle is released with no egg, it fills with fluid and forms cysts

51
Q

what hormone is linked to causing PCOS

A

testosterone
- hence there abnormal hair grown
- overweight etc

52
Q

what is used to diagnose PCOS

A
  • ultrasound to see ovary
    +
  • clinical and biochemical assessments
53
Q

common pathologies effect fertility by causing obstruction in fallopian tubes

A
54
Q

ectopic pregnancies are due to issues with fallopian tube

A
55
Q

how can chlamydia cause infertility

A
  • brings about infection to the Fallopian tube
56
Q

Fallopian tubes are too small to see on scans, hence what modality is used to see them

A

HSG = hysterosalpingogram

57
Q

what is hysterosalpingogram

A

iodine based dye injected via catheter into uterine cavity to check tubal patency (if it is open)

  • imaged as dye flows out of the tubes
  • can be therapeutic as it can remove blockages
58
Q

what is HyCoSy

A

hysterosalpingo contrast sonography

  • combines dye and ultrasound
59
Q

what are 2 most common types of tumours/cysts found in male scrotum

A

teretomas (similar to dermoid cysts can grow teeth etc)

seminomas

60
Q

what is the usually resolution for testiular tumours

A

orchidectomy
- removal of testis

61
Q

90% of intratesticular masses are malignant

many are asymptomatic and have non tender lumps

A
62
Q

what is a seminoma

A

regular germ cell cancer

63
Q

what population of males in specific get seminomas

A

any age group after puberty

64
Q

what does a seminoma look like on ultrasound

A

hypoechoic

65
Q

what is a teratoma

A

germ cell tumour

  • painless mass
66
Q

what population of males in specific get teratomas

A

pre pubescent

67
Q

why is it important to remove teratomas before boys hit puberty

A
  • after puberty the teratoma becomes malignant and aggressive
68
Q

what is varicocoele

A

enlargement of veins in the spermatic cord
/dilation of pampiniform plexus
(due to pampiniform plexus not draining blood out)

69
Q

why is varicocoele more common on the left side of testis

A

because of the relation of the spermatic vein to the left renal vein

  • due to draining of testicular vein into renal vein at 90 degree
  • man has more blood flow on that side
70
Q

check kidneys with suspected vericocoele as it might be a kidney tumour causing increased venous pressure

A
71
Q

what manouvre can dilate the pampiniform pelxus

A

valsalva manoucre
- deep breath, hold or puff out cheeck

72
Q

what are the 4 symptoms of varicocele

A
  • scrotal swelling
  • pain
  • testicular atrophy ( hence get smaller)
  • subfertility
73
Q

what is inguinal hernia

A

bowel or abdominal fat entering inguinal canal and can go down to scrotum

74
Q

inguinal hernia can go down too far into scrotum, get strangulated and die

A
75
Q

what is hydrocele

A

serous fluid collection in between layers of tunica vaginalis

fluid in scrotum

76
Q

hydrocele can present as unilateral or bilateral swelling of scrotum

A
77
Q

where is hydrocele most prevalent in

A

babies, as their testis have only just been pulled down

78
Q

if you shine light on testis, it will glow/light shines through as there is hydrocele

A
79
Q

what is epidydimo orchitis

A

inflammation of epidydimis and testis

80
Q

what can be seen on the doppler scan due to epidydimo orchitis

A

increased vascular on colour doppler due to inflammatory response

81
Q

what is the cause of epididymo orchitis

A
  • infection from bladder or prostate spreading through ducts and lymphatic system reach down to epididymis and testis
82
Q

what are symptoms of epididymis orchitis

A
  • fever
  • mild tenderness / scrotal pain
83
Q

what are the 2 issues that can happen to the prostate

A
  1. gets bigger
  2. gets cancer
84
Q

what is benign prostatic hyperplasia

A

enlarged prostate

85
Q

what are 3 issues associated with enlarged prostate

A
  • painful ejaculation
  • can squash urethra and or ejaculatory duct
  • can causer bladder or urinary issues
86
Q

what is similar and different between cancer and enlarged prostate on ultrasound

A

both indent bladder wall

cancer= irregular borders

enlarged = smooth borders

RAD415 PT2 (14 decks)

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